2.The Evaluation of the Endothelial Cells after Cataract Extraction and IOL Insertion in Patients with Corneal Guttata.
Journal of the Korean Ophthalmological Society 1998;39(10):2272-2279
When the corneal endothelium is injured by intraocular surgery, corneal edema occurs above the threshold level. Preoperative examination of corneal endothelium is valuable in prediction the degree of transparency of the cornea. We conducted this study to elucidate what factors affect corneal endothelial cells in performing the cataract extraction and IOL insertion and what is necessary to minimize the corneal endothelial damage. We performed pacoemulsification and IOL insertion in guttata patients, and preoperative and postoperative endothelial examination was done by using specuar microscope and pachymeter. Although the mean of endothelial cell density was diminished from 1498.7cells/mm2 to 1301cells/mm2 after operation. visible edema was not detected by slit lamp examination and visual acuity was improved from 0.15 to 0.48. The older the patient`s age, the longer the time of phaceemulsification; as the ages of the patients are increased, postoperative corneal thicknesses were increased and postoperative endothelial cell densities were decreased. The endothelial cells were relatively well preserved after cataract operation in patients of preoperative diminished endothelial cells. We suggest that when performing the cataract operation in patients of decreased endothelial function, one must use appropriate large amount of viscoelastic substances, and minimize phacoemulsification power and time in as short operation time as possible by accurate surgical technique. We also believe that periodic postoperative endothelial examination is necessary in patients with decreased endothelial function.
Cataract Extraction*
;
Cataract*
;
Cornea
;
Corneal Edema
;
Edema
;
Endothelial Cells*
;
Endothelium, Corneal
;
Humans
;
Phacoemulsification
;
Viscoelastic Substances
;
Visual Acuity
3.Correlation between Heart Rate Variability and Sleep Structure in Primary Insomnia.
Sang Jin LEE ; Doo Heum PARK ; Jaehak YU ; Seung Ho RYU ; Ji Hyeon HA ; Man Kyoo SONG
Sleep Medicine and Psychophysiology 2010;17(1):21-27
OBJECTIVES: It is well established that primary insomnia affects the activity of autonomic nervous system. We tried to know how the activity of autonomic nervous system during night sleep changes by analyzing correlation between heart rate variability (HRV) index and the variables related with sleep structure in primary insomnia. METHODS: Thirty three subjects (mean age:36.2+/-14.2 years, male:female=15:18) who were diagnosed with primary insomnia were selected for the study. Nocturnal polysomnography (NPSG) was carried out on each subject and correlation was analyzed between high frequency/low frequency ratio (LF/HF ratio), one of HRV indices and the variables related with sleep structure which were calculated from NPSG. RESULTS: When age and sex were controlled, LF/HF ratio showed negative correlations with slow wave sleep and stage 2 sleep, respectively (r(p)=-0.43, p=0.01;r(p)=-0.37, p=0.04). On the other hands LF/HF ratio showed a positive correlation with arousal index (r(p)=0.65, p<0.001). The activity of autonomic nervous system responded differentially depending on the change of sleep structure in primary insomnia. Especially the increase of arousal index and the decrease of slow wave sleep and stage 2 sleep which are the components of non-REM sleep provoked hyperactivity of sympathetic nervous system. CONCLUSION: This study suggests that the typical change of sleep structure in primary insomnia can negatively impact on cardiovascular system.
Arousal
;
Autonomic Nervous System
;
Cardiovascular System
;
Hand
;
Heart
;
Heart Rate
;
Polysomnography
;
Sleep Initiation and Maintenance Disorders
4.The Evaluation of the Influences of the Patient's Characteristics in Performing the Pinpoint Anesthesia.
