• Title/Summary/Keyword: 동시치료

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Outcomes of the Modified Maze Procedure for Chronic Atrial Fibrillation Combined with Rheumatic Mitral Valve Disease (류마티스성 승모판막질환과 동반된 만성 심방세동 치료에 대한 변형 Maze 술식의 결과)

  • Baek Man-Jong;Kim Jae-Hyun;Seo Hong-Joo;Lee Chang-Ha;Oh Sam-Se;Na Chan-Young
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.681-691
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    • 2006
  • Background: The aim of this study was to investigate the mid-term outcomes of our modifications to the maze procedure using cryoablation for treating atrial fibrillation associated with rheumatic mitral valve disease. Material and Method: Between March 2000 and February 2004, 177 consecutive patients underwent the modified maze procedure with the use of cryoablation concomitant with mitral valve surgery for atrial fibrillation associated with rheumatic mitral valve disease, and were divided into three groups: (1) modified Cox-maze III (CM group, n=88): (2) modified Kosakai-maze (KM group, n=63): and (3) left atrial maze procedure (LA group, n=26). The postoperative and follow-up results were analyzed and compared between the groups. Result: There were three hospital deaths (1.7%) and no significant differences in the incidence of postoperative complications between the three groups. The operative time, such as the cardiopulmonary bypass and aortic crossclamp time, were significantly longer in the CM group than in the KM and LA groups, respectively (p<0.0001). The mean follow-up was $22.4{\pm}15.1$ months ($1\sim52.6$ months) for all patients. One late death developed in the CM group (0.0%). At last follow-up, 139 patients exhibited sinus rhythm (79.9%), which was also regained in 67 patients (77.9%) in the CM group, 50 (80.7%) in the KM group and 22 (84.6%) in the LA group (p=0.743). The actuarial freedom from stroke at 4 years was $84.5{\pm}9.4%$ in the CM group, $95.0{\pm}4.9%$ in the KM group, and $92.9{\pm}6.9%$ in the LA group (p=0.916). Conclusion: The modified maze procedure using cryoablation is safe and effective in treating chronic atrial fibrillation associated with rheumatic mitral valve disease.

Arthroscopic Treatment of Greater Tuberosity fracture - Preliminary Report - (상완골 대결절 골절 손상에 대한 관절경적 치료 -예비 보고-)

  • Ji, Jong-Hoon;Kim, Young-Yul;Park, Sang-Eun;Ra, Ki-Hang;Do, Jeong-Hun;Kim, Weon-Yoo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.57-65
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    • 2007
  • Purpose: The purpose of this study was to evaluate the clinical result of arthroscopic treatments by using suture anchors or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture. Materials and Methods: From March 2004 to March 2006 we have used suture anchor or suture anchors combined with cannulated screw for 6 cases of the greater tuberosity fracture which include displaced fractures, comminuted fractures and minimally displaced fractures with comcomittent lesions such as rotator cuff tears, stiffness and labral lesion. In this retrospective study, we analyzed the clinical outcomes by using the range of motion, University of California at Los Angeles shoulder rating scale (UCLA) and the ASES shoulder index score (ASES) in the average 6 months follow up. Results: At the last follow up, average range of motion was improved to 154.3 degree, 145.8 degree, 32.6 degree and L1 vertebrae in each forward flexion, abduction, external rotation and internal rotation. Clinically the UCLA rating scales improved to 31.5 and the ASES shoulder index score (ASES) improved to 93.6 in the last follow up. Conclusion: Arthroscopic treatments by using suture anchor or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture is an alternative treatment of the greater tuberosity fracture of the proximal humerus fracture.

