1.A Study on Hyperbaric Chambers for Treating Decompression Sickness in the Republic of Korea.
Kang Jin OH ; Seong Woo CHOI ; Jun Sik PARK ; Seng Uk LEE
Journal of the Korean Society of Emergency Medicine 2011;22(3):253-258
PURPOSE: With the recent increase in underwater activity, the number of people at risk for decompression sickness has greatly increased. However, an organized medical system for emergency treatment, evacuation, and hyperbaric oxygen therapy of decompression sickness has not been established yet. We collected information about domestic hyperbaric chambers available for treating decompression sickness. METHODS: We identified 95 hyperbaric chambers in hospitals, hydrospace construction corporations, military, maritime police, 119 rescue services, and other organizations through a telephone survey. We visited the 95 chambers and collected information about location, operating institutes, chamber specifications, and operational status. Twenty-four oxygen capsules were excluded from the study because of inadequate working pressure. RESULTS: Seventy-one hyperbaric chambers available for hyperbaric oxygen therapy were identified among 59 organizations. The hyperbaric chambers were distributed evenly along coastal lines; that is, 21 on the east coast, 26 on the west coast, 21 on the southern coast, and three on Jeju Island. Thirty-eight chambers with maximal working pressure of > or =5 atm could be used for severe decompression sickness and arterial gas embolism treatment. Twenty-nine chambers had a seating capacity equal to-or more than three patients. Twenty-eight chambers had two or more compartments; thus, they could handle complex medical situations. Thirty-eight chambers with medical locks were useful for severe decompression sickness treatment. CONCLUSION: A sufficient number of domestic hyperbaric chambers available for treating decompression sickness were distributed evenly along the coastal lines. However, potential barriers need to be overcome to establish an efficient decompression sickness treatment system.
Academies and Institutes
;
Capsules
;
Decompression
;
Decompression Sickness
;
Diving
;
Embolism, Air
;
Emergency Treatment
;
Humans
;
Hyperbaric Oxygenation
;
Military Personnel
;
Oxygen
;
Police
;
Republic of Korea
;
Telephone
2.Iatrogenic Dural Arteriovenous Fistula after Superficial Temporal Artery to Middle Cerebral Artery Anastomosis: A Case Report.
Seng Won KIM ; Kil Sung CHAE ; Jae Hyon SHIM ; Seung Jin RHO ; Hak Ki CHOI ; Hwa Seung PARK
Korean Journal of Neurotrauma 2015;11(2):151-153
Dural arteriovenous fistulas (AVFs) are uncommon, representing only 10% to 15% of all intracranial AVFs. Here we present the case of a patient with cerebral infarction who experienced a dural AVF after craniotomy for superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery. A 48-year-old man presented with dysarthria and right side hemiparesis. A brain magnetic resonance imaging scan revealed multiple acute infarctions and severe stenosis of the left MCA. Therefore, STA-MCA bypass surgery was performed. A follow-up angiography performed 2 weeks after the surgery showed an abnormal vascular channel from the left middle meningeal artery (MMA) to the middle meningeal vein (MMV) just anterior to the border of the craniotomy margin. This fistula originated from a screw used for cranial fixation. The screw injured the MMA and MMV, and this resulted in the formation of a fistula. The fistula was successfully treated with transarterial embolization. Surgeons should be careful when fixing bones with screws and plates as fistulas can develop if vessels are injured.
