1.Arthroscopy for Rotational Ankle Fractures
Tae Hun KWON ; Yoon Hyo CHOI ; Kyoung Min LEE
Journal of Korean Foot and Ankle Society 2023;27(1):7-11
Rotational ankle fractures are one of the most common injuries of lower limbs treated by orthopedic surgeons. Open reduction and internal fixation (ORIF) is considered a gold standard treatment for unstable ankle fractures, though adjunct ankle arthroscopy is being increasingly used in cases of ankle trauma. Although the role and use of ankle arthroscopy are expanding, the clinical outcomes and cost-effectiveness of arthroscopy remain undefined. Furthermore, despite the number of clinical research studies performed on arthroscopically assisted surgery for ankle fractures, no definite guidelines have been agreed, and no consensus has been reached regarding indications. This article reviews the role, indications, operative techniques, and complications of ankle arthroscopy and compares the clinical outcomes of conventional ORIF and arthroscopically assisted ORIF.
2.Anesthetic Management of Premature Infant with Severe Respiratory Distress Syndrome Who Underwent Surgical Closure of Patent Ductus Arteriosus: A case report.
Jae Hun CHO ; Jin Seok YEO ; Won Kyoung KWON ; Duck Kyoung KIM ; Hae Kyoung KIM ; Kyoung Min LEE
Korean Journal of Anesthesiology 2006;51(4):495-498
Premature infants with respiratory distress syndrome may have clinically significant shunting through a patent ductus arteriosus (PDA). Left-to-right shunting through the PDA may lead to left ventricular volume overload and pulmonary edema. We present a case of perioperative management for severe respiratory distress syndrome in a premature infant who underwent surgical closure of PDA. Under general anesthesia, the infant was successfully managed by inhaled nitric oxide, high frequency oscillation ventilation with intermittent mandatory ventilation despite intermittent hypoxia. The operation was performed safely in the neonatal intensive care unit.
Anesthesia, General
;
Anoxia
;
Ductus Arteriosus, Patent*
;
High-Frequency Ventilation
;
Humans
;
Infant
;
Infant, Newborn
;
Infant, Premature*
;
Intensive Care, Neonatal
;
Nitric Oxide
;
Pulmonary Edema
;
Ventilation
3.Changes of Transepidermal Water Loss (TEWL) in Psoriatic Plaques during D-PUVA Therapy.
Dae Hun SUH ; Tae Eun KWON ; Sang Duck KIM ; Seok Bum PARK ; Oh Sang KWON ; Kyu Han KIM ; Kyoung Chan PARK
Annals of Dermatology 2001;13(1):7-11
BACKGROUND: Psoriatic lesions have reduced water-holding capacity and show increased transepidermal water loss (TEWL). The effect of D-PUVA therapy, which combines topical calcipotriol and PUVA therapy, on epidermal barrier function has not yet been evaluated. OBJECTIVE: The purpose of this study was to verify the change of TEWL in lesional and normal skin according to D-PUVA therapy in psoriasis patients. METHODS: TEWL was measured consecutively by TEWAMETER TM210®, in 13 psoriasis patients who received D-PUVA therapy. Clinical grading was done according to psoriasis severity index (PSI). RESULTS: TEWL of psoriatic lesion decreased as D-PUVA continued. TEWL of normal-looking skin gradually increased, although the increase was trivial. Clinical grading of scale and in-filtration followed the pattern of PSI in the decrease of TEWL, while that of erythema did not. CONCLUSION: In psoriatic plaques, TEWL was decreased according to the improvement. In normal-looking skin, D-PUVA therapy caused only a little effect on TEWL.
Erythema
;
Humans
;
Psoriasis
;
PUVA Therapy
;
Skin
;
Water*
4.Measurement of Skin Elastic Properities in Normal Korean Individuals.
Dae Hun SUH ; Tae Eun KWON ; Oh Sang KWON ; Kyoung Chan PARK ; Kwang Hyun CHO ; Hee Chul EUN
Korean Journal of Dermatology 1999;37(9):1296-1304
BACKGROUND: The elastic properties of skin may be useful indicators of cutaneous diseases and skin aging. OBJECTIVE: The purpose of this study is to obtain the normal range of skin elastic properties according to anatomical sites in normal Korean individuals and to show the differences among them. METHODS: Eleven different anatomical sites were measured in 41 healthy volunteers (20 males and 21 females) with a measuring device, Dermaflex-A . Tensile distensibility(TD), elasticity(E), and hysteresis(H) were recorded. RESULTS: TD was decreased in the distal portions (e.g. 2.30 +/- 0.35 in the arm vs 1.62 +/- 0.30 in the palm in males) and in the sites where the subcutaneous tissue was thin (e.g. 3.08 +/- 0.60 in the abdomen vs 1.20 +/- 0.44 in the medial malleolus in males). E was also decreased in the distal portions (e.g. 82.3 +/- 8.5 in arm vs 51.2 +/- 11.1 in the palm in males) and in the sites where the subcutaneous tissue was thin (e.g. 89.3 +/- 8.3 in the abdomen vs 58.8 +/- 13.8 in the medial melleolus in males). In contrast, H had greater individual variations and it showed no definite tendency according to sites. TD and E were generally greater in males than in females, and there were some significant differences between sexes according to sites. CONCLUSION: Cutaneous elastic properties varied according to anatomical sites and sexes. This feature must be considered in future studies measuring elastic properties, such as aging experiments.
