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The Comparison on the General Characteristics of Acute Stroke Patients between Excess Syndrome and Deficiency Syndrome (급성기 뇌중풍 환자의 실증(實證) 및 허증(虛證)군 특성비교연구)

  • Leem, Jung-Tae;Kim, Mi-Young;Choi, Won-Woo;Min, In-Kyu;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.979-987
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    • 2008
  • Objectives : This study aimed to evaluate the characteristics of acute stroke patients between excess syndrome and deficiency syndrome groups. Method : We recruited stroke patients from the patients admitted to the Department of Internal Medicine of Kyunghee University Oriental Medical Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2008. We diagnosed acute stroke patients as either excess syndrome or deficiency syndrome and analyzed their characteristics for type of stroke, blood test result. Sasang constitution and lifestyle. Result : We found height, weight, BMI, W/H ratio, hypertension, diabetes, migraine, silent infarction, TG, total lipid, HDL-chol, RBC, Hb, hematocrit, alcohol, smoking and Sasang constitution (Tae-eum, So-yang) were more associated with the excess syndrome group. And we found sea food and Sasang constitution(So-eum) was more associated with the deficiency syndrome group. Conclusion : According to the analysis, we found that the excess syndrome group had more risk factors than the deficiency syndrome group. These results could be utilized in the future as a basis material for Oriental medicine therapy. Further studies will be needed to better understand the differences between excess syndrome and deficiency syndrome groups among acute stroke patients.

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The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Sexual Attitudes and Experience in Middle School Students, Kangwon-Do, Korea (강원도 중학생의 성 태도와 경험)

  • Yang, Soon-Ok;Jeong, Geum-Hee;Paik, Sung-Sook
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.482-501
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    • 1998
  • As an initial step toward the improvement of sexual education in middle school students, a survey on sexual attitudes and experience was done in Kangwon - Do, Korea. Questionnaires consisted of 68 items distributed to 240 boys and 240 girls from November 1 to December 20, 1996. Answers from 420 students were subjected to an analysis with SPSS. 92.4% of the girls experienced menstruation. Of them, 74.0% showed a negative reaction. 52.0% of the boys experienced night ejaculation. Of them, 81. 7% showed a negative reaction. Boys (64.3%) masturbated more than girls (17. 6%) (p= 0.0000). The understanding of masturbation was higher in boys than in girls (p = 0.0000). 87.2% of the subjects wished meetings with the opposite sex. During the meeting with the opposite sex, 12.9% of the students enjoyed drinking or smoking, 8.8% had intercourse. Boys(91.9%) watched pornography or porno-video more than girls(40.5%)(p=0.0000). 83.3% of the girls thought that both males and females should keep their virginity untill marriage. However, only 48.6% of boys thought that(p=0.0000). Of boys who had experienced sexual touch, 34.8% had intercourse. Of the 30 students(26 boys, 4 girls) who experienced sexual intercourse, 22 students had partners of the opposite sex and were friends. First intercourse 63.4% of these students had their in middle school period. The frequencys of sexual intercourse (more than 6times) was written by 12 students (40.0%). 24 students(16 boys and 8 girls) experienced sexual violence. As for dealing with sexual violence, 14 suffered by him or herself whill 7 students discussed it with a friend. There was a significant difference in the sources of information between boys and girls(p= 0.000), 36.0% had learned from an official sexual education source, usually from school nurses (74.0%). 92.6% of the students thought that sexual education was necessary. They believed that the appropriate person for sexual education was from a school nurse (53.1%) or from parents (19.5%). According to the above results, the following might be suggested: Realistic and future-directed sexual education material should be developed : Education programs to improve students insight and control sexual desire should be prepared: a systematic approach to activate the role of school nurse in sexual education should be prepared.

