• Journal of Chest Surgery
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• 제35권8호
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• pp.584-589
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• 2002

배경: 흉복부 대동맥 질환 수술은 부위에 따라 사용되는 수술법이 다양하며 각 방법마다 장단점이 있어 논란의 대상이 되고 있다. 이에 저자들은 지금까지 여러 방법으로 흉복부 대동맥 질환을 수술한 성적과 위험 요소를 분석하여 보고하고자 한다. 대상 및 방법: 1992년 6월부터 2001년 8월까지 저자들은 36명의 흉복부 대동맥 수술을 시행하였다. 이중 17명은 대동맥 박리증, 17명은 대동맥류, 1명은 대동맥 축착증에 병발한 대동맥박리증, 1명은 외상성 대동맥손상이었다. 수술은 26례에서 흉부대동맥 치환술을, 10명에서 흉복부 대동맥 치환술을 시행하였다. 흉부대동맥치환술은 11명에서 좌심방대퇴동맥간 centrifugal 펌프을 통한 우회로를 하며 수술하였고, 11명에서 대퇴동정맥 사이에, 4명은 우심방과 상행대동맥 사이에 심폐기를 가동하며 이중 6명은 극저체온순환정지하에 수술을 하였다. 흉복부대동맥 치환술은 6명에서 대퇴동정맥을 통한 심폐기를 가동시키며 수술하였고 3명은 대퇴정맥에 삽관하여 흡입한 혈액을 pump 로 주입하며 수술을 하였고 한 명은 심폐기의 도움없이 수술하였다. 결과: 수술합병증은 신부전 7례, 간기능부전 11례, 폐혈증 2례, 호흡부전 5례, 심부전 2례, 뇌경색 7례, 허혈성 척추손상 1례 등이 발생되었다. 술 후 원내 사망은 9례로 수술직후 24시간 이내 사망한 경우가 6례로 사망원인은 출혈 2례, 심부전 2례, 신부전 2례 등이었고, 수술 후 1주 뒤 원내 사망은 3례로 패혈증, 호흡부전증, 뇌경색증 등으로 사망하였다. 퇴원 후 만기 사망은 3례로 사인은 원위부 파열로 인한 쇽 와 뇌경색증 폐렴 합병증으로 사망하였다. 결론: 흉부대동맥치환술을 받은 환자 26명 중 수술사망은 5명이며 이중 3명이 극저체온 순환정지하에 수술을 시행받은 환자들이었다. 흉복부대동맥 치환술을 받은 10명 중 수술사망은 4명이었고 이중 2명이 복부동맥을 같이 광범위하게 치환한 환자들이었다.

• 대한통합의학회지
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• 제8권4호
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• pp.79-92
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• 2020

Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.

• Journal of Chest Surgery
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• 제18권4호
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• pp.537-541
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• 1985

Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

• Journal of Ginseng Research
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• 제34권2호
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• pp.122-131
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• 2010

This clinical study was performed to evaluate whether supplementation of proton pump inhibitor (PPI)-based triple therapy with Korean red ginseng can enhance Helicobacter pylori (H. pylori) eradication and reduce levels of halitosis-associated volatile sulfur compounds (VSCs) in the stomach. Seventy-six patients were randomized into an eradication regimen-only group (n=45) or an eradication regimen plus 10 weeks of Korean red ginseng supplementation group (n=31). The eradication regimen consisted of PPI b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d.. for seven days. Korean red ginseng supplementation commenced on the last day of the eradication regimen. $^{13}C$-urea breath test and halimeter measurements were performed prior to protocol repetition. By intention-to-treat analysis, the H. pylori eradication rate in the Korean red ginseng group (77.4%, 24 of 31) was higher than that in the control group (45.0%, 26 of 45). However, by per protocol analysis, the eradication rate in the Korean red ginseng group was significantly higher than that in the control group (92.3%, 24/26 vs. 69.4%, 26/38; p<0.05). H. pylori infection was significantly associated with increased VSC levels. However, VSC levels decreased significantly in the Korean red ginseng group (p<0.05). In conclusion, supplementation of triple therapy with Korean red ginseng increased the H. pylori eradication rate and led to significant reductions in VSC levels, suggesting the usefulness of this substance in combating H. pylori infection.

