• Journal of Korean Neurosurgical Society
• /
• 제52권4호
• /
• pp.312-319
• /
• 2012

Objective : In patients with spontaneous intracerebral hemorrhage (ICH), the risk factors for seizure and the effect of prophylactic anticonvulsants are not well known. This study aimed to determine the risk factor for seizures and the role for prophylactic anticonvulsants after spontaneous ICH. Methods : Between 2005 and 2010, 263 consecutive patients with spontaneous ICH were retrospectively assessed with a mean follow-up of 19.5 months using medical records, updated clinical information and, when necessary, direct patient contact. The seizures were classified as early (within 1 week of ICH) or late (more than 1 week after ICH). The outcomes were measured with the Glasgow Outcome Scale at discharge and the modified Rankin Scale (mRS) at both 2 weeks and discharge. Results : Twenty-two patients (8.4%; 9 patients with early seizures and 13 patients with late seizures) developed seizures after spontaneous ICH. Out of 263 patients, prophylactic anticonvulsants were administered in 216 patients. The prophylactic anticonvulsants were not associated with a reduced risk of early (p=0.094) or late seizures (p=0.326). Instead, the factors associated with early seizure were cortical involvement (p<0.001) and younger age (60 years or less) (p=0.046). The risk of late seizure was increased by cortical involvement (p<0.001) and communicating hydrocephalus (p=0.004). The prophylactic anticonvulsants were associated with a worse mRS at 2 weeks (p=0.024) and at last follow-up (p=0.034). Conclusion : Cortical involvement may be a factor for provoked seizures. Although the incidence of early seizures tended to decrease in patients prescribed prophylactic anticonvulsants, no statistical difference was found.

• Journal of Korean Neurosurgical Society
• /
• 제29권5호
• /
• pp.623-627
• /
• 2000

Objective : Spontaneous lumbar epidural hematoma is a rare entity, although the precipitating factors such as anticoagulation therapy frequently precede it. The authors report four cases of surgically confirmed spontaneous epidural hematoma mimicking lumbar disc herniation. Methods : Between 1995 and 1998, four patients with spontaneous lumbar epidural hematoma were diagnosed. The clinical findings which are identical to that of acute disc herniation are included in this study. The operative findings and radiological characteristics are also included. Results : The magnetic resonance(MR) image findings demonstrated epidural lesions of intermediate to low signal intensity equivalent to those of normal discs on $T_1$-weighted images, and epidural lesions of high signal intensity higher than these normal discs on a $T_2$-weighted image. The image findings also showed rim enhanced pattern of the gadolinium-enhanced $T_1$-weighted MR images. All of the hematomas was associated with a small concomitant disc herniation or underlying annular tear. Conclusion : The authors speculate that spontaneous lumbar epidural hematoma results from tearing of the fragile penetrating vein caused by underlying disc or annulus disruption between Batson' plexus and vertebral body.

• 한국의료질향상학회지
• /
• 제9권1호
• /
• pp.34-51
• /
• 2002

Background : The purpose for this study is to develop a critical pathway of bullectomy for spontaneous pneumothorax patients. Methods : For this study a conceptual framework of critical pathway was developed through a review of the literature including five critical pathways which are currently being used in USA, and opinions of the critical pathway development team members at Y university hospital. In order to identify the service contents required by these patients and to draw up a preliminary critical pathway, 33 cases of medical records of patients who had received bullectomy for spontaneous pneumothorax between September, 2000 to August, 2001 at the Respiratory Center of Y university hospital in Seoul was analyzed. Results : In order to test the clinical validity of the preliminary critical pathway, it was applied to ten patients who had received bullectomy for spontaneous pneumothorax from October, 2001 to December, 2001. The average discharge day was 4.89th post operation day, six patients discharged on the fourth post operation day which was the expected day, one patients discharged one day earlier than the expected day, one patient discharged three days later than the expected day, and one patient discharged six days later than the expected day. There were variances between the critical pathway and the actual practice. The variances came from tests, medications, and treatments. One item that showed variance in clinical applications was complemented, and three items were decided not to be corrected for the final determination of the critical pathway. Conclusion : This critical pathway is applicable to the care of patients with bullectomy for spontaneous pneumothorax, but it needs more clinical applications to grasp varied variances.

