• 대한기관식도과학회지
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• 제11권1호
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• pp.10-14
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• 2005

Background and Objectives : Laryngotracheal stenosis in bum patients with inhalation have features distinct from other stenosis after intubation or tracheostomy. However few studies have been reported and the incidence was reported variable. The purpose of this study is to evaluate the clinical manifestation and the incidence of laryngotracheal stenosis in bum patients with inhalation. Methods We retrospectively analyzed 138 bum Patients diagnosed inhalation injury who admitted to Hangang Sacred Heart Hospital from July 2002 to June 2004. Result : 5 patients were developed laryngotracheal stenosis. The incidence of Laryngotracheal stenosis in bum patients with inhalation was $3\%$. Symptom developed early in 2 patients, late in 3 patients.4 patients required trachostomy as initial airway support. The location of stenosis is subglottic region except 1 patient. Montgomery T-tube was inserted in 3 patients, and Single-stage laryngotracheal reconstruction was performed in 1 patient. Conclusion Incidence of laryngotracheal stenosis in our study is lower than other reports due to late presentation of symptom and early discharge after acute bum stage. Inhalation injury may lead to severe complication and sequelae, therefore physicians should be have a awareness for early diagnosis and all burn patients who have a history of inhalation injury should be followed closely.

• Journal of Chest Surgery
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• 제19권1호
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• pp.50-57
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• 1986

Sixty-nine patients with various types of cyanotic congenital heart disease underwent systemic-pulmonary artery shunts with a microporous polytetrafluoroethylene [PTFE] prosthesis between 1979 and 1985. Their ages ranged from 2 months to 39 years [mean$\pm$SD: 5.2$\pm$7.4, median: 3.3 years]. Diagnosis included the following: Tetralogy of Fallot, 45: Double outlet right or left ventricle, 11: Single ventricle, .5: Transposition of great vessels, 4: Tricuspid atresia, 3 and Pulmonary atresia with intact ventricular septum, 1. Forty-eight patients had subclavian-pulmonary artery anastomosis, 12 patients aorta-right pulmonary artery anastomosis, 6 patients aorta-main pulmonary artery anastomosis, and 3 patients descending aorta-pulmonary artery anastomosis. The PTEE graft of 3 mm in diameter was used in 1, 4 mm in 29, 5 mm in 35 and 6 mm in 4 patients. Ten patients were died within 30 days after operation [mortality rate: 14.5%]. Among them, 6 patients were operated in urgency due to cardiac arrest or severe anoxic spell after cardiac catheterization, and so surgical mortality of elective operation is 9.5%. The 59 survivors showed improvement of the arterial oxygen saturation [65.4% - 9.8%] and hemoglobin [18.8 gm/dl - 16.0 gm/dl] values [V<0.01]. The follow up period ranged from 1 month to 67 months, [752 patient-months] and during this periods there were 4 late shunt failures after 3 months postoperatively with 4 mm graft, and 2 with 5 mm graft. The over-all patency rate of 4 mm PTFE was 85.9$\pm$9.2% [SEM] in 12 months and 40.9$\pm$22.5% in 24 months. The over-all patency rate of 5 mm PTFE was 87.5$\pm$9.6% in 12 months and 58.3$\pm$24.6% in 36 months. The lowest systolic pressure in death group was 64.9$\pm$15.0 mmHg and in survival group, 86.4$\pm$12.1 mmHg [P<0.001]. We think that the PTFE graft is useful in palliative shunt operation, but the effectiveness of the 4 mm PTFE graft may be limited. The blood pressure also may play an important role in patency of Prosthesis.

• 대한두개안면성형외과학회지
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• 제16권1호
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• pp.35-38
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• 2015

Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbital hemorrhage is a rare complication of these implants and has been reported rarely in Korea. The purpose of this article is to report a late complication case focusing on their etiology and management. A 20-year-old male patient underwent open reduction with Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. The initial symptom occurred with proptosis in the right side as well as vertical dystopia, which had started 4 days earlier, 8 months after surgery. Any trauma history after the surgery was not present. We performed an exploration and removal of hematoma with Medpor titanium meshed alloplastic implant. A case of delayed orbital hematoma following alloplastic implant insertion was identified. It occurred within the pseudocapsule of the implant. One week after surgery, overall symptoms improved successfully, and no complications were reported during the 11-month follow-up period. Although rare, orbital hemorrhage is a potential complication of alloplastic orbital floor implants, which may present many years after surgery. As in the case presented, delayed hematoma should be included in the differential diagnosis of late proptosis or orbital dystopia.

• Journal of Yeungnam Medical Science
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• 제12권2호
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• pp.400-404
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• 1995

국소 결절성 과형성은 섬유성 격막에 의해 나누어지는 간세포와 Kupffer 세포의 결절로 이루어진 양성 종괴이다. 방사선학적으로 다른 종괴와 유사한 소견을 보이나 그 예후와 치료는 달라 감별이 요구된다. 저자들이 경험한 증례는 조영 후 영상을 조영전기영상과 조영후기영상으로 분리함으로써 종괴의 혈류형태를 관찰할 수 있는 급속조영 CT를 설시하여 감별진단에 도움을 받을 수 있었고 병리조직학적으로 국소 결절성 과형성으로 확인된, 급속조영 CT 설시 후 국내에서 보고되는 최초의 증례이다.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.217-225
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• 2021

Background: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration. Methods: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO₂ <90%. Results: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups. Conclusion: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality.

