• Journal of The Korean Dental Society of Anesthesiology
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• 제11권2호
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• pp.146-152
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• 2011

Background: Elderly patients with progressive dementia including Alzheimer's disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients. Methods: We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min ${\pm}$ 60 min and staying time at PACU was 83 ${\pm}$ 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications. Conclusions: If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제12권2호
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• pp.795-804
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• 2011

This study was performed to determine the levels of quality of life(QOL) according to the grade of long-term care service in the elderly people who affiliated from long-term care insurance, and to reveal its association with socio-demographic characteristics, health status and health related behaviors. The interviews were performed, during the period from March 1st, to May 31th, 2009, to 410 elderlies in rural areas. As a results, the levels of QOL were lower in the group of higher grade of long-term care insurance. In hierarchial multiple regression analysis, the factors influencing on the level QOL were age, Living status, Subjective health status, Bed ridden status, Disability of body, Urinary incontinence, Amnesia and Frequency of going out. Especially, the health status variables were higher related with QOL than other variables.

• Quality Improvement in Health Care
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• 제23권2호
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• pp.69-78
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• 2017

Background: The purpose of this study was to examine associations between classification of the Geriatric Screening for Care-10 (GSC-10) and the Morse Fall Scale (MFS) among elderly inpatients. Methods: Among elderly inpatients aged over 65 admitted to hospital (from November 1, 2016 to July 31, 2017), the data for 5,780 patients (who were evaluated using the Morse Fall Scale and the Geriatric Screening for Care-10) were analyzed using x2-tests and t-tests to examine differences between the GSC-10 and MFS, according to general characteristics of elderly inpatients (i.e., gender) using IBM SPSS Statistics 24. Results: : Scores for the GSC-10 were significantly higher in women than men for depression (p<.001), delirium (p=.048), functional decline (p<.001), incontinence (p<.001), and pain (p<.001). Statistically significant differences in all domains of the GSC-10 for elderly hospitalized patients were found for the classification of fall risk. Conclusion: The findings of this study, as supported by the GSC-10, indicate that the most common problems experienced by the elderly are related to the risk of falling. In order to reduce the incidence of falls in elderly inpatients, customized fall prevention based on the GSC-10 results is necessary.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.514-520
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• 2000

Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

• The Journal of Korean Medical History
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• 제34권2호
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• pp.89-96
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• 2021

This research aims to find a way to utilize the literature to select the herbs to be added or subtracted according to the condition of the patient after determining the basic prescription to be used for the patient. The study is based on data concerning the herbal composition and application of prescriptions described in the Donguibogam. The composition herbs was expressed as a weight ratio, the standard deviation of the weight ratio was calculated for each prescription, and the case where the weight ratio was greater than the base value (highest weight ratio - standard deviation) was designated as a principal herb. The various expressions of applications were changed to representative terms by the researcher and used to calculate the frequency. Of the 4,373 prescriptions for Donguibogam, 3,307 were able to be expressed in terms of weight ratios with 640 prescriptions using Rehmannia glutinosa, Cnidium officinale, Angelica gigas and Paeonia lactiflora as the principle herb. Of the 640 prescriptions, 508 prescriptions included applied information. Rehmannia glutinosa can also be used for symptoms such as fetal leakage(胎漏), short ingestion(食少), fever(發熱), dazed expression(眼花). Cnidium officinale can also be used for symptoms such as migraine(偏頭痛), stroke(中風癱瘓), tetanus(破傷風). Angelica gigas can also be used for symptoms such as forgetfulness(健忘), incontinence of urination(小便不通), palpitations(驚悸). Paeonia lactiflora can also be used for symptoms such as heart pain and abdominal pain(心腹痛), cough(咳嗽).

• 한국노년학
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• 제38권3호
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• pp.537-550
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• 2018

The purpose of this study was to investigate the status of total body water and it's influencing factors in community elderly. In this descriptive study, data were collected from 135 elderly at senior citizen center, from October 4 2016 to February 28 2017. Surveys using questionnaire and anthropometric measurements for BMI and total body water were done for data collection. The results of the study showed that while most of the subjects of the study showed total body water within the appropriate range, some elderly especially elderly women show a degraded total body water. Total body water showed significant difference according to sex, body mass index, number of chronic illness, number of medication and urinary incontinence levels. Significant influencing factors were BMI(${\beta}=-0.51$, p=<.001), sex(${\beta}=-0.47$, p=<.001) and this regression model explained 51% of the variance in total body water. In the future, attention needs to be paid to the total body water of the elderly in the local community, especially to the elderly women with risk factors.

