• Journal of Trauma and Injury
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• v.20 no.2
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• pp.115-118
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• 2007

Purpose: A eutectic mixture of local anesthetics (EMLA$^{(R)}$) cream has been used as a topical anesthetic to reduce the pain of procedures penetrating the skin. It is generally applied for 40 to 60 minutes before the painful procedure. Because of the long application period, EMLA$^{(R)}$ is not useful in the emergency department (ED). The purpose of this study was to determine whether a 20-minute application of 9.6% lidocaine would be useful in reducing the pain of routine peripheral intravenous cannulation in the ED. Methods: We examined 27 male and 19 female patients ages over 18 years of age who required intravenous cannula insertion. Intravenous insertion was performed on 46 patients: 24 patients in the placebo group (mean age: 40.0 years) and 22 in the 9.6% lidocaine group (mean age: 37.6 years). The 9.6% lidocaine or placebo gel was applied and covered with an occlusive dressing for 20 minutes. Pain was scored by the patients using a 0- to 10-cm visual analogue scale. Results: The patients in the 9.6% lidocaine group (mean pain score: 3.4) experienced less pain than those in the placebo group (mean: 5.3), and the difference was statistically significant (p=0.029). Conclusion: We concluded that a 20-minute application of 9.6% lidocaine is safe and effective for reducing pain associated with venipuncture.

• Clinical and Experimental Pediatrics
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• v.60 no.6
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• pp.196-201
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• 2017

Purpose: Myocardial dysfunction and dysrhythmias are inevitable consequences of Duchenne muscular dystrophy. We aimed to evaluate specific trends of electrocardiographic changes that reflect the progress of cardiomyopathy in patients with Duchenne muscular dystrophy. Methods: Fifty electrocardiograms (ECGs) of 30 patients (ages 1 to 27 years) who had not been prescribed medications for heart failure treatment at the time of examination were retrospectively analyzed and compared with 116 ECGs of age-matched healthy 116 controls. Heart rate, leads with fragmented QRS (fQRS), corrected QT, Tpeak-to-Tend, and Tpeak-to-Tend/QT were analyzed. Results: The patients with Duchenne muscular dystrophy failed to show a normal age-related decline in heart rate but showed an increasing trend in the prevalence of fQRS, corrected QT, corrected Tpeakto-Tend, and Tpeak-to-Tend/QT over time. In the ${\leq}10-year-old$ patient group, a significant difference was found only in the prevalence of fQRS between the patients and the controls. The prevalence of fQRS, heart rate, Tpeak-to-Tend/QT, and corrected Tpeak-to-Tend demonstrated significant differences between the patients and the controls in the middle age group (11 to 15 years old). All the indexes were statistically significantly different in the ${\geq}16-year-old$ patient group. Conclusion: The prevalence of lead with fQRS representing regional wall motion abnormalities was higher in the young patients than in the young healthy controls, and this might be one of the first signs of myocardial change in the patients. Markers of depolarization and repolarization abnormalities were gradually prominent in the patients aged >10 years. Further studies are needed to confirm these findings.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.67-74
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• 2017

Objective : The purpose of this study was to investigate the prevalence of and the relevant risk factors for lumbar spondylosis (LS) among middle-aged and elderly rural Korean residents and to explore the association between radiographic LS and lower back pain (LBP) in relation to age and gender. Methods : This community-based, cross-sectional study evaluated 1512 subjects with available radiograph. The prevalence of LBP was obtained using a questionnaire and disability resulting from LBP was measured using a validated Korean version of the Oswestry disability index (ODI). In lumbar spine radiographs, vertebral levels from L1/2 to L4/5 were evaluated for the presence of osteophytes and joint-space narrowing (JSN), and Kellgren-Lawrence (KL) grading was applied. Results : Of 4261 subjects aged 40-79 years, data from 1512 subjects were included. The prevalence of radiographic LS indicated by grade ${\geq}2$ osteophytes and JSN were 53.9 and 15.8%, respectively. Seventy-three percent of subjects had KL grade ${\geq}2$ spondylosis and LBP was present in 36.5% of subjects. Although LS was more common among males, the prevalence of LBP was higher among females. Age, male gender and history of hand or knee arthritis were risk factors for LS. LS was significantly associated with LBP mostly among females over 60 years old and correlated with the ODI after adjusting for age and gender. Conclusion : Our study among rural Korean residents revealed a high prevalence of LS and LBP. The association between LS and LBP was observed mostly among females and LS was significantly correlated with the severity of back pain.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.265-269
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• 2019

