• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.58-65
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• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.260-265
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• 2018

Background: A method of wound closure using knotless suture material in the chest tube site has been introduced at our center, and is now widely used as the primary method of closing chest tube wounds in video-assisted thoracic surgery (VATS) because it provides cosmetic benefits and causes less pain. Methods: We included 109 patients who underwent VATS pulmonary resection at Samsung Medical Center from October 1 to October 31, 2016. Eighty-five patients underwent VATS pulmonary resection with chest drain wound closure utilizing knotless suture material, and 24 patients underwent VATS pulmonary resection with chest drain wound closure by the conventional method. Complications related to the chest drain wound were compared between the 2 groups. Results: There were 2 cases of pneumothorax after chest tube removal in both groups (8.3% in the conventional group, 2.3% in the knotless suture group; p=0.172) and there was 1 case of wound discharge due to wound dehiscence in the knotless suture group (0% in the conventional group, 1.2% in the knotless suture group; p=0.453). There was no reported case of chest tube dislodgement in either group. The complication rates were non-significantly different between the 2 groups. Conclusion: The results for the complication rates of this new chest drain wound closure method suggest that this method is not inferior to the conventional method. Chest drain wound closure using knotless suture material is feasible based on the short-term results of the complication rate.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.1-8
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• 2016

Objectives Danggwisu-san (Dangguixu-san) is a herbal prescription frequently used to treat pain or swelling caused by contusion. To determine the expiration period through scientific methodology, stability of Danggwisu-san (Dangguixu-san) water extract, a herbal medicine, was examined under various storage conditions and periods. Methods Danggwisu-san (Dangguixu-san) was stored either at room temperature ($23{\pm}2^{\circ}C$), under a refrigerating condition ($4^{\circ}C$) or under a freezing condition ($-18{\pm}2^{\circ}C$) for 0, 1, 2, 3 or 4 weeks and then freeze-dried. Total phenol and total flavonoid amounts were investigated; contents of amygdalin (Prunus persica), paeoniflorin (Paeonia lactiflora), and glycyrrhizin (Glycyrrhiza uralensis) - the marker compounds of Danggwisu-san (Dangguixu-san) - were also analyzed through high performance liquid chromatography (HPLC). Results No significant change in total phenol and total flavonoid amounts was observed under the indicated storage conditions. Moreover, the contents of marker compounds, i.e. amygdalin, paeoniflorin, and glycyrrhizin, did not alter significantly under the indicated conditions, as well. Conclusions Danggwisu-san (Dangguixu-san) was found to be stable up until 4 weeks under the indicated conditions. Further studies on efficacy and long-term stability are warranted to establish the expiration period of Danggwisu-san (Dangguixu-san).

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.37-45
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• 2010

Purpose: First introduced by Buncke and Rose in 1979, the neurovascular partial $2^{nd}$ toe pulp free tissue transfer has been attempted to reconstruct posttraumatic finger tip injuries. Although some surgeons prefer other reconstructive methods such as skin graft and local flap, we chose the partial $2^{nd}$ toe pulp flap owing to its many advantages. We report three successful surgical cases in which the patients had undergone this particular method of reconstruction. Methods: We retrospectively examined three cases of fingertip injury patients due to mechanical injury. Bone exposure was seen in all three cases, All had undergone partial toe pulp free flap for soft tissue defect coverage. Results: All flaps survived without any complications such as partial necrosis, hematoma or dehiscence. Although tingling sensation has returned in both cases, two-point discrimination has not returned yet. Currently no patient is complaining of any pain which gradually improved during their course of recuperation. All stitches were removed on postoperative 2 weeks. Patients are satisfied with the final surgical result and there are no signs of any edema or hematoma. Conclusion: The homodigital reconstruction of finger tip injury using the partial $2^{nd}$ toe pulp flap has numerous advantages compared to other reconstructive modalities such as its resistance to wear and tear and in that it provides a non-slip palmar digital surface. However it requires microsurgery which may not be preferred by surgeons. Advanced age of the patient can be a relative contraindication to this approach since atheromatous plaque from the donor toe can compromise flap circulation after surgery. We report three successful cases which patient age was considered appropriate. Further investigation with a larger number of cases and long term follow-up is deemed necessary.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.115-122
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• 2018