• Clinical and Experimental Pediatrics
• /
• 제58권5호
• /
• pp.178-182
• /
• 2015

Purpose: The purpose of this study was to determine the frequency of $CD4^+CD25^+FoxP3^+$ regulatory T cells (Treg) in the peripheral blood of patients with childhood chronic immune thrombocytopenic purpura (ITP) exhibiting thrombocytopenia and spontaneous remission. The findings of this study indicate the possibility of predicting spontaneous recovery and pathogenesis of childhood chronic ITP. Methods: Eleven children with chronic ITP (seven thrombocytopenic and four spontaneous remission cases; mean age, 8.8 years; range, 1.7-14.9 years) were enrolled in this study. Five healthy children and eight healthy adults were included as controls. The frequency of Treg was evaluated by flow cytometry in the peripheral blood. Results: In this study, four patients (36%) achieved spontaneous remission within 2.8 years (mean year; range, 1.0-4.4 years). The frequency of Treg was significantly lower in patients with persisting thrombocytopenia ($0.13%{\pm}0.09%$, P<0.05), than that in the patients with spontaneous remission ($0.30%{\pm}0.02%$), healthy adults controls ($0.55%{\pm}0.44%$), and healthy children controls ($0.46%{\pm}0.26%$). A significantly positive correlation was found between the frequency of Treg and the platelet count in children. Conclusion: These data suggest that a lower frequency of Treg contributes to the breakdown of self-tolerance, and may form the basis for future development of specific immunomodulatory therapies. Furthermore, Treg frequency has prognostic implication toward the natural course and long-term outcomes of childhood chronic ITP.

• Journal of Korean Neurosurgical Society
• /
• 제48권5호
• /
• pp.399-405
• /
• 2010

Objective : Patients with spontaneous intracerebral hemorrhage (ICH) presenting within 24 hours of symptom onset are known to be increased risk of hematoma expansion which is closely correlated with morbidity and mortality. We investigated whether tiny enhancing foci ('Spot sign') on axial view of 3-dimensional computed tomography angiography (3D-CTA) source images can predict subsequent hematoma expansion in spontaneous ICH. Methods : During a 2-year period (March 2007-March 2009), we prospectively evaluated 3D-CTA of 110 patients with spontaneous ICH. Based on source images of 3D-CTA, patients were classified according to presence or absence of 'Spot sign'; 'Spot sign' (+) group, 'Spot sign' (-) group. Radiological factors and clinical outcomes were compared between two groups. Results : Hematoma expansion occurred in 16 patients (15%). Mean Glasgow Coma Scale (GCS) score of patients with hematoma expansion was significantly different compared to score of patients without hematoma expansion (5 vs. 9, P < 0.001). Nineteen patients (16%) of 110 ICH patients demonstrated 'spot sign' on 3D-CTA. Among the 'spot sign' (+) group, 53% of patients developed hematoma expansion. Conversely 7% of patients without 'spot sign' demonstrated the hematoma expansion (p < 0.001). Initial volume and location of hematoma were significantly not associated with hematoma expansion except shape of hematoma. Conclusion : Our study showed that patients with hematoma expansion of spontaneous ICH had significant clinical deterioration. And the fact that 'spot sign' (+) group have higher risk of hematoma expansion suggests the presence of 'spot sign' on source images of 3D-CTA can give a clue to predict hematoma expansion in spontaneous ICH.

