• Title/Summary/Keyword: Korean Medical school

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Pain Recovery Pattern According to the Integrity after an Arthroscopic Rotator Cuff Repair (관절경하 회전근 개 봉합술 후 파열 정도에 따른 통증 회복 양상)

  • Kim, Ju-O;Sim, Sang-Don;Noh, Kyung-Hwan;Shon, Suk-June;Kim, Sul-Jun;Yang, Yun-Hyeok
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.155-160
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    • 2009
  • Purpose: The purpose of this study was to evaluate the pain recovery pattern according to the integrity and to analyze the factors affecting the progress and level of pain postoperatively. Materials and Methods: We examined 153 patients, who were treated with arthroscopic rotator cuff repair. 101 rotator cuff tears were full-thickness tear and 52 were partial tear. The mean follow up duration was 20 months (12~30 months). We evaluated the visual analogue scale, range of motion, ASES (American Shoulder and Elbow Surgeons), and UCLA (University of California at Los Angeles) scores preoperatively and postoperatively. We analyzed the pain recovery pattern between partial and full thickness tear using Student T-test and the factors affecting the progress and level of postoperative pain using multiple regression analysis. Results: The change patterns of visual analogue scale after arthroscpoic repair were similar regardless of the tear integrity. The VAS showed a continuous decreasing pattern, but increased at first 3 weeks postoperatively and at 7 weeks postoperatively, and then, decreased thereafter. The average VAS was ${\leqq}2$ points by postoperative 3 months. The factor affecting the pain score at 3 months was related to the preoperative limitation in forward flexion ($r^2=0.377$, p=0.021). Conclusion: There was no differences of the pain recovery pattern according to the integrity, and the factor affecting the progress of postoperative pain was preoperative angle of forward elevation. So, the appropriate preoperative rehabilitation protocol that can improve motions of the shoulder joint would help to improve the level of postoperative pain and functional recovery.

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Impacts of Diastolic Function on Clinical Outcomes in Young Patients with Acute Myocardial Infarction (젊은 급성 심근경색증 환자에서 좌심실 이완 기능 및 충만압이 관상동맥중재술 후 임상 경과에 미치는 영향)

  • Cho, Eun Young;Jeong, Myung Ho;Yoon, Hyun Ju;Kim, Yong Cheol;Sohn, Seok-Joon;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Ahn, Youngkeun;Cho, Jae Young;Kim, Kye Hun;Park, Jong Chun
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.538-547
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    • 2018
  • Background/Aims: The impact of left ventricular (LV) diastolic function and filling pressure on clinical outcomes in young patients with acute myocardial infarction (AMI) has been poorly studied. Therefore, the aim of this study was to investigate the impact of LV diastolic function and LV filling pressure on major adverse cardiac events (MACEs) in young patients with AMI. Methods: A total of 200 young patients (males < 45 year, females < 55 year) with AMI were divided into two groups according to the diastolic function; normal (n = 46, $39.5{\pm}5.3$ years) versus abnormal (n = 154, $43.5{\pm}5.1$ years). Results: Despite regional wall motion abnormalities, normal LV diastolic function was not uncommon in young AMI patients (23.0%). During the 40 months of clinical follow-up, MACEs developed in 26 patients (13.0%); 14 re-percutaneous coronary intervention (7.0%), 8 recurrent MI (4.0%), and 4 deaths (2.0%). MACEs did not differ between the normal and abnormal diastolic function group (13.6% vs. 10.9%, p = 0.810), but MACEs were significantly higher in the high LV filling pressure group than the normal LV filling pressure group (36.8% vs. 10.5%, p < 0.001). On multivariate analysis, high LV filling pressure was an independent predictor of MACEs (hazard ratio 3.022, 95% confidence interval 1.200-7.612, p = 0.019). Conclusions: This study suggested that measurement of the LV filling pressure (E/e' ratio) would be useful in the risk stratification of young patients with AMI. However, it would be necessary to monitor this category of patient more carefully.

Distribution and Antimicrobial Resistance of Non-Tuberculous Mycobacteria during 2015~2020: A Single-Center Study in Incheon, South Korea (2015~2020년 동안 인천 지역 단일기관에서의 비결핵항산균 분포 및 항균제 내성률)

  • Kim, Jiwoo;Ju, Hyo-Jin;Koo, Jehyun;Lee, Hyeyoung;Park, Hyeonhwan;Song, Kyungcheol;Kim, Jayoung
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.3
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    • pp.225-232
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    • 2021
  • This study sought to investigate the distribution, antimicrobial resistance rate, and bacterial co-infection frequency of non-tuberculous mycobacteria (NTM) in a single center in Incheon, South Korea. A total of 8,258 specimens submitted for tuberculosis (TB)/NTM real-time PCR tests during the years 2015 to 2020 were retrospectively reviewed. In total, 296 specimens (3.6%) were NTM positive, and the positivity increased from 2.5% (30/1,209) in 2015 to 3.8% (66/1,740) in 2020. Of 296 NTM specimens, 54.7% (162/296) were identified as the Mycobacterium avium complex (MAC) followed by the Mycobacterium abscessus complex (MABC) 20.9% (62/296), M. fortuitum 6.4% (19/296) and M. flavescens 3.4% (10/296). Of the NTM-positive specimens, 76.7% (227/296) were tested for drug resistance. The results showed multidrug-resistant NTM in 40.1% (91/227) and extensively drug-resistant NTM in 59.9% (136/227) of these specimens. Of the 145 isolates taken for bacterial culture, bacteria/fungi co-infection with NTM accounted for 43.4% (63/145), in which the most common bacterial species was Klebsiella pneumonia (23.8%, 15/63). This study is the first report on the distribution and antimicrobial resistance of NTM in Incheon. As the proportion of NTM infections increases, active treatment and thorough infection control are required for effective management.

