1.Uncommon Causes of Small Bowel Obstruction.
Byungseok CHOI ; Shin SON ; Jaechul BYUN ; Heeyoung YANG ; Kyunghwan PARK
Journal of the Korean Surgical Society 1999;56(5):701-707
BACKGROUND: The major causes of small bowel obstruction (SBO) are postoperative adhesion, hernia, intussusception and malignancies. However, in cases of uncommon causes of SBO, surgeons are be in a dilemma because the preoperative diagnosis and the decision to operate are frequently difficult and delayed. METHODS: We reviewed retrospectively the cases of 29 patients with SBO who were operated on for unknown etiology at Daedong Hospital between Jan. 1, 1991, and Dec. 31, 1997. The common causes of SBO, such as postoperative adhesion, external hernia, congenital anomaly of the gastrointestinal tract in neonate, intussusception in children, and known intraabdominal malignancy, were all excluded. RESULTS: 1) The incidence of uncommon causes of SBO included in this study was 8.7% of all cases of SBO operated on during the same period. 2) Among the 29 cases, 12 cases were caused by tumors (41.4%), of which the number of malignant tumors was double that of benign ones. 3) Besides tumors, there were 3 cases of bezoar, two cases of congenital bands, mesenteric cysts, internal hernias, Meckel's diverticula, and intussusception, one case each of mesenteric panniculitis and Crohn's disease, and two cases with an unknown etiology of inflammation. 4) Five cases were due to adult intussusception, 3 cases of which were due to benign tumors of the small bowel. All of the SBOs by intussusception were located at the terminal ileum. 5) The most common site of obstruction was the ileum (20 cases), followed by the jejunum (7 cases), and the duodenum (2 cases). 6) Males were dominant (1.6:1) especially in cases of tumor-origin SBOs (2:1). 7) In viewing the age distribution, the incidence was relatively high in the 5th and the 8th decades. Especially, tumor-origin SBOs had their peak in the 5th decade, and all cases of bezoar were found in 8th decade. 8) Operations were performed within 72 hours in 19 cases (65.5%) after first inspection of the patients, and intussusception, congenital band, and bezoar were the common causes of the cases involved in early surgical intervention. 9) Segmental resection of the small bowel was the most common surgical procedure (19 cases, 65.5%), followed by bypass surgery (6 cases), removal of the bezoar (2 cases), and excision of the mesenteric cyst or band (1 case, respectively). Coclusions: We think it reasonable to perform an exploratory laparotomy in cases of unknown causes of SBO as early as possible because almost all the cases require surgical intervention eventually, and studies searching for the causes of obstruction will only be time-consuming. While surgeons should keep in mind that tumors are major causes of uncommon SBOs.
Adult
;
Age Distribution
;
Bezoars
;
Child
;
Crohn Disease
;
Diagnosis
;
Diverticulum
;
Duodenum
;
Gastrointestinal Tract
;
Hernia
;
Humans
;
Ileum
;
Incidence
;
Infant, Newborn
;
Inflammation
;
Intussusception
;
Jejunum
;
Laparotomy
;
Male
;
Mesenteric Cyst
;
Panniculitis, Peritoneal
;
Retrospective Studies
2.Effects of age, sex, and body mass index on sudomotor and cardiovagal functions in a healthy Korean population
Heejeong Jeong ; Ki-Jong Park ; Heeyoung Kang ; Nack-Cheon Choi ; Oh-Young Kwon ; ByeongHoon Lim
Neurology Asia 2016;21(3):255-260
Background: Hypertension results from an impaired baroreceptor reflex and enhanced sympathetic
activity. The prevalence of hypertension differs among ethnicities and is more frequent in South Asians
than in Caucasians, suggesting that baseline autonomic nervous system functions and their regulation
may also differ among ethnic groups. In most studies, the reference values for clinical autonomic
function tests are obtained from heterogeneous ethnic populations, or ethnic factors are not considered
in the study design. Obtaining reference data in a homogenous ethnic group and comparing them within
various ethnic groups could be helpful to detect ethnic differences in autonomic functions. The aim of
this study was to identify normative reference values for standard autonomic reflex measurements in
a homogeneous Korean population. Methods: A total of 181 healthy Korean volunteers (age, 20–74
years) underwent standard autonomic function tests: heart rate difference during deep breathing,
Valsalva maneuver, and the quantitative sudomotor axon-reflex test. Mean and 5th and 95th percentile
values were obtained for each age group. We also analyzed factors (age, sex, and body mass index)
that can influence autonomic functions. Results: The heart rate difference during deep breathing and
expiratory-inspiratory ratio were higher in males than in females and were inversely related to age.