• 대한척추외과학회지
• /
• 제25권4호
• /
• pp.175-179
• /
• 2018

연구 계획: 증례 보고 목적: 탈출된 요추 추간판이 자연 소실된 이후 추간판 간격이 감소된 증례를 보고하고자 한다. 선행 문헌의 요약: 보존적 치료를 통한 탈출된 요추 추간판의 자연 소실이 보고되었다. 대상 및 방법: 요추 추간판 탈출증으로 진단된 3명의 환자를 외래 추시를 통해 보존적 치료를 시행하였다. 내원 당시에 관찰되었던 방사통은 호전 되었으나, 만성적인 요통을 호소하였다. 원인 파악을 위해 MRI 촬영을 다시 시행하였다. 결과: 보존적 치료로 탈출된 요추 추간판이 자연 소실 되었지만, 추간판 간격의 현저한 감소가 관찰되었다. 결론: 요추 추간판 탈출증이 추간판 간격 감소의 위험요인 중 하나일 수 있다. 요추 추간판 탈출증을 진단 받은 환자의 경우 탈출된 요추 추간판이 자연 소실되더라도 만성 요통이 발생 할 수 있음을 인지하는 것이 중요하다.

• The Journal of Korean Physical Therapy
• /
• 제20권3호
• /
• pp.69-74
• /
• 2008

Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.

• 말소리와 음성과학
• /
• 제6권1호
• /
• pp.21-30
• /
• 2014

This study aims to discuss pitch slope on Korean intonation curve in spontaneous speech data. For this study, 656 utterances were taken in the spoken corpus and used 'close-copy stylization'. And then the physical feature of pitch movements was extracted for the study. The pitch slope was calculated on the basis of time and pitch range in each utterance. As a result, the average and distribution of pitch slope is similar between men and women in the range of the pitch movement except for essential differences. The slope of pitch movement confirms that there are no differences between men and women. Pitch slope on a scale of -10 to 10 is 90% of the entire pitch slope; pitch slope that moves by time scale without curve is 33.1%; pitch slope that moves half of the pitch bandwidth during the average time for pitch movement is 23.4%; pitch slope that moves 100% of pitch bandwidth during a half of the average time for pitch movement is 10.4%. Those results imply the possibility of standardization methods of Korean intonation by pitch slope.

• Journal of Preventive Medicine and Public Health
• /
• 제15권1호
• /
• pp.179-186
• /
• 1982

The methods controlling the confounding factors were discussed using the data of secondary infertility with induced abortion. Mantel-Haenszel method and logistic model were applied in the analysis to find out which factors were confounding and/or effect modification variables. In the logistic analysis, the main effect of induced abortion, spontaneous abortion, age and interaction effect between induced abortion and spontaneous abortion were chosen as independent variables being regressed into logistic functions. Spontaneons abortion was interpreted as a potential confounder and at the same time potential effect modifier and age was interpreted as potential confounder. Spontaneous abortion was shown to be more important influencing factor than age to the secondary infertility. In the course of logistic analysis, the problem of parameter estimation and hypothesis testing, assessing the fitness of a model, and selection of the best model were briefly explained. For the program of logistic model, FUNCAT Procedure of SAS package was chosen.

• 대한한방부인과학회지
• /
• 제30권3호
• /
• pp.158-166
• /
• 2017

Objectives: The purpose of this paper is to report the spontaneous pregnancy of Jokyung-san-gagam treatments on two infertile patients who were failed to in intrauterine insemination (IUI) by three times. Methods: Two patients, in this case, were who failed three times IUI were treated with Jokyung-san-gagam, acupuncture and moxibustion. Results: The two infertile women achieved spontaneous pregnancy after taking Jokyung-san-gagam without assisted reproductive technology. Conclusions: These cases suggest that Jokyung-san-gagam is effective in treating infertile female after failure in IUI and can be an effective option for patients who were failed in IUI. For further study, the clinical approach on infertile patients that is based on Korean medicine treatment including Jokyung-san-gagam would be sustained.