Between 1983 and 1993, 250 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular disease were reviewed. 222 patients were divided into acyanotic group and 28 patients were cyanotic group. The most common defects were atrial septal defect [96 patients and ventricular septal defect [95 patients . There were 128 patients in the third decade, 71 patients under 20 years of age, 40 patients in the fourth decade and 11 patients over 40 years of age. The male to female ratio was 1.05:1. Operative mortality was 6.8% [4.1% in the acyanotic group and 26.8% in the cyanotic group and the most common cause of death was low cardiac output syndrome.
A clincal study was performed on 124 cases of the esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Chosun University during 6 year period from 1986 to 1991. The result were as follows: 1. The incidence ratio of male to female in esophageal diseases was 3.6: l. 2. The most common esophageal disease was cancer and occupied 73% of the total. 3. The most common associated disease was pulmonary tuberculosis. 4. Esophageal stricuture occurs in young woman and its cause is lye and strong acid. 5. The mortality rate was 33% [2/6] in esophageal perforation
Background and Objectives Cervical necrotizing fasciitis is a fulminant disease associated with necrosis of connective tissue, spread along the fascial plane, and high mortality. We analyzed the clinical characteristics and treatment outcome of this rare fatal disease. Materials and Methods We retrospectively reviewed the medical records of 19 patients treated for cervical necrotizing fasciitis from January 1999 to January 2009. Mean age was 53.7 years. Results The most common predisposing illness was tonsillitis (36.8%), followed by odontogenic infection (15.7%). Diabetes mellitus was most common underlying disease. Liver cirrhosis and chronic renal failure were found in 2 patients each. All patients were treated with combination of parenteral antibiotics and wide surgical debridement by transcervical and/or thoracotomy approach. Multiple surgical debridements were performed in 7 patients. Tracheotomy was performed in most of the patients (88.8%). Period of total hospitalization and Intensive care unit was 23 days and 10.1 days. Two patients died of disease and overall survival rate was 89.4%. Conclusion Early surgical management and care in intensive care unit are essential for cervical necrotizing fasciitis. Possible complications such as respiratory failure, mediastinitis or sepsis should be carefully evaluated.
Kim, Yi-Seul;Kim, Kyung-Ran;Kang, Ji-Man;Kim, Jong-Min;Kim, Yae-Jean
Clinical and Experimental Pediatrics
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제60권3호
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pp.77-85
/
2017
Purpose: Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. Methods: Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ${\geq}38.0^{\circ}C$ for longer than ${\geq}14days$ and failure to reach a diagnosis after one week of investigations were included. Results: Total 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%). Conclusion: Almost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.
Objectives: This study was designed to evaluate the methods of diagnosis and treatment of thyroid nodules. Materials and Methods : We performed a clinical review of patients with thyroid nodules, who were surgically treated at the Department of Surgery, College of Medicine, Chosun University from January 1996 to December 1998. Results: 1) The patients were divided into two groups; 65 patients(80.2%) with benign nodular disease and 16 patients(19.8%) with malignant disease. 2) The sex distribution showed a preponderance of females with a ratio of 5.2:1 in benign nodular disease and 3:1 in malignant disease. Benign nodules were more prevalent in patients in their 40's as compared to malignant nodules in patients in their 50's and 60's. 3) The most common duration of illness was 3 months, occurring in 45.7% of the total cases. 4) The most prominent symptom and sign was a palpable nodule in the anterior aspect of the neck. 5) The location of the nodule was ; 41 cases in the right lobe, 29 cases in the left lobe, and 11 cases in both lobes. 6) Thyroid scanning of 40 patients revealed cold nodules in 90.6% of benign nodules and in all malignant disease. 7) Fine needle aspiration cytology were performed in 32 cases of the 81 patients. Comparing with postoperative pathological findings, the results were the same in 87.5% of 32 cases. 8) Intra-operative frozen section study was performed in 56 cases of the 81 patients. Comparing with postoperative pathological finding, the results were same in 96.4% of the 56 cases. 9) The histopathological classification revealed that adenomatous goiters were the most common benign disease and papillary carcinomas were the most common malignant disease. 10) The most frequently employed operation for benign nodules and malignant disease was unilateral total lobectomy. When the metastasis was confirmed, lymphadenectomy and radical neck dissection was performed in malignant disease. 11) Important postoperative complications were transient hoarseness, transient hypocalcemia, hypothyroidism, wound bleeding, and hoarseness. Conclusions: The results of this study suggest that palpable nodules in anterior aspect of neck is revealed cold nodule by thyroid scanning and malignancy by fine needle aspiration cytology, which should be removed surgically. There is no difference in complication and survival rate with type of operation and lymphatic dissection. Therefore, procedure of operation is dependent on the site of nodule and involvement of lymph node.