Ebstein's anomaly is attached to the right ventricle with the tricuspid leaf attached to the lower right ventricle without any attachment to the tricuspid annulus. Most patients in their 20s are alive. Patients older than 25 years of age are similar in the incidence of heart failure and sudden death, and survive approximately 70% from 2 years, and 50% from 3 years, from 5% to over 50 years of age. Through this example, Ebstein's anomaly exists in various forms. A 22 year old case with WPW syndrome and those who survived to 77 years of age are reported. The normal heart structure in the apical four-chamber view should be observed on similar lines, even though the tricuspid annulus is slightly lower than the mitral annulus. If not, there will be some doubt regarding this anomaly. Furthermore, echocardiography plays an important role in the diagnosis and prognosis of congenital heart disease.

• Korean Journal of Health Education and Promotion
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• v.15 no.2
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• pp.143-161
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• 1998

The purpose of this study is to find out the educational needs for the coronary heart disease patients of a general hospital in a municipal general hospital. The study subjects were 90 outpatients who had been diagnosed as myocardial infection or angina at the hospital from January 3, 1998 to January 31, 1998. The questionaire was consisted of risk factors and educational needs for coronary heart disease patients. The qusetions on the education needs of the coronary heart disease were consist of 34 questions in 6 fields. In analyzing the data, the number and the percentage were calculated in patients general characteristics, the average and the standard-deviation were calculated to understand the educational needs, t-test and ANOVA were used to find out inter group difference on educational needs. In ANOVA, the advanced analysis was done by Scheffe-test. The results of this study were as follows: 1. 52(57.8%) of the patients (90%) live in Kangnung-city and 95% of the patients live in the middle-east part of Korea. At the age distribution 39 to 80, 41.1% of the patients were in their sixties and average age was 62.4 years old. 40% of the patients left school in mid-course or graduated from middle school or high school 2. As a result of the study on the risk factors of the coronary heart disease, the patients who have hypertension and diabetes were 41.1% and 20% respectively. In smoking and drinking, smokers were 30% and drinkers were 40% and average of smoking and drinking duration over 30 years old. 47.8% were over 140mgHg systolic - BP and 45.8% were over 90mmHg diastolic - BP 3. The patients' educational needs average 94.88 (maximum 134), and item average 2.79(maximum 4.0), the highest needs field was the characteristic of disease 33.22(maximum 44). Item average 3.02 (maximum 4.0) and the lowest education needs field was the physical activity and exercise 10.21(maximum 16). Item average 2.55(maximum 4.0) 4. General characteristics which were different from the general characteristic educational needs were statistically different by group of educational level, occupation, age and sex. 5. The risk factors which were different from the coronary heart disease patients' risk factors educational needs were statistically different by groups of the heart disease patients in family and the patients who take regular exercise. with a result the nurses need to improve the educational programs while considering the high educational needs field and the characteristics which showed significant concerns statistically.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.83-87
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• 2003

Purpose: To evaluate the factors which affect the level of the amputation for treatment of DM foot excluding arterial occlusion. Materials and Methods: We selected 30 patients (10 of major amputations, 20 of minor amputations) who were amputated from May, 1999 to April, 2001 because of DM foot. Major amputation is BK amputation, and minor amputation is amputation below ankle joint. Gender, age, size of the wound, extent of the necrosis, infectious organism, medical com orbidity, duration of DM and blood glucose level, duration of DM foot and treatment history were investigated. Results: In major amputations, male to female ratio was 9:1, average of the age was 63.8, the average of sizes of the wound was 16cm2, duration of DM was 15.0 years, duration of DM foot was 10.6 weeks, and 80% of patients had necrosis and the organisms were S. aureus, E. faecium, Streptococcus, P. vulgaris, average of the blood glucose levels was 301 and 40% of them had been treated for DM foot. In minor amputations, male to female ration was 9:1, average of the age was 56.6, the average of sizes of the wound was 4.8cm2, duration of DM was 11.2 years, duration of DM foot was 5.7 weeks, and 40% of patients had necrosis and the organisms were S. aureus, Streptococcus, M. morganini, E. faecium, average of the blood glucose levels was 257 and 20% of them had been treated for DM foot. Conclusion: In DM foot patients, extents of the necrosis, duration of DM, duration of DM foot, the infectious organism were significant factors to decide extent of the amputation level.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.404-420
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• 1991

