Hye Jin Moon

Keimyung University, Sŏul, Seoul, South Korea

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Publications (10)10.89 Total impact

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    ABSTRACT: General anesthetic-induced coma therapy has been recommended for the treatment of refractory status epilepticus (RSE). However, the influence of electroencephalographic (EEG) burst suppression (BS) on outcomes still remains unclear. This study investigated the impact of intravenous anesthetic-induced BS on the prognosis of RSE using a retrospective analysis of all consecutive adult patients who received intravenous anesthetic treatment for RSE at the Seoul National University Hospital between January 2006 and June 2011. Twenty-two of the 111 episodes of RSE were enrolled in this study. Of the 22 RSE patients, 12 (54.5%) were women and 18 (81.4%) exhibited generalized convulsive status epilepticus. Sixteen patients (72.7%) were classified as having acute symptomatic etiology, including three patients with anoxic encephalopathy, and others with remote symptomatic etiology. Only two patients (9.1%) had a favorable Status Epilepticus Severity Score (0-2) at admission. All patients received midazolam (MDZ) as a primary intravenous anesthetic drug for RSE treatment; three (13.6%) received MDZ and propofol, and one (4.5%) received MDZ and pentobarbital. The rates of mortality and poor outcome at discharge were 13.6% (n=3) and 54.5% (n=12), respectively. While BS was achieved in six (27.5%) patients, it was not associated with mortality or poor outcome. Induced BS was associated with prolonged hospital stay in subgroup analysis when excluding anoxic encephalopathy. Our results suggest that induction of BS for treating RSE did not affect mortality or outcome at discharge and may lead to an increased length of hospital stay. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Journal of Clinical Neuroscience 03/2015; 22(5). DOI:10.1016/j.jocn.2014.11.007 · 1.32 Impact Factor
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    12/2014; 38(6):879-80. DOI:10.5535/arm.2014.38.6.879
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    ABSTRACT: Although non-convulsive status epilepticus (NCSE) is an important type of epilepsy, it is not often recognized. In order to analyze the clinical characteristics and outcome in patients with NCSE, we examined the medical records of patients with NCSE admitted to the Seoul National University Hospital between June 2005 and October 2008. The clinical details and electroencephalography records of 34 adult NCSE patients (aged over 16years) were collected. Their mean age was 47years (standard deviation 20years, range, 16-87years), and 20 were female. Twenty-seven patients (79.4%) showed decreased awareness with acute onset, and seven (20.6%) were obtunded or comatose. Ten patients (29.4%) had a history of epilepsy, and four (11.8%) had a history of stroke. NCSE was etiologically attributed to acute medical or neurological problems in 25 patients (73.5%), was cryptogenic in three (8.8%), and was secondary to underlying epilepsy in six (17.7%). Acute symptomatic etiology was associated with poor recovery (p=0.048), with all unresponsive patients in this acute symptomatic group. Eight (23.5%) of the 34 NCSE patients did not recover or died, whereas nine (26.5%) recovered. Our study shows that the presence of acute symptoms or central nervous system infection is associated with poor outcome, suggesting that a high level of vigilance is required to identify and prevent complications.
    Journal of Clinical Neuroscience 07/2014; DOI:10.1016/j.jocn.2014.03.018 · 1.32 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the changes in blood glucose and cortisol levels after glucocorticoid injections into the epidural space or the glenohumeral joint in patients with or without diabetes. Twenty-nine patients with sciatic or shoulder pain were included. Fasting plasma glucose and cortisol levels were measured at baseline. After glucocorticoid injection, the levels were measured again after 1, 7, and 21 days. The patients were divided into four subgroups according to the presence of diabetes and site of injection. In all subgroups, fasting plasma glucose levels were significantly higher 1 day after injection but returned to baseline 7 days after the injection. Compared with baseline, cortisol levels were markedly reduced 1 and 7 days after the injection. For both the diabetic and nondiabetic subjects, this drop was significantly larger in the epidural injection than the glenohumeral joint injection. At 21 days after injection, cortisol levels returned to baseline in all subgroups except in the diabetic patients treated with epidural injections. These findings indicate a need for caution when using local glucocorticoid injection therapy in diabetic patients, most notably when an epidural injection is given. It is also recommended that diabetic patients take more time off before receiving a succeeding epidural glucocorticoid injection.
    American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 02/2014; DOI:10.1097/PHM.0000000000000001 · 2.01 Impact Factor
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    ABSTRACT: Although non-convulsive status epilepticus (NCSE) is an important type of epilepsy, it is not often recognized. In order to analyze the clinical characteristics and outcome in patients with NCSE, we examined the medical records of patients with NCSE admitted to the Seoul National University Hospital between June 2005 and October 2008. The clinical details and electroencephalography records of 34 adult NCSE patients (aged over 16 years) were collected. Their mean age was 47 years (standard deviation 20 years, range, 16–87 years), and 20 were female. Twenty-seven patients (79.4%) showed decreased awareness with acute onset, and seven (20.6%) were obtunded or comatose. Ten patients (29.4%) had a history of epilepsy, and four (11.8%) had a history of stroke. NCSE was etiologically attributed to acute medical or neurological problems in 25 patients (73.5%), was cryptogenic in three (8.8%), and was secondary to underlying epilepsy in six (17.7%). Acute symptomatic etiology was associated with poor recovery (p = 0.048), with all unresponsive patients in this acute symptomatic group. Eight (23.5%) of the 34 NCSE patients did not recover or died, whereas nine (26.5%) recovered. Our study shows that the presence of acute symptoms or central nervous system infection is associated with poor outcome, suggesting that a high level of vigilance is required to identify and prevent complications.