• 사상체질의학회지
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• 제23권1호
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• pp.132-138
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• 2011

1. Objectives: This case study reports a Taeumin patient with Gastro-esophageal reflux disease who had suffered from chest pain, heartburn, acid regurgitation and dyspepsia who improved after Yeoldahanso-tang(Reduohanshao-tang) medication. 2. Methods: This patient had started treatment with Yeoldahanso-tang(Reduohanshao-tang), three times per day for three months and assessed the changes of the main symptoms such as chest pain, heartburn and acid regurgitation from baseline to post-treatment using a questionnaire with visual analogue scale(VAS). Electrogastrography(EGG) was also performed for assessment of gastric function from baseline to post-treatment. 3. Results: After the treatment, symptoms of GERD such as chest pain, heartburn, and acid regurgitation are almost disappeared. The patient don't need to take the proton pump inhibitor therapy. There was significant increase of % bradygastria parameters in fed EEG after treatment with Yeoldahansotang(Reduohanshao-tang). And significant increase of the power ratio after treatment was shown (20.5), compared with initial EGG(0.0). 4. Conclusions: This results show Yeoldahanso-tang(Reduohanshao-tang) can be used to treat GERD with Dry-heat symptom of Taeumin. This results suggest that Sasang Constitutional treatment for GERD patients who has a chronic condition with highly recurrence rate, might be a candidate for a therapeutic agent. Also effects of Yeoldahanso-tang(Reduohanshaotang) on GERD need further studies such as clinical trials.

• 한국멀티미디어학회논문지
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• 제17권11호
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• pp.1363-1373
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• 2014

In this study, a hybrid multi-cup electric cupping system (HMECS) was proposed, based on the ancient cupping method. HMECS consisted of several cups that could be used simultaneously to treat different areas of the patient's body. Each cup was equipped with its own pump and pressure-monitoring system. Moreover, the vacuum pressure of the cups was controlled using fuzzy logic. Through automated control of the vacuum pressure, long-term relief of muscle tightness was achieved. To develop a scientific foundation for this alternative treatment, we compared the VAS(Visual Analog Scale) and ODI(Oswestry Disability Index) scores from conventional basic cupping to the VAS and ODI scores for our proposed HMECS. The improvement rate in the VAS and ODI scores using HMECS after three treatments was higher than that achieved by basic cupping. These results, combined with the convenience offered by enhanced IT capabilities, should increase the popularity of this device among an aging society, and facilitate the opportunity to further explore the potential of Oriental medical practices.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.20-25
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• 2022

Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst^®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst^® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst^® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst^® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst^® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst^® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst^® treatment as a standard treatment for globus.

• Journal of Chest Surgery
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• 제40권3호
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• pp.209-214
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• 2007