The Valsalva ratio was inversely related to age. Males had higher sweat volumes at all body areas
evaluated than those of females, and only forearm sweat volume was significantly different between
the age groups.
Conclusions: Cardiovagal function was affected by age and sex in Koreans. Sudomotor function was
affected by sex, and only forearm sweat volume was affected by age and sex. These results represent
preliminary normative clinical autonomic data in a Korean population comprised of a single ethnicity
Hypertension
3.Ab Interno Trabeculotomy with Trabectome(R) for Refractory Primary Open-Angle Glaucoma: A Case Report.
Heeyoung CHUNG ; Jaewan CHOI ; Jin Young CHOI ; Yeon Deok KIM
Journal of the Korean Ophthalmological Society 2011;52(4):502-506
PURPOSE: To report a case of ab interno trabeculotomy with Trabectome(R) (NeoMedix Corp., CA, USA) conducted on a refractory primary open angle glaucoma (POAG) patient. CASE SUMMARY: Trabectome(R) has microelectrocautery with simultaneous infusion and aspiration of debris and ablates a segment of trabecular meshwork and the inner wall of Schlemm's canal. The patient, a 54-year-old man had uncontrolled intraocular pressure (IOP) with topical anti-glaucoma medications after trabeculectomy and Ahmed valve implantation for POAG. For the patient, ab interno trabeculotomy with Trabectome(R) was performed. There were no other postoperative complications except for microhyphema immediately after surgery. The IOP was controlled between 14 to 24 mm Hg up to 3 months postoperatively with topical anti-glaucoma medications (Cosopt(R), Alphagan-P(R), Lumigan(R)). CONCLUSIONS: Ab interno trabeculotomy with Trabectome(R) appears to offer a newer method of lowering IOP in POAG than conventional trabeculectomy and glaucoma drainage device surgery.
Drainage
;
Glaucoma
;
Glaucoma, Open-Angle
;
Humans
;
Intraocular Pressure
;
Middle Aged
;
Postoperative Complications
;
Trabecular Meshwork
;
Trabeculectomy
4.Age, hypertension, and genetic polymorphisms and their relative associations with white matter hyperintensities in Korean patients with Alzheimer’s disease
Heejeong Jeong ; Seungnam Son ; Soo-Kyoung Kim ; Ki-Jong Park ; Nack-Cheon Choi ; Oh-Young Kwon ; Byeonghoon Lim ; Heeyoung Kang
Neurology Asia 2015;20(1):35-41
Objectives: White matter hyperintensities are known to influence dementia in Alzheimer’s disease.
Genetic components are suggested as putative risk factors for vascular pathology and cognitive
decline. This study aimed to determine whether there is an association between candidate genetic
polymorphisms and the severity of white matter hyperintensities in patients with Alzheimer’s disease.
Methods: Seventy-five patients diagnosed with Alzheimer’s disease underwent genetic tests for specific
alleles of apolipoprotein E, angiotensin-converting enzyme, and methylenetetrahydrofolate reductase.
All patients underwent brain magnetic resonance imaging scans and neuropsychological tests. The
severity of white matter hyperintensities was semiquantified using the CREDOS rating scale, and
patients were divided into three groups according to their rating. Results:The severity of white matter
hyperintensities was related to age and hypertension. However, none of the gene polymorphisms we
tested was found to be associated with the severity of white matter hyperintensities.
