1.Epinephrine-induced lactic acidosis in orthognathic surgery: a report of two cases.
Hee Won SON ; Se Hun PARK ; Hyun Oh CHO ; Yong Joon SHIN ; Jang Ho SON
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2016;42(5):295-300
Submucosal infiltration and the topical application of epinephrine as a vasoconstrictor produce excellent hemostasis during surgery. The hemodynamic effects of epinephrine have been documented in numerous studies. However, its metabolic effects (especially during surgery) have been seldom recognized clinically. We report two cases of significant metabolic effects (including lactic acidosis and hyperglycemia) as well as hemodynamic effects in healthy patients undergoing orthognathic surgery with general anesthesia. Epinephrine can induce glycolysis and pyruvate generation, which result in lactic acidosis, via β2-adrenergic receptors. Therefore, careful perioperative observation for changes in plasma lactate and glucose levels along with intensive monitoring of vital signs should be carried out when epinephrine is excessively used as a vasoconstrictor during surgery.
Acidosis, Lactic*
;
Administration, Topical
;
Anesthesia, General
;
Anesthesia, Local
;
Epinephrine
;
Glucose
;
Glycolysis
;
Hemodynamics
;
Hemostasis
;
Humans
;
Lactic Acid
;
Orthognathic Surgery*
;
Plasma
;
Pyruvic Acid
;
Vital Signs
2.Intervention effects in the transmission of COVID-19 depending on the detection rate and extent of isolation
Okyu KWON ; Woo-Sik SON ; Jin Yong KIM ; Jong-Hun KIM
Epidemiology and Health 2020;42(1):e2020045-
Objectives:
In 2020, the coronavirus disease 2019 (COVID-19) respiratory infection is spreading in Korea. In order to prevent the spread of an infectious disease, infected people must be quickly identified and isolated, and contact with the infected must be blocked early. This study attempted to verify the intervention effects on the spread of an infectious disease by using these measures in a mathematical model.
Methods:
We used the susceptible-infectious-recovery (SIR) model for a virtual population group connected by a special structured network. In the model, the infected state (I) was divided into I in which the infection is undetected and Ix in which the infection is detected. The probability of transitioning from an I state to Ix can be viewed as the rate at which an infected person is found. We assumed that only those connected to each other in the network can cause infection. In addition, this study attempted to evaluate the effects of isolation by temporarily removing the connection among these people.
Results:
In Scenario 1, only the infected are isolated; in Scenario 2, those who are connected to an infected person and are also found to be infected are isolated as well. In Scenario 3, everyone connected to an infected person are isolated. In Scenario 3, it was possible to effectively suppress the infectious disease even with a relatively slow rate of diagnosis and relatively high infection rate.
Conclusions
During the epidemic, quick identification of the infected is helpful. In addition, it was possible to quantitatively show through a simulation evaluation that the management of infected individuals as well as those who are connected greatly helped to suppress the spread of infectious diseases.
3.Intervention effects in the transmission of COVID-19 depending on the detection rate and extent of isolation
Okyu KWON ; Woo-Sik SON ; Jin Yong KIM ; Jong-Hun KIM
Epidemiology and Health 2020;42(1):e2020045-
Objectives:
In 2020, the coronavirus disease 2019 (COVID-19) respiratory infection is spreading in Korea. In order to prevent the spread of an infectious disease, infected people must be quickly identified and isolated, and contact with the infected must be blocked early. This study attempted to verify the intervention effects on the spread of an infectious disease by using these measures in a mathematical model.
Methods:
We used the susceptible-infectious-recovery (SIR) model for a virtual population group connected by a special structured network. In the model, the infected state (I) was divided into I in which the infection is undetected and Ix in which the infection is detected. The probability of transitioning from an I state to Ix can be viewed as the rate at which an infected person is found. We assumed that only those connected to each other in the network can cause infection. In addition, this study attempted to evaluate the effects of isolation by temporarily removing the connection among these people.
Results:
In Scenario 1, only the infected are isolated; in Scenario 2, those who are connected to an infected person and are also found to be infected are isolated as well. In Scenario 3, everyone connected to an infected person are isolated. In Scenario 3, it was possible to effectively suppress the infectious disease even with a relatively slow rate of diagnosis and relatively high infection rate.
Conclusions
During the epidemic, quick identification of the infected is helpful. In addition, it was possible to quantitatively show through a simulation evaluation that the management of infected individuals as well as those who are connected greatly helped to suppress the spread of infectious diseases.
4.Anatomy as Elective Course for Fourth-Year Medical Students.