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Clinical Results According to the Level and Extent of Sympathicotomy in Essential Hyperhidrosis (본태성다한증에서 흥부교감신경의 차단 범위와 부위에 따른 임상결과)

  • 최순호;박권재;이삼윤
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.127-132
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    • 2002
  • Video-assisted thoracic sympathicotomy is a safe and effective therapy for the treatment of essential hyperhidrosis with immediate symptomatic improvement. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory hyperhidrosis. Therefore, by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathicotomy at various levels and the extent of block, we are to determine the optimal level of sympathicotomy and which method will result in minimal side effects and maximal benefits. Material and Method: From January 1998 to June 2001, the thoracoscopic sympathicotomy was performed in 150 patients suffering from essential hyperhidrosis in the Dept. of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital. The patients were divided into three groups. GroupI(n=50): patients having undergone 72,3,4 sympathicotomy, GroupII (n=50): patients having undergone 72 sympathicotomy which consist of blocking the interganglionic neural fiber on the second rib, and group 111(n=50): patients having undergone 73 sympathicotomy which consist of blocking the interganglionic neural fiber on the third rib. The parameters were composed of the satisfaction rate of treatment, the degree of compensatory sweating, postoperative complications, and changes of plantar sweating. Results: There was no difference in age and sex among the groups. All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis in immediate postoperative period. However the rate of long-term satisfaction were 80%, 92%, and 96% in groupsI,II, and III respectively(p<0.05). More than embarrassing compensatory hyperhidrosis was present in 50%, 28%, and 18% in groups I,II ,and III respectively(p<0.05). Slight but comfortable amounts of palmar humidness was expressed in decreasing order, group III(34%), groupII(6%), and group I(4%) respectively(p<0.05). In regard to plantar sweating, decrease in sweating was expressed in each of the three groups, but was not significant between the groups.

Comparative Analysis of Medical Terminology Among Korea, China, and Japan in the Field of Cardiopulmonary Bypass (한.중.일 의학용어 비교 분석 - 심폐바이패스 영역를 중심으로 -)

  • Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.159-167
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    • 2007
  • Background: Vocabularies originating from Chinese characters constitute an important common factor in the medical terminologies used 3 eastern Asian countries; Korea, China and Japan. This study was performed to comparatively analyze the medical terminologies of these 3 countries in the field of cardiopulmonary bypass (CPB) and; thereby, facilitate further understanding among the 3 medical societies. Material and Method: A total of 129 English terms (core 85 and related 44) in the field of CPB were selected and translated into each country's official terminology, with help from Seoul National University Hospital (Korea), Tokyo Michi Memorial Hospital(Japan), and Yanbian Welfare Hospital and Harbin Children Hospital (China). Dictionaries and CPB textbooks were also cited. In addition to the official terminology used in each country, the frequency of use of English terms in a clinical setting was also analyzed. Result and Conclusion: Among the 129 terms, 28 (21.7%) were identical between the 3 countries, as based on the Chinese characters. 86 terms were identical between only two countries, mostly between Korea and Japan. As a result, the identity rate in CPB terminology between Korea and Japan was 86.8%; whereas, between Korea and China and between Japan and China the rates were both 24.8%. The frequency of use of English terms in clinical practices was much higher in Korea and Japan than in China. Despite some inherent limitations involved in the analysis, this study can be a meaningful foundation in facilitating mutual understanding between the medical societies of these 3 eastern Asian countries.

The Whole Extract of Enterococcus faecalis Has Suppressive Effect on the Allergic Responses in Asthmatic Mouse Model (천식 마우스 모델의 알러지 반응에서 Enterococcus faecalis 전체 추출물의 억제 효과)

  • Chang, Jeong Hyun;Yang, EunJu;Yu, Sun Nyoung;Ahn, Soon-Cheol
    • Journal of Life Science
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    • v.27 no.10
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    • pp.1168-1175
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    • 2017
  • Probiotics are usually defined as intestinal bacteria that provide healthy benefit to the host and may offer new therapeutic materials for the treatment of inflammatory diseases. Lactobacillus, Bifidobacterium and Enterococcus are known as typical probiotics. But, these bacteria have mostly a weak viability and thus decreased probiotics-mediated effects in the intestinal tract. Asthma is an inflammatory airway disease, which is characterized by the releases of inflammatory mediators including cytokine and IgE. They are mainly associated with the recruitment, activation and disregulation of specific inflammatory cells, especially mast cells, monocytes, T cells, eosinophils and neutrophils in asthma. We performed these studies as in vitro and in vivo test the human inflammatory cell lines and ovalbumin (OVA)-induced asthma mouse model. And then the inhibitory effects of Enterococcus faecalis whole extract on inflammatory responses were examined. For our examinations, the E. faecalis whole extract (Ef extract) was acquired from whole bacteria of E. faecalis using freeze/thawing after ultrasonication method. As results, OVA-mediated THP-1 cell viability was decreased by the treatment of Ef extract. In the asthmatic mouse model, Ef extract inhibited the infiltration of inflammatory cells into the inflammatory sites and blood. This whole extract may have anti-asthmatic effects associated with the regulation of IL-5 and IgE expression. It may also be a promising candidate in anti-allergic medicine for the treatment of asthma.

