1.Clinical and MR Findings of Tethered Cord Syndrome.
Hyae Young KIM ; Young Seok LEE ; Hyo Keun LIM ; Eun Chul CHUNG ; Ho In CHUNG ; Jeong Soo SUH ; Seoung Ro LEE
Journal of the Korean Radiological Society 1994;31(3):545-551
PURPOSE: Tethered cord syndrome(TCS) is defined as low position of the conus medullaris by the abnormally fixed spinal cord with progressive neurologic deficit MATERIALS AND METHODS: To evaluate the findings of TCS at MRI and its diagnostic value, we performed a retrospective analysis of MRI of 30 patients with emphasis on clinical manifestation, level of conus medullaris, cause of tethering, and associated findings. RESULTS: Clinical presentation included back mass(26 cases), neurogenic bladder(5 cases), urinary incontinence(5 cases), progressive constipation(2 cases), skin dimpling(1 case), gait disturbance(1 case) and club foot (1 case). Neurologic deficit was developed in 11 cases(40% and mean age of these patients at the time of diagnosis was 8.6 years. The most common cause of tethering was lipoma(63%). The tips of conus medullaris were below the level of the second lumbar spine in all patients. The causes of tethering were lipomatous component(spinal lipoma and lipomyelomenigocele) in 67% myelomeningocele in 20%, presacral mass in 7%, thickened filum terminale in 3% and postoperative change in 3%. Associated anomalies included syringomyelia(20%) and hydrocephalus was associated in 3 out of 5 patients who underwent brain MRI. CONCLUSION: MRI clearly delineated the location of conus, tethering of the filum terminale with their causes and associated abnormalities. MRI examination is a very useful diagnostic tool for the early evaluation of TCS and the postoperative follow up.
Brain
;
Cauda Equina
;
Conus Snail
;
Diagnosis
;
Follow-Up Studies
;
Foot
;
Gait
;
Humans
;
Hydrocephalus
;
Lipoma
;
Magnetic Resonance Imaging
;
Meningomyelocele
;
Neural Tube Defects*
;
Neurologic Manifestations
;
Retrospective Studies
;
Skin
;
Spinal Cord
;
Spine
2.Radiographic evaluation of alveolar bone profile of maxillary anterior teeth in Korean young adult.
Hyo Seok SEO ; Chin Hyung CHUNG ; Sung Bin LIM ; Ki Seok HONG
The Journal of the Korean Academy of Periodontology 2006;36(2):461-471
In order to achieve a satisfactory esthetic result of periodontal surgery or implant in maxillary anterior area, periodontists must be aware of normal alveolar bone anatomy. The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 78(mean age : 25 yrs) periodontally healthy volunteers participated in this study. Two maxillary central incisor and one lateral incisor were selected to study. With minimal local anesthesia, guttapercha cone inserted to labial gingival sulcus of selected teeth just after bone sounding with periodontal probe. Metal ball (4mm diameter) attached to palatal fossa of central incisor. Then, periapical radiograph was taken according to long cone paralleling technique. After film scan, labial alveolar bone profile reproduced along interproximal bone and apical ends of gutta-percha cones on computer screen. By utilizing computer program, the distance from height of interproximal bone to the labial bone crest in central incisor-central incisor and central incisor-lateral incisor area was measured and converted to real distance by using vertical length of metal ball on film. After measuring crown length & width of central incisor, the 10 individuals ranked lowest CW/L ratio (crown width/length ratio) and the 10 ranked highest were selected as having a long-narrow(group N), or a short-wide(group W) form of the central incisors. Means of the distance from height of interproximal bone to the labial bone crest of group N, W were calculated and compared by means of independent t-test. The results were as follows: 1. Mean distance from the height of the interproximal bone to the labial bone crest was 3.5+/-0.7mm between two central incisor, and 2.8+/-0.6mm between central and lateral incisor. 2. Mean CW/L ratio of group N was 0.57, and group W was 0.8. Mean distance from the height of the interproximal bone to the labial bone crest of group N was higher than group W in both measured area(measurements of group N, W were 3.9+/-0.2mm and 3.5+/-0.2mm between two central incisor, 3.0+/-0.2mm and 2.8+/-0.2mm between central and lateral incisor), but there were no statistically significant differences when the groups were compared. Within the limits of the present study, there was a tendency that subjects with long-narrow teeth have more scalloped alveolar bone profile than subjects with short-wide teeth in upper anterior area, but no statistically significant differences were found.