Tae Hwan KONG ; Sang Hun KIM ; Yong Hun SON ; Ki Sang CHUNG ; Ho Kyung JIN ; Hye Won JANG ; Chang Seok OH
Korean Journal of Physical Anthropology 2016;29(1):1-7
Five medical students in the fourth-year took anatomy as their elective courses for 1 month. They dissected one cadaver, and investigated Digital Report, under the course subjects as follows; (1) the shape of thyroid gland and the location of its isthmus, (2) the branches of left and right coronary arteries, (3) the number of blood vessels and bronchi on the hilum of lung, (4) topographical relationship of the renal vessels and ureter, and the shape of the renal pelvis, (5) the location and attachment of the appendix, (6) the penetration of median nerve through the pronator teres, (7) the sensory nerves and the extensor tendons on the dorsum of hand, (8) the branches of deep femoral artery. The pancreatic and live samples were processed and stained with H&E, for LM observation, since the individual had suffered from pancreatic cancer and got a Pylorus preserving pancreatico-duodenectomy (PPPD). At the last step of the elective course, students wrote small articles following the conventional method for writing manuscript. From the viewpoint of professor, the anatomy course for the fourth-year students were definitely different from that for first-year students, and had many positive effects in terms of anatomy education.
Appendix
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Blood Vessels
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Bronchi
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Cadaver
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Coronary Vessels
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Education
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Femoral Artery
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Hand
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Humans
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Kidney Pelvis
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Lung
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Median Nerve
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Pancreatic Neoplasms
;
Pylorus
;
Students, Medical*
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Tendons
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Thyroid Gland
;
Ureter
;
Writing
5.Preoperative Evaluation of Brain Lesion with 201Tl Brain SPECT: Is It Useful to Differentiate Benign and Malignant Lesions?.
Hyung Sun SON ; Eui Nyung KIM ; Sung Hun KIM ; Yong Ahn JUNG ; Soo Gyu JUNG ; Yong Gil HONG ; Yeon Soo LEE
Korean Journal of Nuclear Medicine 2000;34(5):371-380
PURPOSE: Thallim-201 (201Tl) brain SPECT, which can represent cellular activity of brain lesions, may provide more useful information in differentiating between benign and malignant brain lesions more so than CT or MRI, that merely represents anatomic changes or breakdown of blood brain barrier. We used 201Tl brain SPECT prospectively to evaluate the utility of 201Tl-indices as an indicator of benign or malignant lesions. MATERIALS AND METHODS: We studied 28 patients. There were 13 cases of benign lesions (3: nonspecific benign lesion, 3: meningioma, 2: low grade glioma, 1: tuberculoma, central neurocytoma, hemangioblastoma, radiation necrosis, and choroid plexus papilloma) and 15 cases of malignant lesions (6: glioblastoma multiforme, 5: anaplastic glioma, 2: medulloblastoma, 1: metastasis and lymphoma). In all patients, CT and/or MRI were obtained and then 201Tl brain SPECT was obtained with measuring mean 201Tl index and peak 201Tl index. An unpaired t-test was performed to compare the 201Tl-indices and pathologic diagnoses to evaluate the utility of 201Tl-indices as an indicator of benign or malignant lesions. RESULTS: There were no statistically significant difference in 201Tl-indices between benign and malignant brain lesions (P>0.05). CONCLUSION: These results demonstrated that we could not use 201Tl indices on brain SPECT alone as an indicator of benign or malignant brain lesions.
Blood-Brain Barrier
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Brain*
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Choroid Plexus
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Diagnosis
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Glioblastoma
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Glioma
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Hemangioblastoma
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Humans
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Magnetic Resonance Imaging
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Medulloblastoma
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Meningioma
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Necrosis
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Neoplasm Metastasis
;
Neurocytoma
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Prospective Studies
;
Tomography, Emission-Computed, Single-Photon*
;
Tuberculoma
6.Miniscrews versus surgical archwires for intermaxillary fixation in adults after orthognathic surgery.