ORTHODONTIC TRACTION OF HORIZONTALLY ERUPTED LOWER LATERAL INCISOR ON THE LINGUAL SIDE (설측으로 수평 맹출한 하악 측절치의 교정적 견인)

  • Mah, Yon-Joo;Sohn, Hyung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.117-123
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    • 2010
  • Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

Evaluation of p53 and Bax Expression as Prognostic Markers in Invasive Cervical Carcinoma Stage IIB Patients Treated with Radiation Therapy (근치적 방사선치료를 시행한 제2기의 자궁경부암 환자에서 p53과 Bax의 발현과 임상적 의의)

  • Choi Sukjin;Kim Hunjung;Song Eunseop;Kim Changyoung;Lee Meejo;Kim Woochul;Loh John J. K.
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.98-105
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    • 2005
  • Purpose : The objective of our study was to evaluate the immunohistochemical expression of p53 and bax proteins as prognostic markers in FIGO stage IIb invasive squamous cell carcinoma of the uterine cervix. Materials and Methods : Sixty-five cases of squamous cell carcinoma of the cervix (stage IIb) that were diagnosed from October 1995 to December 2003 were analyzed retrospectively for the bax and p53 expression. These expressions were determined immunohistochemically and they were correlated to the patients' overall survival and disease-free survival. Results : The overall 5-year survival (OS) rate and the disease-free survival (DFS) rate were $65.1\%$ and $62.9\%$, respectively. p53 and bax immunoreactivity was seen in $26.2\%$ and $52.3\%$ of cases, respectively, with variable levels of expression. On the univariate analysis, only p53 positivity correlated with poor survival in DFS (log-rank test p=0.027), but this significance was not maintained on multivariated analysis by Cox's regression. The nine cases with the immunophenotype ps3+/bax- had the poorest survival. Conclusion : Neither p53 nor bax expression are Independent predictors of the prognosis for stage IIb cervical squamous cancers. Evaluation of p53 and bax co-expression may affect the clinical outcome and further investigation is needed.

Clinical Usefulness of Rapid Antigen Test on the Diagnosis of Influenza (인플루엔자 진단을 위한 신속 항원검사의 유용성)

  • Kim, Jae Seon;Choi, Hyon Joo;Ahn, Young Min;Hwang, Young Ok
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1348-1353
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    • 2005
  • Purpose : Influenza is a respiratory disease which prevails widely every year and shows high morbidity and mortality among not only chronic invalids and the old, but also among infants and young children. To prevent community-acquired influenza infection, to facilitate prompt antiviral therapy and to avoid unnecessary use of antibiotics, an easy, rapid diagnostic method for the influenza virus is needed. We evaluated a lateral-flow immunoassay(QuickVue Influenza Test), compared to viral culture. Methods : During two consecutive years from Jan. 2004 to June 2004 and from Feb. 2005 to Jan. 2005, 408 patients who were suffering from fever, cough and/or sore throat and myalgia were enrolled in our study. A total of 408 patients were tested with $QuickVue^{(R)}$(Quidel Co., San Diego, USA) influenza rapid antigen test and virus cultures at the same time. Results : Of the 408 patients tested, children who showed positive results at the virus culture numbered 77; among them, 55(71.4 percent) were type A/H3N2 and 22(28.5 percent) were type B. QuickVue influenza test had a sensitivity of 71.4 percent and a specificity of 95.8 percent. The positive and negative predictive values were 79.7 percent and 93.5 percent, respectively. Conclusion : In our study, this test had comparable high sensitivity and high specificity and many advantages, such as being easy to perform and simple to interpret, and showing rapid results. If rapid influenza antigen tests are widely applied in the clinic, we can begin treatment more rapidly and reduce influenza complications and the abuse of antibiotics.

