• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.194-200
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• 2018

Objective : Sometimes a vertebral artery (VA) enters the spinal canal via the C1-2 intervertebral space, a variation regarded as a C2 segmental-type VA. This paper describes the anatomy of the C2 segmental-type VA and reviews its clinical importance. Methods : Between March 2014 and November 2015, 3386 patients underwent computed tomographic angiography. I identified C2 segmental-type VAs, associated vascular variation, the origin of ipsilateral posterior inferior cerebellar arteries (PICAs), and the clinical symptoms associated with C2 segmental-type VAs. The origin of an ipsilateral PICA is divided into 5 types. A type 1 PICA originates from ipsilateral VAs coursing suboccipitally (IVASO), a type 2 originates from ipsilateral proximal C2 segmental-type VAs, a type 3 originates from ipsilateral distal C2 segmental-type VAs. For type 4, the PICA does not originate from an ipsilateral VA. For type 5, the PICA is the terminal end of an ipsilateral C2 segmental-type VA. Results : One hundred thirteen patients had 121 C2 segmental-type VAs; 47 were associated with an IVASO, and 74 were not. Four type 1, 13 type 2, 60 type 3, 42 type 4, and two type 5 PICAs were identified. Only one patient showed symptoms associated with a C2 segmental-type VA, being a 71-year-old man presenting with a C2 segmental-type VA infarction. Conclusion : For C2 segmental-type VAs, the ipsilateral IVASO and origin of the PICA are important for predicting the outcome of this type of VA infarction.

• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.110-118
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• 2010

Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

• Journal of Oriental Neuropsychiatry
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• v.25 no.2
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• pp.203-212
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• 2014

Objectives: The aim of this study is to bring new light on TalYeong-SilJeong (exhaustion of Yeonggi and loss of Essence) through the verification of both the original intention of Hwangjenaegyeong and the conceptual variation afterwards. Methods: Of various East Asian medical texts, those inferring to TalYeong-SilJeong includeing Hwangjenaegyeong itself were closely examined under the aspect of its conception. Results: TalYeong-SilJeong was suggested as the first representative tool and accurate diagnostic method of questioning in order to determine the mental state of a patient. However, medical scholars have suggested different levels of meaning. Some used the term for the broad coverage of mental illnesses, understanding Hwangjenaegyeong's discrimination as symbolic gesture, while others projected an unchallenged value on it and weaved it into the concrete set of a disease. Conclusions: The treatment of TalYeong-SilJeong is suggested according to the varying viewpoints of each medical text. By understanding multiple layers of the conception beyond, a clinician is expected to gain an exuberant image of conception on the one hand and an insight for more effective treatment on the other hand.

• Journal of Biomedical Engineering Research
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• v.27 no.6
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• pp.402-408
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• 2006

The choice of suitable hip implant is one of important factors in the total hip arthroplasty (THA). In clinical view point, an improper adaptation of hip implant might induce abnormal stress distribution to the bone, which can shorten the lifespan of replaced hip implant. Currently, interest in the custom-designed hip implants has increased as studies reveal the significance of geometric shape of patient's femur in modeling and designing the implants. In this study, we have developed custom-designed hip implant models with various sizes, and analyzed the stress distribution in the bone and bone cement using the Finite Element Method. It was found that minimizing the gap between implant stem and femoral cavity is crucial to minimize the stress concentration in the bone.

• Journal of Institute of Control, Robotics and Systems
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• v.10 no.11
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• pp.1089-1094
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• 2004

Diseases in the gastro-intestinal track are on an increasing trend. In order to diagnose a patient, the various signals of the digestive organ, such as temperature, pH, and pressure, can offer the helpful information. Among the above mentioned signals, we choose the pressure variation as a monitoring signal. The variation of a pressure signal of the gastro-intestinal track can offer the information of a digestive trouble or some clues of the diseases. In this paper, a pressure monitoring system for the digestive organs of a living pig is presented. This system concept is to transmit the measured biomedical signals from a transmitter in a living pig to wireless receiver that is positioned out of body. The integrated solution includes the following parts: (1) the swallow type pressure capsule, (2) the receiving set consisting of a receiver, decoder box, and PC. The merit of the proposed system if that the monitoring system can supply the precise and repeatable pressure in the gastro-intestinal track. In addition, the design of low power consumption enables it to keep sending reliable signals while the pressure capsule is working in the digestive organ. The subject of the study for the pressure monitoring system is in-vivo experiments for a living pig. We achieved the pressure tracings in digestive organs and verified the validity of system after several in-vivo tests using pressure monitoring system. As a result, we found each organ has its own characterized pressure fluctuation.

