• Journal of Chest Surgery
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• 제52권2호
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• pp.112-115
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• 2019

We describe aortic arch endarterectomy performed concomitantly with on-pump cardiac surgery in 2 patients with grade V arch atherosclerosis. In both patients, transesophageal echocardiographic findings led to the diagnosis of severe arch atherosclerosis associated with a mobile atheromatous plaque in the aortic arch. The severe arch atherosclerosis was managed with endarterectomy under deep hypothermic circulatory arrest. In patients with severe grade V atherosclerosis in the aortic arch, performing endarterectomy simultaneously with primary cardiac surgery may be justified as a way to reduce the risk of peripheral embolism, including cerebrovascular accidents, with minimal additional surgical risk.

• 대한한의학회지
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• 제21권4호
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• pp.264-270
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• 2000

The occurrence of neurologic symptoms after cervical manipulation(Chuna treatment) seems to be an uncommon event considering the large number of manipulations performed. The precise incidence is unknown, for only patients with serious complications seek medical care. We recently experienced a 3D-year-old woman who developed sudden neurologic complications after cervical Chuna treatment by a nonprofessional therapist. Whether the manipulation is the major causative factor in the subsequent stroke can be disputable and must be considered in each case. Physicians and patients, however, should be aware that cerebrovascular accidents may occur as a result of cervical manipulation.

• Journal of Chest Surgery
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• 제43권3호
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• pp.260-265
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• 2010

배경: 복합 인공 판막 도관(composite valve graft) 치환술은 다양한 대동맥 근부 질환들에 사용되어 왔다. 이 연구의 목적은 이 술기에 대한 중기 결과를 알아보는 데 있다. 대상 및 방법: 1992년부터 2009년까지 대동맥 근부 복합 인공 판막 도관 치환술을 받은 39명의 환자를 대상으로 후향적 조사를 하였다. 환자들의 평균 나이는 $49.2{\pm}16.4$세였고, 평균 추적 관찰 기간은 $64.2{\pm}53.4$개월이었다(최대 기간, 176개월). 결과: 4명(8.6%)의 병원 내 사망이 있었고 모두 응급 대동맥 박리인 경우였다. 4명의 만기 사망이 있었는데 2명은 잔류 대동맥류, 1명은 경막하 출혈, 1명은 판막 주위 역류가 원인이었다. 생존율은 각각 1년, 5년, 10년에 93.5%, 85.0%, 85.0%였다. 추적 관찰 기간 동안 3명의 환자에서 뇌혈관 사고가 발생하였고, 뇌혈관 사고로부터의 자유율은 각각 1년, 5년, 10년에 97.0%, 92.0%, 80.0%였다. 모든 뇌혈관사고는 출혈과 연관된 합병증이었다. 결론: 복합 인공 판막 도관을 이용한 대동맥 근부 치환술은 좋은 결과를 보여 왔다. 그러므로 이 술기는 다양한 대동맥 근부 질환의 치료에 좋은 방법이라 할 수 있다.

• 농촌의학ㆍ지역보건
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• 제23권1호
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• pp.51-64
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• 1998

This study was carried out during 3 years from March 1992 to March 1995, 140 healthy people and 140 C.V.A patients were investigated, at an oriental clinic in Taejon. The data collected was analysed using a SAS. The results are as follows. 1. The Relationships between patients who have undergone one or more abortion procedures and C.V.A occurrence. A statistical significant difference was recorded between the control group and the outpatients group of P<0.05 2. Number of years after initial C.V.A diagnosis before C.V.A symptom onset. within 1 years 52% (2-3 years, 3-4 years, 4-5 years, 5 years and over) 3. Additional diseases occurring after initial stroke 1 disease 50.7% (2, 3, 4, 5 or more) 4. Alcohol Consumption "A statistical significant difference was recorded between the control group and the outpatients group of" P<0.01 5. Previous Treatment Experience for stoke outpatients Oriental Hospital, clinic 64.3% (General Hospital, clinic, a public health center drug store, home remedies, etc) 6. Exercise Frequency Outpatients Regular 28.6%, Irregular 71.4% Control sample Regular 27%, Irregular 72.9% 7. Degree of Appetite "A statistical significant difference was recorded between the control group and the outpatients group of" P<0.01 8. People who include fish in their diet "A statistical difference was recorded between the control group and the outpatients group of" P<0.01.

