BACKGROUND: The cuff inflation of laryngeal mask airway (LMA) with excessive volume of air may injure soft tissue and nerves around hypopharynx because of high cuff pressure. But it is not well known about adequate cuff volume of LMA. The cuff inflation of LMA in hypopharynx accomodate pharynx, so various injection volume may differ in sealing effect. This may influence ventilation. This study was proposed to investigate the effect of cuff volume on cuff pressure and ventilation when LMA inserted. METHODS: Fifteen male patients were inserted with #4 LMA, fifteen female patients were inserted #3 LMA. For male patients, 10, 20, 30 and 40 ml of air were injected into cuff of LMA and 10, 15, 20 and 25 ml for female patients. Cuff pressure, minute ventilation and airway pressure were randomly measured. RESULTS: Volume of injected into cuff and cuff pressure of LMA were closly related. But minute ventilation and airway pressure were not related with injected air volume of LMA. CONCLUSION: Excessive volume of air injected to LMA cuff was not beneficial to ventilation. So minimal sealing cuff volume under maximal recommended volume of LMA may reduce the incidence of complications associated with high cuff pressure.
Female ; Humans ; Hypopharynx ; Incidence ; Inflation, Economic ; Laryngeal Masks* ; Male ; Pharynx ; Ventilation*

The pathogenetic mechanism of focal segmental glomerulosclerosis (FSGS) is not known. Some authors suggest glomerular hypertrophy may precede the development of FSGS in patients with minimal lesion. It was recently reported that the size of nonsclerotic glomeruli in adults with FSGS is significantly larger than that of cases with minimal lesion. It is not clear whether glomerular hypertrophy observed in adults with FSGS is also seen in children with FSGS. Thus, we have analyzed 37 renal biopsies from children with FSGS by morphometry and the data were compared with 37 renal biopsies from age- and sex-matched patients with minimal lesion. The number of glomeruli submitted for morphometric analysis was 22.6+/-14.2 in cases with FSGS and 30.9+/-11.4 in cases with minimal lesion. Mean glomerular volume (MGV) in FSGS group was significantly larger than that of minimal lesion [(13.1+/-3.9) x10(5) microm3 vs. (10.1+/-1.9) x10(5) microm3, p<0.001]. The relative interstitial volume of renal cortex in patients with FSGS was significantly larger than that of minimal lesion [(0.106+/-0.051) microm3/microm3 vs. (0.029+/-0.012) microm3/microm3, p<0.0001]. In FSGS, the percentage of glomeruli with FSGS was significantly correlated with relative interstitial volume of renal cortex (r=0.79, p<0.0001). As is the case for adult FSGS, MGV of children with FSGS is significantly larger than that of minimal lesion. Thus, the presence of glomerular hypertrophy observed in biopsies with minimal lesion nephropathy seems to be an indication that the coexistent FSGS lesions are undetected due to sampling problems.
Child ; Adult ; Male ; Female ; Humans ; Biopsy

This report is a review of experience with 45 patients plication methods of redundant rectal mucosa by longitudinal over and over suture who were admitted in department of surgery at Dongsan sacred Heart Hospital during 1997. This new technique was indicated by incomplete rectal prolapse, first degree complete rectal prolapse (internal rectal intussusception), 3rd degree hemorrhoids, redundant rectal mucosa in operation field, anal prolapse and severe external anal skin tag. At first, entire hemorrhoid-bearing area was dissected by excision and ligation methods. Within upward 1cm from ligationpoint, No.3 chromic catgut suture was done including rectal submucosa. Starting from this, linear continueous overlapping locking suture was done until redundant mucosa was tented by Chromic suture traction in range of 1 to 1.5 cm widths. If there is wide redundant mucosa not corrected one time, another linear continuous overlapping locking suture especially not circular may be done. This method is very easy and few complication-bleeding, pain, infection, mucosa loss, etc. The patients who have incomplete defecation sensation, rectocele and skin tag were satisfied with operation. This method may be an easy, effective new technique in patients who have anal prolapse, skin tag, rectocele and constipation etc.
Catgut ; Constipation ; Defecation ; Heart ; Hemorrhoids ; Humans ; Ligation ; Mucous Membrane* ; Prolapse ; Rectal Prolapse ; Rectocele ; Sensation ; Skin ; Sutures* ; Traction

No abstract available.

