1.Secondary Erythromelalgia: A Case Report.
Byoung Chan KANG ; Da Jeong NAM ; Eun Kyoung AHN ; Duck Mi YOON ; Joung Goo CHO
The Korean Journal of Pain 2013;26(3):299-302
Erythromelalgia is a rare neurovascular pain syndrome characterized by a triad of redness, increased temperature, and burning pain primarily in the extremities. Erythromelalgia can present as a primary or secondary form, and secondary erythromelalgia associated with a myeloproliferative disease such as essential thrombocythemia often responds dramatically to aspirin therapy, as in the present case. Herein, we describe a typical case of a 48-year-old woman with secondary erythromelalgia linked to essential thrombocythemia in the unilateral hand. As this case demonstrates, detecting and visualizing the hyperthermal area through infrared thermography of an erythromelalgic patient can assist in diagnosing the patient, assessing the therapeutic results, and understanding the disease course of erythromelalgia.
Aspirin
;
Burns
;
Erythromelalgia
;
Extremities
;
Female
;
Hand
;
Humans
;
Neuralgia
;
Thermography
;
Thrombocythemia, Essential
2.Tunnelized-facial Artery Myomucosal Island Flap (t-FAMMIF) for Palatomaxillary Reconstruction: A Report of Two Cases
Da Jung RYU ; Hyo Won JANG ; Hye Jeong PARK ; Hyung Jun KIM ; In Ho CHA ; Woong NAM
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 2013;35(2):100-106
3.“Spray-as-you-go” medical technique for awake intubation using a combination of an epidural catheter and the OptiScope in a patient with Ludwig's angina: A case report.
Da Jeong NAM ; Joung Goo CHO ; Sang Hwa KANG ; Soojeong KANG
Anesthesia and Pain Medicine 2018;13(3):336-340
A 73-year-old woman presented to the emergency department with submandibular pain and swelling. The patient was diagnosed to have Ludwig's angina, and she was planned to undergo urgent incision and drainage under general anesthesia. However, her physical examination revealed severe diffuse swelling extending from the bilateral submandibular spaces to the submental space and further down to the neck. As our view was blocked by the patient's neck swelling, we did not perform a regional anesthesia of the airway or a transtracheal block. Several non-invasive alternatives were considered. The “spray-as-you-go” technique was chosen, and it was performed using the OptiScope®. However, the OptiScope did not have a working channel or syringe adaptor for the administration of the local anesthetic solution. To solve this problem, we combined the OptiScope with a 27-G tunneled epidural catheter (100 cm) for the administration of lidocaine and this combination made the awake intubation successful.
Aged
;
Anesthesia, Conduction
;
Anesthesia, General
;
Catheters*
;
Drainage
;
Emergency Service, Hospital
;
Female
;
Humans
;
Intubation*
;
Lidocaine
;
Ludwig's Angina*
;
Neck
;
Physical Examination
;
Syringes
4.National Healthcare Service and Its Big Data Analytics.
Da Jeong NAM ; Hyuk Won KWON ; Haeyeon LEE ; Eun Kyung AHN
Healthcare Informatics Research 2018;24(3):247-249
No abstract available.
Delivery of Health Care*
5.Peripheral Neuropathy and Decreased Locomotion of a RAB40B Mutation in Human and Model Animals
Wonseok SON ; Hui Su JEONG ; Da Eun NAM ; Ah Jin LEE ; Soo Hyun NAM ; Ji Eun LEE ; Byung-Ok CHOI ; Ki Wha CHUNG
Experimental Neurobiology 2023;32(6):410-422
Rab40 proteins are an atypical subgroup of Rab GTPases containing a unique suppressor of the cytokine signaling (SOCS) domain that is recruited to assemble the CRL5 E3 ligase complex for proteolytic regulation in various biological processes. A nonsense mutation deleting the C-terminal SOCS box in the RAB40B gene was identified in a family with axonal peripheral neuropathy (Charcot-Marie-Tooth disease type 2), and pathogenicity of the mutation was assessed in model organisms of zebrafish and Drosophila. Compared to control fish, zebrafish larvae transformed by the human mutant hRAB40B-Y83X showed a defective swimming pattern of stalling with restricted localization and slower motility. We were consistently able to observe reduced labeling of synaptic markers along neuromuscular junctions of the transformed larvae. In addition to the neurodevelopmental phenotypes, compared to normal hRAB40B expression, we further examined ectopic expression of hRAB40B-Y83X in Drosophila to show a progressive decline of locomotion ability. Decreased ability of locomotion by ubiquitous expression of the human mutation was reproduced not with GAL4 drivers for neuron-specific expression but only when a pan-glial GAL4 driver was applied. Using the ectopic expression model of Drosophila, we identified a genetic interaction in which Cul5 down regulation exacerbated the defective motor performance, showing a consistent loss of SOCS box of the pathogenic RAB40B. Taken together, we could assess the possible gain-of-function of the human RAB40B mutation by comparing behavioral phenotypes in animal models; our results suggest that the mutant phenotypes may be associated with CRL5-mediated proteolytic regulation.