Abdomen
;
Aging
;
Arm
;
Elasticity
;
Female
;
Healthy Volunteers
;
Humans
;
Male
;
Reference Values
;
Skin Aging
;
Skin*
;
Subcutaneous Tissue
5.Isolation and Characterization of Avian Metapneumovirus from Broiler Breeder Chickens in Korea.
Kang Seuk CHOI ; Woo Jin JEON ; Mi Ja PARK ; Eun Kyoung LEE ; Jun Hun KWON
Journal of Bacteriology and Virology 2009;39(4):373-382
Avian metapneumovirus (AMPV) is an emerging pathogen causing respiratory and reproductive illness in poultry worldwide. To demonstrate the presence of AMPV in domestic chickens in Korea, we attempted to isolate AMPV from affected chickens. A cytopathic agent was isolated using chicken tracheal ring culture from dead chickens from a broiler breeder farm with reduced egg production in Korea. This agent, termed SC1509 strain, subsequently passed in Vero cells with distinct cytopathic effects. The SC1509 strain was confirmed as avian metapneumovirus (AMPV) using both RT-PCR test and monoclonal antibody-based immunofluorescence assay. Sequence analysis based on the G glycoprotein revealed that the SC1509 strain had 22.5 to 96.0% nucleotide sequence identity and 11.1 to 92.7% predicted amino acid sequence identity with previously published AMPV strains, particularly with the highest sequence homology (95.8 to 96% for nucleotides and 92.2 to 92.7% for amino acids) to European strains belonging to genotype B. The SC1509 strain was phylogenetically clustered with genotype B viruses, confirming that the SC1509 strain belongs to genotype B. This is the first report of genotype B avian metapneumovirus from chickens in Korea.
Amino Acid Sequence
;
Base Sequence
;
Chickens
;
Fluorescent Antibody Technique
;
Genotype
;
Glycoproteins
;
GTP-Binding Proteins
;
Herpesvirus 1, Cercopithecine
;
Korea
;
Metapneumovirus
;
Nucleotides
;
Ovum
;
Poultry
;
Sequence Analysis
;
Sequence Homology
;
Sprains and Strains
;
Vero Cells
6.The Case-Control Study on the Risk Factors of Cerebrovascular Diseases and Coronary heart Diseases.
Jong Ku PARK ; Hun Joo KIM ; Keum Soo PARK ; Sung Su LEE ; Sei Jin CHANG ; Kye Chul SHIN ; Sang Ok KWON ; Sang Baek KO ; Eun kyoung LEE
Korean Journal of Preventive Medicine 1996;29(3):639-656
Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group(RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of menarch, and prothrombin time. The factor whose level was higher in AMI than in RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAH than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAH and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age uric aci, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.
Adult
;
Blood Glucose
;
Body Mass Index
;
Case-Control Studies*
;
Cause of Death
;
Cholesterol
;
Coronary Disease*
;
Discrimination (Psychology)
;
Education
;
Gangwon-do
;
Hematocrit
;
Humans
;
Inpatients
;
Korea
;
Leukocyte Count
;
Prothrombin Time
;
Risk Factors*
;
Stroke
;
Triglycerides
;
Uric Acid
7.The optimal concentration of remifentanil required for i-gel insertion in patients with simulated difficult airways.
Woo Jae JEON ; Sang Yun CHO ; Kyoung Hun KIM ; Yong Deok KWON
Anesthesia and Pain Medicine 2014;9(4):258-262
BACKGROUND: Because difficult airways are not commonly encountered, simulation of a difficult airway using a cervical collar has become a well-established technique of for modeling difficult laryngoscopic views and evaluating interventions for use in difficult airway scenarios. In this study, we have determined the optimal remifentanil concentrations (EC50 and EC95) required for i-gel insertion in anesthetized patients fitted with cervical collars at propofol effect-site concentrations of 4.0 and 6.0 microg/ml (group 4.0 and group 6.0). METHODS: The remifentanil dosage for each propofol effect-site concentration group was determined by the modified Dixon's up-and-down method using previous results. The experiment was started using a 4.0 ng/ml effect-site remifentanil concentration, and the dose was reduced by 0.5 ng/ml for the next attempt when tube insertion was successful; if tube insertion failed, the dose for the next attempt was increased by 0.5 ng/ml. RESULTS: EC50 and EC95 were respectively 2.11 ng/ml (95% CI, 1.78-2.26 ng/ml) and 2.44 ng/ml (95% CI, 2.28-3.67 ng/ml) for the 4.0 group, and 0.42 ng/ml (95% CI, -1.30 to 0.77 ng/ml) and 0.75 ng/ml (0.56-14.3 ng/ml) for the 6.0 group. CONCLUSIONS: In this study, a cervical collar was attached and head fixation was performed to induce a difficult airway. The optimal concentration of remifentanil at a propofol effect-site concentration of 4.0 microg/ml was greater than 2.44 ng/ml (95% CI, 2.28-3.67 ng/ml), and that at the propofol effect-site concentration of 6.0 microg/ml was greater than 0.75 ng/ml (0.56-14.3 ng/ml).
