• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.167-174
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• 2001

A 54-year old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.228-232
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• 1995

Computed tomography[CT is an effective technique for the evaluation of the thorax following blunt trauma. To evaluate multiply injured 30 patients who were diagnosed as hemothorax in emergency room, computed tomography of thorax was done. The thickness of slice was one centimeter and the entire pleural cavity from the apex to the costophrenic angle was included in the evaluation. Integration and addition of the hemothorax area for each CT slice was made and amount of blood in the pleural cavity was estimated. The slice which showed largest area of hemothorax was selected and the height and width of the hemothorax area were measured. The number of slices which showed radiographic evidence of hemothorax was counted. Regression analysis was done and measured amount of hemothorax, the height and width of the hemothorax area for each slice and number of slices were put as variables. And following equation was derived. V=108.3A-0.8B-7.4C+84.7 [R2=0.74 [ V: amount of hemothorax, A: height, B: width, C: number of slices Total amount of blood from thoracic drainage was compared to the measured amount by computed tomography and the relation between the two values was statistically significant.[p=0.001 In conclusion, quantitative estimation of size of hemothorax was possible by the above equation and the process was very helpful for determination policy of treatment of individual patient.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.209-212
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• 1997

A fifteen-year-old boy was transported to our hospital emmergency room due to sudden onset of chest pain, hemoptysis and dyspnea. He was diagnosed as persistent ductus arteriosus that had developed acute bacterial endocarditis with pulmonic valve vegetation and pulmonary embolism with pulmonary infarction. After conservative antibiotic therapy (vancomycin + aminoglycoside), we operated this patient successfully - patch closer of the ductus and pulmonary valve valvuloplasty - under the cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.115-122
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• 1991

From April 1986 to December 1989, 25 infants under the age of 12 months with tetralogy of Fallot were operated on. Age ranged from 3 to 12 months[mean 8.9$\pm$4.9 months] and mean body weight was 7.8$\pm$ 2.6kg. All the patients were deeply cyanotic, 12 of them experienced anoxic spell. Transannular patch was laid down in 19 patients, in 7 of them monocuspid patch was utilized. Postrepair P RV/LV was measured at operation room in 17 patients[mean 0.48$\pm$0. 14]. Hospital mortality was 20Yo. Causes of deaths include right ventricular failure and low cardiac output. The mortality was closely related with patient`s age and body surface area at operation. Also higher mortality was noticed in patients having major associated anomaly or previous palliative operation, preoperative management with propranolol and transannular repair. 18 patients were followed up for 12 to 50 months with a mean follow-up time of 24 months after operation. There were no late deaths and late ventricular arrhythmia or congestive heart failure was not detected as yet. Redo operation was performed in one case because of residual pulmonic stenosis. Considering several advantages of early primary repair, primary repair of symptomatic infants with tetralogy of Fallot should be encouraged despite somewhat high mortality rate as yet and better results could be anticipated along with improvement of myocardial protection method and postoperative care.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.76-78
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• 2015

This report details a case of unexpected, severe post-operative cerebral edema following cranioplasty. We discuss the possible pathological mechanisms of this complication. A 50-year-old female was admitted to our department with sudden onset of stuporous consciousness. A brain computed tomography (CT) revealed a subarachnoid hemorrhage with intracranial hemorrhage and subdural hematoma. Emergency decompressive craniectomy and aneurysmal neck clipping were performed. Following recovery, the decision was made to proceed with an autologous cranioplasty. The cranioplasty procedure was free of complications. An epidural drain was placed and connected to a suction system during skin closure to avoid epidural blood accumulation. However, following the procedure, the patient had a seizure in the recovery room. An emergency brain CT scan revealed widespread cerebral edema, and the catheter drain was clamped. The increased intracranial pressure and cerebral edema were controlled with osmotic diuretics, corticosteroids, and antiepileptic drugs. The edema slowly subsided, but new low-density areas were noted in the brain on follow-up CT 1 week later. We speculated that placing the epidural drain on active suction may have caused an acute decrease in intracranial pressure and subsequent rapid expansion of the brain, which impaired autoregulation and led to reperfusion injury.

