• The Journal of Korean Medicine
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• v.19 no.2
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• pp.296-312
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• 1998

BACKGROUND The purpose of this study was to find out predictors influencing on the clinical course of stroke during the first 4 weeks after the onset through statistical research, especially whether the blood glucose level after stroke and the stroke with Diabetes Mellitus correlate with functional impairments and neurological outcome or not. METHOD During 7 months period(from 1-1-1997 to 7-31-1997), 32 selected patients prognosed as acute cerebral thrombosis were studied by using Modified Barthel Index, PULSES profile in an attempt to correlate Diabetes Mellitus and hyperglycemia(more than $120mg/d{\ell}$, $150mg/d{\ell}$) with functional impairment and neurological outcome and to evaluate the influence of sex, the side of hemiparesis and age at admission, 1 week and 4 weeks after admision(admitted within 2 days after the onset). RESULT 1. The sex, side of hemiparesis and age had no significant effect upon functional impairment during first 4 weeks after the onset, but recurrent-stroke resulted in significantly higher degree of functional impairment than first-stroke during first 4 weeks after the onset. 2. The patients with Diabetes Mellitusin in acute cerebral thrombosis resulted in significantly higher degree of functional impairment than the patients without Diabetes Mellitus in acute cerebral thrombosis during first 4 weeks after the onset. 3. The patients with hyperglycemia in acute cerebral thrombosis resulted in significantly more severe neurological outcome than the patients without hyperglycemia in acute cerebral thrombosis within 2 days after the onset. CONCLUSION The study suggested that recurrent-stroke and Diabetes Mellitus were the poorer prognosis factors of functional impairment in acute cerebral thrombosis patients during first 4 weeks after the onset. and the poorer prognosis factor of neurological outcome in acute cerebral thrombosis patients was hyperglycemia within 2 days after the onset.

• Advances in pediatric surgery
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• v.1 no.1
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• pp.18-26
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• 1995

For the prevention of later contralateral hernia as well as unnecessary contralateral exploration in pediatric patients with unilateral inguinal hernias, a reasonable indication of contralateral exploration is required. To examine the contralateral positivity, a prospective selective contralateral exploration has been performed by the author from Sept. 1985 to Dec. 1993, at Pediatric Surgical Section of the Department of Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College. Among the total 1200 cases of pediatric inguinal hernias, 580 cases of contralateral side were explored at hernia operations, by the indications as; male with infant onset, 2)female of all age, 3)prematurity, 4)profuse ascites due to cirrhosis, nephrotic syndrome, and ventriculoperitoneal shunt, and 5)remarkable silk sign. Overall positive rate was 71.4%, and positive rates of each indication were 80.7%, 70.4%, 73.1%, 66.7%, and 72.0%, respectively. Right side hernia showed 67.0%, left s ide 75.7%, and positive familial history 71.8% of contralateral positivities. In male, getting older revealed lower positive rates and the rate suddenly dropped after 12 years of age. Birth order, mother's age at delivery, postmaturity did not show any significant differences between the rates. Recurrence was seen in 3(0.5%) ipsilateral and 2(0.3%) contralateral, both of which were negative esplorations on previons operations. Overall complication rate was 3.8%, including 1 infection, 14 fluid or blood accumulation, 5 edemas, 3 temporary testicular edemas, 2 persisting fevers, 2 enures is and one delayed recovery from anesthesia. Among 38 cases with contralateral hernias developed after unilateral surgery by authors(6 cases) or surgeons in other institutions, 14 were males with infant onset, 4 were prematurities and 9 were females. Therefore, 27(71.7%) cases were originally under the contralateral exploration indications. The primary site of the hermia was right in 25 and left in 13. With above results, the following indications for contralateral exploration could be suggested ; 1)under one year of age, both sex, 2)prematurity, 3) remarkable silk sign, 4)in the double checked suspicions among males with infant onset, all age females, ascites, left hernia and familial history. After 12 years of age, exploration is not required. Considering complications, contralateral explorations could be considered only in the following situations; 1)expert, experienced pediatric surgeon, 2)experienced pediatric anesthesiologist, 3)operations could be done smoothly in an hour, 4)good general condition of the patient.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.5
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• pp.1075-1078
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• 2002

