• 대한족부족관절학회지
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• 제18권2호
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• pp.62-67
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• 2014

Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from $27.5^{\circ}$ to $46.7^{\circ}$. In radiographic measurements, calcaneal pitch angle improved from $19.1^{\circ}$ to $15.8^{\circ}$, Meary angle from $13.0^{\circ}$ to $9.3^{\circ}$, Hibb's angle from $44.3^{\circ}$ to $37.0^{\circ}$, and tibio-calcaneal axis angle from varus $17.5^{\circ}$ to varus $1.5^{\circ}$ Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.

• Clinical and Experimental Pediatrics
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• 제50권4호
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• pp.376-380
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• 2007

목 적 : 중추 신경계를 제외한 기타 경미한 감염의 경우에 유발성 경련 및 열성 경련과의 연관성에 대해 조사하였고, 또한 이러한 경련 환아들을 추적해 보았을 때 비유발성 경련으로의 발현과는 어떠한 관련성을 보이는가에 관해 통계적으로 분석하고자 하였다. 방 법 : 첫 경련을 주소로 내원한 환아 중에서 중추 신경계에 관련된 감염을 제외한 경미한 감염을 원인으로 하는 경우를 대상으로 하였고, 이를 유발성 경련과 열성 경련으로 구분하여 이에 따른 원인별 비교 및 역학적 조사를 실시하였다. 또한 이러한 유발성 경련과 열성 경련 환아를 대상으로 1년 이상의 추적 관찰을 시행하여 비유발성 경련으로의 이행 여부를 조사하고 통계 분석을 실시하였다. 결 과 : 총 120명의 환아들 중에서 유발성 경련은 36명, 열성 경련은 84명이었고, 여러 원인들 가운데 위장관염과 호흡기계 감염이 대부분을 차지하여 두 원인 군에 따른 비교 분석을 시행하였다. 유발성 경련의 경우는 위장관염이 가장 많은 원인을 차지하였고, 열성 경련의 경우는 호흡기계 감염이 많은 원인을 차지하였으며 이러한 경미한 감염원인 인자들과 경련과의 분포 차이는 통계적으로 유의하게 나타났다. 그러나 경련에 따른 비유발성 경련으로의 이행의 차이는 통계적으로 유의하지 않은 것으로 나타나 향후 보다 장기적인 추적관찰이 시행되어져야 할 것으로 사료된다. 결 론 : 소아에서 감염에 관련된 이러한 경련의 경우는 중추 신경계에 관련된 경우보다 경련에 대한 주의와 신속한 대처가 상대적으로 미흡했다고 볼 수 있다. 그러나 앞으로는 이러한 경미한 감염이 있는 경우에도 세심한 관찰과 주의가 필요하다고 보여지며 향후 비유발성 경련 발현에 대한 지속적인 추적관찰이 필요하다고 생각된다.

• Korean Journal of Radiology
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• 제23권10호
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• pp.976-985
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• 2022

