1.Clinical analysis of dissecting aortic aneurysm in emergency department.
Keun Hwa WOO ; Won Yul KIM ; Hong Yong KIM
Journal of the Korean Society of Emergency Medicine 1998;9(2):257-263
Dissecting aortic aneurysm is an emergency condition which requires prompt diagnosis and management. From January 1992 to December 1996, 54 patients were admitted to our department. Patients were categorized according to the Stanford classification of aortic dissection and investigation of the clinical records utilized the retrospective method. Male constituted the majority, according for 38(70.4%) of the total number of patients, whereas females accounted for 16(29.6%). Mean age was 52.1+/-2.2 years old (range:25~82). Clinical findings included chest pain in 46 cases(85.2%), renal failure in 11(20.4%), aortic insufficiency in 10(18.5%) and stroke in 9(16.7%). Predisposing factors were hypertension in 48 cases(88.9%), Marfan's syndrome in 5(9.3%) and diabetes mellitus in 1(1.8%). 21 patients(type A:12, type B:9) underwent surgical treatment. There were three(2 in type A and 1 in type B) deaths in the surgical treatment group and nine(5 in type A and 4 in type B) deaths in the medical treatment group. These results reflect our current policy in the management of dissecting aortic aneurysm.
Aortic Aneurysm*
;
Causality
;
Chest Pain
;
Classification
;
Diabetes Mellitus
;
Diagnosis
;
Emergencies*
;
Emergency Service, Hospital*
;
Female
;
Humans
;
Hypertension
;
Male
;
Marfan Syndrome
;
Renal Insufficiency
;
Retrospective Studies
;
Stroke
2.The Efficacy of Emergency Computed Tomography in Patients with Chest Trauma.
Keun Hwa WOO ; Won Yul KIM ; Kyung Hwan KIM ; Hong Yong KIM ; Ghi Jai LEE
Journal of the Korean Society of Emergency Medicine 1999;10(1):91-96
BACKGROUND: Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography (CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest indies are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest. METHODS: To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour. RESULTS: Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3%and 45.1%respectively), whereas 65.7% (44/67) of patients had thoracostomy only by CXR. CONCLUSIONS : Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.
Abdomen
;
Cause of Death
;
Diagnosis
;
Emergencies*
;
Head
;
Humans
;
Pleural Effusion
;
Pneumothorax
;
Radiography
;
Retrospective Studies
;
Thoracic Injuries
;
Thoracostomy
;
Thorax*
;
Tomography, X-Ray Computed
3.On-Line Assessment of Left Ventricular Volume and Ejection Fraction by the Automated Border Detection Echocardiography.
Hyun Muck CHOI ; Young Woo KIM ; Keum Hee LEE ; Sin Hwa LEE ; Neung Hwa PARK ; Sang Keun JI ; Tae Joon CHA ; Seung Jae JOO ; Jae Woo LEE
Korean Circulation Journal 1995;25(3):614-621
BACKGROUND: The automated border detection(ABD) echocardiography has the ability of recognizing the endocardial-blood interface, and therefore, on-line estimation of the left ventricular(LV) volume every cardiac cycle. Compared with the off-line conventional 2-dimensional echocardiographic method that requires tracing the endocardial border manually, the ABDd system can be a convenient and objective method in the estimation of the LV volume and the ejection fraction(EF). The purpose of this study is to compare the LV volume and EF between the on-line ABD system and the convertional off-line echocardiographic method. METHODS: In two weeks, 83 adult patients older than 16 years of age were referred to our echocardiographic laboratory. Among these 83 patients, 64 patients who had a normal sinus rhythm were included to our study. Using the Hewlett-Packard SONOS 1500, a 2.5 MHz transducer was placed dat the cardiac apex. Patients with an apical 4 chamber view of the LV in which at least 75% of the endocardium was clearly seen were selected for study. On that view, the ABD system was turned on, and the reansmit power and the time-gain compensation controls were adjusted in order to approximate the automated border to the visually apparent endocardial surface. The LV end-diastolic volume(LVESV) and LV end-systolic volume(LVESV) were calculated by the method of disc. LVEDV, LVESV, and EF were displayed every cardiac cycle. Also the off-line estimation of the LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view. RESULTS: 44 patients(69%) of 64 patients had > or =75% of the LV endocardium visualized. LVEDV, LVESV, and Ef with the ABD system were highly correlated with those with the off-line, manually traced method(r=0.95, 0.8, respectively), but LVEDV and EF with toe ABD system were significantly less than those with the latter(p<0.01). The limits of agreement between tow methods(off-line, manually traced method-ABD system) were somewhat wide. Those of LVEDV, LVESV and EF were +22~-10ml(mean 6ml), +15~-14ml(mean 0.1ml), and +19~-12%(mean 3.8%), respectively. CONCLUSION: LVEDV,LVESV, and EF measurements by the ABD system and the off-line manually traced methods thve a strong correlation, The ABD system should habe clinical applications in setting, in which measurements of LV volume and Ef are important, But, the comparison with a more reliable method is necessary.