You-Jung Choi;Jung-Woo Son;Eun Kyoung Kim;In-Cheol Kim;Hyung Yoon Kim;Jeong-Sook Seo;Byung Joo Sun;Chi Young Shim;Se-Jung Yoon;Sahmin Lee;Sun Hwa Lee;Jun-Bean Park;Duk-Hyun Kang
Journal of Cardiovascular Imaging
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제31권1호
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pp.51-61
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2023
BACKGROUND: Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS: In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS: The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS: This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.
This observation was aimed to evaluate the clinical manifestations and clinical incidence of $Beh{\varsigma}et's$ Disease. It was records of patients seen in the period between January 1992 and December 1998 at the Department of Dermatology, Oriental Medical Hospital, Kyung Hee University. $Beh{\varsigma}et's$ Disease is a chronic, systemic disease which manifests itself as recurrent, multiple lesions in many organs, including the skin. The clinical features of $Beh{\varsigma}et's$ Disease are important as there is no reliable method of laboratory diagnosis. The results were summarized as follows; 1. The total number of patients were 34, including $42\%$ male and $52\%# female. 2. The pick incidence of age group was 30 to 39($44\%$). 3. The most frequent duration was from 2 years to 5 years($41\%$). 4. According to Diagnostic Criteria of the $Beh{\varsigma}et's$ Disease Research committee of Japan, there were $41\%\;of\;Incomplete\;type,\;29\%\;of\;Suspected,\;24\%\;of\;Complete,\;6\%$ of Passible. 5. The most common major symtom is a oral u1cer($91\%$), and there were erythema nodosum like lesion($79\%$), genital ulcer($56\%$), problem of the eyes($38\%$). 6. The most common minor symtom was arthritis($32\%$). 7. The first main symtom were oral ulcer($50\%$), erythema nodosum like lesion($26\%$), problem of the eyes($18\%$). 8. There were 2 cases of Intestinal $Beh{\varsigma}et's$ Disease and 5 cases of uveitis. 9. The most frequently treated prescription was Eunhwasagantang which occupied 79 of all, Gamisopunghwalhultang($44\%$) a.nd Gamipadoksan($41\%$), Gamiguakjungsan($24\%$) in that order of frequency.
Purpose: There has been no nationwide surveillance survey of poisoning cases in Korea. This study examined the clinical characteristics of poisoning admissions in order to obtain preliminary data for future planning. Methods: This study retrospectively reviewed the data on poisoning admissions of 150 hospitals based on the hospital discharge injury surveillance data of Center for Disease Control and Prevention in Korea from January to December in 2004. The demographic data, poisons used, causes of poisoning, reasons for attempted suicide and mortality rate was investigated according to the age group. The factors associated with mortality were also evaluated. Results: A total 836 patients admitted for poisoning were analyzed. Their mean age was $46.5{\pm}19.5$ years (male 415, female 421). The most frequent age group was the 4th and 5th decades. The most common poisons involved were pesticides (45%) and medications (23%). The majority (64%) involved intentional poisoning except for those in the 1st decade. The most common reason for the attempted suicide was family problems. However, individual disease was the most common reason in those over 60 years. The overall mortality rate was 8.7% (73/836). Pesticides and being elderly (over 65 years old) were strongly correlated with fatality. Conclusion: The incidence of intentional poisoning increases from the 2nd decade making it a preventable injury. "Overall, the incidence of intentional poisoning increases from the 2nd decade". Therefore, there is a need to frame a prevention policy corresponding to each factor related to fatality, such as an elderly population and pesticides.
