1.Clinical Manifestation, Diagnosis, and Treatment of Obstructive Sleep Apnea Syndrome.
Yoon Kyung SHIN ; Seung Chul HONG
Journal of the Korean Academy of Family Medicine 2007;28(2):85-91
No Abstract available.
Diagnosis*
;
Sleep Apnea, Obstructive*
2.Surgical Treatment of the Closed Complete Rupture of Achilles Tendon.
Joo Chul IHN ; Byung Chul PARK ; Hee Soo KYUNG ; Shin Yoon KIM ; Seung Ho SHIN
The Journal of the Korean Orthopaedic Association 1997;32(7):1681-1686
Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon*
;
Ankle
;
Braces
;
Calcaneus
;
Electricity
;
Exercise
;
Female
;
Follow-Up Studies
;
Foot
;
Humans
;
Hydrotherapy
;
Immobilization
;
Leg
;
Male
;
Membranes
;
Needles
;
Orthotic Devices
;
Rehabilitation
;
Rupture*
;
Suture Techniques
;
Sutures
;
Tendons
;
Ultrasonography
;
Weight-Bearing
3.Usefulness and Limitation of 24 Hour Reinjection Images to Assess Myocardial Viability in Patients with Acute Myocardial Infarction.
Seok Nam YOON ; C H PARK ; Jun Han SHIN ; Myung Ho YOON ; Kyung Hoon HWANG
Korean Circulation Journal 2001;31(1):74-82
OBJECTIVE: The study was performed to evaluate whether thallium reinjection (RI) distinguishes viable from nonviable myocardium among myocardial segments which showed persistent perfusion defect (PD) in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We studied 22 patients underwent PTCA after AMI. SPECT was performed in all patients using dipyridamole stress- 4 hour redistribution (RD) followed by 24 hour RI protocols. Dysfunctional segs were classified into 5 groups: 1) normal, 2) reversible, 3) mild to moderate PD, 4) severe PD and 5) reverse redistribution (RR). All patients underwent follow up echocardiography after 4 months to assess regional wall motion (WM) improvement such as a criteria of viable myocardium. RESULTS: A total of 127 segs with abnormal WM was analyzed. Of 74 segs with PD, 17 (23%) showed enhanced uptake after 24 hour RI. Five of 17 segs (29%) with PD that responded to RI with enhanced thallium uptake showed WM improvement. WM improvement were seen in the 24 of 57 segs (42%) not responding to RI. All four segs (100%) with RR that responded to RI showed improvement. WM improvement were not seen in the 5 of 8 segs (71%) with RR not responding to thallium RI. Eleven (73%) of 15 segs with mild-moderate PD after RI showed improvement, but 33% of segs with severe PD after RI did not showed improvement. Segs with mild-moderate PD after RI and fill in after RI showed improvement in comparison to segs with severe PD after RI(p<0.05). CONCLUSIONS: These data indicate that because only small proportion of PD showed further perfusion improvement after RI and predictive value by the uptake after RI was low, there was limited role of RI after myocardial infarction. Usefulness of RI could be found in segs showing RR responding to RI in AMI reflects viable myocardium.
Dipyridamole
;
Echocardiography
;
Follow-Up Studies
;
Humans
;
Myocardial Infarction*
;
Myocardium
;
Perfusion
;
Thallium
;
Tomography, Emission-Computed, Single-Photon
4.Survivorship of lateral closing wedge proximal tibial osteotomy
Dae Kyung Bae ; Kyung Ho Yoon ; Sang Jun Song ; Myeung Cheol Shin
Orthopedic Journal of China 2008;16(13):987-991
[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7~9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°~15°.
5.The effects of Broad Spectrum Antibiotics and Endotoxin to the Carbon Tetrachloride-induced Liver Injury.