Angiography
;
Brain
;
Central Nervous System Vascular Malformations*
;
Cerebral Infarction
;
Cerebral Revascularization
;
Constriction, Pathologic
;
Craniotomy
;
Dysarthria
;
Fistula
;
Follow-Up Studies
;
Humans
;
Infarction
;
Magnetic Resonance Imaging
;
Meningeal Arteries
;
Middle Aged
;
Middle Cerebral Artery*
;
Paresis
;
Temporal Arteries*
;
Veins
3.Comparison of Psychological Characteristics of Lesch Types 2 (Anxiety Model) and 3 (Depressive Model) Alcoholism
Sae Heon JANG ; Min Ho CHANG ; Young Myo JAE ; Jin Hyuk CHOI ; Gyeong Hwan LEE
Mood and Emotion 2019;17(2):49-56
BACKGROUND: Lesch types 2 (L2, anxiety model) and 3 (L3, depressive model) of alcoholism exhibit different responses to anti-craving agents, and most treatment guidelines provide differential treatment strategies for bipolar depression (DEP) and unipolar DEP. We compare the psychological characteristics of L2 and L3 alcoholism and between the unipolar and bipolar subgroups.METHODS: We reviewed medical records of patients who were diagnosed with alcohol use disorder using the DSM-5 diagnostic criteria and classified as L2 and L3 using Lesch Alcohol typology software. All patients completed self-report scales (Alcohol Use Disorders Identification Test [AUDIT], Beck Anxiety Inventory [BAI], Beck Depression Inventory-II [BDI-II], and Korean Symptom Checklist-95 [KSCL95]). The data were analyzed using descriptive statistics, the Wilcoxon Rank-Sum test, and ANOVA.RESULTS: Of the 43 patients, 23 were assigned L2, and 20 were assigned L3. The scores for the KSCL95 subscales fell generally in the increasing order of the L2-unipolar (L2U, n=10), L2-bipolar (L2B, n=13), L3-unipolar (L3U, n=11), and L3-bipolar (L3B, n=9) types. The L3B scores were greater than the L3U scores for most KSCL95 subscales, by contrast with the DEP and BAI scores.CONCLUSION: We found psychological differences between L2 and L3 and identified the unique psychological characteristics for each subgroup by polarity. The psychological characteristics of these subgroups of alcohol use disorder may help improve the treatment success rates through individualized treatment strategies.
Alcoholism
;
Anxiety
;
Bipolar Disorder
;
Depression
;
Depressive Disorder
;
Humans
;
Medical Records
;
Weights and Measures
4.A Study of Factors Influencing Subjective Memory Complaints among Community Dwelling Elderly.
Ui Sub LEE ; Young Myo JAE ; Sae Heon JANG ; Jin Hyuk CHOI ; Kyoung Hwan LEE
Journal of Korean Geriatric Psychiatry 2018;22(1):19-24
OBJECTIVE: We examined the factors influencing subjective memory complaints among community dwelling elderly in urban area. METHODS: The subjects of this research were 160 community-dwelling elderly people without dementia and major depressive disorder. The questionnaires regarding the socio-demographic characteristics were conducted by each person. They include Korean version of Subjective Memory Complaints Questionnaires (SMCQ), Korean version of Short Geriatric Depression Scale (SGDS-K) and Korean version of Mini-Mental State Examination (K-MMSE). Subjective memory complaints were defined as above 4 points of SMCQ. RESULTS: 39.38% of the subjects had subjective memory complaints. There were significant associations between subjective memory complaints and SGDS-K (p < 0.001), physical illness (p=0.001), but there was no association with K-MMSE (p=0.383). CONCLUSION: There is a discrepancy between subjective memory complaints and actual cognitive impairments. This discrepancy suggests that the depressive disorders including minor depressive disorder and subsyndromal depression, might play a role in the subjective memory complaints rather than actual cognitive impairments in community-dwelling elderly people. Therefore, the treatments for the depressive disorders should be considered in dealing with the subjective memory complaints.
Aged*
;
Cognition Disorders
;
Dementia
;
Depression
;
Depressive Disorder
;
Depressive Disorder, Major
;
Humans
;
Independent Living*
;
Memory*
5.Development and Validation of the Radiology Common Data Model (R-CDM) for the International Standardization of Medical Imaging Data
ChulHyoung PARK ; Seng Chan YOU ; Hokyun JEON ; Chang Won JEONG ; Jin Wook CHOI ; Rae Woong PARK
Yonsei Medical Journal 2022;63(S1):74-83
Purpose:
Digital Imaging and Communications in Medicine (DICOM), a standard file format for medical imaging data, contains metadata describing each file. However, metadata are often incomplete, and there is no standardized format for recording metadata, leading to inefficiency during the metadata-based data retrieval process. Here, we propose a novel standardization method for DICOM metadata termed the Radiology Common Data Model (R-CDM).
