• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.777-783
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• 2020

Objective : To compare the accuracy and breach rates of freehand (FH) versus navigated (NV) pedicle screws in the thoracic and lumbar spine in patients with metastatic spinal tumors. Methods : A retrospective review of adult patients who underwent pedicle screw fixation in the thoracic or lumbar spine for metastatic spinal tumors between 2012 and 2018 was conducted. Breaches were assessed based on the Gertzbein and Robbins classification and only screws placed >4 mm outside of the pedicle wall (lateral or medial) were considered breached. Results : A total of 62 patients received 547 pedicle screws (average 8 per patient) - 34 patients received 298 pedicle screws in the FH group and 28 patients received 249 screws in the NV group. There were 40/547 breaches, corresponding to a breach and accuracy rate of 7.3% and 92.7%, respectively. The breach rate was 9.7% in the FH group and 4.4% in the NV group (chi-squared test, p=0.017); this corresponded to an accuracy rate of 90.3% and 95.6%, respectively. Only one patient from the overall cohort (in the FH group) required revision surgery due to a medial breach abutting the spinal cord (1.6% of all patients; 2.9% of FH patients); no patient suffered organ, vessel, or neurological injury from screw breaches. Conclusion : Navigated pedicle screw placement in patients with metastatic spinal tumors has a significantly higher radiographic accuracy compared to the FH technique. However, the revision surgery was low and no patient suffered from clinically-relevant breach. Navigation also offers the advantage of real-time localization of spinal tumors and aids in targeting and resection of these lesions.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.350-355
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• 2016

Background: Mitral stenosis (MS) remains one of the important heart diseases. There are many factors that influence the clinical outcomes, and little is known about how left ventricular (LV) dysfunction clinically affects the prognosis of the patient with MS after mitral valve replacement (MVR). We reviewed our clinical experiences of MVR in patients with MS who had LV dysfunction. Methods: Between January 1991 and January 2013, 110 patients with MS who underwent MVR were analyzed and divided into two groups according to ejection fraction (EF). Group 1 ($EF{\leq}45%$) included 13 patients and group 2 (EF>45%) included 97 patients. Results: Thromboembolism occurred in 8 patients after MVR (group 1: n=3, 23.1%; group 2: n=5, 5.2%) and its incidence was significantly higher in group 1 than in group 2 (p=0.014). There were 3 deaths each in groups 1 and 2 during follow-up. The overall rate of cardiac-related death in group 1 was significantly higher than in group 2 (group 1: n=3, 23.1%; group 2: n=3, 3.1%; p=0.007). The cumulative survival rate at 1 and 15 years was 83.9% and 69.9% in group 1 and 97.9% and 96.3% in group 2 (p=0.004). The Cox regression analysis revealed that survival was significantly associated with postoperative stroke (p=0.011, odds ratio=10.304). Conclusion: This study identified postoperative stroke as an adverse prognostic factor in patients with MS after MVR, and a s more prevalent in patients with LV dysfunction. Postoperative stroke should be reduced to improve clinical outcomes for patients. Preventive care should be made in multiple ways, such as management of LV dysfunction, atrial fibrillation, and anticoagulation.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.509-515
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• 2010

Purpose : This study was performed to examine the effect of stimulation task-oriented training on the balance ability of the hemiplegic patients caused by stroke. Methods : We made a random sampling of 25 hemiplegic patients caused by stroke. 10 patients(experimental group)were treated by simulation Task-oriented training and Conventional training used by balance pad. The other 10 patients(control group) were only treated by Conventional training used by balance pad. During the training, 3 patients from the experimental group and 2 patients from the control group were excluded by private affairs. The control group has done Conventional training 6 times a week for 6 weeks. And experimental group has done Simulation task-oriented training two times, conventional training four times a week for 6 weeks. Balance ability was assessed by Fuctional Reaching Test (FRT) : unilateral and bilateral reaching. Results : In comparison of FRT before and after training, two groups all was significantly improved(p<.05). But bilateral reaching variation was significantly improved in experimental group. Conclusion : we can use simulation Task-oriented training valuably to increase balance ability of hemiplegic patients.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.1
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• pp.3-12
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• 1998

Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

• Journal of Sasang Constitutional Medicine
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• v.29 no.4
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• pp.336-346
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• 2017

Objectives The purpose of this study is to investigate the characteristics of low back pain and shoulder arm pain patients according to the Sasang Constitution. Method We classified Seventy-nine participants by their Sasang Constitution. We investigated various aspects of the participant's pain such as the location of pain, diseases and Syndrome Differentiation etc. then intended to confirm relationship the Sasang Constitution and these research items through the statistics analysis. Results The numbers of lower back pain patients was statistically higher in Soyangin group than any other groups and the number of shoulder arm pain patients was statistically higher in Taeeumin group or Eumin group (Taeeumin group and Soeumin group) than Soyangin group. The number of diabetes patients and obesity patients was statistically higher in Taeeumin lower back pain patients, and that of obesity patients was statistically higher in Taeeumin shoulder arm pain patients than any other groups. The numbers of shoulder arm pain patients due to blood stasis and lower back pain patients due to kidney deficiency were statistically higher in Soyangin group than any other groups. The numbers of shoulder arm pain patients due to phlegm fluid retention and lower back pain patients due to phlegm fluid retention were statistically higher in Taeeumin group than any other groups. Conculsions The characteristics of lower back pain and shoulder arm pain could be different according to Sasang constitution.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.53-58
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• 1995

Open lung biopsy still has important roles for the marking of diagnosis of diffuse infiltrative lung disease even though transbronchial bronchoscopic lung biopsy and percutaneous needle aspiration biopsy gain popularity nowadays. This is clinical retrospective review of the 56 patients with diffuse infiltrative lung disease undergoing open lung biopsy by minithoracotomy from 1984 to Dec. 1992 in the Department of Thoracic & Cardiovascular Surgery of Catholic University Medical College. 27 men and 29 women, aged 17 to 73 year [mean 49 year , were enrolled & divided into 2 groups;Group A consisted of patients with immunocompromised state [n=19 , Group B patients with non-immunocompromised state[n=38 . Pathologic diagnosis was made in 54 cases[96.4% of these two groups and as follows: infectious; 12 patients[21.4% , Neoplastic; 10 patients[17.9% , granulomatous; 4 patients[7.1% , interstitial pneumonia; 12 patients[21.4% , Pulmonary fibrosis; 8 patients[14.3% , others; 3 patients[5.4% , nonspecific; 5 patients[8.9% , and undetermined; 2 patients[3.6% . Therapeutic plans were changed in 39 patients[69.6% after taking of tissue diagnosis by open lung biopsy. Group B has higher incidence of infectious diseases and change of therapeutic plan than the Group A. The postoperative complications developed in 8 cases[14.3% ,and there is no difference of incidence between the 2 groups. 4 patients belongs to group A, died of respiratory distress syndrome [2 and sepsis [2 which were not related with open lung biopsy procedure. In conclusion, open lung biopsy is a reliable method to obtain a diagnosis in diffuse pulmonary infiltrates and can be performed safely, even in acutely ill, immunosuppressed patients.

• Journal of Chest Surgery
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• v.13 no.1
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• pp.41-47
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• 1980

Fifty one consecutive patients undergoing open heart surgery, twenty eight congenital and twenty three acquired heart disease, were studied between May and August 1979 in Dept. of Thoracic and Cardiovascular Surgery SNUH. During the same time 10 patients of PDA were included in this study as control group. Four out of fifty one OHS patients, two ASD and two pulmonic stenosis patients, were operated without aortic cross-clamp. In all patients, serial determination of total level of creatine phosphokinase [CPK], lactic dehydrogenase [LDH], glutamic oxaloacetic transaminase [SGOT] were made preoperatively, operative day [immediate post-op], and post-operative days up to 7th day. Electrocardiograms were also evaluated serially. Open heart surgery patients were divided into two groups; Group A was aorta clamp time beyond SO minutes, and Group B was below 50 minutes. The peak level of each enzyme was compared, and electrocardiographic changes were also compared between groups. Although the electrocardiographic changes were more frequent in Group A [50%] than Group B [24%], the peak levels of each enzymes were almost same in Group A and Group B.

