Kim, Ha Eun;Paik, Hyo Chae;Kim, Song Yee;Park, Moo Suk;Lee, Jin Gu
Journal of Chest Surgery
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v.51
no.6
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pp.384-389
/
2018
Background: Airway anastomotic complications are a leading cause of mortality after lung transplantation. Among the factors that cause airway complications, preoperative steroid use has been considered to be related with postoperative airway healing. We analyzed the influence of preoperative steroid use on postoperative airway complications. Methods: The medical records of 66 double-lung transplant recipients from January 2014 to December 2015 were reviewed. Forty patients were prescribed steroids preoperatively. The daily steroid dose was standardized using the patient's body mass index (BMI). Patients who received preoperative steroids were sub-divided into high-dose (HD) and low-dose (LD) groups (cut-off value, 1.6 mg/BMI/day). Results: Thirteen patients suffered from airway complications postoperatively (bronchopulmonary fistula, 9; bronchial stenosis, 4). There was a tendency for early development of airway complications in the steroid use group compared to the non-steroid use group, but it was not significant (percentage free from airway complications in year 1: non-steroid group, 90.9% vs. steroid group, 79.2%; p=0.43). The percentage of patients in the LD and HD groups who were free from airway complications in year 1 was not significantly different (84.0% vs. 77.8%, p=0.39). Conclusion: The airway complication rate did not vary significantly according to steroid use. Additionally, in patients who received preoperative steroids, the dose did not affect the rate of development of airway complications.
Jung, Yu Sang;Park, Hyerin;Park, Jung Hyun;Park, Hee Jae;Cho, Han Eol
Clinical Pain
/
v.20
no.2
/
pp.127-130
/
2021
Ultrasound (US)-guided hydrodissection (HD) is a widely applied therapeutic method to release the entrapped peripheral nerve. However, this therapy has only been studied for the nerve entrapments such as carpal tunnel syndrome, and there are no reports of its effect on direct nerve injuries with incomplete axonal damage. Here, we report a case of direct traumatic injury of a median nerve with incomplete axonal injury in a 28-year-old man. He presented hypoesthesia and weakness along with the median nerve territory of the left hand after a laceration wound of the wrist. The patient underwent a surgical procedure, but did not experience prominent improvement for the next six months. Symptoms improved after we performed the US-guided HD with dextrose. We propose this procedure as one of the new treatment methods for direct axonal injury of nerves including the median nerve.
Journal of The Korean Dental Society of Anesthesiology
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v.13
no.4
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pp.215-220
/
2013
The co-occurrence of congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease (HD) is termed Haddad syndrome, which is an extremely rare discorder. It was reported first by Haddad in 1978 and there are approximately 60 cases reported in the worldwide literature. Recent studies described that congenital central hypoventilation syndrome had deep relation to the mutation of the PHOX2B gene in its diagnosis and phenotype. This article presents a case report: Dental treatment of a 3-year-old male patient with Haddad syndrome under outpatient general anesthesia. The special considerations of dental care, especially caries theatment of the patient with Haddad syndrome are discussed.
Kim, Min-Jee;Lee, Hyoung-Song;Lim, Chun-Kyu;Cho, Jae-Won;Kim, Jin-Young;Koong, Mi-Kyoung;Son, In-Ok;Kang, Inn-Soo;Jun, Jin-Hyon
Clinical and Experimental Reproductive Medicine
/
v.34
no.3
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pp.179-188
/
2007
Objectives: Many neurological diseases are known to be caused by expansion of trinucleotide repeats (TNRs). It is hard to diagnose the alteration of TNRs with single cell level for preimplantation genetic diagnosis (PGD). In this study, we describe methods optimized for PGD of TNRs related diseases such as Huntington's disease (HD), spinocerebellar ataxia 3 (SCA3) and fragile X syndrome (FXS). Methods: We performed the preclinical assays with heterozygous patient's lymphocytes by single cell PCR strategy. Fluorescent semi-nested PCR and fragment analysis using automatic genetic analyzer were applied for HD and SCA 3. Whole genome amplification with multiple displacement amplification (MDA) method and fluorescent PCR were carried out for FXS. Amplification and allele drop-out (ADO) rate were evaluated in each case. Results: The fluorescent semi-nested PCR of single lymphocyte showed 100.0% of amplification and 14.0% of ADO rate in HD, and 94.7% of amplification and 5.6% of ADO rate in SCA3, respectively. We could not detect the PCR product of CGG repeats in FXS using the fluorescent semi-nested PCR alone. After applying the MDA method in FXS, 84.2% of amplification and 31.3% of ADO rate were achieved. Conclusions: Fluorescent semi-nested PCR is a reliable method for PGD of HD and SCA3. The advanced MDA method overcomes the problem of amplification failure in CGG repeats of FXS case. Optimization of methods for single cell analysis could improve the sensitivity and reliability of PGD for complicated single gene disorders of TNRs.
Kim, Myeong-Seong;Jeong, Jong-Seong;Kim, Myeong-Goo
Journal of Radiation Protection and Research
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v.36
no.2
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pp.79-85
/
2011
OThe purpose of this article was to measure and compare the value of the metal artifact reduction (MAR) algorithm by Dual energy(kVp switching) CT (Computed Tomography) for non using MAR and we introduced new variable Dual energy CT applications through a clinical scan. The used equipment was GE Discovery 750HD with Dual-Energy system(kVp switching). CT scan was performed on the neck and abdomen area subject for patients. Studies were from Dec 20 2010 to Feb 10 2011 and included 25 subject patients with prosthesis. We were measured the HU (Hounsfield Unit) and noise value at metal artifact appear(focal loss of signal and white streak artifact area) according to the using MAR algorithm. Statistical analyses were performed using the paired sample t-test. In patient subject case, the statistical difference of showing HU was p=0.01 and p=0.04 respectively. At maximum black hole artifact area and white streak artifact area according to the using MAR algorithm. However noise was p=0.05 and p=0.04 respectively; and not the affected black hole and white streak artifact area. Dual Energy CT with the MAR algorithm technique is useful reduce metal artifacts and could improve the diagnostic value in the diagnostic image evaluation of metallic implants area.
