• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.767-773
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• 2018

Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

• 대한한의학회지
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• 제40권3호
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• pp.1-20
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• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• 한국학교ㆍ지역보건교육학회지
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• 제24권4호
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• pp.27-37
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• 2023

Objectives: The purpose of this study was to investigate the effect of handgrip strength level on cognitive impairment in hypertensive patients. Methods: This study used the first to eighth year data of the Korean Longitudinal Study of Aging (KLoSA). Of the 10,254 respondents who participated in the basic survey, respondents were included that they were diagnosed with high blood pressure and had no cognitive impairment. The handgrip strength was based on the highest value of handgrip strength for both hands. Cognitive function using MMSE results and 23 points or less were defined as cognitive impairment. Cox models were conducted to estimate the hazard ratios (HRs) of cognitive impairment in relation to handgrip strength adjusting for covariates. Results: In the case of hypertension patients, the probability of cognitive decline decreased by 3.0% every time the maximum handgrip strength increased by 1 unit. In the analysis by age, under the age of 64 had a 1.8% decrease in the probability of cognitive decline whenever the maximum handgrip strength increased by 1 unit, and a 3.6% decrease in those over the age of 65. In the gender analysis, male had a 3.2% decrease in the probability of cognitive decline for every 1 unit increase in the maximum handgrip strength, and female had a 2.6% decrease. Conclusions: The results of this study are expected to be used as basic data for the development of interventions to prevent cognitive decline in hypertensive patients by identifying the effect of handgrip strength level on cognitive decline. It is also expected to be used as basic data for health education on the necessity of increasing muscle strength for hypertension patients in the community.

• Advances in pediatric surgery
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• 제4권2호
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• pp.125-130
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• 1998

To assess the clinical and nutritional status of long-term survivors of biliary atresia, history taking, medical record review, physical examination (height, weight, MAC, TSF), blood tests (LFT, prothrombin time, platelet count, prealbumin, calcium) and liver needle biopsy were performed in 12 patients in whom Kasai procedure were performed more than 10 years ago at Department of Pediatric Surgery in Seoul National University Hospital. None were below the 5th percentile in height and weight. TSF was above the 75th percentile in all patients and showed good subcutaneous fat deposition. MAC was above the 5th percentile in all patients. Serum prealbumin level was abnormal in 2 patients with abnormal liver function and revealed visceral protein malnutrition. Serum calcium level was decreased below normal range in 4 patients with abnormal liver function. One patient had mild ascites. Five patients had abnormal liver function and 7 patients showed clinical manifestation of portal hypertension. Liver needle biopsy was performed in 5 patients and no cirrhotic change was observed. Although some patients who have survived for more than 10 years after Kasai procedure developed protein malnutrition and vitamin deficiencies, growth and development and nutritional status were generally satisfactory. Five patients(42%) showed normal liver function and no portal hypertension. In conclusion, Kasai procedure is satisfactory as a primary treatment in biliary atresia but significant portion of long-term survivors had abnormal liver function and portal hypertension. Continuous and careful follow-up is necessary to determine when liver transplantation may be indicated.

• Journal of Chest Surgery
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• 제18권2호
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• pp.139-150
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• 1985

From 1977 through 1984, 97 patients of V.S.D. were treated surgically at Department of Thoracic and Cardiovascular Surgery, Korea University college of Medicine. Among 97 patients, 3 patients were treated by PDA ligation, 3 patients were treated by PDA ligation and subclavian flap aortoplasty, 1 patient were treated by pulmonary artery banding. All of the above patients were analyzed clinically. The results were as follows; 1. Of the patients, 52 patients were male [55.5%] and 45 patients were female [44.5%]. Their age ranged from 7 days to 32 year, and the mean age was 9 year of age and 28.9% of patients were between 4 and 8 year of age. 2. The most common clinical symptoms were frequent U.R.l. and D.O.E.. 3. The most common chest PA findings were cardiomegaly and increased pulmonary vascularity. 4. Associated anomaly was founded in 27 cases and PDA was most common associated anomaly and others were A.S.D., pulmonary stenosis, aortic regurgitation, D.C.R.V.. 5. Pulmonary hypertension was founded in 37 patients and it`s incidence was increased by patient age and shunt amount. 6. On Kirklin`s anatomical classification, type 11 defect was most common [45.5%], and type 1 was 35.5%, and type 111 was 4.4%, and type 1V was 4.4%. 7. Mean E.C.C. time was 69.1 min. and varied by closing method and associated anomaly as in case of simple closure; 47.8 min., in case of patch closure; 77.2 min., in cases with associated anomaly; 92.7 min.. 8. Mean postoperative ventilatory assisted time was 7.3 hour and varied by preoperative pulmonary artery pressure and E.C.C. time, as the group with pulmonary hypertension; 10.5 hour, the group without pulmonary hypertension; 5.5 hour, the group of short E.C.C time [within 1 hour]; 4.4 hour, the group of long E.C.C. time [over 1 hour]; 8.4 hour. 9. Overall operative mortality was 9.3% [9 cases].

