• Title/Summary/Keyword: medical study

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Clinical observation for the Geriatric C.V.A. (노인(老人) 뇌졸중(腦卒中)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Seo, Un-Kyo;Jeong, Ji-Cheon;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.14 no.2
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    • pp.50-70
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    • 1993
  • Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

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Detection and Measurement of Nuclear Medicine Workers' Internal Radioactive Contamination (핵의학과 종사자의 방사성동위원소 체내오염 측정)

  • Jeong, Gyu-Hwan;Kim, Yong-Jae;Jang, Jeong-Chan;Lee, Jai-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.123-131
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    • 2009
  • Purpose: We tested a sample of nuclear medicine workers at Korean healthcare institutions for internal contamination with radioactive isotopes, measuring concentrations and evaluating doses of individual exposure. Materials and Methods: The detection and measurement was performed on urine samples collected from 25 nuclear medicine workers at three large hospitals located in Seoul. Urine samples were collected once a week, 100~200 mL samples were gathered up to 6~10 times weekly. A high-purity germanium detector was used to measure gamma radiations in urine samples for the presence of radioactive isotopes. Based on the detection results, we estimated the amounts of intake and committed effective doses using IMBA software. In cases where committed effective doses could not be adequately evaluated with IMBA software, we estimated individual committed effective doses for radionuclides with a very short half life such as $^{99m}Tc$ and $^{123}I$, using the methods recommended by International Atomic Energy Agency. Results: Radionuclides detected through the analysis of urine samples included $^{99m}Tc$, $^{123}I$, $^{131}I$ and $^{201}Tl$, as well as $^{18}F$, a nuclide used in Positron Emission Tomography examinations. The committed effective doses, calculated based on the radionuclide concentrations in urine samples, ranged from 0 to 5 mSv, but were, in the majority of cases, less than 1 mSv. The committed effective dose exceeded 1 mSv in three of the samples, and all three were workers directly handling radioactive sources. No nurses were found to have a committed effective dose in excess of 1 mSv. Conclusions: To improve the accuracy of results, it may be necessary to conduct a long-term study, performed over a time span wide enough to allow the clear determination of the influence of seasonal factors. A larger sample should also help increase the reliability of results. However, as most Korean nuclear medicine workers are currently not necessary to monitored routinely for internal contamination with radionuclides. Notwithstanding, a continuous effort is recommended to reduce any unnecessary exposure to radioactive substances, even if in inconsequential amounts, by regularly surveying workplace environments and frequently monitoring atmospheric concentrations of radionuclides.

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Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

Tumors of the Foot (족부의 종양)

  • Shin, Duk-Seop;Park, Sung-Hyuk;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.69-76
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    • 2003
  • Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

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Effect of Boxing Aerobic Dance on Body Composition, Blood Component and Vascular Compliance in Obese Middle Aged Women (복싱에어로빅 참여가 비만 중년여성의 신체조성, 혈액성분 및 혈관탄성에 미치는 영향)

  • Zhang, Seok-Am;Kim, Seung-Suk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.9
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    • pp.4009-4017
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    • 2012
  • This study was conducted to test the effects of participation in 12-week program of boxing aerobics by obese middle-aged women on their body composition, blood constituents, and vascular compliance The samples are the middle-aged women in their forties or more, who has 30% or more body fat percentage, but has no medical history in cardiovascular disorders or metabolic diseases. The samples are divided into 8 of exercising group, and 8 of control group by random assignment. The intensity of boxing aerobics was HRmax 50% for the initial 4 weeks, HRmax 60% for the 5th to 8th week, and HRmax 70% for the 9th to 12th week. Each session took 60 minutes. The result is as follows. First, as a result of participating in the boxing aerobics program, body weight, body fat percentage, and muscle showed significant differences depending on the measuring period and the interacting term of the group and measuring period(p<.001), and the result of t-test on the sample matched to each group's measuring time also showed the significant increase or decrease in the exercising group(p<.001). Second, as a result of participating in the boxing aerobics program, the exercising group's TC, TG, HDL-C, and LDL-C, all showed significant differences in accordance with each group, measuring time, and the interaction term between groups and measuring time(p<.01, p<.001), and the result of t-test on each group's samples matched to the measuring time also shows significant increase or decrease in the exercising group(p<.01). Third, as a result of participating in the boxing aerobics programs, the vascular compliance of right hand, left hand, right hand, and left hand showed significant differences in accordance with each group, measuring time, and the interacting term between the measuring time and the group(p<.001), the t-test results of the samples matched to the each group's measuring time also showed significant differences in the exercising group(p<.001). To summarize the results above, it is suggested that the 12-week boxing aerobics program can improve body composition, blood constituents, and the blood circulation, which may prevent or enhance relevant diseases such as cardiovascular disorders.

