1.The Importance of Initial Mechanical Ventilation Mode in Acute Respiratory Failure: Risk Factors for the Development of Cardiac Arrhythmias.
Young Ju LEE ; Won KIM ; Young Deuk KIM ; Seok Cheon CHEON ; Kyoung Soo LIM
Journal of the Korean Society of Emergency Medicine 2000;11(4):539-545
BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac*
;
Arterial Pressure
;
Heart
;
Heart Rate
;
Humans
;
Hydrogen-Ion Concentration
;
Multivariate Analysis
;
Respiration, Artificial*
;
Respiratory Insufficiency*
;
Risk Factors*
;
Ventilation
;
Ventilators, Mechanical
2.Schwannoma on the Lateral Side of the Proximal Thigh
Jae-Cheon SIM ; Sang-Won PARK ; Tae-Jong JEONG ; Tae-Seok NAM
The Journal of the Korean Orthopaedic Association 2025;60(1):56-61
A schwannoma is a benign soft tissue tumor derived from Schwann cells of the nerve sheath. The lateral femoral cutaneous nerve is a sensory nerve originating from the second and third lumbar vertebra nerve roots, passing under the inguinal ligament and dividing into anterior and posterior branches. The anterior branch which is a major division and the main nerve that causes meralgia paresthetica supplies the knee joint from the anterior thigh. In addition, the posterior branch supplies the lateral thigh at the greater trochanter level.This paper reports the case of a 52-year-old woman with a very rare schwannoma in the terminal twig of posterior branch of the lateral femoral cutaneous nerve of right thigh protruded through the fascia lata with literatures review.
3.Schwannoma on the Lateral Side of the Proximal Thigh
Jae-Cheon SIM ; Sang-Won PARK ; Tae-Jong JEONG ; Tae-Seok NAM
The Journal of the Korean Orthopaedic Association 2025;60(1):56-61
A schwannoma is a benign soft tissue tumor derived from Schwann cells of the nerve sheath. The lateral femoral cutaneous nerve is a sensory nerve originating from the second and third lumbar vertebra nerve roots, passing under the inguinal ligament and dividing into anterior and posterior branches. The anterior branch which is a major division and the main nerve that causes meralgia paresthetica supplies the knee joint from the anterior thigh. In addition, the posterior branch supplies the lateral thigh at the greater trochanter level.This paper reports the case of a 52-year-old woman with a very rare schwannoma in the terminal twig of posterior branch of the lateral femoral cutaneous nerve of right thigh protruded through the fascia lata with literatures review.
4.Schwannoma on the Lateral Side of the Proximal Thigh
Jae-Cheon SIM ; Sang-Won PARK ; Tae-Jong JEONG ; Tae-Seok NAM
The Journal of the Korean Orthopaedic Association 2025;60(1):56-61
A schwannoma is a benign soft tissue tumor derived from Schwann cells of the nerve sheath. The lateral femoral cutaneous nerve is a sensory nerve originating from the second and third lumbar vertebra nerve roots, passing under the inguinal ligament and dividing into anterior and posterior branches. The anterior branch which is a major division and the main nerve that causes meralgia paresthetica supplies the knee joint from the anterior thigh. In addition, the posterior branch supplies the lateral thigh at the greater trochanter level.This paper reports the case of a 52-year-old woman with a very rare schwannoma in the terminal twig of posterior branch of the lateral femoral cutaneous nerve of right thigh protruded through the fascia lata with literatures review.
5.Amylase-Producing IgG Kappa Type Multiple Myeloma.