• 대한비뇨기종양학회지
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• 제15권3호
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• pp.137-142
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• 2017

Purpose: To examine and compare the perioperative outcomes of laparoscopic adrenalectomy (LA) and to determine its efficacy in patients with nonfunctioning adrenal adenomas (NFA) and subclinical Cushing syndrome (SCS). Materials and Methods: We retrospectively analyzed the clinical data obtained from 79 consecutive patients who underwent LA for the treatment of either NFA (n=35) or SCS (n=44) between 2011 and 2016. All patients had undergone computed tomography, as well as endocrinological tests to confirm the diagnosis prior to the adrenalectomy. The primary endpoint was improved metabolic parameters relating to diabetes, hypertension, dyslipidemia, and obesity. Results: Patients with SCS compared to those with NFA showed a higher occurrence of diabetes (29.5% vs. 11.4%), hypertension (59.1% vs. 34.3%), and dyslipidemia (43.2% vs. 14.3%). Patients with SCS showed a smaller median tumor size compared to those with NFA (2.5 cm vs. 5 cm). No significant perioperative complications ${\geq}$ Clavien-Dindo classification grade III were observed in any patient (SCS or NFA group). In terms of their metabolic profile, patients with SCS showed a significant postoperative improvement in hypertension (50.0%), diabetes (53.9%), dyslipidemia (31.6%), and obesity (29.2%). However, patients with NFA showed a postoperative improvement only in dyslipidemia (40.0%) and obesity (4.8%). Conclusions: Owing to absence of significant perioperative complications and the marked postoperative improvement in metabolic impairment, LA is a useful treatment strategy in patients diagnosed with SCS. In contrast, LA was not observed to show beneficial effects in correcting/improving the metabolic profile in patients presenting with NFA.

• Journal of Chest Surgery
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• 제15권3호
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• pp.311-315
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• 1982

Between 1973 and 1981 a total of 38 patients with a adult Patent Ductus Arteriosus, resulting from a congenital heart disease. There were 10 males and 28 females and most were in their twenties. In 21 cases, typical Patent Ductus Arteriosus without pulmonary hypertension and in 17, atypical Patent Ductus Arteriosus with pulmonary hypertension were noted. Methods of surgical treatment were division, double ligation, triple ligation, or wrapping with Teflon felt and ligation. The number of patients for each surgical treatment were 23 cases with double ligation, 4 cases with triple ligation, 3 cases of wrapping with Teflon felt and ligation and 8 cases with division. Surgical mortality occurred in one case[2.6%].

• 셀메드
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• 제13권4호
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• pp.13.1-13.3
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• 2023

Objective: A case report on the improvement of metabolic syndrome by Ortho-Cellular Nutrition Therapy (OCNT). Methods: A 50-year-old Korean male with chronic fatigue and overlapping risk factors impaired fasting glucose, hypertension, and hypertriglyceridemia. Results: Diabetes and blood triglyceride levels improved after Ortho-Cellular Nutrition Therapy (OCNT). Conclusion: Ortho-Cellular Nutrition Therapy (OCNT) is effective in relieving the symptoms of metabolic syndrome patients.

• 보건교육건강증진학회지
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• 제31권3호
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• pp.27-37
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• 2014

Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

• 동서간호학연구지
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• 제3권1호
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• pp.27-38
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• 1998

This study was carried out to understand the general conditions about management of hypertension and the differences in opinions between the Eastern-Western Nursing Sciences. In this context, this study was aimed to find out a possible integration of the Eastern-Western Nursing Sciences for the management of hypertension and to suggest a distinct frame of Korean nursing intervention method which is unique for the hypertensive patients by combining two hypertensive management systems originated from the Western type, "mainly classified by stage", and the Eastern type, "typically classified by form" as they are identified in the literature. From the research literature including both domestic and foreign, this study identified that exuberance of Yang of the Liver form mainly appeared to the patient who is at a border hypertension or the first stage of hypertension, Deficiency of Yin of the Liver and Kidneys form mostly appeared to the first stage and the second stage of Hypertension and Deficiency of the both of Yin and Yang form appeared to the third stage of Hypertension. These unifications of the types of Hypertension classified by stages and forms suggest the possibility not only of integration of the Eastern-western Medicine but also of establishment for the intervention of specific nursing management which is the united Eastern-western Nursing Science for the Hypertension. Hence, the new frame for the nursing management of Hypertensive patient is suggested as follows : 1) In case of the exuberance of Yang of the Liver form, as classified by form which is categorized to the border Hypertension or the first stage of Hypertension, nursing intervention should include general therapy, cooking meal and neutral care to restrain the condition of the exuberance of Yang of the liver. 2) In case of the deficiency of Yin of the liver and the Kidneys form, as classified by form which is categorized to the second stage of Hypertension, nursing intervention should include both the general and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of the deficiency of Yin of the Li ver and Kidneys. 3) In case of the deficiency of both of Yin and Yang form, as classified by form which is categorized to he third stage of Hypertension should include both the general therapy and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of deficiency of the both of Yin and Yang. In addition, using this basic frame of Hypertensive management, a specific way of nursing intervention, which is suitable for exuberance of Yang of the Liver form, deficiency of Yin of the Liver and Kidneys form, and deficiency of both of the Yin and Yang form and classified by Korean herbal medicine related to hypertension, should be pursued continuously in the future.