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.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
6.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
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.Effect of Preoperative Aspirin Use on Postoperative Bleeding and Thromboelastography in Off-Pump Coronary Artery Bypass Operations.
Seung Ho KIM ; Young Lan KWAK ; Young Jun OH ; Helen Ki SHINN ; Shin Hyung KIM ; Yong Woo HONG
Korean Journal of Anesthesiology 2005;48(3):235-240
BACKGROUND: Aspirin has been shown to effectively increase survival and reduce morbidity in patients with ischemic heart disease. Continued aspirin use during the preoperative period could increase the postoperative blood loss in patients who have on-pump coronary artery bypass grafting. This study aimed to determine the effect of continued aspirin use before off-pump CABG on intraoperative and postoperative bleeding and coagulation profile in thromboelastography. METHODS: In 43 patients undergoing OPCAB, they were assigned aspirin user (n = 22), who received aspirin until the day of operation or nonaspirin user (n = 21), who discontinued aspirin before 7 days before the surgery. Intraoperative and postoperative bleeding and transfusion requirement were measured. TEG was performed and R, K, alpha angle, maximum amplitude and TEG index was measured at preinduction and at 24 hours after surgery. RESULTS: There were no differences in patient characteristics between aspirin users and nonaspirin users. We found no significant difference between postoperative bleeding and blood product requirements for the two groups. Similarly, we found no significant difference in the coagulation profiles. CONCLUSIONS: The use of aspirin continued preoperatively does not increase intraoperative and postoperative blood loss, and blood product requirement and influence on coagulation profile.
Aspirin*
;
Coronary Artery Bypass
;
Coronary Artery Bypass, Off-Pump*
;
Hemorrhage*
;
Humans
;
Myocardial Ischemia
;
Postoperative Hemorrhage
;
Preoperative Period
;
Thrombelastography*
10.Hemodynamic Effects of Vecuronium, Pancuronium and Rocuronium during O2-Midazolam-Fentanyl Anesthesia in Patients with Coronary Artery Disease or Valvular Heart Diseases.
Young Lan KWAK ; Young Jun OH ; Jong Hwa LEE ; Helen Ki SHINN ; Wong Chul LEE ; Yong Woo HONG
Korean Journal of Anesthesiology 2003;44(1):24-33
BACKGROUND: This study was designed to evaluate the hemodynamic effects of vecuronium, pancuronium and rocuronium in patients with coronary artery disease (CABG) or valvular heart disease (VHD). METHODS: With IRB approval, 121 patients (61 patients with CABG and 60 patients with VHD) were randomly divided into a vecuronium, pancuronium and rocuronium group, respectively. Midazolam and fentanyl were administered and then 3 times of ED95 of a muscle relaxant (vecuronium, 0.12 mg/kg; pancuronium, 0.12 mg/kg; or rocuronium, 0.9 mg/kg) was injected. Additional dose of fentanyl was given and the patient was intubated. Hemodynamic variables were measured before the induction of anesthesia, just prior and 1 min after the administration of the muscle relaxant, just before intubation, 5 and 10 min after intubation. RESULTS: The number of patients enrolled in the CABG-vecuronium, CABG-pancuronium, CABG- rocuronium, VHD-vecuronium, VHD-pancuronium, and VHD-rocuronium was 20, 20, 21, 19, 20, and 21 respectively. Each of 10, 4, 4, 5, 1, and 1, respectively, were treated for hypotension or bradycardia during the induction of anesthesia. The heart rate (HR) changed significantly only in the CABG- vecuronium group compared with the control value. All three muscle relaxants decreased mean systemic artery pressure (MAP) significantly in both CABG and VHD patients. The decrease in HR and MAP were significantly greater in CABG-vecuronium and VHD-vecuronium than in CABG-pancuronium and VHD-pancuronium, respectively. The decrease in HR was also greater in VHD-vecuronium than in VHD-rocuronium. Cardiac index (CI) decreased in CABG-vecuronium and all VHD patients. The decrease in CI was greater in CABG-vecuronium than in CABG-pancuronium but it was not significantly different among the three muscle relaxants in VHD patients. CONCLUSIONS: While pancuronium and rocuronium exerted minimal hemodynamic effects, vecuronium reduced HR and MAP more significantly than pancuronium in both CABG and VHD patients, and CI also decreased more significantly with vecuronium in CABG patients.
Anesthesia*
;
Arteries
;
Bradycardia
;
Coronary Artery Disease*
;
Coronary Vessels*
;
Ethics Committees, Research
;
Fentanyl
;
Heart Rate
;
Heart Valve Diseases*
;
Hemodynamics*
;
Humans
;
Hypotension
;
Intubation
;
Midazolam
;
Pancuronium*
;
Vecuronium Bromide*