Adult
;
Male
;
Female
;
Humans
3.Spontaneous Jejunal Intussusception after a Colectomy: A Rare Cause of Postoperative Intestinal Obstruction: A Case Report.
Seok Byung LIM ; Hee Jin CHANG ; Jun Yong JEONG ; Hyo Seong CHOI ; Seung Yong JEONG
Journal of the Korean Society of Coloproctology 2008;24(2):134-136
Intussusception is a rare cause of intestinal obstruction in adults and is most often due to a primary abnormality of the bowel, which serves as the leading point. Idiopathic intussusception in adults is distinctly uncommon, comprising 10% of diagnosed intussusceptions. We report a case of a spontaneous jejunal intussusception in a 48-year-old man that developed shortly after an open colectomy. The 48-year-old man, with no history of a laparotomy, underwent a left hemicolectomy and a left hemihepatectomy for descending colon cancer with liver metastasis. For 14 postoperative days, the patient complained of ileus, and conservative management with a long intestinal tube failed. When the patient underwent a laparotomy, intussusception of the mid jejunum was observed. The intussusception was resected, and no underlying bowel abnormality was identified. This report highlights the importance of considering this rare etiology in patients with ileus who have recently undergone a laparotomy.
Adult
;
Colectomy
;
Colon, Descending
;
Humans
;
Ileus
;
Intestinal Obstruction
;
Intussusception
;
Jejunum
;
Laparotomy
;
Liver
;
Middle Aged
;
Neoplasm Metastasis
4.Cefotetan versus Conventional Triple Antibiotic Prophylaxis in Elective Colorectal Cancer Surgery.
Woon Kyung JEONG ; Ji Won PARK ; Seok Byung LIM ; Hyo Seong CHOI ; Seung Yong JEONG
Journal of Korean Medical Science 2010;25(3):429-434
This study examined infectious outcomes in elective colorectal cancer surgery between cefotetan alone or conventional triple antibiotics. From January to December 2007, 461 consecutive primary colorectal cancer patients underwent elective surgery. Group A contained 225 patients who received conventional triple antibiotics (cephalosporin, aminoglycoside and metronidazole) for prophylaxis, and group B contained 236 patients who received cefotetan alone for prophylaxis. Treatment failure was defined as the presence of postoperative infection including surgical-site infection (SSI), anastomotic leakage, and pneumonia or urinary tract infection. The two groups were similar in terms of demographics, American Society of Anesthesiologists (ASA) score, tumour location, stage, surgical approach (conventional open vs. laparoscopy-assisted), and type of operation. The treatment failure rates were 3.1% in Group A and 3.4% in Group B (absolute difference, -0.3%; 95% confidence interval [CI], 0.39 to 3.07, P=0.866), with SSI being the most common reason for failure in both groups (2.7% in Group A and 3.0% in Group B [absolute difference, -0.3%; 95% CI, 0.37 to 3.37, P=0.846]). Cefotetan alone is as effective as triple antibiotics for prophylaxis in primary colorectal cancer patients undergoing elective surgery.
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Anti-Bacterial Agents/*therapeutic use
;
*Antibiotic Prophylaxis
;
Cefotetan/*therapeutic use
;
Colorectal Neoplasms/*surgery
;
Drug Therapy, Combination
;
Humans
;
Male
;
Middle Aged
;
Postoperative Complications/*prevention & control
;
Surgical Wound Infection/*prevention & control
;
Treatment Failure
;
Treatment Outcome
;
Young Adult
5.Cardiac Arrest Occurred by Tension Pneumothorax during Right Thoracotomy: A case report.
Seung Moon RYU ; Hyo Seok NA ; Jin Ho BAE ; Jong Myeon HONG ; Seung Woon LIM
Korean Journal of Anesthesiology 2006;51(6):756-759
Tension pneumothorax during one-lung ventilation is an insidious, life threatening emergency. Even though early diagnosis and rapid intervention are necessary to prevent mortality, treatment may be difficult because of the clinical diagnosis-mediastinal shift, hypoxemia, hypotension and increased airway pressure may be confusing in the operative setting. We present here the case of a patient who underwent right thoracotomy with one-lung ventilation and the patient developed left tension pneumothorax with resulting cardiac arrest.