• International Neurourology Journal
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• 제22권4호
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• pp.275-286
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• 2018

Purpose: OnabotulinumtoxinA (BoNT-A) is a promising therapy for treating neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). This systematic review and meta-analysis aimed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI. Methods: The PubMed, Embase, and Cochrane databases were searched for all relevant articles published from 2001 to 2016 that referred to NDO, SCI, and BoNT-A or botulinum toxin A. All data were recorded in an Excel spreadsheet by 2 individual reviewers. Review Manager version 5.3 was used to carry out the meta-analysis. Results: This analysis included 17 studies involving 1,455 patients. Compared with placebo and baseline, BoNT-A was effective in increasing maximum cystometric capacity, volume at first involuntary detrusor contraction, cystometric bladder capacity (all P<0.00001), compliance (P=0.001), and the number of patients with complete dryness (P=0.0003), and decreasing detrusor pressure, the number of patients with no involuntary detrusor contractions, the maximum flow rate, the incidence of detrusor overactivity (all P<0.00001), and the number of urinary incontinence episodes (P=0.001). There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa. There were no life-threatening adverse events. Conclusions: BoNT-A is effective and safe in treating NDO after SCI. There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa. However, more high-quality randomized controlled trials are still needed.

• The Journal of Korean Obstetrics and Gynecology
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• 제32권2호
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• pp.87-99
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• 2019

Objectives: The aim of this study was to analyse the domestic trends of Chuna manual therapy on Obstetrics and Gynecological Diseases in Korean literature. Methods: We searched for papers which had Chuna manual therapy through 2 related journals and 5 Korean web databases. All relevant papers were selected and extracted to be analyzed according to their study designs, academic journals, and target disease. Results: Nine papers belonged to four types of study designs, systematic review, randomized or non-randomized controlled trial and case report. And they were published in four kinds of academic journals. There were four papers about postpartum pain, two low back pain during pregnancy, and a stress urinary incontinence. The exact Chuna techniques were explained in only seven papers. All of papers have been shown that Chuna manual therapy is useful for obstetrics and gynecological diseases. Conclusions: It has been identified that Chuna manual therapy could be a good treatment for obstetrics and gynecological diseases. However, more clinical and well-designed studies with Chuna manual therapy will be needed.

• The Journal of Internal Korean Medicine
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• 제43권1호
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• pp.90-103
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• 2022

Objective: The purpose of this case study is to report the effectiveness of Baliao acupoints electro-acupuncture treatment on a neurogenic overactive bladder induced by stroke. Method: A patient suffering from middle cerebral artery infarction was diagnosed with a neurogenic overactive bladder and treated by Korean medicine, including electro-acupuncture on Baliao acupoints six times per week. The evaluation was performed by monitoring urinary frequency and using the Korean versions of the Overactive Bladder Symptom Score (OABSS) and Urinary Incontinence Quality of Life (I-QoL). Results: After 27 days of electro-acupuncture treatment, the OABSS score improved from 6 to 3. The I-QoL total score improved from 60 to 87. The patient also showed a decrease in nocturia frequency. Conclusion: This case suggests that electro-acupuncture on Baliao acupoints can be effective for overactive bladders due to supra-pontine lesions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권4호
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• pp.340-346
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• 2022

Purpose: The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern. Methods: We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes. Results: Out of a total of 48 patients treated within the study period, 28 were enrolled in this study. Among the latter, more than 35% had at least one long-time complication, and more than 90% had a good lifestyle. Urinary and fecal continence was achieved in more than 95% of the patients using medical devices. Conclusion: This study aimed to bring up new concepts; taking into consideration all aspects of life in patients with ARM, from school life to sexuality, while evaluating fecal and urinary continence. This is essential for the improvement of the skills of the different specialists involved in the management of these patients, and for the implementation of strategies that can improve postoperative function. Most especially, it will also help improve communication between doctors to ensure an adequate transition of these children into adult life.