The success of the total hip arthroplasty is revealed as initial stability, range of motion, and long term pain, etc. Depending upon choice of implantation options such as femoral neck offset, diameter of the femoral head, the lateral opening tilt. Especially the impingement between femoral head component and acetabular cup limits the range of motion of the hip. In this sense, estimation or evaluation of the range of motion before and after the total hip arthroplasty is important. This study provides the details of a computer simulation technique for the hip range of motion of intact hip as well as arthroplasty. The suggested method defines the hip rotation center and rotation axes for flexion and abduction, respectively. The simulation uses CT-based reconstructed 3D models and an STL treating software. The abduction angle of the hip is defined as the superolateral rotation angle from sagittal plane. The flexion angle of the hip is defined as the superoanterior angle from the coronal plane. The maximum abduction angle is found as the maximum rotation angle by which the femoral head can rotate superolaterally about the anterior-posterior axis without impingement. The maximum flexion angle is found as the maximum rotation angle by which the femoral head can rotate superoanteriorly about the medial-lateral axis without impingement. Compared to the normal hip, the total hip replacement hip showed decreased abduction by 60 degrees and decreased flexion by 4 degrees. This measured value implies that the proposed measurement technique can make surgeons find a modification of increase in the femoral neck offset or femoral head, to secure larger range of motion.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1318-1326
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• 1992

Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

• Journal of Acupuncture Research
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• v.20 no.1
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• pp.131-143
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• 2003

Objective : The purpose of this study is to arrange the literature about acupuncture therapy on the hemorrhoids and hemorrhoid complicated by anal fistula. Methods : We arrange Huang Di Nei Jing and fifteen kinds of literature about the hemorrhoids and hemorrhoid complicated by anal fistula. Results : 1. The cause of hemorrhoids are overfatigue, overeating, imbalance of stool(const-ipation or diarrhea), uncontrol sexual excess or abstinence, pathgenic factors of wetness, heat, wind, dry, fire, chronical hemorrhoids that has not been treated, and general weakness. 2. Symptom of hemorrhoids is that skin is projected form the nine holes or varicose extension to become hemorrhoid. Hemorrhoids is small nodosity that projected on the anal inter or outer region, and hemorrhoid complicated by anal fistula is pus which comes out form one or some fistula on the anal around inter and outer region. 3. Therapy method of hemorrhoid and hemorrhoid complicated by anal fistula are elimination pathological heat from blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat form the blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat from the blood and eliminate dampness, tonify the spleen and replenish Ki, dispel wind and alleviate pain and so forth. Therapy method of hemorrhoid is to give the first consideration to relieve blood: eliminating pathological heat form blood complicated by anal fistula is to tonify the blood first, than after that eliminating pathological heat form blood. About external method are method of fumigation, method of ointment, method of close with medicine, necrotizing method and also operation(injection, bind etc.)was used for treatment. 4. The prescription are Gurgak-hwan, Wypi-hwan, Gunggyi-tang, Jingyochangchul-tang, Jingyobangpung-tang, Mokhyangbinrang-hwan, Ochi-san, Gamihyanso-san, Jojang-hwan, Sinyung-hwan used frequently. 5. food taboo on patient's diet of the hemorrhoid and hemorrhoid complicated by anal fistula are raw grain, cold or dampness food, alcohol, hot food, Singiberis rhizoma recens, Cinnamomi ramulus. 6. Acupuncture therapy on the hemorrhoid and hemorrhoid complicated by anal fistula are, in the first stage eliminating pathological heat form blood and eliminate dampness, and in the long term eliminate dampness, promote and remove meridian energy, remove that form the intestines, dispel channels and collaterals. 7. Acupuncture points at B2, CV1, B58, B36, B56, Sp5, S30, B25, B54, GV1, GV20, L6, B40 used frequently for the acupuncture therapy, and acupuncture point at GV4, GV1, B30, hemorrhoidal point used form moxibustion. Reduction blood at B40 and blue capillary of Sp9 and acupuncture Chungbaek, Ki-gack, Ki-jung, Ki-mun(Dongsh Kihyel) makes the treatment very effective.