배경: 경피적 관상동맥 성형술(angioplasty, translumial, percutaneous coronary, PTCA)은 현재 거의 모든 관상동맥 협착증 환자에서 시도되고 있다. 따라서 PTCA 실패로 인한 치명적인 응급 상황도 나타나고 있다. 이 연구에서는 PTCA의 실패로 응급 관상동맥 우회술이 필요했던 환자의 임상결과를 분석하고자 한다. 대상 및 방법: 1988년 5월부터 2005년 5월까지 총 5,712예의 PTCA를 시행했고 그 중 실패 후 발생한 응급 환자는 84명(1.4%)이었고 이 중 응급 수술이 가능했던 27명(32.1%)을 대상으로 하였다. 환자들의 평균 연령은 $63.7{\pm}8.9\;(46{\sim}80)$세이었고, 그 중 남자가 14명(51.9%)이었다. PTCA 전 진단은 급성 심근경색(12명), 불안정형 협심증(13명), 안정형 협심증(2명)이었다. 결과: PTCA 실패의 원인으로는 새로운 색전에 의한 관상동맥 폐쇄가 4명, 시술 도중 관상동맥 박리가 17명, 관상동맥 파열이 3명, 기타가 3명이었다. 수술이 가능했던 환자들은 6시간 내로 응급수술을 시행했고 그 중 22명은 고식적 관상동맥 우회술(coronary artery bypass grafting, CABG)을 받았고 5명은 off-pump CABG (OPCAB)을 받았다. 평균 사용된 이식편의 수는 $2.58{\pm}0.95$개였다. 수술 환자 중에서는 18.5%의 사망률을 보였다(5/27). 단변량 분석에서는 수술 환자들의 사망률은 좌전하행지 침범유무, 수술 전 쇼크상태, 수술 후 2가지 이상의 수축 촉진제의 사용, 수술 후에도 대동맥 풍선 펌프를 사용한 경우가 통계적으로 유의하게 나타났다. 결론: PTCA는 환자들이 수술에 비해 상대적으로 안전하다고 생각하지만 PTCA 실패로 인한 응급상황이 발생 시에는 매우 높은 사망률을 보이며 관상동맥 우회술을 시행하더라도 수술 사망률 및 수술 부작용이 상대적으로 높다. 따라서, 치명적인 합병증이 생길 수 있으므로 신중한 환자의 선택이 요구되며 합병증의 발생 시 적극적인 수술 치료를 준비해야 한다.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.255-260
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• 2013

Purpose: For the treat hypothermia patients, active warming might be needed. In most emergency departments, IV warm saline infusion is used for treatments. However, during IV warm saline infusion, heat loss from the warm saline may occur and aggravate hypothermia. Thus, in this study, we conducted an experiment on conserving heat loss from warm saline by using a simple method. Methods: Four insulation methods were used for this study. 1) wrapping the set tube for the administration of the IV fluid with a cotton bandage, 2) wrapping the set tube for the administration of the IV fluid with a cotton bandage with aluminum foil, 3) wrapping the warm saline bag and tube with a cotton bandage, and 4) wrapping the warm saline bag and tube with a cotton bandage with aluminum foil. Intravenous fluid was preheated to a temperature between $38-40^{\circ}C$. The temperatures of the saline bag temperature and the distal end of the IV administration set were measured every ten minutes for an hour. The infusion rate was 1000 cc/hr, and to obtain an accurate infusion rate, we used an infusion pump. Results: The mean initial temperature of the saline bag was $39.11^{\circ}C$. An hour later, the fluid temperature at the distal end of the fluid temperature ranged from $39.11^{\circ}C$ to $34.3^{\circ}C$. Without any insulation, the initial temperature of the pre-heated warm saline, $39^{\circ}$ had decreased to $34.8^{\circ}C$ after having been run through the 170-cm-long IV administration tube, and after 1-hour, the temperature was $29.63^{\circ}C$. As we expected, heat loss was prevented most by wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil. Conclusion: Wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil can prevent heat loss during IV infusion in Emergency departments.

• 한국어병학회지
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• 제18권1호
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• pp.91-97
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• 2005

침지식 해수 순환 여과 사육 시스템에서 여과조 숙성과 넙치의 성장을 조사하였다. 생물 여과조가 숙성되는데 60일이 소요되었다. 사육 기간 중 수온은 17.5-25.1$^{\circ}C$, 염분은 30.1-33.5ppt, 용존산소는 7.25-10.49ppm, pH는 8.1-7.5를 유지하였다. 사육수는 매일 5% 범위에서 환수하였으며 사육수의 암모니아성 질소 및 아질산성 질소 농도는 각각 0.096-0.315mg/L 및 0.015-0.504mg/L이었으나, 질산성 질소는 질산화 과정이 지속되어 그 농도가 2.530mg/L에서 39.517mg/L까지 증가하였다. 사료 효율은 64.1-69.8% 이었고, 사육 밀도는 시험 종료 시 15.9kg/$m^2$이었다. 사육기간 중 Vibrio spp.는 검출되었으나 질병 발생에 의한 폐사는 없었으며 생존율은 97.1%를 나타내었다.