6.Prospective analysis of factors associated with inadequate bowel preparation for colonoscopy in actual clinical practice.
Dae Hyung WOO ; Kyeong Ok KIM ; Da Eun JEONG ; Yoon Jeong NAM ; Si Hyung LEE ; Byung Ik JANG ; Tae Nyeun KIM
Intestinal Research 2018;16(2):293-298
BACKGROUND/AIMS: Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice. METHODS: We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation. RESULTS: Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5–16.0 hours); that of the adequate group was 5.0 hours (range, 1.5–16.0 hours); and that of the inadequate group was 5 hours (range, 2–23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake < 2 L were the independent predictors of inadequate bowel preparation. CONCLUSIONS: The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education.
Aged
;
Appendectomy
;
Cerebrovascular Disorders
;
Colon
;
Colon, Ascending
;
Colonoscopy*
;
Education
;
Gastrectomy
;
Humans
;
Male
;
Mass Screening
;
Multivariate Analysis
;
Polyethylene Glycols
;
Polyps
;
Prospective Studies*
;
Risk Factors
7.Impact of Mediastinal Lymphadenopathy on the Severity of COVID-19 Pneumonia: A Nationwide Multicenter Cohort Study
Jong Eun LEE ; Won Gi JEONG ; Bo Da NAM ; Soon Ho YOON ; Yeon Joo JEONG ; Yun-Hyeon KIM ; Sung Jin KIM ; Jin Young YOO
Journal of Korean Medical Science 2022;37(22):e78-
Background:
We analyzed the differences between clinical characteristics and computed tomography (CT) findings in patients with coronavirus disease 2019 (COVID-19) to establish potential relationships with mediastinal lymphadenopathy and clinical outcomes.
Methods:
We compared the clinical characteristics and CT findings of COVID-19 patients from a nationwide multicenter cohort who were grouped based on the presence or absence of mediastinal lymphadenopathy. Differences between clinical characteristics and CT findings in these groups were analyzed. Univariate and multivariate analyses were performed to determine the impact of mediastinal lymphadenopathy on clinical outcomes.
Results:
Of the 344 patients included in this study, 53 (15.4%) presented with mediastinal lymphadenopathy. The rate of diffuse alveolar damage pattern pneumonia and the visual CT scores were significantly higher in patients with mediastinal lymphadenopathy than in those without (P < 0.05). A positive correlation between the number of enlarged mediastinal lymph nodes and visual CT scores was noted in patients with mediastinal lymphadenopathy (Spearman’s ρ = 0.334, P < 0.001). Multivariate analysis showed that mediastinal lymphadenopathy was independently associated with a higher risk of intensive care unit (ICU) admission (odds ratio, 95% confidence interval; 3.25, 1.06-9.95) but was not significantly associated with an increased risk of in-hospital death in patients with COVID-19.
Conclusion
COVID-19 patients with mediastinal lymphadenopathy had a larger extent of pneumonia than those without. Multivariate analysis adjusted for clinical characteristics and CT findings revealed that the presence of mediastinal lymphadenopathy was significantly associated with ICU admission.
8.Sleep Irregularity in the Previous Week Influences the First-Night Effect in Polysomnographic Studies.
