• Journal of Chest Surgery
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• v.41 no.2
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• pp.239-246
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• 2008

Background: Aortic surgery for high risk patients has high mortality and morbidity rates, and the necessity of performing aortic surgery in cancer patients is questionable because of their short life expectancy. Endovascular repair of aneurysm repair can be considered for high risk patients and cancer patients because it has relatively lower invasiveness and shorter recovery times than aortic surgery does. Especially, percutaneous endovascular stent graft treatment is more useful for high risk patients because it does not require general anesthesia. Material and Method: From July 2003 to September 2007, twelve patients who had inoperable malignancy or who had a high risk of complication because of their combined diseases during aortic surgery underwent endovascular aortic aneurysm repair. he indications for endovascular repair were abdominal aortic aneurysm in 5 patients, descending thoracic aortic aneurysm in 6 patients and acute type B aortic dissection in one patient. The underlying combined disease of these patients were malignancy in 3 patients, respiratory disease in 6 patients, old age with neurologic disease in 6 patients, Behcet's iseae in one patient and chronic renal failure in one patient. Result: Stent grafts were inserted percutaneously in all cases. There were 4 hospital deaths and there were 3 delayed deaths during the follow-up periods. There were no deaths from aortic disease, except one hospital death. There were several complications: a mild cerebrovascular accident occurred in one patient, acute renal failure occurred in 2 patients and ischemic bowel necrosis occurred in one patient. Mild type I endoleak was observed in 2 patients and type II endoleak was observed in a patient after stent graft implantation. Newly developed type I endoleak was observed in a patient during the follow-up period. Conclusion: Percutaneous endovascular stent graft insertion is relatively safe procedure for high risk patients and cancer patients. Yet it seems that its indications and its long term results need to be further researched.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.95-102
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• 2008

Objectives : Diabetes patients suffer from severe stress in maintaining the diet therapy and exercise therapy as well as the disease itself, and this stress has bad effects on controlling the glucose level and causes high prevalence rate of depressive and anxiety disorders. These symptoms again have deleterious effects on blood glucose control. A lot of researches about the relationship between glycemic control and symptoms of depression and anxiety and about the positive effects of the treatments of depression and anxiety disorder on glycemic control in diabetic patients are being performed. In Korea, the research regarding the relationship between glycemic control and depression and anxiety symptoms are seldom performed. In this study, we tried to find out the correlation between the glycemic control and depressive symptom and anxiety symptom. Methods : The study included 65 patients(male 34, female 31) with Diabetes in outpatient clinic of the Department of Endocrinology in Dankook University Hospital. We used the HbA1c levels to check glycemic control through blood sample analysis and used Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). Results : Among the 65 Diabetes patients, 21(32.30%) had mild depressive symptoms, and 6(9.23%) had moderate or severe depressive symptoms. The relation of HbA1c and BDI was not statistically significant, but was significant between HBA1c and BAI, (R=0.567, P<0.001). In the linear regression analysis, BAI had an effect on HbA1c($\beta=0.533$, T=5.012, P=0.00), but BDI, diabetes complications, diabetic morbid period and BMI had no effect on HbA1C. The relationship between HbA1c and BDI was not statistically significant, but the relationship between HbA1c and BAI was statistically significant(R=0.254, P<0.001). Conclusions : In this study, the rates of diabetic patients with depressive symptoms were higher, but those with anxiety symptoms were not higher than the general population. We could not find out significant relationship between depressive symptom and glycemic control, but found the significant relationship between the anxiety symptom and glycemic control in diabetic patients.

• Journal of Gastric Cancer
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• v.5 no.1
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• pp.29-33
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• 2005

Purpose: To determine the prognostic values of the hematologic parameters checked preoperatively in gastric cancer patients, we evaluated and compared the relationship between hematologic parameters and clinicopathologic factors of gastric cancer patient. Materials and Methods: The medical records of 357 consecutive patients who had undergone surgery for gastric cancer at the Department of Surgery, Hanyang University Hospital, between Dec. 2,000 and Dec. 2003 were reviewed. To exclude any adverse effect of invasive procedures to hematologic parameters, the samples taken immediately at outpatient department was used. The normal range of serum albumin was defined above 3.5 g/dl, serum hemoglobin above 12 g/dl, and serum platelet count under $400\times10^{3}{\mu}l$. Patients were defined as group 1 when any of these parameters was abnormal, and defined as group 2 when all parameters were normal. The relationships between hematologic parameters and survival rate were investigated. Results: The mean values of platelet count increased, but level of serum albumin and serum hemoglobin decreased significantly according to the advancement of the disease stage (P=0.000). The differences of depth of tumor invasion and lymph node metastasis between the group 1 and the group2 was statistically significant (P=0.001). Three-year survival difference between group 1 and group 2 was significant (P=0.037). Conclusion: The hematologic parameters checked preoperatively in patients of gastric cancer are simple and cheap, meanwhile reflect the general condition of the patients. Any presence of anemia, hypoalbuminemia, or thrombocytosis can predict the progression of the disease and poor survival rates.

• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.52-58
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• 2001

Objectives: An Increased level of psychophysiologic arousal and diminished physiologic flexibility would be observed in patients with panic disorder compared with a normal control group. We investigated the differences of psychophysiologic response between patients with panic disorder and normal control to examine this hypothesis. Methods: Ten Korean patients with panic disorder who met the diagnostic criteria of DSM-IV were compared with 10 normal healthy subjects. In psychological assessment, levels of anxiety and depression were evaluated by State-Trait Anxiety Inventory, Beck's Depression Inventory and Hamilton Rating Scale For Anxiety and Depression. Heart rate, respiration rate, electrodermal response, and electromyographic activity were measured by biofeedback system (J & J I-330 model) to determine psychophysiologic responses on autonomic nervous system. Stressful tasks included mental arithmetic, video game, hyperventilation, and talking about a stressful event. Psychophysiologic responses were measured according to the following procedures : baseline(3 min)-mental arithmetic (3 min)-rest (3 min)-video game (3 min)-rest (3 min)-hyperventilation (3 min)-rest (3 min)-talking about a stressful event (3 min). Results: The baseline level of anxiety and depression, electrodermal response (p=.017), electromyographic activity (p=.047) and heart rate (p=.049) of patients with panic disorder were significantly higher than those of the normal subject group. In electrodermal response, patient group had significantly higher startle response than the control group during hyperventilation (p=.001). Startle and recovery responses of heart rate in the patient group were significantly lower than responses in the control group during mental arithmetic (p=.007, p=.002). In electrodermal response of the patient group, startle response was significantly higher than recovery response during mental arithmetic (p=.000) and video game task (p=.021). Recovery response was significantly higher than startle response in respiratory response during hyperventilation. Conclusion: The results showed that patients with panic disorder had higher autonomic arousal than the control group, but the physiologic flexibility was variable. We suggest that it is helpful for treatment of panic disorder to decrease the level of autonomic arousal and to recover the physiologic flexibility in certain stressful event.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.700-708
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• 1993

Background: Lung cancer has become one of the most common cancers in Korea. It is important to determine the accurate histologic types and stages because of different therapeutic modlaity, especially in small cell carcinoma. This study was designed to evaluate diagnostic yields according to variable diagnostic methods in lung cancer. Methods: The records of 683 patients with a confirmed diagnosis of primary lung cancer during the period of 7 years, from January, 1986 until December, 1992 at Presbyterian Medical Center were analyzed retrospectively. Results: 1) Age and sex distributions Male: female sex ratio was 5.57:1 and age distributions were 7th decade 41.4%, 6th decade 30.2%, 8th decade 17.0%, 5th decade 7.9%, 4th decade 2.5%, 9th decade 1.3%, and 3rd decade 0.2% in decreasing order. 2) The frequencies according to histologic cell types were squamous cell carcinoma 44.7%, small cell carcinoma 23.9%, adenocarcinoma 22.8%, alveolar cell carcinoma 2.5%, large cell carcinoma 1.2%. mixed forms 1.2%, undifferenciated cell carcinoma 0.6% and malignant fibrous histiocytoma 0.2%(1 case) in decreasing order. 3) The most common locations of lung cancer were in left upper lobe and right lower lobe, and no differences of diagnostic methods according to locations were noted. 4) In central lesions, bronchoscopic examination was very accurate and frequently used diagnostic method, and in peripheral lesions, transthoracic lung biopsy(TTLB) was apparent1y accurate method. 5) The diagnostic yields of bronchoscopic biopsy, bronchial brushing, sputum cytology, transthoracic lung biopsy and transbronchial lung biopsy(TBLB) were 81.3%, 57.5%, 31.1%, 69.6% and 61.6%, respectively. 6) The concordance rates between the histologic diagnosis with bronchial brushing and sputum-cytology were 91.3% and 98.4%, respectively. 7) It was appropriate in lung cancer to repeat sputum cytology 3 to 5 times. Conclusion: Bronchoscopic examination is important to determine the histologic cell types in lung cancer. In addition, we should be interrested in improving diagnostic yields of sputum cytology as an easy method.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.79-84
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• 2002

