The Armed Forces Capital Hospital

Seongnam, South Korea

The Armed Forces Capital Hospital

Seongnam, South Korea
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Kim J.-M.,Chung - Ang University | Jung K.-H.,Seoul National University | Sohn C.-H.,Seoul National University | Moon J.,Seoul National University | And 6 more authors.
International Journal of Stroke | Year: 2016

Background: Intracranial atherosclerosis is associated with frequent stroke recurrence. High resolution vessel wall magnetic resonance imaging (HRMRI) can provide atheroma information related to its vulnerability. Aims: We performed HRMRI in stroke patients with intracranial atherosclerosis to determine whether plaque characteristics from vessel wall imaging can predict future stroke recurrence. Methods: Between July 2011 and June 2013, acute stroke patients with symptomatic intracranial atherosclerosis were prospectively enrolled and 3-tesla HRMRI was performed on the relevant artery. The plaque enhancement was visually determined from T1 post-gadolinium enhancement image. Stroke recurrence was monitored after index event and multivariate Cox proportional hazards model was constructed to identify factors related to future stroke recurrence. Results: A total of 138 patients were included with a median follow-up of 18 months. There were 39 stroke recurrences. Plaque enhancement was detected in 108 patients (78.3%), and 37 of them experienced stroke recurrence. Among 30 stroke patients without plaque enhancement, two patients experienced stroke recurrence. Kaplan-Meier curves demonstrated a significant difference in event free survival between the patients with plaque enhancement and those patients without plaque enhancement (event rates at year 1: 30.3% vs. 6.8%, log-rank test, p = 0.004). Multivariate Cox-regression analysis showed that the plaque enhancement from HRMRI was independently associated with stroke recurrence (hazard ratio: 7.42, 95% confidence interval: 1.74-31.75, p = 0.007). Conclusion: Intracranial plaque enhancement from HRMRI is associated with stroke recurrence among the patients with symptomatic intracranial atherosclerosis. © 2016 World Stroke Organization.


Kim K.M.,The Armed Forces Capital Hospital | Park J.B.,Yonsei University | Bae K.S.,Yonsei University | Kim C.B.,Yonsei University | And 2 more authors.
Endocrine Journal | Year: 2013

This study created a new staging system using a risk model that employed clinical factors that were associated with recurrence, verified by preoperative clinical information and intraoperative finding and was compared with other staging systems. A review was conducted of patients who have undergone thyroidectomy and followed-up between January 1, 1983 and September 31, 2007 at Yonsei University Wonju Christian Hospital. The final prognostic staging system was defined as University of Yonsei clinical staging system (Prognostic score = 0.03 × Age + 0.8 × (if male gender) + 0.5 × (if extrathyroidal tumor extension present) + 0.7 × (if clinically apparent lymph node metastasis present), Stage I, less than 1.50; Stage II, 1.50 to 2.29; Stage III, 2.30 to 3.29; Stage IV 4, 3.3 or more). Compared with the other staging systems, the proportion of variation explained (PVE %) was calculated for each. The University of Yonsei clinical staging system appeared to be first as an accurate prognosis predictor with 11.9%. New staging system can predict recurrence and has advantage can use preoperative clinical information and intraoperative finding. Those who are diagnosed as high risk patients using the new staging system should be treated with aggressive surgical treatment and close follow-up. © The Japan Endocrine Society.


Lee J.K.,Seoul National University | Lee S.,Seoul National University | Kim D.,The Armed Forces Capital Hospital | Lee S.M.,Eulji University | And 3 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013

Purpose: The aims of this retrospective study were to provide the basis for the choice of prosthesis in revision total knee arthroplasty (TKA) and to evaluate the outcome with varus-valgus constrained prosthesis compared with posterior stabilized (PS) prosthesis. Methods: One hundred and five patients (121 knees) received revision TKA; of which thirty-seven patients (42 knees) received PS prosthesis and sixty-eight patients (79 knees) received varus-valgus constrained prosthesis. The mean follow-up duration was 64. 8 ± 31. 5 months and 63. 2 ± 28. 1 months in the PS and varus-valgus constrained groups, respectively. The criterion of prosthesis choice was a subjective laxity assessed by the surgeon intraoperatively. A multivariate analysis was performed to evaluate the preoperative factors in the choice of the prosthesis. Results: The grade of femoral bone defect was the only factor that affected the choice of prosthesis. Clinical results improved significantly in both groups after surgery. There were no significant differences in clinical results between the two groups. Complication rates were 9. 5 % in the PS group and 10. 1 % in the varus-valgus constrained group, and the Kaplan-Meier survivorship analysis revealed 8-year component survival rates of 83. 1 and 93. 0 % in the PS and varus-valgus constrained groups, respectively. Conclusions: Femoral bone defect is an important factor to be considered in the choice of prosthesis for revision TKA. The varus-valgus constrained prosthesis showed an outcome similar to that of the PS prosthesis. For clinical relevance, varus-valgus constrained prosthesis is recommended in revision TKA when the PS prosthesis seems unsuitable for the management of instability. Level of evidence: III. © 2012 Springer-Verlag.


