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정호중,엄문섭,최성복,김도성,강경문 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.1
Objective: To identify the risk factors for secondary lymphedema after breast cancer surgery. Lymphedema, a sequelae of breast cancer therapy, changes functional abilities and may affect a patient's psychosocial adjustment and overall quality of life. It is generally underreported and undertreated. Method: Six hundred two patients who had undergone breast cancer surgery between January 2000 and December 2005 were examined. The circumferences of the upper extremities were measured and lymphedema was defined as difference of greater than 2cm between the affected and normal arms. The effects of age, body mass index, diabetes, hypertension, side of tumor, sugery method, radiotherapy, chemotherapy, TNM stage, involvement of axillary lymph nodes, menopausal state and laboratory findings on the development lymphedema were investigated and analyzed by t-test, chi-square test and multiple logistic regression analysis. Results: 121 out of 602 patients had lymphedema. Those patients with lymphedema had a higher body mass index. Univariate analysis indicated an increased occurrence of lymphedema due to those with body mass index, radiotherapy, T2 stage, N3 stage and axillary lymph node invasion. Multivariate analysis revealed that body mass index and radiotherapy were independently associated factors for lymphedema after breast cancer surgery. Conclusion: The patients who had radiotherapy or BMI greater than 25 must be considered as potential candidates to have lymphedema after breast cancer surgery. Therefore, these patients should be informed during the follow-up period about this morbidity, the preventive measure, and the treatment.
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정호중,김기찬,엄문섭 고신대학교의과대학 2006 고신대학교 의과대학 학술지 Vol.21 No.2
Primary lymphedema tarda is considered to be a congenital disease with delayed manifestations. The cause is unknown; an autoimmune destruction of lymphatic channels can be hypothesized. We report a case of isolated lymphedema of the left lower extremity in a 38-year-old male. The diagnosis of lymphedema was confirmed by lymphoscintigraphy and appropriate diagnostic studies were done to rule out other known causes of limb edema. We report a rare case of primary lymphedema tarda of the left lower extremity.
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정호중,김기찬,심영주,엄문섭,홍진영,이종화 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.3
Objective: To determine the time period and factors inhibiting recovery of orthostatic hypotension during head up tilt with ischemic stroke patients.Method: Fourty two ischemic stroke patients with orthostatic hypotension were included. Blood pressure and heart rate were taken after resting in the supine position for 10 minutes and again after standing for one minute every week. Age, gender, body mass index, laboratory findings, diabetes mellitus, anti-hypertensive use, side of involved hemisphere and K-MBI were obtained.Results: The numbers of orthostatic hypotension patients were significantly decreased at 3rd week. Non recovering group until 3rd week were older in age and had higher plasma creatinine level. On the other hand, body mass index and K-MBI were lower than the group without orthostatic hypotention. Multivariate analysis revealed that age, body mass index, anti-hypertensive medication were independently associated factors for resistant orthostatic hypotension during head up tilt.Conclusion: For 7 weeks, especially at 3rd week, the numbers of orthostatic hypotension patients significantly decreased. Age, BMI, and antihypertensive medication were inhibitiing factors for recovery of orthostatic hypotension.
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