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A Study on the Relations between Yangseng Level and Obesity in Industrial Workers (근로자(勤勞者)의 양생수준(養生水準)과 비만(肥滿)과의 관계(關係))

  • Park, Jung-Eun;Yu, Seong-Gi;Lee, Hyung-Beom;Chong, Myong-Soo;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.1
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    • pp.65-84
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    • 2007
  • In this study, the researcher tried to present the groundwork to prepare the oriental medical yangseng plan for the future obesity with the comparison between yangseng level and the obesity of workers. The researcher made up the questionnaire which asks the general character, health-related character and yangseng level, projected among 560 people. All collected material was analyzed by SPSS and tested by T-test and ANOVA. 1. The general yangseng level average is 3.27, morality yangseng 3.90, sleep yangseng 3.39, mind yangseng 3.31, sex life yangseng 3.30, exercise yangseng 3.15, activities and rest yangseng 3.08, diet yangseng 2.94, seasonal yangseng 2.84. The highest is morality yangseng and seasonal yangseng is the lowest. 2. In the aspect of yangseng level: Having a spouse, Non-smoking, Regular exercising, Sufficient sleeping have higher yangseng levels. 3. Obesity related index is changing into the higher level when he/she is older, more paid, more job experience, more education background but less metabolic calory. And drinking and regular exercising have relativity with body composition analysis. 4. After comparing yangseng level with body composition analysis, we can easily find that the more visceral fat, the higher WHR has a high yangseng level. The more mineral also has a high mind yangseng and a low diet yangseng. The visceral fat level has a high yangseng level when higher morality yangseng and mind yangseng are getting higher and higher. And sex life yangseng shows that the highest yangseng level is from 9-10 visceral fat and the lowest yangseng level is from below 4 visceral fat. The higher WHR, the higher morality, mind and sleep yangseng. The heavier, the lower diet yangseng. The mind yangseng was very high when body fat rate was higher. The more body fat, the higher morality yangseng. The higher yangseng, when we have more muscle. Yangseng level and obesity of laborer has a close relationship with individual character and daily habits. Also, relevance can be easily found between yangseng level and obesity. Now the researcher came into the conclusion that we need to control over laborers' health and prevention of their obesity.

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A Study on the Relations between Yangseng Level and Stress in Industrial Workers (근로자(勤勞者)의 양생수준(養生水準)과 스트레스와의 관계(關係))

  • Ahn, Hun-Mo;Kim, Sung-Sam;Kim, Wan-Gyeom;Yu, Ho-Dal;Chong, Myong-Soo;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.1
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    • pp.109-129
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    • 2007
  • This study aims at grasping the relativity between laborers' yangseng level and stress so as to present the groundwork for preventive oriental medicine approach in industrial health. The researcher prepared the questionnaire on general character, health-related yangseng level and chose 632 people to execute Autonomic balance test through heartbeat change. The collected material was analyzed by SPSS and tested by T-test, ANOVA. The general yangseng level average is 3.27, morality yangseng 3.91, sleep yangseng 3.39, mind yangseng 3.32, sex life yangseng 3.29, exercise yangseng 3.14, activities and rest yangseng 3.07, diet yangseng 2.95, seasonal yangseng 2.84. The highest is morality yangseng and seasonal yangseng is the lowest. In the aspect of yangseng level : Having a spouse, Non-smoking, Non-drinking, Regular exercising, Sufficient sleeping have higher yanseng levels. In Autonomic balance test, age from 35 to 40 has the highest autonomic activity and job period from 5 years to 10 years has the highest stress resistance. Non-smokers have high autonomic activity and stress resistance. Further, have low autonomic balance, stress index and fatigue strength. In the case of regular exercising person, he/she has high autonomic activity and stress resistance with low stress index. Regarding sleeping time, autonomic balance is the highest when he/she sleeps less than 6 hours. Stress resistance is the highest when he/she sleeps 7 hours and stress index is the highest when he/she sleeps 6 hours. After comparing the relativity between yangseng level autonomic balance test, only exercise yangseng has plus factor on autonomic activity and stress resistance and minus factor on stress ind ex and fatigue strength. Yangseng level has been affected by individual character and daily habits. Also stress is more influenced by daily habits than by individual character. We can find the relativity of exercise yangseng between yangseng and stress which suggests that we need to take measures to win over stress in individual health in the near future.

