• Title/Summary/Keyword: Guro

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Mechanical ventilation in patients with idiopathic pulmonary fibrosis in Korea: a nationwide cohort study

  • Jae Kyeom Sim;Seok Joo Moon;Juwhan Choi;Jee Youn Oh;Young Seok Lee;Kyung Hoon Min;Gyu Young Hur;Sung Yong Lee;Jae Jeong Shim
    • The Korean journal of internal medicine
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    • v.39 no.2
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    • pp.295-305
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    • 2024
  • Background/Aims: The prognosis of patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure requiring mechanical ventilation is poor. Therefore, mechanical ventilation is not recommended. Recently, outcomes of mechanical ventilation, including those for patients with IPF, have improved. The aim of this study was to investigate changes in the use of mechanical ventilation in patients with IPF and their outcomes over time. Methods: This retrospective, observational cohort study used data from the National Health Insurance Service database. Patients diagnosed with IPF between January 2011 and December 2019 who were placed on mechanical ventilation were included. We analyzed changes in the use of mechanical ventilation in patients with IPF and their mortality using the Cochran-Armitage trend test. Results: Between 2011 and 2019, 1,227 patients with IPF were placed on mechanical ventilation. The annual number of patients with IPF with and without mechanical ventilation increased over time. However, the ratio was relatively stable at approximately 3.5%. The overall hospital mortality rate was 69.4%. There was no improvement in annual hospital mortality rate. The overall 30-day mortality rate was 68.7%, which did not change significantly. The overall 90-day mortality rate was 85.3%. The annual 90-day mortality rate was decreased from 90.9% in 2011 to 83.1% in 2019 (p = 0.028). Conclusions: Despite improvements in intensive care and ventilator management, the prognosis of patients with IPF receiving mechanical ventilation has not improved significantly.

Late Results of Successful Replantation of Severed Limb by Avulsion Injury (결출성 절단사지에 대한 재접합 후 추시결과)

  • Lim, H.C.;Suh, S.W.;Hong, J.S.;Jang, W.S.
    • Archives of Reconstructive Microsurgery
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    • v.2 no.1
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    • pp.53-61
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    • 1993
  • High level, major limb amputation above the wrist and ankle joint has some characteristic problems because of the large muscle mass and poor potential for nerve regeneration. As an adjunct method to reduce warm ischemic time prior to bony stabilization, temporary vascular shunting by simple catheterization has been performed, which has not been associated with any significant complication and has improved on success rate in replantation surgery. The authors have experienced 198 cases replantation of amputated limbs and digits from September, 1983 at the Korea medical center, Guro hospital, of which, 13 cases of successful replantation of amputated limbs by avulsion injury above the wrist and ankle joint level, which is generally considered as contraindication, were followed up for average 4.5 years(minimum 1.5 to maximum 8.4 years) on terms of survival rate, function and appearance. The clinical analysis upon these cases is to be presented with review of references.

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RADIOLOGIC ASSESSMENT OF BONE HEALING BY FRACTAL ANALYSIS AFTER THE TREATMENT OF JAW BONE CYST BY DECOMPRESSION (프랙탈 분석을 통한 악골 내 낭종의 감압술 후 골 치유에 대한 방사선학적 평가)

  • Baek, Jin-Woo;Seok, Min;Lee, Eui-Suk;Jang, Hyun-Seok;Rim, Jae-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.494-498
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    • 2007
  • Purpose: This study was done to know the usefulness of fractal analysis when evaluating the radiologic changes after decompression on jaw bone cystic lesions using fractal analysis. Materials and methods: 30cases of cystic lesions were followed up after decompression. Panoramic image was used to observe radiologic changes around the cystic lesion. The part of the panoramic image which showed radiologic change was defined as region of interest(ROI); The fractal dimension of the ROI was calculated using box-counting method. Results: Using sign-rank test, there was a statistically significant difference in fractal dimensions after decompression therapy(P<0.0001). The fractal dimensions statistically increased after decompression(the median of D:0.12). Conclusions: The ROI after decompression showed higher fractal dimensions which offer the objective proof of the bone healing around cystic lesions after decompression treatment.

