1.A Pilot Survey of Difficult Intubation and Cannot Intubate, Cannot Ventilate Situations in Korea.
Jung Soo KIM ; Hyun Kyoung LIM ; Jeong Yun SONG ; Hyun Keun LIM ; Kyungchul SONG ; Jae Hwa CHO
Korean Journal of Critical Care Medicine 2016;31(3):202-207
BACKGROUND: There have been no studies of airway management strategies for difficult intubation and cannot intubate, cannot ventilate (CICV) situations in Korea. This study was intended to survey devices or methods that Korean anesthesiologists and intensivists prefer in difficult intubation and CICV situations. METHODS: A face-to-face questionnaire that consisted of a doctor's preference, experience and comfort level for alternative airway management devices was presented to anesthesiologists and intensivists at study meetings and conferences from October 2014 to December 2014. RESULTS: We received 218 completed questionnaires. In regards to difficult intubation, the order of preferred alternative airway devices was a videolaryngoscope (51.8%), an optical stylet (22.9%), an intubating laryngeal mask airway (11.5%), and a fiber-optic bronchoscope (10.6%). One hundred forty-two (65.1%) respondents had encountered CICV situations, and most of the cases were identified during elective surgery. In CICV situations, the order of preferred methods of infraglottic airway management was cricothyroidotomy (CT) by intravenous (IV) catheter (57.3%), tracheostomy by a surgeon (18.8%), wire-guided CT (18.8%), CT using a bougie (2.8%), and open surgery CT using a scalpel (2.3%). Ninety-eight (45%) of the 218 respondents were familiar with the American Society of Anesthesiologists' difficult airway algorithm or Difficult Airway Society algorithm, and only 43 (19.7%) had participated in airway workshops within the past five years. CONCLUSION: The videolaryngoscope was the most preferred device for difficult airways. In CICV situations, the method of CT via an IV catheter was the most frequently used, followed by wire-guided CT method and tracheostomy by the attending surgeon.
Airway Management
;
Bronchoscopes
;
Catheters
;
Congresses as Topic
;
Education
;
Intubation*
;
Intubation, Intratracheal
;
Korea*
;
Laryngeal Masks
;
Methods
;
Surveys and Questionnaires
;
Tracheostomy
2.A Case of Esophageal Duplication.
Hyung Kuk HAM ; Jeong Kyu SEOH ; Jae Seung YANG ; Baek Keun LIM ; Jong Soo KIM ; Hee Jae JOO
Journal of the Korean Pediatric Society 1990;33(8):1133-1137
No abstract available.
3.Clinical and MR Findings of Tethered Cord Syndrome.
Hyae Young KIM ; Young Seok LEE ; Hyo Keun LIM ; Eun Chul CHUNG ; Ho In CHUNG ; Jeong Soo SUH ; Seoung Ro LEE
Journal of the Korean Radiological Society 1994;31(3):545-551
PURPOSE: Tethered cord syndrome(TCS) is defined as low position of the conus medullaris by the abnormally fixed spinal cord with progressive neurologic deficit MATERIALS AND METHODS: To evaluate the findings of TCS at MRI and its diagnostic value, we performed a retrospective analysis of MRI of 30 patients with emphasis on clinical manifestation, level of conus medullaris, cause of tethering, and associated findings. RESULTS: Clinical presentation included back mass(26 cases), neurogenic bladder(5 cases), urinary incontinence(5 cases), progressive constipation(2 cases), skin dimpling(1 case), gait disturbance(1 case) and club foot (1 case). Neurologic deficit was developed in 11 cases(40% and mean age of these patients at the time of diagnosis was 8.6 years. The most common cause of tethering was lipoma(63%). The tips of conus medullaris were below the level of the second lumbar spine in all patients. The causes of tethering were lipomatous component(spinal lipoma and lipomyelomenigocele) in 67% myelomeningocele in 20%, presacral mass in 7%, thickened filum terminale in 3% and postoperative change in 3%. Associated anomalies included syringomyelia(20%) and hydrocephalus was associated in 3 out of 5 patients who underwent brain MRI. CONCLUSION: MRI clearly delineated the location of conus, tethering of the filum terminale with their causes and associated abnormalities. MRI examination is a very useful diagnostic tool for the early evaluation of TCS and the postoperative follow up.