Plasma Levels of Cytokines in Patients with Postpartum Depression (산후우울증 환자에서 혈장 Cytokine의 농도변화에 대한 전향적 연구)

  • Lee, Younjung;Kim, Yong-Ku;Kim, Kye-Hyun;Lee, Bun-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.177-184
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    • 2020
  • Objectives : Postpartum depression is known to occur in 10-15% of mothers. The concentration of cytokine varies depending on stress, depression, pregnancy and general medical conditions. We hypothesized that the concentration of cytokines may be related to reproduction and childbirth, and that women with postpartum depression would show alterations in cytokines levels. Methods : A total of 104 pregnant women were selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups perinatal non-depression controls (n=61), postpartum depression-recovery (n=18), and postpartum depression (n=25). Results : The plasma concentration of TGF-β1, IGF-1 was higher in the pregnant group than in non-pregnant controls (TGF-β1 ; p<0.01, IGF-1 ; p=0.026). At 24 weeks of pregnancy and 6 weeks of delivery, there were no significant differences in the plasma concentration of TGF-β1, IGF-1, β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α between the three groups. There was no statistically significant difference in all three groups during the course of depression in pregnant women. Conclusions : This study found significant difference in plasma cytokines concentrations between non-pregnant controls and perinatal non-depression controls.

Needs and Related Factors for Return-to-Work Support in Cancer Survivors (암 경험자의 직장복귀지원에 대한 요구도 및 관련 요인)

  • Lee, Sungwon;Lee, Kwang-Min;Oh, Gyu-Han;Yeom, Chan-Woo;Jung, Sanghyup;Hahm, Bong-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.126-134
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    • 2020
  • Objectives : The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods : 182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-to-work support between the patient group and caregiver group (patient's needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results : 34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is "very necessary". The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-to-work support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p=0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions : The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Evaluation of Patient Radiation Doses Using DAP Meter in Interventional Radiology Procedures (인터벤션 시술 시 면적선량계를 이용한 환자 방사선 선량 평가)

  • Kang, Byung-Sam;Yoon, Yong-Su
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.27-34
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    • 2017
  • The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipments in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effectives of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were $237.7Gy{\cdot}cm^2$ in TACE, $17.3Gy{\cdot}cm^2$ in AVF, $114.1Gy{\cdot}cm^2$ in LE PTA & STENT, $188.5Gy{\cdot}cm^2$ in TFCA, $383.5Gy{\cdot}cm^2$ in Aneurysm Coil, $64.6Gy{\cdot}cm^2$ in PTBD, $64.6Gy{\cdot}cm^2$ in Biliary Stent, $22.4Gy{\cdot}cm^2$ in PCN, $4.3Gy{\cdot}cm^2$ in Hickman, $2.8Gy{\cdot}cm^2$ in Chemo-port, $4.4Gy{\cdot}cm^2$ in Perm-Cather, $17.1Gy{\cdot}cm^2$ in PCD, and $357.9Gy{\cdot}cm^2$ in Vis, EMB. Dose referenece level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipments and procedures in the interventional radiology procedures, further studies and monitorings are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

Research on the Measures and Driving Force behind the Three Major Works of Daesoon Jinrihoe in North Korea in Case of the Respective Types of Unification on the Korean Peninsula (한반도 통일 유형별 북한지역의 대순진리회 3대 중요사업 추진 여건과 방안 연구)

  • Park, Young-taek
    • Journal of the Daesoon Academy of Sciences
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    • v.39
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    • pp.137-174
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    • 2021
  • The main theme of this paper centers on how to promote Three Major Works of Daesoon Jinrihoe, charity aid, social welfare, and education projects, during the unification period. Determining the best methods of promotion is crucial because the Three Major Works must be carried out after unification, and the works must remain based on the practice of the philosophy of Haewon-sangsaeng (the Resolution of Grievances for Mutual Beneficence). The idea of Haewon-sangsaeng is in line with the preface of the U.N. Charter and the aim of world peace. North Korean residents are suffering from starvation under their devastated economy, which is certain to face a crisis of materialistic deficiency during reunification. In this study, the peaceful unification of Germany, unification under a period of sudden changes in Yemen, and the militarized unification of Vietnam were taken as case studies to diagnose and analyze the conditions which would affect the implementation of the Three Major Works. These three styles of unification commonly required a considerable budget and other forms of support to carry out the Three Major Works. Especially if unification were to occur after a period of sudden changes, this would require solutions to issues of food, shelter, and medical support due to the loss of numerous lives and the destruction of infrastructure. On the other hand, the UNHCR model was analyzed to determine the implications of expanding mental well prepared and sufficiently qualified professionals, reorganizing standard organizations within complex situations, task direction, preparing sufficient relief goods, budgeting, securing bases in border areas with North Korea, and establishing networks for sponsorship. Based on this, eight detailed tasks in the field of system construction could be used by the operators of the Three Major Works to prepare for unification. Additionally, nine tasks for review were presented in consideration of the timing of unification and the current situation between South and North Korea. In conclusion, in the event of unification, the Three Major Works should not be neglected during the transition period. The manual "Three Major Works during the Unification Period" should include strategic points on organizational formation and mission implementation, forward base and base operation, security and logistics preparation, public relations and external cooperation, safety measures, and transportation and contact systems.

