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A Modified Technique for Pectus Carinatum Surgery: Partial Costal Cartilage Resection and Pre-sternal Compression with Using a Stainless Steel Bar (새가슴 수술의 변형수기: 부분 늑연골 절제와 스테인리스 금속막대를 이용한 흉골압박)

  • Lee, Seock-Yeol;Oh, Jae-Yun;Lee, Seung-Jin;Lee, Chol-Sae
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.742-746
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    • 2008
  • Background: The surgical treatment of pectus carinatum is usually a modified Ravitch operation that consists of complete costal cartilage resection and sternal wedge osteotomy. We tried a simple and easy technique that is resection of only deformed, protruded costal cartilage and pre-sternal compression with using a stainless steel bar and this is done without sternal osteotomy. Therefore, we performed partial cartilage resection and pre-sternal compression with a stainless steel bar and we observed the effects and the efficiency of treatment. Material and Method: From July, 2006 to June, 2008, 10 patients with pectus carinatum underwent our modified technique of pectus carinatum surgery. The effects of surgery and the complications were reviewed. Result: 5 patients with only pectus carinatum underwent our modified technique of pectus carinatum surgery. 5 patients with pectus carinatum and pectus excavatum underwent our modified technique of pectus carinatum surgery and Nuss surgery. The mean patient age was 13.4+3.3 years old. The mean operation time was 137.6+22.9 minutes for the pectus carinatum patients and 234.0+36.5 minutes for the pectus carinatum and pectus excavatum patients. The mean length of hospitalization was 11.8+1.0 days. The Haller pectus index of pectus carinatum was $2.10{\pm}0.21$ preoperatively and this was increased to $2.53{\pm}0.07$ postoperatively. The only complication was simple partial wound disruption in 1 patient. Conclusion: We performed partial cartilage resection and pre-sternal compression with a stainless steel bar in 10 patients with pectus carinatum and its effects were good. Our modified technique of pectus carinatum is easy and simple as compared with the Ravitch operation. But removal of the stainless steel bar has not yet been performed for these patients and long-term follow up is needed to accurately evaluate the. effects of this surgery in many surgical cases.

Immunogenicity and Protective Effectiveness of Japanese Encephalitis Vaccine: A Prospective Multicenter Cohort Study (일본뇌염 예방접종 후 면역원성 및 중화항체 지속률에 관한 조사: 전향적 다기관 코호트 연구)

  • Kim, Dong Hyun;Hong, Young-Jin;Lee, Hoon-Jai;Choi, Bo-Yul;Kim, Chang Hwi;Park, Jae Ock;Kang, Jin Han;Choi, Byung Joon;Kim, Jong Hyun;Ahn, Young Min;Ju, Young Ran;Jeong, Young Eui;Han, Myung Guk
    • Pediatric Infection and Vaccine
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    • v.20 no.3
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    • pp.131-138
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    • 2013
  • Purpose: This study aimed to study the antibody response of Japanese encephalitis vaccination in children using different kinds of vaccines (inactivated vaccine, live attenuated vaccine or interchanged) and evaluate the effectiveness of the vaccines to provide the basis of efficient immunization schedule of Japanese encephalitis. Methods: Measurement of the neutralization antibody (NTAb) titers following Japanese encephalitis vaccination using different vaccines for 170 children, 2-6 year of age, who visited six university hospitals and are confirmed by immunization records. Results: Among 170 children who were given primary immunization on Japanese encephalitis, 103 children were given inactivated vaccine, 64 children were given live attenuated vaccine and 3 children were given interchangeably. NTAb titers were more than 1:10 in all children of three groups. The geographic mean antibody titer was 322 in inactivated vaccine group and 266 in live attenuated vaccine group. However, there was no significant difference between two groups. In both groups, the NTAb titer showed the peak at 1-4 months after the third immunization and declined. The NTAb titers of three children who were given two kinds of vaccines alternately were 1:135, 1:632, and 1:2511, respectively. Conclusion: According to the results of this study in children younger than 6 years old, there is no significant difference in effectiveness between inactivated and live attenuated vaccines. However, further studies for the changes of antibody titers for a longer period of time on larger population are required.

