• Title/Summary/Keyword: Veterans

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Miller Fisher syndrome in a patient with pulmonary tuberculosis

  • Park, Jae Young;Jung, Hoe Jong;Bae, Heewon;Han, Jeong-Ho;Kang, Min Ju
    • Annals of Clinical Neurophysiology
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    • v.22 no.2
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    • pp.117-120
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    • 2020
  • Miller Fisher syndrome (MFS) is characterized by the acute ophthalmoparesis, ataxia and areflexia. We describe the case of 70-year-old man with cardinal symptom of MFS and active pulmonary tuberculosis (Tb). A thorough evaluation led to the diagnosis of MFS and treatment with intravenous immunoglobulin (IVIg) was started. The complete resolution of ophthalmoparesis and ataxia was observed from the fourth day of IVIg treatment. This is the first report to describe a case of MFS that developed in patient pulmonary tuberculosis.

Migration of K-wires from the Acromioclavicular Joint to the Neck - Case Report(2 cases) - (견봉 쇄골 관절 탈구에 사용된 K-강선의 경추부로의 이동 - 증례보고(2예) -)

  • Lee, Woo-Seung;Kim, Taik-Seon;Yoon, Jeong-Ro;Kim, Young-Bae;Seo, Dong-Hoon;Kwon, Jae-Ho
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.196-201
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    • 2006
  • We report two cases of migration of K-wires from the acromioclavicular joint to the neck. A 73-year-old man complained of right shoulder pain for one month and had undergone orthopedic surgery because of acromioclavicular joint dislocation about 27 years earlier. Another 56-year-old man complained of left shoulder pain and neck pain for 5 years and had undergone orthopedic surgery because of acromioclavicular joint dislocation about 25 years earlier. In both cases, we took X-rays to look for the cause of shoulder pain and discovered broken and migrated K-wires in the neck. We removed the K-wires from the trapezius muscle and the paraspinal muscle respectively. K-wire fixation technique is simple and effective but should be followed up with X-rays periodically. In addition, we should warn patients of the possibility of migration of K-wire. And it is desirable for us to avoid using K-wire near major neurovascular structures like the sternoclavicular joint and the clavicle.

Retrospective Analysis of Re-operated Patients after Chronic Subdural Hematoma Surgery

  • Jeong, Chul-An;Kim, Tae-Wan;Park, Kwan-Ho;Chi, Moon-Pyo;Kim, Jae-O;Kim, Jung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.116-120
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    • 2005
  • Objective : The aim of this study is to analyze the clinical symptoms, radiological changes, interval from first operation to symptom recurrence and to propose the proper treatment method for re-operated patients following chronic subdural hematoma surgery. Methods : Between January 1992 and April 2003, 18 of 138patients of chronic subdural hematoma repeatedly underwent surgical treatment. The symptoms, mental status by Bender grade, radiological hematoma size and midline shifting, interval from symptom onset to diagnosis, surgical method and prognosis by Glasgow outcome scale[GOS] between the first attack and the recurrence were compared. Results : The symptoms at the time of recurrence were nearly the same as with the first attack, but two patients[2/18, 11.1%] showed a more declined mentality. In addition, the recurred hematoma sizes were the same or large than those previously found. Many patients were recurred within two weeks[13/18, 72.2%]. Most patients were operated on using the previous burr hole, with the exception of one patient who recurred at a different site. All patients had a good prognosis more than GOS 4 [GOS 4:4, GOS 5:12], but two died due to extracranial complication and infection. Conclusion : These results suggest that the early diagnosis and treatment are important, mostly recurred same symptoms within two weeks. Re-operation using the previous burr hole site is a good method.

