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Long term Result of Valve Replacement in Children (소아 심장판막치환술의 장기성적)

  • 한재진
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.479-487
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    • 1988
  • Valve replacements in 82 children, aging up to 15 years[mean 11.67 years] were done at Seoul National University Hospital during 13 years period from 1974 to 1986. The patients were composed of 5] males and 31 females and 50 patients had acquired heart disease and 32 patients congenital heart disease. 75 patients received single valve replacements, 6 patients double valve replacements, 1 patient triple valve replacement, and among all of them, 11 patients redo-replacements. The bioprosthetic valves have been applied to 58 patients and prosthetic valve to 24 patients and the latter was the main artificial valve since 1984. Among the 69 patients who had definite post-operative records, the overall mortality was 27.5%[20.3% was early mortality and 7.2% late mortality] and the overall mortality was lowered to 4.3% since 1984. There were early post-operative complication rate of 26.1% and late complication rate 34.8%, and among the latter, the valve failure rate was 11.4% patient-year, and the thrombo-embolism rate 1.76%/patient-year. 55 patients among the survivals after post-operative 1 month, were received follow-up with various anticoagulating medication for total 2046 patient-months[mini-mum 1 month to maximum 90 month, mean 37.2*25.44 months] and actuarial survival rate was 82*8% at 5 years and valve failure free and thrombo-embolic free survival rate were 61*8% and 90*3% respectively. And among them, valve failure free survival `rate of tissue valve were 91*6% at post-operative 2 years, 78*3% at 3 years, 59*9% at 4 years, 54*10% at 5 years, 53*15% at 6 years, so markedly decreased at 3-5 years post-operatively. These results suggest that cardiac valve replacement in children have been effective therapeutic method though various problems are still remained, and the choice of valve should be prosthetic valve mainly due to its durability at the present.

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A Case Report of an Essential Tremor Patient Treated with Gamigyejak-tang-gamibang (가미계작탕가미방(加味桂芍湯加味方)으로 호전된 본태성 수족진전(手足振顫) 환자 1례)

  • Lee, Da-eun;Jeong, Hyun-jin;Kim, Eui-su;Shin, Man-ho;Lee, Young-su
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.984-993
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    • 2018
  • Objectives: This report describes the case of a patient suffering tremor of the hands and feet, which was improved by Gamigyejak-tang-gamibang. Methods: For relieving symptoms, Korean medicine treatments, including herbal medicine, acupuncture, and moxibustion, were performed. To evaluate the effects of treatments, effective rate, visual analog scale, and patient's condition scale were used. Results: After treatment for 3 months, the clinical symptoms of the patient were improved. Effective rate increased from 10% to 95%. Both visual analog scale and patient's condition scale scores decreased from 8 to 1. Conclusions: This report suggests that Gamigyejak-tang-gamibang is effective for treating essential tremor.

Clinical Study for Characteristics of Heart Rate Variability in Acute Dyspepsia Patients (급체 환자의 심박변이도 특성에 대한 임상적 연구)

  • Kim, Won-Il
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.16 no.3
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    • pp.49-58
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    • 2012
  • Objectives: This research was designed to study the characteristics of heart rate variability in acute dyspepsia patients compared with normal group. Methods: The testing of HRV was carried out at Oriental Medical Center of ${\bigcirc}{\bigcirc}$University with the participation of 94 acute dyspepsia patients and 85 control group people. We checked HRV of the 2 groups that were checked on the first visit day and compared HRV index between groups. Results: In the frequency domain analysis, HF, LF, VLF, LF/HF ratio, TP were significantly lower than control group on acute dyspepsia patient group. HF, LF, VLF, LF/HF ratio, TP were not significantly associated with age. Conclusions: According to this study, autonomic nerve system was more decreased on the acute dyspepsia patient group compared with the control group. Though further studies will be needed, the present finding provide us the possibility that stress is a major cause of the acute dyspepsia along with food factor.