• Journal of Korean Physical Therapy Science
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• v.2 no.1
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• pp.413-422
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• 1995

The trigger point phenomenon is an extremely common syndrome in physical therapy room. The symptoms created by these syndromes may be interpreted as originating in discogneic disease, nerve entrapment syndromes, viscerosomatic pain, and certain myalgic pain of unknown etiology. Injuries, viral or bacterial infections, immobilization, psychogenic stress, and other environment factors can preciptate and perpetuate these syndromes, which may occur in any of the voluntary muscles of the human body and thus lead to a multitude of myofascial pain syndromes. Obviously symptomatic treatment can meet with only partial success. Knowledge of the trigger point phenomenon will aid the diagnostician in understanding otherwise in explicable symptom. The trigger point are $2{\sim}5mm$ in diameter, hyperirritable palpable taut in a tissue, when compressed, is locally tender, if sufficiently hypersensitive, give rise to referred pain and tenderness, and sometimes to referred automatic phenomena and distortion of proprioception. The treatment of myofascial trigger point pain syndrome is not difficult once the source of the problem has been determined. Where as many modalities may be used, two of the most effective are spray-and stretch and TP injection. These can be followed by deep massage, specific, manual resistive exercise, and an exercise program which the patient can follow at home. The goal of management is to inactivate the TPs and to restore shortened and stretch resistent muscles to their full range of motion. The purpose of this case study was to know about the pathophysiologic mechanism of the trigger point and will enable to physical therapist to direct his treatment to the real source of trouble.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.719-723
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• 1997

We experienced a case of aneurysm of the sinus of Valsalva dissecting into the ventricular dseptum. This dissection was induced by paravalvular leakage after aortic and mitral valve replacement. This 37-year-old male was admitted via emergence room due to progressive dyspnea. He had undergone aortic valve replacement(carbomed c" 23 mm) and mitral valve replacement(carbomedic 31 mm) due to aortic regurgitation and mitral regurgitation about 6 years prior to admission and followed up regularly. The diagnosis was made by transthoracic and transesophageal echocardiography and reconfirmed by root aortography. The inlet of the ventricular septal aneurysmal sac was repaired by one layer suture with 3-0 prolene of the endocardium, epicardium and homograft muscle shoulder altogether. Postoperative course was uneventful and the patient was discharged on the 11th postoperative day. day.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.185-189
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• 2016

Background: For treatment of pneumothorax in Korea, many institutions hospitalize the patient after chest tube insertion. In this study, a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) was used for pneumothorax management in an outpatient clinic. Methods: Between August 2014 and March 2015, 56 pneumothorax patients were treated using the Thoracic Egg. Results: After Thoracic Egg insertion, 44 patients (78.6%) were discharged from the emergency room for follow-up in the outpatient clinic, and 12 patients (21.4%) were hospitalized. The mean duration of Thoracic Egg chest tube placement was 4.8 days, and the success rate was 73%; 20% of patients showed incomplete expansion and underwent video-assisted thoracoscopic surgery. For primary spontaneous pneumothorax patients, the success rate of the Thoracic Egg was 76.6% and for iatrogenic pneumothorax, it was 100%. There were 2 complications using the Thoracic Egg. Conclusion: Outpatient treatment of pneumothorax using the Thoracic Egg could be a good treatment option for primary spontaneous and iatrogenic pneumothorax.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.2
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• pp.341-352
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• 1998

The purpose of this study was to provide a bases for comfort of patient through of measuring the noise level in emergency room and grasping the perception to noise of inpatient. Data on noise level through sound level meter in ER and patients' perception of the noise through a structured questionnaire and were collected from August 21 to September 5 in 1998. And collected data were analyzed with SAS statistics progeam, descriptive statistic, t-test and ANOVA. The result of examination is as follows : 1. Among a noise level of measured highest was 64.6dB(A) in 'rounding of medical teams', the lowest was 54.8dB(A) in 'traffic noise from outside'. 2. The mean score of noise perception was 0.93. Among a kind of noise reported by the subjects, that which ranked highest was 'conversation of patients' caregiver and visitors'(1.75). The ranked lowest was 'noise of airconditioner'(0.59). 3. The relationship between perception of noise and subjects' characteristics was not significient. Therefore, based on this result, ways require to decrease the noise level in emergency department.

• Journal of Korean Public Health Nursing
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• v.12 no.2
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• pp.136-148
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• 1998

This study was conducted to provide basic knowledge of effective environmental control of patients with allergic rhinitis during the period of July to December 1995. The subjects were consisted of 29 patients with allergic rhinitis. Each patient of nasal symptom scores assessed and dust samples drowned from their bedrooms twice for 1 month interval. The data. 58 samples were analyzed by using ANOVA. t-test and stepwise multiple regression. The results were as follows 1. Out of a total 52 dust samples $(89.7\%)$ were isolated house mites. Total 815mites/0.5gm dust were collected and identified the most prevalent house mites was Pyroglypidae mite with $81.1\%$ 2. The amount of house dust mites in the group of bedding laundry with hot water was significantly lower than that those of with cold water. 3. The nasal symptoms of the patients in the group of bedding laundry with hot water was significantly less than that those of with cold water. and also those of using large size bedroom was significantly lower than that those of using small size one. The nasal symptoms of the patients was closely associated with the washing water temperature. bedroom size. bedroom temperature. type of bedclothes, and frequency of cleanig room.