• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1419-1425
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• 1997

Primary mediastinal nonseminomatous germ cell tumor associated with Klinefelter's syndrome is a rare disorder. We experienced a case of recurred primary mediastinal nonseminomatous germ cell tumor developed in a 24-year-old patient with Klinefelter's syndrome. The patient had been treated with surgery and combination chemotherapy under the diagnosis of primary mediastinal nonseminomatous germ cell tumor before. A round mass was found on the right lower lung field in the chest X-ray during follow up. The patient was diagnosed as recurred primary nonseminomatous genu cell tumor and Klinefelter's syndrome through tumor markers, peripheral blood karyotyping, and other tests including hormonal assay and was treated with combination chemotherapy and surgery again. When the patient is diagnosed as primary mediastinal nonseminomatous germ cell tumor, Klinefelter's syndrome and hematologic malignancies should be considered to be associated diseases and vice versa.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.166-173
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• 2002

Transient peripheral eosinophilia occurs in several disorders, such as allergic diseases, cancer, and parasitic infections. However, in most cases, their presence is not accompanied by tissue destruction or organ dysfunction. In certain disease states, eosinophils can accumulate in any organ in the body and cause tissue destruction as a result of the eosinophil infiltration or the toxic effects of the degranulated proinflammatory products. Idiopathic hypereosinophilic syndrome is a rare disorder characterized by persistent eosinophilia of an unknown origin, usually associated with a dysfunction of organs such as the heart, lung, skin, and nervous system. Idiopathic hypereosinophilic syndrome usually has an indolent course over a period of several months. However, in some cases, they have grave symptoms if vital organs such as heart and lung are infiltrated. Here we report a case of idiopathic hypereosinophilic syndrome presenting acute pulmonary edema involving the heart, bone marrow, and lung with a review of the relevant literatures.

• Tuberculosis and Respiratory Diseases
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• v.82 no.3
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• pp.201-210
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• 2019

Background: Radial probe endobronchial ultrasound (R-EBUS) is widely used for diagnosing peripheral pulmonary lesions. However, the utility of R-EBUS-guided transbronchial lung biopsy (TBLB) for diffuse lung lesions (DLLs) remains unknown. We designed this study to evaluate the utility of R-EBUS-guided TBLB in DLLs. Methods: This retrospective study enrolled patients admitted from January 2016 to November 2017 who underwent TBLB for DLLs. The R-EBUS-guided TBLB and blind TBLB groups were compared. DLL was defined as any lung disorder that involved more than one segment of the lung. In both the groups, fluoroscopy and guided sheath were not used during TBLB. Results: A total of 127 patients underwent TBLB for DLLs (67 patients in the R-EBUS-guided TBLB group and 60 in the blind TBLB group). There were no differences in age, sex, and comorbid illnesses between the two groups. Furthermore, there was no difference in the TBLB diagnostic yield of the two groups (p=0.660) although more samples were collected from the R-EBUS-guided TBLB group (p=0.003). Procedure time was significantly longer in the R-EBUS-guided TBLB group than in the blind TBLB group (p<0.001). Thus, incidence of pneumothorax was significantly lower in the R-EBUS-guided TBLB group than in the blind TBLB group (p=0.032). Conclusion: Diagnostic yield in DLLs did not differ between the R-EBUS-guided TBLB and blind TBLB groups. Findings show that R-EBUS-guided TBLB in DLLs may reduce risk of pneumothorax.

• Neonatal Medicine
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• v.25 no.4
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• pp.137-143
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• 2018

Purpose: This study was performed to determine the clinical features of full-term infants with hypoxemia detected by pulse oximetry and to establish the diagnosis of critical congenital heart disease (CCHD). Methods: We retrospectively reviewed the medical records of neonates who had been admitted to the neonatal intensive care unit within 2 weeks of birth at Korea University Ansan Hospital between January 2013 and October 2017 (n=450). We classified these neonates based on the presence of hypoxemia at admission and investigated neonatal characteristics, initial symptoms, echocardiographic findings, and final diagnosis associated with hypoxemic diseases. Results: Of 450 term infants, 265 infants (58.9%) were identified hypoxemia by pulse oximetry at admission. The most common symptoms of them were cyanosis and tachypnea. Among them, 80.1% of infants (214/265) were diagnosed with respiratory tract disease and 8.3% of infants (22/265) had congenital heart disease. Thirteen infants (13/265, 4.9%) had CCHD and were treated with urgent surgery or transcatheter intervention within 28 days of birth. Majority of infants with respiratory tract disorder were transferred from hospital immediately after birth, but 46.1% of infants (6/13) with CCHD remained asymptomatic after birth and were admitted after 48 hours after birth. In addition, other hypoxemic illnesses were identified as neonatal infectious and neurological diseases. Conclusion: This study showed the importance of assessment in neonates with hypoxemia, including those diagnosed with CCHD. The possibility of CCHD should be considered in the differential diagnosis in neonates demonstrating hypoxemia after 48 hours of birth. A larger prospective study is needed to assess the effectiveness and outcomes of pulse oximetry for neonatal screening in Korea.