Surgical treatment of congenital and acquired heart disease preceded the development of accurate techniques for diagnosis, heart lung machine and cardiopulmonary bypass, intraoperative myocardial protection, operative techniques and cardiac anesthesia. For 5 years from Sep. 1985 to Sep. 1990, six hundred cases of open heart surgeries [OHS] were performed in the department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. The results were summarized as follows. 1. The annual number of OHS[cases per year] was above 100 since 1987, and the increasing rate of cases was 23.5% per year since 1986. 2. Among the total 600 cases, there were 470 cases of congenital heart diseases and 130 cases of acquired. Age range of the congenital patients was 8 months to 44 years with the mean age of 10 years, and acquired patients was 16 to 56 years with the mean age of 36 years. 3. Among the 470 congenital anomalies, there were 429 cases of acyanotic and 41 cyanotic patients. Totally, VSD was 286 cases[60.6%], ASD 103 cases[21.9%], TOF 35 cases [7.4%], PS 20 cases [4.1%], ECD 12 cases [2.0%], Ebstein`s anomaly 3 cases [0.6%], Valsalva sinus rupture 3 cases [0.6%] and others. The appropriate one stage radical operations were applied to the all congenital cases with the result of 2.6% immediate postoperative hospital mortality rate. 4. Among the 130 acquired cases, there were 122 cases of valvular heart diseases, 6 of heart tumors [5 myxoma, one malignant histiocytoma], one of LA thrombus and one of annuloaortic ectasia. Cardiac tumors and LA thrombus were removed through the atrial septal approach. Bentall procedure was adopted to the annuloaortic ectasia case. AVR, MVR and TVA [DeVega procedure] were applied to 120 valve diseases, and there were also one of OMC and one of MVA[Jerome-Kay procedure]. 5. Among the 120 valve replacement cases, there were 87 of single valve replacement cases [AVR: 8, MVR: 79], 11 of double valve replacement [AVR+MVR: 11], 12 of MVR+TVR and 10 of MVR+AVR+TVA. The total number of implanted prosthetic valves were 141. In MVR, 45 of St. Jude Medical valves, 63 of Carpentier-Edward valves and 4 of Ionescu-Shiley valves were used. In AVR, 18 of St. Jude Medical valves and 11 of Carpentier-Edward valves were used. in MVR, 29mm and 31mm sized valves were used mostly and In AVR, 23mm sized valves were used mostly. 6. Postoperatively many kinds of complications were occurred. Among them, wound problems [30 cases], low output syndrome [29 cases], arrhythmia [20 cases], pleural effusion and pneumothorax [13 cases] were occurred frequently. The postoperative immediate hospital mortality was 3.0% in total [congenital 2.6%, acquired 4.6%].

• Journal of Korean Academy of Nursing
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• v.47 no.1
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• pp.110-120
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• 2017

Purpose: The purpose of this study was to describe the lived experience of patients with heart transplantation in Korea. Methods: Individual indepth interviews and a focus group interview were used to collect the data from nine patients who had heart transplantations in 2015. All interviews were audio-taped and verbatim transcripts were made for the analysis. Data were analyzed using Colaizzi's phenomenological method. Results: Among the nine participants, eight were men. Mean age was 57.30 years. Six theme clusters emerged from the analysis. 'Joy of rebirth obtained by good luck' describes the pleasure and expectation of new life after narrow survival. 'Suffering from adverse drug effects' illustrates various psychosocial difficulties, such as low self-esteem, helplessness, alienation, and burnout, arising from the side effects of medications. 'Body and mind of being bewildered' illustrates disintegrated health and haunting fear of death. 'Alienation disconnected with society' describes isolated feeling of existence due to misunderstandings from society. 'Suffering overcome with gratitude and responsibility' includes overcoming experience through various social supports and suitable jobs. Finally, 'acceptance of suffering accompanied with new heart' illustrate changed perspective of life itself. Conclusion: The findings in this study provide deep understanding and insights of the lived experience of heart related illness for these patients and should help in the development of tailored-interventions for patients with heart transplantation.