• Clinical and Experimental Reproductive Medicine
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• 제27권2호
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• pp.117-131
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• 2000

Objectives: To develop a new immunohistochemical marker system for supplementation of the Noyes histological classification of the endometrium in women of child bearing age with regular menstrual cycles, and to employ this system to evaluate pathologic factors involved in endometriosis, and thus to ascertain if it is useful in diagnosis. Materials and Methods: Endometrial biopsies were sampled from the posterior fundus of 41 (24 proliferative phases, 17 secretory phases) women with regular menstrual cycles (28-32 days), and each sample was immunohistochemically stained according to Noyes et al (1975) for determination of expression for estrogen receptor (ER), progesterone receptor (PR), integrin ${\alpha}_1$, ${\alpha}_4$, ${\beta}_3$, COX-1 and COX-2. Then, the PR, integrin ${\beta}_3$ and COX-2 which were clearly expressed in the luteal phase was with endometrial samples were obtained from 20 cases of normal patients (group 1) and 25 cases with endometriosis (group 2) after confirming the day of ovulation by sex steroid level measurements 7-8 days after ovulation Results: In the regular menstruation group the expression of ER showed a tendency to be increased in the proliferative phase and decreased in the secretory phase, and was the highest in the proliferative phase. However, PR in the stromal cells showed no change in the entire menstrual cycle while in the epithelial cells, PR reached a peak in the late proliferative phase and was almost absent in the secretory phase. Integrin (${\alpha}_1$, ${\alpha}_4$, and ${\beta}_3$ expression in the epithelial cells was absent in the proliferative phase but ${\alpha}_1$ was strongly expressed starting from the early secretory phase into the entire secretory phase. ${\alpha}_4$ was expressed strongly in the early and mid secretory phases and disappeared in the late proliferative phase, while ${\beta}_3$ appeared after the mid secretory phase and continued to be expressed until the late secretory phase. Expression in the stromal cells was weak overall and did not show any cyclic pattern. COX-1 expression was shown as a cyclic pattern in the stromal and epithelial cells and was particularly strongly expressed in the mid secretory phase of epithelial cells, and in the mid secretory and menstruation phase of stromal cells. In the endometrial epithelial cells there was strong expression during the entire cycle with stronger expression in the secretory phase compared to the prolferative phase. COX-2 was clearly expressed in the late proliferative, early and mid secretory phases in the stromal cells. No expression was observed in the proliferative phase of the epithelial cells, but which began to appear in the early secretory phase reaching a significant pattern from the mid secretory phase onwards. There was almost no expression in the stromal cells. In the cases with endometriosis showing normal endometrial maturation according to the Noyes classification, PR expression was increased while Integrin-${\beta}_3$의 expression was significantly decreased compared to the normal group. Also, COX-2 expression was slightly decreased in the stromal cells of patients with endometriosis while it was significantly increased in the stromal cells. Conclusion: Immunohistochemical markers can supplement the original Noyes classification of histological endometrial dating and therefore ascertain existing pathologic conditions. Particularly for patients with endometriosis with normally mature endometrial cells, changes in COX-2 and integrin expression patterns may assist in elucidating pathophysiologic mechanisms and therefore aid in the diagnosis of abnormal implantation conditions, and consequently determine a treatment modality.

• Asian-Australasian Journal of Animal Sciences
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• 제17권6호
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• pp.760-768
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• 2004

The present study was undertaken to evaluate the accuracy of ultrasonography in early pregnancy diagnosis in goats. Ultrasonographic scanning with real time B-mode ultrasound machine having 5 MHz linear array transducer was performed on gravid uterus (n=24) obtained from slaughterhouse (Group I). Crown rump length (CRL) measured by ultrasound was found significantly different (p<0.05) with actual CRL measured after dissection in early pregnancy. However, age predicted by ultrasound through the measurement of CRL was found highly correlated (r=0.92) with age measured after dissection through CRL and the weight of fetus. Ages predicted by ultrasound through the measurement of trunk diameter (TD) and uterine diameter (UD) and ages measured after dissection were found highly and equally correlated (r=0.98) and did not differ significantly. Data from six does synchronized (Group II) with PGF2$\alpha$ (Estrumate) at 11 days apart were collected through ultrasound from 17 to 42 days post breding. The correlation between CRL and gestational age was high (r=0.97) in day 30 to 42 post breeding. A high coefficient of correlation (r=0.98) was also observed between predicated age by ultrasound and actual age calculated after kidding. The correlation between CRL and gestational age by the formula Y=(a+bX) i.e. Y=24.42+0.39 X where Y=gestational age and X=CRL, was recorded very high (r=0.99). Accuracy of ultrasonography was lowest on day 17 to 19 (66%) and reached 100% on day 34. Data from 30 does (group III) randomly subjected to only one time ultrasounds scanning to assess the accuracy of pregnancy diagnosis were also obtained. Ages predicted by TD and UD measurements were observed to be non-significantly different with actual age obtained after kidding and correlation between ages predicted by TD and UD measurement with actual age after kidding was found equally and highly correlated (r=0.98). The operator's accuracy in the whole experiment including all three groups was found to be 92%. The sensitivity was 93% and specificity was 86%. From the present study, it was observed that CRL was the most reliable parameter to find out gestational age in early pregnancy and the new formula derived was found very accurate to find out gestational age. TD and UD were also found to be equally reliable parameter to find out gestational age in mid and late stage of pregnancy through ultrasonography. It was concluded that ultrasonography by real time B mode with 5 MHz transrectal transducer was found to be reliable, safe and accurate and practicable means in diagnosing early pregnancy diagnosis as early as 25 days post breeding.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3945-3948
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• 2013

