1.Open Repair of Ruptured Huge Aorto-Iliac Aneurysm: Warning of Colon Ischemia.
Jayun CHO ; Heekyung JUNG ; Hyung Kee KIM ; Seung HUH
Vascular Specialist International 2014;30(2):76-79
A giant abdominal aortic aneurysm (AAA) renders surgical treatment much more difficult by deforming the proximal infrarenal aortic neck (shortened length and disturbed angulation), by altering the iliac arteries (marked tortuosity and aneurysmal dilatation), and by displacing abdominal organs. Because the retroperitoneal rupture of giant AAA makes the mesentery more elongated and deformed, compromising its blood flow and thus increasing the risk of mesenteric ischemia such as colon ischemia. We describe here the surgical repair of a large infrarenal AAA with a ruptured huge left common iliac artery aneurysm of 13.5 cm in diameter, accompanied by colostomy due to colon ischemia which occurred during the operation. We discuss the pathophysiology and preventive strategy of colon ischemia during ruptured giant AAA repair.
Aneurysm*
;
Aneurysm, Ruptured
;
Aortic Aneurysm, Abdominal
;
Colitis, Ischemic
;
Colon*
;
Colostomy
;
Iliac Artery
;
Ischemia*
;
Mesentery
;
Neck
;
Rupture
2.Central Transposition of the Cephalic Vein in Patients with Brachiocephalic Arteriovenous Fistula and Cephalic Arch Stenosis.
Jihoon JANG ; Heekyung JUNG ; Jayun CHO ; Jihye KIM ; Hyung Kee KIM ; Seung HUH
Vascular Specialist International 2014;30(2):62-67
PURPOSE: Our study aims to evaluate to evaluate clinical outcomes after cephalic vein transposition (CVT) to the axilla in patients with brachiocephalic arteriovenous fistula (BC-AVF) and cephalic arch stenosis (CAS). MATERIALS AND METHODS: Hospital records of 13 patients (median age, 61 years; males, 54%) who received CVT to the proximal basilic/axillary vein due to either dysfunction (n=2) or thrombosis (n=11) between January 2010 and February 2014 were retrospectively reviewed. RESULTS: Operation was performed under local anesthesia in all cases. There was no technical failure. Concomitant inflow procedure (banding or aneurysmorrhaphy) was performed in 5 patients (38%). During follow-up (1 to 50 months, median 17 months), 3 patients died with functioning AVF and one was successfully transplanted. Two patients suffered from recurrent symptomatic stenosis of AVF and received percutaneous balloon angioplasty. Another 2 patients experienced AVF occlusion treated with interposition graft and manual fragmentation. Overall primary, assisted primary, and secondary patency rates were 77.5%, 92.3%, and 100% at 6 months and 66.1%, 92.3%, and 100% at 1 year, respectively. CONCLUSION: Although most patients presented with BC-AVF occlusion, technical success and access patency rates after CVT were favorable compared with historical data for interventional treatment. CVT should be considered as an appropriate option in selected patients with CAS.
Anesthesia, Local
;
Angioplasty, Balloon
;
Arteriovenous Fistula*
;
Axilla
;
Constriction, Pathologic*
;
Follow-Up Studies
;
Hospital Records
;
Humans
;
Male
;
Renal Dialysis
;
Retrospective Studies
;
Thrombosis
;
Transplants
;
Veins*
3.Risk Factors Affecting Recurrence of Thyroglossal Duct Cyst in Children.
Journal of the Korean Association of Pediatric Surgeons 2011;17(1):35-44
Thyroglossal duct cysts (TGDC) are the most common type of congenital developmental anomaly encountered in the anterior midline of the neck in childhood. The aim of the study was to evaluate the clinical characteristics of TGDC and identify any factors that could be related to recurrence after surgery. This study consisted of a retrospective chart review of 45 patients treated at Kyungpook National University Hospital for TGDC between 1990 and 2008. All records were reviewed for age and sex, length of history, presentation, diagnostic methods, sizes and locations of cyst, surgical management, histopathology of the lesion and recurrences. The statistical analysis of risk factors for recurrence was made using the Fisher's exact test with a significance level of p < 0.05. The male to female ratio was 2.2:1 with a male preponderance. The mean age at operation was 5 years and 2 months (4 months - 17 years). The most common presenting symptom was a nontender cervical mass (78%). Most TGDC were found in the midline position. Twenty four were infrahyoid, 17 were hyoid, and 4 were suprahyoid level. Forty one (91%) patients received the Sistrunk operation, and 4(9%) patients received cyst excision. Postoperative a seroma developed in six patients in the early postoperative days. There were a total of 3(6.6%) recurrences, 2 in patients who had excision only and in one patient who had the Sistrunk operation. Univariate analysis for risk factors with recurrence showed that there was no statistical relationship between the presence of preoperative infection and the development of recurrence. The removal of hyoid bone along with TGDC was a statistically significant risk factor for recurrent disease. This study suggests that the Sistrunk operation is the treatment of choice for TGDC in order to reduce recurrence.