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Effects of Tobacco-Specific Carcinogen on Protein Kinase C Isoforms (흡연특이성 발암물질이 특정 Protein Kinase C Isoform에 미치는 영향)

  • Kang, Hyung-Seok;Ko, Moo-Sung;Park, Ki-Sung;Lee, Sub;Jheon, Sang-Hoon;Kwon, Oh-Choon
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.666-673
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    • 2003
  • Cigarette smoking is the leading cause of the lung cancer. However, mechanism of action underlying the carcinogenesis in the lung still remains to be elucidated. The present study attempted to look into the carcinogenic potential of tobacco-specific nitrosamine, NNK (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone) and the effects of protein kinase C (PKC) isoforms in an immortalized human epithelial cell model. Material and Method: Immortalized human epithelial cells were exposed with NNK and examined for its carcinogenic potential as measured by saturation density, soft-agar colony formation, and cell aggregation assay. The specific isoform of PKCs involved in the cellular transformation was analysed through western blot with monoclonal antibody and measured separately in cytosolic fraction and membrane fraction. Result: Human epithelial cells exposed with NNK showed prominent carcinogenic potential in saturation density, soft agar colony formation, and cell aggregation assay. PKC isoform analysis results are as follows: PKC- $\alpha$ showed significant translocation of protein levels from cytosolic fraction to membrane fraction, as analyzed by immunoblot. PKC- $\varepsilon$ showed a dose-dependent increase of translocation. PKC- λ was not affected by NNK treatment. Conclusion: The study demonstrated that there was a certain specificity in the patterns of isoform induction following chemical carcinogen exposure. Thus, it is suggested that identification of specific isoform be a clue to find target molecules in the carcinogenesis.

Clinical Significance of Increased Ki-67 Protein Expression in Non-small Cell Lung Cancers (비소세포폐암 환자에시 Ki-67 단백질 발현증가의 임상적 의의)

  • Lee Gun;Lim Chang-Young;Kim Kwang-Il;Lee Hyeon-Jae
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.376-381
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    • 2006
  • Background: The Ki-67 protein is a biomarker associated with cell proliferation and a valuable negative prognostic factor in non-small cell lung cancer. We investigated the Ki-67 protein expression in resected non-small cell lung cancer to evaluate the impact on clinicopathological characteristics and postoperative prognosis. Material and Method: Using monoclonal antibody Ki-67, we immunohistochemically examined 38 surgically resected non-small ceil lung cancers to determine Ki-67 Labeling Index (LI). We analysed the differences of clinicopathological characteristics and postoperative recurrence and survival between High Ki-67 Group $(LI{\ge}20%)$ and Low Ki-67 Group (LI<20%). Result: The Ki-67 LIs were heterogenous and a mean values was $20.0{\pm}20.05%$. There were no significant differences in age, sex, smoking, TNM stage, and vascular invasion between High Ki-67 Group and Low Ki-67 Group. A High Ki-67 Group was significantly associated with squamous cell type, poor differentiation, and lymphatic invasion $(p{\le}0.05)$. High Ki-67 Group showed a trend of lower survival (median 47.2 vs. 90.5 months, p=0.312) and lower disease-free survival (median 18.2 vs. 72.3 months, p=0.327) than Low Ki-67 Group. Conclusion: These results indicate that increased Ki-67 protein expression may be a negative prognostic factor and showed a trend of shortened survival and disease-free survival. To evaluate the pivotal role of Ki-67 protein expression, a long-term follow-up and further study are required.

Risk Factors for Recurrent Pneumothorax after Primary Spontaneous Pneumothorax (원발 기흉 수술 후 재발의 위험인자)

