• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.475-478
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• 2006

Background: The simultaneous bilateral spontaneous pneumothorax is a rare clinical event. Contrary to the unilateral pneumothorax, the patients with simultaneous bilateral spontaneous pneumothorax sometimes complains of severe respiratory distress, cyanosis and chest pain without tention pneumothorax. It is often dangerous; therefore, the chest drain should be inserted immediately. Material and Method: Between March 1994 and February 2004, 802 patients were treated in our department for spontaneous pneumothorax. Among these, the simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%). Result: Out of fourteen patients, two females and twelve males presented with simultaneous bilateral spontaneous pneumothorax. The patient age ranged between 0 and 79 years with mean age of 31.2 years. In eleven patients, this was the first episode of pneumothorax. One patient had combined hemopneumothorax and two patients had combined pyopneurnothorax. Six patients had smoking history (42.8%, average 17.3 p-y). Five patients had pulmonary tuberculosis history and among these, two patients had active pulmonary tuberculosis. Three patients were died due to meconium-aspiration pneumonia (1 patient) and ARDS (Acute Respiratory Distress Syndrome) with pneumonia (2 patients). We treated these patients with nasal oxygen inhalation, chest drain insertion, thoracotomy, VATS (Video-Assisted Thoracoscopic Surgery) and chemical pleurodesis. Conclusion: The simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%) among 802 patients. Prompt insertion of chest drain is needed for a relief of severe symptoms, and to reduce the risk of recurrence, early thoracotomy or VATS should be performed rather than chest drain insertion only.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.677-683
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• 2009

May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome. We now present two cases of chronic (> 1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3207-3210
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• 2014

Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterized by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d'orange appearance. It accounts for 1-3% of all newly diagnosed cases of breast cancer in the west. Data on IBC from India are lacking. The aim of our study was to assess the clinical-pathological parameters and outcome of IBC at, All India Institute of Medical Sciences, a large tertiary care centre. Materials and Methods: We screened 3,650 breast cancer cases registered from January 2004 to December 2012 and found 41 cases of IBC. Data included demographics as well as clinical, radiological and histopathological characteristics, and were collected from clinical case records using the International Classification of Diseases code (C-50). Patients who presented with IBC as a recurrence, or who had a neglected and advanced breast cancer that simulated an IBC were excluded from this study. Results: The median age was 45 years (range 23-66). The median duration of symptoms was 5 months. The American Joint Committee on Cancer stage (AJCC) distribution was Stage III - 26 and IV - 15 patients. Estrogen receptor (ER), progesterone receptor (PR) positivity and human epidermal growth factor receptor 2 (HER2/neu) positivity were 50%, 46% and 60%, respectively. Triple negativity was found in 15% of the cases. All the non metastatic IBC patients received anthracycline and/ or taxane based chemotherapy followed by modified radical mastectomy, radiotherapy and hormonal therapy as indicated. Pathological complete remission rate was 15%. At a median follow-up of 30 months, the 3 year relapse free survival and overall survival were 30% and 40%respectively. Conclusion: IBC constituted 1.1% of all breast cancer patients at our centre. One third of these had metastatic disease at presentation. Hormone positivity and Her2 neu positivity were found in 50% and 60% of the cases, respectively.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.223-244
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• 1997

Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.53-59
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• 1989

The ameloblastoma is the most common form of the odontogenic tumors exhibiting minimal inductive change in connective tissue, it comprising 1% of all tumor and cysts of the jaws. It is a true neoplasm, generally considered to be a benign but persistent or, locally malignant lesion. The tumor occurs most commonly in persons between the age of 20 and 50 years. 80% and 90% of all lesions are in the mandible. The presenting clinical signs and symptoms of the ameloblastoma very from patient to patient, but most common symptom was swelling, followed by pain, draining sinuses, and superficial ulcerations. It is slow-growing lesion, and the radiographic features of the ameloblastoma depend large one the nature and the local bone reaction to the particular tumor. Recurrence rate is about 33%, but this is probably due to incommplete initial removal of lesion. We had operated a patient ; 29-year-old female immediate reconstruction combined with autocompression plate and iliac bone graft and screw fixation after hemimandibulaectomy with recurred ameloblastoma involving from premolar to ascending ramus at right side mandible. We obtained favorable results of good function, short intermaxillary fixation periods and easy operation precedure than the other reconstruction methods.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.4 no.1
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• pp.33-41
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• 1991

The clinical entity referred to as epithelial hyperplasia has been called by various terms : keratosis, hyperkeratosis, pachydermia, acanthosis, leukoplakia, hyperkeratotic laryngitis. The metaplasia and keratinization of the layngeal mucosa are associated with the subsequent appearance of invasive epidermoid carcinoma. Therefore. frequent and prolonged periods of observation and histologic study on keratosis of the larynx are essential. A retrospective review of 18 patients with laryngeal hyperkeratosis seen at Department of Otolaryngology Yondong Severance Hospital during the 7 years period was completed. The results are summarized as follows : 1) The incidence was much higher in males(22 patients) than in females(4 patients) 2) The peak age of male was 4th decades and the peak age of female was 4th. 5th decades. 3) The chief complaint of the patients was hoarseness in all cases. 4) The average duration of symptoms was less than 24 months for 19 cases(73.1%). 5) 17 patients(65.4%) was smokers and duration of smoking was 10~20 years for 10 cases(38.8%). 6) On histological examination. the lesions were classified into three types: simple hyperplasia(61.5%). dysplasia(26.9%) and carcinoma in situ(2 cases). 7) The recurrence rates was 9 cases(34.6%) and transformation rate into invasive carcinoma was 1 case(3.8%).