Anoxia
;
Early Diagnosis
;
Emergencies
;
Heart Arrest*
;
Humans
;
Hypotension
;
Mortality
;
One-Lung Ventilation
;
Pneumothorax*
;
Thoracotomy*
6.Locked-jaw as a Result of an Unexpected Anatomic Variation of the Temporomandibular Joint: A case report.
Jin Ho BAE ; Hyo Seok NA ; Geon KIM ; Kyoung Won KIM ; Seung Woon LIM
Korean Journal of Anesthesiology 2006;51(6):738-741
A 36-year-old woman with an unremarkable medical history presented for laparoscopic cholecystectomy. Routine preoperative assessment of the patient's airway revealed normal jaw opening. Upon induction of anesthesia, her jaw locked in a nearly closed position. X-ray and MRI of the temporomandibular joints that were taken postoperatively showed normal findings except for the steeper posterior angles of the articular eminences. During the next induction of anesthesia, intubation was readily accomplished by opening the mandible with a forward pulling of the chin.
Adult
;
Anatomic Variation*
;
Anesthesia
;
Chin
;
Cholecystectomy, Laparoscopic
;
Female
;
Humans
;
Intubation
;
Jaw
;
Magnetic Resonance Imaging
;
Mandible
;
Temporomandibular Joint*
7.Aortic Translocation for Complete Transposition of the Great Arteries with a Ventricular Septal Defect and Pulmonic Stenosis.
In Seok JEONG ; Chang Ha LEE ; Cheul LEE ; Hong Gook LIM ; In Sub KIM ; Hyo Chul YOUN
The Korean Journal of Thoracic and Cardiovascular Surgery 2008;41(4):476-479
The Rastelli operation has been a standard procedure for repairing complete transposition of the great arteries combined with a ventricular septal defect and pulmonary stenosis. Yet this procedure has several shortcomings, including the risk of incurring left ventricular outflow tract obstruction on long-term follow-up. In this regard, aortic translocation has recently been regarded as a potent alternative to Rastelli's operation. We report here on a case of complete transposition of the great arteries that was combined with an inlet-extended perimembranous ventricular septal defect and pulmonary stenosis in a 2-year-old boy. All the problems were successfully repaired using the aortic translocation technique. Postoperative echocardiography showed a straight and wide left ventricular outflow tract.
Arteries
;
Echocardiography
;
Follow-Up Studies
;
Heart Septal Defects, Ventricular
;
Preschool Child
;
Pulmonary Valve Stenosis
;
Transposition of Great Vessels
8.Clinical Significance of Serum Concentration of Intercelluar Adhesion Molecule-1 in Patients with Acute and Chronic Liver Disease.
Sung Shick LIM ; Seok Ho DONG ; Hyo Jong KIM ; Byung Ho KIM ; Joung Il LEE ; Rin CHANG
The Korean Journal of Hepatology 1996;2(1):68-76
BACKGROUND/AIMS: Recent studies, have examined the expression of adhesion molecules in liver inflammation, and the existence of soluble ICAM 1 in serum could be proved by ELISA. We maeasured s-ICAM 1 in patients with acute and ehronic liver disease to see the level of s-ICAM 1 can reflect degree of necroinflammation or progress of disease. METHOD: Serum levels of soluble forms of intercellular adhesion molecule 1(sIGAM 1) in 78 patients with acute and chronic liver disease including acute hepatitis B, CAH, C.'PH, post-necrotic and alcoholic liver cirrhosis, hepatoceliular carcinoma, toxic hepatitis were measured by enzyme-linked immunosorbent assays. RESULTS: 1) ICAM 1 semm levels in acute and chronic liver disease including acute hepatitis B(709.6+/-321.7 ng/L, p<0.001), C:AH(582.2+/-312.4 ng/L, p<0.001), CPH(357,8+/-135.0 ngL, p<0.044), postnecrotic livercirrhosis(716.2+/-348.0 ng/L, p<0.0001), alcoholic liver cirrhosis(763.3+/-48l.5 ng/L, p<0.009). Hepatocellular carcinoma(728.2+/-329.0 ng/L, p<0.002), toxic hepatitis(817.3+/-324.4 ng/l, p<0.0001) were signiticantly higher than that of healthy controLs(234.5+/-67.5 ng/L).2) In comparison with CPH we found significantly increased ICAM- 1 serum levels in CAH.(p=0.027) A significant correlation was found between the ICAM-1 serum level and the histologically graded inflammatory activity in CAH. 3) No correlation was found be1ween the ICAM l serum level aml the Child- Pugh classification in liver cirrhosis. 4) In comparison with chronic hepatitis we found signitcantly increased 1CAM 1 serum levels in liver cirrhosis(p = 0.001) , and in hepatocellular carcinoma(p = 0.0001). CONCLUSION: Soluble ICAM I serum level correlated well with ongoing necrointlammatory activity in acute and chronic hepatitis and also slCAM 1 can reflect disease severity in various chronic 1iver disease groups.