• 제어로봇시스템학회:학술대회논문집
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• 2005.06a
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• pp.196-201
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• 2005

Diseases in the gastro-intestinal tract are on an increasing trend. In order to diagnose a patient, various signals of the digestive organ, such as temperature, pH, and pressure, can offer the helpful information. Among the above mentioned signals, we choose the pressure variation as a monitoring signal. The variation of a pressure signal of the gastro-intestinal tract can offer the information of a digestive trouble or some clues of the diseases. In this paper, a pressure monitoring system for the digestive organs of a living pig is presented. This is why a pig's gastro-intestinal tract is very similar as human's. This system concept is to transmit the measured biomedical signals from a transmitter in a living pig to a wireless receiver that is positioned out of body. The integrated solution includes the swallow type pressure capsule and the receiving set consisting of a receiver, decoder circuit. The merit of the proposed system is that the monitoring system can supply the precise and a durable characteristic to measure and to transmit a signal in the gastro-intestinal tract. We achieved the pressure tracings in digestive organs and verified the validity of system after several in-vivo tests using the pressure monitoring system. Through various experiments, we found each organ has its own characterized pressure fluctuation.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.14-17
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• 2011

Autologous breast reconstruction after mastectomy in breast cancer patient is now increasing. The deep inferior epigastric artery (DIEA) free flap is well known as an ideal donor site for the microsurgical breast reconstruction. The branching pattern of the DIEA was well described in the literature. In that study, DIEA has three branching patterns near the arcuate line. We describe a case in which branching variation of the DIEA before entering the posterior surface of the rectus abdominis muscle. In three cases, DIEA originated from the external iliac artery ascended as a double trunk at 1cm, 2cm, and 4cm above the originating point, respectively. In one case, DIEA ascended as a single trunk along the linea alba toward to the umbilicus until it supply overlying subcutaneous tissue. Preoperative 3D computed tomographic angiography to identify the anomaly is recommended and meticulous dissection to the originating point of DIEA is needed.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.750-754
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• 2022

Trigger wrist, characterized by a clicking or snapping sensation around the wrist joint during finger or wrist motion, and bifid or trifid median nerve, which occurs in carpal tunnel syndrome along with anatomical variation of median nerve, are rare conditions. We report the case of a patient with a thickened tendon caused by severe tenosynovitis and flexor tendon subluxation to the hamate hook due to bowing of the flexor retinaculum, thereby resulting in trigger wrist as well as an anatomical median nerve variation (bifid median nerve in the right wrist and trifid median nerve in the left wrist). A 59-year-old housewife visited our hospital with bilateral fingertip numbness, tingling sensation, and aggravated severe night cramping that began 2 months ago. She also complained about trigger wrist during small finger flexion. Based on magnetic resonance imaging, ultrasonography, and nerve conduction study, trifid median nerve and bilateral severe median nerve neuropathy of the wrist were diagnosed; therefore, transverse carpal tunnel release and exploration under wide-awake anesthesia were planned. Intraoperative findings showed trifid and bifid median nerves in left and right wrists, respectively. Additionally, bowing of flexor retinaculum and severe flexor tendon tenosynovitis were observed. Tenosynovitis with thickened flexor sheath resulted in subluxation of the small finger flexor tendon above the hamate hook. After transverse carpal ligament release with antebrachial fascia release and tenosynovectomy, subluxation of the flexor tendon was resolved. At 6 months postoperatively, the tingling and dullness in fingertips also resolved, and no trigger wrist or any other complications were noted.

• Journal of Korean Academy of Nursing
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• v.14 no.1
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• pp.60-68
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• 1984

The main purpose of this study is to observe patterns of pain of surgical patients following surgery The postoperative pain was checked with the interval of every 2 hours from 6 hours to 80 hours after surgery. Graphic rating scale from unidimensional concept of pain and sensory intensity scale and unpleasantness scale from two dimensional concept of pain were used for pain measurement. Thirty two patients were participated in this study in which 22 were undergone upper abdominal surgery, 7 thyroid or neck surgery and 3 other surgeries. The findings obtained from this study were as follows: 1) In all cases of using 3 different pain measurement tools, postoperative pain was markedly decreased since 36 hours after surgery. In case of patient's less cooperation, either sensory intensity scale or graphic rating scale may be chosen for the measurement of pain. 2) Pain amounts measured by sensory intensity scale were highly correlated with those measured by unpleasantness scale in all situations except several situations having few cases included. Unpleasantness scale may be separately used for themeasurement of affective response due to pain. 3) Almost 90% of total amount of analgesics used for relief of pain were used within 36 hours after surgery. 4) Mean frequency of analgesics used by every patient during 80 hours following surgery was 0.84.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.116-120
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• 2016

Congenital hyperinsulinism (CHI) is a rare condition that can cause irreversible brain damage during the neonatal period owing to the associated hypoglycemia. Hypoglycemia in CHI occurs secondary to the dysregulation of insulin secretion. CHI has been established as a genetic disorder of islet-cell hyperplasia, associated with a mutation of the ABCC8 or KCNJ11 genes, which encode the sulfonylurea receptor 1 and the inward rectifying potassium channel (Kir6.2) subunit of the ATP-sensitive potassium channel, respectively. We report the case of a female newborn infant who presented with repetitive seizures and episodes of apnea after birth, because of hypoglycemia. Investigations revealed hypoglycemia with hyperinsulinemia, but no ketone bodies, and a low level of free fatty acids. High dose glucose infusion, enteral feeding, and medications could not maintain the patient's serum glucose level. Genetic testing revealed a new variation of ABCC8 mutation. Therefore, we report this case of CHI caused by a novel mutation of ABCC8 in a half-Korean newborn infant with diazoxide-unresponsive hyperinsulinemic hypoglycemia.