Kim D.,The Armed Forces Capital Hospital | Seong S.C.,Seoul National University | Lee M.C.,Seoul National University | Lee S.,Seoul National University
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2012

Purpose: The anatomical landmark for the anteroposterior (AP) axis of the proximal tibia and its variability was investigated in order to determine whether a certain landmark could be employed as a reference axis for the proximal tibia after the rotating platform mobile bearing and fixed bearing total knee arthroplasties (TKAs). Methods: Eighty primary osteoarthritic knees were randomized to undergo either rotating platform mobile bearing (Group A, n = 40) or fixed bearing (Group B, n = 40) TKAs, and were followed up for 31 and 30 months, respectively. The AP axes were defined for the distal femur, proximal tibia, ankle, and each TKA component on the reconstructed CT scan and the angles between the distal femoral AP axis and those of each bone or component were estimated. Clinical and radiographic outcomes were evaluated during the follow up. Results: A significant difference was seen between the preoperative and postoperative rotational position of the proximal tibia relative to the distal femur following rotating platform mobile bearing TKA (P = 0. 014) whereas no such difference was seen after fixed bearing TKA. The mean postoperative alignment of the tibia differed between the two groups (Group A:Group B = -2. 9:0. 2, P = 0. 010) and its variability was significantly greater in group A (P <0. 001). There were no differences in the clinical outcomes including range of motion, knee society score, function score, HSS, and WOMAC score as well as the mean postoperative coronal tibiofemoral alignment between the two groups. Conclusion: The unpredictable change in the rotational axis of the tibia and its broad variability after rotating platform mobile bearing TKA may provide a warning against the use of a fixed landmark for establishing tibial rotational alignment. Level of evidence: Prospective comparative study, Level II. © 2011 Springer-Verlag.


Lee S.Y.,The Armed Forces Capital Hospital | Yoon J.,The Armed Forces Capital Hospital | Cho Y.S.,The Armed Forces Capital Hospital | Son R.C.,The Armed Forces Capital Hospital | And 3 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2015

Purpose: Lateral meniscus allograft transplantation (LMAT) is a feasible surgical option for young meniscus-deficient patients. Although several studies have explored the factors that contribute to graft extrusion, they have not been fully elucidated. The aim of this study was to determine the various factors that contribute to graft extrusion. Methods: Patients with knees that had received LMAT using a keyhole technique (n = 87 knees in 82 patients) were reviewed. The median age of these patients was 22 years (range 19–54 years), and the median postprocedural follow-up interval was 5 days (range 1–136 days). Twelve magnetic resonance imaging (MRI) measurement parameters (axial and coronal location of the bone block) that could potentially influence graft extrusion were evaluated, along with absolute graft extrusion and relative percentage of extrusion (RPE). Results: A significant correlation was found between 8 of the 12 MRI measurement parameters and both the absolute extrusion and RPE (r = 0.241–0.438, p < 0.05). The absolute middle distance and depth of the bone block were independent predictors of the absolute extrusion (β = 0.30 and 0.15, respectively; p < 0.05), and the relative middle distance and relative bone-block elevation were found to be predictors of RPE (β = 2.29 and 1.44, respectively; p < 0.05). Conclusion: The rate of graft extrusions after LMAT was high in this study. Both the coronal and axial locations of the bone block were found to influence graft extrusion in LMAT. Therefore, correct positioning of the bone block, including in both the axial and coronal planes, is essential to minimize graft extrusion. Future studies need to investigate the long-term clinical outcome and longevity of extruded menisci after transplantation. Level of evidence: Therapeutic case series, Level IV. © 2015 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)


Park J.Y.,The Armed Forces Capital Hospital | Ahn R.S.,CHA Medical University
Psychoneuroendocrinology | Year: 2012

