1.Systolic pressure amplification of the aortic pressure in children with congenital heart disease.
Chan Uhng JOO ; Byoung Geun LEE ; Sun Jun KIM ; Jung Soo KIM
Journal of the Korean Pediatric Society 1993;36(2):232-238
Direct intraarterial measurement of blood pressure is an important diagnostic procedure in critical patients and premature baby care. Direct measurement was more accepted and confident method in physician than the indirect methods. But the presence of a significant amplification of systolic pressure in peripheral artery may lead to important error. So we have investigated the degree of the systolic pressure amplification from the ascending aorta to the femoral artery in children. Pressure waves recorded in the ascending aorta, aortic arch, diaphragmatic level of the descending aorta, common iliac artery, and femoral artery in 37 patients with congenital heart disease, aged 9 months to 21 years old (mean 7.16 yrs old) during diagnostic cardiac catheterization. The results were as follows 1) Amplification of the systolic pressure increased progressively from the ascending aorta to the femoral artery (16.7%) 2) Diastolic pressure decreased progressively from the ascending aorta to the femoral artery (6.5%) 3) Mean pressure decreased progressively from the ascending aorta to the femoral artery (1.5%) 4) Pulse pressure increased progressively from the ascending aorta to the femoral artery (42.8%) 5) There was significant drop (7%) of the systolic pressure of the ascending aorta compared with that of left ventricle. The results showed that the peripheral amplifications were limited to the systolic and pulse pressure, but the diastolic and mean pressure in peripheral arteries were lower than that of central artery.
Aorta
;
Aorta, Thoracic
;
Arterial Pressure*
;
Arteries
;
Blood Pressure*
;
Cardiac Catheterization
;
Cardiac Catheters
;
Child*
;
Femoral Artery
;
Heart Defects, Congenital*
;
Heart Ventricles
;
Humans
;
Iliac Artery
;
Young Adult
2.Nasal Bone 3 Dimentional Computer Tomography Guided Tailored Osteotomy of the Bony Deviated Nose.
Joo Wan JO ; Seok Won JEON ; Joo Geun JUNG ; Min Jung KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2016;59(1):19-27
BACKGROUND AND OBJECTIVES: Correction of deviated nose is considered one of the most difficult and serious surgical operations in rhinoplasty. The correction of bony deviation, in particular, requires osteotomy. Although there are individual differences in the shapes or features of bony deviations of each patient, the techniques of osteotomy are limited. Therefore, for proper correction of bony deviation, it is necessary to set up a precise pre-surgical plan. SUBJECTS AND METHOD: We categorized 187 patients with bony deviated nose into 5 types based on the analysis of preoperative nasal bone 3D computer tomography, and studied surgical method for each type. RESULTS: Of 187 patients, 92 (49%) patients are categorized into type I, 62 (36%) patients into type II, 12 (6%) patients into type III, 2 (1%) patients into type IVa, 7 (4%) patients into type IVb and 7 (4%) patients into type V. Only did eight patients (5%) undergo revision surgery due to unsuccessful outcomes. Major complications like infection, abscess, arteriovenous fistula, epiphora, and saddle deformation did not occur at all. CONCLUSION: Preoperative planning under the analysis and categorization using 3D CT is considered helpful for the precise and individualized surgery in corrective rhinoplasty.
Abscess
;
Arteriovenous Fistula
;
Humans
;
Individuality
;
Lacrimal Apparatus Diseases
;
Nasal Bone*
;
Nose*
;
Osteotomy*
;
Rhinoplasty
3.Traumatic Diaphragmatic Ruputure: 4-Year Clinical Experience.
