1.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
2.Exploring Factors Related to Menopausal Symptoms in Middle-aged Women:A Study of Body Composition, Physical Fitness, and Physical Activity
Younghwan CHOI ; Young Hye KWON ; Yeon-Hwan PARK ; Meejung CHIN ; Sowon HAHN ; Yeon Soo KIM
The Korean Journal of Sports Medicine 2024;42(3):202-211
Purpose:
The aim of study is to analyze the associations between menopause symptoms, including sleep quality and depressive symptoms, and body composition, physical fitness, and physical activity indices in middle-aged women.
Methods:
This cross-sectional study included 91 women aged 45 to 55 years. The study employed the Menopause Rating Scale to assess menopausal symptoms, the Pittsburgh Sleep Quality Index to evaluate sleep quality, and the Center for Epidemiologic Studies Depression scale to measure depressive symptoms. Cardiorespiratory fitness was assessed by breath-by-breath respiratory exchange during an incremental cycle ergometer, while muscle fitness was assessed by hand grip strength measurement. Physical activity was assessed using both the Global Physical Activity Questionnaire and Fitbit devices.
Results:
According to correlation analysis, indicators of obesity such as body fat and waist circumference were positively associated with menopausal symptoms. Conversely, muscle fitness and engaging in light physical activity were negatively associated with these symptoms.
Conclusion
This study identified physical indicators in Korean middle-aged women linked to menopausal symptoms.This study suggests that exercise programs for middle-aged women should include resistance training and promote physical activity to improve obesity markers and manage menopausal symptoms for healthy aging.
3.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
4.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
5.Skin Hydration Measurement:Comparison Between Devices and Clinical Evaluations
Ju Heon PARK ; YoungHwan CHOI ; Yeon Joo JUNG ; Taemin LEE ; Heeyeon KIM ; Youngjoo CHO ; Jong Hee LEE
Annals of Dermatology 2024;36(5):275-281
Background:
The need for an objective method for measuring skin hydration levels is becoming increasingly important. Various devices with different measuring principles for assessing skin hydration have been developed and are widely used.
Objective:
This study aimed to investigate the reproducibility and correlation between clinical evaluation and skin hydration measurement devices that are the most widely used in the field.
Methods:
A prospective comparative clinical trial was conducted on 184 healthy volunteers. Skin hydration levels were measured using the Corneometer (CM820) and hydration probe (HP: DermaLab Combo) at 3 points: the ventral forearm, the dorsal forearm, and the shin. We used the intraclass correlation coefficient (ICC) to evaluate the reproducibility and Pearson’s correlation coefficient (PCC) to evaluate the correlation of each measurement. Simple linear regression was used to analyze the Corneometer and HP skin hydration value changes according to changes in xerosis severity scale (XSS) values, which were evaluated by clinicians.
Results:
Both the Corneometer and HP showed significant, excellent reproducibility (ICC for Corneometer: 0.954–0.971, ICC for HP: 0.980–0.986) and significant high positive correlations (PCC: 0.708–0.737) regardless of the measurement site. Both devices showed negative regression coefficients in all measurement sites in XSS analysis, but this was not statistically significant.
Conclusion
The Corneometer and HP were both accurate and objective skin hydration measuring devices, regardless of the measurement site. Using reliable and objective devices such as the Corneometer or HP can aid in understanding an individual’s skin condition and making more informed decisions for skin care.
