• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.675-679
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• 2005

Background: Clinical reports on replacement of all three (AV + MV + TV) valves are rare. Material and Method: From January 1992 to December 2003, 38 patients received triple valve replacement (aortic, mitral, tricuspid) at Yonsei Cardiovascular Center. Mean age of patients was $49.5\pm10.7 (28\~69)$ years, and 24 patients $(63.1\%)$ were female. Rheumatic valve disease was the most common cause of operation (n=37). Preoperative New York Heart Association functional class were II in 4, III in 24 and IV in 10. Fifteen patients (group 1) received triple valve replacement at their first operation. Twenty three patients (group 2) received one or more operations before tricuspid valve replacement (TVR). Seven patients received tricuspid valve annuloplasty at first operation and received TVR later. Result: Six patients died at hospital after operation $(15.8\%)$ and all these patients were in group 2. All patients in group I survived and were discharged. Three patients $(9.4\%)$ died during follow up periods. Most of the survivors had improved functional class (I in 22, II in 8, III in 1, IV in 1). During follow up period, there were 4 valve related complications. The 10-year survival rate was $68.8\%$ and survival rate for free from valve related event at 10 years was $85.5\%$. Conclusion: After triple valve replacement, most patients showed improvement of symptoms. And during follow up period, valve related complications and survival were acceptable. Therefore, if indicated, triple valve replacement is recommended before the patients' conditions get worse.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.812-819
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• 2003

Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

• Journal of muscle and joint health
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• v.22 no.2
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• pp.105-113
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• 2015

Purpose: The purpose of this study was to examine the effects of the new version of the arthritis self-management program (ASMP) developed by the Korean Society of Muscle and Joint Health. Methods: A total of 150 patients with osteoarthritis (OA) were participated in a 6-week self-arthritis management program provided once a week in 3 community health centers. Each session took 1.5 hours. This study measured present health status, frequency of fall during last 3 months, pain, difficulties in activity of daily living, exercise-related efficacy, flexibility of both arms, balance, and health-related quality of life. Results: After a 6-week program, pain, difficulties in ADL, present health status, exercise-related efficacy, health-related quality of life, flexibility of both shoulders, and balance were significantly improved. Conclusion: The results showed the possibility of the 6-week ASMP program in improving health state, physical function, and health-related quality of life in patients with OA.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.381-393
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• 2016

This was a qualitative study to explore and better understand the adaptation experience and processes of peoples with fibromyalgia syndrome (FMS), as well as to develop a substantive theory using the grounded theory method. There were 13 patients (12 females and 1 male) who received FMS treatment from Rheumatic Medicine outpatient department of one general hospital. The data were collected through an in-depth interview between January and May of 2014. Transcribed interview contents were analyzed by the grounded theory method of Corbin and Strauss (2008). As a result, a total of 98 concepts, 26 sub-categories, and 10 categories were identified through the open coding process. The process of adaptation experience showed 4 steps: perception of uncertainty and limited condition, evaluation of self-control possibility and determinations of expectations of life, searching and trying of strategies, as well as self-regulation. The 4 types of adaptation experience were expansionary, complacently, effusively and withering. The 'protective self-regulation' theory was derived from the core category of 'learning to self-regulation method'. Patients with FMS has repeatedly attempted these strategies of protective self-regulation in order to gain stability from uncertainty and limited condition of the disease. Based on these results, it is necessary to develop an educational program for patients and families which has appropriate nursing intervention strategies in accordance with the types of adaptation.

• Pediatric Infection and Vaccine
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• v.8 no.1
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• pp.90-93
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• 2001

Purpose : The accurate diagnosis and proper treatment of group A streptococal infection should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. Inadequate & improperance of antobiotics have resulted in increased number of antibiotic-resistant bacteria. We would like to know the clinical usefulness of rapid strep test compared with conventional throat culture in out-patients with acute pharyngotonsilitis. Methods : From Sep. 2000. to Jan. 2001, rapid strep test(LINK 2 Strep A, USA) & throat culture were taken from 87 patients with clinically suspect pharyngotonsilitis from Masan Fatima hospital & kyunghee university hospital. Results : Of 87 cases with pharyngitis, 39 cases proved to have group A streptococci by throat culture. The positive predictive value of rapid test was 92.3%(36 of 39 cases) and sensitivity test was 81.8%(36 of 44 cases). The specificity of rapid test was 93.0%(40 of 43 cases) and negative predictive value was 83.3%(40 of 48 cases). Conclusion : The positive predictive value & specificity of rapid strep test is high. And so, this test will give the pediatricians practical guidance of antibiotic use in patients with pharyngitis. But more efforts should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.195-211
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• 2018

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.51-61
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• 2023

BACKGROUND: Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS: In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS: The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS: This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.480-486
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• 2009

Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.237-241
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• 2006

Infective endocarditis remains an important, life-threatening infection despite improvements in diagnosis and management. Despite the decrease in rheumatic heart disease and the improvements in antibiotic prophylaxis, infective endocarditis has been reported with increasing frequency in the last few decades. Presumably, this is due to the rise in the incidence of intravenous drug users, carriers of prosthetic valves and other intracardiac devices, and the longer survival of patients with congenital heart disease. Despite the great advances in medical and surgical treatment, infective endocarditis is still a life-threatening disease with an estimated mortality of 27%. Infective endocarditis represents one of the few potentially fatal infections that may occur in a dental patient. Efforts to reduce the incidence of this disease usually take the form of appropriate antibiotic coverage before dental treatment, together with the establishment and maintenance of good oral health. This study is a case report of a patient who developed infective endocarditis after multiple tooth extractions due to chronic periodontitis of dental origin.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.62-65
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• 2011

Eagle's syndrome occurs when an elongated styloid process or calcified stylohyoid ligament causes recurrent throat pain or foreign body sensation, dysphagia. It is supposed that this symptoms and signs are due to the compression of the styloid process on some neural and vascular structures. More uncommonly, symptoms such as dysphagia, tinnitus, and otalgia may occur in patients with this syndrome. It may also cause stroke due to the compression of carotid arteries. The compression depends on the size, shape, and orientation of the ossified styloid process Besides, degenerative or inflammatory changes in the tendinous portion of the styloid ligament insertion or rheumatic styloiditis may also cause this syndrome. Diagnosis can usually be made on physical examination by digital palpation of the styloid process in the tonsiller fossa. Three-dimensional computed tomography can utilized for supporting diagnosis. The treatment of Eagle's syndrome is primarily surgical. The styloid process can be shortened through an intraoral and extraoral approach. We report a 62-years-old man with the symptomatology of Eagle's syndrome and literature reviews.