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      • KCI등재
      • KCI등재

        심초음파로 결정된 응급 심낭천자술의 천자부위

        김성환,황성오,이강현,조준휘,강구현,문중범,이승환,윤정한,최경훈,김영식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

        Background: The aim of this study was to determine whether the conventional subcostal approach is suitable for emergency pericardiocentesis in patients with cardiac tamponade or impending cardiac tamponade. Methods: This study was a prospective, observational study conducted at the emergency department of a tertiary hospital, Patients who had symptomatic pericardial effusion and who needed emergency pericardiocentesis in the emergency department were included in this study. We measured the epicardium-to-pericardium distance at the subcostal, parasternal, and apical area with two-dimensional echocardiography to determine the appropriate puncture site for pericardiocentesis. An epicardium-to-pericardium distance of more than 1.0 cm was considered as the primary safety factor in determining the Puncture site for pericardiocentesis. The skin-to-pericardium distance was considered as secondary safety factor. Results: Ninety-five consecutive patients(55 males and 40 females; total mean age: 53 year old) with cardiac tamponade or impending cardiac tamponade were enrolled in this study. The puncture site for pericardiocentesis, as determined by echocardiography, was the subcostal area in 43 patients(45%), the apical area in 40 patients(42%), the left parasternal area In 11 patients(12%), and the right parastemal area in one patient(1%). Pericardiocentesis failed in 2 patients(2%) with the subcostal approach and in one patient(1%) with the apical approach. The average epicardium-to-pericardium distance was 31 ±21 mm in patients with the subcostal approach and 21±8 mm in patients with other approaches. There were no differences in the amount of pericardial fluid and in the intraperical pressure among patient groups according to puncture site. There were two procedure related complications: a puncture of the right ventricle with the subcostal approach and a ventricular tachycardia with the apical approach.

      • KCI등재

        주의력결핍/과잉행동장애와 양극성장애 공존 환아군과 주의력결핍/과잉행동장애 환아군의 비교연구

        정동선,하규섭,정희연,구훈정,황준원,김붕년,신민섭,조수철,홍강의 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

        Objective : Attention deficit hyperactivity disorder (ADHD) is frequently comorbid with a variety of psychiatric disorders. Among them, bipolar disorder (BPD) has especially attracted growing interest. This is partly due to the fact that early onset BPD has been frequently misdiagnosed as ADHD because of symptomatic overlap. The aim of the present study is to find the differences in demographic data and clinical features of ADHD+BPD and ADHD in children and adolescents. Method : Children and adolescents patients participating in the present study have been enrolled at the child psychiatric clinic since 2004. 14 patients meeting the DSM-IV chteria for ADHD+BPD and 19 patients meeting the criteria for ADHD and 15 healthy comparison subjects were recruited. All groups were evaluated through the Schedule for Affective disorders and Schizophrenia for School-Age Children-Present and Life Time version-Korean version (K-SADS-PL-K). Demographic data and clinical charactehstics of the subjects were also collected. Parents were asked to complete the Child Behavior Check List(CBCL) and the Toddler Temperamental Scale (TTS) clinical ratings were obtained using the Young Mania Rating Scale(YMRS), the Children's Depression Iventory (CDI) and the Dupaul ADHD scale. Clinical variables between ADHD+BPD and ADHD were analyzed using the Mann-Whitney U test. YMRS, CDI, Dupaul ADHD scale (inattention and hyperactivity), CBCL, and TTS among the three groups were analyzed using the Kruskal-Wallis test with post-hoc Mann-Whitney U test. Results : 1) ADHD+BPD group had an earlier onset age of ADHD than ADHD group 2) ADHD+BPD group had more co-morbid psychiathc disorders than ADHD group. 3) Compared to ADHD group, ADHD+BPD had more psychiathc family history, especially mood disorders. 4) ADHD+BPD group had prodromal symptoms such as irritability, anger dyscontrol and academic dysfunction, compared to ADHD group who rarely showed prodromal symptoms. 5) ADHD+BPD group had higher ADHD scores than the ADHD group in the Dupaul ADHD inattentive scale. 6) In global functions of CBCL, ADHD+BPD group showed more impaired functions at home and school than ADHD group. 7) In Attention diagnostic system (ADS), ADHD+BPD group had more omission and commission errors than ADHD group, especially in the visual system. 8) In the subtests of the IQ profile, ADHD+BPD group had lower arithmetic and block design scores than ADHD group. Conclusion : Clinicians have to rule out underlying bipolarity in children and adolescents with ADHD who show earlier age of onset and severe clinical features. Bipolarity should be explored intensively in ADHD children and adolescents who have early onset of symptoms and severe functional impairment.