• Journal of Physiology & Pathology in Korean Medicine
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• v.34 no.6
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• pp.309-318
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• 2020

Besides respiratory infection, COVID-19 has many neurological symptoms not only loss of smell and taste but also fatigue and brain fog. But it is a challenge to treat the neurological symptoms especially of anosmia and ageusia. In order to search for the therapeutic methods, the geographical diversity and pathological mechanisms of the COVID-19 and two symptoms were investigated from the latest clinical studies. Because the environmental conditions of the monsoon climate zone of East Asia and the Mediterranean and Oceanic climate zone of Italy, Britain, United States and tropical Brazil are different, each of diverse etiology and internal milieu should be considered differently in the treatment. SARS-CoV-2 exhibits the dampness-like characteristics and the olfactory and gustatory disorders are particularly more common than other flu or cold. and it tends to show features of damaging the lung qi of olfaction and heart-spleen qi of gustation. The mechanisms of olfactory and gustatory loss are various according to precursory, inflammatory, non-inflammatory and sequelar forms, so the therapeutic method should be designed for each period and pathology. If the process of inflammation arises from nasal and respiratory, olfactory epithelium to the central nervous structure by way of blood brain barrier, the treatment should be corresponded with the stage and depth of pathogen place. And if the olfactory loss is asymptomatic or in the initial stage, it can be applied intranasal topical scent therapy to relieve temporary locking of qi movement, but maybe also used in parallel together with herbs of relieving dampness toxin latent in the lung parenchyma.

• International Journal of Heart Failure
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• v.6 no.2
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• pp.76-81
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• 2024

Background and Objectives: Real-world clinical data, outside of clinical trials and expert centers, on adverse events related to the use of SyncCardia total artificial heart (TAH) remain limited. We aim to analyze adverse events related to the use of SynCardia TAH reported to the Food and Drug Administration (FDA)'s Manufacturers and User Defined Experience (MAUDE) database. Methods: We reviewed the FDA's MAUDE database for any adverse events involving the use of SynCardia TAH from 1/01/2012 to 9/30/2020. All the events were independently reviewed by three physicians. Results: A total of 1,512 adverse events were identified in 453 "injury and death" reports in the MAUDE database. The most common adverse events reported were infection (20.2%) and device malfunction (20.1%). These were followed by bleeding events (16.5%), respiratory failure (10.1%), cerebrovascular accident (CVA)/other neurological dysfunction (8.7%), renal dysfunction (7.5%), hepatic dysfunction (2.2%), thromboembolic events (1.8%), pericardial effusion (1.8%), and hemolysis (1%). Death was reported in 49.4% of all the reported cases (n=224/453). The most common cause of death was multiorgan failure (n=73, 32.6%), followed by CVA/other non-specific neurological dysfunction (n=44, 19.7%), sepsis (n=24, 10.7%), withdrawal of support (n=20, 8.9%), device malfunction (n=11, 4.9%), bleeding (n=7, 3.1%), respiratory failure (n=7, 3.1%), gastrointestinal disorder (n=6, 2.7%), and cardiomyopathy (n=3, 1.3%). Conclusions: Infection was the most common adverse event following the implantation of TAH. Most of the deaths reported were due to multiorgan failure. Early recognition and management of any possible adverse events after the TAH implantation are essential to improve the procedural outcome and patient survival.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.58-63
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• 2005

Objectives: REM sleep behavior disorder (RBD), characterized by excessive motor activity during REM sleep, is associated with loss of muscle atonia. In recent years, it has been reported that RBD has high co-morbidity with CNS disorders (especially, Parkinson's disease, dementia, multiple system atrophy, etc.). We aimed to assess differences in clinical and polysomnographic findings among RBD patients, depending on the presence or absence of central nervous system (CNS) disorders. Methods: The medical records and polysomnographic data of 81 patients who had been diagnosed as having RBD were reviewed. The patients were classified into two groups: associated RBD (aRBD, i.e., with a clinical history and/or brain MRI evidence of CNS disorder) and idiopathic RBD (iRBD, i.e., without a clinical history and/or brain MRI evidence of CNS disorder) groups. Twenty-one patients (25.9%) belonged to the aRBD group and 60 patients (74.1%) belonged to the iRBD group. The clinical characteristics and polysomnographic findings of the two groups were compared. Results: Periodic limb movement disorder (PLMD), i.e., PLMI (periodic limb movement index)>5, was observed more frequently in the aRBD group than in the iRBD group (p<0.001, Fisher's exact test). Also, obstructive sleep apnea syndrome (OSAS), i.e., RDI (respiratory disturbance index)>5, was found more frequently in the aRBD group (p=0.0042, Fisher's exact test). The percentages for slow wave sleep and sleep efficiency were significantly lower in the aRBD group than in the iRBD group. Conclusion: We found that 1 out of 4 RBD patients had associated CNS disorders, warranting more careful neurological evaluation and follow-up in this category of RBD. In this category of RBD patients, we also found more frequent PLMD and OSAS. These patients were also found to have lower slow wave sleep and sleep efficiency. In summary, RBD patients with associated CNS disorders suffer from more disturbed sleep than those without them.

