• Journal of Chest Surgery
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• 제18권4호
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• pp.872-880
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• 1985

Myasthenia gravis is a neuromuscular transmission disorder characterized by fatigue and weakness of voluntary muscles. Although the pathogenesis is known as reduction of available acetylcholine receptors at neuromuscular junctions by autoimmune attack, the thymic role in myasthenia gravis is still unclear and under investigation. But thymectomy in the management of myasthenia gravis has become increasingly important since the first successful operation with remission of symptoms in 1939 by Blalock. From January 1983 to June 1985, authors performed 17 thymectomies for patients with myasthenia gravis. Among them, 12 patients were free from thymoma [Croup A] and 5 were coupled with thymoma [Group B]. The results were as follows: 1] Sex distribution was 11 females and 6 males. Mean age of the patients was 32.2 year old. Sex and age distribution by the Group A and B are shown Table 1. 2] Clinical manifestations of ocular symptoms were seen in 5 patients [88.2%], extremity weakness in 13 patients, bulbar weakness in 12 patients and dyspnea in 6 patients. According to the Osserman`s classification, 5 patients were in group IIA, 6 in IIB and 6 in IIC. 3] Pre-operatively, all patients were positive response to the anti-cholinesterase test and 12 patients [92.3%] revealed positive findings in electromyography [EMC] which was done in 13 patients. 4] The postoperative complications were respiratory distress in 3 patients, myasthenic crisis in 2 patients and wound disruption in one patients. 5] Pathologic examination of the thymus showed hyperplasia in 10 patients [90%] and thymoma in 5 patients, of which 4 were mixed type with invasion to the adjacent tissues and one lymphocytic type without invasion. Normal thymus was noticed in only 2 patients. 6] In postoperative evaluations, among the 12 patients c free from thymoma [Group A], complete remission of symptoms was noticed in 3 patients and improvement in 7 patients. But among the 5 patients coupled with thymoma [Group B], only one patients showed improvement [Table 8]. Therefore, remission and clinical improvement were noticed in 11 patients [64.7%] of the all and complete remission was noticed in 3 patients [17.6%].

• Journal of Chest Surgery
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• 제24권8호
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• pp.741-750
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• 1991

Between April, 1986 and July, 1991, 477 patients underwent open heart surgery with hypothermic cardiopulmonary bypass. There were 242 patients [50.7%] of acyanotic congenital anomalies, 34 patients [7.1%] of cyanotic congenital anomalies, and 187 patients [39.2%] of acquired heart diseases, 8 patients [1.7%] of coronary artery diseases, and 6 patients [1.3%] of mixed anomalies. Among the 276 congenital cardiac anomalies, 147 patients [53.3%] were male and 129 patients [46.7%] were female, ranged in age from 2 years to 58 years. Among the 187 acquired heart diseases, 72 patients [38.5%] were male and 115 patients [61.5%] were female, ranged in age from 10 years to 68 years. The common congenital defect were VSD and ASD in acyanotic cardiac patients, and TOF in cyanotic cardiac patients. Among the 187 acquired heart diseases, 180 patients underwent operation for cardiac valvular diseases, 4 patients were resected left atrial myxoma, and 3 patients underwent operation for aortic regurgitation with ascending aortic aneurysm. The operative mortality rate was 1.2% in acyanotic cardiac patients, 11.8% in cyanotic cardiac patients, and 6.9% in acquired cardiac patients, with overall mortality rate 4.2%.

• Journal of Chest Surgery
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• 제21권4호
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• pp.641-648
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• 1988

Between April 9, 1986 and September 2, 1987, 134 patients underwent open heart surgery with hypothermic cardiopulmonary bypass and cold blood cardioplegia. There were 65 patients[48.5%] of acyanotic congenital cardiac anomalies, 19 patients[14.2%] of cyanotic congenital cardiac anomalies, and 50 patients[37.3%] of acquired heart diseases, which included 49 valvular diseases and 1 myxoma. In 84 congenital cardiac anomalies, 44 patients were male and 40 patients were female ranged in age from 2 years to 57 years. In 50 acquired heart diseases, 18 patients were male and 32 patients were female ranged in age from 10 years to 65 years. The common congenital defects operated were VSD in acyanotic cardiac patients, and Tetralogy of Fallot in cyanotic cardiac patients. Among 50 acquired heart diseases, 49 patient underwent operation for cardiac valvular lesions. 33 patients had mitral valve replacement and 7 patients had aortic valve replacement. 1 patient underwent aortic valvuloplasty and 8 patients had double valve replacement. The operative mortality rate was 3.1%[2 out of 65 patients] in acyanotic cardiac patients, 5.3%[1 out of 17 patients] in cyanotic cardiac patients, and 12.0%[6 out of 50 patients] in acquired cardiac patients, with overall mortality rate of 6.7%[9 out of 134 patients].

