1.Pharyngolaryngeal closure after supraglottic partial laryngectomy.
Eun Chang CHOI ; Hong Shik CHOI ; Young Ho KIM ; Se Heon KIM ; Yoon Woo KOH ; Hun Yi PARK
Korean Journal of Otolaryngology - Head and Neck Surgery 2000;43(3):312-317
BACKGROUND AND OBJECTIVES:Although the various methods of pharyngolaryngeal closure after supraglottic partial laryngectomy(SPL) have been reported, the difference of postoperative function and complications has not been adequately analyzed. Therefore, We investigated the relationship between different pharyngolaryngeal closure methods and postoperative function and complications. PATIENTS AND METHODS: According to the methods of pharyngolaryngeal closure, postoperative complications, decannulation day and postoperative day when to start oral feeding were retrospectively investigated on 22 patients who underwent SPL. We divided the patients into two groups according to the methods of pharyngolaryngeal closure. In cartilage group(13 cases), the closure of pharyngolaryngeal defect was done with direct suture between the thyroid cartilage and base of the tongue. In perichondrial group(9 cases), the closure was done between preserved thyroid perichondrium and base of the tongue. RESULTS: There was no case requiring either a gastrostomy or a persistent tube feeding in our series. Fistula occurred more often in perichodrial group(3 cases) than cartilage group(0 case). In one case of perichondrial group, total laryngectomy was performed because of a fistula. Also, aspiration pneumonia occurred more often in perichodrial group(2 cases) than cartilage group(0 case). Decannulation could be performed relatively earlier in cartilage group than in perichondrial group. Also, oral feeding could be performed relatively earlier in cartilage group than in perichondrial group. CONCLUSION: Direct approximation between cut margin of the thyroid cartilage and base of tongue was safe, time-saving and reliable method of pharyngolaryngeal closure after SPL.
Cartilage
;
Enteral Nutrition
;
Fistula
;
Gastrostomy
;
Humans
;
Laryngectomy*
;
Pneumonia, Aspiration
;
Postoperative Complications
;
Retrospective Studies
;
Sutures
;
Thyroid Cartilage
;
Thyroid Gland
;
Tongue
2.Validation of the Korean Version of the Delirium Diagnostic Tool-Provisional (K-DDT-Pro)
Kyeong Mee KIM ; Man-shik SHIM ; Dahyun YI ; So Yeon JEON ; Jeong Lan KIM
Psychiatry Investigation 2022;19(9):748-753
Objective:
The Delirium Diagnostic Tool-Provisional (DDT-Pro) was designed to detect the presence and severity of delirium briefly and objectively regardless of psychiatric expertise. We translated the DDT-Pro into Korean and validated it in elderly Korean patients.
Methods:
To validate the translation and evaluate inter-rater reliability, a psychiatric trainee and a research nurse independently assessed the same patients referred to the Department of Psychiatry. The results were compared with the reference evaluations performed by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
Results:
We enrolled 42 elderly patients. The Cronbach’s alpha coefficient were 0.839 (the trainee), 0.822 (the nurse). The Cohen’s weighted κ between the trainee and nurse, ranged from 0.555±0.102 to 0.776±0.062. The Pearson correlation coefficients (Korean version of the DDT-Pro [K-DDT-Pro] and Korean version of the Delirium Rating Scale-Revised-98 [DRS-R98-K] total score) were γ=-0.850 (the trainee), and γ=-0.821 (the nurse). The areas under the ROC curves (AUCs) were 0.974 (the trainee) and 0.893 (the nurse).
Conclusion
The K-DDT-Pro exhibited high internal consistency and relatively substantial inter-rater reliability. The correlation with the DRS-R98-K was strongly negative. The accuracy of the K-DDT-Pro was excellent, regardless of expertise. In conclusion, the K-DDT-Pro is a brief and simple tool that usefully screens for delirium in elderly patients.
3.Acute Necrotizing Esophagitis: An Autopsy Case Report and Literature Review.