Conclusion:The genetic polymorphisms found in apolipoprotein E, angiotensin-converting enzyme
and methylenetetrahydrofolate reductase did not contribute to white matter hyperintensities in
Alzheimer’s disease.Only age and hypertension factors were found to be contributory to white matter
hyperintensities.
Alzheimer Disease
;
Dementia
5.A Case of Possible Neurosarcoidosis with Dementic Features.
Heeyoung KANG ; Oh Young KWON ; Imsuk SUNG ; Ki Jong PARK ; Nack Cheon CHOI ; Byeong Hoon LIM
Journal of the Korean Neurological Association 2003;21(3):325-327
No abstract available.
Meningitis
;
Peptidyl-Dipeptidase A
6.A Case of Candida parapsilosis Meningitis in a Patient with Ventriculo-peritoneal Shunt.
Imsuk SUNG ; Oh Young KWON ; Heeyoung KANG ; Ki Jong PARK ; Nack Cheon CHOI ; Byeong Hoon LIM
Journal of the Korean Neurological Association 2003;21(3):297-299
Candida species is an uncommon pathogen and usually causes meningitis as a nosocomial infection. We report a case where a ventriculoperitoneal shunt was placed in a 72-year-old woman with hydrocephalus. Three months later, the patient was referred to the department of neurology due to fever and drowsiness. Candida parapsilosis was cultured in the cerebrospinal fluid as the causative agent of meningitis. Candida species should be considered as a pathogen when meningitis is present in severely ill patients with ventriculoperitoneal shunts.
Aged
;
Candida*
;
Cerebrospinal Fluid
;
Cross Infection
;
Female
;
Fever
;
Humans
;
Hydrocephalus
;
Meningitis*
;
Neurology
;
Sleep Stages
;
Ventriculoperitoneal Shunt*
7.Relationship between End-Tidal CO2 and Frequency of Interictal Spikes during Hyperventilation in Temporal Lobe Epilepsy.
Seonhye KIM ; Oh Young KWON ; Heeyoung KANG ; Ki Jong PARK ; Nack Cheon CHOI ; Byeong Hoon LIM
Journal of Korean Epilepsy Society 2006;10(1):41-45
PURPOSE: To determine whether the change of end-tidal pCO2 (ETCO2) level by hyperventilation evokes seizures or epileptiform discharges in temporal lobe epilepsy. METHODS: Twenty-four temporal lobe epilepsy patients were enrolled in this study. Hyperventilation was done for 5 min during EEG recording. We gathered data on ETCO2 levels during hyperventilation. The data included baseline ETCO2 (B-ETCO2), ETCO2 after 5 min of hyperventilation (5 min-ETCO2), the mean value of the ETCO2 (M-ETCO2), and the change in ETCO2 between baseline and the level after 5 min of hyperventilation (delta ETCO2). We counted the numbers of interictal spikes and considered the cases with more than 120% increments of the number during hyperventilation as the cases with the increased number of spikes. We compared the four variables between two groups, divided according to the increment to hyperventilation. RESULTS: Seizures were not induced by hyperventilation in all the cases. Thirteen of 24 patients were in the increment group. The M-ETCO2 was 33.0+3.3 mmHg (mean+SD) in the increment group and 29.4+5.3 in the no-increment group (p=0.064). The delta ETCO2 was 13.0+5.3 and 14.0+5.3, respectively (p=0.622). The 5 min-ETCO2 was 28.2+4.8 and 24.8+5.9, respectively (p=0.077). CONCLUSION: In this study, the frequency of interictal spikes was increased well by hyperventilation. The spike increments were not associated with the ETCO2 level or the change of that, but maybe with the individual susceptibility.
Carbon Dioxide
;
Electroencephalography
;
Epilepsy, Temporal Lobe*
;
Humans
;
Hyperventilation*
;
Seizures
;
Temporal Lobe*
8.Expression of Oscillin in Mouse Testis.
