Kim, Jeong-Eun;Lim, Dong-Jun;Hong, Chang-Ki;Joo, Sung-Pil;Yoon, Seok-Mann;Kim, Bum-Tae
Journal of Korean Neurosurgical Society
/
v.47
no.2
/
pp.112-118
/
2010
Objective : There have been no clinical studies regarding the epidemiology and treatment outcome for unruptured intracranial aneurysm (UIA) in South Korea yet. Thus, The Korean Society of Cerebrovascular Surgery (KSCVS) decided to evaluate the clinical and epidemiological characteristics, and outcome of the treatment of UIA in 2006, using the nationwide multicenter survey in South Korea. Methods : A total of 1,696 cases were enrolled retrospectively over one year at 48 hospitals. The following data were obtained from all patients : age, sex, presence of symptoms, location and size of the aneurysm, treatment modality, presence of risk factors for stroke, and the postoperative 3D-day morbidity and mortality. Results : The demographic data showed female predominance and peak age of seventh and sixth decades. Supraclinoid internal carotid artery was the most common site of aneurysms with a mean size of 5.6 mm. Eight-hundred-forty-six patients (49.9%) were treated with clipping, 824 (48.6%) with coiling, and 26 with combined method. The choice of the treatment modalities was related to hospital (p=0.000), age (p=0.000), presence of symptom (p=0.003), and location of aneurysm (p=0.000). The overall 30-day morbidity and mortality were 7.4% and 0.3%, respectively. The 30-day mortality was 0.4% for clipping and 0.2% for coiling, and morbidity was 8.4% for clipping and 6.3% for coiling. Age (p=0.010), presence of symptoms (p=0.034), size (p=0.000) of aneurysm, and diabetes mellitus (p=0.000) were significant prognostic factors, while treatment modality was not. Conclusion : This first nation-wide multicenter survey on UIAs demonstrates the epidemiological and clinical characteristics, outcome and the prognostic factors of the treatment of UIAs in South Korea. The 30-day postoperative outcome for UIAs seems to be reasonable morbidity and mortality in South Korea.
Objectives : The acupuncture has been used as treatment of disease in the oriental medicine. In this study, it was investigated at had an effects of Heart JEONGGYEOK(心正格) of SAAM five evolutive phase acupuncture techniques(舍岩五行鑛法) for appling deficiency in the heart induced by experimental focal ischemia. Materials and methods : The focal ischemia was induced by middle cerebral artery occlusion for 2hours. The groups divided into 6 groups, normal(intactness group), control(no therapy group after ischemia-induced), AT1(reinforcing acupoint of Heart JEONGGYEOK : acupuncture therapy group at LR1, HT9 after ischemia-induced), AT2(reinforcing acupoint of Kidney JEONGGYEOK : acupuncture therapy group at LU8, KI7 after ischemia-induced) AT3(combination of reinforcing acupoint of Heart JEONGGYEOK and Kidney JEONGGYEOK : acupuncture therapy group at LR1, HT9, LU8, KI7 after ischemia-induced) AT4(reinforcing and reducing acupoint of Heart JEONGGYEOK : acupuncture therapy group at LR1, HT9, HT3, KI10 after ischemia-induced), AT4(reinforcing and reducing acupoint of Heart JEONGGYEOK : acupuncture therapy group at LRI, HT9, HT3, KI10 after ischemia-induced). Acupuncture therapy was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task and neuropretective effect of acupuncture therapy was observed by Cresyl violet, AchE, ChAT-stain. Results : The error rate in the eight-arm radial maze task was significantly decreased in AT3 group on 3days, in AT1 and AT4 groups on 4days, in AT3 and AT4 groups on 5days compared to the control group. The rate of correct choice was significantly increased AT4 group compared to the control group. The density of neurons in the hippocampal CA1 were significantly increased in all experiment groups, AT1, AT2, AT3 and AT4 groups compared to the control group. The density of AchE in the hippocampal CA1 was significantly increased in AT4 group compared to the control group. The density of ChAT in the hippocampal CA1 were significantly increased in AT1 and AT3 group compared to the control group. Conclusions : These results suggest that reinforcing and reducing acupoint of Heart JEONGGYEOK could be used as a medication for controlling the stroke by deficiency in the heart.