• Journal of Oral Medicine and Pain
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• 제47권3호
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• pp.109-116
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• 2022

Purpose: This study was conducted to analyze the clinical characteristics and distribution of the tongue-related diagnoses in patients with tongue symptoms. Methods: The subjects were patients who visited Chosun University Dental Hospital with tongue symptoms from January 1, 2021, to December 31, 2021. We analyzed 491 patients (139 males and 352 females) with tongue-related diagnostic code names in the Korean Standard Classification of Disease (KCD) in the Electronic Medical Record (Dentopinformation Technology Co., Seoul, Korea). Results: On analyzing the diagnoses of tongue diseases using the KCD, glossopyrosis (44.8%) and painful tongue (15.2%) showed high rates. Of the 491 patients, 139 (28.3%) were males and 352 (71.7%) were females, and the average age was 58.1 years. As for systemic diseases, there were many patients with diseases of the circulatory system (27.0%) and endocrine, nutritional, and metabolic diseases (13.7%). Tongue symptoms were discomfort in 58 patients, pain in 329 patients, paresthesia in 10 patients, burning sensations in 222 patients, dysgeusia in 25 patients, dryness in 110 patients, fissures in 57 patients, and other symptoms in 72 patients. Areas with tongue symptoms were the anterior area in 102 patients, the lateral area in 140 patients, the posterior area in 12 patients, the dorsal area in 140 patients, the ventral area in 42 patients, and which area in 126 patients overall. Patients with burning mouth syndrome and oral candidiasis had significantly more tongue symptoms. Conclusions: Patients with tongue symptoms exhibited a variety of tongue diseases. Tongue symptoms were more common in women over 50 years of age and were frequently seen in patients with burning mouth syndrome and oral candidiasis.

• Journal of Chest Surgery
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• 제27권9호
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• pp.752-758
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• 1994

From July 1983 to December 1992, 145 patients with mitral valvular disease underwent open heart surgery at Chonbuk National University Hospital. Of these patients, 89 patients[61.4%] required mitral valve replacement. 56 patients [38.6 %] had mitral valve repair. There were 32 women and 24 men and the mean age was 34.3 years[range 6 years to 62 years].There were 23 cases of pure mitral stenosis, 19 cases of mitral regurgitation and 14 cases of mixedmitral valvular disease. The mean duration of symptom was 4.53 years and mean mitral valvularorifice diameter[in cases of pure stenosis and mixed mitral valvular lesion] was 0.96 cm. According to the NYHA classification, the distribution of patients preoperatively was as follows; class IIa, 15 patients; class lib, 17 patients; class III, 22 patients; class IV, 2 patients. Four patients[7%] had an embolic history preoperatively. 24 patients[ 43 %] were in atrial fibrillation. In cases of pure mitral stenosis, the technique used included open mitral commissurotomy[21atients], open mitral commissurotomy with mitral annuloplasty[2 patients]. In mixed mitral valvular disease, open mitral commissurotomy[ll patients] and open mitral commissurotomy with mitral annuloplasty[l patient] were performed. In cases of mitral regurgitation, mitral annuloplasty[5 patients], mitral valvuloplasty[6 patients], mitral annuloplasty with valvuloplasty [3 patients] and ring annuloplasty [5 patients] were performed.There was one perioperative death related to acute renal failure and sepsis. One late death was occurred related to heart failure after 10 months postoperatively. One patient required reoperation due to restenosis and no embolic episode was occured. After operation, 34 patients were in NYHA functional class I, 20 patients were in class IIa.

• Journal of Gastric Cancer
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• 제14권4호
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• pp.238-245
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• 2014

Purpose: Gastric cancer often occurs in the elderly but is uncommon in young individuals. Whether young patients have different clinical behaviors and outcomes from those of older patients remain unclear. Materials and Methods: We identified 1,366 cases of newly diagnosed noncardia gastric adenocarcinoma from the Kaiser Permanente Northern California Cancer Registry between 2000 and 2010. We then compared the clinicopathological features and survival among the different age groups. Results: The male : female ratio differed significantly between the younger and older patient groups (0.84 in age <50 years vs. 1.52>60 years, P<0.01). More younger patients were Hispanic (54% patients <40 years vs. 19% patients ${\geq}70$ years, P<0.0001), while more older patients were Caucasian (49% patients ${\geq}70$ years vs. 15% patients <40 years; P<0.0001). The diffuse/mixed histological type was more prevalent in younger patients (70% patients <40 years vs. 27% patients ${\geq}70$ years; P<0.0001), whereas the intestinal type was more frequent in older patients (71% in patients ${\geq}70$ years vs. 30% in patients <40 years; P<0.0001). Poorly differentiated adenocarcinoma was more common in the younger patients (80% in patients <40 years vs. 60% in patients ${\geq}70$ years; P=0.016). Survival rates at 1, 2, and 5 years gradually declined with increasing age (overall P=0.0002). Conclusions: Young patients with gastric cancer had more aggressive disease but higher overall survival rates than older patients. Younger Hispanic patients and older Caucasian patients were more likely to be diagnosed with gastric cancer. These differences may be due to biological predisposition and/or environmental exposure.