Kyoung Cheon KIM ; Hong Seok LEE ; Yong Seok JANG ; Won Sik LEE ; Hong Suk SON
Korean Journal of Hematology 2002;37(2):158-160
Amylase-producing multiple myeloma is a rare disorder and has poor prognosis. Its characteristics are elevation of salivary type amylase, extensive extramedullary spread, extensive bone destruction, shorter survival time, and abnormal karyotype. Recently, we have experienced a case of amylase-producing IgG kappa type multiple myeloma in a 63-year-old woman. On admission, serum and urine amylase was 8,450U/L and 169,710U/L, 85% and 86% of which was determined to be the salivary type, respectively. The other cause of hyperamylasemia had not been detected. The presence of immunoglobulin and amylase in the myeloma cells was demonstrated immunohistochemically. Bone marrow aspiration smear revealed 59.1% plasma cells. The cytogenetic study of bone marrow cell showed normal karyotype. The patient died 3 months after chemotherapy with melphalan and prednisolone.
Abnormal Karyotype
;
Amylases
;
Bone Marrow
;
Bone Marrow Cells
;
Cytogenetics
;
Drug Therapy
;
Female
;
Humans
;
Hyperamylasemia
;
Immunoglobulin G*
;
Immunoglobulins
;
Karyotype
;
Melphalan
;
Middle Aged
;
Multiple Myeloma*
;
Plasma Cells
;
Prednisolone
;
Prognosis
6.Hemoptysis: Comparison of High-resolution CT with Fiberoptic Bronchoscopy.
Won Jin MOON ; Yo Won CHOI ; Seok Chol JEON ; Jae Cheon OH ; Heung Suk SEO ; Chang Kok HAHM ; Choong Ki PARK
Journal of the Korean Radiological Society 1997;37(5):839-844
PURPOSE: To compare the precise roles of high-resolution computed tomography (HRCT) and fiberoptic bronchoscopy (FOB) in the evaluation of patients presenting with hemoptysis and to determine the optimal timing for HRCT. MATERIALS AND METHODS: The results of HRCT and FOB were compared in 23 patients (15 men, 8 women) presenting with hemoptysis. Etiologies included bronchietasis (n=4), parenchymal pulmonary tuberculosis (n=4), lung cancer (n=4), endobronchial tuberculosis (n=2), and broncholithiasis (n=2). Hemoptysis was proved to be due to miscellaneous causes in an additional three cases and to be cryptogenic in four. The diagnostic results of FOB performed before and after HRCT were compared as were those of HRCT performed within and after the first 48 hours of active bleeding. RESULTS: FOB and HRCT offered a correct diagnosis in 39% and 65% of cases, respectively (p=0.005). HRCT demonstrated three cases of bronchiectasis and three of parenchymal pulmonary tuberculosis which were beyond the range of a bronchoscope. In two of five cases in which HRCT findings were nonspecific, chondromatous hamartoma and lung cancer were confirmed by FOB. In cases where HRCT was performed prior to FOB, the latter demonstrated the location and diagnosis in 82% and 47% of cases, respectively (p=0.303) ; when HRCT was performed after FOB, HRCT was correct in 67% and 17% of cases, respectively (p=0.178). In none of three cases (0%) in which HRCT was performed during the first 48 hours of active bleeding did the procedure allow a specific diagnosis. In 15 of 20 (75%) cases in which HRCT was performed after the first 48 hours, however, the diagnosis provided by CT was correct. CONCLUSION: The results of this study suggest that in patients presenting with hemoptysis, both HRCT and FOB should be used for evaluation, since they are diagnostically complementary. FOB is more useful for the diagnosis of endobronchial lesion, and HRCT for bronchiectasis and parenchymal pulmonary tuberculosis. If, in cases of hemoptysis, initial diagnosis is attempted within the first 48 hours of active bleeding, FOB should be the initial step, and HRCT images should not be obtained until active bleeding has been shown on plain chest radiograph to have abated. If this initial approach takes place after the first 48 hours of active bleeding, FOB and HRCT are equally suitable.
Bronchiectasis
;
Bronchoscopes
;
Bronchoscopy*
;
Diagnosis
;
Hamartoma
;
Hemoptysis*
;
Hemorrhage
;
Humans
;
Lung Neoplasms
;
Male
;
Radiography, Thoracic
;
Tuberculosis
;
Tuberculosis, Pulmonary
7.A Study on the Preemptive Analgesic Effect of Low Dose Intravenous Ketamine and Combined Ketamine-Clonidine.