Kim, Tae-Hun;Park, Kay-Hyun;Yoo, Jae Suk;Lee, Jae Hang;Lim, Cheong
Journal of Chest Surgery
/
v.45
no.5
/
pp.295-300
/
2012
Background: With growing attention to the aortopathy associated with aortic valve diseases, the number of candidates for accompanying ascending aorta and/or root replacement is increasing among the patients who require aortic valve replacement (AVR). However, such procedures have been considered more risky than AVR alone. This study aimed to compare the surgical outcome of isolated AVR and AVR combined with aortic procedures. Materials and Methods: A total of 86 patients who underwent elective AVR between 2004 and June 2010 were divided into two groups: complex AVR (n=50, AVR with ascending aorta replacement in 24 and the Bentall procedure in 26) and simple AVR (n=36). Preoperative characteristics, surgical data, intra- and postoperative allogenic blood transfusion requirement, the postoperative clinical course, and major complications were retrospectively reviewed and compared. Results: The preoperative mean logistic European System for Cardiac Operative Risk Evaluation (%) did not differ between the groups: $11.0{\pm}7.8%$ in the complex AVR group and $12.3{\pm}8.0%$ in the simple AVR group. Although complex AVR required longer cardiopulmonary bypass ($152.4{\pm}52.6$ minutes vs. $109.7{\pm}22.7$ minutes, p=0.001), the quantity of allogenic blood products did not differ ($13.4{\pm}14.7$ units vs. $13.9{\pm}11.2$ units). There was no mortality, mechanical circulatory support, stroke, or renal failure requiring hemodialysis/filtration. No difference was found in the incidence of bleeding (40% vs. 33.3%) which was defined as red blood cell transfusion ${\geq}5$ units, reoperation, or intentional delayed closure. The incidence of mediastinitis (2.0% vs. 0%), ventilator ${\geq}24$ hours (4.0% vs. 2.8%), atrial fibrillation (18.0% vs. 25.0%), mean intensive care unit stay (34.5 hours vs. 38.8 hours), and median hospital stay (8 days vs. 7 days) did not differ, either. Conclusion: AVR combined with additional aortic or root replacement showed an excellent outcome and recovery course equivalent to that after isolated AVR.
Background: We assessed the efficacy of intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery. Material and Method: We studied seven hundred ninety-six patients who underwent off-pump coronary artery bypass between January 2000 and December 2006. The patient were divided into group I (n=39), which received intraoperative intra-aortic balloon pump therapy, and group II (n=757), which did not receive intraoperative intra-aortic balloon pump therapy. Result: There were no differences in the operative mortalities (2.6%, 1/39 vs 0.8%, 6/757; p=0.195) and morbidities such as atrial fibrillation (p=0.691), stroke (p=0.908) and mediastinitis (p=0.781) between the 2 groups, although the ventilator support time, the length of the intensive care unit stay and the length of the hospital stay were longer in group I than in group II (p<0.05). Multivariate analysis failed to prove that group I was a high risk group for operative mortality (p=0.549). There were 3 intraoperative intra-aortic balloon pump-related complications in group I (7.9%). However, no longer complications occurred after 2003, when the surgeons began using a smaller sized 8 F catheter that was inserted using a sheathless technique. Conclusion: Intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery can be performed safely and it showed comparable clinical results to that of not using intraoperative intra-aortic balloon pump therapy.
Kim, Ha-ri;Jeong, Hye-seon;Shin, Hee-yeon;Choi, Jeong-woo;Yang, Seung-bo;Cho, Seung-yeon;Park, Jung-mi;Ko, Chang-nam;Park, Seong-uk
The Journal of Internal Korean Medicine
/
v.40
no.2
/
pp.220-227
/
2019
Objectives: Parkinson's disease is the neurodegenerative disease that affects both motor and non-motor function, including postural instability. Camptocormia is an abnormal condition in which the thoracolumbar spine bends forward during walking or standing. However, the treatment options are limited and often not effective. The purpose of this study was to report on the Korean medical treatment of a Parkinson's disease patient with postural instability who presented with camptocormia. Methods: We used Korean medical treatment including herbal medicine (Jemageopung-tang), acupuncture and pharmacopuncture therapy to the patient who was admitted to the hospital for 21 days. The clinical symptoms were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) and walking time without assistance. Results: After treatment, the UPDRS Parts 2 and 3 scores were decreased from 5 to 3 and 20 to 9, respectively. Also, the walking time without assistance was improved. Conclusion: This study suggested that Korean medical treatment could be an effective option for treating Parkinson's disease with postural instability.