Minsung CHOI ; Go Un JUNG ; Yun Teak SHIM ; Hyung Nam KOO ; Byung Ha CHOI ; Nak Eun CHUNG ; Young Shik CHOI ; Yi Suk KIM
Korean Journal of Legal Medicine 2014;38(1):30-33
Acute necrotizing esophagitis (AEN), also called "black esophagus," is a rare disorder with an unknown pathogenesis. Endoscopic findings generally show black pigmentation throughout the esophagus. This case also offered rare views of the gross anatomy of this disorder. Histological examination revealed that the mucosal and submucosal layers of the esophagus were involved in the severe necrotizing inflammation. The chief manifestation of this disease is hematemesis from hemorrhage of the upper gastrointestinal tract with a typically multifactorial etiology. AEN is also characterized by a clear boundary at the gastroesophageal junction where the necrosis stops. In this study, we report an autopsy case of a 61-year-old man with necrotizing inflammation throughout the esophagus and esophageal necrosis from the laryngopharynx to the gastroesophageal junction. The patient was a disabled person with a history of alcohol abuse who was also diagnosed with mild coronary arteriosclerosis and fatty liver on the basis of the underlying diseases. In this case, the main etiology for poor perfusion from the distal esophageal area was likely underlying illness, history of alcoholism, and malnutrition.
Alcoholism
;
Autopsy*
;
Coronary Artery Disease
;
Disabled Persons
;
Esophagitis*
;
Esophagogastric Junction
;
Esophagus
;
Fatty Liver
;
Hematemesis
;
Hemorrhage
;
Humans
;
Hypopharynx
;
Inflammation
;
Malnutrition
;
Middle Aged
;
Necrosis
;
Perfusion
;
Pigmentation
;
Upper Gastrointestinal Tract
4.Fatal Hemophagocytic Syndrome : Three Autopsy Cases.
Yi Suk KIM ; Tae Jung KWON ; Nak Eun CHUNG ; Young Shik CHOI
Korean Journal of Legal Medicine 2005;29(1):79-83
Hemophagocytic Syndrome (HS) is a systemic lymphohistiocytic proliferative disorder associated with infection or malignancies, particularly Epstein-Barr virus (EBV) HS is presented with high fever, skin rash, hepatosplenomegaly, and cytopenia. The characteristic pathologic finding is massive lymphohistiocytic infiltration with hemophagocytosis in various organs including bone marrow, liver, and spleen. Hyperproduction of cytokines by activated T lymphocytes has been presumed to account for the hemophagocytosis and clinical manifestations of HS. We report three childhood autopsy cases with HS which was confirmed by histopathologic examination. According to medical records, all cases had high fever with or without skin rash, cytopenia, AST/ALT elevation, and hyperfibrinogenemia, and showed multiple organ failure eventually. At autopsy, there were no specific gross findings except splenomegaly, but extensive lymphohistiocytic infiltration with hemophagocytosis was seen in various organs including lymph nodes, spleen, liver, and bone marrow. In one of three cases, EBV was identified with in situ hybridization method. As this disease has rapidly progressive clinical course with fatal outcome during childhood, so the possibility of HS should be considered in children presenting with high fever and hepatosplenomegaly.
Autopsy*
;
Bone Marrow
;
Child
;
Cytokines
;
Exanthema
;
Fatal Outcome
;
Fever
;
Herpesvirus 4, Human
;
Humans
;
In Situ Hybridization
;
Liver
;
Lymph Nodes
;
Lymphohistiocytosis, Hemophagocytic*
;
Medical Records
;
Multiple Organ Failure
;
Spleen
;
Splenomegaly
;
T-Lymphocytes
5.Why Cannot Suction Drains Prevent Postoperative Spinal Epidural Hematoma?.