Purpose : About 41% of obtained group A streptococci in the 1998 was reported as erythromycin-resistant streptococci in Seoul, Korea. The most common T serotype was T12, followed by T4 and T28. We'd like to monitor the serological changes and antibiotic sensitivity test of Streptococcus pyogenes obtained from the patients with pharyngotonsillitis and invasive diseases from 1999 through 2001. Also, it could be proposed to choose the proper antibiotic selection in the area where the rate of erythromycin-resistant streptococci is high. Methods : From Jan. 1999 to Oct. 2001, 208 isolates of group A streptococci were collected from inpatients and outpatients with pharyngotonsillitis, scarlet fever, and invasive infections in Seoul and Southern part of peninsula. All isolates were serotyped by T-agglutination, minimum inhibitory concentrations(MICs) which were determined by agar dilution methods, according to the guidelines of the National Committee for Clinical Laboratory Standards (NCCLS). Results : The most common T serotype was T12(29.8%), followed by T1(23.1%), T4 (14.9%). T1 was prominent serotype compared with previous year. T serotyping, among 25 isolates obtained from the patients with scarlet fever in Southern part of peninsula mostly, was T12, T1, and T4 in order of frequency. All the isolates tested were susceptible to penicillin, cefprozil, vancomycin, ceftriaxone, and chloramphenicol. However, 23 isolates(14.2%) was resistant to erythromycin and 18 isolates(11.1%) was resistant to clarithromycin. Serotype T12 was found to be the most resistant serotype to erythromycin and/or clarithromycin. Conclusion : High rate of erythromycin-resistant streptococci which surveyed in 1998 were reduced to 14.2% in this study. We should have to further evaluate the reason of decreased resistant strains and consider the resistant strains of streptococci in choosing the antibiotics. There was no serological characteristics according to the types of disease entities. Between the serologic distributions in Seoul and the Southern part of peninsula area are same, we could presume that the serological typing of strains obtained over the country may be not different.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.28-42
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• 2016

Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.227-236
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• 2019

Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.

• The Journal of the Convergence on Culture Technology
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• v.9 no.3
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• pp.137-143
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• 2023

This study was conducted to analyze factors affecting the length of stay in children with injuries by determining relationships between length of stay and characteristics of children(aged 0 to 12) with injuries. 7,804 patients aged 0 to 12 who participated in the Korea Nation Hospital Discharge In-Depth Injury Surveys, got a diagnosis of sequelae of injuries and of other consequences of external causes(S00-T98), and were discharged between 1 January 2016 and 31 December 2020 were investigated. A frequency analysis, independent samples t-test, and ANOVA were performed. Also, to identify factors affecting the length of stay, a regression analysis was performed. The average length of stay for the patients investigated in this study was 5.5 days. The length of stay for school-age children(aged 7 to 12) and children who had either public or private coverage was higher than that for preschoolers(aged 0 to 6) and children who didn't have public or private coverage, respectively. The length of stay for children admitted to a hospital in a rural area(Jeolla-do or Gyeongsang-do) was higher than that for children admitted to a hospital in a metropolitan area and the length of stay for children admitted to a hospital that had 100-299 hospital beds was relatively long. However, children who first visited a hospital for outpatient care stayed relatively short in hospital and children who had been burned or injured in traffic crashes stayed relatively long in hospital. Children who got a secondary diagnosis and had a principal procedure or who died after being discharged were in hospital for a long time. The findings of this study shall be useful, as they identified characteristics related to the length of stay for Korean children with injuries and factors that determine the length of stay for those children by analyzing the national dataset, or more specifically, the data from the Korea National Hospital Discharge In-Depth Injury Surveys. The risk of child injuries can be easily reduced by taking actions to prevent them and providing safety education programs. The present study has provided essential baseline data for the provision of aggressive care for child injuries and the establishment of a range of policies for child injury prevention.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.77-83
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• 2000

Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.