Won Seok KWON ; June Seog CHOI ; Cheon Hee PARK ; Cheol Seung LEE ; Won Tae KIM
Korean Journal of Anesthesiology 2002;43(5):655-660
BACKGROUND: The purpose of this study was to evaluate the preemptive analgesic effect of a single intravenous infusion of low dose ketamine-clonidine. We compared the placebo with low dose ketamine and low dose ketamine-clonidine in patients undergoing an appendectomy. METHODS: Sixty ASA class 1 or 2 patients who received general anesthesia for an appendectomy were allocated randomly to three groups. Group 1 received intravenous normal saline 6 ml and group 2 received ketamine 0.15 mg/kg in normal saline 6 ml and group 3 received ketamine 0.15 mg/kg and clonidine 1microgram/kg in normal saline 6 ml 5 minutes before surgical incision. In the recovery room postoperative analgesia was assessed by the verbal numerical rating scale (VNRS) at 0 min, 15 min, 30 min, 60 min, 90 min and 120 min. Vital signs, sedation score and side effects were also checked. For postoperative analgesia, morphine 2 mg was given intravenously whenever a patient complained of pain, or the VNRS score was above 7. RESULTS: There were no intergroup differences of individual morphine requirements for postoperative pain control among the three groups. VNRS score, blood pressure, heart rate, sedation score and side effects were not significantly different among the three groups. CONCLUSIONS: A single low dose of ketamine-clonidine may not produce a postoperative analgesic effect in the recovery room, and a single low dose of ketamine also may not produce the preemptive effect for at least 2 hours.
Analgesia
;
Anesthesia, General
;
Appendectomy
;
Blood Pressure
;
Clonidine
;
Heart Rate
;
Humans
;
Infusions, Intravenous
;
Ketamine*
;
Morphine
;
Pain, Postoperative
;
Recovery Room
;
Vital Signs
8.Expression of Cyclin D1, Cytokeratin 7, Cytokeratin 20 and Vimentin in Papillary Thyroid Cancer and Relationship with Patient's Prognostic Factors.
Ho Jin KIM ; Yoo Seok KIM ; Se Won KIM ; Kweon Cheon KIM
Korean Journal of Endocrine Surgery 2012;12(2):92-96
PURPOSE: Cyclin D1, cytokeratin(CK)7, CK20 and vimentin play an important role in tumorigenesis and tumor progression. Our aim was to investigate the expression of cyclin D1, CK7, CK20 and vimentin in 138 papillary thyroid cancer and relationship with clinicobiological factors. We also tried to evaluate the value of those as prognostic factors. METHODS: We performed an immunohistochemical assay for cyclin D1, CK7, CK20, and vimentin in 138 papillary thyroid cancer tissue specimens. The correlation between these factors and the clinicobiological parameters was analyzed. RESULTS: In 138 papillary thyroid carcinoma specimens, the expression of cyclin D1, CK7, CK20 and vimentin was seen in 118 cases (85.5%), 133 cases (96.4%), 2 cases (1.4%) and 119 cases (86.2%), respectively. In our cases, there was a significant association among the expressions of cyclin D1, gender and lymph node metastasis. However, no obvious correlation was found between those proteins, age, tumor size, tumor amount, lymph node status and the TNM stage. CONCLUSION: Our results suggested increased cyclin D1 expression was seen in female gender and it may be a useful marker for evaluating lymph node metastasis. However, the clinical utility of cyclin D1, CK7, CK20 and vimentin in thyroid cancer patients has to be further defined by prospective studies with larger sample sizes.
Carcinogenesis
;
Cyclin D1*
;
Cyclins*
;
Female
;
Humans
;
Keratin-20*
;
Keratin-7*
;
Keratins*
;
Lymph Nodes
;
Neoplasm Metastasis
;
Prospective Studies
;
Sample Size
;
Thyroid Gland*
;
Thyroid Neoplasms*
;
Vimentin*
9.A Case Report of Cerebral Infarction Following General Anesthesia.