6.Presenilin 2 N141I Mutation Induces Hyperimmunity by Immune Cell-specific Suppression of REV-ERBα without Altering Central Circadian Rhythm
Hyeri NAM ; Boil KIM ; Younghwan LEE ; Han Kyoung CHOE ; Seong-Woon YU
Experimental Neurobiology 2023;32(4):259-270
Circadian rhythm is a 24-hour cycle of behavioral and physiological changes. Disrupted sleep-wake patterns and circadian dysfunction are common in patients of Alzheimer Disease (AD) and are closely related with neuroinflammation. However, it is not well known how circadian rhythm of immune cells is altered during the progress of AD. Previously, we found presenilin 2 (Psen2) N141I mutation, one of familial AD (FAD) risk genes, induces hyperimmunity through the epigenetic repression of REV-ERBα expression in microglia and bone marrow-derived macrophage (BMDM) cells. Here, we investigated whether repression of REV-ERBα is associated with dysfunction of immune cell-endogenous or central circadian rhythm by analyses of clock genes expression and cytokine secretion, bioluminescence recording of rhythmic PER2::LUC expression, and monitoring of animal behavioral rhythm. Psen2 N141I mutation down-regulated REV-ERBα and induced selective over-production of IL-6 (a well-known clock-dependent cytokine) following the treatment of toll-like receptor (TLR) ligands in microglia, astrocytes, and BMDM. Psen2 N141I mutation also lowered amplitude of intrinsic daily oscillation in these immune cells representatives of brain and periphery. Of interest, however, the period of daily rhythm remained intact in immune cells. Furthermore, analyses of the central clock and animal behavioral rhythms revealed that central clock remained normal without down-regulation of REV-ERBα. These results suggest that Psen2 N141I mutation induces hyperimmunity mainly through the suppression of REV-ERBα in immune cells, which have lowered amplitude but normal period of rhythmic oscillation. Furthermore, our data reveal that central circadian clock is not affected by Psen2 N141I mutation.
7.The Activities and Roles of Trauma Surgeons in the Treatment of COVID-19 Patients
Journal of Acute Care Surgery 2023;13(2):43-46
Trauma surgeons' roles in a national hospital in Korea changed during the COVID-19 pandemic. In this study, we report on their roles over a 15-month period (March 2020 to May 2021) including the eight months where the hospital was a COVID-19-only hospital. Despite shortages in medical resources including medical personnel, and intensive care unit (ICU) beds, the trauma surgeons helped to control the public health problem by assuming various roles including working in another COVID-19 ICU in Dae-gu, treating trauma patients with COVID-19 or those who needed self-quarantine, being in charge of care for some COVID-19 patients in the ICU (for two months), and performing the role of a rapid response team member for COVID-19 ICU patients. In this report, we emphasize how trauma surgeons, along with intensivists, played an active role in treatment of COVID-19 patients, and helped prevent the collapse of the healthcare system within the hospital during the pandemic.
8.COVID-19 in a Patient Previously Exposed to Toxic Disinfectant from a Humidifier
Seok Hwa YOUN ; Sung Soo HONG ; Sun Young BAEK ; Younghwan KIM
Journal of Acute Care Surgery 2022;12(2):82-85
In August, 2011, the Korean Public Health Surveillance declared an outbreak of pulmonary disease due to the inhalation of humidifier disinfectants (HDs), which led to approximately 20,000 deaths. In March, 2020, the World Health Organization declared coronavirus disease-2019 (COVID-19) a pandemic. In this Case Report, we present a rare case of a patient who inhaled toxic HDs and developed COVID-19. He was young and had a low risk of severe COVID-19, however, he had a critical course to recovery. He was admitted to the intensive care unit and administered high-flow oxygen via a nasal cannula. He received dexamethasone injections each day for 10 days and his condition began to improve on hospital Day 6, although radiographical findings revealed no improvement. He was discharged on hospital Day 26. Despite the patient’s chronic lung disease becoming asymptomatic, HDs could be an important risk factor affecting the clinical course of COVID-19.
9.A Case Series of Trauma Resuscitation in the Intensive Care Unit Bypassing the Emergency Room During the Conversion to a COVID-19 Only Hospital
Seok Hwa YOUN ; Hyemi KWON ; Sun Young BAEK ; Sung Soo HONG ; Younghwan KIM
Journal of Acute Care Surgery 2022;12(2):70-73
When a patient with severe trauma is admitted to the emergency room (ER), they are evaluated before transfer to either the intensive care unit (ICU) or operating room. To minimize the time until a definitive treatment can be provided, direct operating room resuscitation can be performed. In this hospital the ER was closed during the hospital’s transition to a coronavirus disease 2019-dedicated hospital, and direct ICU resuscitation for patients with trauma was performed for a short period. To perform effective trauma resuscitation, all ICU beds were reorganized to achieve a modified, experienced nurse: patient ratio (1:2-3) and 2 beds were assigned for trauma ICU resuscitation alone. The equipment for initial resuscitation was installed and ICU nurses received training. Consultations with the hospital administration, nursing, and pharmaceutical departments were completed in advance to avoid formal problems. Conversion of the ICU for direct resuscitation procedures was performed in 4 patients.

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