Journal of the Korean Ophthalmological Society 1998;39(9):2043-2047
Local anesthesias such as retrobulbar anesthesia, peribulbar anesthesia and topical anesthesia are commonly preferred as intraocular surgical anesthesia. We evaluated the efficacy of pinpoint anesthesia described by Hidefaru Fukasaku in 1993. We performed in point anesthesia in 57 cataract patients from March 1995 to May 1995 at Kangnam St, Mary's Hospital. The younger the patients and the higher the education level, the smaller intraocular pressure increase and the better patient's compliance. Pinpoint anesthesia might be substituted with other currently used local ocular anesthesia might be substituted with other currently used local ocular anesthesia when patient's selection is appropriate and it is carried out by the well-trained doctors.
Anesthesia*
;
Anesthesia, Local
;
Cataract
;
Compliance
;
Education
;
Humans
;
Intraocular Pressure
5.Non-obstructive Biliary Dilatation After Gastrectomy for Gastric Carcinoma.
Nak Kwan SUNG ; Ok Dong KIM ; Young Hwan LEE ; Hag Young CHEONG ; Kyoo Hyun OH ; Cheong Man LEE ; Won Hun LEE ; Duk Soo CHEONG
Journal of the Korean Radiological Society 1995;33(6):933-937
PURPOSE: To evaluate the incidence,. degree, and clinical significance of non-obstructive intrahepatic bile duct di'latation encountered on follow up CT after gastrectomy for gastric carcinoma. MATERIALS AND METHODS: We retrospectively analyzed follow-up abdominal CT of 65 patients who had undergone gastrectomy with truncal vagotomy and subtotal gastrectomy for gastric carcinoma. We classified those patients who showed intrahepatic duct dilatation into non-obstructive or obstructive groups depending on the presence or absence of the lesions obstructing the duct. We also evaluated the incidence, degree and pattern, and appearance time of non-obstructive type of duct dilatation. RESULTS: Non-obstructive and obstructive biliary dilatations were present in 8 cases(12.3%) and 9 cases(13. 8%), respectively. The degree of non-obstructive group was mild in 6 cases(75%) and moderate in 2 cases (25%) who had taken cholecystectomy during the follow up period, and patterns were proportional dilatation of the central and peripheral intrahepatic ducts. It appeared on follow up CT obtained 6 to 12 months after operation in 7 cases and 3.5 months in one case. No statistical significance was noted between the type of surgery and the incidence of non-obstructive dilatation(p>0.05). CONCLUSION: Mild dilatation of the central intrahepatic ducts without evidence of mechanical biliary obstruction can be seen on follow-up CT obtained more than 6 months after gastrectomy for gastric carcinoma, and the incidence is about 12%. We think that this finding is non-obstructive and clinical evaluation is unnecessary.
Bile Ducts, Intrahepatic
;
Cholecystectomy
;
Dilatation*
;
Follow-Up Studies
;
Gastrectomy*
;
Humans
;
Incidence
;
Retrospective Studies
;
Tomography, X-Ray Computed
;
Vagotomy, Truncal
6.Extracorporeal Membrane Oxygenation Support in Adult Patients with Hematologic Malignancies and Severe Acute Respiratory Failure.
Tai Sun PARK ; You Na OH ; Sang Bum HONG ; Chae Man LIM ; Younsuck KOH ; Je Hwan LEE ; Jung Hee LEE ; Kyoo Hyung LEE ; Jin Won HUH
Korean Journal of Critical Care Medicine 2016;31(3):243-250
BACKGROUND: Administering extracorporeal membrane oxygenation (ECMO) to critically ill patients with acute respiratory distress syndrome has substantially increased over the last decade, however administering ECMO to patients with hematologic malignancies may carry a particularly high risk. Here, we report the clinical outcomes of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO. METHODS: We performed a retrospective review of the medical records of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO at the medical intensive care unit of a tertiary referral hospital between March 2010 and April 2015. RESULTS: A total of 15 patients (9 men; median age 45 years) with hematologic malignancies and severe acute respiratory failure received ECMO therapy during the study period. The median values of the Acute Physiology and Chronic Health Evaluation II score, Murray Lung Injury Score, and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score were 29, 3.3, and -2, respectively. Seven patients received venovenous ECMO, whereas 8 patients received venoarterial ECMO. The median ECMO duration was 2 days. Successful weaning of ECMO was achieved in 3 patients. Hemorrhage complications developed in 4 patients (1 pulmonary hemorrhage, 1 intracranial hemorrhage, and 2 cases of gastrointestinal bleeding). The longest period of patient survival was 59 days after ECMO initiation. No significant differences in survival were noted between venovenous and venoarterial ECMO groups (10.0 vs. 10.5 days; p = 0.56). CONCLUSIONS: Patients with hematologic malignancies and severe acute respiratory failure demonstrate poor outcomes after ECMO treatment. Careful and appropriate selection of candidates for ECMO in these patients is necessary.