This study was carried out to investigate consumption patterns of health functional foods (HFF) and analyze their related factors in male workers in order to provide basic data for appropriate understanding and optimal use of HFF. The subjects were 325 shipbuilding workers aged 20~50 in the Geoje area. About 84% of subjects reported that they were currently consuming or had experience of consuming HFF. The most commonly used type of HFF was vitamins (53.5%), followed by red ginseng (28.9%) and vegetable extract (15.4%). The major reasons for consuming and not-consuming HFF were 'to recovery from fatigue' (49.5%) and 'can not trust the effects' (39.4%), respectively. The intake period was 'less than 3 months' (35.5%), average monthly expense was 'less than 50,000 won' (49.1%), and purchase place was 'store of health functional foods' (32.2%) as the most common answers. The effects after consuming HFF were 'moderate' (51.3%) as the most common answer, and 16.1% of subjects experienced side effects, such as diarrhea, indigestion and nausea. Contributing factors for selecting and desire for future use of HFF were 'effectiveness' (52.2%) and 'when necessary' (67.8%) as the most common answers. Experience of using HFF was positively correlated with age (p<0.05), marital status (p<0.05), unbalanced diet (p<0.01), concern about health (p<0.05), and fear for disease (p<0.05). Purchase of HFF was positively correlated with fear of disease (p<0.01), whereas it was negatively correlated with frequency of exercise (p<0.05). The desire for future use of HFF was positively correlated with concern about health (p<0.05), fear of disease (p<0.01) and drinking (p<0.05). In conclusion, factors affecting consumption patterns of health functional foods (HFF) were age, marital status, unbalanced diet, concern about health, fear of disease and drinking.
General practitioners, internists, pediatricians, and family physicians are classified as so-called primary care physicians in the United States. We carried out this study for the purpose of answering the following question; "Who are the primary care physicians in Korea\ulcorner" We analyzed the 663, 154 claims which were drawn from the health insurance processing file made during the period of one month, April 1992 on the basis of systemic random sampling technique. The 663, 154 cases were matched with the doctor's file registered at the National Federation Medical Insurance by using the indivisual physician code number and analyzed according to the kind of specialty. If we follow the Geyman's definition of primary care physician in the United States, this study shows that they can take care of 43.2% of the total private clinic's claims in Korea. Provided that general practitioners and family physicians are considered the same way as in the United Kingdom, they could with only 8.3% of the total claims in Korea. The most frequent diseases are those which rank first to 46th in the total private clinic's claims. The proportion of the most frequent diseases was highest for pediatricians(90.4%) and followed by internists(81.4%), otolaryngologists(78.7%) and family physicians(76.5%). The proportion of the most frequent diseases in the most common 46 diseases was highest for radiologists(80.4%) and the next was as follows : general practitioners(78.3%), family physicians(67.4%), and internists(67.4%). We classified the most common 20 diseases of each specialty into 17 categories of ICD-9 and compared it with those of general practitioners. The specialists who had managed a similar disease pattern to those of general practitioners were identified as anesthesiologists, family physicians, general surgeons, and internists. Some specialists practicing at private clinics managed the diseases which were not quite appropriate for their specialties. After we evaluated each specialty by the most common diseases, the most frequent diseases, and the most frequent 20 diseases of each specialty in terms of the 17 categories of ICD-9, a tentative assumption is made that the primary physicians in the Republic of Korea are general practitioners, anesthesiologists, family physicians, internists, and general surgeons. This study has concluded that the categories of the primary care physicians are so diverse that their roles and distributions are distorted accordingly. Vigorous health policy efforts in correcting the malcomposition need to be made for the better provision of primary health care in Korea. in Korea.
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