• Journal of Oriental Neuropsychiatry
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• v.23 no.3
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• pp.47-62
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• 2012

Objectives : This study is to figure the relations of the heart rate variability, body component analysis and accompanying symptoms of 350 insomnia patients. Methods : For this study we evaluated Heart Rate Variability(HRV) and body component analysis on 350 insomnia patients who visited Dongeui oriental hospital of Dongeui university from January 2008 to March 2012. The accompanying symptoms was collected based on each patient's progress note. Results : 1. There was no difference between PR, LF and VLF of male and female groups. HF was higher in the patients' of female group and LF/HF ratio was higher in the male group. The patients' group of age under 39 had higher HF, LF, VLF and LF/HF ratio than the group over 39. 2. The average of LF was the smallest, and the average of VLF was in the middle, while the average of HF was the largest. 3. Regarding patients' age and gender, as the patients' age increased, their HF, LF, VLF and LF/HF ratio decreased significantly. HF, LF, VLF, and LF/HF ratios were, however, independent on the patients' gender. As the patients' age increased, their BMI increased, while the patients' gender did not affect on their BMI. The amount of visceral fat increased with the patients' age, but wasn't dependent on the patients' gender. 4. As the patients' BMI increased, PR and LF decreased. As the patients' amount of visceral fat increased, PR, HF, LF and VLF decreased. 5. The most frequent accompanying symptoms of the insomnia patients was headache. Neither HF nor LF/HF ratio was dependant on any of the accompanying symptoms. Patients with anxiety showed significantly higher LF than those without anxiety. Patients with fatigue and physical pain showed significantly higher VLF than those without either of them. Conclusions : The study showed that as the insomnia patients age increased, the HF, LF, VLF, LF/HF ratio significantly decreased, but the BMI and visceral fat increased. The HF, LF, VLF, LF/HF ratio BMI, or the visceral fat was independent on the gender. As BMI increased, PR and LF decreased. As visceral fat increased, PR HF, LF and VLF decreased. Patients presenting anxiety had higher LF. Patients either with fatigue or physical pain had higher VLF. Neither HF nor LF/HF ratio had any significant correlation with any of the accompanying symptoms.

• Journal of Preventive Medicine and Public Health
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• v.15 no.1
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• pp.95-110
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• 1982

For the purpose of investigation to identify the quantities of heavy metals contained in the tissues of the Korean people, a series of analyses was conducted with atomic absorption spectrophotometry to measure the amount of lead, cadmium and copper distributed in various tissues, such as brain, liver, kidney, heart, lung, spleen, large intestine, hair, muscle, fat, stomach, costal cartilage, blood and urine, obtained from 30 cadaverous bodies who were believed not exposed to the said heavy metals during their life time either occupationally or therapeutically. 1. Lead content: Inter-individual difference was noted in lead contents in each tissue, vis., the average content of lead in hair was the highest with $14.90{\pm}9.74ppm$. The next was in costal cartilage that contained $5.56{\pm}3.86ppm$. The average contents of lead in liver, kidney and muscle were the lowest in value, showing $1.11{\pm}0.92ppm,\;0.73{\pm}0.48ppm\;and\;0.06{\pm}0.06ppm$, respectively, The lead contents in tissues of children under the age of 10 were significantly lower than those of adults, and the higher values were shown in males than in females in general. The lead contents in most of the tissues such as hair, costal cartilage, kidney, lung, fat, stomach, large intestine, heart, muscle and urine were well correlated with age. 2. Cadmium content: The average content of cadmium in kidney appeared to be the highest of other tissues showing $20.72{\pm}9.82ppm$, and liver came next with the value of $1.17{\pm}0.99ppm$. It was estimated that 83.9% of the total cadmium absorbed into the body was stored in kidney, 4.796 in liver, and the remaining 11.4% was distributed in the rest of the tissues. Cadmium contents in tissues showed difference between both sexes showing higher values in the females than in the males, which was quite contrary to the lead content. Cadmium contents in tissues steadily increased in amount with age, showing a significant correlation with age in all tissues. 3. Copper content: The average content of copper in hair was the highest with $10.36{\pm}2.21ppm$, and liver came next with $6.31{\pm}1.24ppm$. The copper that was absorbed into the body was distributed in each tissue: 29.9% in hair, 18.2% in liver, $5{\sim}11.0%$ in brain, heart and kidney, and $3.0{\sim}3.5%$ in stomach, blood, and lung. The copper contents in tissues of children under the age of 10 showed significantly higher values in liver, kidney, heart and large intestine than those of the adults. The copper contents in brain, costal cartilage and fat were well correlated with age showing the highest correlation coefficient of 0.870 (p<0.01) in brain tissue. There was no difference in copper contents in tissues between both sexes, and the values were, in general, lower than those for Japanese.