Background: Lung cancer is the leading cause of cancer death, late diagnosis being the main obstacle to improving the outcomes with stage at diagnosis as an important prognostic factor. Relationships between ABO blood groups and risk of benign or malignant diseases have been observed and in this study, we aimed to investigate whether they might affect prognosis and response to chemoradiotherapy in patients with local advanced non-small cell lung cancer (NSCLC). Materials and Methods: Eighty-one patients with non-metastatic local advanced NSCLC were included in the study. ABO blood groups were A in 45 (55.6%), B in 7 (8.6%), AB in 8 (9.9%), and O in 21 (25.9%) patients. The patients were also divided two groups according to blood group A (45 patients) and non-A (B, AB and O; 36 patients). Response to chemoradiotherapy was complete remission in 10 (12.3%), disease regression in 42 (51.9%), stable disease in 12 (14.8%), and disease progression in 17 (21.0%) patients. Results: There was no significant difference among ABO blood group categories or between patients with A blood group and those with non-A blood group in terms of responses to chemoradiotherapy (p>0.05). There were also no significant differences regarding overall and disease-free survival rates. Conclusion: The ABO blood group system has no significant effect on prognosis and response to chemoradiotherapy in patients with non-metastatic NSCLC.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2555-2558
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• 2016

Background: Gastric cancer is the second most common gastrointestinal cancer and is still associated with significant morbidity and mortality due to late presentation and diagnosis at advanced stages. Studies have reported that a variable proportion of gastric cancer is positive for the human epidermal growth factor receptor 2 (HER2) and patients with HER2 positive (HER2 +ve) lesions can benefit from targeted therapy. This study was conducted to assess the prevalence of HER2 +ve gastric cancers in Brunei Darussalam, a developing Southeast Asian nation. Materials and Methods: Patients were identified from the Department of Pathology registry and retrospectively reviewed. HER2 expression was assessed by immunohistochemistry and only those staining 3+were considered positive. Results: Our study included 103 cases (66 males and 37 females) with a mean age of $65.1{\pm}14.8$ years old. There were 14 cases positive for HER2 (10 males and 4 females) giving a prevalence of 13.6%. The HER2 +ve cases were significantly older ($70.6{\pm}19.3$ years old) than the negative cases ($64.2{\pm}13.8$, p=0.041) and had significantly more advanced disease (stages 3 and 4, p=0.026). There were no significant differences in gender distribution, presence of intestinal metaplasia, EBV status, Helicobacter pylori status, tumor location (proximal vs. distal) and degree of tumor differentiation (all p values >0.05). Conclusions: Our study showed that 13.6% of our gastric cancers are positive for HER2, the affected patients being older and having more advanced disease at diagnosis.

• 한국의사학회지
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• 제23권2호
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• pp.89-101
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• 2010

Lee Jae Won is a scholar who wrote the most in Euirim, a representative Oriental Medical magazine after the liberation of Korea, on the Sa-am Acupuncture Method. In order to understand the principles of this method, he proposed rather distinctive theories called the Comparative Pulse Diagnosis and the Five Constitutions. Lee Jae Won distinguished the deficiency and exuberance of the Five Phases through the Comparative Pulse Diagnosis, and set harmonizing the Five Phases by tonifying the deficient and purging the exuberant as the object of the Sa-am Acupuncture Method. He took pulses from both the patient's hands and distinguished the deficiency and exuberance of the five viscera. Then, he balanced the Five Phases by tonifying the weakest viscus and purging the strongest viscus. Lee Jae Won argued that because the Five Constitutions are something that one has innately, people suffer from differnet diseases according to their constitutions. Therefore, he argued, when treating a patient, one should first decide the constitution of the patient and then treat the patient according to his/her deficiency or exuberance. From the late 50's to early 60's, Lee Jae Won wrote Acupuncture and Moxibustion According to Yin-Yang and the Five Phases, explaining the principles of the Sa-am Acupuncture Method and its applications. Seen from this, Lee Jae Won is a person from whom we can confirm the historical lineage of the Sa-am Acupuncture Method after the liberation of Korea.