Objective: To compare the clinical and radiological features of various etiologies of chronic diffuse lacrimal gland enlargement. Materials and Methods: We retrospectively reviewed 91 consecutive patients who underwent surgical biopsy for chronic diffuse lacrimal gland enlargement and were diagnosed with non-specific dacryoadenitis (DA) (n = 42), immunoglobulin G4-related dacryoadenitis (IgG4-RD) (n = 33), and lymphoma (n = 16). Data on patient demographics, clinical presentation, and CT imaging findings (n = 73) and MRI (n = 43) were collected. The following radiologic features of lacrimal gland enlargement were evaluated: size, unilaterality, wedge sign, angle with the orbital wall, heterogeneity, signal intensity, degree of enhancement, patterns of dynamic contrast-enhanced, and apparent diffusion coefficient value. Radiological features outside the lacrimal glands, such as extra-lacrimal orbital involvement and extra-orbital head and neck involvement, were also evaluated. The clinical and radiological findings were compared among the three diseases. Results: Compared to the DA and IgG4-RD groups, the lymphoma group was significantly older (mean 59.9 vs. 46.0 and 49.4 years, respectively; p = 0.001) and had a higher frequency of unilateral involvement (62.5% vs. 31.0% and 15.2%, respectively; p = 0.004). Compared to the IgG4-RD and lymphoma groups, the DA group had significantly smaller lacrimal glands (2.3 vs. 2.8 and 3.3 cm, respectively; p < 0.001) and a lower proportion of cases with a wedge sign (54.8% vs. 84.8% and 87.5%, respectively; p = 0.005). The IgG4-RD group showed more frequent involvement of the extra-orbital head and neck structures, including the infraorbital nerve (36.4%), paranasal sinus (72.7%), and salivary gland (58.6%) compared to the DA and lymphoma groups (4.8%-28.6%) (all p < 0.005). Conclusion: Patient age, unilaterality, lacrimal gland size, wedge sign, and extra-orbital head and neck involvement differed significantly different between lymphoma, DA, and IgG4-RD. Our results will be useful for the differential diagnosis and proper management of chronic lacrimal gland enlargement.

• Journal of Korean Neurosurgical Society
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• 제30권6호
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• pp.734-742
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• 2001

Objective : To evaluate the role of anterior lumbar interbody fusion in treatment of failed back surgery syndrome, the authors retrospectively analyzed the result of anterior lumbar interbody fusion performed in our institute. Methods : Fifteen FBSS patients due to variable causes have been treated with anterior lumbar interbody fusion in our institute from April 1994 to June 1999. We analyzed clinical changes in 15 patients who were followed up for an average of 23 months. Results : The etiologies of FBSS were post operative discitis(6 cases), post operative instability(3 cases), post operative adhesion(5 cases), and recurrence(1 case). These fifteen FBSS patients were treated with anterior lumbar interbody fusion. The overall treatment outcome was satisfactory(excellent and good) in 11 cases. Three patients were slightly improved, but post operative low back pain was remained. One patient who had underwent nerve root injury due to pedicle screw insertion showed no improvement. Conclusion : We conclude that the anterior lumbar interbody fusion for FBSS seems to be safe and favorable treatment in selective patients, because low incidence of nerve injury risk and post-operative infection.

• 대한간호학회지
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• 제43권5호
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• pp.579-586
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• 2013

Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

• Molecules and Cells
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• 제27권1호
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• pp.89-97
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• 2009

We investigate the molecular and cellular etiologies that underlie the deletion of the six amino acid residues (${\Delta}F323-Y328$; ${\Delta}FY$) in human torsin A (HtorA). The most common and severe mutation involved with early-onset torsion dystonia is a glutamic acid deletion (${\Delta}E$ 302/303; ${\Delta}E$) in HtorA which induces protein aggregates in neurons and cells. Even though ${\Delta}FY$ HtorA forms no protein clusters, flies expressing ${\Delta}FY$ HtorA in neurons or muscles manifested a similar but delayed onset of adult locomotor disability compared with flies expressing ${\Delta}E$ in HtorA. In addition, flies expressing ${\Delta}FY$ HtorA had fewer aberrant ultrastructures at synapses compared with flies expressing ${\Delta}E$ HtorA. Taken together, the ${\Delta}FY$ mutation in HtorA may be responsible for behavioral and anatomical aberrations in Drosophila.