Brain
;
Cauda Equina
;
Conus Snail
;
Diagnosis
;
Follow-Up Studies
;
Foot
;
Gait
;
Humans
;
Hydrocephalus
;
Lipoma
;
Magnetic Resonance Imaging
;
Meningomyelocele
;
Neural Tube Defects*
;
Neurologic Manifestations
;
Retrospective Studies
;
Skin
;
Spinal Cord
;
Spine
4.A Case of Dapsone Syndrome.
Jeong Kyu SEOH ; Hye Kyong BAE ; Jae Seung YANG ; Eung Deok CHOI ; Baek Keun LIM ; Jong Soo KIM
Journal of the Korean Pediatric Society 1988;31(10):1376-1380
No abstract available.
Dapsone*
5.Oculopharyngodistal myopathy in three unrelated Korean patients: Early distal limb weakness is characteristic finding in oculopharyngodistala myopathy
Sun-Young Kim ; Jeong-Keun Lim ; Young-Eun Park ; Chang-Hoon Lee ; HyangSook Kim ; Dae-Seong Kim
Neurology Asia 2011;16(4):315-320
Objectives: To determine the clinical characteristics of Korean patients with sporadic oculopharyngodistal
myopathy. Methods: Three consecutive unrelated Korean patients with sporadic oculopharyngodistal
myopathy participated in this study. Stepwise approaches were performed including careful clinical
examination, electrophysiological study, pathology evaluation and genetic study. The literature on
oculopharyngodistal myopathy was reviewed. Results: Clinically, our patients showed consistent
features of initial distal limb weakness with variable ophthalmoplegia, bulbar weakness or proximal
weakness. All the patients showed rimmed vacuoles and myopathic changes.
Conclusion: Through the literature review and this study, we believe that initial distal limb weakness
is a characteristic fi nding in patients with oculopharyngodistal myopathy in some ethnic groups.
6.Change of Ovary Before and After Radiotherapy in Reproductive Women with Cervix Carcinoma in MR Imaging.
Young Min CHO ; Yong Yeon JEONG ; Heoung Keun KANG ; Hyo Soon LIM ; Woong YOON ; Tae Woong CHUNG ; Jeong Jin SEO
Journal of the Korean Radiological Society 2001;45(6):621-625
PURPOSE: To investigate changes in the ovary revealed by MR imaging before and after radiotherapy in premenopausal patients with cervical carcinoma. MATERIALS AND METHODS: Thirty-three premenopausal patients with cervical carcinoma underwent radiation therapy at an average dosage of 11,279 (external: 5,352; internal: 5,927) cGy. Before and after this therapy, all underwent pelvic MR imaging using a 1.5T MR scanner (GE Medical Systems, Milwaukee, U.S.A.). The average interval of follow-up MR imaging was 7.2 months, and axial T1-weighted and axial and sagittal T2-weighted MR images were obtained. The presence, size number of follicles, and differentiation of the zonal anatomy of the ovary were determined by two radiologists, who reached a consensus. RESULTS: After radiation therapy, all patients ceased menstruation. For ovaries, the detection rates before and after radiation therapy were 94% (62/66) and 39% (26/66) (p<0.05), respectively, and average ovary size was 2.6x1.9x2.2 cm before and 1.7x1.3x1.4 cm after therapy (p<0.05). The average number of ovarian follicles before and after therapy was 5.1 and 3.1, respectively (p<0.05). T2-weighted imaging, demonstrated differentiation of zonal anatomy in 74% of cases (46/62) before radiotheraphy, and 15% (4/26) after (p<0.05). CONCLUSION: Our study has shown that after radiation therapy in premenopausal patients with cervical cancer, detection rates, average size, and the number of ovaries decreased, findings which are similar to those for normal postmenopausal ovary. MR imaging can reveal structural change in ovaries.