Yang Han LEE ; Kyoo Wan CHOI ; Jong Weol KIM ; Moon Kyoo KIM ; Heeyoung NAH ; Myung Chan GYE
Korean Journal of Andrology 1998;16(2):129-134
PURPOSE: To verify the expression of the egg activator oscillin in mouse testis and adult organs. MATERIALS AND METHODS: Genomic PCR using primers for oscillin was conducted to confirm that the PCR product was derived from cDNA. Total RNA isolated from developing, immature, and mature testis was subjected to RT-PCR and restriction analysis. In situ hybridization of adult testis was performed to localize the oscillin transcript using cRNA probe. RESULTS: Genomic PCR using the primer for RT-PCR revealed no amplification product, suggesting that the oscillin gene consists of at least two exons. The RT-PCR product of oscillin mRAN was detected in testis beginning 2 weeks after birth. Oscillin mRAN was detected in both germ and somatic cells such as Sertoli and Leydig cells by in situ hybridization. The testis showed al high level of oscillin mRAN compared with other adult organs. CONCLUSION: Oscillin is not a testis-specific transcript and therefore may have another function intracellularly as well ad serving as a trigger for egg activation.
Adult
;
Animals
;
DNA, Complementary
;
Exons
;
Humans
;
In Situ Hybridization
;
Leydig Cells
;
Male
;
Mice*
;
Ovum
;
Parturition
;
Polymerase Chain Reaction
;
RNA
;
RNA, Complementary
;
Testis*
9.Assessment of the quality of life and oral health status in diabetic patients.
Yoon Young CHOI ; Jae Young LEE ; Heeyoung LEE ; Bo Hyoung JIN
Journal of Korean Academy of Oral Health 2015;39(3):207-213
OBJECTIVES: The aim of this study was to investigate changes in the quality of life and oral health status in diabetic patients as a result of non-surgical periodontal treatments. METHODS: In total, 55 diabetic patients who visited the health care center at our institution participated in this study. The patients were divided randomly into 3 groups as follows: scaling and root planning (SRP), professional maintenance care (PMC), and control (CT). The patients were asked to answer the Short-Form-36 Health Survey (SF-36) to evaluate their quality of life, and two examiners evaluated the patients' oral health status before and after the periodontal treatments. To evaluate the oral health status, the current number of teeth, DMFT index, bleeding on probing rate (BOP), pocket depth (PD), and calculus index (CI) were used. Statistical analyses were conducted using SPSS with appropriate sampling weights to adjust for the stratified sample design. RESULTS: In both the SRP and PMC groups, the BOP and CI decreased after the treatment (P<0.05). In the SRP group, physical functioning and the mental health score increased (P<0.05). CONCLUSIONS: According to the results, non-surgical periodontal treatment in diabetic patients is effective in increasing the health-related quality of life.
Calculi
;
Delivery of Health Care
;
Health Surveys
;
Hemorrhage
;
Humans
;
Mental Health
;
Oral Health*
;
Quality of Life*
;
Tooth
;
Weights and Measures
10.Experience of Healthcare Providers in the Advanced Practice Nurse System
Min Young KIM ; Mi-Kyeong JEON ; Su Jung CHOI ; Jeong Hye KIM ; Heeyoung KIM ; Cho Sun LEEM
Journal of Korean Critical Care Nursing 2021;14(2):42-56
Purpose:
: The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master’s course professors at a graduate school.
Methods:
: Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis.
Results:
: Based on the data, we extracted four themes and 14 categories. The themes were “Role and system of APNs started according to healthcare environment changes”, “Optimal healthcare provider to ensure quality of care”, “Confused role and system of APNs due to incomplete medical law”, and “Tasks for the stable operation of the APN system.”
Conclusion
: For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs’ scope of practice is required. Finally, a discussion is necessary about the integration of APNs’ 13 fields.