Child
;
Female
;
Humans
;
Hyoid Bone
;
Male
;
Neck
;
Recurrence
;
Retrospective Studies
;
Risk Factors
;
Seroma
;
Thyroglossal Cyst
4.Nursing Students' Self Esteem, Assertiveness and Interpersonal Relationship according to their Style of Conflict Management.
Journal of Korean Academic Society of Nursing Education 2014;20(3):345-352
PURPOSE: The purpose of this study was to describe the level of self esteem, assertiveness and interpersonal relationship according to the style of conflict management among nursing students. METHODS: The subjects of this study were 236 nursing students who enrolled in sophomore classes at A university in J city. The data were analysed with descriptive analysis including t-test, ANOVA, Scheffe's test, and Pearson correlation coefficient. RESULTS: Compromising was the most prevalent style(45.8%) for managing conflict and collaborating style was 8.5%. Collaborating style for managing conflict showed the highest score in self-esteem, assertiveness, and interpersonal relationship. CONCLUSION: Based on the findings of this study, developing an intervention program that can lead to change the style of conflict management and to improve self esteem, assertiveness and interpersonal relationship is suggested.
Assertiveness*
;
Humans
;
Interpersonal Relations
;
Nursing*
;
Self Concept*
;
Students, Nursing
5.Long-term outcomes of infrainguinal bypass surgery for patients with diabetes mellitus and tissue loss.
Heekyung JUNG ; Jayun CHO ; Hyung Kee KIM ; Jihye KIM ; Seung HUH
Annals of Surgical Treatment and Research 2015;88(1):35-40
PURPOSE: To determine the long-term outcomes of patients with diabetes mellitus (DM) and tissue loss who have undergone infrainguinal bypass surgery (IBS). METHODS: We retrospectively reviewed the medical records of 91 patients with DM and tissue loss who underwent IBS between July 2003 and December 2013. We determined the rates of overall survival (OS), amputation-free survival (AFS), limb salvage (LS), and graft patency (GP). In addition, we evaluated data to identify risk factors that affected long-term outcomes. RESULTS: The mean age of patients was 66 +/- 8 years, and 78 patients (85.7%) were men. The locations of tissue loss were toe on 76 limbs (71.6%), heel on 6 limbs (5.7%) and others on 24 limbs (22.6%). Single lesions were found in 81 limbs (76.4%). According to categorization by distal anastomosis artery, there were 57 popliteal (53.8%) and 49 infrapopliteal bypasses (46.2%). Among infrapopliteal bypasses, 5 cases (10.2%) were sequential bypasses. The OS at 1, 3, and 5 years was 90.5%, 70.9%, and 44.2%, respectively. At 1, 3, and 5 years, the LS was 92.1%, 88.9%, 88.9%, respectively; and AFS was 84.4%, 67.6%, 45.7%, respectively. At 1, 3, and 5 years, the GP was 84.8%, 74.5%, and 69.8%, respectively. Renal failure was a negative predictor for OS, and female gender was a negative predictor for GP. CONCLUSION: IBS for patients with DM and tissue loss led to acceptable OS, AFS, LS, and GP. Active revascularization for patients with DM and tissue loss can reduce the risk of major amputation.
Amputation
;
Arteries
;
Diabetes Mellitus*
;
Extremities
;
Female
;
Heel
;
Humans
;
Limb Salvage
;
Male
;
Medical Records
;
Renal Insufficiency
;
Retrospective Studies
;
Risk Factors
;
Toes
;
Transplants
6.Treatment of Giant Celiac Artery Aneurysm by Conjoined Splenic-Hepatic Trunk Transposition.
Hyung Kee KIM ; Heekyung JUNG ; Jayun CHO ; Jae Min CHUN ; Seung HUH
Journal of the Korean Society for Vascular Surgery 2013;29(2):67-70
Celiac artery aneurysms are extremely rare vascular lesions usually diagnosed by chance. A 62-year-old male was being referred to Kyungpook National University Hospital with a seven day history of upper right quadrant abdominal pain. A computed tomography scan revealed an acute cholecystitis and a 7-cm sized huge aneurysm located from the origin of celiac artery to the bifurcation of celiac artery. After an initial cholecystectomy, the aneurysm was opened and the origin of celiac artery was oversewn with aorta followed by transposing and implanting the conjoined splenic-hepatic trunk to supraceliac aorta. The patient was discharged without complications on the tenth postoperative day. Conjoined splenic-hepatic trunk transposition for the repair of a celiac artery aneurysm may be an appropriate alternative option especially in cases complicated with other infectious conditions.
