• Journal of Preventive Medicine and Public Health
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• v.51 no.4
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• pp.205-212
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• 2018

Objectives: The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. Methods: A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. Results: Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. Conclusions: Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.960-967
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• 2008

This study was carried out to evaluate the effects of the Bojungikki-tang gami on patients with headache. This clinical study has been carried out with 32 patients, who visited the Department of Internal medicine, Donng-eui oriental medical center from January 2005 to September 2007, had been treated for headache with herbal medicine(Bojungikki-tang gami) and acupuncture. This study has been carried out by chart-review or telephone research. After treatment with Bojungikki-tang gami, 32 patients's headache was improved. (87.5%) After treatment with Bojungikki-tang gami, patients's other symptoms- fatigue, mild fever and feeling tight, anorexia, sweating, stiffness and numbness, dizziness -was improved. The treatment of headache with Bojungikki-tang gami is effective.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.26-31
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• 2016

Background The global prevalence of myelomeningocele has been reported to be 0.8-1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and skin grafts. The aim of this study was to describe the clinical characteristics of myelomeningocele defects and present the surgical outcomes of recent cases of myelomeningocele at our institution. Methods Patients who underwent surgical closure of myelomeningocele at our institution from January 2004 to December 2013 were included in this study. A retrospective chart review of their medical records was performed, and comorbidities, defect size, location, surgical procedures, complications, and the final results were analyzed. Results A total of 14 patients underwent surgical closure for myelomeningocele defects. Twelve cases were closed with direct skin repair, while two cases required local skin flaps to cover the skin defects. Three cases of infection occurred, requiring incision and either drainage or removal of allogenic materials. One case of partial flap necrosis occurred, requiring secondary revision using a rotational flap and a full-thickness skin graft. Despite these complications, all wounds eventually healed completely. Conclusions Most myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local flaps may be used to cover the defect. Complications such as wound dehiscence and partial flap necrosis occurred in this study; however, all such complications were successfully managed with simple ancillary procedures.

• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.513-525
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• 1999

Objectives : High-normal blood pressure' is a factor influencing decision to initiate targeted intensive intervention strategy in westernized populations. JNC-VI offered the vigorous lifestyle modification for persons with 'high-normal blood pressure', who could be early detected. As a hypertension seems to be the result of multiple genetic factors operating in concert with associated environmental factors, it will be necessary to identify the high-normal blood pressure as a risk factor of hypertension for applying primary prevention strategy in Korean people. Methods : Although cohort study design might be adequate to recruit incidence cases, to keep time sequence of events, and to prevent information bias, nested case-control study was chosen for avoiding measurement errors because hypertension is a benign disease. Source population was the 'Seoul Cohort' participants and follow-up was done by using Korea Medical Insurance Corporation's database on the utilization of health services from 1 Jan93 to 30Jun97. Incidence cases were ascertained through the chart review, telephone contacts, and direct blood pressure measurements. Controls included the pairing of 4 individuals to each case on the basis of age. Results : As 75% of 247 incident cases had high-normal blood pressure, the crude odds ratio for hypertension was 2.04 (95% CI 1.47-2.83). Another statistically significant risk factors of hypertension were body mass index, dietary fiber, alcohol consumption, weekly activity and history of quitting smoking. The multivariate odds ratio of high-normal blood pressure adjusted for all risk factors was 1.84 (95% CI 1.31-2.56). Among high-normal blood pressure group, body mass index, weekly ethanol amounts, weekly physical activity, and dietary fiber except history of quitting smoking were still risk factors of hypertension. Conclusion : 'High-normal blood pressure' is a risk factor for hypertension in Korean middle-aged men, which represents that the vigorous lifestyle modification for persons with 'high-normal blood pressure' is need.

• Journal of Trauma and Injury
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• v.25 no.2
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• pp.37-43
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• 2012

Purpose: A tube thoracostomy is an invasive procedure that places patients at risk for complications. Tube thoracostomies are frequently performed by emergency medicine residents. Thus, the purpose of the study was to assess both the complication rate for tube thoracostomies performed by emergency medicine residents and the factors associated with these complications. Methods: A retrospective chart review of all patients who had undergone a tube thoracostomy performed by emergency medicine residents between January 2008 and February 2009 was conducted at a university hospital. Complications were divided into major and minor complications and into immediate and delayed complications. Complications requiring corrective surgical intervention, requiring the administration of blood products, or involving situations requiring intravenous antibiotics were defined as major. Complications that were detected within 2 hours were defined as immediate. Results: Tube thoracostomies were performed in 189 patients, and 70 patients(37%) experienced some complications. Most complications were immediate and minor. In multiple logistic regressions, BMI, hypotension and resident seniority were significantly associated with complications. Conclusion: The prevalence of complications was similar to these in previous reports on the complications of a tube thoracostomy. Most complications from tube thoracostomies performed by emergency medicine residents were immediate and minor complications. Thus, emergency medicine residents should be allowed to perform closed tube thoracostomies instead of thoracic surgeons.

• Journal of Sensor Science and Technology
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• v.20 no.5
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• pp.343-350
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• 2011

The compliance and stiffness of artery are closely related with disease of arteries. Pulse wave velocity(PWV) in the blood vessel is a basic and common parameter in the hemodynamics of blood pressure and blood flow wave traveling in arteries because the PWV is affected directly by the conditions of blood vessels. However, there is no standardized method to measure the PWV and it is difficult to measure. The conventional PWV measurement has being done by manual calculation of the pulse wave transmission time between coronary arterial proximal and distal points on a strip chart on which the pulse wave and ECG signal are recorded. In this study, a pressure sensor consisting of strain gauges is used to measure the blood pressure of arteries in invasive method and regular ECG electrodes are used to record the ECG signal. The R-peak point of ECG is extracted by using a reference level and time windowing technique and the ascending starting point of blood pressure is determined by using differentiation of the blood pressure signal and time windowing technique. The algorithm proposed in this study, which can measure PWV automatically, shows robust and good results in the extraction of feature points and calculation of PWV.