Materials and Methods:
R-CDM was designed to be compatible with Health Level Seven International (HL7)/Fast Healthcare Interoperability Resources (FHIR) and linked with the Observational Medical Outcomes Partnership (OMOP)-CDM to achieve a seamless link between clinical data and medical imaging data. The terminology system was standardized using the RadLex playbook, a comprehensive lexicon of radiology. As a proof of concept, the R-CDM conversion process was conducted with 41.7 TB of data from the Ajou University Hospital. The R-CDM database visualizer was developed to visualize the main characteristics of the R-CDM database.
Results:
Information from 2801360 cases and 87203226 DICOM files was organized into two tables constituting the R-CDM. Information on imaging device and image resolution was recorded with more than 99.9% accuracy. Furthermore, OMOP-CDM and RCDM were linked to efficiently extract specific types of images from specific patient cohorts.
Conclusion
R-CDM standardizes the structure and terminology for recording medical imaging data to eliminate incomplete and unstandardized information. Successful standardization was achieved by the extract, transform, and load process and image classifier. We hope that the R-CDM will contribute to deep learning research in the medical imaging field by enabling the securement of large-scale medical imaging data from multinational institutions.
6.A Case of a Gastric Submucosal Lymphatic Cyst Associated with Early Gastric Cancer.
Kwang Jin JEONG ; Yong Kun KIM ; Geon Jo LIM ; Dae Hyun CHOI ; Jin Do KIM ; Ju Hong LEE ; Dae Yong KOO ; Sang Ik SUH ; Kyong Yoon LEE ; Il Son LEE
Korean Journal of Gastrointestinal Endoscopy 2000;20(6):468-471
A lymphatic cyst of the stomach is rare benign tumor which is composed of thin-walled lymphatic space lined by benign-appearing endothelial cells. It rarely manifests clinical symptoms, so it is found incidentally in most cases. Recently, a case of submucosal lymphatic cyst associated with early gastric cancer was experienced. An endoscopy revealed a slightly elevated, edematous lesion adjacent to the malignant ulcer. This case is herein reported with a brief review of related literature.
Endoscopy
;
Endothelial Cells
;
Lymphocele*
;
Stomach
;
Stomach Neoplasms*
;
Ulcer
7.Rituximab and Plasmapheresis for Post-transplant Recurrence of FSGS.
Ju Yeon NAM ; An Sook CHOI ; Su Jin KIM ; Byoung Hoon JI ; Joon Suk OH ; Young Ki SON ; Yong Hun SIN ; Joong Kyung KIM ; Yong Jin KIM
Korean Journal of Nephrology 2010;29(2):292-295
Focal segmental glomerular sclerosis (FSGS) is known to recur in 20-40% of the renal allografts with graft loss in about half of these cases. We report a successful treatment of a recurrent FSGS after kidney transplantation with rituximab and plasmapheresis. An 16-year-old patient whose primary kidney disease was FSGS developed recurrence of proteinuria after living donor kidney transplantation despite preemptive plasmapheresis and one dose of rituximab (375 mg/m2). After kidney transplantation, nephrotic range proteinuria was detected. Kidney biopsy was done and showed recurrent FSGS. She undergone 11 times of plasmapheresis in the first 4 week post transplantation. In addition, she received additional one dose of rituximab (375 mg/m2) on day 14. Proteinuria was decreased below nephrotic range at 37 day. Ten months later, proteinuria was at 30 mg/day with excellent graft function. No significant adverse events related to rituximab or plasmapheresis were observed. Rituximab with plasmapheresis may be another option for recurrent FSGS after kidney transplantation.