Hyun Ho SHIN ; O Joon KWON ; Yoon Kyung SOHN ; In Soo SUH ; Tae Joong SOHN
Korean Journal of Pathology 1992;26(4):329-337
This study was performed to investigate the effect of endotoxin to the CCl4-induced liver injury. Twelve Sprague-Dawley rats were intraperitoneally injected 1.6 g/kg CCl4 as control group. Another 24 rats were orally administrated 300 mg/kg of neomycin at 16 and 3 hours prior to CCl4 injection as experimental group. Twelve among them were intraperitoneally infected 1.0 mg/kg of endotoxin(E-Coli, 0111:B4, No L-2630, lipopolysaccharide, Sigma, USA) and CCl4 simultaneously for offsetting neomycin effect. The rats were sacrificed at 1, 4, 10, and 24 hours after CCl4 injection. The liver tissues from all experimental groups were observed by light and electron microscopy. The results obtained were summarized as follows: In the CCl4 only group, the hepatocytes revealed sweling of ER and mitochondria with many lipid droplet in the cytoplasm. Focal cellular necrosis was seen at the later phase. The Kupffer cells were activated and showed many cytoplasmic processes, secondary lysosomes, and vaculoles. The endothelial cells were edematous. Several neutrophils, platelets, and microthrombi were scattered in the sinusoid. In the neomycin-CCl4-endotoxin administrated group, both hepatocytic destruction and intrasinusoidal microthrombi formation were more pronounced. In the neomycin pretreated group, the hepatocytes revealed mild cellular destruction without necrosis. There is no intrasinusoidal microthrombi. According to these results, it would be concluded that the small dosage of gastrointestinal tract-derived endotoxin affects to the liver injury caused by CCl4. The synergistic effects of CCl4 and gastrointestinal tract-derived endotoxin which can not be detoxified by damaged Kupffer cells, may be more important in the pathogenesis of CCl4-induced liver injury.
Rats
;
Animals
6.Experience of 'Well-being' of Female College Students.
Korean Journal of Women Health Nursing 2008;14(2):104-113
PURPOSE: This study was to identify the meaning of the experience of 'well-being' of female college students in Korea and provide fundamental materials to improve nursing interventions. METHODS: The participants were six female students who gave consent to participate in this study. This study was conducted between August 2006 and November 2006. Each interview took one to three hours. The contents of the interviews were recorded and dictated afterwards. In addition, the interviews were carried out such a way that the gathered information was sufficiently saturated. The data was analyzed with the phenomenological analytic method suggested by Giorgi (1985). RESULTS: As a result of analysis, the following have been identified.: proper dietary treatment, proper physical treatment, harmonized psychological treatment, environmental- friendly treatment, and hypersensitivity to the mass media. CONCLUSIONS: The finding of this study offers profound information on the 'well-being' of female college students in Korea and provides fundamental materials to improve the quality of nursing interventions.
Female
;
Humans
;
Hypersensitivity
;
Korea
;
Mass Media
7.Magnetic resonance imaging of the pituitary adenoma: analysis of the enhancement patterns.
Ik YANG ; Woo Suk CHOI ; In Soo SHIN ; Kyung Nam RYU ; Yup YOON
Journal of the Korean Radiological Society 1993;29(6):1128-1133
The magnetic resonance images (MRI) of 30 patients with surgically or biochemically confirmed pituitary adenomas (20 macroadenomas, 10 microadenomas) were retrospectively evaluated. Ten patients had hyperprolactinemia, another eight had acromegaly, another eight had nonfunctioning adenoma and four had Cashing disease. The examination were performed at a 1.5-T superconducting MR system using a multisection spin-echo technique with 3mm-thick sections and a 256×224 matrix. TI weighted sagittal and coronal images were obtained before and within 30 minutes after the administration of Gd-DTPA (0.1mmol/kg). Analysis of the MRI was focused on the signal intensity and enhamcement patterns of the pituitary adenoma before and after Gd-DTPA administration. Compared with endocrinologic diagnosis, macroadenoma showed heterogeneous enhacement in 55%, rim enhancement in 35% and homogeneous enhancement in 10%, Conclusively, the enhancement patterns of the pituitary adenoma did not correlate with the subtypes made according to hormone production.
Acromegaly
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Adenoma
;
Diagnosis
;
Gadolinium DTPA
;
Humans
;
Hyperprolactinemia
;
Magnetic Resonance Imaging*
;
Pituitary Neoplasms*
;
Retrospective Studies
8.A clinical and radiological study on seizures after cerebral infarction.