• Research in Community and Public Health Nursing
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• v.13 no.4
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• pp.595-607
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• 2002

The objectives of this study were to identify the phenomena of school health nursing at schools in Korea and to contribute to building a school health domain of International Classification for Nursing Practice. A retrospective method was used in this study to develop ICNP during the period from July to October 200l. The procedure of the study involved choosing nursing phenomena using preliminary terms from the reports on the field of school health nursing practice documented by nursing students in 10 different nursing colleges. The detail procedures of the study were as follows. 1) Choosing nursing phenomena by using preliminary terms 2) Choosing the characteristics of school health nursing practice from the selected nursing phenomena 3) In order to make a consensus regarding the appropriate characteristics of phenomena. 15 study group members re-categorized the nursing phenomena through 5 times of cyber meetings and 3 times of formal meetings. 4) To verify each characteristic, 5 community nursing faculties and 25 school health nurses participated in the procedure to give scores on nursing characteristics. 5) Classification of the definite nursing phenomena and characteristics. Following the 5 step procedures, school health nursing phenomena were categorized into human and environmental domains. Human domains were classified into human behavioral and functional domains. Environmental domains were classified into physical and psychosocial domains. The essential characteristics of each phenomena were selected when it obtains the mean score of 3.0 or over at the related characteristics. The human behavioral domain consisted of 7 phenomena including risk for spinal disorder, inadequate dietary habit, inadequate weight control, smoking and substance abuse, inadequate stress management, inadequate sex related coping strategies and inadequate accident management. The human functional domain consisted of 6 phenomena including inadequate eye care and visual management, risk for respiratory disorder, inadequate dental health care, inappropriate infectious disease control, risk for gastrointestinal disorder, and lack of sexual identity. The physical environmental domain consisted of 6 phenomena including risk for incident at inside classroom, risk for incident at outside classroom, risk for incident around school, risk for exposure to hazardous facilities around school. inadequate garbage and disposal management, and inadequate physical environment for learning. The psychosocial domain included impaired social interaction at school. Each phenomenon was composed of 2 to 8 characteristics and all phenomena will include a total number of 85 characteristics. The phenomena of school health nursing in Korea partially confirmed school health architecture of ICNP. Further study on verification of school health nursing phenomena in Korea needs to be done to support the findings of this study through review of literature on nursing classifications or field studies.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.1-10
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• 2019

Purpose : To investigate the relationship between breathing pattern disorder and joint position error (JPE) in patients with chronic low back pain (CLBP). Methods : Thirty nine patients with CLBP participated. End-tidal $CO_2$ and respiration rate (RR) were measured using a capnography. Breathing-hold time (BHT) and Nijmegen Questionnaire (NQ) were investigated. Thoracic excursion was measured with a cloth tape measurement technique. Joint position error were measured using a small laser point mounted on a lightweight headband. they were asked to relocate the head, after the neck movement on the horizontal plane. Pearson 's test was used for correlation analysis between respiratory variables and JPE in patients with CLBP. Independent t-test was used to verify the difference between thoracic and diaphragm breathing pattern in patients with CLBP. The significance level was set at 0.05. Results : There was a significant correlation between JPE (LR) and JPE (RR, EX) (r=.639, r=.813) (p<.001) and a low negative correlation with end-tidal $CO_2$ (r=-.357) (p<.05). There was a significant correlation between RR and JPE (EX) (r=.750) (p<.001). There was a low correlation between JPE (EX) and NQ (r=.333) (p<.05). There was a somewhat high negative correlation between NQ and thoracic excursion (r=-.528) (p<.001). There was a somewhat high negative correlation between thoracic excursion and JPE (LR, RR, EX) (r=-.470, r=-.484, r=-.602) (p<.001). There were no significant differences in the RR, BHT, NQ, and thoracic excursion between the thoracic and diaphragmatic breathing (p>.05). There was a significant difference in the JPE (EX), end - tidal $CO_2$, and VAS values between the thoracic and diaphragm breathing (p<.05). Conclusion : There was a correlation between JPE (EX) and NQ in patients with CLBP, and correlation between thoracic excursion and JPE (LR, RR, EX) and NQ. There was a significant difference in the JPE (EX), end-tidal $CO_2$ level, and VAS value in the comparison of thoracic breathing and diaphragm breathing. The results showed that breathing patterns and JPE were related to each other.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.26-33
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• 2021

Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘²=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘²=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.