The depth of wound level is as important as the level of the tendon injury itself. And the timing of the operative procedure is an important factor. As a rule, tendons injured outside of the flexor sheath yield much better results than those injured within the sheath. The nutritional supply of the flexor tendons is not completely understood. Many elaborate studies have outilned the vascular anatomy of these tendons, and not all authors are in agreement. It is now clear that synovial fluid within the sheath supplies nutrition to the tendon much as synovial fluid in a joint supports cartilage. With this in mind, the present study was designed to determine the effect of exposing tendons for varying periods of time on the viability of the tendon and sequential morphological changes. The results are as follows: 1. Twelve hours after tendon sheath removal, collagen fibrillar dissociation and irregular surface of the tendon sheath were noted on the chicken flexor tendons by electronmicroscopy. 2. Superficial tenocyte necrosis was created after 24 hours of tendon exposure. 3. At 3 days, inflammatory cell infiltration and thickening of the outer synovial layer were noted. After 7 days, fibrosis of the degenerated tendon started from the exposed surface. 4. The fibrous connective tissue and new blood vessel infiltration into the tendon were progressed after 7 days. From these morphological results, any interference with the synovial environment leads to a regressive change of the flexor tendons immediately. It is suggested that delayed primary wound covering procedure within three days an after exposed tendon injury is ideal, and it should by done at least 7 days after tendon exposure.
Blood Vessels ; Cartilage ; Chickens ; Collagen ; Connective Tissue ; Equipment and Supplies ; Fibrosis ; Joints ; Necrosis ; Surgical Procedures, Operative ; Synovial Fluid ; Tendon Injuries ; Tendons ; Wounds and Injuries

PURPOSE: This study was designed to explore the attitudes of physicians and nurses. METHOD: Attitudes were measured by using the korean version of the SADP(Scale of Attitudes toward the Disabled Persons : Choi, G. H., & Lam, C. S., 2000). A korean version SADP consist of 24-item, six-point Likert-type scale(the points are -3, -2, -1, +1, +2, +3, where -3 is disagree very much and +3 is Agree very much), measuring general attitudes toward people with disabilities. The sample included 90 physicians, 114 nurses at a university hospital in Busan. The data were collected using questionnaires, and were analyzed using frequency, percentage, mean score, standard deviation, t-test and one-way ANOVA. RESULT: When studying the physicians group by itself, SADP scores tended to increase with women physicians, old age, married, higher educational level, more years of experience, medical unit. When studying the nurses group by itself, SADP scores tended to increase with the age of thirty, single, educational level, more years of experience, surgical unit. But not to a statistically significant degree. CONCLUSION: Findings suggest that the nurses had significantly higher score than the physicians(t=-4.63, p<.001). When studying the physicians group and the nurses group by itself, not to a statistically significant degree.
Busan ; Disabled Persons* ; Female ; Humans ; Physicians, Women ; Surveys and Questionnaires

BACKGROUND: It is a routine practice that High Frequency Jet Ventilation (HFJV) is applied through a 14~16 gauge (about 12 French (Fr.)) angiocath. The 14 Fr. suction catheter which is similar to angiocath in its internal diameter is commonly available in the operating room. We evaluated the suction catheter as a carrier of HFJV in point of ventilation, oxygenation and operating field during HFJV at microlaryngeal endoscopic surgery (MES). METHODS: Fifteen adult patients undergoing HFJV via 14 Fr. suction catheter during MES were studied. Time-based arterial blood gas analyses were done before and after HFJV. The movement of operating field was examined using laryngoscopic examination by surgeon and anesthesiologist. We also evaluated complications such as abdominal distension, barotrauma and so on. RESULTS: The mean arterial oxygen tension was maintained above 250 mmHg all the time during HFJV. The mean carbon dioxide tension was less than 51 mmHg. There were no remarkable catheter movement and complications. CONCLUSION: The 14 Fr. suction catheter is a good replacement of angiocath. It provided good operating field, ventilation and oxygenation without complications.
Adult ; Barotrauma ; Blood Gas Analysis ; Carbon Dioxide ; Catheters* ; High-Frequency Jet Ventilation* ; Humans ; Operating Rooms ; Oxygen ; Suction* ; Ventilation

No abstract available.
Breast Neoplasms* ; Breast*

We experienced a cose of occupational asthma induced by the tobacco leaf in 49-year old man. He has worked at the Korean Tobacco and Ginseng company for 23 years but suffered from the intermittent mild wheezing and dyspnea since 6 years ago. He has not involved in the process making the tobacco directly, but just managed it at the storage barn. He showed a whole negative reaction to 55 inhalant allergens(Bencard, UK) and the allergen extracted from the yellow Korean tobacco leaf, but showed the dual asthmatic respose to the allergen bronchial provocation test with it. His basal PC is 6.35 mg/ml with methacholine inhalation challenge. Now he changed the workplace far away from the barn at the same company and is treated with bronchodilator and anti-asthmatic inhaler.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dyspnea ; Humans ; Inhalation ; Methacholine Chloride ; Middle Aged ; Nebulizers and Vaporizers ; Panax ; Respiratory Sounds ; Tobacco*

Placenta previa percreta is an uncommon and lifetbreatening complication of pregnancy. tbe incidence of both placenta previa and placenta acaeta are increased in patients with scaned uteri, and patienth with uterine scars and placenta previa are at inaeased risk for also baving placenta accreta. A case of placents previa percreta involving the urinary bladder was experienced and treated with surgical management. We reported a case with concerned literatures
Cicatrix ; Humans ; Incidence ; Placenta Accreta* ; Placenta Previa ; Placenta* ; Pregnancy ; Urinary Bladder* ; Uterus