• The Journal of Internal Korean Medicine
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• 제22권4호
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• pp.503-512
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• 2001

Objective : This study was carried out to investigate the effects of DDT on the brain damage and hypertension. Methods : We observed the effect of Dodamtang(DDT) extract on KCN-induced coma, focal brain ischemia by MCA occlusion, cytotoxicity and protection of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35). To prove the effect of DDT as a blood pressure depressant, we measured aldosterone, renin activity, catecholamine, sodium and NO density using the seperated blood plasma. Results : DDT showed a protective effect on cytotoxicity of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35) in a dose dependent manner and proved the significant abridgement of brain ischemic area and edema induced by MCA occlusion, a critical decrease of neurologic deficitic grade in the fore-limbs. DDT didn't reduce the duration of KCN(1.87mg/kg iv.)-induced coma and prolonged the survival rate in the case of KCN(3.0mg/kg iv.)-induced coma by the ratio of 20%. While DDT increased the value of NO in SHR, it significantly decreased the blood pressure of SHR and the value of aldosterone& epinephrine in SHR. Conclusions : These results suggested that DDT might be usefully applied for treatment of hypertension, cerebral infarction, and brain damage.

• The Journal of Internal Korean Medicine
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• 제30권4호
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• pp.696-707
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• 2009

Objective : We designed this study to investigate differences between stroke reattack and stroke first attack group to establish fundamental data and prevent a secondary stroke. Methods : 826 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 1 April 2007 to 31 August 2009. We compared general characteristics, classification of diagnosis, subtypes of cerebral infarction, risk factors, Sasang constitution, diagnostic classifications between stroke reattck and stroke first attack groups. Results : 1. In general characteristics, age differed significantly between the reattck and first attack groups. 2. Classification of diagnosis differed significantly between reattck and first attack groups. 3. In risk factors, hypertension, diabetes mellitus, alcohol drinking, and stress were significantly different between reattck and first attack groups. 4. Diagnostic classifications were significantly different between reattck and first attack groups. Conclusion : To prevent recurrence of stroke, education on stroke risk factors associated with recurrence is needed. In addition, those who are diagnosed as Dampness-Phlegm need to be well-controlled.

• Journal of Society of Preventive Korean Medicine
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• 제3권1호
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• pp.147-155
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• 1999

In order to investigate the effect of circulating blood and extinguishing blood stasis method on acute ischemic stroke treatment, we compared muscle weakness in two groups. Dansamhwanotang was administered to experimental group and the Sopungtang was administered to comparison group. In prospective and consecutive study, 24 patients(male 14, female 10) were admitted to hospital within 6hours(median $4.21{\pm}2.45)$ after stroke attack. All of them were diagnosed computed tomography as acute cerebral infarction. We divided that patients into two groups. The experimental group was 13, took median $4.17{\pm}1.72hrs$ to admission after stroke attack and the comparison group 11, median $4.31{\pm}2.72hrs$ to admission after stroke attack. There was no statistical difference in time consumed from stroke onset to admission(P>0.05). Muscle weakness was measured on admission and 7 days later on AMA(American Medical Association) method. In the experimental group, muscle weakness on admission was $2.23{\pm}0.51$ and $2.79{\pm}0.72$ in upper and lower extremity, respectively. In comparison group, muscle weakness on admission was $2.17{\pm}0.43$ and $2.67{\pm}0.82$ in upper and lower extremity, respectively. There was no difference in muscle weakness(P〈0.05). In 7 days after, muscle weakness was $2.31{\pm}0.35$ in upper extremity and $3.15{\pm}0.12$ in lower extremity in experimental group, and $2.27{\pm}0.74$ in upper extremity and $3.45{\pm}0.48$, lower extremity in comparison group. There was no meaningful improvement statistically in upper extremity(p<0.05) but significant evolution in lower extremity(p<0.05). The muscle weakness comparison between admission time and 7 days later was as follows. Experimental group had improvement at the degree of $0.24{\pm}0.92$, $0.42{\pm}0.82$ in upper and lower extremity, respectively and comparison group, $0.12{\pm}0.82$, $0.27{\pm}0.97$ in same part(p<0.05). So, Dansamhwanotang administered group had more good muscle weakness improvement than Sopungtang administered group(P>0.05). From the above result, I suppose that circulating blood and extinguishing blood stasis method helps recover hemiparesis caused by acute ischemic cerabral disease, in acute stage at least.