Pueraria lobata Ohwi as an Osteoporosis Therapeutics (칡의 부위별 골다공증 치료효과)

  • Kim, Chung-Sook;Ha, Hye-Kyung;Kim, Hye-Jin;Lee, Je-Hyun;Song, Kye-Yong
    • Korean Journal of Food Science and Technology
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    • v.34 no.4
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    • pp.710-718
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    • 2002
  • It is reported that Pueraria Radix contains phtoestrogens whereas flower, and bud of Pueraria lobata Ohwi were not known. In the present study, we determined the amount of phytoestrogen in each portion of P. lobata Ohwi and carried out therapeutic effects of osteoporosis. The amounts of genistein, daidzein, and formononetin in Pueraria Radix (PR), Pueraria Flos (PF), and young Pueratia Folium (PL) were quantitated using a HPLC system. Proliferation of osteoblast and growth inhibitory effect on osteoclast were measured in order to screen their effects on osteoporosis. Proliferation of osteoblast-like cells (Saos-2) was analyzed by both MTT methods and alkaline phosphatase (ALP) assays. Growth inhibitory effect on osteoclast was also detected as Tartrate resistant acid phosphatase (TRAP) assay. Ovariectomized rat as an in vivo animal model was selected and administrations of PR were 1 g/kg/day (PR-1) and 5 g/kg/day (PR-5) for 9 weeks, respectively. Trabecular bone areas (TBAs) of tibia and lumbar were analyzed usibg histomorphological methods. Results show that PR contains the highest level of daidzein ($10435{\pm}2143\;mg/kg$ of dried herb) and stimulated ALP activity, approximately 160% of the control. Growth inhibitory effect on osteoclast by both PR and daidzein were almost identical with control although $IC_{50}$ of genistein was $5.81{\times}10^{-7}$ M. Increases in body weight of OVX rats were suppressed by administration of PR but wet weights of uterus in PR-5 group were increased (p<0.05). Plasma ALP and HDL-cholesterol levels were decreased following ages (p<0.01), and LDL-cholesterol level was also decreased in PR-5 group at 20 week of age (p<0.01). TBAs of tibia and lumbar in PR-1 and PR-5 groups were higher than those of the control although the values were less than those of the sham group (each p<0.01) In conclusion, administrations of PR prevented loss of TBAs of tibia and lumber in OVX rats, while PL and PF did not (p<0.01).

Development of Contents for the Activities of Daily Living Training for Life Care - Korean Version (라이프케어를 위한 한국형 일상생활활동훈련치료 콘텐츠 개발)

  • Lee, Chun-Yeop;Park, Young-Ju
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.529-538
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    • 2020
  • This study aims to develop of contents for the activities of daily living training - Korean version that reflexes the domestic situation and can be applied to clinical practice. For contents development, a Delphi survey was conducted with 13 experts. In the first Delphi survey, 133 items of activities of daily living training are derived based on previous studies, and then the extracted items are asked to group of experts, and the derived items are answered for actual domestic clinical application. In the second survey, 118 items were added by excluding items with a low content validity ratio (CVR) including the results of the first survey, and adding items that can be derived from other opinions. In the 3rd survey, while presenting the 2nd Delphi survey items as they are, it provides an opportunity to change their opinions by presenting their 2nd response and the 2nd average score of other expert panels, and adding appropriateness and importance together. The data were analyzed to obtain the mean, standard deviation, interquartile range, CVR, convergence, and consensus. Finally, a total of 69 items were selected and 49 items were excluded so that 105 items for CVR 0.54 or higher, 111 items for convergence degree 0.50 or lower, and 70 items for continuity degree 0.75 or higher. Sexual activity, care of others, care of pets, and child rearing are difficult to apply socially and culturally, driving and community mobility cannot be performed within the clinical room, and home establishment and management may have different roles depending on gender, and religious spiritual activities and expression are so personal. For these reasons, these items were found to have low importance or suitability. This study can be usefully used as an indicator on the activities of daily living training - Korean version in clinic or community setting.