Jung, hae youn;Seok, jin yong;Hong, joo wan;Chang, nam jun;Choi, byeong don;Park, jin hong
The Journal of Korean Society for Radiation Therapy
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v.27
no.1
/
pp.45-52
/
2015
Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.
The purpose of this study was to investigate the levels of hope and the influencing factors on the hope in the hemodialysis patients. The subjects of this study consisted 101 patients who had received hemodialysis In two hospitals affiliated with Catholic University from June to August, 2000. The instruments used for the study were the Hope scale by Miller(1998) and Quality of life scale, Self esteem scale and Social support scale. Cronbach's $\alpha$ of measurement tools used in the study were 0.93 for the hope, 0.96 for quality of life, 0.78 for self-esteem and 0.92 for the social support. The data were analyzed by mean, t-test, ANOVA. Scheffe test, Pearson correlation coefficients and Stepwise multiple regression using the SAS program. The results were as follows; 1. Out of a score of 164 the mean score of the hope was $107.3\pm16.7$. The mean quality of life score was 102.5 out of 160. The scores concerning social support turned out to have a mean of 67.8 out of 100. The levels concerning self-esteem and self respect had a mean of 25.1 out of 40. 2. There was a positive relation between the quality of life and social support. Furthermore, the hope level was proportional to factors such as quality of life and social support. 3. Social support accounted for $32\%$ of influential variable on the hope. If transportation way to the hospital and quality of life were added. the total predictors explained $45\%$. The results suggested that the hope levels of hemodialysis patients were influenced by their social support and quality of life. Therefore nurses are encouraged to elevate the levels of patients' hope by using the social support and quality of life in caring the patients receiving hemodyalysis.
We will provide basic data on the evaluation of patient dose in terms of DECT quality control by comparing the equipment-provided dose with the measured dose according to the configuration method of the X-ray generator by the manufacturer of the dual-energy CT unit. For computed tomography (CT) equipment, Discovery 750HD, Aquilion ONE GENESIS Edition, and Somatom Definition Flash were used. The $CTDI_{vol}$ value was measured by inserting the Unfors Xi ion chamber into a 32 cm PMMA acryl Phantom. The results of estimated $CTDI_{vol}$ DECT and measured $CTDI_{vol}$ showed that the dose difference between DECT 80 + 140 kVp of G company was at least 0.51% and -1.90% max, and measured $CTDI_{vol}$ was slightly lower (p<0.05). The difference of 80 + 140 kVp of S company was the minimum of 5.84% and the maximum of 7.52% (p<0.05). The measured $CTDI_{vol}$ was less than estimated $CTDI_{vol}$. The C company's 80 + 135 kVp showed a difference of at least 7.58% and a maximum of 13.58% (P<0.05), and all of measured $CTDI_{vol}$ was less. The linearity of exposure dose for all DECT equipment was very linearly reflected with $R^2$ being 0.97 or above, and the measured dose of the ionization chamber was less than the predicted dose of the monitor.
The Journal of Korea Assosiation for Disability and Oral Health
/
v.13
no.1
/
pp.47-51
/
2017
Haddad syndrome, the association of Congenital Central Hypoventilation Syndrome (CCHS) and Hirschsprung's disease (HD), is a disease caused by mutation of PHOX2B gene. This disease, which occurs very rarely worldwide, is characterized by adequate ventilation during wakefulness and hypoventilation during sleep due to decreased ventilatory sensitivity. In this case report, we report a case of dental treatment under general anesthesia in a child with Haddad syndrome. A 3-year-old child with Haddad syndrome visited Seoul National University Dental Hospital for dental treatment. Dental treatment was planned under general anesthesia because of his medical condition. Treatment was successfully done without any postoperative complications. This case suggests that general anesthesia may be advantageous for dental treatment due to the risk of respiratory depression in a child with Haddad syndrome.
The purpose of this study was to develop an assist device that could correct and support patient position during biopsy on computed tomography (CT) using 3D printing technology. The development method was conducted in the order of 3D design, 3D output, intermediate evaluation for product, final assist device evaluation. The 3D design method was conducted in the order of prior research data survey, measurement, primary modeling, 3D printing, output evaluation, and supplementary modeling. The 3D output was the 3D printer (3DWOX 2X, Sindoh, Korea) with additive manufacturing technology and the polylactic acid (PLA) materials. At this time, the optimal strength was evaluated to infill degree of product as the 3D printing factors into 20%, 40%, 60%, and 80%. The intermediate evaluation and supplementation was measured noise in the region of interest (ROI) around the beam hardening artifact on the CT images. We used 128-channel MDCT (Discovery 75 HD, GE, USA) to scan with a slice thickness of 100 kVp, 150 mA, and 2.5 mm on the 3D printing product. We compared the surrounding noise of the final 3D printing product with the beginning of it. and then the strength of it according to the degree of infill was evaluated. As a result, the surrounding noise of the final and the early devices were measured at an average of 3.3 ± 0.5 HU and 7.1 ± 0.1 HU, respectively, which significantly reduced the noise of the final 3D printing product (p<0.001). We found that the percentage of infill according to the optimal strength was found to be 60%. Finally, development of assist devices for CT biopsy will be able to minimize artifacts and provide convenience to medical staff and patients.
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