Adult*
;
APACHE
;
Critical Illness
;
Extracorporeal Membrane Oxygenation*
;
Hematologic Neoplasms*
;
Hemorrhage
;
Humans
;
Intensive Care Units
;
Intracranial Hemorrhages
;
Lung Injury
;
Male
;
Medical Records
;
Respiratory Distress Syndrome, Adult
;
Respiratory Insufficiency*
;
Retrospective Studies
;
Tertiary Care Centers
;
Weaning
7.Analysis of Repeated Bone Graft after Secondary Bone Graft in Children with Alveolar Cleft.
Kyung Suck KOH ; Sung Wook LEE ; Jong Woo CHOI ; Young Kyoo LEE ; Soon Man KWOUN
Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(3):273-278
PURPOSE: The most widely accepted protocol for alveolar cleft reconstruction is to repair it during the mixed dentition stage. There were lower resorption rate (about 88%) at this stage. However we found some cases that need repeated bone grafting. Therefore we sought to analyze the cause of repeated alveolar bone grafting in connection with other factors. METHODS: From January 2000 to January 2006, thirty-nine secondary alveolar bone grafts with iliac crest spongiosa were carried out. In 39 patients, 5 patients who had significant bone graft resorption received repeated alveolar bone graft. In all the cases, the causes of repeated bone grafts were dental root exposure(angulation), and the deficiency of the bony support for lateral incisor or canine eruption. In 3 cases, there was deficiency of the alveolar bone at the cleft side. There was the need of repeated bone grafts for orthodontic treatment in 2 cases and for application of dental implants in 1 case. RESULTS: During the follow-up period, the clinical and radiologic examinations showed that repeated alveolar bone grafts were maintained successfully without any complications. The volume of the repeated bone graft was sufficient for orthodontic treatment and implantation. CONCLUSION: The essential conditions for successful alveolar bone grafting includes the status of cleft sided teeth, further treatment and planed schedule, as well as canine eruption. Alveolar bone grafting has to be performed with difference of each case in mind.
Appointments and Schedules
;
Bone Resorption
;
Bone Transplantation
;
Child
;
Dental Implants
;
Dentition, Mixed
;
Follow-Up Studies
;
Humans
;
Incisor
;
Tooth
;
Transplants
8.A Case of Ovarian Cellular Fibroma with Endometriosis.
Dong Hyung LEE ; Jeong Sup YUN ; Sung Kyoo JANG ; Ki Hyung KIM ; Man Soo YOON
Korean Journal of Obstetrics and Gynecology 2001;44(7):1336-1340
Ovarian cellular fibroma is an uncommon benign tumor and accounts for approximately 4% of all ovarian neoplasms. It mimics fibrosarcoma histologically because of its rich cellularity and high number of mitoses. Ovarian cellular fibroma with endometriosis was a rare case. We experienced a case of ovarian cellular fibroma in a 25-year-old woman underwent exploratory laparotomy for huge ovarian enlargement and report the case with brief review of literature.
Adult
;
Endometriosis*
;
Female
;
Fibroma*
;
Fibrosarcoma
;
Humans
;
Laparotomy
;
Mitosis
;
Ovarian Neoplasms
9.A Case of Recurrent Herpes Simplex Virus Disease of a Preterm Infant, Who Needed Continuous Oral Acyclovir Suppressive Therapy.
