2.Microbial Flora of The Conjunctival Sac in Prosthesis Wearers.
Helen LEW ; Sang Yeul LEE ; Hong Bok KIM
Journal of the Korean Ophthalmological Society 1995;36(6):938-943
Persistent physical stimulation and foreign body contact in prosthesis wearers may develop secondary infection, frequent conjunctival injection and responses such as giant papillary conjunctivitis. In 77 patients wearing prostheses, the bilateral conjunctival flora was studied and compared with the expect of conjunctival floral change. The predominent organisms were essentially the same in both sides: Staphylococcus epidermidis, Staphylococcus aureus followed by streptococcus. The incidence of bacterial isolation on the anophthalmic side (67.5%) was significantly higher than on the healthy side (32.5%). Especially the incidence of potential pathogenic bacterial isolation(Staphylococcus aureus, Streptococcus, Gram negative bacilli)(27.9%) was significantly higher on the anophthalmic side than on the healthy side(6.5%). The conjunctival smear study showed the higher incidence of polymorpho nucleoleukocyte and bacteria on the anophthalmic side. The isolation rates of the moderate to marked responded conjunctiva(46.9%) was lower than on the mild responded conjunctiva(69.2%) . The wearing time of the prostheses, the frequency of cleaning of prostheses, type of cleaner and topical drops used did not effect the incidence of bacterial isolation of conjunctival sac. Therfore these results showed that persistent physical stimulation and foreign body contact with prosthesis wearing may alter the microbial flora of the conjunctival sac.
Bacteria
;
Coinfection
;
Conjunctivitis, Allergic
;
Foreign Bodies
;
Humans
;
Incidence
;
Physical Stimulation
;
Prostheses and Implants*
;
Staphylococcus aureus
;
Staphylococcus epidermidis
;
Streptococcus
3.A Lethal Sequelae of Spinal Infection Complicating Surgery and Radiotherapy for Head and Neck Cancer.
Jason Pui Yin CHEUNG ; Kin Cheung MAK ; Helen Hoi Lun TSANG ; Keith Dip Kei LUK
Asian Spine Journal 2015;9(4):617-620
Patients who have undergone neck dissection and radiotherapy are at risk of cervical spine infections. Furthermore, previous radiotherapy and cervical spine infections can lead to fistula formation to the subarachnoid space and intracranial infection. This report discusses the serious consequences of a missed cervical spine infection including cerebrospinal fluid fistula formation and persistent central nervous system infection, and serves as a reminder to clinicians of the possible association between cervical spine infections and prior head and neck surgery and radiotherapy. In all such cases, the posterior pharyngeal wall should be inspected during follow-up. Despite the appearance of an intracranial infection, the cervical spine should be investigated, especially if the response to appropriate antibiotics is suboptimal.
Anti-Bacterial Agents
;
Central Nervous System Infections
;
Cerebrospinal Fluid
;
Discitis
;
Fistula
;
Follow-Up Studies
;
Head
;
Head and Neck Neoplasms*
;
Humans
;
Neck
;
Neck Dissection
;
Radiotherapy*
;
Spine
;
Subarachnoid Space
4.Association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars: a long-term follow-up clinical and radiographic analysis.
Jae Hong LEE ; Helen Hye In KWEON ; Seong Ho CHOI ; Young Taek KIM
Journal of Periodontal & Implant Science 2016;46(6):396-404
PURPOSE: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. METHODS: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. RESULTS: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. CONCLUSIONS: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.
Bicuspid*
;
Dental Implants*
;
Dental Implants, Single-Tooth
;
Follow-Up Studies*
;
Humans
;
Incidence
;
Molar
;
Periodontal Ligament
;
Retrospective Studies
;
Splints
;
Tooth
;
Tooth Mobility
5.Panoramic radiography can be an effective diagnostic tool adjunctive to oral examinations in the national health checkup program
Helen Hye In KWEON ; Jae Hong LEE ; Tae mi YOUK ; Bo Ah LEE ; Young Taek KIM
Journal of Periodontal & Implant Science 2018;48(5):317-325
PURPOSE: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. METHODS: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009–2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. RESULTS: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. CONCLUSIONS: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.
