• Neonatal Medicine
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• v.18 no.1
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• pp.153-157
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• 2011

Pneumopericardium is a rare form of neonatal air leakage. Tension pneumopericardium is much more infrequent, but can cause a cardiovascular deterioration with high mortality up to 80% and neurodevelopmental morbidity in half of the cases. We report two cases of preterm infants who successfully recovered from tension pneumopericardium that developed during mechanical ventilator assistance. The patients displayed a sudden increase in oxygen demand and subsequent cardiovascular deterioration. Immediate needle aspiration of the pneumopericardium performed after checking X-ray images rescued each of patient. Since the clinical symptoms are non-specific, clinicians' suspicion is most important when patients show sudden refractory cardiovascular collapse, especially in ventilator-assisted neonates. This life threatening complication demands instant diagnosis and intervention.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.294-298
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• 2007

Moyamoya disease is a progressive cerebrovascular disorder with stenosis or occlusion of the bilateral internal carotid arteries with abnormal vascular networks at the base of the brain. Previous reports have shown that there are extracranial vascular involvements in Moyamoya disease, especially in the renal artery. We report a 7-year-old patient with Moyamoya disease associated with renovascular hyper tension, who presented in infancy with seizures and hemiparesis. Renal angiography showed multiple stenoses of the right renal artery. Although renal artery stenosis in Moyamoya disease has been effectively treated with balloon angioplasty, stent implantation, or surgery, bat-loon angioplasty could not be done in this patient due to multiple stenoses. His blood pressure was successfully controlled with medical treatment, and remained normotensive during the follow up period of 6 months.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.903-910
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• 2004

Background: The total aortic arch replacement is one of the most difficult operations with high mortality rate. But the arch first technique with subclavian arterial perfusion has been reported to be a safe methods for arch replacement. Material and Method: Between Feb 2003 and July 2004, 18 patients, 10 men and 8 women, underwent total aortic arch replacement with arch first technique. Their mean age was $59.3\pm12.9$ years. The patietns received 11 acute aortic dissections, 3 chronic aortic dissectiong aneurysms, and 4 ruptured aortic arch aneurysms. Result The mean admission period was $20.2\pm7.4$ days. There was one early mortality case which died of low cardiac output syndrome and another late mortality case which died of cerebral hemorrhage. The others were discharged without any sequelae and they were followed up for an average period of $180\pm156.3$ days. Conclusion: The total aortic arch replacement with arch first technique and subclavian arterial perfusion is a good method that will reduce the surgical mortality and the possibility of secondary late reoperation from the remnant distal aortic problems.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.8
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• pp.5476-5484
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• 2015

The purpose of this study was to verify the clinical usefulness of the virtual reality rehabilitation system which Academic-Industrial cooperation develop through clinical experiment for recovering the functional abilities in stroke. For this purpose, 24 Stroke(hemorrhage13, infarction11)participated in a clinical experiment. They were randomly assigned to the virtual reality rehabilitation system group(n=13) and conventional rehabilitation training(Activities of daily living, cognition training, motor control) group(n=11). All participant were evaluated with three standardized assessment tools(Functional Independent Measure; FIM, Mini-Mental State Examination for Korean; MMSE-K, Self-esteem scale) before and after the planned intervention sessions. All participant were intensively carried out for 8weeks, 3times a week. The results were as follows. The experimental group showed significant improvements for Activities of daily living, basic cognitive abilities and self-esteem related with life satisfaction after the interventions(p<.05). There were no significant differences between two groups for all assessment tool after interventions. Because of this experimental results, the virtual reality rehabilitation system showed the clinical utility for recovering the function in stroke. Further studies are needed to verify the clinical usefulness on the improvement of various functions in brain injury and dementia.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.72-81
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• 1997

The causes of stroke are presumed hypertension, atherosclerosis,. cardiac disease, diabetes mellitus and old age and risk factors of stroke are suggested hypertension, hyperlipidemia. obesity, smoking and drinking etc. Especilly, hypertension is one of the most important cause and risk factor of stroke, therfore without therapy hypertension leads to stroke. The frequence of hypertension is significantly higher in hemorrhage patients of intracranial hemorrhage and subarachnoid hemorrhage. Antihypertensive therapy has an impact not only on the primary prevention of stroke but also on stroke recurrence and the declining of stroke motality has been attributed to the widespread availability and use of antihypertensive therapy. The goals of antihypertensive therapy decrease the complications and motalitv of cardiovascular system and prevent the promoting arteriosclerosis. In this study, we observed the blood pressure change of cb-hemorrhagic patients with hypertension who were hospitalized from 1996. 3. 1 to 1997. 2 .26 in Wonkwang Oriental Hospital. These patients had no antihypertensive therapy and were supplied herb med(Jaum sikpoongtang, Chungrijagamtang, Gojinumja) in medication. Our results suggested as follows. 1. Systolic and diastolic average BP at admission is $150.71{\pm}15.61mmHg$ and $95.00{\pm}8.8mmHg$ and this is hypertension state defining WHO 2. During one week in admission, the blood pressure demostrated a marked declination by SBP 8.97mmHg and DBP 6.22mmHg. 3. During two week in admission, the declination of SBP was significant in paired t-test(p<0.05) but, the declination of DBP was non-significant in paired t-test. 4. The blood pressure during third and fourth weeks gradually declined but, non-significant in test. According to the above results, we suggested that the BP declination Was affected by $Jamyang{\cdot}Jaum$ prescriptions in acute stage of cerebral hemorrhage.