A Study on the Reduction of Patient's Exposure Dose according to the Arrival Time of Contrast Media in Abdominal CT Scan using Bolus Tracking Technique (Bolus tracking 기법을 이용한 복부 CT 검사 시 조영제 도달시간에 따른 환자 피폭선량 감소에 관한 연구)

  • Lee, Seung yong;Han, Dong kyoon
    • Journal of the Korean Society of Radiology
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    • v.15 no.2
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    • pp.93-100
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    • 2021
  • The purpose of this study is to find out the factors that affect the patient's exposure dose during the abdominal CT scan using the bolus tracking technique, and reducing the radiation exposure to the patient during the abdominal CT scan using the bolus tracking technique by adjusting the delay time according to the corresponding factor. The experiment was divided into two parts, and the first experiment was conducted with 300 patients There were 188 males and 112 females, and their average age was 58±12.18(19~85). In the second experiment, 150 subjects (100 males and 50 females) who were undergoing their follow-up examination among the first experiment subjects, and the difference in dose before and after was compared by applying the delay time according to the influencing factor. As a result of the first experiment, there was a relationship between the arrival time of the contrast media and the heart rate, and it was found that the arrival time decreased as the heart rate increased for both men and women. As a result of the second experiment, the average dose of CTDIvol and DLP before/after applying the delay time according to the heart rate decreased 4.98 mGy and 5.33 mGy·cm in the male group, and 3.54 mGy and 3.88 mGy·cm in the female group. By applying proper delay time according to the patient's heart rate during abdominal CT scan with the bolus tracking technique, the radiation exposure dose of the patient can be reduced.

A Case Report of a Patient Diagnosed with Ankylosing Spondylitis Treated with Korean Medicine (통합 한방치료로 호전된 강직성 척추염 환자 1례 보고)

  • Kim, Eun-jung;Kim, Dong-hoon;Yoo, Sang-gu;Kim, Soo-yeon;Kim, Da-hye;Lee, Se-won;Kim, Seon-woo;Park, Cheol-woo
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.776-784
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    • 2019
  • Objective: The aim of the study was to determine the effects of traditional Korean medicine treatments on a patient diagnosed with ankylosing spondylitis. Case Summary: A 29-year-old male patient suffering from lower back pain and chest pain was diagnosed with ankylosing spondylitis. Korean medicine treatments, including acupuncture, pharmacopuncture, and herbal medicine, were applied. The treatment effect was evaluated with a numeral rating scale (NRS) for pain and by changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). After 44 days of treatment, the patient's symptoms of ankylosing spondylitis were improved. The NRS score for lower back pain decreased from 3 to 2, and the NRS score for chest pain decreased from 10 to 1. In addition, the ESR level decreased from 13 to 10 and the CRP level decreased from 1.39 to 0.84. Conclusion: The integrative Korean medicine treatments appeared to be effective in relieving pain associated with ankylosing spondylitis.

The One Case of Infertle Women Taking Herbal Medicine before In Vitro Fertilization to Birth (체외수정 전부터 출산까지 한약을 병용한 난임 1례)

  • Jang, Se-Ran;Park, Young-Sun;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.4
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    • pp.194-204
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    • 2011
  • Purpose: Many infertile women are receiving in vitro fertilization-embryo transfer (IVF-ET). But side effects occur after IVF-ET and pregnancy rate is still low. So this study is to report the effect of herbal medicine on a woman receiving IVF-ET and herbal medicine's low risk on a pregnant woman. Methods: The patient was underwent artificial insemination five times and IVF-ET three times. In this study, the patient steadily took a herbal medicine before IVF-ET to birth. Results: The side effects of IVF-ET and the miscarriage symptoms ware decreased. And by taking a herbal medicine during IVF-ET, the patient was pregnant and gave birth when she was 33 weeks pregnant by cesarian section. Conclusions: This case study shows that herbal medicine is effective for reducing side effects of IVF-ET and increasing pregnancy rate. And in this case the patient gave birth to healthy babies, althogh steadily taking herbal medicine during pregnancy.