A Study on a Changed Power of Tear lens at Spherical RGP lens Fitting (구면 RGP렌즈 Fitting시 누액렌즈 굴절력 변화에 대한 연구)

  • Park, Seong-Jong;Joo, Seok-Hee;Jung, Ju-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.455-462
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    • 2004
  • In this paper, we measured and analysised the power change of tear lens for 85 patients - 170 myopia eyes - who are fitted using RGP lens, considering the BGR of RGP lens, the corneal astigmatism power, and corneal curvature. We got the following results from these experiments; 1. When the BCR of RGP lens changes, the diopters of tear lens of "on-k", 0.05Pt, 01.0Ft, 0.05St, and 0.10St are -0.25D, -0.46D, -0.63D, +0.07D, and +0.26D, respectively. 2. When the corneal astigmatism power changes, the diopters of tear lens of group below 0.75D, group of 1.00D~1.25D, group of 1.50D~1.75D, and group over 2.00D in "on-k" state, are -0.25D, -0.18D, -0.09D, and -0.39D, respectively. 3. When the corneal astigmatism power changes and the BCR of test lens is changed by 0.05mm step, the change values of tear lens diopter for 0.05St and 0.05Ft approximate to ${\pm}0.25D$, while these for 0.10St and 0.10Ft don't approximate to the value below ${\pm}0.25D$.[are irregular value below ${\pm}0.25D$.] 4. When the corneal curvature and the HCR of RGP lens change, the diopters of tear lens of group below 7.50mm, group of 7.55~7.80mm, group of 7.85~8.20mm, and group over 8.25mm in "on-k" state, are -0.40D, -0.11D, -0.20D, and -0.19D, respectively. 5. When the BCR of test lens is changed by 0.05mm step and the corneal curvature increases, the change values of tear lens diopter decrease, while these over 8.25mm are mean value ${\pm}0.17D$ and the value below ${\pm}0.25D$.

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The timing of sexual maturation and secular trends of menarchial age in Korean adolescents (한국 청소년의 성성숙 시기 및 장기간의 초경연령 추세분석)

  • Park, Mi Jung;Lee, In-Sook;Shin, Eun-Kyung;Joung, Hyojee;Cho, Sung-Il
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.610-616
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    • 2006
  • Purpose : The purpose of this study was to evaluate the timing of sexual maturation and secular trends of menarchial age in Korean adolescents. Methods : Nine hundred eighty two school students and 119 university female students were included. Tanner's pubertal assessment method was applied using a self-assessment sheet with pictures for their developmental stages. A medical checkup database from 1,156,022 women was also used to analyze the age of menarche from the year 1900 to 1980. Results : Onset of puberty was at $11.3{\pm}1.3$ years(y) in girls and $12.1{\pm}1.5$ y in boys and total pubertal duration was 3.6 y in girls and 3.3 y in boys. Height at the onset of puberty was $146.1{\pm}7.9cm$ in girls and $152.7{\pm}9.8cm$ in boys. Weight at the onset of puberty was $39.3{\pm}6.9kg$ in girls and $47.7{\pm}14.4kg$ in boys. The mean age of menarche was $12.0{\pm}1.0y$ and mean age at nocturnal emission was $12.3{\pm}1.8y$. By age ten, 3.0 percent of girls experienced menarche, which increased to 41.1 percent by age 12, and 98.0 percent by age over 15. By SMR 2 breast stage, 18.2 percent of girls experienced menarche, which increased to 66.1 percent and 91.7 percent by SMR stages 3 and 4, respectively. By SMR 2 pubic hair stage, 52.0 percent and by SMR 3, 93.8 percent of girls experienced menarche. While the menarchial age of women born around 1980 was $12.4{\pm}1.1y$, the menarchial age of women born around 1990 was $12.0{\pm}1.1y$. Age at menarche has been advanced approximately by 2 years between 1900 and 1980 birth cohorts. Conclusion : There was a downward secular trend in pubertal timing. Age at menarche has been advanced by 2 years during the last 80 years. Further large scale, prospective studies, including inspection by specialists, are needed to provide reference data for pubertal timing in Korean adolescents.

