• Title/Summary/Keyword: Dankook University Hospital

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Pharmacological Management of Germinal Matrix-Intraventricular Hemorrhage

  • Jaewoo Chung;Sang Koo Lee;Chun-Sung Cho;Young Jin Kim;Jung Ho Ko;Jung-Ho Yun;Jin-Shup So;In-Ho Jung
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.258-262
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    • 2023
  • Germinal matrix-intraventricular hemorrhage (GM-IVH) is among the devastating neurological complications with mortality and neurodevelopmental disability rates ranging from 14.7% to 44.7% in preterm infants. The medical techniques have improved throughout the years, as the morbidity-free survival rate of very-low-birth-weight infants has increased; however, the neonatal and long-term morbidity rates have not significantly improved. To this date, there is no strong evidence on pharmacological management on GM-IVH, due to the limitation of well-designed randomized controlled studies. However, recombinant human erythropoietin administration in preterm infants seems to be the only effective pharmacological management in limited situations. Hence, further high-quality collaborative research studies are warranted in the future to ensure better outcomes among preterm infants with GM-IVH.

Quality Improvement in the Trauma Intensive Care Unit Using a Rounding Checklist: The Implementation Results

  • Chang, Ye Rim;Chang, Sung Wook;Kim, Dong Hun;Yun, Jeongseok;Yun, Jung Ho;Lee, Seok Won;Jo, Han Cheol;Choi, Seok Ho
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.113-119
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    • 2017
  • Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.

`Y-stenting` for Endovascular Coiling of Small Basilar Tip Aneurysm

  • Cho, Chun-Sung;Kim, Young-Joon;Lee, Sang-Koo;Cho, Maeng-Ki
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.31-34
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    • 2006
  • This 58-year-old woman was transferred from a local hospital due to symptoms of acute headache and decreased consciousness. Computed tomography revealed a subarachnoid hemorrhage with blood clot in prepontine cistern. On the first day in the hospital, diagnostic cerebral angiography revealed a basilar tip aneurysm. We performed basilar artery to bilateral posterior cerebral artery[PCA] stent placement to reconstruct the basilar artery apex.

Acalculous Hemorrhagic Cholecystitis with Chronic Intraluminal Hematoma: MRI Findings (혈종을 동반한 무결석 출혈성 담낭염: 자기공명영상소견)

  • Oh, Sang-Young;Park, Mi-Hyun;Jee, Keum-Nahn;Jeon, Gyeong-Sik;Kim, Hong-Ja
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.195-198
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    • 2009
  • Acalculous hemorrhagic cholecystitis is a rare complication of acute cholecystitis and is associated with a high mortality rate. We present a case of acalculous hemorrhagic cholecystitis with hematoma in the gallbladder lumen, which was diagnosed using magnetic resonance imaging (MRI). The T1- & T2-weighted MRI revealed gallbladder distension with a hypointense intraluminal hematoma. The excellent tissue contrast provided by MRI is useful for detecting hematomas in the cases of hemorrhagic cholecystitis.

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RASA1-Related Parkes Weber Syndrome in a Neonate

  • Koh, Hong Ryul;Lee, Yeon Kyung;Ko, Sun Young;Shin, Son Moon;Han, Byoung-Hee
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.126-130
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    • 2018
  • Parkes Weber syndrome is a rare congenital vascular anomaly, related to the RAS p21 protein activator 1 (RASA1) gene. It is characterized by capillary cutaneous malformations, bony and soft tissue hyperplasia, and multiple arteriovenous fistulas throughout the affected upper or lower extremity. These arteriovenous fistulas can be associated with life-threatening complications such as bleeding, thrombosis, and high output heart failure. In this report, we present a neonate who had a disproportionately hypertrophied left upper limb with port-wine stain, dystrophy of the left humerus, and hypertrophy of the left clavicle on X-ray, and arteriovenous malformation and massive dilatation of the left subclavian artery on magnetic resonance angiography. Exome sequencing analysis revealed a novel heterozygous splicing mutation (c.1776+2T>A) in the RASA1 gene. To the best of our knowledge, this report is the first case of RASA1-related Parkes Weber syndrome in Korea.

Mucoepidermoid Carcinoma with Distant Metastases to the Kidney, Adrenal Gland, Skull and Gluteus Maximus Muscle: a Case Report

  • Son, Sang-wook;Lee, Kye-ho;Lee, Jai Hyuen;Myong, Na-Hye;Yoo, Dong-soo
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.1
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    • pp.66-70
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    • 2016
  • Introduction: Distant metastases of mucoepidermoid carcinoma (MEC) are reported with the most common sites being the soft tissue of skin, lung, liver, and bone. We report here a very rare case of MEC with multiple metastases to the kidney, adrenal gland, skull and gluteus maximus muscle. Case report: A 63-year-old male patient presented with left-sided headache. Radiologic evaluations including CT and MRI showed ill-defined soft tissue lesion involving the left infratemporal fossa and left sphenoid sinus, and multiple enlarged lymph nodes in neck and mediastinum. PET-CT demonstrated multiple hypermetabolic lesions in and around the left kidney, left adrenal gland, right ischium, right gluteus maximus and skull base. These lesions were confirmed as MEC with multiple metastases through biopsy. Discussion: Only one case of metastasis to the skull has been previously reported, and moreover, there has not been a case of metastatic MEC to the kidney, adrenal gland and gluteus maximus muscle so far in the medical literature. It is important to acknowledge the possibility of every unusual MEC metastases, since the presence of metastasis has statistically significant influence on the survival of MEC.