Sieun SON ; Seong Sik KIM ; Woo Sung SON ; Yong Il KIM ; Yong Deok KIM ; Sang Hun SHIN
The Korean Journal of Orthodontics 2015;45(1):3-12
OBJECTIVE: We compared the skeletal and dental changes that resulted from the use of two methods of intermaxillary fixation (IMF)-miniscrews and surgical archwire-in 74 adult patients who had Class III malocclusion and were treated with the same orthognathic surgical procedure at a hospital in Korea. METHODS: All the patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with rigid fixation. They were divided into two groups according to the type of IMF used-group 1 underwent surgical archwire fixation and group 2 underwent orthodontic miniscrew fixation. In a series of cephalograms for each patient, we compared vertical and horizontal tooth-position measurements: (a) immediately after surgery (T0), (b) 3 months after surgery (T1), and (c) 6 months after surgery (T2). Cephalometric changes within each group were examined using one-way analysis of variance (ANOVA) while the independent samples t-test procedure was used to compare the two groups. RESULTS: After surgery, the maxillary incisors tended to be proclined in both groups although there were no significant differences. Incisor overbite increased significantly in both groups from T0 to T1, and the miniscrew group (group 2) showed slightly greater overbite than the archwire group (group 1). CONCLUSIONS: This study suggest that the use of orthodontic miniscrews and orthodontic surgical archwire for IMF in adult patients results in similar skeletal and dental changes.
Adult*
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Humans
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Incisor
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Korea
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Malocclusion
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Orthognathic Surgery*
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Orthognathic Surgical Procedures
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Osteotomy
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Osteotomy, Sagittal Split Ramus
;
Overbite
7.Clinical outcome of kidney transplantation in patients with diabetic nephropathy.
Young Ki SON ; Joon Seok OH ; Hyae Ju OH ; Yong Hun SHIN ; Joong Kyung KIM
Korean Journal of Medicine 2009;77(3):321-327
BACKGROUND/AIMS: Diabetic nephropathy is a growing cause of end-stage renal failure, and renal transplantation is considered the best option for survival in patients who experience such renal failure. Patients with diabetes are older and frequently have comorbidity, and only a minority of these patients is considered for renal transplantation. The survival rate of patients having diabetes treated with transplantation has improved, although the long-term prognosis has not been determined. This study examined the clinical outcome of renal transplantation in patients having diabetes compared to that in nondiabetic patients. METHODS: We compared diabetic (n=70) and nondiabetic (n=355) groups of patients for whom medical records were available for more than 3 months at our hospital from March 1998 to August 2008. RESULTS: The recipients were significantly older in the diabetic group (50.6+/- 10.5 vs. 39.8+/- 10.8 years), while donor age was significantly younger in that group (33.2+/- 9.0 vs. 37.5+/- 1.3 years). Cardiovascular events occurring after transplantation were more frequent in the diabetic group (11/70 vs. 10/355). Kaplan-Meier curves for cumulative survival of the renal allograft and patient survival revealed no difference between the two groups. The allograft survival rate in the diabetic group was 100% at 5 years and 79% at 10 years posttransplantation. In the nondiabetic group, the renal allograft survival rate was 98% at 5 years and 75% at 10 years. The patient survival rates did not differ significantly: 100% vs. 99% at 5 years and 91% vs. 91% at 10 years for the diabetic and nondiabetic groups, respectively. CONCLUSIONS: In our study, the long-term survival of renal transplantation in patients with diabetes equaled that of nondiabetic patients. Graft survival was also comparable between the two groups. Therefore, kidney transplantation may be another therapeutic option for end-stage diabetic nephropathy.
Comorbidity
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Diabetic Nephropathies
;
Graft Survival
;
Humans
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Kidney
;
Kidney Failure, Chronic
;
Kidney Transplantation
;
Medical Records
;
Prognosis
;
Renal Insufficiency
;
Survival Rate
;
Tissue Donors
;
Transplantation, Homologous
;
Transplants
8.The Effect of the Length of the Lingual Frenum and the Tongue Motion on Speech.