Sung Seok KIM ; Ki Woong HONG ; Eun Ryoung KIM ; Young Don KIM ; Kyoo Man LEE
Journal of the Korean Pediatric Society 2003;46(9):939-943
Neonatal herpes simplex virus(HSV) infections result in significant morbidity and mortality. Although acyclovir treatment has improved survival, severe neurological sequelae can occur in the majority of survivors. HSV infections limited to the skin, eyes and mouth(SEM) can cause neurologic impairment. A direct correlation exists between the development of neurologic deficits and the frequency of cutaneous HSV recurrences. National Institutes of Allergy and Infectious Diseases(NIAID) Collaborative Antiviral Study Group conducted a phase I/II trial of continuous oral acyclovir therapy for the suppression of cutaneous recurrences. We describe a preterm infant who had two recurrences after neonatal SEM disease had been treated with intravenous acyclovir, and there were no more recurrences after continuous oral acyclovir suppressive therapy for six months. We report this case with a review of related literature.
Academies and Institutes
;
Acyclovir*
;
Herpes Simplex*
;
Humans
;
Hypersensitivity
;
Infant, Newborn
;
Infant, Premature*
;
Mortality
;
Neurologic Manifestations
;
Recurrence
;
Simplexvirus*
;
Skin
;
Survivors
10.EFFECTS OF BONE MORPHOGENETIC PROTEIN ON THE HEALING OF PERIODONTIUM AFTER TOOTH REPLANTATION OF THE RAT.
Ji Sook KIM ; Joon Bong PARK ; Man Sup LEE ; Young Hyuk KWON ; Kyoo Sung CHO
The Journal of the Korean Academy of Periodontology 2002;32(3):501-521
The purpose of this study is to evaluate the influences of the bone morphogenetic protein (BMP) on the healing of periodontal ligament and alveolar bone after replantation of tooth, and to examine the possibility of its clinical application. 45 Sprague Dawley rats weighted about 100 gram were divided into 3 experimental groups by different dose of BMP. All the upper right and left 1st molar were extracted after 5 days feeding of 0.4% beta-aminopropionitrile, and right molar were used as experimental group and left molar were used as control group. The root surface of experimental molar were treated with 25, 50 and 100ng/ml of human recombinant Bone morphogenetic protein-4 (rh-BMP-4) with micropipet, and 1M Sodium hypochloride were used on control root surface. All the experimental animals were sacrificed as 1, 2, 4, 7 and 14 days after autoreplantation of upper 1st molar into their own position. The maxilla were disected included both side of 1st molar. The collected tissue were processed from demineralization to paraffin embeding as usual procedure, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was no significant differences between control and experimental site on 1 and 2 days after replantation of tooth. In the case of 4th days, the evidence of tissue regeneration were observed on experimental site to compare the controls. New osteoid were revealed on high concentration of BMP at 7 days after replantation, and it became more obvious at 14 days. 2. The effect of the rh-BMP-4 coated on root surface was revealed slight influences for the prolifertion of cells of periodontium and tissue regeneration as dose-dependent pattern. 3. Bony ankylosis was observed between alveolar bone and root surface due to the remarkable amount of osteoid formation on the 14 days after replantation of root. In the conclusion, it was suggested that topical application of the rhBMP-4 on the root surface has influence on the periodontal ligament and alveolar bone. The application method of BMP on the root should be designed with calculation of proper concentration.
Aminopropionitrile
;
Animals
;
Ankylosis
;
Bone Morphogenetic Proteins*
;
Humans
;
Maxilla
;
Molar
;
Paraffin
;
Periodontal Ligament
;
Periodontium*
;
Rats*
;
Rats, Sprague-Dawley
;
Regeneration
;
Replantation
;
Sodium
;
Tooth Replantation*
;
Tooth*