Shang Shin JEUN ; Kyung Yoon EAH
Journal of the Korean Neurological Association 1998;16(4):494-499
BACKGROUND: Seizures after cerebral infarction are uncommon and their mechanisms are not yet elucidated. The aim of this study is to review the clinical features of the patients with cerebral infarction who developed seizures. METHODS: We retrospectively studied 22 patients who developed seizures after cerebral infarction. We examined the clinical features( onset and type ), EEG and CT findings from patient's clinical recordings and CT. The lesion size shown on CT scan was measured. RESULTS: The patients comprised 11 men and 11 women with their ages ranging from 46 to 78 ( mean 63.5 ) years. After cerebral infarction, ten patients developed seizures within 2 weeks after the onset, five between 2 weeks and 6 months after the onset, one between 6 months and 1 year and six 1 year after the onset of stroke. CT scans were available in all patients. The location of the cerebral infarction was ; the cortical is 14, subcortical in 2, basal ganglia in 8 and one had multiple infarcts. The size of infarction on CT was measured and twelve patients of 22 seizures after cerebral infarction were smaller than 20 cm2. Focal seizures were the most common seizure type. Eight patients showed focal slowing on EEG. CONCLUSIONS: In this study, we found the seizures after cerebral infarction are selectively frequent the frontal and temporal cortices and less frequent when the basal ganglia was involved. The seizures were frequent when the cerebral infarction was smaller than 20 cm2 were. We need to follow up the patient with small sized cortical cerebral infarction with a special attention to the occurrence of seizures.
Basal Ganglia
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Cerebral Infarction*
;
Electroencephalography
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Female
;
Follow-Up Studies
;
Humans
;
Infarction
;
Male
;
Retrospective Studies
;
Seizures*
;
Stroke
;
Tomography, X-Ray Computed
9.A Case of Benign Mixed Tumor Presenting as a Nodular Eyelid Lesion.
Ki Sup SHIN ; Yoon Duck KIM ; Hye Kyung LEE
Journal of the Korean Ophthalmological Society 1991;32(1):101-105
A 23-year-old woman visited our clinic for the evaluation of a small bean-sized mass in the right lower eyelid. She noticed a mass in the right lower eyelid 6 years ago. The mass was treated with incision and curettage under the impression of chalazion twice at the local clinic, but recurred soon after the operation. On examination, the visual acuity was 1.0 in both eyes. A firm, non-tender, smooth, movable and small bean-sized mass was palpable in the right lower eyelid. A white scar from the previous operation was seen on the palpebral conjunctiva of the right lower eyelid. The mass was excised through the conjunctiva. The histopathological diagnosis of the excised mass was benign mixed tumor. The patient was recommended of further radical excision. The pentagon-shaped excision of the right lower eyelid under frozen section control was done 2 weeks after the first operation. The patient is doing well as of now. The benign mixed tumor of the lower eyelid can arise from either ectopic lacrimal gland or accessory lacrimal gland.
Chalazion
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Cicatrix
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Conjunctiva
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Curettage
;
Diagnosis
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Eyelids*
;
Female
;
Frozen Sections
;
Humans
;
Lacrimal Apparatus
;
Visual Acuity
;
Young Adult
10.MR findings of spinal epidural mass.
Tae Hoon KIM ; Woo Suk CHOI ; In Soo SHIN ; Kyung Nam RYU ; Yup YOON
Journal of the Korean Radiological Society 1993;29(5):907-913
We analyzed the MR findings of spinal epidural mass in 23 patients retrospectively. MR images were performed at 1.5T unit. The lesions were confirmed as metastasis(12 cases), lymphoma (2 cases), leukemia(1 cases), multiple myeloma(2 cases), meningioma(3 cases), neurofibroma(1 case), dysraphism with lipoma(1 case) and lipomatosis(4 cases), Most MRI examinations consisted of T1, proton density and T2 weighted sagittal imaging of the spine, with additional pulse sequences or image planes as needed for clarification. The level of the spinal epidural mass was cervical spine level in 2 cases, thoracic in 15 cases, lumbar in 7 cases, and sacral in 2 cases. The location of epidural mass within the spinal canal was eccentric in 20 cases, multiple in 2 cases, and encircled in 4 cases. Paraspinal mass was seen in 11 cases. Signal intensity of epidural mass was variable. The marrow of spine revealed low signal intensity(SI) on TIWI and high SI on T2WI in 14 cases. In conclusion, MRI is a useful diagnostic tool for the evaluation of spinal epidural mass.
Bone Marrow
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Humans
;
Lymphoma
;
Magnetic Resonance Imaging
;
Protons
;
Retrospective Studies
;
Spinal Canal
;
Spine