Adolescent
;
Antibodies, Monoclonal, Murine-Derived
;
Biopsy
;
Glomerulosclerosis, Focal Segmental
;
Humans
;
Kidney
;
Kidney Diseases
;
Kidney Transplantation
;
Living Donors
;
Plasmapheresis
;
Proteinuria
;
Recurrence
;
Sclerosis
;
Transplantation, Homologous
;
Transplants
;
Rituximab
8.Comparison of the Urine Protein to Creatinine Ratio with 24-Hour Urinary Protein Amounts in Patients with Kidney Transplants.
Su Jin KIM ; An Sook CHOI ; Jin Ho LEE ; Seong Min YU ; Joon Seok OH ; Sung Min KIM ; Yong Hun SIN ; Joong Kyung KIM
Korean Journal of Medicine 2011;81(1):82-88
BACKGROUND/AIMS: Many studies have reported the correlation between the spot urine protein to creatinine (P/C) ratio and 24-hour urinary protein amounts in patients with glomerulonephritis. This correlation has also been reported in Western patients with kidney transplants, but no prior study has reported on this association in Eastern populations. We compare the correlation between the spot urine P/C ratio and 24-hour urinary protein amounts and the associating factors in Korean patients with kidney transplants. METHODS: The study included 66 patients with kidney transplants from our hospital. The subjects had urine samples evaluated between January 2005 and July 2010. We compared 24-hour urinary protein amounts with a spot urine P/C ratio collected in the morning and analyzed the factors affecting the correlation in each group. RESULTS: The 24-hour urinary protein amounts were 1.31 +/- 1.69 g/day and the spot urine P/C ratio was 1.29 +/- 1.70 in all subjects. A strong positive linear correlation was observed between the 24-hour urinary protein amounts and the spot urine P/C ratio (r = 0.95). The primary factor affecting accurate quantitation of proteinuria using the spot urine P/C ratio was gender (p = 0.003). The spot urine P/C ratio and the 24-hour urinary protein levels were 1.05 +/- 1.51 and 1.26 +/- 1.68 g/day in males (p = 0.005) and 1.57 +/- 1.88 and 1.36 +/- 1.72 g/day in females (p = 0.047), respectively. CONCLUSIONS: We determined that the spot urine P/C ratio provides an accurate estimate of 24-hour urinary protein levels in Korean patients with kidney transplants.
Creatinine
;
Female
;
Glomerulonephritis
;
Humans
;
Kidney
;
Kidney Transplantation
;
Male
;
Proteinuria
;
Transplants
9.The Report of the Epidemiology of Measles which Prevailed in the Kyungi-Incheon Districts from July, 1993 & June, 1994.
Sang Uk MOON ; Sung Dong CHOI ; Seng Yeon JUNG ; Byung Kyu SEO ; Won Bae LEE ; Jin Han KANG ; Kyung Soo LEE
Journal of the Korean Pediatric Society 1996;39(10):1378-1384
PURPOSE: As a result of the development and the supply of vaccination, the epochal progress in vaccination against measles has been made. Nevertheless measles intermittent prevalence throughout the world was reported and measles prevailed throughout country in 1993 & 1994. So, we studied the epidemics of measles which prevailed in the Kyungi-Incheon districts and then evaluated the effects of the present vaccination indirectly and estimated the necessity of booster vaccination in addition to initial and second vaccination. METHODS: This study was based on the questionnaires to 233 patient who were diagnosed as measles in Holy Family Hospital and Our Lady Of Mercy Hospital from July, 1993 to June, 1994. RESULTS: 1) The incidence peaked in Jan(24.0%) and April(23.2%). 2) In sex distribution, we could not find any difference between boys(116 case) and girls(117 case). 3) The age distribution showed that the children between 0 and 12 month of age were 81 cases(34.8%), the children between 13 and 24 month of age 28 cases(12.0%), 8 year old children 21 cases(9.0%), 6 year old children 18 cases(7.7%), 7 year old children 16 cases(6.9%) and 9 year old children 14 cases(6.0%). 