• Title/Summary/Keyword: 동반경

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The Predictive Factors of Olfactory Changes after Endoscopic Sinus Surgery (부비동 내시경 수술 후 후각변화에 대한 예측 인자)

  • Ye, Mi Kyung
    • Journal of Rhinology
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    • v.25 no.2
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    • pp.63-68
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    • 2018
  • Olfactory dysfunction is one of the most common complaints of patients with chronic rhinosinusitis. Patients who suffer from olfactory dysfunction report a negative effect on their overall quality of life. Chronic rhinosinusitis-related olfactory impairment is the most treatable form of olfactory disorder; however, outcomes after endoscopic sinus surgery (ESS) are challenging to predict. Previous studies have documented a wide range in overall improvement after ESS. The purpose of this study is to review the factors that predict changes in olfaction after ESS.

A Clinical Case Report of Taeeumin Patient Diagnosed as Fibromyalgia with Headache and Dizziness (두통, 현훈을 동반한 섬유근통 태음인 환자 치험 1례)

  • Park, Minyoung;Lee, Min-jung;Hwang, Minwoo
    • Journal of Sasang Constitution and Immune Medicine
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    • v.32 no.4
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    • pp.129-140
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    • 2020
  • Objectives This study aimed to report significant improvement of fibromyalgia patient who was diagnosed with 'Taeeumin esophagus-cold lung-dry symptomatology' based on Sasang Constitutional Medicine. Methods The patient was treated with herbal medicine. To evaluate the results of this treatment, the patient assessed pain of Fibromyalgia by using the Numeral Rating Scale (NRS) and American College of Rheumatology Preliminary Diagnostic Criteria (ACR, 2010). Results After 64 days of treatment, the NRS of pain reduced from 6 to 2. There was no difference before and after treatment with Widespread Pain Index 7, but Symptom Severity scale score decreased from 8 to 4. Headache, dizziness, and chilling symptoms were also improved. Conclusions The patient showed a significant improvement of Fibromyalgia and accessory symptoms without any side effects, who was treated with herbal medicine.

Clinical Characteristics, Prognostic Factors and Influence of Prophylaxis in Children with Pneumocystis jirovecii Pneumonia (소아 주폐포자충 폐렴의 임상양상, 위험인자 및 예방요법의 효과 연구)

  • Kim, Seohee;Yoo, Reenar;Sung, Hungseop;Lee, Jina
    • Pediatric Infection and Vaccine
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    • v.23 no.1
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    • pp.31-39
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    • 2016
  • Purpose: The aim of this study was to investigate the prognostic factors for Pneumocystis jirovecii pneumonia (PCP) and to evaluate the influence of PCP prophylaxis in pediatric patients. Methods: From January 2002 to April 2015, patients aged <18 years with a diagnosis of confirmed PCP at our institute were reviewed retrospectively. Clinical characteristics and outcomes were compared according to the groups with or without PCP prophylaxis. Risk factors associated with PCP-related death were analyzed by logistic regression analysis. Results: During study period, a total of 24 patients were diagnosed with PCP by immunofluorescence assay and/or PCR. The median age of the patients was 5 years (range, 3 months-18 years) and 23 (96%) had immunocompromised conditions including hematologic disorders with or without hematopoietic stem cell transplantation (n=15), solid organ transplantation (n=4), and primary immune deficiency (n=4). Most common presenting symptoms were tachypnea and cough (92%, each). At the time of diagnosis, 79% (19/24) and 25% (6/24) suffered from respiratory failure and multi-organ dysfunction syndrome (MODS), respectively. Mechanical ventilation was required in 8 (33%) patients and 5 (21%) patients died of PCP. Multivariate analysis showed that MODS at initial presentation was an indicator of poor prognosis (OR, 17.1 [95% CI 1.13-257.67]; P=0.04). Compared to the patients without PCP prophylaxis, the frequency of MODS at diagnosis, need for mechanical ventilation and length of hospital days were significantly less common in the children who received PCP prophylaxis. Conclusions: MODS at presentation was a significant predictor for poor outcome and PCP prophylaxis could alleviate the clinical courses of pediatric PCP. Prospective study will be mandatory to determine the risk factors for development and deterioration of PCP in children.