• The Journal of Internal Korean Medicine
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• v.26 no.1
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• pp.1-11
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• 2005

Backgrounds : Gamichungsangboha-tang extract has been known to improve pulmonary functions and quality of life within four weeks of treatment. Cessation of treatment causes recurrence of symptoms and regression of pulmonary function and poorer quality of life. Long-term herbal therapy is difficult to maintain due to economic burden and other reasons. AF-365 is made with reduced dosage of Gamichungsangboha-tang extract. This study was designed to evaluate the effectiveness of AF-365 for maintenance therapy. Materials and Methods : The subjects consisted of 27 patients with asthma who had beed treated with AF-365 for four weeks. First, patients were treated with Gamichungsangboha-tang extract for four weeks. Second patients stopped herbal medicine for four weeks and after that they took AF-365. Pulmonary function test(PFT) was checked before and after four weeks of treatment. Quality of Life Questionnaire for Adult Korean Asthmatics(QLQAKA) was checked every two weeks from the beginning. The effects of AF-365 were analysed throughout the last four weeks. Results : Treatment of AF-365 for four weeks resulted in significant increase in PEFR%, QLQAKA. The QLQAKA of the step3, step4 group classified by Global initiative for asthma(GINA) showed significant improvement, and the QLQAKA of the step2 group showed no significant difference. In step3 group, PEFR% increased significantly. Conclusions : This study supports a role for AF-365 in maintenance of pulmonary function and quality of life, especially in persistent symptomatic asthmatics.

• Korean Journal of Acupuncture
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• v.28 no.2
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• pp.59-75
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• 2011

Objectives : The Aim of this study was to investigate the clinical characteristics of male and female patients who have been suffered from headaches. The investigation was undertaken based on Qi-section(Methods of prescribing oriental herbal medicine) from DongEuiBoGam(東醫寶鑑). Methods: A statistical survey was conducted to compare the difference in clinical characteristics between male and female patients experiencing headaches. Oriental medical Diagnosis was used to classify all parients under the following categories Qi-deficiency (氣虛), Jing-dificiency (精虛), Food-stagnation (食積), Damp-accumulation (痰飮), Qi-stagnation (氣滯). Patients were treated using acupuncture therapy and herbal medicines. Results : 1. The ratio between male and female patients was about 1:3. 2. It showed that periods of illness were longer in female patients than in male patients. 3. The total number of treatments received was higher in female patients than in male patients. 4. Statistically, most female patients had Metopodynia and Migraines(Rt.), while male patients suffered mostly from Laryngalgia. 5. Male patients had feelings of strain in the head and female patients had splitting headaches. 6. Musculo-skeletal System and General Symptoms were frequently observed in male patients. Digestive System and Nervous System were frequently observed in female patients. 7. Results from oriental medical Diagnosis showed that male patients mostly had Qi-deficiency, ling-deficiency while the majority of female patients had Food-stagnation, Damp-accumulation, Qi-stagnation. 8. The recovery time for male patients was shorter than it was for female patients. The recurrence rate of the headaches were higher for female patients. Prognosis was better than in female patients in comparison to male patients. Conclusions : The statistical survey conducted was based on Qi-section of DongEuiBoGam. It had significant differences in clinical characteristics between male & femal patients.

• The Journal of Korean Medicine
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• v.24 no.3
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• pp.165-171
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• 2003

Objective : Stroke is the second major cause of death in Korea. It is known that the survival and ultimate outcome in stroke depend on various factors, so it is not easy to predict unexpected death in stroke. This study was performed in order to find predicting factors of unexpected death in stroke. Methods : A retrospective study was accomplished by reviewing 21 medical records of stroke patients who expired in the ward of Kyung Hee Oriental Medical Center from January 1998 to December 2001. Data analyzed Were physical examination, laboratory findings, clinical charts and APACH III scoring system. Results : I. The number of unexpected deaths at the ward of Kyung Hee Oriental Medical Center from January in 1998 to December in 2001 were 21 patients (0.1%). 2. Major risk factors of unexpected death were age (${\geq}60$), high blood pressure on 1st admission day and acute stage (${\leq}30{\;}days$). 3. The most frequent time of unexpected death was from 6 a.m. to noon. 4. Major cause of unexpected death was recurrence of stroke (40%). 5. APACH III scores of 75% of unexpected death patients were over 30 points. 6. Clinical change of symptoms 3 or 4 days before the unexpected death were dyspnea, change of urination and defecation. Conclusion; This mortality study suggests that old age, high blood pressure on 1st admission day, acute stage, and high APACH III score are the major predictors of unexpected death in stroke patients and that intensive medical attention is necessary to reach a better outcome.

• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.241-250
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• 2007

We examined 104 patients(primary group, controlled group) who had visited PNUH from 1994 to 2002, having been diagnosed as temporomandibular disorders(TMDs) and treated in conservative ways such as Behavior modification, medications, physical therapies and splint therapies. We also examined 54 patients(recurred group, experimental group) who had visited PNUH from 1991 to 2001, having been diagnosed as TMDs and experienced recurrence after conservatively treated. To find out the symptoms of Recurred TMD patients and their results of conservative treatments, we compared these two groups mentioned above. The obtained results were as follows: 1. Both primary and recurred groups have showed great improvements with conservative treatments. 2. Both primary and recurred groups have showed no differences in pain, LOM, MCO in their first visits but the noise were louder in primary group. 3. Both primary and recurred groups have showed no differences in pain, LOM, MCO when the treatments were over but the noise were louder in recurred group. 4. Treatments modalities, diagnosis, sex, kind of disease had not affected the results of treatment in either of groups. 5. It has come out that much better results were achieved when the patients in primary group had treated for over 6 months and for more than 10 times.