• The Journal of Korean Physical Therapy
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• v.28 no.3
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• pp.201-204
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• 2016

Purpose: The purpose of this study was to compare the immediate effects of alternative treatment methods in lowering the blood pressure and pulse of prehypertensive patients. Methods: A total of 48 prehypertensive patients were randomly divided into 4 groups of 12 patients and each group received a different intervention. The control group was made to rest, the heat pack (HP) group received heat pack treatment, the ultrasound (US) group received an ultrasound massage, and the myofascial release (MFR) group received myofascial release. The blood pressure and pulse rate were measured before and after intervention. Results: Following intervention, the patients of the MFR group showed a decrease in systolic pressure, diastolic pressure, and pulse rate. Although blood pressure was similar in all groups, a significant decrease in pulse rate was seen in the MFR group compared to others. Conclusion: The application of MFR was shown to be an effective method for lowering the blood pressure and pulse rate in prehypertensive patients.

• Journal of Korean Physical Therapy Science
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• v.13 no.3
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• pp.27-40
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• 2006

The purpose of this study is comparative with administrative and clinical standard of conservative treatment on herniated intervertebral lumbar disc patients. The persons who diagnosed to herniated intervertebral lumbar disc were attended in this study. The number of cases were 120 cases. We evaluated their chart, X-ray and MRI. The result of the group 1 study(60 cases) were as follows; 1. The patients who treated for 41days were improved 100%, which was 3cases(5%). 2. The patients who treated for 45days were improved 90%, which was 13cases(22%). 3. The patients who treated for 43days were improved 80%, which was 28cases(47%). 4. The patients who treated for 39days were improved 70%, which was 6cases(10%). 5. The patients who treated for 28days were improved 60%, which was 5cases(28%). 6. The patients who treated for 22days were improved 50%, which was 4cases(7%). 7. The patient who treated for 28days were improved 40%, which was 1case(2%). The result of the group 2 study(60 cases) were as follows; 1. The patients who treated by administrative standard were improved 40%, which was 8cases(13%). 2. The patients who treated by administrative standard wereimproved 30%, which was 32cases(53%). 3. The patients who treated by administrative standard wereimproved 20%, which was 7cases(12%). 4. The patients who treated by administrative standard were improved 10%, which was 9cases(15%). 5. The patients who treated by administrative standard wereimproved 0%, which was 4cases(7%). Conclusion ; In herniated intervertebral lumbar disc patients who had conservative treatment. The highest improve patients were 28 cases(47%), who treated for 43 days in group 1. The lowest improve patient were 4 case(7%), who treated by administrative standard in group 2. The Effective duration of conservative treatment was more than 43 days in group 1. Group 1 which applied to clincal standard was much batter than group 2 which applied to administrative standard.

• Journal of Korean Academy of Nursing
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• v.44 no.4
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• pp.381-390
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• 2014

Purpose: The purpose of this study was to identify the effects of a Progressive Walking program (PW) on physical activity, exercise tolerance, recovery, and post-operative complications for patients with a lung resection. Methods: A nonequivalent control group non-synchronized design was utilized and 37 participants with a lung resection (22 for control group, 15 for experimental group) were recruited at A university hospital from December 2012 to August 2013. The PW consisted of preoperative education, goal setting, and feedback, provided to the experimental group, and usual care to the control group. Data were analyzed using the SPSS WIN 18.0. Results: A higher proportion of patients in the experimental group showed adequate levels of physical activity (p=.001), shorter period of chest tube retention (${\leq}7$ days; p=.011), and shorter stay in the hospital (${\leq}10$ days; p=.036) than patients in the control group. Patients in the experimental group reported longer 6-minute walking distance (p=.032) and lower levels of dyspnea (p=.049) than patients in the control group. The PW did not influence the occurrence of pulmonary complications. Conclusion: The findings of this study suggest that the PW could be a useful strategy for improving patients' post-operative health and reducing cost after lung resection.