Calculi
;
Dental Caries
;
Dental Clinics
;
Diagnosis
;
Diagnosis, Oral
;
Humans
;
Inflammation
;
Mass Screening
;
National Health Programs
;
Radiography, Dental
;
Radiography, Panoramic
;
Root Caries
;
Sensitivity and Specificity
;
Survival Rate
;
Tooth
;
Tooth Loss
6.Subtraction CT Angiography with Motion Correction for Detection of Intra- and Extra-cranial Vascular Lesions: Technical Considerations and Initial Experience.
Sang Joon KIM ; Helen HONG ; Seon Mi KIM ; Hyun Joo KIM ; Jeong Hyun LEE ; Dae Chul SUH
Neurointervention 2009;4(1):15-23
PURPOSE: Clinical implementation of subtraction computed tomographic angiography (CTA) is limited due to motion artifact and/or long processing time. We evaluated the utility of a motion-corrected subtraction CTA technique for visualization of intra- and extra-cranial vascular lesions. MATERIALS AND METHODS: Pre- and post-contrast CT images were obtained in the target region of 53 consecutive patients which were consisted of 36 patients with 53 lesions and 17 normal patients. The source images were transferred to a personal computer (PC) and were automatically post-processed within one minute using novel motion-corrected subtraction CTA. The image quality of subtraction and non-subtraction CTAs was compared in each lesion category and lesion location using 3-point scale and Chi square test. RESULTS: The image quality of subtraction CTA was better than those from non-subtraction CTA (p<0.05) especially in the skull base lesions, such as carotid-cavernous fistulas, aneurysms in the cavernous internal carotid artery (ICA), and steno-occlusive lesions of the distal ICA, and extracranial lesions such as facial arteriovenous fistulas. CONCLUSION: The PC-based motion-corrected subtraction CTA technique allows fast generation of postprocessed images and can provide improved visualization of vascular anatomy and pathologies adjacent to bone in the skull base and head and neck areas.
Aneurysm
;
Angiography*
;
Arteriovenous Fistula
;
Artifacts
;
Carotid Artery, Internal
;
Fistula
;
Head
;
Humans
;
Microcomputers
;
Neck
;
Pathology
;
Skull Base
7.A "tricky" subarachnoid hemorrhage.
Yat-Fung SHEA ; Hoi-Lun Helen TSANG ; Yat-Hin Desmond YAP ; Lai-Fung LI ; Wai-Shing Wilson HO
Chinese Medical Journal 2013;126(18):3598-3598
8.Development of a Non-Invasive Liver Fibrosis Score Based on Transient Elastography for Risk Stratification in Patients with Type 2 Diabetes
Chi-Ho LEE ; Wai-Kay SETO ; Kelly IEONG ; David T.W. LUI ; Carol H.Y. FONG ; Helen Y. WAN ; Wing-Sun CHOW ; Yu-Cho WOO ; Man-Fung YUEN ; Karen S.L. LAM
Endocrinology and Metabolism 2021;36(1):134-145
Background:
In non-alcoholic fatty liver disease (NAFLD), transient elastography (TE) is an accurate non-invasive method to identify patients at risk of advanced fibrosis (AF). We developed a diabetes-specific, non-invasive liver fibrosis score based on TE to facilitate AF risk stratification, especially for use in diabetes clinics where TE is not readily available.
Methods:
Seven hundred sixty-six adults with type 2 diabetes and NAFLD were recruited and randomly divided into a training set (n=534) for the development of diabetes fibrosis score (DFS), and a testing set (n=232) for internal validation. DFS identified patients with AF on TE, defined as liver stiffness (LS) ≥9.6 kPa, based on a clinical model comprising significant determinants of LS with the lowest Akaike information criteria. The performance of DFS was compared with conventional liver fibrosis scores (NFS, FIB-4, and APRI), using area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive and negative predictive values (NPV).