Analysis of procedural performance after a pilot course on endovascular training for resuscitative endovascular balloon occlusion of the aorta

  • Sung Wook Chang;Dong Hun Kim;Dae Sung Ma;Ye Rim Chang
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.3-7
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    • 2023
  • Purpose: As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes. Methods: Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016-August 2017, n=9) and postcourse (September 2017- February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups. Results: Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course. Conclusions: The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.

Role of fetal ultrasound in prenatally diagnosed de novo balanced translocations

  • Seong, Eui Sun;Youn, Hye Jin;Park, Min Kyung;Boo, Hye Yeon;Lee, Bom Yi;Ryu, Hyun Mee;Han, You Jung
    • Journal of Genetic Medicine
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    • v.15 no.1
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    • pp.8-12
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    • 2018
  • Purpose: This study aimed to investigate fetal ultrasonographic findings in cases of prenatally diagnosed de novo balanced translocations and the role of fetal ultrasound in prenatal genetic counseling. Materials and Methods: We collected cases with de novo balanced translocations that were confirmed in chorionic villus sampling, amniocentesis, and cordocentesis between 1995 and 2016. A detailed, high-resolution ultrasonography was performed for prediction of prognosis. Chromosomes from the parents of affected fetuses were also analyzed to determine whether the balanced translocations were de novo or inherited. Results: Among 32,070 cases with prenatal cytogenetic analysis, 27 cases (1/1,188 incidence) with de novo balanced translocations were identified. Fourteen cases (51.9%) showed abnormal findings, and the frequency of major structural anomalies was 11.1%. Excluding the major structural anomalies, all mothers who continued pregnancies delivered healthy babies. Conclusion: Results of a detailed, high-resolution ultrasound examination are very important in genetic counseling for prenatally diagnosed de novo balanced translocations.

A Nasal Myiasis in a 76-Year-Old Female in Korea

  • Kim, Jae-Soo;Seo, Pil-Won;Kim, Jong-Wan;Go, Jai-Hyang;Jang, Soon-Cheol;Lee, Hye-Jung;Seo, Min
    • Parasites, Hosts and Diseases
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    • v.47 no.4
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    • pp.405-407
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    • 2009
  • On July 2009, 5 fly larvae were discovered inside the nose of a 76-year-old female. She was living in Cheonansi, and in a state of coma due to rupture of an aortic aneurysm. Surgery was performed on the day of admission, and the larvae were found 4 days later. By observing their posterior spiracle, the larvae were identified as Lucilia sericata. Considering the rapid development of this species, the infection was likely acquired during hospitalization. Further investigation on the hospital environment should be needed to know the origin of the infection.

Effectiveness of Overnight Orthokeratology with a New Contact Lens Design in Moderate to High Myopia with Astigmatism

  • Park, Yuli;Kim, Hoon;Kang, Jae Ku;Cho, Kyong Jin
    • Medical Lasers
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    • v.10 no.4
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    • pp.229-237
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    • 2021
  • Background and Objectives To assess the effectiveness of overnight orthokeratology (OK) in myopia using a new contact lens design over a one-month wearing period. Materials and Methods Participants were required to have myopia between -3.00 and -7.50D and astigmatism ≤ 2.00 D to participate in the study. The participants underwent OK with the White OK lens® (Interojo, Pyungtek, Korea), which has a 6-curve lens design. Participants were assessed at weeks 1, 2, and 4 using slit-lamp bio-microscopy, and tested for refraction, uncorrected distance visual acuity, and corneal topography. Success was defined as achieving a Logarithm of the Minimum Angle of Resolution (logMAR) ≤ 0.1. Results A total of 46 eligible subjects with a mean age of 23.11 ± 7.89 years were recruited. Baseline logMAR was 1.18 ± 0.30 and a consistent decrease in logMAR was observed from week 1 to week 4. The success rate was 95.35% at week 4. The mean sphere significantly decreased from a mean pre-fitting value of -4.58 ± 1.28 D to a mean value of -0.65 ± 0.69 D at week 4 (p < 0.0001). Statistically significant corneal flattening was detected during keratometry at week 4. Conclusion Overnight OK with the White OK lens is effective for the correction of moderate and high myopia with astigmatism over a one-month wearing period.