• Journal of Chest Surgery
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• 제26권7호
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• pp.532-537
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• 1993

To assess the therapy of spontaneous pneumothorax in the aged patients, the treatment methods and results in 60 patients 50 years of age or older were retrospectively reviewed. Most of the patients were male [56 of 60 patients] and the major underlying lung diseases associated with spontaneous pneumothorax were tuberculosis [32 patients] and chronic obstructive lung disease [20 patients]. The recurrence rate of thoracostomy tube drainage with or without chemical pleurodesis using tetracycline was 39.6% [21 of 53 patients], but there was no recurrence in the patients treated with open thoracotomy, pleural abrasion, and chemical pleurodesis using talcum powder[Asbestosis free]. In the patients treated with open thoracotomy, the bullous or bleb lesions were placed in the various sites of both lungs. We concluded that even though thoracostomy tube drainage is the first choice of therapy for spontaneous pneumothorax in the aged patients, the recurrence rate is high, especially in the patients with persistent air leakage for more than 2 days, and the open thoracotomy with pleural abrasion and chemical pleurodesis using talcum powder can prevent the recurrence in the selected patients.

• 보건의료산업학회지
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• 제6권4호
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• pp.143-152
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• 2012

This study analyzes Korea health panel data (2008) (beta version 1.2) of Korea Institute for Health and Social Affairs, and National Health Insurance Corporation to figure out determinants of healthcare expenditure. In result of Multiple Logistic Analysis, in-patents felt burden on the medical expenditure were 70.0%. As to the patients' payment of medical expenditure, patients over 65 years old had 4.765 times higher than those under 14 years, disabled patients 2.778 than non-disabled patients, chronic patients 1.632 times than non-chronic patients, patients belonging to 12 million won ~ 46 million won and under 12 million won in family income had 1.680 times and 2.168 times respectively than patients with over 46 million won, patients in professional recuperation facility 1.546 times than patients in hospital, patients in private medical institutions 1.700 times than patients in national and public medical institutions, patients using upper grade rooms 1.701 times than patients in non-upper grade rooms. As a health care safety net mechanism to protect people from medical expenditure burden, there is the patients' payment ceiling in the National Health Insurance System. Thus, in order to facilitate the patient's payment ceiling, it is required that the level of ceiling is to be specified according to the income level, and self-payment items is to be included.

• 대한물리치료과학회지
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• 제3권1호
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• pp.871-879
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• 1996

The authors studied 74 patients with cal therapy Kosin University Medical March 1994 through February 1995. The results were, as follows: 1. Average age of the subject patients was 59.3 years old, their age ranged from 20 to 84 years old, and the incidence between male and female was 1:1.24 2. In respect to the economy level the middle class revealed the highest incidence, 40(54%) in 74cases. 3. The cause of injury revealed the highest incidence in hypertension 52 patients(72 %), more than all revealed the highest incidence 23 patients(44 %) in 60th years old. 4. The form of injury revealed the highest incidence in infarction 36 patients(49 %), more then all revealed the highest incidence 13 patients (36 %) in 60th years old. 5. As for the region cerebral artery of infarction patients, middle cerebral artery was the highest region of injury 72 %. 6. As for the physical paralysis side, the left side showed higher incidence 40 patients(54 %) compared to the right side 31 patients (42 %). 7. The period of therapy was 56 days, in average extending from 7 days to II months, nore then all there were the most numerous patients within 3 weeks 28 patients(38 %). 8. The upper side of the upper lims had improved 67 patients(91 %), the lower side 48(65 %). In the cases of the lower limb, the upper side had improved 70(95 %), the lower side 58(78 %). In short, patients had improved more the lower limb than the upper limb, the upper side(elbow and shoulder part) then the lower side(wrist and finger) of the upper limb. In the cases of the lower limb, patients had improved more the upper side (knee and hip part) then the lower side(foot and ankle) 9. In the cases of patients can be walking among subject patients 55(74 %) and patients cannot be walking 19 (26 %), In the cases of patients utilized assistant apparatus 34 (62 %) among self-walking, completely patients can be self-walking 21(28 %).

• Journal of Chest Surgery
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• 제18권1호
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• pp.86-91
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• 1985

A clinical analysis was performed on 11 cases of metastatic lung cancer experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during the 15 year period from 1970 to 1984. Of the 1lpatients of metastatic lung cancer, 4 patients were male and 7 patients were female and the age ranged from 27 years to 60 years old with the average of 38.8 years old. The sites of primary tumor were uterus and ovary in 5 patients, breast in 2, sarcoma in 2, rectum in 1 and testis in l.\ulcorner Tumor free intervals in each patients were as followed; unrecognition of primary site in 2 patients, simultaneous discovery of primary tumor and metastasis in 3, 14 months in 1, 4 years in 4 and 5 years in Twelve thoracotomies were performed in 11 patients and performed procedures were as followed; pneumonectomy in 1 patient, lobectomy in 7, wedge resection in 2, decortication and wedge resection in 1 and biopsy only in 1. Of the 11 patients, 4 patients died within one year after operation, 2 patients died within 2 years and 2 patients are alive over 5 years after operations. Other 3 patients are alive 2 months, 4 months and 9 months after operation at present.