• The Journal of Korean Medicine
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• v.32 no.5
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• pp.100-113
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• 2011

Objectives: Brain edema is brain swelling that occurs due to the accumulation of excess water in the brain parenchyma. AQP4 and AQP9 are water-channel proteins expressed strongly in the brain and control water fluxes into and out of the brain parenchyma. This study was conducted to evaluate effect of Hwangnyeonhaedok-tang on brain edema and intracerebral hemorrhage. Methods: Intracerebral hemorrhage was induced by intrastriatal injection of type IV collagenase(0.23 U/${\mu}l$, 0.1 ${\mu}l$/min) into Sprague-Dawley rat brains. Hwangnyeonhaedok-tang water extract(1,000 mg/kg) was administered orally three times every 20 hours from 4 hours after ICH operation. Then hematoma volume, brain edema percentage, and water content of brain tissue were measured. Immuno-histochemistry was performed for AQP4 and AQP9 expressions in the brain sections and area % of immuno-labeling was analyzed with image analyzing system. Results: 1. Water extract of Hwangnyeonhaedok-tang reduced hematoma volume of ICH induced rat. 2. Water extract of Hwangnyeonhaedok-tang reduced MPO positive neutrophils in the perihematoma of the ICH induced rat. 3. Water extract of Hwangnyeonhaedok-tang reduced brain edema percentage and water content of brain tissue of ICH induced rat. 4. Water extract of Hwangnyeonhaedok-tang reduced AQP4 immuno-positive cells in the perihematoma of the ICH induced rat. 5. Water extract of Hwangnyeonhaedok-tang reduced AQP9 immuno-positive cells in the perihematoma of the ICH induced rat. Conclusions: These results suggest that Hwangnyeonhaedok-tang decreases intracerebral hemorrhage and brain edema by means of downregulating AQP4 and AQP9 expressions in the brain.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.171-176
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• 1996

From March, 1983 to June, 1994, twenty-two patients underwent coronary artery and combined operations. The ages of the patients ranged from 42 years to 72 years (mean 60.4$\pm$8.2 years). There were 17 male and 5 female patients. The left ventricular (LV) ejection fraction ranged from 25% to 65% (mean 46.9$\pm$14.2%). Nine patients had mechanical complication of myocardial infarction (MI), of which 5 were LV aneurysm, 3 ventricular septal defect and 1 mitral regurgitation. Nine patients had rheumatic valvular heart disease of whom 7 with aortic valve disease and 2 with mitral valve disease. Two other patients had left atrial thrombi, only one with atrial septal defect a d another with aneurysm of ascending aorta. An average of 2.1$\pm$1.0 bypasses was done, ranging from one to four. There were 3 postoperative complications; 2 perioperative MI and 1 leg wound infection. Among complicated patients, mortality was 1 patient (4.5%) due to low cardiac output syndrome after perioperative MI. With 3 to 136 months follow-up (mean 41.1$\pm$40.2 months), late mortality was 1 patient due to cerebral vascular accident. Among long-term survivors, all patients are in New York Heart Association functional class I or II. Although the number of patients was small, our surgical results were favorable. Therefore we think that coronary revascularization combined with heart operation does not increase the operative risk when associated coronary artery disease is present, and it reduces the occurrence of late death.

• Journal of Acupuncture Research
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• v.22 no.3
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• pp.69-75
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• 2005

Objective : This study is designed to find out the effect of Bee Venom Acupuncture Therapy on the Post-stroke Pain. Methods : Bee venom solution was injected on Seven Points of CVA-GB2l(肩井), LI15(肩隅), Ll11(曲池), GB31(風市), ST36(足三里), GB39(絶骨), ect- every other day for 3 weeks, in twenty patients who were admitted in Dong-Seo Oriental Medical Hospital, as diagnosed by their typical pain characteristics of central pain from stroke. Result : After 3 weeks treatment, visual analogue scale of pain severity showed significant decrease.

• Journal of Sasang Constitutional Medicine
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• v.10 no.2
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• pp.431-453
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• 1998

1. Background and Purpose: We intended to make the standards of CVA management of Sasang Constitutional Medicine and be helpful to understand the constitutional symptoms through a clinical study of CVA. 2. Methods: We studied 157 CVA inpatients(79 men and 78 women) who were in constitutional clinic of Dongguk Pundang Oriental Hospital during 1 year from March 1997 to February 1998. We investigated and analysed the characteristics, past histories, symptoms and progresses of patients. 3. Results: The results of constitutional analysis showed 88 Taeumin(56.1%), 48 Soyangin(30.6%) and 21 Soeumin(13.4%). The frequency of strokes was much the same between male and female and the greater part of cases were 50-70 of age. The CVA cases were classified into 119 cerebral infarction(75.8%), 11 cerebral hemorrhage(7.0%), 1 subarachnoid hemorrhage(0.6%) and 26 trasient ischemic attack. From the standards of symptom management, there were abnormality of a coated tongue(63.1%) in most cases, sleeping disorders(48.4%), excremental disorders(44.7%) and urinary disorders(36.9%) on admission. With regard to the rate of improvement in the standards of CVA management, excremental disorders improved 87.1% and emotional disorder 81.0%, swallowing disorder 78.7% and so on.

• Journal of Korean Neurosurgical Society
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• v.30 no.2
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• pp.207-210
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• 2001

Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.