Protective Effects of Trifolium pratense L. Extract against H2O2-induced Oxidative Stress in HaCaT Keratinocytes (인간 피부각질세포에서 Hydrogen peroxide로 유도된 산화적 스트레스에 대한 붉은 토끼풀 추출물의 세포 보호 효과)

  • Mi Song Shin;You Kyeong Lee;Seo Young Choi;Ji Sun Hwang;Parkyong Song;Hyeon Cheal Park;Keun Ki Kim;Hong-Joo Son;Yu-Jin Kim;Kwang Min Lee
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.2
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    • pp.223-232
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    • 2023
  • Oxidative stress plays a significant role in the pathogenesis of various skin conditions, resulting in cellular and tissue damage that can contribute to the development of skin tone unevenness, roughness and wrinkles. In this study, we found that Trifolium pratense L. extract (TE) attenuated oxidative-induced damage in HaCaT cells and elucidated the underlying molecular mechanism. Our finding demonstrated that TE effectively protected HaCaT cells against H2O2-induced cell death by inhibiting caspase-3 activation, downregulating Bax and upregulating Bcl-2, and attenuating the activation of three mitogen-activated protein kinases (MAPKs). Our results suggest that TE has remarkable cytoprotective properties against oxidative damage in HaCaT cells and could serve as a complementary or alternative approach to prevent and treat skin damage.

Comparison of the Outcomes after Primary Total Hip Arthroplasty Using a Short Stem between the Modified Anterolateral Approach and Direct Anterior Approach with a Standard Operation Table (일반 수술 침대와 짧은 대퇴 주대를 이용한 인공 고관절 전 치환술의 직접 전방 도달법과 변형된 전 측방 도달법에 따른 결과 비교)

  • Park, Myung-Sik;Yoon, Sun-Jung;Choi, Seung-Min;Cho, Hong-Man;Chung, Woochull;Kang, Kyung-Rok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.244-253
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    • 2019
  • Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

CT Evaluation of Long-Term Changes in Common Bile Duct Diameter after Cholecystectomy (담낭 절제술 후 총담관 직경의 장기 변화에 대한 CT 평가)

  • Sung Hee Ahn;Chansik An;Seung-seob Kim;Sumi Park
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.581-595
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    • 2024
  • Purpose The present study aimed to investigate the frequency and extent of compensatory common bile duct (CBD) dilatation after cholecystectomy, assess the time between cholecystectomy and CBD dilatation, and identify potentially useful CT findings suggestive of obstructive CBD dilatation. Materials and Methods This retrospective study included 121 patients without biliary obstruction who underwent multiple CT scans before and after cholecystectomy at a single center between 2009 and 2011. The maximum short-axis diameters of the CBD and intrahepatic duct (IHD) were measured on each CT scan. In addition, the clinical and CT findings of 11 patients who were initially excluded from the study because of CBD stones or periampullary tumors were examined to identify distinguishing features between obstructive and non-obstructive CBD dilatation after cholecystectomy. Results The mean (standard deviation) short-axis maximum CBD diameter of 121 patients was 5.6 (± 1.9) mm in the axial plane before cholecystectomy but increased to 7.9 (± 2.6) mm after cholecystectomy (p < 0.001). Of the 106 patients with a pre-cholecystectomy axial CBD diameter of < 8 mm, 39 (36.8%) showed CBD dilatation of ≥ 8 mm after cholecystectomy. Six of the 17 patients with long-term (> 2 years) serial follow-up CT scans (35.3%) eventually showed a significant (> 1.5-fold) increase in the axial CBD diameter, all within two years after cholecystectomy. Of the 121 patients without obstruction or related symptoms, only one patient (0.1%) showed IHD dilatation > 3 mm after cholecystectomy. In contrast, all 11 patients with CBD obstruction had abdominal pain and abnormal laboratory indices, and 81.8% (9/11) had significant dilatation of the IHD and CBD. Conclusion Compensatory non-obstructive CBD dilatation commonly occurs after cholecystectomy to a similar extent as obstructive dilatation. However, the presence of relevant symptoms, significant IHD dilatation, or further CBD dilatation 2-3 years after cholecystectomy should raise suspicion of CBD obstruction.