Alcoholics
;
Classification
;
Drug-Induced Liver Injury
;
Enzyme-Linked Immunosorbent Assay
;
Hepatitis
;
Hepatitis B
;
Hepatitis, Chronic
;
Humans
;
Inflammation
;
Intercellular Adhesion Molecule-1
;
Liver Cirrhosis
;
Liver Cirrhosis, Alcoholic
;
Liver Diseases*
;
Liver*
9.The Effect of Premedication using a Jet-injector in Pediatric Patients.
Geon KIM ; Hyo Seok NA ; Seon Jung KIM ; Seung Woon LIM ; Jin Ho BAE
Korean Journal of Anesthesiology 2007;53(3):291-297
BACKGROUND: This study was designed to evaluate the efficacy and safety of midazolam premedication administered by a jet-injector in pediatric patients. METHODS: Children undergoing outpatient surgery were randomized into three groups: intravenous induction with thiopental sodium (control group, n = 20), oral midazolam premedication (PO-med group, n = 20) or midazolam premedication using a jet-injector (Jet-med group, n = 20). In the PO-med and Jet-med group patients, anesthetic induction was performed by sevoflurane inhalation and an intravenous catheter (IVC) was inserted after the children had been anesthetized by sevoflurane inhalation. For the control group patients, an IVC was placed in the preoperative holding area. Agitation scores were recorded in the preoperative holding area and recovery room. Anesthesia times and the views of the medical staff concerning the technique benefits were also noted. Patients and parents were interviewed on the following day. RESULTS: Maximum agitation scores in the preoperative holding area and during separation with parents were significantly lower in the PO-med and Jet-med groups. The induction time was significantly longer in the PO-med and Jet-med groups. No statistically significant differences were found for the recovery characteristics. Though interviews with patients and parents produced similar results for patients in each group, the medical staff satisfaction levels were significantly higher for patients in the PO-med and Jet-med groups. CONCLUSIONS: The findings of this study suggest that the application of the jet-injector for midazolam premedication may be clinically useful in children who do not have an IVC. The use of the jet-injector could be a substitute for the oral route for midazolam administration.
Ambulatory Surgical Procedures
;
Anesthesia
;
Catheters
;
Child
;
Dihydroergotamine
;
Humans
;
Inhalation
;
Medical Staff
;
Midazolam
;
Parents
;
Preanesthetic Medication
;
Premedication*
;
Recovery Room
;
Thiopental
10.Technetium-99m MDP bone scintigraphic findings of hypercalcemia in accelerated phase of chronic myelogenous leukemia.
Hyo Sung KWAK ; Myoung Hee SOHN ; Seok Tae LIM ; Jae Yong KWAK ; Chang Yeol YIM
Journal of Korean Medical Science 2000;15(5):598-600
Hypercalcemia in accelerated phase of chronic myelogenous leukemia (CML) is very rare. Its pathogenesis is considered humoral hypercalcemia of malignancies mediated by parathyroid hormone-related protein (PTHrP). In severe hypercalcemia, calcifications in kidneys, skin, vessels, heart, and stomach may occur. Our two cases were admitted because of severe hypercalcemia in accelerated phase of CML. On Tc-99m methylene diphosphonate (MDP) bone scintigraphies, a marked tracer accumulation was seen in the lung, heart, stomach and kidney. We report increased tracer accumulation of multiple organs on Tc-99m MDP bone scintigraphy in two rare hypercalcemic patients with CML.
Adult
;
Bone Diseases/radionuclide imaging*
;
Bone Diseases/etiology*
;
Calcinosis/radionuclide imaging
;
Calcinosis/etiology
;
Case Report
;
Human
;
Hypercalcemia/radionuclide imaging*
;
Hypercalcemia/etiology*
;
Leukemia, Myeloid, Chronic/metabolism
;
Leukemia, Myeloid, Chronic/complications*
;
Male
;
Middle Age
;
Proteins/metabolism
;
Technetium/diagnostic use