Repeat Vertebroplasty for the Subsequent Refracture of Procedured Vertebra

  • Choi, Sang Sik;Hur, Won Seok;Lee, Jae Jin;Oh, Seok Kyeong;Lee, Mi Kyoung
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.94-97
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    • 2013
  • Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the $1^{st}$ and $4^{th}$ (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient's pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.

A Case of Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma Occurring in Thyroid Gland (갑상선에서 발생한 Epstein-Barr Virus 양성 미만성 큰 B세포 림프종 1예)

  • Hyunseok Choi;Dongha Kim;Jaeman Park;Jeong-Soo Woo;Jae-Gu Cho
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.59-63
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    • 2023
  • Epstein-Barr virus positive diffuse large B-cell lymphoma is very rare malignant tumor in thyroid gland. Compared to Epstein-Barr virus negative diffuse large B-cell lymphoma, it tends to have more extranodal involvement, does not respond to chemoimmunotherapy well, and has worse prognosis. We have encountered a patient with Epstein-Barr virus positive diffuse large B-cell lymphoma of thyroid gland in 75-year-old female presenting with aggravating dyspnea and neck pain.

An unstable patient with a large sucking chest wound managed with gauze packing for preventing tension and bleeding control before surgery in Korea: a case report

  • Chang-Sin Lee;Min-Jeong Cho;Tae-Wook Noh;Nak-Jun Choi;Jun-Min Cho
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.147-150
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    • 2024
  • This case report describes the management of a 51-year-old female patient who arrived at the emergency room with a stab wound to the upper right chest. Immediate medical interventions were undertaken, including blood transfusions and endotracheal intubation. To prevent tension and control bleeding, gauze packing was applied directly through the large open wound. Further surgical exploration identified a laceration in the lung, necessitating a right upper lobe resection. Postoperatively, the patient's vital signs stabilized, and she was subsequently discharged without complications. This case highlights the decision-making process in selecting between an emergency department thoracotomy and an operating room thoracotomy for patients with penetrating chest trauma. It also illustrates the role of gauze packing in managing tension and hemorrhage. In summary, gauze packing can be an effective interim measure for stabilizing patients with traumatic injuries, unstable vital signs, and large open chest wounds, particularly when a chest tube is already in place, to prevent tension and facilitate bleeding control prior to surgical intervention.

Macrophage Activation Syndrome Presented in a Case of Neonatal Lupus

  • Kang, Chang Min;Choi, Jinwha;Lee, JungHwa
    • Neonatal Medicine
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    • v.28 no.3
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    • pp.139-142
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    • 2021
  • Macrophage activation syndrome (MAS) is a potentially life-threatening complication in many autoimmune diseases. Early recognition and intervention are essential for a favorable outcome. Neonatal lupus, an acquired autoimmune disease in neonates caused by the transplacental passage of maternal autoantibodies, is rare and usually self-limited. Herein, we report a case of MAS in a patient with neonatal lupus, which improved with intravenous immunoglobulin.

Primary Uterine Lymphoma: A Case Report

  • In Joo Cheong;Se Hyun Kim;Cheol Min Park
    • Korean Journal of Radiology
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    • v.1 no.4
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    • pp.223-225
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    • 2000
  • Primary lymphoma of the uterus is a rare disease, the reported characteristic MR imaging findings being homogeneous intermediate signal intensity of the indistinct mass on T1- and T2-weighted images, and the preservation of endometrial lining and uterine architecture. We report a case of primary uterine lymphoma which showed tumoral necrosis, endometrial disruption and diffuse anterior vaginal wall involvement.

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Bilateral Oculomotor Nerve Palsy after Head Trauma: A Case Report

  • Noh, Hae Won;Song, Jae Young;Kim, Jong Hyun;Kim, Jang Hun
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.66-69
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    • 2017
  • We introduce a patient who was suffered from isolated traumatic bilateral oculomotor nerve palsy after head trauma. The patient presented with bilateral ptosis and abnormal pupilary responses with slightly drowsy mentality at first. Performed images demonstrated some hematomas along subarachnoid, intraventricular, subdural spaces and multiple small supratentorial contusions. There was no bony abnormality or ligament injury. We assumed that small amount of interpeduncular hematoma might be the proper lesion associated with oculomotor nerve palsies, since the clinical symptom and signs presented bilaterally and the oculomotor neural fascicles run through the interpeduncular fossa.