Cervix Uteri*
;
Consensus
;
Female
;
Fluconazole
;
Follow-Up Studies
;
Humans
;
Magnetic Resonance Imaging*
;
Menstruation
;
Ovarian Follicle
;
Ovary*
;
Radiotherapy*
;
Uterine Cervical Neoplasms
7.Effect of taper and surface area of inner crown on the retentive force of electroformed outer crown.
Wan Keun KANG ; Jang Seop LIM ; Young Chan JEON ; Chang Mo JEONG ; Hee Chan JEONG
The Journal of Korean Academy of Prosthodontics 2006;44(2):165-173
PURPOSE: With gold electroforming system for the double crown, the secondary crown is electroformed directly onto the primary crown. An even thick layer of high precision can be acquired. It is thought that the retention of electroformed outer crown is primarily acquired by the adhesive force (surface tension) through the saliva which is interposed between precisely fitted inner and outer crown. The purpose of this study was to investigate the effect of taper and surface area of inner crown on the retentive force of electroformed outer crown according to the presence of saliva. MATERIALS AND METHODS: 32 titanium inner crowns with cervical diameter of 8 mm and cone angles of 0, 2, 4, 6 degrees, which had same surface area by regulated height, were machined on a lathe. Another 32 titanium inner crowns with cone angles of 0, 2, 4, 6 degrees, which had doubled surface area by increased cervical diameter, were fabricated. Eight specimens of each group, for a total of 64 titanium inner crowns, were prepared. The electroformed outer crowns were fabricated directly on the inner crowns by using electroforming machine(GAMMAT free, Gramm Technik, Germany). The tertiary frameworks were waxed-up on the electroformed outer crown and cast using nonprecious alloy(Rexillium(R)III, Jeneric(R)/ Pentronh(R) Inc., USA). The cast metal frameworks were sandblasted with alubimium oxides and cemented using resin cement(Superbond C and B, Sun Medical Co., Japan) over the electroformed copings of each specimen. Then, artificial saliva(Taliva(R), Halim Pharm Co., Korea) was sprayed between the inner and outer crown, and they were connected under 5 kg force. The retentive force was measured by the universal testing machine(Tinius Olsen 1000, Tinius Olsen, USA) with a cross-head speed of 66.67 mm/sec. The direction of cross-head travel was exactly aligned with the path of removal of the respective specimens. This measurement procedures for retentive force of electroformed outer crown with artificial saliva were repeated in the same way without presence of artificial saliva. RESULTS AND CONCLUSION: The following conclusions were drawn: 1. The retentive force of electroformed outer crown was decreased according to increased taper of inner crown(P<.05). 2. The retentive force of electroformed outer crown showed no significant differences according to surface area and the presence of artificial saliva(P>.05).
Adhesives
;
Crowns*
;
Oxides
;
Saliva
;
Saliva, Artificial
;
Solar System
;
Titanium
8.Expression of Thymidine Phosphorylase in Human Gastric Carcinoma.
Kee Hwan KIM ; Cho Hyun PARK ; Jeong Soo KIM ; Keun Woo LIM
Journal of the Korean Surgical Society 2004;67(1):18-24
PURPOSE: Angiogenesis plays an important role in the growth and metastasis of solid tumors. It has been recently reported that thymidine phosphorylase (dThdPase) is identical to platelet-derived endothelial cell growth factor. In this study, we analyzed the correlation between dThdPase activity and neovascularization, and also determined their prognostic significance by enzyme-linked immunosorbent assay (ELISA) and immunohistochemical staining in patients with gastric carcinoma. METHODS: The medical records of 57 patients with gastric carcinoma who underwent radical gastrectomy were retrospectively reviewed. Primary tumors were studied by immunohistochemical staining with anti-PD-ECGF/dThdPase and anti- CD34 monoclonal antibodies. The dThdPase activity level was also analyzed by ELISA. Microvessels were assessed by immunostaining endothelial cells for CD34. We counted the number of microvessels in the tumors of the patients. RESULTS: The dThdPase activity of tumor tissues (82.4+/-66.2 unit/mg protein) was significantly higher than that of normal mucosas (8.9 +/- 18.2 unit/mg protein) (P < 0.0001). Immunohistochemical staining with anti-dThdPase and anti-CD34 monoclonal antibodies was performed in 57 gastric carcinoma tissue samples. Positive dThdPase expression was observed in 24 (42.1%) tumors. The average number of cells expressing CD34 was significantly higher in the dThdPase- positive carcinomas (44.4+/-15.3) than in the dThdPase- negative carcinomas (30.7+/-15.8)(P<0.003). The expression of dThdPase was significantly associated with the intratu moral microvessel counts (P=00005). The patients with dThdPase-positive carcinoma showed a significantly worse prognosis than those with dThdPase-negative carcinoma (P=0.034). CONCLUSION: These results suggest that dThdPase plays a role in the promotion of angiogenesis, and that it is a possible candidate as a prognostic factor in human gastric carcinomas.