Abdominal Pain
;
Aneurysm
;
Aorta
;
Celiac Artery
;
Cholecystectomy
;
Cholecystitis
;
Cholecystitis, Acute
;
Humans
;
Male
;
Splenic Artery
7.2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology
Soon Ho YOON ; Sang Min LEE ; Chul Hwan PARK ; Jong Hyuk LEE ; Hyungjin KIM ; Kum Ju CHAE ; Kwang Nam JIN ; Kyung Hee LEE ; Jung Im KIM ; Jung Hee HONG ; Eui Jin HWANG ; Heekyung KIM ; Young Joo SUH ; Samina PARK ; Young Sik PARK ; Dong-Wan KIM ; Miyoung CHOI ; Chang Min PARK
Korean Journal of Radiology 2021;22(2):263-280
Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.
8.Impact of Infection Prevention Programs on Catheter-Associated Urinary Tract Infections Analyzed in Multicenter Study
Sun Hee NA ; Joong Sik EOM ; Yu Bin SEO ; Sun Hee PARK ; Young Keun KIM ; Wonkeun SONG ; Eunjung LEE ; Sung Ran KIM ; Hyeon Mi YOO ; Heekyung CHUN ; Myoung Jin SHIN ; Su Hyun KIM ; Ji Youn CHOI ; Nan hyoung CHO ; Jin Hwa KIM ; Hee-jung SON ; Su ha HAN ; Jacob LEE
Journal of Korean Medical Science 2024;39(18):e151-
Background:
Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes.
Methods:
Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals.
Results:
Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals.
Conclusion
We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.
9.Current Trends of the Incidence and Pathological Diagnosis of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) in Korea 2000-2009: Multicenter Study.
Mee Yon CHO ; Joon Mee KIM ; Jin Hee SOHN ; Mi Jung KIM ; Kyoung Mee KIM ; Woo Ho KIM ; Hyunki KIM ; Myeong Cherl KOOK ; Do Youn PARK ; Jae Hyuk LEE ; Heekyung CHANG ; Eun Sun JUNG ; Hee Kyung KIM ; So Young JIN ; Joon Hyuk CHOI ; Mi Jin GU ; Sujin KIM ; Mi Seon KANG ; Chang Ho CHO ; Moon Il PARK ; Yun Kyung KANG ; Youn Wha KIM ; Sun Och YOON ; Han Ik BAE ; Mee JOO ; Woo Sung MOON ; Dae Young KANG ; Sei Jin CHANG
Cancer Research and Treatment 2012;44(3):157-165
PURPOSE: As a result of various independently proposed nomenclatures and classifications, there is confusion in the diagnosis and prediction of biological behavior of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A comprehensive nationwide study is needed in order to understand the biological characteristics of GEP-NETs in Korea. MATERIALS AND METHODS: We collected 4,951 pathology reports from 29 hospitals in Korea between 2000 and 2009. Kaplan-Meier survival analysis was used to determine the prognostic significance of clinicopathological parameters. RESULTS: Although the GEP-NET is a relatively rare tumor in Korea, its incidence has increased during the last decade, with the most significant increase found in the rectum. The 10-year survival rate for well-differentiated endocrine tumor was 92.89%, in contrast to 85.74% in well differentiated neuroendocrine carcinoma and 34.59% in poorly differentiated neuroendocrine carcinoma. Disease related death was most common in the biliary tract (62.2%) and very rare in the rectum (5.2%). In Kaplan-Meier survival analysis, tumor location, histological classification, extent, size, mitosis, Ki-67 labeling index, synaptophysin expression, lymphovascular invasion, perineural invasion, and lymph node metastasis showed prognostic significance (p<0.05), however, chromogranin expression did not (p=0.148). The 2000 and 2010 World Health Organization (WHO) classification proposals were useful for prediction of the prognosis of GEP-NET. CONCLUSION: The incidence of GEP-NET in Korea has shown a remarkable increase during the last decade, however, the distribution of tumors in the digestive system differs from that of western reports. Assessment of pathological parameters, including immunostaining, is crucial in understanding biological behavior of the tumor as well as predicting prognosis of patients with GEP-NET.
Biliary Tract
;
Carcinoma, Neuroendocrine
;
Digestive System
;
Humans
;
Incidence
;
Intestinal Neoplasms
;
Korea
;
Lymph Nodes
;
Mitosis
;
Neoplasm Metastasis
;
Neuroendocrine Tumors
;
Pancreatic Neoplasms
;
Population Characteristics
;
Prognosis
;
Rectum
;
Stomach Neoplasms
;
Survival Rate
;
Synaptophysin
;
World Health Organization