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The Clinical Outcomes of Arthroscopic Repair of Isolated type II SLAP Lesion in Non-athletes (비 운동선수에 있어 단독 제 2형 SLAP 병변의 관절경적 봉합수술의 임상적 결과)

  • Yoo, Jae-Chul;Ahn, Jin-Hwan;Koh, Kyoung-Hwan;Kim, Seung-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.185-190
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    • 2008
  • Purpose: The purpose of this study is to provide the clinical outcomes of arthroscopic type II SLAP repair in non-athletes, and to compare the clinical outcomes between those who had isolated type II SLAP lesion and those who had combined partial thickness supraspinatus tear that did not required a combined repair. Materials and Methods: From July 2005 to January 2007, 142 consecutive type II SLAP lesions were treated with arthroscopic surgery. The inclusion criteria for the study were; (1) younger than 50 years old; and (2) non-athletes. Exclusion criteria were; (1) prior surgery, fracture or combined recurrent dislocation history on the affected shoulder; (2) combined full thickness rotator cuff tear or PTST (>50% thickness) patient that needed repair; and (3) combined infection, arthritis or inflammatory disease. Remaining 19 patients meet the criteria. Among them, 13 had combined PTRCT that did not require repair (Group I), and 6 had isolated type II SLAP lesion without combined supraspinatus tear (Group II). The mean age was 36.7 years (29~49 years), mean symptom duration was 39.1 months (3~216 months) and mean follow-up was 19.0 months (12~27 months). In all patients, the range of motion of affected shoulder, pain and function visual analogue scale (PVAS, FVAS), the Constant score and UCLA score were evaluated preoperatively and postoperatively. Results: In group I, external rotation at side was decreased significantly (p=0.003),but there were no statistical significant change at the remains(p>0.05). And there were no differences between groups (p>0.05). At the final follow-up, all clinical outcome measurements improved after surgery with statistical significance (p<0.05): UCLA score, $22.8{\pm}5.2$ to $32.8{\pm}2.1$; Constant score, $79.4{\pm}8.6$ to $94.9{\pm}4.3$; PVAS $5.4{\pm}2.7$ to $1.1{\pm}1.4$; FVAS $63.2{\pm}15.3$ to $93.4{\pm}7.3$. But, in group comparison of the mean UCLA score and Constant score, there were no statistical significant differences between two groups. Conclusion: Arthroscopic repair of type II SLAP lesion provided good clinical outcomes in nonathletic population. Combined partial thickness supraspinatus tear does not seem to hamper the final outcome at minimal 1 year follow-up.

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The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 (제 5기 국민건강영양조사로 추정한 한국 성인의 대사증후군 유병률과 관련 요인)

  • Park, Eunok;Choi, Su Jung;Lee, Hyo Young
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.1-13
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    • 2013
  • Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

Potassium intake of Korean adults: Based on 2007~2010 Korea National Health and Nutrition Examination Survey (한국 성인의 칼륨 섭취 현황 : 2007~2010년 국민건강영양조사 자료 이용)