A survey of infant sleep positions associated with sudden infant death syndrome (영아 돌연사 증후군과 연관하여 아기를 재우는 방법에 대한 인식 연구)

  • Lee, Dong Jun;Jang, So Ick;Shim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.602-609
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    • 2006
  • Purpose : As the prone position is thought to be an important factor in sudden infant death syndrome(SIDS), this study was conducted to contribute to reducing SIDS by analyzing sleeping positions of infants. Methods : A face-to-face questionnaire was carried out with a total of 170 parents with a baby aged less than 6 months. Results : A total of 170 infants included 95 males(55.9 percent) and 75 females(44.1 percent); their average age was 2.8 months. 45.3 percent slept in a supine position; 34.7 percent in a side or supine position; 7.1 percent in a side position; 4.7 percent in a prone position; 4.1 percent in a non-specific position. Among those in a side position, 59.7 percent were in a supine position in the morning; 19.5 percent were in the side position; 13.4 percent were in a non-specific position; and 4.1 percent were in a prone position. To the question why they slept in a specific position, 34.9 percent answered their baby slept comfortably, and particularly, 42.9 percent in the prone position group answered so. In the supine position group, 21.6 percent answered they had no reason. Both in the prone position and side position groups, 21 percent each answered they were worried about the shape of their baby's head. In the side position group, 22 percent answered that they had a fear of choking due to vomiting. In all sleeping position groups, 8.2 percent and 7.4 percent answered it was because they had a fear of suffocation and they wanted to avoid SIDS, respectively. Conclusion : Many of the parents preferred unstable positions, e.g. the side position and the prone position, which could cause SIDS. Their decision on their baby's sleeping position was not based on exact medical knowledge, but on convenience in taking care of their baby. As it was found that only 6 percent of the subjects were advised from their pediatrist about their baby's sleeping position, moreover, it is necessary to carry out more studies and activities for preventing SIDS caused by improper sleeping positions and educating patents about recommended sleeping positions for their baby.

Bilateral retinoblastoma: Long-term follow-up results from a single institution (단일기관의 장기추적 결과)

  • Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.674-679
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    • 2009
  • Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.

Toll-like receptor 2 expression on monocytes from patients with BCG vaccine-associated suppurative lymphadenitis (BCG 접종 후 발생한 화농성 림프절염 환자의 단핵구에서 Toll-like receptor 2의 발현)

  • Oh, Hyun Joo;Shin, Kyung-Sue
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.667-673
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    • 2009
  • Purpose : Toll-like receptor 2 (TLR2) is critical in the immune response to mycobacterial infections. The purpose of this study was to analyze TLR2 surface expressions and TLR2-mediated tumor necrosis factor-alpha ($TNF-{\alpha}$) and interleukin-6 (IL-6) production in patients with BCG vaccine-associated suppurative lymphadenitis. Methods : Peripheral monocytes were separated from 16 patients with BCG vaccine-associated suppurative lymphadenitis and 10 healthy controls using a magnet cell isolation kit. Monocytes ($1{\times}10^6$ cells/well) were incubated with a constant amount of $Pam_3CSK_4$ ($100{\mu}g/mL$) for 24 hours. TLR2 surface expression on monocytes was analyzed by FACS analysis and TLR-2 mRNA expression was determined by RT-PCR. TLR2-mediated $TNF-{\alpha}$ and IL-6 production were measured by ELISA. Results : In patients with BCG vaccine-associated suppurative lymphadenitis, low TLR2 expression on monocytes ($3.39{\pm}$1.2% versus $4.64{\pm}2.6%$) together with significantly lower TLR2 mRNA expression than in the healthy controls was seen after $Pam_3CSK_4$ stimulation. TLR2-mediated $TNF-{\alpha}$ and IL-6 production in patients with BCG vaccine-associated suppurative lymphadenitis ($TNF-{\alpha}$, $775.5{\pm}60.8pg/mL$; IL-6, $4,645.8{\pm}583.9pg/mL$) were also lesser than that in healthy controls ($TNF-{\alpha}$, $1,098.5{\pm}94.3pg/mL$; IL-6, $6,696.3{\pm}544.3pg/mL$). Conclusion : These findings suggest that low TLR2 expression on monocytes might be associated with increased susceptibility to BCG vaccine-associated suppurative lymphadenitis.