Objective: The management for the stroke should ,given as soon as possible to be effect. But Patients with stroke symptoms commonly delay many hours before seeking medical attention. We evaluated the factors which are related to the time of hospital arrival after acute stroke. Method: Data were obtained from 317 patients admitted to our hospital within 72 hours of stroke onset. We assessed demographic variables, stoke subtype. referral routes. history of previous stroke, level of consciousness, distance from the place where stroke occurred to hospital, and the time interval between onset of stroke and arrival at the hospital. Results: Mean patient age was 65.99±9.57 years. The mean time interval between onset of stroke and hospital arrival was 17.26±18.69 hours and 128 (40.38%) patients arrived within 6 hours. The patients whoes stoke subtype was infarction, who arrived our hospital by way of other hospital, who had no suffered from previous stroke and who showed no impairement of consciousness was arrived at the hospital late(p<0.05). Conclusion: The majority of patients arrive at the hospital after prolonged delays for multiple reasons, and patients with milder symptoms, for whom treatment might be more effective, were less likely to arrive in time for therapy. Our study suggest that effective education about stroke to the patients and public would be highly necessary.

• Annals of Clinical Neurophysiology
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• v.3 no.2
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• pp.122-127
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• 2001

Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of sudden onset and account more than 50% of facial paralysis. It's etiology is unclear, but herpes simplex virus type-1(HSV-1) has been the most suspicious causative agent of BP that ever been studied. We evaluated the effect of add-on acyclovir in acute stage of BP. Methods : Subject consisted of 35 patients who developed acute idiopathic unilateral facial nerve palsy(16 men and 19 women with age 9-78 years old). The treatments were started within 10 days after onset of BP. Facial nerve function was assessed by the House-Brackman facial nerve grading scale and facial nerve conduction study including blink reflex. Follow-up evaluation were made 2 month after onset. Twenty of 35 patients were treated with combined therapy of acyclovir and prednisone. As a control group, 15 patients were treated with prednisone only. We compared the improvement of neurologic defects at recovery phase. Results : Compared with two groups, difference in grading scale at recovery phase is statistically significant(p<0.01). So, acyclovir-prednisone group showed a significant improvement in grading scale at recovery phase compared with prednisone group. Conclusion : We identified the benefits of add-on acyclovir in the acute stage of BP.

• The Journal of Internal Korean Medicine
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• v.21 no.2
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• pp.203-212
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• 2000

Objective : We studied only patients at the acute stage but existing studies on stroke didn't almost classify the stage. We examined 243 patients admitted to the Woo Suk university oriental medical hospital from January 1998 to December 1999 for 2 years. Methods : We analyzed patients into sex, Sasang constitution, the incidence and lesion according to the stroke types, post and family history, onset time, period to admission and physical treatment from onset, and symptom, blood pressure, cholesterol level and herb medicine at entry. Results : Our study was similar to existing studies in the distribution of sex, age and the lesion of stroke, post and family history, and symptoms at entry. But it differed in the constitution, incidence of cerebral infarction and intracranial hemorrhage, attack time, period to admission and physical treatment from onset day, and the symptoms, blood pressure, cholesterol level and herb medication. In comparison between infarction and hemorrhage patients, there was some difference in the distribution of onset time, but wasn't in the cholesterol level. Conclusions : Our study on the acute stage of stroke was similar to existing studies in the general characteristics. But it showed some differences in the herb medicine at entry. In particular, there were much differences in the blood pressure at entry and the incidence of infarction and hemorrhage. We hoped that stroke patients would be synthetically studied in western and oriental medicine.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.115-120
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• 2010

Background: Pediatric deep neck infection can cause critical complications in that they are seldom able to verbalize symptoms or cooperate with physical examination. The objective of this study is to identify the clinical characteristics according to age. Material and Method: A retrospective study was performed on 26 cases with pediatric deep neck infection during 12 years. Patients were classified infancy group (1-7 yr, 19.2%), preschool age group (7-15 yr, 30.8%) and school age group (15 yr-, 50%). We analyzed the age, sex, sites of abscess, predisposing factors, symptoms and compared onset, hospital date, laboratory and outcomes at each group. Results: In pediatric patients with deep neck infection, the age distribution was 18 males (69.2%) and 8 females (30.8%), the mean age was 7.4 years. The most common infection site was the anterior cervical triangle and submandibular space (19.2%). The most commonly known associated preceding disease was upper viral infection (34.6%), but we could not find the preceding diseases in most of cases (50%). Neck swelling (69.2%) was the most frequent symptom. The mean age of patients who performed neck CT was 8.23 years and neck US was 2.75 years. The younger patients were preferred to perform the neck US than the neck CT (p=0.022). The mean time from disease onset to admission was 9 days in the infancy, 5.5 days in the preschool aged and 5 days in the school aged group. The surgical treatment was performed in 30.8% of school aged, 62.5% of preschool aged and 100% of infancy group. Surgical treatment was preferred to younger patients (p=0.026). Conclusion: Abscess sites, size, and antibiotics susceptibility and especially patient age should be carefully considered in treating pediatric deep neck infection.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.232-239
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• 1992

Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

• Journal of Acupuncture Research
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• v.34 no.3
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• pp.23-38
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• 2017

Objectives : The purpose of this study was to evaluate the clinical prognostic factors affecting facial palsy in 98 idiopathic facial palsy patients who were hospitalized and treated in 2015, using retrospective statistical analysis. Methods : We investigated patients with idiopathic facial nerve palsy, admitted to a Korean medical hospital in 2015, and examined patients' variables and therapeutic variables. For analysis of clinical data, an independent sample t-test, analysis of variance (ANOVA), and simple regression analysis were performed using IBM SPSS version 24.0. Results : 1. The initial degree of facial palsy showed statistical significance with age. The older the age, the more severe the initial palsy. 2. Following treatment degree of facial palsy was statistically significant with age, hypertension, and fasting blood sugar (FBS). The higher the value, the slower the recovery from facial palsy. There was a statistical significance with the number of treatments in a Korean medical hospital. The more frequent the treatment, the faster the facial palsy recovery. 3. Degree of facial palsy after 12 months was statistically significant with age, hypertension, diabetes, FBS, and the initial severity of facial palsy. The higher the value, the slower the facial palsy recovery. 4. Sex, left or right sided palsy, alcohol consumption, smoking, history of facial palsy, season of onset, total number of treatments and bio chemistry (BC), complete blood cell count (CBC), urinalysis (UA) factors had no statistical significance with prognosis of facial palsy. Conclusion : Age, season of onset, hypertension, diabetes, FBS, initial severity of facial palsy, and the number of treatments at a Korean medical hospital showed statistical significance. The number of treatments at the Korean medical hospital positively correlated with facial palsy prognosis, and the others variables showed a negative correlation with facial palsy prognosis.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.75-80
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• 2007

Background: While restless legs syndrome (RLS) is a common disorder, many patients are still remained undiagnosed and clinical data on Asian RLS patients is still limited in amount. Thus, we aimed to describe the clinical spectrum of Korean patients with RLS. Methods: We assessed the clinical characteristics of 77 consecutive RLS patients (43 men, mean age $59.1{\pm}14.9years$; 34 women, mean age $59.3{\pm}14.7years$) followed up by us for at least one and a half years. Results: The mean age at onset of symptoms was $56.4{\pm}14.1$. Two patients (2.6%) developed RLS before the age of 20 years (early-onset RLS). In 44 patients (57.1%), no underlying cause of RLS was found (idiopathic RLS). Family history for RLS was positive only in two (4.5%) of the 44 idiopathic RLS patients. The mean age of patients with idiopathic RLS was $56.8{\pm}13.1$ and that of patients with symptomatic RLS was $60.9{\pm}14.3$. However, there was no statistically significant difference between two groups (p=0.196). All patients complained sensory and motor symptoms in legs, and additional patients (14.3%) also had symptoms in arms. Two significant complications of long-term treatment with dopaminergic agents, namely augmentation and rebound of symptoms, were only reported in two patients. No patient had been diagnosed as RLS before evaluated by us. Conclusions: Our study had some limitations because limited number of patients was enrolled during a fixed period of follow-up in single third referral hospital. However, our findings suggest there are differences in the clinical characteristics of RLS and long-term responses to dopaminergic agents between patients in Korea and western countries.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.142-151
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• 2019

Purpose: The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. Methods: The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed. Results: Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction (<48 vs. ${\geq}48$ hours) was significantly longer in the recurrence group (p=0.034) and patients in the recurrence group had higher levels of C-reactive protein (CRP) (p=0.024). Bloody stools and a history of infection were significantly more frequent in the non-recurrence group (p=0.001 and p<0.001, respectively). On stepwise regression analysis, age >1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56-14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06-0.58; p=0.004) were retained as predictors of recurrence. Conclusion: Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ${\geq}48$ hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.