Patterns of Meniscus Injury with Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열과 동반된 반월상 연골 손상의 양상)

  • Cho Sung-Do;Ko Sang-Hoon;Hwang Soo-Yeon;Kim Moon-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.58-62
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    • 2003
  • Purpose : The purpose of this study was to investigate the incidence, location, type and treatment of meniscal injury associated with acute anterior cruciate ligament (ACL) tears Material and Methods: From Mar. 1997 to Feb. 2002, we reviewed 73 cases of acute ACL tear. There were 66 males and 7 females. The average age at the time of surgery was 33 year old (range, 16-62 years). The common causes of meniscal injury were sports injuries (45 cases) and traffic accidents (19 cases). In 45 sports injuries, thirty four cases were soccer injuries. All patients had undergone arthroscopic evaluation. We analyzed incidence, type, location, and treatment of meniscal injuries, especially those of soccer injuries. Results : Foully eight (57 sites) out of 73 had meniscal tears : Of these injuries, tears of lateral meniscus (26 cases, $54.2\%$) were more common than medial meniscus. Posterior horn of the meniscus was the most common location (52 cases, $91.2\%$) and radial tears were the most common type (15 cases, $26.3\%$). Thirty eight cases $(66.7\%)$ were treated by partial menisectomy. In soccer injuries, twenty eight (33 sites) out of 34 had meniscal tears. and tears of lateral meniscus (17 cases, $60.7\%$) were more common. Posterior horn of the meniscus was the most common location (30 cases, $90.9\%$) and radial tears were the most common type (9 cases, $27.3\%$). Twenty two cases $(66.7\%)$ were treated by partial menisectomy. Conclusions : Lateral meniscal tears in the setting of an acute ACL insufficiency are more common than medial meniscal tears. The findings in the this study would be helpful in clinical diagnosis and subsequent treatment decisions in patients with an acute ACL tears.

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Operative Treatment of Distal Clavicle Fracture with Acromioclavicular Joint Injury (견봉 쇄골 관절의 손상을 동반한 원위 쇄골 골절의 수술적 치료)

  • Kang, Ho-Jung;Koh, Il-Hyun;Joo, Jong-Hwan;Chun, Yong-Min;Kim, Hyung-Sik
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.59-66
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    • 2011
  • Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

The Prognostic Indicies of Pneumocystis Carinii Pneumonia in Immunocompromised Patients other than Acquired Immune Deficiency Syndrome (비 AIDS 면역 결핍 환자들에서 발생한 주폐포자충 폐렴의 예후인자)

  • Park, Wann;Kim, Yoo-Kyum;Lee, Jin-Seong;Ahn, Jong-Jun;Hong, Sang-Bum;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.805-812
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    • 1998
  • Background: Among the variety of opportunistic infections, pneumonia comprises the major morbidity in immunocompromised patients. Pneumocystis carnii pneumonia (PCP) and cytomegalovirus (CMV) pneumonia are common infectious illness of immunocompromised hosts. Although there are many reports regarding to the co-infection of PCP and CMV diagnosed by bronchoalveolar lavage (BAL) fluid examination, the effects of CMV co-infection on the outcome of PCP is still controversial. The purpose of this investigation is to evaluate the effects of CMV detected by BAL fluid examination on the clinical course of PCP in the immunocompromised patients other than human immunodeficiency virus infection. Method: Ten patients with PCP were enrolled and retrospective analysis of their medical records were done. HIV infected persons were excluded. The PCP was diagnosed by BAL fluid examination with Calcofluor-White staining. CMV was detected in BAL fluid by Shell-vial culture system. Chest radiographic findings were reviewed. We used Fisher's exact test and Mann-Whitney U test for statistical analysis of data. Results: The underlying disorders of patients were idiopathic pulmonary fibrosis (n=1), renal transplantation (n=4), necrotizing vasculitis (n=l), systemic lupus erythematosus (n=1), brain tumor (n=1), chronic myelogenous leukemia (n=1), unidentified (n=1). There were no difference in clinical course, APACHE III score, arterial blood gas analysis, white blood cell count, lymphocyte count, serum albumin concentration, chest radiographic findings and mortality between patients with PCP alone (n=4) and those with CMV co-infection (n=6). Univariate analysis regarding to the factors that associated with mortality of PCP were revealed that the application of mechanical ventilation (p=0.028), the level of APACHE III score (p=0.018) and serum albumin concentration (p=0.048) were related to the mortality of patients with PCP. Conclusion: The clinical course of PCP patients co-infected by CMV were not different from PCP only patients. Instead, accompanied respiratory failure, high APACHE III score and poor nutritional status were associated with poor outcome of PCP.

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Histopathological Study of Cartilage in the Bone Bruise of the Lateral Femoral Condyle Associated with Anterior Cruciate Ligament Rupture (전방 십자 인대 파열시 손상된 대퇴골 외과 연골의 병리조직학적 연구)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;Kim, Hee-Seon
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.154-161
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    • 2005
  • Purpose: to describe the histologic appearance of the type III bone bruise in knees which had sustained an acute anterior cruciate ligament (ACL) rupture. Materials and Method: Twenty-five patients who sustained acute ACL rupture were prospectively enrolled in this study. On MRI, 14 patients demonstrated type III bone bruise on lateral femoral condyle, and 11 patients didn't demonstrated bone bruise. Arthroscopic evaluation and biopsy of the articular cartilage and subchondral bone wert performed before ACL reconstruction. Histologic and immunohistochemical evaluations were done. Results: There was no difference between the bone bruise and control group in the hematoxylin-eosin staining for cell distribution, Masson's trichrome staining for collagen and immunohistochemical staining for type I and type II collagen (p>0.05). But in the safranin-O staining for glycosaminoglycan distribution, the bone bruise group had an evidence of decreased staining at the superficial and middle layers, compared with the control group (p<0.05). We also found fatty change of bone marrow in calcified zone of the bone bruise group with safranin-O staining. Conclusion: We suggest that the type III bone bruise found on MRI indicates a substantial damage to normal articular cartilage homeostasis, and may induce further damage of the articular cartilage.