  • Lee, Su Yeoun;Lee, Sim-Yeol;Ko, Young-Eun;Ly, Sun Yung
    • Journal of Nutrition and Health
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    • v.50 no.1
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    • pp.98-110
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    • 2017
  • Purpose: The purpose of this study was to evaluate the dietary potassium intake, Na/K intake molar ratio, consumption of 18 food groups, and foods contributing to potassium intake of Korean adults as well as the relationships among quartile of potassium intake level and blood pressure, blood biochemical index. Methods: This study was conducted using the Korea National Health and Nutrition Examination Survey, 2007~2010. The total number of subjects was 20,291. All analyses were conducted using a survey weighting to account for the complex survey design. Results: Overall average intakes of potassium were 2,934.7, 3,070.6, 3,078.1, and 3,232.0 mg/day, and they significantly increased by year in Korean adults. The average dietary potassium intake was close to adequate intake (AI), whereas that of women was considerably lower than the AI. The Na/K intake molar ratio in males (2.89~3.23) was higher than in females (2.62~2.95). The major food groups contributing to potassium intake were vegetables, cereals, and fruits/meats. The two major foods contributing to potassium intake were polished rice and cabbage kimchi. The rankings of food source were as follows; polished rice > cabbage kimchi > potato > oriental melon > sweet potato > seaweed > radish > apple > black soybean. In 50~64 year old females, systolic blood pressure (SBP) significantly decreased (p < 0.01) and HDL-cholesterol significantly increased (p < 0.05) as potassium intake increased. Triglyceride (TG) was significantly higher in the other quartile of potassium intake level than in the first quartile (p < 0.05). Conclusion: In conclusion, our study suggests the need for an appropriate set of dietary reference intakes according to caloric intake by sex and age groups and for development of eating patterns to increase potassium intake and decrease sodium intake.

Pharmaco-mechanical Thrombectomy and Stent Placement in Patients with May-Thurner Syndrome and Lower Extremity Deep Venous Thrombosis (May-Thurner 증후군과 동반된 하지 심부정맥혈전환자에서 혈전제거술과 스텐트삽입술)

  • Jeon, Yonh-Sun;Kim, Yong-Sam;Cho, Jung-Soo;Yoon, Yong-Han;Baek, Wan-Ki;Kim, Kwang-Ho;Kim, Joung-Taek
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.757-762
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    • 2009
  • Background: Compression of the left common iliac vein by the overriding common iliac artery is frequently combined with acute deep vein thrombosis in patients with May-Thurner Syndrome. We evaluate the results of treatment with thrombolysis and thrombectomy followed by stenting in 34 patients with May-Thurner Syndrome combined with lower extremity deep venous thrombosis. Material and Method: The authors retrospectively reviewed the records of 34 patients (mean age: $65{\pm}14$ year old) who had undergone stent insertion for acute deep vein thrombosis that was caused by May-Thurner syndrome. After thrombectomy and thrombolysis, insertion of a wall stent and balloon angioplasty were performed to relieve the compression of the left common iliac vein. Urokinase at a rate of 80,000 to 120,000 U/hour was infused into the thrombosed vein via a multi-side hole thrombolysis catheter. A retrieval inferior vena cava (IVC) filter was placed to protect against pulmonary embolism in 30 patients (88%). Oral anticoagulation with warfarin was maintained for 3 months, and follow-up Multi Detector Computerized Tomography (MDCT) angiography was done at the date of the patients' hospital discharge and at the 6 months follow-up. Result: The symptoms of deep venous thrombosis disappeared in two patients (4%), and there was clinical improvement within 48 hours in twenty eight patients (82%), but there was no improvement in four patients (8%). The MDCT angiography at discharge showed no thrombus in 9 patients (26%) and partial thrombus in 21 (62%), whereas the follow-up MDCT at $6.4{\pm}5.5$ months (32 patients) revealed no thrombus in 23 patients (72%), and partial thrombus in 9 patients (26%). Two patients (6%) had recurrence of DVT, so they underwent retreatment. Conclusion: Stent insertion with catheter-directed thrombolysis and thrombectomy is an effective treatment for May-Thurner syndrome combined with acute deep vein thrombosis in the lower extremity.