  • Yu, Jai-Kun;Lee, Seong-Ki;Seo, Hong-Joo;Seo, Min-Bum
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.724-728
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    • 2008
  • Background: The purpose of this study was to identify factors associated with recurrent pneumothorax after wedge resection in primary spontaneous pneumothorax in our hospital. Material and Method: Two hundred thirty-five consecutive patient (98% males; mean age, $23.9{\pm}4.5$ years) who had undergone video-assisted thoracoscopic surgery (VATS) were reviewed retrospectively. The two groups were divided as follows: group A, non-recurrent patients (225 patients [96%]); and group B, recurrent group (10 patients [4%]); the risk factors were compared between the two groups. The single and multiple factors that influenced the recurrence rate were analyzed using Cox's proportional hazard model. Result: There were no significant differences between the recurrent and non-recurrent groups in terms of gender, smoking, site of recurrence, degree of collapse, operative time, and number or weight of resected bullae. The recurrence rate was significantly more common in the following: younger ages, increased height/weight ratio, longer initial air leakage period, and shorter duration of chest drainage. Early aggressive exercise (<30 days) of patients after wedge resection increased the tendency for recurrence. Conclusion: Thoracoscopic wedge resection does not have a higher recurrence rate than open thoracotomy. However, young age, height/weight ratio, continuous air, and duration of chest tube placement were risk factors for a recurrent pneumothorax.

Clinical Study of Extra-anatomic Bypass (해부외 회로 조성술에 관한 임상적 고찰)

  • Kim Jong Won;Chung Sung Woon
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.377-381
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    • 2005
  • Background: Extra-anatomic bypass was performed in the patient who could not use anatomic bypass due to many causes. The purpose of this study is to evaluate the efficacy of extra-anatomic bypass surgery. Material and Method: We reviewed 31 patients who underwent extra-anatomic bypass surgery at Pusan national university hospital. We analysed the combined diseases, etiologic diseases, symptoms, patency rate and the factors affecting patency rate retrospectively. Result: There were 26 cases of femoro-femoral bypass and 5 cases of axillo-bifemoral bypass among 31 patients. The mean age was 70.23 years. Combined disease were hypertension, hyperlipidemia, and ischemic heart disease in order of frequency. The indications for surgery were disabled claudication, tissue necrosis, rest pain, and a cute ischemia. We analysed the ages, smoking history, hypertension, ischemic heart disease, severity of limb ischemia, and hyperlipidemia as factors affecting patency rate. We could not find any statistical differences between these factors. The primary graft patency rates were $73.65\%$ one year, $73.65\%$ two year, and $65.46\%$ three year respectively according to the Kaplan-Meier method. Conclusion: Nevertheless extra-anatomic bypass has a relatively low patency rate, it has good merits that is less dangerous, simple and easy re-do surgery compared to anatomic bypass. We think that extra-anatomic bypass is one of the good treatment modalities for the high risk vascular patients.

Simultaneous Bilateral Spontaneous Pneumothorax (동시에 발생한 양측성 자발성 기흉)

  • Kim Eung-Soo;Sohn Sang-Tae;Kang Jong-Yael
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.475-478
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    • 2006
  • Background: The simultaneous bilateral spontaneous pneumothorax is a rare clinical event. Contrary to the unilateral pneumothorax, the patients with simultaneous bilateral spontaneous pneumothorax sometimes complains of severe respiratory distress, cyanosis and chest pain without tention pneumothorax. It is often dangerous; therefore, the chest drain should be inserted immediately. Material and Method: Between March 1994 and February 2004, 802 patients were treated in our department for spontaneous pneumothorax. Among these, the simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%). Result: Out of fourteen patients, two females and twelve males presented with simultaneous bilateral spontaneous pneumothorax. The patient age ranged between 0 and 79 years with mean age of 31.2 years. In eleven patients, this was the first episode of pneumothorax. One patient had combined hemopneumothorax and two patients had combined pyopneurnothorax. Six patients had smoking history (42.8%, average 17.3 p-y). Five patients had pulmonary tuberculosis history and among these, two patients had active pulmonary tuberculosis. Three patients were died due to meconium-aspiration pneumonia (1 patient) and ARDS (Acute Respiratory Distress Syndrome) with pneumonia (2 patients). We treated these patients with nasal oxygen inhalation, chest drain insertion, thoracotomy, VATS (Video-Assisted Thoracoscopic Surgery) and chemical pleurodesis. Conclusion: The simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%) among 802 patients. Prompt insertion of chest drain is needed for a relief of severe symptoms, and to reduce the risk of recurrence, early thoracotomy or VATS should be performed rather than chest drain insertion only.