• Journal of the Korean Society of Radiology
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• 제12권3호
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• pp.313-319
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• 2018

In radiation treatment, it is unavoidable to block the influence of scattered ray on a skin and prevent internal normal organs from being exposed to radiation. It is fair to say that radiation therapy aims to reduce an absorbed dose of normal tissues. In particular, in radiation therapy of left-sided breast cancer, the internal neighboring organs are normal breast tissues, the heart, and the lung. The side effects on the heart include cardioplegy and myocardial infarction. This study tried to observe changes in the volume and dose of the heart in general radiation therapy plan and respiratory control based radiation therapy plan for patients with left-sided breast cancer, and to find the heart's volume and dose generated by respiration. According to the 4D computer tomography (CT), a volume of the heart had $12.8{\pm}8.7cc$ on average, and its dose had $17.3{\pm}12.1cGy$ on average. The differences in the volume and dose may cause side effects in radiation treatment. Therefore, it is necessary to apply respiratory control technique to establish the radiation treatment plan based on an accurate position of the heart.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

• Korean Journal of Psychosomatic Medicine
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• 제12권1호
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• pp.23-29
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• 2004

The objective of this study was to make a comparison on anger level between patients with coronary artery diseases and healthy individuals. 233 patients with coronary artery diseases and 215 normal controls were enrolled in this study. The Anger Expression Scale, the anger and aggression subscales of the Stress Response Inventory(SRI) and the hostility subscale of the Symptom Checklist-90-revised(SCL-90-R) were used to assess the level of anger. The patients with coronary artery diseases scored significantly higher on the anger-out and anger total subscales of the anger expression scale, the anger and aggression subscales of the SRI than the normal controls. The patients with angina pectoris had significantly higher scores in the anger-out and anger-total subscale than those with myocardial infarction. Male subjects scored significantly higher on the anger-in subscale than females, whereas female subjects scored significantly higher on the anger-out subscale than male subjects. These results suggest that patients with coronary artery diseases are likely to have a higher level of anger or anger expression than normal controls and that there may be difference in anger expression between male and female patients. It is emphasized that anger management is needed to prevent the coronary artery disease patients from aggravating the illness.

• Korean Journal of Clinical Laboratory Science
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• 제50권3호
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• pp.267-274
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• 2018

Posterior canal benign paroxysmal positional vertigo (PCBPPV) is the most common disease among patients who visited the st. Carollo hospital dizziness center with the head suddenly feeling rolling or rotational dizziness caused by head and body movements. Most patients showed improvements in symptoms after a single treatment. On the other hand, there are more causes requiring multiple treatments. This study examined the factors affecting the canalithiasis repositioning maneuver for symptom recovery of dizziness, which is posterior BPPV. Dizziness patients who visited the dizziness center of PCBPPV were classified. From March 2008 to November 2010, the cure rate of 165 posterior BPPVs patients was investigated. The success rate after the first, second, third, and further treatments was 57.6%, 17.6%, 10.3%, and 14.5%, respectively. The factors affecting treatment of PCBPPVs included traumatic, medical disease, cerebral infarction, small vessel disease, vestbro basilar artery insufficiency (VBI), cerebrovascular disease, brain disease, and vestibuloplasty (P<0.05). Vomiting, nausea, and syncope can be treated easily by considering the factors affecting these treatments. If the related diseases are combined with the treatment of the canalithiasis repositioning maneuver for symptom recovery of dizziness, the results will show an improvement in daily life that is free from painful dizziness.

• Health Policy and Management
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• 제23권1호
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• pp.3-18
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• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

• Journal of Yeungnam Medical Science
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• 제13권2호
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• pp.225-233
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• 1996

From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years(range form 30 to 71years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarctation history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients(40%) were hypercholesterolemia, 38 patients(60%) have smoking history and 19 patients(30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessele disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis(mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia(7cases), wound infection(5cases), perioperative myocardial infarction(4cases), reoperation for bleeding control(4cases) and stroke(4cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp tirne(>2hours) were found to be predective factor of morbidity and old age(>65years) was found to be predective factor of mortality.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제19권2호
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• pp.456-461
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• 2018

Carotid artery stenting (CAS) has emerged as an alternative treatment for carotid stenosis in patients poorly suited for endarterectomy. Intracerebral hemorrhage following carotid revascularization (endarterectomy, angioplasty, artery stenting) is rare and thought to be related to reperfusion injury in most cases. Early experience suggests an increased incidence of hemorrhage following CAS as compared to endarterectomy. In this study, data were obtained through a case report on an 80-year-old male patient with cerebral infarction. The 80-year-old hypertensive man developed sudden monoparesis in the left arm. He underwent CAS for 90% stenosis of the left proximal internal carotid artery. Brain CT after procedure showed acute hematoma with left posterior cerebral artery territorial hemorrhage, including the upper thalamus with extended intraventricular hemorrhage (IVH). Since this hemorrhage occurred in vascular territory unlikely to have been supplied by the treated artery, this case suggests that the mechanism of intracerebral hemorrhage following CAS may in some cases be different from hyperperfusion hemorrhage classically described following endarterectomy.