• 동의생리병리학회지
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• 제17권6호
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• pp.1543-1546
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• 2003

Psoriasis is a common inflammatory disease of the skin marked by excessive scaling associated with inflammation, affecting 1-2% of the population. Although their etiologies remain unknown, the finding of CD4+ and CD8+ lymphocytes at sites of psoriasis has led many reports to hypothesize that psoriasis is a T lymphocyte-mediated disease directed against unknown autoantigens. The oriental medicine understands the cause of psoriasis as low humidity of skin tissues and functional deteriorations of the liver and lung. Gami-Yunbueum (GY) is a mixture of two previous prescription, which were used to the protection of liver and lung. We had prescribed the GY to the three psoriasis patients for 11 weeks and examined the effectiveness of the GY by PASI (Psoriasis Area and Severity Index) score. In our experiment, GY improved the symptoms of psoriasis in all cases. These results indicated that GY can apply to the treatment of psoriasis. Furthermore, the process for treatment of psoriasis is possible to provide humidity to skin and control the functions of liver and lung.

• 동의생리병리학회지
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• 제31권1호
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• pp.1-7
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• 2017

There are two kinds of body fluid metabolism in Traditional Korean Medicine based on 'Internal Classic'("內經"); one is metabolism of body fluid(津液) meaning metabolism of physiological substance, and another is metabolism of humor meaning a metabolic process that excretes waste out of the body. 'Phlegm-retained fluid'(痰飮) is a typical pathological condition caused by abnormal fluid metabolism in Traditional Korean Medicine. As a result of reviewing the literature on 'phlegm-retained fluid'(痰飮), the following facts were found; 'Phlegm-retained fluid'(痰飮) is formed by abnormal state of metabolism of body fluid(津液). In other words, because of the action of various etiologies, qi(氣) and body fluid(津液) metabolism can have abnormal conditions and these metabolic disorders cause formation of 'phlegm-retained fluid'(痰飮). Treatments for 'phlegm-retained fluid'(痰飮) include the following: Eliminating the causes of illness, recovery of metabolism of qi(氣) and body fluid(津液), and functional recovery of pancreas and kidney related to body fluid(津液) metabolism. These treatments are distinguished from promotion of sweating(發汗) and helping urination, the treatments for humor metabolism abnormality.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.11-18
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• 2008

소아의 급성 복통은 많은 환자들이 복통의 성격에 대해 적절히 표현하지 못하므로 진단에 어려움을 겪는 경우가 많다. 연령별 급성 복통의 원인들을 잘 숙지하고, 복통의 위치에 따른 진단적 접근을 시행한다. 가장 우선적으로 외과적 복통 여부를 가능한 빠른 시간 내에 감별해야 하며, 다음으로 장 폐쇄, 궤양성 질환, 간담도계 질환 등을 확인해야 한다. 이 때 주의해야 할 것은, 환자의 복통이 완전히 좋아질 때까지 반복적인 문진과 진찰을 게을리 하지 않아야 하는 것이다. 이렇게 함으로써 진단이 지연되거나 피할 수 없는 오진으로 인해 발생하는 환자의 고통을 최소한으로 줄일 수 있을 것이다. 끝으로, 지금까지 금기시 해왔던 급성 복통 환아들에 대한 통증 치료에 대한 인식의 전환이 필요한 때이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.29-34
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• 2008

소아에서의 급성 상부 위장관 출혈은 흔하지는 않지만 잠재적으로 심각한 위험을 초래할 수 있는 문제이다. 상부 위장관 출혈의 원인은 환아의 연령에 따라 다양하기 때문에 소아 환자를 평가할 때는 각 연령대 별로 흔한 특정 원인들을 미리 염두에 두는 것이 필요하다. 환자의 상태가 위중할 때는 신속한 병력 청취와 활력 징후 측정, 정맥 확보 및 특정 검사 등이 빠른 시간내에 이루어지는 것이 중요하다. 응급 상황에서는 기도 확보, 호흡, 순환 등 초기 심폐소생술을 먼저 시행한 후에 자세한 병력 청취, 신체 검사와 함께 상부 위장관 출혈을 일으킨 기저 질환을 확인하기 위하여 더 자세한 특수한 진단적 검사 등이 필요하고, 이를 근거로 각각의 원인에 따른 적절한 치료가 시행되어야 한다.