Monitoring of Methicillin-resistant Staphylococcus aureus in Nasal Swabs Obtained from Dental Clinic Healthcare Providers and Medical Environment Nurses

  • Han, Seung-Ho;Song, In-Sook;Kim, Jong-Koan;Park, Jum-Gi;Park, Jang-Hwan;Lee, Myeong-Jae;Kim, Shin-Moo;Kim, Kang-Ju
    • International Journal of Oral Biology
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    • v.35 no.1
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    • pp.7-12
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    • 2010
  • The aims of this study were to investigate the nosocomial infection route of methicillin-resistant Staphylococcus aureus (MRSA) and explore preventative methods for this pathogen that involve blocking its dispersion. We cultured MRSA from nasal cavity swabs collected between June and July 2008 that we obtained from eight dental healthcare providers, 32 nurses and the sputum specimens of two patients from our hospital. In addition, we used VITEK 2 equipment to measure drug sensitivity, and we further performed biochemical testing and pulse-field gel electrophoresis (PFGE) to isolate MRSA colonies. The incidence of these bacteria on the nasal swabs was 25.0% from dental clinic healthcare providers, 13.6% from the internal medicine ward nurses and 30.0% from intensive care unit nurses. Moreover, MRSA was detectable in sputum specimens of ward patients. The antimicrobial agents resistance and partial PFGE types of MRSA showed a similar pattern. We suggest from these analyses that nasal cavity infection by MRSA could occur by cross contamination between healthcare providers and patients which underscores the importance of stringent MRSA management practices.

Prognostic Value of $^{99m}Tc-Phytate$ Liver Scintigraphy in Patients with Liver Cirrhosis ($^{99m}Tc-phytate$ 간스캔을 이용한 간 경변증의 예후 평가)

  • Yang, Soo-Hyun;Park, Bong-Chul;Che, Dong-Ho;Cho, Jun-Koo;Park, Sung-Ki;Byun, Jong-Hoon;Song, Tae-Won
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.76-80
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    • 1991
  • To evaluate the prognostic significance of $^{99m}Tc-phytate$ liver scintigraphy in patients with cirrhosis, we measured the grade of extrahepatic uptake (EHU) of $^{99m}Tc-phytate$, from 0 (absent EHU) to 5 (important EHU), according to the relative distribution of the radiotracer among liver, spleen and bone marrow. The results were as follows: 1) EHU score was correlated to the Pugh score (r=0.64) and to survival. 2) The ROC curve on an observed status of death was superior for EHU score. In conclusion, $^{99m}Tc-phytate$ liver scintigraphy nay be a useful prognostic method in patients with liver cirrhosis.

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The Influence of Post-Traumatic Stress and Social Support on Depression of Vietnam Veterans (베트남 참전군인의 외상 후 스트레스와 사회적 지지가 우울에 미치는 영향)

  • Hyun, Hye-Sun;Kim, Tae-Yeol;Kim, Yun-Young
    • The Korean Journal of Health Service Management
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    • v.12 no.1
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    • pp.137-147
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    • 2018
  • Objectives : The purpose of this study was to identify the post-traumatic stress, social support, and depression of Vietnam veterans and the effects of post-traumatic stress and social support on depression. Methods : This study was carried out from June 2017 to September 2017 with the cooperation of the Korean Society of Veterans' Affairs and 250 Vietnamese veterans from D city were randomly sampled and collected. The collected data were used by SPSS 24.0 Statistics Program. Results : Social support was inversely correlated with post-traumatic stress (r=-.268, p<.001) and depression (r=-.333, p<.001), and post-traumatic stress and depression (r=.592, p<.001) were positively correlated. Post-traumatic stress and social support of veterans had a significant effect on depression, and post-traumatic stress and social support showed an explanatory power of 37.7% in depression. Conclusions : It is necessary to improve soldiers' mental health by mediating their post-traumatic stress and reducing their depression level by establishing a social support system.

Fludarabine and Rituximab in Relapsed or Refractory Hairy Cell Leukmia Variant: A Case Report and Review of Literature

  • Lee, Ji Won;Choi, Youn Mi;Yang, Jae Yun;Han, Seung Moon;Kim, Bong Seog;Nam, Seung-Hyun
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.438-445
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    • 2018
  • Hairy cell leukemia (HCL) is a rare chronic B cell leukemia morphologically characterized by cells with an abundant cytoplasm and hair-like projections that can be found in the peripheral blood and bone marrow. The treatment for HCL is splenectomy or chemotherapy with the purine analogs pentostatin and cladribine. However, patients continue to relapse. Retreatment with the same or alternate purine analogs produces lower response rates and a shorter duration of response. Fludarabine is another purine analog widely used in treating indolent lymphoid cancers, often in combination with rituximab. Here, we report a case of HCL variant in a 60-year-old man who experienced multiple relapses after splenectomy and retreatment with cladribine. The patient was then treated with fludarabine and rituximab combination chemotherapy. After the treatment, he achieved complete remission that continued for 35 months.