• 대한중풍순환신경학회지
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• 제9권1호
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• pp.1-7
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• 2008

Objectives : We questioned whether the tongue diagnosis is effective for judging seriousness of cerebrovascular accidents. This study is about the relationship between tongue diagnosis and National Institute of Health Stroke Scale(NIHSS) in acute stroke patients. Methods : 738 subjects were recruited from the patients admitted to the department of internal medicine at Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center from April 2007 to August 2008. We looked at the tongue as in three dimensions of tongue color, tongue fur color and tongue body. And, we calculated NIHSS means according to the subtypes of three dimensions. Results : 1. In the Tongue color, from the most commom to least common colors were pale red, red, pale, bluish purple, and ect. The NIHSS mean score of red is significantly higher than pale and pale red. 2. In the Tongue fur color, white fur was the most common, and then yellow fur, etc. There is no significant difference among three subtypes in the NIHSS mean score. 3. In the Tongue body, etc. is the most common, followed by teeth-marked tongue, enlarged tongue, blood patchy tongue, and mirror tongue. The NIHSS mean score of teeth-marked tongue is significantly lower than blood patchy tongue and mirror tongue. Conclusions : The tongue color and the tongue body are useful indexes for judging seriousness of cerebrovascular accidents presented by NIHSS. But in our study, the tongue fur color was not useful. Further study is necessary on the tongue fur.

• 대한한의학회지
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• 제21권1호
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• pp.62-67
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• 2000

Background and Purpose: Sybsun-points are located at the tips of all fingers, 0.1chon from the finger nails, totaling 10 points on both hands. These points have been used for emergency care, fainting, epilepsy, cerebrovascular accidents, hypertension, unconsciousness, high fever etc. The most common technique is bleeding with a needle at these points. Hypertension and fever are the main factors for stroke patients’progress. We investigated whether venesection at Sybsun-points has effects on blood pressure and body temperature in stroke patients. Materials and Methods: 79 stroke patients were enrolled in this study from 1 Jan. 1999 to 30 Sep. 1999. All of them were admitted in Kyunghee University, Hospital of Oriental Medicine. Among them, 62 patients were hypertensive people, 17 were normal. Among the hypertensive patients, 27 were stage 1,20 were stage 2, 15 were stage 3 by classification of JNC 1997. All of the hypertensive patients had been taking drugs, while the normal group did not. From 2pm to 3pm, every 30 minutes we checked patients' blood pressure and body temperature by 24ABPM and tympanic thermometer. After 30 minutes passed, we phlebotomized patients Sybsun-points with Samneung needle 2-3cc of blood. Right after the bleeding, we checked blood pressure and body temperature. After the bleeding, for the next hour and a half, we checked each patient’s blood pressure and body temperature every thirty minutes, or a total of three times. We compared the blood pressure and the body temperature before and after treatment(p<0.05). Results: 1. Venesection at Sybsun-points significantly decreased systolic blood pressure on stage 3 hypertensive patients(p<0.0l). 2. Venesection at Sybsun-points significantly decreased diastolic blood pressure on stage 3 hypertensive patients(p<0.05) 3. Venesection at Sybsun-points had no effect on the change of body temperature. Conclusions: Though further study is needed, our findings suggest that Venesection at Sybsun-points may alleviate hypertension in stroke patients.

• 대한치과의사협회지
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• 제53권4호
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• pp.249-258
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• 2015

Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

• Journal of Chest Surgery
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• 제52권5호
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• pp.335-341
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• 2019

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

• Journal of Chest Surgery
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• 제57권4호
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• pp.380-386
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• 2024

Background: Type A aortic dissection (AD) and intramural hematoma (IMH) are critical medical conditions. Emergency surgery is typically performed under cardiopulmonary bypass immediately after diagnosis, which involves lowering the body temperature to induce total circulatory arrest. Selection of the arterial cannulation site is a critical consideration in cardiac surgery and becomes more challenging in patients with AD. This study explored the strengths and weaknesses of different cannulation methods by comparing each cannulation strategy and analyzing the reasons for patients' outcomes, especially mortality and cerebrovascular accidents (CVAs). Methods: This retrospective study reviewed the medical records of patients who underwent surgery for type A AD or IMH between 2008 and 2023, using the moderate hypothermic circulatory arrest approach at a single center. Results: Among the 146 patients reviewed, 32 underwent antegrade cannulation via axillary, innominate artery, aortic, or transapical cannulation, while 114 underwent retrograde cannulation via the femoral artery. The analysis of surgical outcomes revealed a significant difference in the total surgical time, with 356 minutes for antegrade and 443 minutes for retrograde cannulation (p<0.001). The mean length of stay in the intensive care unit was significantly longer in the retrograde group (5±16 days) than in the antegrade group (3±5 days, p=0.013). Nevertheless, no significant difference was found between the groups in the 30-day mortality or postoperative CVA rates (p=0.2 and p=0.7, respectively). Conclusion: Surgeons should consider an appropriate cannulation strategy for each patient instead of adhering strictly to a specific approach in AD surgery.

• 대한임상독성학회지
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• 제9권2호
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• pp.39-48
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• 2011

In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine ($^{131}I$) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.