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Results of Arthroscopic inside to Out Repair of Meniscus Tear (반월상연골 파열에 대한 관절경적 inside to out 봉합술의 결과)

  • Kim, Bo-Hyun;Hwang, In-Sung;Yun, Tae-Bong;Byun, Jae-Yong
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.1-8
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    • 2004
  • Purpose: This study examined clinical cure and patients' satisfaction degrees by factors influencing surgical operation results, after arthroscopic inside to out repair as a nonabsorbable suture material, in case of meniscal rupture. Materials and Methods: Materials were 110 cases of 95 patients who could make paces for over 12 months from August 1999 to June 2002. Results were evaluated by clinical cure and subjective satisfaction degrees. This study, concerning those results, analyzed age, term from taking pictures to taking surgical operation, rupture section, rupture length, rupture types, lesion of articular-cartilage, and effects of anterior cruciate ligament operation accompanied. Results: 84 cases(76%) were clinically cured, 98 cases(89%) were subjectively satisfied. In case of accompanying anterior cruciate ligament rupture, and in case that rupture length was below 2 cm, rates of clinical cure and patients subjective satisfaction were significantly high. In case of complex or degenerative rupture, patients satisfaction rates were higher when comparing with clinical cure rates. Conclusion: Various sutures are possible as well as available in case of arthroscopic meniscal inside to out repair using nonabsorbable suture material. It can be concluded that patients age is not absolte consideration in determining the suture of meniscus. In cases of complex rupture, degenerative rupture, ruptures companied by joint-cartilage injuries, considerate consideratin need be paid to choose patients and operations.

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Resection of Ganglion Cyst of the Posterior Cruciate Ligament using Arthroscopic Posterior Trans-septal Approach (관절경하 후격막 통과 도달법을 이용한 후방십자인대 결절종의 치료)

  • Nam, Il-Hyun;Yoo, Yon-Sik;Yun, Ki-Pyo;Ahn, Gil-Yeong
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.31-36
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    • 2004
  • Purpose: We reviewed the effectiveness and the result of arthroscopic resection for ganglion cyst of posterior cruciate ligament(PCL) through the posterior trans-septal approach. Material and Method: Seven patients with symptomatic ganglion cyst of the PCL were treated with arthroscopic resection using posterior trans-septal approach. We analyzed advantages of the posterior trans-septal approach and presence of intra articular problem. Knee function was assessed using the lysholm knee scale. Results: The overall result for the 7 knees were very satisfied in all. We found that four of seven patients had intra articular problems, and past history of trauma could be found in 3 cases. The Lysholm knee scale was increased from average 93.3 points preoperatively to average 97.8 points postoperatively. Conclusion: Arthroscopic posterior trans-septal approach shows an effective technique for complete resection of cyst and evaluation of the combined posterior compartment injury.

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Analysis of Lateral Meniscus Injury - Non-discoid versus Discoid - (외측 반월상 연골 손상의 분석 - 비원판형과 원판형의 비교 -)

  • Cho, Sung-Do;Go, Sang-Hun;Jung, Kwang-Hwan;Cha, Jae-Ryong;Lee, Chae-Chil;Youm, Yoon-Seok;Seo, Dong-Kyo
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.122-127
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    • 2007
  • Purpose: To know about the clinical characteristics such as causes, types, associated injuries and treatment of the lateral meniscus injuries. Materials and Methods: Retrospective analysis was performed for 129 lateral meniscus tears which were divided into 2 groups, Non-discoid and Discoid. Analysis included age and sex distribution, causes of injury, types and location of tear, associated injuries, and methods of treatment. Results: Both Non-discoid and Discoid were prevalent in man and Discoid group was equally distributed through 2nd to 5th decades and Non-discoid group was more prevalent in 4th to 5th decades. Sports injury was the most common cause in both groups and the Nondiscoid group tended to sustain minor injuries compared to Discoid group. Complex tear and body was most common type and site of tear in both groups. Associated injuries were common in Non-discoid group and isolated injuries were common in Discoid group. Partial meniscectomy was commonly done in Non-discoid group and subtotal meniscectomy in Discoid group based on the types of tear. Conclusion: Non-discoid and Discoid lateral meniscus injuries are similar in types and sites of injuries but different in causes of injury, associated injuries and methods of treatment. Therefore, proper diagnosis and treatment would be necessary according to the characteristics.

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