• Environmental Mutagens and Carcinogens
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• v.23 no.1
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• pp.1-6
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• 2003

The purpose of this study was to evaluate whether the MTHFR variants, folate and vitamin $B_{12}$ deficiencies increase the risk of hyperhomocysteinaemia and adverse pregnancy outcome such as short gestational age or reduced birth weight. Healthy pregnant women (n=136; 24-28 gestational weeks; 20-40 years old), who visited Ewha Womans University Hospital for prenatal care, participated in this study. At the time of delivery, trained nurses recorded the pregnancy outcome from medical chart. We determined maternal MTHFR polymorphisms (C to T subsitution at nucleotide 677) and measured serum homocyteine, vitamin $B_{12}$, and folate concentrations. We compared serum homocysteine level by MTHFR genotype, serum folate and serum vitamin B12 levels using ANOVA. To evaluate the association between serum homocysteine level and pregnancy outcome, we compared the gestational age and birth weight by serum homocysteine levels using multiple regression analysis, adjusting for other potential predictors. Mean level of serum homocysteine was highest among pregnant women of the MTHFR variants with low levels of serum folate and vitamin $B_{12}$. Regarding association with birth outcome, we found the relationship between homocysteine levels and increased gestational age (p=0.03) and reduced birth outcome (p>0.05). Our data demonstrates that serum level of folate and vitamin $B_{12}$ among pregnant women affects significantly serum homocysteine levels, and the genetic polymorphism of MTHFR modulates the relationship between them. However, we did not have conclusive evidence of association between high homocysteine level and adverse pregnancy outcome such as preterm or low birth weight.

• Journal of Nutrition and Health
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• v.6 no.1
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• pp.53-69
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• 1973

For the purpose of ascertaining the status of physical growth and development of the University students, an intensive survey was conducted by the authors towards a total of 2,197 (male: 1,694, female: 503) who passed the written enterance examination at the Korea University in 1972. The items included the measurements on physical growth, various physical indices, status of visual distourbance and pulmonary infiltration. The findings and results can be summarized as follows. 1. Physical growth: The average of body height by sex were 167.2 cm in male and 156.0cm in female, body weight 59.3kg and 51.9kg, chest-girth 86.7cm and 81.2cm, sitting height 91.7cm and 85.8cm, respectively. 2. Various indices about physical growth & development; Relative body weight by sex were 35.47 and 33.27, relative chest girth 51.85 and 52.05, relative sitting height 54.84 and 55.00, respectively. $R{\ddot{a}}here$ index was 1,269 in males and 1,367 in females, Kaup index 2,121 and 2,133, Verveck index 87.32 and 85.32, respectively. 3. Status of visual distaurbance: The vision of the students under 0.9 with Han's testing chart was 52.83% and 55.27% in left eye and 53.60% and 54.87% in right eye, respectively. 4. Pulmonary infiltration Among the total 58 students were diagncsed as pulmonary infiltration (tuberculosis), of whom 43 were minimal case, 12 were moderately advanced cases and 3 were far advanced cases.

• Korean Journal of Oriental Medicine
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• v.18 no.2
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• pp.117-122
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• 2012

Objectives : A Survey was conducted to find out usages of Korean medicine electronic charts and requirements of clinical decision support functionalities in the charts. Methods : An e-mail was sent to about 12,000 Korean medicine doctors that was affiliated to the Association of Korea Oriental Medicine. 250 doctors answered the questionnaires during one week. Results : Most doctors of 83% answered in use the electronic charts and use it mainly to insurance claims. 46% of them felt that diagnosis functions need to be improved first in the electronic charts. Moreover, 66% of them answered that expert systems to support diagnosis is required if provided. Conclusions : The clinical decision support systems help doctors diagnosis patients in a desirable manner. Many researches have been proposed about them in modern medical science, while a few studies suggested in Korean medicine. In the future, more researches in the field of diagnosis of electronic charts should be proceeded.

• Clinical and Experimental Pediatrics
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• v.57 no.11
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• pp.489-495
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• 2014

Purpose: The aims of this study were to document our single-center experience with pediatric acute fulminant myocarditis (AFM) and to investigate its clinical features and short-term outcomes. Methods: We performed a retrospective chart review of all children <18 years old who were diagnosed with AFM between October 2008 and February 2013. Data about patient demographics, initial symptoms, investigation results, management, and outcomes between survivors and nonsurvivors were collected. Results: Seventeen of 21 patients (80.9%) with myocarditis were diagnosed with AFM. Eleven patients (64.7%) survived to discharge, and 6 (35.3%) died. Electrocardiography on admission revealed dysrhythmia in 10 patients (58.8%); of these, all 7 patients with a complete atrioventricular block survived. Fractional shortening upon admission was significantly different between the survivors (16%) and nonsurvivors (8.5%) (P=0.01). Of the serial biochemical markers, only the initial brain natriuretic peptide (P=0.03) and peak blood urea nitrogen levels (P=0.02) were significantly different. Of 17 patients, 4 (23.5%) required medical treatment only. Extracorporeal membrane oxygenation (ECMO) was performed in 13 patients (76.5%); the survival rate in these patients was 53.8%. ECMO support was initiated >24 hours after admission in 4 of the 13 patients (30.7%), and 3 of those 4 patients (75%) died. Conclusion: AFM outcomes may be associated with complete atrioventricular block upon hospital admission, left ventricular fractional shortening at admission, time from admission to the initiation of ECMO support, initial brain natriuretic peptide level, and peak blood urea nitrogen level.