In Seok LEE ; June Seog CHOI ; Cheon Hee PARK ; Cheol Seung LEE ; Won Tae KIM
Korean Journal of Anesthesiology 2001;41(4):518-521
Stroke is defined as a focal neurological deficit lasting more than 24 hours. The complications related to the central nervous system after general surgery is unusual and is difficult to discover the exact causes. We are going to report a case of an unexpected cerebral infarction after a Whipple's operation. The patient was a sixty-three years old female weighing 53 Kg with a diagnosis of cancer of ampulla of Vater scheduled for a Whipple's operation under general anesthesia. Preanesthetic assessment revealed a history of hypertension and hypercholesterolemia. After surgery, she was alert but she appeared to have right hemiparesis, aphasia and right facial palsy. A brain MRI showed a cerebral infarction in the bilateral basal ganglia, left medial temporal lobe and insular cortex. The cause of the cerebral infarction in this patient was unclear. Cerebral thrombosis was first thought of, but we couldn't completely exclude other possible causes e.g., embolism etc. In cases where risk factors of a stroke were found in preoperative evaluation, it is important to correct risk factors preoperatively. Furthermore, it is necessary to prevent hypotension, keep proper hematocrit levels and temperature during an operation, and use hemocoagulase carefully in cases of patients having risk factors of thrombosis and embolism.
Ampulla of Vater
;
Anesthesia, General*
;
Aphasia
;
Basal Ganglia
;
Batroxobin
;
Brain
;
Central Nervous System
;
Cerebral Infarction*
;
Diagnosis
;
Embolism
;
Embolism and Thrombosis
;
Facial Paralysis
;
Female
;
Hematocrit
;
Humans
;
Hypercholesterolemia
;
Hypertension
;
Hypotension
;
Infarction
;
Intracranial Thrombosis
;
Magnetic Resonance Imaging
;
Paresis
;
Risk Factors
;
Stroke
;
Temporal Lobe
10.The Effect of Autogenous Demineralized Dentin Matrix and Interleukin-6 on bone Regeneration.
Won Seok JANG ; Min Gu KIM ; Dae Suk HWANG ; Gyoo Cheon KIM ; Uk Kyu KIM
International Journal of Oral Biology 2017;42(4):203-211
The aim of this study was to evaluate the role of demineralized and particulate autogenous tooth, and interleukin-6 in bone regeneration. A demineralized and particulate autogenous tooth was prepared and human osteoblast-like cells (MG63) and human osteosarcoma cells were inoculated into the culture. The rate of cell adhesion, proliferation and mineralization were examined, and the appearance of cellular attachment was observed. An 8 mm critical size defect was created in the cranium of rabbits. Nine rabbits were divided into three groups including: An experimental group A (3 rabbits), in which a demineralised and particulate autogenous tooth was grafted; an experimental group B (3 rabbits), in which a demineralized, particulate autogenous tooth was grafted in addition to interleukin-6 (20 ng/mL); and a control group. The rabbits were sacrificed at 1, 2, 4 and 6 weeks for histopathological examination with H-E and Masson's Trichrome, and immunohistochemistry with osteocalcin. The cell-based assay showed a higher rate of cell adhesion, mineralization and cellular attachment in the experimental group A compared with the control group. The animal study revealed an increased number of osteoclasts, newly formed and mature bones in the experimental group A compared with the control group. Eventually, a higher number of osteoclasts were observed in the experimental group B. However, the emergence of newly formed and mature bone was lower than in the experimental group A. The current results suggest that treatment with demineralized and particulate autogenous tooth and interleukin-6 is not effective in stimulating bone regeneration during the bone grafting procedure.
Animals
;
Bone Regeneration*
;
Bone Transplantation
;
Cell Adhesion
;
Dentin*
;
Humans
;
Immunohistochemistry
;
Interleukin-6*
;
Miners
;
Osteocalcin
;
Osteoclasts
;
Osteosarcoma
;
Rabbits
;
Skull
;
Tooth
;
Transplants