Objective : Aphasia interferes with communication between the patient and conversation partner. Adequate communication is essential not only for the patient but also for caregiver education and training Method : This study examined the benefits of parental education and group training in terms of improving the communication of six aphasic patients and their caregivers(family members). Caregiver education provided caregivers with information on stroke and aphasia, and group training was conducted according to the experimental learning cycle. Result : As a result, communication increased in terms of sending and receiving messages or interactive communication. Furthermore, the questionnaire analysis showed that caregivers learned more about aphasia and had confidence in using facilitation strategies. Conclusion : Giving educational opportunities to patients and caregivers promotes caregiver's knowledge and positively interacts.
Objectives: The LI11 (Quchi) acupuncture point has always been included in the Seven acupoints for stroke; however, additional LI11 acupuncture research is needed. In this study, the effect of LI11 acupuncture on cerebral blood flow of the anterior cerebral arteries (ACA) and middle cerebral arteries (MCA) was investigated. Method: This study included 10 healthy young male subjects. Cerebral blood flow velocity and cerebrovascular reactivity were measured using transcranial Doppler sonography. Changes in hyperventilation-induced carbon dioxide (CO2) reactivity and modified ACA and MCA blood flow velocity at 40 mmHg (CV40), blood pressure, and heart rate were observed before and after LI11 acupuncture treatment. Results: A statistically significant increase in contralateral anterior cerebral artery CO2 reactivity (p=0.036) and decrease in contralateral middle cerebral artery CV40 (p=0.047) were observed. No significant difference in mean blood pressure was shown. A statistically significant increase in heart rate occurred after LI11 acupuncture; however, it was not clinically significant as there were negligible changes in the heart rhythm. Conclusions: LI11 acupuncture treatment could improve cerebral blood flow velocity. These results might be explained by regulating endothelium-dependent vessel dilation in the anterior cerebral artery region. Trial registration: This trial has been registered with Clinical Research Information Service, a service of the Korea Centers for Disease Control and Prevention: KCT0004494 (retrospectively registered). https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=15359
The Journal of the Institute of Internet, Broadcasting and Communication
/
v.23
no.2
/
pp.119-129
/
2023
Sleep apnea causes various secondary disease such as hypertension, stroke, myocardial infarction, depression and cognitive impairment. Early detection and continuous management of sleep apnea are urgently needed since it causes cardio-cerebrovascular diseases. In this study, wearable device for monitoring respiration during sleep using PVDF film was developed to detect vibration through trachea caused by breathing, which determines normal breathing and sleep apnea. Variables such as respiration rate and apnea were extracted based on the detected breathing sound data, and a noise reduction algorithm was established to minimize the effect even when there is a noise signal. In addition, it was confirmed that irregular breathing patterns can be analyzed by establishing a moving threshold algorithm. The results show that the accuracy of the respiratory rate from the developed device was 98.7% comparing with the polysomnogrphy result. Accuracy of detection for sleep apnea event was 92.6% and that of the sleep apnea duration was 94.0%. The results of this study will be of great help to the management of sleep disorders and confirmation of treatment by commercialization of wearable devices that can monitor sleep information easily and accurately at home during daily life and confirm the progress of treatment.
Objective : Among the studies using neglect interventions in the field of occupational therapy, this study was conducted to confirm the contents and characteristics of literature applying single-subject studies, and to analyze the intervention effect and quality level. Methods : This study is a systematic review, and the single subject study published in academic journals for the last 10 years. Results : As a result of the thesis analysis, it was conducted on stroke, and the removal design with seven studies, and two studies were multiple baseline designs. As a result of analyzing the size of the intervention effect applied to neglect, 'highly effective' was found seven times, 'fairly effective' 18 times, 'questionable effective' five times, and 'unreliable effective' six times. As a result of the quality level, there were no studies with low level, with six high level and three medium level. Conclusion : As a result of the study, various methods were applied to neglect interventions. It is thought that this study will provide basic data for evidence-based interventions.
Kim, Euimyung;Chun, Jin Woo;Kim, Young Min;Yoon, Jae Chul;Lim, Hae Jun;Cho, Yong Suk;Kim, Dohern;Hur, Jun;Chun, Wook
Journal of the Korean Burn Society
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v.22
no.2
/
pp.66-70
/
2019
Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.
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