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    ABSTRACT: To evaluate the long-term efficacy and safety of levetiracetam based on a large population of patients in a tertiary epilepsy centre. All patients who received levetiracetam at the Seoul National University Hospital between January 2007 and March 2009 were evaluated. Patients who underwent brain surgery for seizure control or who had associated progressive disease were excluded from this study. The electronic medical records of these patients were reviewed retrospectively. A total of 568 patients were recruited, including 124 patients with generalised epilepsy. The mean duration of the follow-up period was 29.3 months. The seizure-free rate was 33.6% and was higher in patients with generalised epilepsy (51.6%) than patients with localisation-related epilepsy (28.6%). There was a strong correlation between initial response and dose-up response in 351 patients with increased dosage during the follow-up period. A total of 486 adverse events developed in 316 patients. The most common adverse event (24.3%) was irritability, which was associated with a high rate of drug discontinuation. Previous history of mood disorder was the only factor related to the development of irritability in patients using this medication. Levetiracetam was effective and safe as monotherapy and add-on therapy for partial and generalised epilepsy. The initial response to levetiracetam may provide useful information for predicting the response to increased dose of levetiracetam. However, the use of this medication was associated with a rate of irritability that was higher than expected in patients with a history of mood disorders.
    Epileptic disorders: international epilepsy journal with videotape 08/2013; 15(3). DOI:10.1684/epd.2013.0599 · 0.90 Impact Factor
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    ABSTRACT: To compare the effects of lumbar stabilization exercises and lumbar dynamic strengthening exercises on the maximal isometric strength of the lumbar extensors, pain severity and functional disability in patients with chronic low back pain (LBP). Patients suffering nonspecific LBP for more than 3 months were included prospectively and randomized into lumbar stabilization exercise group (n=11) or lumbar dynamic strengthening exercise group (n=10). Exercises were performed for 1 hour, twice weekly, for 8 weeks. The strength of the lumbar extensors was measured at various angles ranging from 0° to 72° at intervals of 12°, using a MedX. The visual analog scale (VAS) and the Oswestry Low Back Pain Disability Questionnaire (ODQ) were used to measure the severity of LBP and functional disability before and after the exercise. Compared with the baseline, lumbar extension strength at all angles improved significantly in both groups after 8 weeks. The improvements were significantly greater in the lumbar stabilization exercise group at 0° and 12° of lumbar flexion. VAS decreased significantly after treatment; however, the changes were not significantly different between the groups. ODQ scores improved significantly in the stabilization exercise group only. Both lumbar stabilization and dynamic strengthening exercise strengthened the lumbar extensors and reduced LBP. However, the lumbar stabilization exercise was more effective in lumbar extensor strengthening and functional improvement in patients with nonspecific chronic LBP.
    02/2013; 37(1):110-7. DOI:10.5535/arm.2013.37.1.110
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    ABSTRACT: The aim of this study was to determine the effects of bladder reconditioning by indwelling urethral catheter (IUC) clamping before IUC removal in stroke patients. Sixty patients with stroke were randomized to 0-, 1-, and 3-day IUC clamping groups. IUCs were removed without clamping in the 0-day group. In the other two groups, IUCs were clamped for 4 hrs followed by 5 mins of urinary drainage, a cycle repeated over 24 hrs in the 1-day and over 72 hrs in the 3-day clamping groups. Time to first voiding (FV), first voided volume (FV-vol), residual urine volume after FV, mean void volume, and residual urine volume on the third day after IUC removal were measured. We also recorded the voiding method such as self-voiding or intermittent catheterization, incidence of urinary tract infection, subjective complaints, and other complications. Time to FV, FV-vol, residual urine volume after FV, voiding method, mean voided volume, and residual urine volume on the third day after IUC removal had no significant difference among three groups, nor between the 0-day and the other two clamping groups. We observed a strong negative correlation between age and FV-vol. Of the patients in the 1- and 3-day clamping groups, 3 (7.5%) had symptomatic urinary tract infection and 9 (22.5%) complained of urinary leakage during IUC clamping program. Bladder reconditioning through IUC clamping has no noticeable benefits in stroke patients and may induce additional problems. These findings suggest that IUC removal without clamping is superior to IUC clamping for bladder reconditioning in stroke patients.
    American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 05/2012; 91(8):681-8. DOI:10.1097/PHM.0b013e31825a0a1b · 2.01 Impact Factor
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    ABSTRACT: The authors reviewed the medical records of very low-birth-weight infants admitted from 1998 to 2007 and compared neurodevelopmental outcomes with their previously reported data from 1989 to 1997. The recent group included 824 infants, and the previous group included 471 infants. Neurodevelopmental outcomes were classified into cerebral palsy and non-cerebral palsy neurodevelopmental impairment. In the recent group, the survival rate was significantly higher (79.4% vs 66.2%), the rate of cerebral palsy was lower (7.9% vs 10.5%), and the rate of non-cerebral palsy neurodevelopmental impairment was higher (6.0% vs 4.5%) but not significant. The survival rate increased significantly over time, but there was no significant change in neurodevelopmental outcomes over time. Multivariate analysis indicated that abnormal neurosonographic findings, using assisted ventilation, vaginal delivery, and abnormal brainstem auditory evoked potential, were associated with increased risk for cerebral palsy.
    Journal of child neurology 06/2011; 26(11):1405-10. DOI:10.1177/0883073811408606 · 1.67 Impact Factor
  • Hye Jin Moon, In young Sung, Jin Sook Yuk
    PM&R 09/2010; 2(9):S136-S137. DOI:10.1016/j.pmrj.2010.07.338 · 1.66 Impact Factor