Results:
DFS comprised body mass index, platelet, aspartate aminotransferase, high-density lipoprotein cholesterol, and albuminuria, five routine measurements in standard diabetes care. Derived low and high DFS cut-offs were 0.1 and 0.3, with 90% sensitivity and 90% specificity, respectively. Both cut-offs provided better NPVs of >90% than conventional fibrosis scores. The AUROC of DFS for AF on TE was also higher (P<0.01) than the conventional fibrosis scores, being 0.85 and 0.81 in the training and testing sets, respectively.
Conclusion
Compared to conventional fibrosis scores, DFS, with a high NPV, more accurately identified diabetes patients at-risk of AF, who need further evaluation by hepatologists.
9.An Anesthetic Experience in a Patient with Menkes Disease: A case report.
Helen Ki SHINN ; Hong Sik LEE ; Young Deog CHA ; Jae Hak LEE ; Hyun Zu KIM ; Jang Ho SONG
Korean Journal of Anesthesiology 2007;53(5):672-675
Menkes disease, so-called kinky hair disease or steely hair disease, is a rare X-linked recessive disorder of intracellular copper transport protein ATP7A defect, due to mutation of ATP7A gene, resulting in copper deficiency. It is characterized by seizure, retarded neurological development, kinky hair, skeletal abnormality, recurrent infection and subnormal body temperature. In addition, gastroesophageal reflux with the risk of aspiration is another important feature. This article is the first report of anesthetic management in a patient with Menkes disease who underwent gastrostomy and bladder diverticulectomy in Korea.
Body Temperature
;
Copper
;
Gastroesophageal Reflux
;
Gastrostomy
;
Hair
;
Humans
;
Korea
;
Menkes Kinky Hair Syndrome*
;
Seizures
;
Urinary Bladder
10.Effect of Mitral Disease on the Change of Right Ventricular Function Following Mitral Valve Replacement.
Young Jun OH ; Young Lan KWAK ; Jong Hwa LEE ; Helen Ki SHIN ; Hyun Joo KWAK ; Yong Woo HONG
Korean Journal of Anesthesiology 2003;44(2):193-200
BACKGROUND: Mitral stenosis (MS) and mitral regurgitation (MR) have different pathophysiologies and left ventricular function after miral valve replacement (MVR) in both diseases has been well known. However, there has been no report comparing the change of right ventricular (RV) function immediately after MVR. We evaluated the change of RV function following MVR in MS and MR using a RV ejection fraction (RVEF) thermodilution catheter. METHODS: With IRB approval, 27 patients with MS and 22 patients with MR undergoing MVR were included. Patients with tricuspid regurgitation were excluded. A RVEF catheter was inserted before the induction of anesthesia. Hemodynamic parameters were measured after anesthesia (T1, control), immediately after the termination of cardiopulmonay bypass (T2) and after the sternum was closed (T3). RESULTS: Pulmonary capillary wedge pressure (PCWP) and end systolic and end diastolic RV volume index (RVESVI and RVEDVI) were higher in MS than in MR and there was no difference in RVEF at T1. Heart rate increased and mean pulmonary artery pressure (mPAP), PCWP, and pulmonary vascular resistance significantly decreased at T2 in both groups. RVEF increased and RVESV and RVEDV decreased significantly only in MS after MVR versus that at T2. There was no difference in hemodynamic parameters between both groups at T2 and T3. CONCLUSIONS: RV function was significantly improved in MS but not in MR after MVR. However, there was no significant hemodynamic difference between MS and MR after MVR, though they are known to have different preoperative pathophysilogies and postoperative left heart functions.
Anesthesia
;
Catheters
;
Ethics Committees, Research
;
Heart
;
Heart Rate
;
Hemodynamics
;
Humans
;
Mitral Valve Insufficiency
;
Mitral Valve Stenosis
;
Mitral Valve*
;
Pulmonary Artery
;
Pulmonary Wedge Pressure
;
Sternum
;
Thermodilution
;
Tricuspid Valve Insufficiency
;
Vascular Resistance
;
Ventricular Function, Left
;
Ventricular Function, Right*