4) 6 month age group with one-dose schedule of vaccination was 2 cases. 9 month age group with one-dose schedule of vaccination was 14 cases and their outbreak age was 4.1+/-3.3 years old. 12 month age group with one-dose schedule of vaccination was 1 case. 15 month age group with one-dose schedule of vaccination was 48 cases and their outbreak age was 7.8+/-2.9 years old. Age group with two-dose schedule of vaccination was 51 cases and their outbreak age was 7.3+/-2.9 years old. Therefore, trimed mean age of 15 month age group with one-dose schedule was 7.8+/-2.0 years old and their 99% confidence interval was 7.0~9.2 years old. Trimed mean age of two-dose schedule age group was 8.3+/-2.0 years old and their 99% confidence interval was 7.6~9.2 years old. 5) Among the siblings(n=236) of subjects 224 cases were vaccinated and among vaccinated children 18 cases infected(8.0%). 6) There were no reinfected subjects. CONCLUSIONS: 15 months age group with one-dose schedule and two-dose schedule group showed similar outbreak age. In the case that measles prevails, the proper time for vaccination seems to be at or earlier than 6 months of age and the booster dose should also be considered at age 6.
Age Distribution
;
Appointments and Schedules
;
Child
;
Epidemiology*
;
Humans
;
Incidence
;
Measles*
;
Prevalence
;
Surveys and Questionnaires
;
Sex Distribution
;
Vaccination
10.A Case of Reversible Posterior Leukoencephalopathy Syndrome in a Patient with ABO Incompatible Kidney Transplantation.
Jong In KIM ; An Sook CHOI ; Su Jin KIM ; Byoung Hoon JI ; Joon Seok OH ; Young Ki SON ; Yong Hun SHIN ; Joong Kyung KIM
Korean Journal of Nephrology 2010;29(2):305-309
Reversible posterior leukoencepalopathy syndrome (RPLS) was noted by a reversible syndrome of headache, altered mental status, seizure, and visual loss associated with findings indicating predominantly posterior leukoencephalopathy on imaging studies. We report a successful treatment of RPLS after secondary ABO incompatibility kidney transplantation with blood pressure control. A 41-year-old female whose primary kidney disease was chronic glomerulonephritis had graft failure developed after living donor kidney transplantation (1st kidney transplantation). She was admitted to our hospital for 2nd ABO incompatibility kidney transplantation. She had undergone 6 times of plasmapheresis and received additional two doses of rituximab (375 mg/m2) and intravenous immunoglobulin (0.5 g/kg) before kidney transplantation. She received basiliximab induction therapy, tacrolimus, steroid and mycophenolate mofetile after transplantation. The ABO antibody titer had been low (below 1:1) and evidences of rejection were not detected. Generalized tonic clonic type seizure, eyeball deviation, facial cyanotic change and loss of consciousness occurred at post operation 7th day. Several minutes later, she recovered her consciousness without disability and neurologic deficit. She did not represent attacks any more after we controlled blood pressure without withdrawal of immunosuppressants or dose reduction.
Adult
;
Antibodies, Monoclonal
;
Antibodies, Monoclonal, Murine-Derived
;
Blood Pressure
;
Consciousness
;
Female
;
Glomerulonephritis
;
Headache
;
Humans
;
Immunoglobulins
;
Immunosuppressive Agents
;
Kidney
;
Kidney Diseases
;
Kidney Transplantation
;
Leukoencephalopathies
;
Living Donors
;
Neurologic Manifestations
;
Plasmapheresis
;
Posterior Leukoencephalopathy Syndrome
;
Recombinant Fusion Proteins
;
Rejection (Psychology)
;
Seizures
;
Tacrolimus
;
Transplants
;
Unconsciousness
;
Rituximab