Jong Dae BAE ; Jung Min BAE ; Tae Suk BAE ; Eun A CHOI ; Joo Sup LEE ; Ho Geun JUNG ; Ki Hoon JUNG ; Sung Han BAE ; Byeng Ook JUNG ; Tae Jung JANG
Journal of the Korean Surgical Society 2004;66(2):138-146
PURPOSE: A traumatic diaphragmatic rupture (TDR) is a diagnostic challenge and the associated injuries determine the outcome in those diagnosed early. A TDR has long been considered to be a marker of the severity of injury with an average reported Injury Severity Score (ISS) between 31 and 50. This report reviewed the TDR cases in order to emphasize the method and timing of the diagnosis, associated injuries and the outcome. METHODS: A retrospective analysis was performed on 30 patient treated for TDR between August 1998 and september 2002. RESULTS: The mean age of the patients was 33.4 years and the injury predomiantly affected males (male: female=2: 1). Blunt trauma by TA was the most common cause of the TDR (25 patients). The ruptured sites were on the left in 22 cases and on the right in 8 cases. The most common symptom was chest pain (23 cases) followed dyspnea (21 cases). Liver injuries and a pneumo-hemothorax were the most common associated injuries. The mean CRAMS scale was 6.47 and Injury Severity Score (ISS) was 18.93. Eighteen TDR cases were suspected based on the abnormal chest X-ray findings. Nineteen cases underwent surgery within 6 hours after the trauma (early diagnosis). Although many complications occurred in 11 cases, there were no lethal complications. The mean size of the diaphragmatic rupture was 9.77 cm and an intraabdominal organ herniation had not occurred in ruptures smaller than 6 cm. Surgical repair of the diaphragm was performed via a laparotomy in 20 cases and thoracotomy in 7 cases. A left side TDR was preferred to a laparotomy whereas a right sided TDR was preferred to a thoracotomy. Pulmonary complications (atelectasis, pneumonia, pleural effusion) occurred in 14 cases postoperatively. CONCLUSION: The patient's complaints and physical findings were not a reliable indicator of the diagnosis, but usually a manifestation of the associated injuries. A suspicion and routine chest X-ray was the most reliable diagnostic tool, even though the chest X-ray was normal in 12 cases. A high rate of early diagnosis can be achieved using an aggresive investigation protocol, suspicion and a combined radiologic evaluation in multiple trauma patients. Although pulmonary complications occurred in the early diagnosed cases, lethal complications and long term sequela were directly related to the time of diagnosis. The higher ISS had many complications (11 cases) but there were no lethal complications, long term sequela.
Chest Pain
;
Diagnosis
;
Diaphragm
;
Dyspnea
;
Early Diagnosis
;
Humans
;
Injury Severity Score
;
Laparotomy
;
Liver
;
Male
;
Multiple Trauma
;
Pneumonia
;
Retrospective Studies
;
Rupture
;
Thoracotomy
;
Thorax
4.Laryngeal Electromyography: Clinical Application in Vocal Cord Palsy.
Ji Ho BAE ; Jae Hyung JOO ; Won Ho LEE ; Sung Hoon LEE ; Dae Woo JUNG ; Kyu Hyun PARK ; Jong Geun YOON ; Soo Geun WANG
Journal of the Korean Neurological Association 1995;13(2):278-283
Vocal cord paralysis is a comlex disorder which may result from numerous causes. It is often associated with trauma, disease in adjacent tissue, or a generalized neuroligical disorder. Laryngeal EMG is a useful technique for vocal cord paralysis. However it has not been used due to the uncertainties of normal human vocal cord physiology and the technical difficulties in performing these studies. We investigated the pathophysiology of vocal cord paralysis with laryngeal electromyography(LEMG). We studied 20 patients with idiopathic vocal cord paralysis. 6 patients were denervated in the cricothyroid(CT) and 6 patients in the thyroarytenoid(TA), and 3 patients in both CT and TA muscles. These indicated superior laryngeal neuropathy, recurrent laryngeal neuropathy, and proximal laryngeal or vagus neuropathy, respectively. LEMG proved to be a safe and effective procedure in the diagnosis of laryngeal neuropathy, and make it possible to use electromyography as a routine procedure in diagnosis laryngeal paralysis.
Diagnosis
;
Electromyography*
;
Humans
;
Muscles
;
Physiology
;
Vagus Nerve Diseases
;
Vocal Cord Paralysis*
;
Vocal Cords*
5.Clinical Significance of Preoperative Virtual Colonoscopy for Evaluation of the Proximal Colon in Patient With Obstructive Colorectal Cancer.
Jae Hyuk HEO ; Chun Geun RYU ; Eun Joo JUNG ; Jin Hee PAIK ; Dae Yong HWANG
Annals of Coloproctology 2017;33(4):130-133
PURPOSE: Virtual colonoscopy is the most recently developed tool for detecting colorectal cancers and polyps, but its effectiveness is limited. In our study, we compared the result of preoperative virtual colonoscopy to result of preoperative and postoperative colonoscopy. We evaluated also the accuracy of preoperative virtual colonoscopy in patients who had obstructive colorectal cancer that did not allow passage of a colonoscope. METHODS: A total of 164 patients who had undergone preoperative virtual colonoscopy and curative surgery after the diagnosis of a colorectal adenocarcinoma between November 2008 and August 2013 were pooled. We compared the result of conventional colonoscopy with that of virtual colonoscopy in the nonobstructive group and the results of preoperative virtual colonoscopy with that of postoperative colonoscopy performed at 6 months after surgery in the obstructive group. RESULTS: Of the 164 patients, 108 were male and 56 were female patients. The mean age was 62.7 years. The average sensitivity, specificity, and accuracy of virtual colonoscopy for all patients were 31.0%, 67.2%, and 43.8%, respectively. In the nonobstructive group, the average sensitivity, specificity, and accuracy were 36.6%, 66.2%, and 48.0%, respectively, whereas in the obstructive group, they were 2%, 72.4%, and 25.4%. Synchronous cancer was detected via virtual colonoscopy in 4 of the 164 patients. CONCLUSION: Virtual colonoscopy may not be an effective method for the detection of proximal colon polyps, but it can be helpful in determining the therapeutic plan when its results are correlated with the results of other studies.