Da Hye LEE ; Chul Hyun CHO ; Changsu HAN ; Ki Nam BOK ; Jung Ho MOON ; Eunil LEE ; Heon Jeong LEE ; Leen KIM
Psychiatry Investigation 2016;13(2):203-209
OBJECTIVE: The first-night effect is a well-known phenomenon resulting from an individual's maladaptation to the unfamiliar environment of a sleep laboratory. However, there have been no direct reports of the effect of previous sleep patterns on the first-night effect. We aimed to investigate the effect the previous week's sleep pattern on the first-night effect. METHODS: Twenty-four young, healthy, male participants completed the study procedure. During one week prior to study, the participants kept sleep diaries and wore actigraphs to identify sleep-wake pattern. Two consecutive nights of polysomnography were conducted after that. Wilcoxon signed-rank tests were applied to compare sleep variables of the two nights. Variance (standard deviation) of sleep onset time during the previous week was used as an index of irregularity. A Kendall's ranked correlation analysis and a linear regression test were applied to detect correlation between sleep irregularity and the first-night effect measured by polysomnography. RESULTS: There were significant differences in the values of sleep efficiency (p=0.011) and wake after sleep onset (WASO) (p=0.006) between the two nights. Sleep efficiency was lower and WASO was higher on the first night as compared to the second night. Sleep irregularity in the previous week was negatively correlated with sleep efficiency (p<0.001) of the first night, but was not significantly correlated with any other sleep parameters. CONCLUSION: We replicated the existence of the first-night effect commonly observed in sleep studies. Sleep irregularity in the previous week may influence the first-night effect in polysomnographic studies.
Humans
;
Linear Models
;
Male
;
Polysomnography
9.Cross-cultural Adaptation and Linguistic Validation of the Korean Version of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale.
Cholhee PARK ; Youn Woo LEE ; Duck Mi YOON ; Do Wan KIM ; Da Jeong NAM ; Do Hyeong KIM
Journal of Korean Medical Science 2015;30(9):1334-1339
Distinction between neuropathic pain and nociceptive pain helps facilitate appropriate management of pain; however, diagnosis of neuropathic pain remains a challenge. The aim of this study was to develop a Korean version of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale and assess its reliability and validity. The translation and cross-cultural adaptation of the original LANSS pain scale into Korean was established according to the published guidelines. The Korean version of the LANSS pain scale was applied to a total of 213 patients who were expertly diagnosed with neuropathic (n = 113) or nociceptive pain (n = 100). The Korean version of the scale had good reliability (Cronbach's alpha coefficient = 0.815, Guttman split-half coefficient = 0.800). The area under the receiver operating characteristic curve was 0.928 with a 95% confidence interval of 0.885-0.959 (P < 0.001), suggesting good discriminate value. With a cut-off score > or = 12, sensitivity was 72.6%, specificity was 98.0%, and the positive and negative predictive values were 98% and 76%, respectively. The Korean version of the LANSS pain scale is a useful, reliable, and valid instrument for screening neuropathic pain from nociceptive pain.
*Cross-Cultural Comparison
;
Diagnosis, Differential
;
*Diagnostic Techniques, Neurological
;
England
;
Female
;
Humans
;
Male
;
Middle Aged
;
Neuralgia/classification/*diagnosis
;
Nociceptive Pain/*diagnosis
;
Observer Variation
;
Pain Measurement/*methods
;
Reproducibility of Results
;
Republic of Korea
;
Sensitivity and Specificity
;
Surveys and Questionnaires
;
Symptom Assessment/methods
;
*Translating
10.Four Limb Shaped Auricular Chondrocutaneous Composite Graft for the Alar and the Columellar Defects.
Seok Min YOON ; Da Woon LEE ; Seung Min NAM ; Syeo Young WEE ; Hyun Gyo JEONG ; Chang Yong CHOI
Archives of Aesthetic Plastic Surgery 2017;23(3):149-154
BACKGROUND: Composite grafts have advantages for small nasal defect coverage. However, if the the outer skin defect and the inner skin defect have a different location, conventional composite grafts encounter considerable limitations. Therefore, we devised a 4-limbed graft to overcome this limitation by use of soft tissue transposition. METHODS: Over the course of 5 years, this auricular composite graft was used in 10 cases of reconstruction. We harvested skin and cartilage from the helix. The composite graft had 2 limbs of soft tissue to cover the nasal defect and another 2 limbs of cartilage to support nasal framework. The cartilage limbs extended 3 to 5 mm beyond the margin of the skin. The direction of each limb was modified according to defect position. RESULTS: All 10 composite grafts survived completely. All composite grafts shrank by a small percentage of their bulk. Nonetheless, the nasal framework was maintained to an acceptable extent because of the cartilage limbs. CONCLUSIONS: This technique was capable not only of covering defects in the alar and columellar area, but also of maintaining a satisfactory external appearance, because the 2 limbs of cartilage included in the graft strengthened the nasal framework and provided modest support to the nostril margin. The 2 limbs of soft tissue covered the defect area. Our 4-limbed auricular chondrocutaneous composite graft is reliable option for the reconstruction of alar and columellar defects in a single-stage procedure.
Cartilage
;
Extremities*
;
Reconstructive Surgical Procedures
;
Skin
;
Transplants*