Antibodies, Monoclonal
;
Endothelial Cells
;
Enzyme-Linked Immunosorbent Assay
;
Gastrectomy
;
Humans*
;
Medical Records
;
Microvessels
;
Mucous Membrane
;
Neoplasm Metastasis
;
Prognosis
;
Retrospective Studies
;
Thymidine Phosphorylase*
;
Thymidine*
9.A case of congenital mesoblastic nephroma-diagnosed during intrauterine life.
Jeong Lim KIM ; Chuhl Joo LYU ; Ki Soo PAI ; Chul LEE ; Pyung Kil KIM ; Byung Soo KIM ; Kook LEE ; Ki Keun OH ; Seung Hoon CHOI ; Woo Hee JUNG
Journal of the Korean Cancer Association 1991;23(2):458-464
No abstract available.
10.Lift-up Submucosal Hemorrhoidectomy.
Hyung Kyu YANG ; Cheong Ho LIM ; Hyeon Keun SHIN ; Choon Hoon KANG ; Seung Kyu JEONG ; Jai Pyo CHOI
Journal of the Korean Society of Coloproctology 2005;21(3):145-151
PURPOSE: Hemorrhoidal tissues are normal anatomic structures present in every individual, and they act as cushions and are anchored to the internal anal sphincter by a connective tissue system. When the anchoring connective tissues undergo bears degenerative changes, the hemorrhoids not only bulge but also descend into the lumen of the anal canal. The veins also become distended. The previous hemorrhoidectomy methods (excision and ligation methods) tend to remove excessive amounts of hemorrhoidal tissues, possibly causing incontinence or stenosis. This study introduces a modified hemorrhoidectomy method. METHODS: A retrospective study was done with 650 patients (358 males, 292 females) who underwent hemorroidectomies from Jan. 1997 to Jan. 2000. Under saddle-block anesthesia, the patient was placed in a prone jack-knife position. After narrow incisions on the mucosa of the selected pile, a bilateral submucosal dissection was performed. The pedicle was ligated by transfixing sutures 2 or 3 times with 2-0 chromic catgut to lift up the mucosa. RESULTS: The mean operation time per hemorrhoidal pile was 12.7 minutes, and the mean hospital-stay was 4.3 days. Acute and delayed postoperative anal bleeding occurred in 7 (1.1%) and 3 (0.5%) patients, respectively. The symptoms of both subsided spontaneously. Ninety-three (93) patients (14.3%) reguired nelaton catheterization for voiding difficulty, and one patient (0.2%) showed mild anal stenosis. The most frequent complaint was skin-tag formation (148 cases, 22.8%). In 140 cases, the skin tag was removed under local anesthesia. CONCLUSIONS: It is desirable to keep the normal structure of the anal canal by removing as little of the cushions as possible. Our 'lift-up submucosal hemorrhoidectomy' shows good results and is an easy operative method when compared with Parks' original method.
Anal Canal
;
Anesthesia
;
Anesthesia, Local
;
Catgut
;
Catheterization
;
Catheters
;
Connective Tissue
;
Constriction, Pathologic
;
Hemorrhage
;
Hemorrhoidectomy*
;
Hemorrhoids
;
Humans
;
Ligation
;
Male
;
Mucous Membrane
;
Retrospective Studies
;
Skin
;
Sutures
;
Veins