Adult
;
Compensation and Redress
;
Echocardiography*
;
Endocardium
;
Humans
;
Toes
;
Transducers
4.The significance of mucin producing cancer in colorectal cancer.
Bong Hwa LEE ; Jin Hee SOHN ; Jong Keun LEE ; Gil Ro HAN ; Hyo Sook PARK ; Ze Hong WOO
Journal of the Korean Surgical Society 1991;40(5):633-643
No abstract available.
Colorectal Neoplasms*
;
Mucins*
5.A Case of Congenital Dyserythropoietic anemia Type IV.
Hwa Young JEON ; Hwang Min KIM ; Baek Keun LIM ; Duk Woo PARK ; Myung Seo KANG ; Young Kun DEUNG
Journal of the Korean Pediatric Society 1995;38(5):702-706
No abstract available.
Anemia, Dyserythropoietic, Congenital*
7.The factors associated with Body Mass Index of adults.
Moo Kyung BAE ; Woo Keun LEE ; Chun Hwa SONG ; Keun Mi LEE ; Seung Pil JUNG
Journal of the Korean Academy of Family Medicine 1999;20(7):906-916
BACKGROUND: Overweight and obesity are associated with increased mortality and morbidity. Obesity is influenced by multiple factors, both genetic and environmental factors. We investigated the relationship between socioeconomic, behavioral, dietary, reproductive factors and body mass index(BMI). METHODS: The subject were 3000 adults who had visited the Health Screening and Diagnosis Center of Yeungnam University School of Medicine from February to June, 1997. We evaluated BMI and occupation, exercise, smoking, alcohol intake, total calory intake, fat and carbohydrate intake in both gender and reproductive factors in women. Then, we analyzed the association between BMI and such variables as above. RESULTS: 1629 men and 1371 women were analyzed. The mean BMI was 23.4+/- 2.8kg/M(2) in men, 22.9+/- 3.1kg/M(2) in women. In both gender, 9.7% of our population had BMl over 27. Mean BMI increased with age. Those who were active and light smokers( 20cigarette/day) had the lowest BMI in men. But no relationship was observed between BMI and exercise, smoking in women. Heavy alcohol drinkers(> 1cup/day) had higher BMI than other group in both gender. We found significant correlation between BMI and total calory intake, calory intake to recommended calory ratio in both gender. In women, the group whose number of parity was above 3 had significantly higher BMI than the other. And age at first birth was significantly correlated with BMI in a negative direction. CONCLUSIONS: Our results showed that BMI was associated with age, smoking, alcohol, total calory intake, calory intake to recommended calory ratio, parity, age at first birth. Socioeconomic class, exercise and diet composition appeared to have little influence.
Adult*
;
Birth Order
;
Body Mass Index*
;
Diagnosis
;
Diet
;
Female
;
Humans
;
Male
;
Mass Screening
;
Mortality
;
Obesity
;
Occupations
;
Overweight
;
Parity
;
Smoke
;
Smoking
;
Social Class
8.Panax Ginseng Extract in a Boy with Attention Deficit Hyperactivity Disorder.
Keun Jeong YUK ; Suk Hwa LEE ; Jin A DOH ; Myung Ho LIM ; Hyun Woo KIM
Korean Journal of Psychopharmacology 2010;21(1):35-39
New treatment strategies to attention deficit hyperactivity disorder (ADHD) have been introduced recently. We report and review the effect of Panax ginseng extract administration in a 7 year-old boy with drug naive ADHD. We administered Panax ginseng extract 1,800 mg/day to him for 8 weeks. There were improvement of scores in Attention Diagnostic System, Clinical Global Improvement, Conner's ADHD Rating scale and Dupaul ADHD Rating scale.