Adenocarcinoma
;
Colon*
;
Colonic Polyps
;
Colonography, Computed Tomographic*
;
Colonoscopes
;
Colonoscopy
;
Colorectal Neoplasms*
;
Diagnosis
;
Female
;
Humans
;
Male
;
Methods
;
Polyps
;
Sensitivity and Specificity
6.Three cases of brain tumors with bone metastasis.
Eun Joo KIM ; Kyung Duk PARK ; Eun Sil DONG ; Hye Jung PARK ; Hong Hoe KOO ; Hee Young SHIN ; Hyo Seop AHN ; Je Geun CHI
Journal of the Korean Pediatric Society 1992;35(3):381-389
No abstract available.
Brain Neoplasms*
;
Brain*
;
Drug Therapy
;
Medulloblastoma
;
Neoplasm Metastasis*
;
Neuroectodermal Tumors, Primitive
7.Initial Transient Neurologic Recovery Followed by Delayed Deterioration of Osmotic Demyelination Syndrome: A Case Report.
Hee Sig MUN ; Myong Ho LEE ; Kyung Hwan MIN ; Sang Woong HAN ; Woo Kyoon RHO ; Geun Tae PARK ; Dong Woo PARK ; Young Joo LEE ; Ho Jung KIM
Korean Journal of Nephrology 1998;17(4):614-618
In literatures, most of the studies of severe hyponatremia during or following its treatment has been concentrated with special references to the rate of correction and its neurologic outcomes. But, there is relatively few ones analyzing the diverse clinical manifestations of neurologic symptorns or complications during the course of treating severe hyponatremia. We experienced a catastrophic course related to hyponatremia in a 51 year woman with severe rheumatoid arthritis, who underwent knee joint replacement, and this case revealed the initial transient neurologic recovery for 3 days by the initial rapid correction of hyponatremia, then followed by delayed deterioration of osmotic demyelination syndrome leading to locked-in syndrome. Reported cases with similar clinical course (biphasic course) in the world lituratures were reviewed with special interests in the initial maximum rate of correction of hyponatremia and radiologic findings. This review suggests that clinicians treating the patients with severe symptomatic hyponatremia should be aware of the possibility of delayed neurologic sequelae despite the recovery of neurologic status as well as the degree of hyponatremia in the early treatment course of hyponatremia.
Arthritis, Rheumatoid
;
Demyelinating Diseases*
;
Female
;
Humans
;
Hyponatremia
;
Knee Joint
;
Quadriplegia
8.A Clinical Trial of Pravastatin in Korean Patients with Hypercholesterolemia.