Seong Hee PARK ; Woo Sung SON ; Yong Deok KIM ; Sang Hun SHIN ; Uk Kyu KIM ; In Kyo CHUNG ; Soon Bok KWON
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2001;27(6):526-534
PURPOSE: The objective of this study is to ascertain whether the positive relationship exists among the frenum length, the tongue movement and the speech and to present the normal range of tongue movement and guidelines for the choice of surgery, observation if necessary. MATERIALS AND METHODS: 180 patients were evaluated. We divided 180 patients into 6 groups by age. Each group was separated as follows; the age of 2.5-4, 5-6, 7-9, 10-12, 13-15, 16-18. We measured the frenal length, the range of tongue motion and evaluated the speech so that we really questioned about the positive relationship between the tongue-tie and speech. We let the patient exercise the protrusive, both(right, left) laterotrusive, superior movement of the tongue. During these movements, we measured the distance between the vermilion border and the tongue tip. We also measured the distance from the tongue tip to the point contacting the upper lip with dorsum of the tongue during the maximal protrusive movement of the tongue. Three linear measurements of the anterior, inferior segment of the tongue, including the lingual frenum, are made. These measurements are as follows: 1. Distance A. Free anterior portion of the tongue from the point of frenular insertion to the tongue tip. 2. Distance B. The distance from the initiating point of the lingual frenum to the point connecting the two sublingual caruncles to the lingual frenum perpendicularly. 3. Distance C. The distance from the point contacting the line crossing the sublingual caruncles with the lingual frenum to the terminating point of the lingual frenum. We transform three linear measures into a statistical ratio, A/(A+B+C), representing the length of the free portion of the tongue compared with the total sublingual dimensions. In addition, we assessed the speech through Picture Consonant Articulation Test (PCAT) and tried to find out the relationship between the length of the lingual frenum and speech. CONCLUSION: As people are born, they have small and restricted tongue. As people grow old, tongue motions are more liberate, and unrestricted and they can speak so freely. Therefore we suggest that until age 5, oral and maxillofacial surgeons postpone the surgery if not urgent, evaluate the maximal lingual motions and PCAT according to this article and observe their changes.
Humans
;
Linear Energy Transfer
;
Lingual Frenum*
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Lip
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Reference Values
;
Tongue*
9.Erythema Ab Igne Associated with Frequent Bathing of Feet in Hot Water.
Yong Ju KIM ; Myeung Hun CHOI ; Sang Wook SON ; Chil Hwan OH ; Hae Jun SONG
Korean Journal of Dermatology 2006;44(5):615-616
Erythema ab igne is a relatively uncommon skin lesion caused by chronic exposure to low levels of infrared heat from open fires or stoves, and is characterized by reticulated hyperpigmentation on the exposed skin. Recently, exposure to various 'new' heat sources, such as heated furniture, car heaters, or even laptop computers, has been reported to cause this condition. We present a case of 31-year-old Korean woman with reticulated hyperpigmentation on her feet, which had occurred due to bathing her feet in hot water on a daily basis.
Adult
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Baths*
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Erythema*
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Female
;
Fires
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Foot*
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Hot Temperature
;
Humans
;
Hyperpigmentation
;
Interior Design and Furnishings
;
Skin
;
Water*
10.The Prevalences of Anxiety and Depressive Disorders in Patients of Pediatric Sleep Disorders.
Kwang Kuk SON ; Jong Hun PARK ; Su Min SHON ; Joon Sik KIM ; Joo Hwa LEE ; Yong Won CHO
Journal of the Korean Child Neurology Society 2009;17(2):200-208
PURPOSE: Sleep disorder is common in childhood and adolescence with prevalence of 27-62%, and the patients could have trouble with their daily life due to fatigue and headache; and it can also cause developmental disability, learning disorder, anxiety disorder, and depressive disorder. We studied the prevalence of anxiety and depressive disorder in childhood and adolescence with sleep disorder. METHODS: We studied 34 cases of patients under twenty-year-old who took a sleep polysomnography test at Sleep Center of Keimyung University Dongsan Medical Center and who could answer sleep survey questionnaires; and we used testing methods of Questionnaire for insomnia, Epworth sleepness scale, Hospital Anxiety Depression Scale, and Back Depression Inventory. We studied sleep disorder as two categories of sleep apnea and other sleep disorders and also the relationships of sleep and anxiety and depressive disorder with chi-square test. RESULTS: 29.4% of sleep disorder patients had anxiety disorder, and 47.1% depressive disorder. Considering the two categories of sleep disorder, anxiety disorder was significantly higher(P<0.005) in sleep apnea group with 43.5% than in other sleep disorder group with 9.1%. Depressive disorder was also significantly higher(P<0.05) in sleep apnea group with 65.6% than in other sleep disorder group with 36.4%. CONCLUSION: The patients with sleep disorder also had a tendency of having mood disorder, with prevalence of 29.4% of anxiety disorder and 47.1% of depressive disorder; especially in the group of sleep apnea, mood disorders was significantly higher than other sleep disorder group, which means more aggressive diagnosis and treatment are needed for the combined condition of sleep and mood disorder.
Adolescent
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Anxiety
;
Anxiety Disorders
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Depression
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Depressive Disorder
;
Developmental Disabilities
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Fatigue
;
Humans
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Learning Disorders
;
Mood Disorders
;
Polysomnography
;
Prevalence
;
Surveys and Questionnaires
;
Sleep Apnea Syndromes
;
Sleep Wake Disorders
;
Sleep Initiation and Maintenance Disorders