• Nutritional Sciences
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• v.5 no.2
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• pp.75-83
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• 2002

A case-controlled, 12 week follow-up, study was designed to investigate the effect of dietician-delivered medical nutrition therapy (MNT) on the nutritional status and quality of life in hemodialysis patients. Subjects were recruited at Kyung-Hee Medical Center and were randomly assigned to two groups : the control and the MNT group. The MNT group received individualized MNT for 12 weeks. The results were as follows: 1) The mean ages of the control (n = 20) and MNT (n = 24) groups were 50.6 $\pm$ 14.8 and 45.7 $\pm$ 14.0 years, and the mean durations of dialysis were 2.3 $\pm$ 2.3 and 1.7 $\pm$ 1.9 years, respectively. The interdialysis weight gain of the subjects was higher than that recommended. 2) The indicators of the subjects nutritional status showed that S to 25% of the subjects had some degree of malnutrition, with most of them in the mild malnutrition category. 3) After 12 weeks of the experiment, the percentage of the ideal body weight (% IBW) of the control group decreased, but that of the MNT group increased. Changes in other anthropometric parameters in both groups during the study period were not significantly different. 4) At the beginning of the study, the 54% of the MNT group consumed more than 28 kcal/kg body weight/day and 50% consumed more than 1.0g protein/kg body weight/day. However, these percentages rose to 71% and 75%, respectively, after 12 weeks of the individualized MNT. 5) The serum albumin and blood urea nitrogen (BUN) levels of the control group decreased significantly artier 12 weeks of the experiment, while those of the MNT group did not change. 6) After 12 weeks of individualized MNT, the mean score of nutrition knowledge and total mean score of quality of life (QL) of the MNT group were significantly higher than that of th\ulcorner control group. Body pain and social functioning scores of the MNT group were significantly higher than those of the control group. The positive effect of individualized MNT on the hemodialysis patients consisted of their improved nutritional status, nutritional knowledge, and the quality of life. These results suggest that individualized MNT continuously performed by a dietitian can be helpful for hemodialysis patients. However, larger and longer term studies are needed to confirm these positive effects of MNT. In addition, the development of nutritional education programs for MNT is needed to increase the positive impact of MNT.

• KIPS Transactions on Software and Data Engineering
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• v.9 no.4
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• pp.137-144
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• 2020

Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

• Journal of Veterinary Clinics
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• v.29 no.1
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• pp.82-86
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• 2012

A 5-year-old castrated male Chihuahua weighing 1.54 kg was examined because of a several month history of progressive right hind limb lameness. Physical examination of the stifle joints revealed pain and a grade IV medial patellar luxation on the right stifle joint. The right and left stifle joints were associated with a lameness of grade 2 and grade 0, respectively. Radiography revealed osteophytes or subchondral cystic lesions on the right and left stifle joints. Osteoarthrosis (OA) scores for the right and left stifle joints were 20 and 12 respectively. Combination of surgery and implantation of autologous adipose tissue derived mesenchymal stem cells (aAT-MSCs) was determined with informed consent. $1{\times}10^6$ aAT-MSCs suspended in PBS and 0.6 mL of hyaluronic acid were injected in the right stifle joint postoperatively. Osteoarthrosis scores and the lameness grade for the right and left stifle joints were 19 and 13, and 0 and 0 19 months after treatment, respectively, and 14 and 15, and 0 and 0 five years after treatment, respectively. This case report shows radiographical evidence of a decrease in osteophytes and subchondral cystic lesions on the stifle joint with OA after aAT-MSCs injection.