      • KCI등재

        Oncological and functional outcomes following robot-assisted laparoscopic radical prostatectomy at a single institution: a minimum 5-year follow-up

        ( Jun-koo Kang ),( Jae-wook Chung ),( So Young Chun ),( Yun-sok Ha ),( Seock Hwan Choi ),( Jun Nyung Lee ),( Bum Soo Kim ),( Ghil Suk Yoon ),( Hyun Tae Kim ),( Tae-hwan Kim ),( Tae Gyun Kwon ) 영남대학교 의과대학 2018 Yeungnam University Journal of Medicine Vol.35 No.2

        Background: To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution. Methods: We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated. Results: Based on the D’Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (≥T3a) and 26.6% (34/128) had high grade disease (Gleason score ≥8). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ≥8) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence. Conclusion: Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

      • KCI등재

        Oncological and functional outcomes following robot-assisted laparoscopic radical prostatectomy at a single institution: a minimum 5-year follow-up

        Kang, Jun-Koo,Chung, Jae-Wook,Chun, So Young,Ha, Yun-Sok,Choi, Seock Hwan,Lee, Jun Nyung,Kim, Bum Soo,Yoon, Ghil Suk,Kim, Hyun Tae,Kim, Tae-Hwan,Kwon, Tae Gyun Yeungnam University College of Medicine 2018 Yeungnam University Journal of Medicine Vol.35 No.2

        Background: To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution. Methods: We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated. Results: Based on the D'Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (${\geq}T3a$) and 26.6% (34/128) had high grade disease (Gleason score ${\geq}8$). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ${\geq}8$) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence. Conclusion: Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

      • KCI등재

        Is Routine Voiding Cystourethrogram Necessary Following Endoscopic Subureteral Injection for Primary Low-Grade Vesicoureteral Reflux?

        Jun-Koo Kang,Min Ji Park,Min Hyun Cho,Jun Nyung Lee 대한요로생식기감염학회 2024 Urogenital Tract Infection Vol.19 No.1

        Purpose: An endoscopic subureteral injection (EI) using a bulking agent is a highly successful surgical procedure, particularly for low-grade vesicoureteral reflux (VUR). Despite the serious adverse effects, routine voiding cystourethrogram (VCUG) to determine radiographic success after EI remains controversial. This study evaluated the necessity of routine postoperative VCUG in children with primary low-grade VUR. Materials and Methods: From January 2016 to August 2021, children who underwent EI for primary low-grade (I-III) VUR with a history of febrile urinary tract infection (fUTI) were analyzed retrospectively. From January 2016 to July 2018, routine VCUG following EI was performed on all children. Thereafter, postoperative VCUG was performed only if indicated. Clinical success was defined as no fUTI during a 12-month follow-up, and radiographic success was defined as the disappearance of VUR on postoperative VCUG. The clinical and radiographic outcomes in both groups were compared. Results: Thirty-six children were analyzed in this study. Three children (8.3%) experienced postoperative fUTI. In the routine group, clinical and radiographic success was observed in 16/17 (94.1%) and 15/17 (88.2%), respectively. Two children in the routine group experienced radiographic failure. Among these, one child showed clinical success, and the other underwent additional EI due to clinical failure. Of the indicated group, clinical failure was observed in 2/19 (10.5%). Of them, persistent VUR was identified in one child. Conclusions: Clinical and radiologic success after EI for primary low-grade VUR is high, and routine VCUG for confirming radiographic success has a limited impact on the clinical course.

      • Do Foreign Investors Exhibit a Corporate Governance Disadvantage? An Information Asymmetry Perspective

        Jun-Koo Kang,Jin-Mo Kim 한국재무학회 2008 한국재무학회 학술대회 Vol.2008 No.05

        This paper examines whether the governance role of foreign block acquirers in U.S. targets is different from that of domestic block acquirers. We find that foreign block acquirers are less likely to engage in post-acquisition governance activities in U.S. targets than domestic control block acquirers matched by several key variables. Among foreign block acquirers, those whose countries share a common language and a common legal origin with the U.S., and those with more acquisition experience in the U.S. are more likely to engage in post-acquisition governance activities; those at a further distance from their targets are less likely to engage in post-acquisition governance activities. We also find that foreign block acquirers are more likely to replace poorly performing target management if they are located geographically closer to their acquirers or if their acquirers have more acquisition experience in the U.S. Finally, U.S. targets in foreign block acquisitions realize higher abnormal announcement returns if they are located closer to the acquirers or if their acquirers have more acquisition experience in the U.S. These results suggest that information asymmetries that foreign acquirers face in the host country are an important determinant of their governance activities in domestic targets, and that the stock market takes into account the extent of such information asymmetries when assessing target value.

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