Dong Ki AHN ; Won Shik SHIN ; Jin Woo KIM ; Seong Min YI
Clinics in Orthopedic Surgery 2016;8(4):407-411
BACKGROUND: Postoperative spinal epidural hematoma (POSEH) is different from spontaneous or post-spinal procedure hematoma because of the application of suction drains. However, it appeared that suction drains were not effective for prevention of POSEH in previous studies. The purpose of this study was to test our hypothesis that POSEH can be caused by hypercoagulability. METHODS: This was an experimental study. One hundred fifty milliliters of blood was donated from each of the 12 consecutive patients who underwent spine surgery and infused into 3 saline bags of 50 mL each. One of the 3 bags in each set contained 5,000 units of thrombin. All of them were connected to 120 ± 30 mmHg vacuum suctions: drainage was started 8 minutes after connection to the vacuum system for 12 normal blood bags (BV8) and 12 thrombin-containing blood bags (TBV8) and 15 minutes after connection for the remaining 12 normal blood bags (BV15). The amount of initial and remaining hematoma at 20 minutes, 120 minutes, and 24 hours after vacuum application were measured by their weight (g). The primary endpoint was the difference between BV8 and TBV8. The secondary end point was the difference between BV8 and BV15. RESULTS: The remaining hematoma in TBV8 was significantly greater than that in BV8 at all measurement points: 46.3 ± 12.4 vs. 17.0 ± 1.3 (p = 0.000) at 20 minutes; 33.0 ± 8.2 vs. 16.3 ± 1.2 (p = 0.000) at 120 minutes; and 26.1 ± 4.0 vs. 15.8 ± 1.6 (p = 0.000) at 24 hours after vacuum application. The remaining hematoma of BV15 was significantly greater than that of BV8 at all measurement points: 30.0 ± 12.0 vs. 17.0 ± 1.3 (p = 0.002) at 20 minutes; 24.2 ± 7.6 vs. 16.3 ± 1.2 at 120 minutes (p = 0.002); and 22.2 ± 6.6 vs. 15.8 ± 1.6 (p = 0.004) at 24 hours after vacuum application. CONCLUSIONS: With a suction drain in place, the amount of remaining hematoma could be affected by coagulability. Thrombin-containing local hemostatics and the length of time elapsed before the commencement of suction resulted in hypercoagulability, indicating these two factors could be causes of POSEH.
Drainage
;
Hematoma
;
Hematoma, Epidural, Spinal*
;
Hemostatics
;
Humans
;
Spine
;
Suction*
;
Thrombin
;
Thrombophilia
;
Vacuum
6.Pulmonary Thromboembolectomy for Acute Pulmonary Thromboembolism.
Inho YI ; Joo Chul PARK ; Kyu Seok CHO ; Bum Shik KIM ; Soo Cheol KIM ; Dae Hyun KIM ; Jung Heon KIM ; Hyo Chul YOUN
The Korean Journal of Thoracic and Cardiovascular Surgery 2011;44(5):343-347
BACKGROUND: Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism. MATERIALS AND METHODS: Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicatedfor mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state. RESULTS: The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure. CONCLUSION: Emergency operation should be performed when medical treatments are no longer effective.
Anoxia
;
Brain Death
;
Dyspnea
;
Emergencies
;
Extracorporeal Membrane Oxygenation
;
Heart
;
Hemothorax
;
Humans
;
Male
;
Medical Records
;
Membranes
;
Pericardial Effusion
;
Pleural Effusion
;
Pulmonary Embolism
;
Reoperation
;
Retrospective Studies
;
Schizophrenia
;
Thorax
;
Thromboembolism
;
Veins
7.Necrotizing Bronchial Aspergillosis: A case report.
In Ho YI ; Dae Hyun KIM ; Soo Cheol KIM ; Bum Shik KIM ; Kyu Seok CHO ; Joo Chul PARK ; Youn Wha KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2003;36(11):874-877
Necrotizing bronchial aspergillosis usually occurs in the immumocompromised host. Aspergillus invades bronchial epithelium and forms endobronchial mass or endobronchial stenosis. A 78-year-old male patient with diabetus mellitus complaining of dyspnea and cough was admitted to our hospital. Plain chest X-ray and chest computed tomogram showed a large endobronchial mass and total collapse of left upper lobe of the lung. Bronchoscopic biopsy of the endobronchial mass revealed chronic inflammation. To confirm the endobronchial mass, we performed sleeve lobectomy of left upper lobe of the lung. Histologically the mass was diagnosed as necrotizing bronchial aspergillosis. We report a case of necrotizing bronchial aspergillosis in an elderly man who has diabetus mellitus with review of the literature.
Aged
;
Aspergillosis*
;
Aspergillus
;
Biopsy
;
Constriction, Pathologic
;
Cough
;
Dyspnea
;
Epithelium
;
Humans
;
Inflammation
;
Lung
;
Male
;
Pulmonary Aspergillosis
;
Thorax
8.Primary Sternal Osteomyelitis: A case report.