An exaggerated inflammatory process is considered an important pathophysiological feature of complex regional pain syndrome type 1 (CRPS-1). The hypothalamic-pituitary-adrenal (HPA) axis serves as a negative feedback mechanism for inflammatory processes. The present study examined the HPA axis function in patients with CRPS-1 by a determination of cortisol concentrations in saliva. Three sets of saliva samples were sequentially collected from 24 patients with CRPS-1 during medication (on-Med), 72. h after stopping medication (off-Med) and 8. h after the oral administration of 1. mg dexamethasone. One set of saliva samples was collected from healthy controls. The cortisol awakening response (CAR) and diurnal cortisol decline (DCD) were used as indices for HPA axis function. Cortisol levels during the post-awakening period in patients were increased following withdrawal of medications. The CAR during the off-Med condition was disappeared after administration of dexamethasone. Among the examined CRPS-related numerical variables, the frequency of spontaneous pain attacks showed relationships with the indices of HPA axis function. After classifying the patients into two subgroups, we observed that the CAR and DCD in patient who had a relatively high frequency of spontaneous pain attacks (subgroup 5≤) were lower and less steep than those in patient who had a relatively low frequency of spontaneous pain attacks (subgroup 0-4) for the on- and off-Med conditions. The CAR and DCD in subgroup 5≤ during their off-Med condition were comparable to those in controls. These results suggest that the increase in frequency of spontaneous pain attacks is associated with a reduced CAR and flattened DCD in patients CRPS-1. © 2012 Elsevier Ltd.


Heo J.Y.,The Armed Forces Capital Hospital | Lee J.E.,The Armed Forces Capital Hospital | Kim H.K.,Catholic University of Korea | Choe K.-W.,The Armed Forces Capital Hospital
Emerging Infectious Diseases | Year: 2014

During April 2011-March 2012, we retrospectively reviewed medical records for South Korea soldiers to assess the etiology and epidemiology of acute viral lower respiratory tract infections. Adenovirus was the most commonly identified virus (63.2%) and the most common cause of pneumonia (79.3%) and hospitalization (76.6%); 3 soldiers died of adenovirus-related illness.


Lee S.,The Armed Forces Capital Hospital | Jung S.-M.,The Armed Forces Capital Hospital | Cho B.-K.,Catholic University of Korea | Kim H.,Seoul National University
Journal of Korean Neurosurgical Society | Year: 2012

Desmoplastic fbroma, which develops predominantly in long bones and the mandible, is a rare and benign but locally aggressive tumor. Desmo- plastic fbroma of the cranium is extremely rare. We report a case of desmoplastic fbroma of the frontal bone in a young man. Because of its locally aggressive behavior, complete surgical excision with a safety margin is essential. © 2012 The Korean Neurosurgical Society.


Lee S.,Seoul National University | Cho B.-K.,The Armed Forces Capital Hospital | Kim H.,Catholic University of Korea
Journal of Korean Neurosurgical Society | Year: 2013

Presented here is a 36-year-old male with arterial hypertension who developed brainstem edema and intracranial hemorrhage. Magnetic resonance scan revealed diffuse brainstem hyperintensity in T2-weighted and fluid-attenuated inversion-recovery images, with an increase in apparent diffusion coefficient values. After a reduction in blood pressure, rapid resolution of the brainstem edema was observed on follow-up. The patient's condition was thus interpreted as hypertensive brainstem encephalopathy. While many consider this a vasogenic phenomenon, induced by sudden, severe hypertension, the precise mechanism remains unclear. Prompt recognition and aggressive antihypertensive treatment in such patients are essential to prevent permanent or life-threatening neurologic injury. © 2013 The Korean Neurosurgical Society.


PubMed | University of Seoul, De La Salle Health Sciences Institute, The Armed Forces Capital Hospital, Kyung Hee University and Seoul National University
Type: | Journal: Pain practice : the official journal of World Institute of Pain | Year: 2016

The purpose of this study was to adapt the painDETECT Questionnaire (PD-Q) into a Korean version (KPD-Q) and validate it.A single-center prospective observational study was performed. During the first phase of the study, linguistic adaptation was carried out to develop the KPD-Q. During the second phase of the study, feasibility, internal consistency, discriminant validity, and concurrent validity were assessed for psychometric validation of the KPD-Q.A total of 232 patients participated. Among them, 82 patients (35%) were classified in the neuropathic pain (NeP) group, 80 (34%) in the nociceptive pain group, and 70 (30%) in the mixed pain group. Regarding the reliability of the KPD-Q, internal consistency for the whole scale was 0.804, as evaluated by Cronbachs alpha. Pearsons correlation between the Leeds Assessment of Neuropathic Symptoms and Signs scale and the KPD-Q scores was positive and statistically significant (r = 0.74, P < 0.001). Similar to the result obtained by the original developers, a value of 19 points suggested a clear diagnosis of the presence of an NeP component with 95.4% sensitivity, 73.8% specificity, and 0.737 Youden index. We used 13 (as opposed to 12, as suggested previously) as an alternative cutoff value, which showed a sensitivity of 95.4%, specificity of 73.8%, and the Youden index of 0.691.The KPD-Q showed good psychometric and discriminant features for assessing the neuropathic component in chronic pain patients. We hope that this newly validated KPD-Q will be recognized in Korea as a credible tool for detection of NeP and thus may be used in further international clinical research.

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