Arthroscopic Rotator Cuff Repair For Partial Articular-Surface Tendon Avulsion (PASTA) Lesion (회전근 개 관절내 부분 파열 환자의 관절경적 봉합술)

  • Lee, Bong-Gun;Cho, Nam-Su;Park, Keun-Ho;Moon, Seong-Cheol;Rhee, Yong-Girl
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.242-248
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    • 2009
  • Purpose: To evaluate the clinical and radiologic results of the arthroscopic rotator cuff repair for partial articular surface tendon avulsion lesion. Materials and Methods: Twelve patients with symptomatic, partial articular surface tendon avulsion underwent arthroscopic rotator cuff repair between Mar. 2006 and Sep. 2008. The mean follow-up period was 18.3 months(12~36 months), and the mean age at the time of surgery was 46.9-year-old(19~64 years). Three cases had underwent rotator cuff repair after conversion to full-thickness tear and nine cases had transtendon repair with preserving bursal side cuff. Results: The mean VAS during motion was 6.2 before treatment and 2.0 at final follow-up (p<0.001). The passive forward flexion improved from $163.3^{\circ}$ preoperatively to $169.8^{\circ}$ postoperatively (p=0.038). The mean UCLA score improved from 18.4 preoperatively to 30.1 with 2 excellent, 8 good and 2 fair results at final follow-up. The mean KSS improved from 61.8 preoperatively to 76.8 at final follow-up. By examining the postoperative MR images of 5 patients, complete healing was observed in all of them. Conclusion: Arthroscopic rotator cuff repair may be an effective procedure for partial articular surface tendon avulsion in pain relief and improvement of the range of motion. If the remaining bursal side cuff fibers are intact, transtendon repair procedure with preserving the intact bursal layer of the tendon can be considered. If the remaining bursal side cuff fibers are friable or little, completion from partial-thickness to full-thickness tears with subsequent cuff repair can be considered.

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DENTAL CARIES PATTERNS IN THE PRIMARY DENTITION: A CLUSTER ANALYSIS AND A MULTIDIMENSIONAL SCALING ANALYSIS (군집분석과 다차원척도법으로 본 유치열의 우식패턴)

  • Jeong, Seung-Yeol;Lee, Kwang-Hee;Ra, Ji-Young;An, So-Youn;Kim, Yun-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.159-167
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    • 2010
  • The purpose of this study was to identify patterns of caries in the dentition of preschool children using cluster analysis and multidimensional scaling. 815 preschool children aged 36-71 months old were examined for caries experience. The first four clusters in the cluster analysis were (1) molars, (2) upper incisors, (3) lower 1st molars, and (4) upper 1st molars in teeth, (1) occlusal surfaces of lower molars and upper 2nd molars, (2) mesial surfaces of upper central incisors, (3) occlusal surfaces of lower 1st molars, and (4) separation between occlusal surfaces of upper and lower 2nd molars in tooth surfaces, and (1) proximal surfaces of upper anterior teeth, (2) occlusal surfaces of lower molars, (3) buccolingual surfaces of upper anterior teeth and (4) buccolingual, proximal, and occlusal surfaces of upper molars and buccolingual and proximal surfaces of lower molars in tooth surfaces groups. In the multidimensional scaling analysis, teeth could be divided into lower 1st molars, upper 1st molars, upper central incisors, upper lateral incisors, lower 2nd molars, upper 2nd molars, and the rest(canines, lower incisors), tooth surfaces could be divided into occlusal surfaces of lower molars, mesial surfaces of upper central incisors, occlusal surfaces of upper molars, and the rest, and tooth surface groups could be divided into proximal surfaces of upper anterior teeth, buccolingual surfaces of upper anteiror teeth, occlusal surfaces of lower molars, and the rest in the order of the distance from others. In the cluster analysis and the multidimensional scaling analysis, caries patterns were different according to the age.