In Ho YI ; Hyo Chul YOUN ; Dae Hyun KIM ; Soo Cheol KIM ; Bum Shik KIM ; Kyu Seok CHO ; Joo Chul PARK ; Young Tae KWAK
The Korean Journal of Thoracic and Cardiovascular Surgery 2006;39(4):340-342
Primary sternal osteomyelitis is a rare disease. Primary sternal osteomyelitis occurring during childhood is extremely rare; therefore, only eleven cases have been reported in the English language literatures. The predisposing factors of primary sternal osteomyelitis are malnutrition, immune deficiency, intravenous injection, blunt chest trauma, and sickle cell anemia. Drainage of pus with antibiotic therapy is the treatment of choice. We report a case of primary sternal osteomyelitis occurred in a 16-year old boy, who had no predisposing factors, with review of literatures.
Adolescent
;
Anemia, Sickle Cell
;
Causality
;
Drainage
;
Humans
;
Injections, Intravenous
;
Male
;
Malnutrition
;
Osteomyelitis*
;
Rare Diseases
;
Sternum
;
Suppuration
;
Thorax
9.Pericentric Inversion of the X Chromosome in a Male with Azoospermia and in the Family of a Pregnant Female Carrier.
Bom Yi LEE ; Hyun Mee RYU ; Moon Hee LEE ; Ju Yeon PARK ; Jin Woo KIM ; Joong Shik LEE ; Hye Ok KIM ; Min Hyung KIM ; So Yeon PARK
Journal of Genetic Medicine 2008;5(2):139-144
We report on two cases of pericentric inversion of X chromosome. The cases were found in a 40-year- old man with azoospermia and in a family of a 38-year-old pregnant woman. The first case with 46,Y,inv(X)(p22.1q27) had concentrations of LH, prolactin, estradiol, and testosterone that were within normal ranges; however, FSH levels were elevated. Testis biopsy revealed maturation arrest at the primary and secondary spermatocytes without spermatozoa. There were no microdeletions in the 6 loci of chromosome Y. For the second case, the cytogenetic study of the pregnant woman referring for advanced maternal age and a family history of inversion X chromosome was 46,X,inv(X)(p22.11q27.2). The karyotype of her fetus was 46,X,inv(X)(p22.1q27). Among other family members, the karyotypes of an older sister in pregnancy and her fetus were 46,X,inv(X)(p22.11q27.2), and 46,Y,inv(X), respectively. The proband's father was 46,Y,inv(X)(p22.11q27.2). All carriers in the family discussed above were fertile and phenotypically normal. In addition, the ratio of inactivation of inv(X) by RBG-banding was discordant between the two sisters, with the older sister having only 4.1% of cells carrying inactivated inv(X) while the proband had a 69.5% incidence of late replicating inv(X). Therefore, we suggest that the cause of azoospermia in the first case might be related to inversion X chromosome with positional effect. Also, the family of the second case showing normal phenotype of the balanced inv(X) might be not affected any positional effect of genes.
Adult
;
Azoospermia
;
Biopsy
;
Cytogenetics
;
Estradiol
;
Fathers
;
Female
;
Fetus
;
Humans
;
Incidence
;
Karyotype
;
Lifting
;
Male
;
Maternal Age
;
Phenotype
;
Pregnancy
;
Pregnant Women
;
Prenatal Diagnosis
;
Prolactin
;
Siblings
;
Spermatocytes
;
Spermatozoa
;
Testis
;
Testosterone
;
X Chromosome
10.Urinothorax following Blunt Renal Trauma: One case report.
Dae Hyun KIM ; Hyo Chul YOUN ; In Ho YI ; Soo Cheol KIM ; Bum Shik KIM ; Kyu Seok CHO ; Joo Chul PARK
The Korean Journal of Thoracic and Cardiovascular Surgery 2005;38(11):803-805
Urinothorax occurs when urine leakes into thoracic cavity and it was first reported by Correie in 1968. The mechanism of its occurrence is an accumulation of urine in thoracic cavity by retroperitoneal urinoma formed by urinary tract obstruction or trauma. Retroperitoneal inflammation, malignant neoplasm, kidney transplantation, and kidney biopsy can also induce urinothorax. The diagnosis of urinothorax may be delayed due to its rare incidence rate, but if diagnosis is confirmed the treatment is possible by urinary diversion. We report our experience of a case of urinothorax associated with retroperitoneal urinoma followed by blunt renal trauma with review of literatures.
Biopsy
;
Diagnosis
;
Incidence
;
Inflammation
;
Kidney
;
Kidney Neoplasms
;
Pleural Effusion
;
Thoracic Cavity
;
Urinary Diversion
;
Urinary Tract
;
Urinoma