Head
;
Humans
;
Propofol
8.Relationship between the Maternal-Fetal Complications and the Severity of HELLP Syndrome, Classified based on Maternal Platelet Count Nadir.
Man Chul PARK ; Seung Hun LEE ; Jun Young IM ; Hyun Jun KIM ; Kyoung Soon KWON ; Choong Hak PARK
Korean Journal of Obstetrics and Gynecology 2004;47(3):523-530
OBJECTIVE: To determine the incidence of HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome and assess the relationship between the maternal-fetal complications and the severity of HELLP syndrome, classified based on platelet count nadir. METHODS: We reviewed the maternal and neonatal charts of ten pregnancies complicated by HELLP syndrome, managed at Dankook University Hospital between January, 1995 and December, 2002. Women were divided into 2 groups as class I HELLP which had a maternal platelet nadir
Alanine Transaminase
;
Aspartate Aminotransferases
;
Birth Weight
;
Blood Platelets*
;
Eclampsia
;
Female
;
Gestational Age
;
HELLP Syndrome*
;
Humans
;
Incidence
;
L-Lactate Dehydrogenase
;
Liver
;
Platelet Count*
;
Pre-Eclampsia
;
Pregnancy
;
Uric Acid
9.Comparison of the Indocyanine Green Clearance Test Using Conventional Blood Sampling and Finger Monitoring Methods.
Sinyoung KIM ; Rojin PARK ; Kyoung Ryul LEE ; Jeong Ho KIM ; Oh Hun KWON
The Korean Journal of Laboratory Medicine 2003;23(2):88-91
BACKGROUND: The indocyanine green (ICG) finger monitoring method is a newly developed noninvasive method for the ICG clearance test. This study was performed to determine its clinical usefulness compared with the conventional blood sampling method. METHODS: The ICG clearance test was performed on 270 patients using both the conventional blood sampling method and the finger monitoring method simultaneously. The plasma disappearance rate of the ICG and the 15-minute retention ratio (ICG R15) were analyzed and compared with the conventional blood sampling method. RESULTS: The plasma disappearance rate using the finger monitoring method was slightly lower than that of the conventional blood sampling method with good correlation (r=0.840, P<0.001). ICG R15 using finger monitoring method was slightly higher than that of the conventional blood sampling method with good correlation (r=0.839, P<0.001). CONCLUSIONS: As there was a good correlation between the conventional blood sampling method and the finger monitoring method, the latter method seemed to be clinically useful due to its convenience and accuracy.
Fingers*
;
Humans
;
Indocyanine Green*
;
Plasma
10.Appropriateness of Age-based Formula to Determine Endotracheal Tube Size in Korean Children.
Kyoung Ok KIM ; Young Min LEE ; Jun Kwon CHOI ; Hun CHO
Korean Journal of Anesthesiology 2007;52(3):275-277
BACKGROUND: Age-based formulae have been widely used to predict appropriate size of the endotracheal tube (ETT) in children. The objective of this study was to evaluate the effectiveness of formula (internal diameter (ID) (mm) = [age in years + 16]/4) in Korean children. METHODS: Ninety children under 8 years who required intubation with the regular uncuffed ETT were included in the study. Appropriate sizes were to permit a gas leak at 10-25 cmH2O with positive pressure ventilation. Initial intubation was tried with predetermined size and ETT was adjusted to meet this guideline. RESULTS: A range of three tubes around the predicted tube size covered 79 cases (88%), whereas one size predicted by the formula applied to only 29 cases (32%). The selection of ETT which is 0.5 mm larger than the predicted size could allow appropriate intubation in 41 (45.6%) patients. CONCLUSIONS: The age-based formula (ID (mm) = [age in years + 16]/4) could predict the appropriate tube size in less than one third our patients. Therefore, we recommend three sizes be available before endotracheal intubation.
Child*
;
Humans
;
Intubation
;
Intubation, Intratracheal
;
Positive-Pressure Respiration