Attention Deficit Disorder with Hyperactivity
;
Panax
;
Polyenes
9.The Comparative Study of on Pump CABG during Pulsatile (T-PLS(TM)) and Nonpulsatile (Bio-pump(TM)) Perfusion.
Young Woo PARK ; Keun HER ; Jae Ung LIM ; Hwa Kyun SHIN ; Yong Soon WON
The Korean Journal of Thoracic and Cardiovascular Surgery 2006;39(5):354-358
BACKGROUND: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of T-PLS(TM) through the comparison of clinical effects of T-PLS(TM) (pulsatile pump) and Bio-pump(TM) (non-pulsatile pump) used for coronary bypass surgery. MATERIAL AND METHOD: The comparison was made on 40 patients who had coronary bypass using T-PLS(TM) and Bio-pump(TM) (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. RESULT: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with T-PLS(TM) (46+/-15 mmHg in T-PLS(TM) vs 35+/-13 mmHg in Bio-pump(TM), p<0.05). The T-PLS(TM)-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant (9.7+/-3.9 cc/min in T-PLS(TM) vs 8.9+/-3.6 cc/min in Bio-pump(TM), p=0.20). There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with T-PLS(TM) (24.5+/-21.7 mg/dL in T-PLS(TM) versus 46.8+/-23.0 mg/dL in Bio-pump(TM), p<0.05). There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with T-PLS(TM), but the death rate was not statistically significant. CONCLUSION: Coronary bypass was operated with T-PLS(TM) (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which Bio-pump(TM) was used. In addition, T-PLS(TM) used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of T-PLS(TM).
Arrhythmias, Cardiac
;
Arterial Pressure
;
Blood Cells
;
Blood Pressure
;
Cardiopulmonary Bypass
;
Coronary Artery Bypass
;
Extracorporeal Circulation
;
Heart-Lung Machine
;
Humans
;
Hypertension
;
Infarction
;
Lung Diseases, Obstructive
;
Mortality
;
Perfusion*
;
Plasma
;
Pulsatile Flow
;
Renal Insufficiency
;
Risk Assessment
;
Risk Factors
;
Smoke
;
Smoking
;
Transplants
;
Ventilators, Mechanical
10.Clinical Significance of Interferon gamma Release Assay for Diagnosis of Tuberculosis in Children.
Hee Woo LEE ; Hwa Young PARK ; Young Min AHN ; Keun Chan SOHN
Korean Journal of Pediatric Infectious Diseases 2010;17(2):137-147
PURPOSE: The purpose of this study is to evaluate the usefulness and limitation of QuantiFERON-TB Gold (QTB) for diagnosis of latent tuberculosis in children. METHODS: The medical records of 112 children who were tested by tuberculin skin test (TST) and QTB for detection of latent tuberculosis (TB) in Eulji General Hospital during the period from January 2007 to June 2009 were retrospectively reviewed. RESULTS: Of the 112 participants, the clinical TB group included 15 (13.4%), the contact group included 43 (38.4%), and the non-contact group included 54 (48.2%). Positive rates of TST and QTB were 100% and 80% in the clinical TB group, 64% and 14% in the close contact group, 27% and 0% in the casual contact group, and 52% and 2% in the non-contact group, respectively. Sensitivity of QTB was 80.0% and specificity was 92.6%. Agreement between QTB and TST was poor (kappa=0.209). We also confirmed that the positive rate of QTB increased as the age of the patient increased (P=0.011). A QTB indeterminate result was observed in 11 (9.8%) subjects. QTB was retested in 15 subjects. In 5 of the 6 subjects who had positive results initially, positive results persisted for a median 2.2 months after termination of treatment. CONCLUSION: Although QTB was associated with several problems, including low sensitivity and a high rate of indeterminate results, it had clinical importance due to its high specificity. We found good correlation with regard to exposure and QTB positivity, including that of young children under 5 years of age. However, clinical application of interferon-gamma releasing assay for young children for diagnosis of active and latent tuberculosis will require additional prospective studies.
Child
;
Hospitals, General
;
Humans
;
Interferon-gamma
;
Interferons
;
Latent Tuberculosis
;
Medical Records
;
Retrospective Studies
;
Sensitivity and Specificity
;
Skin Tests
;
Tuberculin
;
Tuberculosis