Joo Hyung PARK ; Young Geun AHN ; Myung Ho JEONG ; Jeong Gean CHO ; Jong Chun PARK ; Ki Chul CHOI ; Jung Chaee KANG
Korean Circulation Journal 1992;22(2):307-313
Hypercholesterolemia is one of the major risk factors for atherosclerosis. Reduction of serum total and low density lipoprotein cholesterol(LDL-C) and the increase of high density lipoprotein cholesterol(HDL-C) are known to be associated with significant decrease of the incidence of atherosclerotic disease. HMG CoA reductase is known as rate limiting enzyme in the synthesis of cholesterol. Among many inhibitors of this enzyme pravastatin was recently released. To evaluate the efficacy and safety of this drug in Korean patients with hypercholesterolemia daily 5-40mg of pravstatin was administred in 30 patients after 4 weeks' wash-out and followed in 4 week-intervals up to 12 weeks. 1) Total cholesterol(TC) was decreased from 247.3+/-24,7mg/dl to 216.6+/-34.8mg/dl after 4 weeks, 214.3+/-36.7mg/dl after 8 weeks and 212,5+/-36.1mg/dl after 12 weeks(p,0.001, respectively). 2) Triglycrride(TG) was decreased from 191.3+/-77.9mg/dl to 161.4+/-61.4mg/dl after 4 weeks(p<0.005),155.4+/-74,8mg/dl after 8 weeks (p<0.05) but after 12 weeks the level of triglyceride was 165.5+/-70.3mg/dl, not significantly different from the basal level. 3) LDL-C was decreased from 155.0+/-29.3mg/dl to 129.8+/-34.4mg/dl after 4 weeks. 132.0+/-32.4mg/dl after 8 weeks and 125.9+/-38.1mg/dl after 12 weeks (p<0.01. respectively). 4) HDL-C was not significantly changed during the trial. 5) TC/HDI-C ratio was decreased from 4.8%+/-1.3 to 4.1+/-0.9 after 4 weeks. 4.3.+/-0.9 after 8 weeks and 4.1+/-1.1 after 12(p<0.01.respectivcly). 6) LDL-C/HDL-C ratio was decreased from3.0+/-1.0 to2.5+/-0.8 after 4 weeks(p<0.01).2.6+/-0.7 after 8 weeks(p<0.05) and 2.4+/-0.9 after 12 weeks(p<0.01). 7) The side effects of pravastatin were mild and transient, including 1 case of nausea, 1 headache, 1 flushing sensation on the face and 2 dizziness. 8) The laboratory studies including serum transaminases,uric acid, creatinine, creatine phoshokinase and blood glucose were not changed significantly. These results suggested that pravastatin is an effective and relative safe hypolipidemic agent in Korean adult patients with hypercholesterolemia.
Adult
;
Atherosclerosis
;
Blood Glucose
;
Cholesterol
;
Creatine
;
Creatinine
;
Dizziness
;
Flushing
;
Headache
;
Humans
;
Hydroxymethylglutaryl CoA Reductases
;
Hypercholesterolemia*
;
Incidence
;
Lipoproteins
;
Nausea
;
Pravastatin*
;
Risk Factors
;
Sensation
;
Triglycerides
9.Wet-wrap Dressing.
Sang Ju LEE ; Mi Jung LEE ; Joo Young KIM ; Geun Soo LEE ; Seung Hun LEE
Korean Journal of Dermatology 2003;41(12):1691-1693
Atopic dermatitis is a chronic dermatitis which accompanies severe pruritus. It has various modalities of treatment and yet ones that resist to temporizing treatments may be difficult to treat. Thus, we report a case of a severe adult type atopic dermatitis that resisted the established treatments, however, was treated successfully by wet-wrap dressing with the literature reviews.
Adult
;
Bandages*
;
Dermatitis
;
Dermatitis, Atopic
;
Humans
;
Pruritus
10.Analysis of p53 and Retinoblasoma(Rb) Gene Polymorphisms in Relation to Lung Cancer in Koreans.
Kyung Sang LEE ; Jang Won SOHN ; Suck Chul YANG ; Ho Joo YOON ; Dong Ho SHIN ; Sung Soo PARK ; Jung Hee LEE ; Chun Geun LEE ; Youl Hee CHO
Tuberculosis and Respiratory Diseases 1997;44(3):534-546
BACKGROUND: The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial. proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. METHODS: In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis The two intragenic polymorphisms of the p53 gene(exon 4/AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain react lion-restriction fragment length polymorphisms(PCR-RFLPS). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. RESULTS: There were no significant differences in the genotype distributions of the p53 gene between lung cart cert patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AcclII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known 13 be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p=0.0297) or adenocarcinomas(p=0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were a]so noted between the high dose smokers and low dose smokers including non-smokers(p=0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio=0.46, 95%C.I.=0.25-0.86, p=0.0124). The combined genotype distribution of the exon 4/AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/pro and r2/r2(odds ratio=1.97, 95%C.I.=0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio=0.54, 95%C.I.=0.25-1.14). CONCLUSION: The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koreans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.
Adenocarcinoma
;
Alleles
;
Cell Line
;
Electrophoresis
;
Exons
;
Gene Frequency
;
Genes, p53
;
Genes, Retinoblastoma
;
Genes, Tumor Suppressor
;
Genetic Predisposition to Disease
;
Genotype
;
Homozygote
;
Humans
;
Introns
;
Linkage Disequilibrium
;
Lung Neoplasms*
;
Lung*
;
Odds Ratio
;
Polymerase Chain Reaction
;
Risk Factors
;
Smoke
;
Smoking