Outcome Assessment of Endodontic Treatment of Mandibular Second Molars with C-shaped Canals in Elderly Patients

  • Go, Yu-Ra;Kim, Mi-Yeon;Kim, Sun-Ho;Kim, Jeong-Hee;Kim, Ran-Ah
    • Journal of Korean Dental Science
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    • v.14 no.2
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    • pp.61-68
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    • 2021
  • Purpose: The aim of this study was to investigate the outcomes of endodontic treatment of mandibular second molar with C-shaped canal in elderly patients and related factors affecting the survival of the tooth. Materials and Methods: From 2010 to 2015, the survival rate following endodontic treatment was evaluated in elderly patients over 60 years who visited the Veterans Health Service Medical Center for endodontic treatment. The presence of C-shaped canals was confirmed using clinical records and radiographic features. Patient's age, sex, systemic diseases, tooth location, vitality, signs and symptoms, fractures, caries, apical radiolucency, canal shaping methods, sealer leakage, filling voids, and restoration of prosthesis were included in the analyses as confounding variables. The survival rate of teeth was analyzed using Kaplan-Meire analysis and the relationship between the survival rate and variables was analyzed using Simple and Multiple Cox regression analysis. Result: In total, 107 teeth in elderly patients had C-shaped canal. The survival rate of teeth that received endodontic treatment was 63.70%. None of the factors investigated significantly influenced the survival rate (P>0.05). Conclusion: In elderly patients with C-shaped canal, the survival rate after root canal treatment was not significantly different from that of other mandibular molars.

The Relationship between Posttraumatic Stress Disorder and the Quality of Life among the Vietnam War Veterans (베트남전 참전 퇴역 군인에서 외상후스트레스장애와 삶의 질과의 관계)

  • Oum, Se-Joon;Choi, Jin-Hee;Kim, Tae-Yong;Chung, Hae-Gyung;Chung, Moon-Yong;So, Hyung-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.83-91
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    • 2011
  • Objectives: Posttraumatic stress disorder(PTSD) has devastating effects on multiple aspects of the quality of life(QoL). Therefore, the purpose of this study is to compare the QoL between PTSD group and non-PTSD group, and identify the variables affecting the QoL of the Vietnam War veterans. Methods: We recruited 39 veterans with PTSD and 43 veterans without PTSD, all of whom had deployed to the Vietnam War. We used the Korean version of Mini International Neuropsychiatric Interview-Plus, the Korean version of Clinician-Administered PTSD Scale, Combat Exposure Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument abbreviated version. We used independent samples t-test to identify the differences between PTSD and non-PTSD group in each domains of the quality of life. We also used stepwise multiple linear regression analysis to figure out the variables affecting the QoL of the Vietnam War veterans. Results: In the PTSD group, all domains of the QoL and the QoL total score(p<0.01) were significantly lower than those in the non-PTSD group. In the Vietnam War veterans, PTSD, major depressive disorder and education levels were the variables affecting the QoL. Among these, PTSD uniquely explained the QoL of the overall and general health(${\beta}$=-1.411, $R^2$=0.180), the physical health domain(${\beta}$=-2.806, $R^2$=0.089) and the total score (${\beta}$=-11.479, $R^2$=0.104). Conclusions: These results suggest that among the Vietnam War veterans, the QoL of the PTSD group is significantly lower than that of the non-PTSD group. Among the combat exposed veterans, PTSD may be one of the main reasons that affect the multiple domains of the QoL.

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D2 Dopamine Receptor (DRD2) Gene Polymorphism and Combat-Related Posttraumatic Stress Disorder in Vietnam Veterans (월남전 참전 재향군인에서 도파민 D2 수용체 유전자 다형성과 외상후 스트레스 장애)

  • Lee, Soo-Young;Chung, Hae-Gyung;Kim, Tae-Yong;Choi, Jin-Hee;Chung, Moon-Yong;So, Hyoung-Seok;Shin, Han-Sang;Lee, Shi-Eun
    • Anxiety and mood
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    • v.4 no.2
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    • pp.142-147
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    • 2008
  • Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

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