Effects of Dietary Supplementation of Ginkgo Leaf and Pumpkin on the Growth Performance, Intestinal Microflora, Blood Biochemical Profile and Antioxidant Status in Broiler Chickens (사료 내 은행잎과 호박 첨가 급여가 육계의 성장, 소장 내 미생물 균총, 혈액 생화학 분석 및 체조직 내 항산화 작용에 미치는 영향)

  • Ko, Young-Hyun;Lee, Seong-Sil;Jang, In-Surk
    • Korean Journal of Poultry Science
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    • v.37 no.1
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    • pp.23-33
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    • 2010
  • The current study was performed to develop natural bio-active substances as additives for the production of high quality broiler chickens. A total of 120 male 3 day-old broiler chicks were randomly allocated to CON (control), GK2.5 (ginkgo leaf 2.5%), GK5.0 (ginkgo leaf 5.0%), PK2.5 (pumpkin 2.5%) and PK5.0 (pumpkin 5.0%) of five groups in cages (24 birds per group). All birds were fed corresponding diets from 3 to 35 d of age and determined growth performance and biological parameters including blood biochemical profiles, antioxidant status and intestinal microflora. During the entire feeding trial, GK5.0 and PK5.0 groups resulted in a significantly (P<0.05) higher FCR than GK2.5 and PK2.5 groups. Plasma triglyceride significantly (P<0.05) increased in GK5.0 group compared with the other groups, and the level of alanine transaminase (ALT) increased (P<0.05) in GK5.0 and PK5.0 groups compared with that in PK2.5 group. Dietary addition of ginkgo leaf and pumpkin significantly (P<0.05) increased superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the small intestine. Also, the addition of 2.5% ginkgo leaf significantly (P<0.05) increased the activities of SOD, GSH-Px and glutathione-S-transferase (GST) in the liver. Futhermore, muscle GST activity significantly (P<0.05) enhanced by dietary addition of ginko leaf and pumpkin. However, the level of lipid peroxidation (MDA) in the small intestine and muscle turned to be higher (P<0.05) in PK5.0 group. The colony forming units (CFU) of E. coli in intestinal digesta significantly (P<0.05) decreased in both ginko leaf and pumpkin supplemented groups compared with CON group. In conclusion, dietary addition of 2.5% ginko leaf and pumpkin as dietary sources can be applicable for the production of high quality broiler chickens.

Isolation of Acid-fast Bacilli from Tissues of Extrapulmonay Tuberculosis (폐외결핵 조직에서의 항산균 검출)

  • Roh, Jin-Woo;Choi, Hee-Jin;Kim, Hyeung-Il;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.240-247
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    • 1994
  • To evaluate the isolation rate of acid-fast bacilli on Ziehl-Neelsen stain from biopsy specimens of extrapulmonary tuberculosis proven by chronic granulomatous inflammation, 286 cases of extrapulmonary tuberculosis were reviewed and the results are as follows: 1) Mean age was 27.3 years old and lymphatic tuberculosis was more prevalent in the female but others were more common in the male. 2) The most common site of extrapulmonary tuberculosis was pleura (103 cases;36%) followed by lymph nodes (87 cases;30.4%), gastrointestinal tract (27 cases;9.4%), skin and soft tissue (23 cases;8.0%), bone (19 cases; 6.6%), urinary tract (14 cases;4.6%), larynx (9 cases;3.2%) and breast (5 cases;1.8%) in order of frequencies. 3) Of 286 cases, 30.4% (87 cases) of the biopsy specimens showed acid fast bacilli on microscopy. The isolation rate according to the sites was slightly higher in breast and lymph nodes as 3 of 5 cases (60.0%) and 35 of 87 cases (40.2%) respectively, and followed by 3 of 9 cases (33.3%) in the larynx, 4 of 13 cases (30.8%) in the urinary tract, 5 of 19 cases (26.3%) in the bone, 7 of 27 cases (25.9%) in the gastrointestinal tract, 26 of 103 cases (25.2%) in the pleura, and 4 of 23 cases (17.4%) in the skin and soft tissue, in order of frequencics. 4) The prevalence of extrapulmonary tuberculosis associated with pulmonary tuberculosis on chest X-ray was 85 of 286 cases (29.7%).

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