A Case Study on Effect of Oriental Medical Treatment to an Aged Female Obese Patient (한방비만치료의 여성노인환자 치험1례)

  • Kim, Eu-Gene;Cha, Yun-Yeop;Kim, Dong-Gun;Heo, Seong-Kyu;Heo, Young-Jin;Han, Seok-Hun;Kong, In-Pyo
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.1
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    • pp.87-96
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    • 2007
  • Objectives : This study was performed to evaluate the effect of oriental medical treatment on aged female obese patient. Methods : We experienced an aged female obese patient. We applied herbal medication(Choweseuncheng-tang), electrolipolysis, auricular acupuncture to her from 26th, March. 2007 to 25th, May. 2007. And we examined the changes of her weight, body composition, body size, skin resistance variability, visual analogue scale of knee pain. Results : 1. Her weight decreased from 73.5kg to 71.1kg and body mass index(BMI) decreased from $29.46kg/m^2$ to $28.11kg/m^2$. 2. Body fat mass(BFM) decreased from 25.7kg to 21.6kg but body muscle mass(BMM) increased from 45.1kg to 46.7kg. 3. Waist-hip ratio(WHR) decreased from 0.96 to 0.92. 4. Basal metabolic rate(BMR) increased from 1,273kcal to 1,314kcal. 5. The circumference of upper extremity decreased 1.03cm and lower extremity decreased 1.30cm but the circumference of the muscle of upper extremity increased 0.41cm and lower extremity increased 0.63cm. 6. The circumference of chest and hip are decreased. In addition to the circumference and fat of abdomen are decreased. 7. The visual analogue scale of knee pain is improved. Conclusions : According to above results, oriental medical treatment could be used safety to aged obese patients without loss of fat free mass. The study is more required to aged obese patient from now on.

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Impact of Selective Health Benefit on Medical Expenditure and Provider Behavior: Case of Gastric Cancer Surgery (선별급여 도입이 위암수술의 건강보험 진료비 및 진료행태에 미치는 영향)

  • Cho, Su-Jin;Ko, Jung-Ae;Choi, Yeonmi
    • Health Policy and Management
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    • v.26 no.1
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    • pp.63-70
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    • 2016
  • Background: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery (ultrasonic shears, electrothermal bipolar vessel sealers) for gastric cancer patients covered since December 2014. Methods: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. Results: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. Conclusion: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.

A Case Report of Korean Medicine Treatment for A Patient with Variant Angina and Asthma Symptoms (천식 증상을 가진 변형 협심증 환자에 대한 한방치료 증례보고)

  • Kim, Min-joo;Kwo, Tae-ha
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.864-873
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    • 2022
  • Objective: The purpose of this case study was to report the symptom improvement effect of integrative Korean medicine treatment based on Pyongsim Solution: Cheonwangbosim-dan in a patient with variant angina and asthma symptoms. Methods: This 68-year-old male patient was treated with Pyongsim Solution, Gamihyangsayukgunja-tang, Gwakhyangjunggi-san, acupuncture, pharmacopuncture, and cupping therapy for 24 days. The European Quality of Life-5 Dimensions-5 Levels profile, Numerical Rating Scale score, and pulse rate per minute were measured on admission, at two weeks of hospitalization, and upon discharge to assess the clinical outcomes. Results: After treatment, the "mobility" dimension profile of the European Quality of Life-5 Dimensions-5 Levels changed from 1 to 1, "self-care" changed from 1 to 1, "usual activity" changed from 3 to 2, "pain/discomfort" changed from 4 to 3, and "anxiety/depression" changed from 3 to 2. The Numerical Rating Scale score for chest pain decreased from 7 to 5, chest tightness decreased from 6 to 4, sleep disturbance decreased from 6 to 3, polydipsia decreased from 5 to 3, and stomach discomfort decreased from 5 to 3. All the profiles of these five dimensions were unchanged for 11 days in the period between the two weeks of hospitalization and discharge. There were also no changes in the profiles of either "mobility" or "self-care" throughout the entire 24-day hospitalization period. Conclusion: This case report shows that integrative Korean medicine treatment based on Pyongsim Solution can improve the symptoms of patients with variant angina and mild intermittent asthma, suggesting that Pyongsim Solution could be an important herbal medication for treatment.

Five-year investigation of a large orthodontic patient population at a dental hospital in South Korea

  • Piao, Yongxu;Kim, Sung-Jin;Yu, Hyung-Seog;Cha, Jung-Yul;Baik, Hyoung-Seon
    • The korean journal of orthodontics
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    • v.46 no.3
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    • pp.137-145
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    • 2016
  • Objective: The purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012. Methods: We evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients. Results: The patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19-39 years, with a gradual increase in patients aged ${\geq}40years$. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth. Conclusions: The most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients.