In evaluating the early state of shock patients and their response to treatment, generally vital signs or additional hemodynamic values were used. Vital signs are easily obtained and repetitious values or continous monitoring is possible, whereas it cannot evaluate the patient's status properly nor is it a good prognostic factor. Meanwhile, additional hemodynamic values are obtained from pulmonary artery catheterization. But this procedure is difficult to proceed in the emergency room. Since central venous oxygen saturation has the advantage of being easily obtained and acts as a good prognostic factor for shock patients, we intended to prove its efficacy. From 1997 May to October, 50 patients admitted to Yonsei University Young Dong Severance Hospital in shock state, with systolic blood pressure below 90mmHg, were evaluated. Central venous catheter was inserted to obtain central venous oxygen saturation, serum lactate, base excess value, and its' initial value compared with the prognosis. The central venous oxygen saturation and base excess were low, while serum lactate value was high in the nonsurvival group. And in ROC(relative operating characteristic) curve, the AUC(area under curve) of central venous oxygen saturation was larger than the others. In comparing the MOF(multi-organ failure) group with the non-MOF group, the MOF group had a lower central venous oxygen saturation and base excess, and a higher serum lactate level, whereas in ROC curve, the AUC of base excess was larger than the others. Therefore, in estimating the prognosis of shock patients, the early central venous oxygen saturation proved to be a good prognostic factor.
Area Under Curve ; Blood Pressure ; Catheterization, Swan-Ganz ; Central Venous Catheters ; Emergency Service, Hospital ; Hemodynamics ; Humans ; Lactic Acid ; Oxygen* ; Prognosis ; ROC Curve ; Shock* ; Vital Signs

No abstract available.
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The purpose of this study was to evaluate the effects of the chincap therapy on the craniofacial structure in persons with skeletal Class III malocclusion. The patients selected for this study were treated with extra-oral chincap therapy only. Both control and treatment samples were obtained from Seoul National University Hospital where these longitudinal data were gathered. 35 treated patients and 14 control patients were studied. The mean ages at the 1st evaluation was 8 years 3 months in the treatment sample and 9 years 4 months in the control sample. The duration of chin cap therapy was variable but averaged 2 years of treatment. Post-treatment observation procedeeded for 1 year 2 months. Active treatment and post treatment effects were evaluated. The results were as follows: 1. Neither significant restraint nor acceleration of growth was found in the cranial base and maxilla during treatment. 2. A distal rotation of the mandibular complex was seen. 3. Some amount of restraint of growth was found in mandibular body length, ramus height, mandibular length during treatment. 4. The gonial angle was reduced. 5. After removal of the chin-cap, forward displacement of the mandible took place.
Acceleration ; Chin ; Humans ; Malocclusion* ; Mandible ; Maxilla ; Seoul ; Skull Base

In order to observe the effects of Nicotine and NNK on cultured human gingival fibroblast, several factors were examined including mutagenicity, the number of cells attached culture plate surface through MTT test, the abundance of collagen & collagenase in mRNA level and collagenolytic activity in extracellular matrix. The results were as follows; 1. Regardless of the co-existence of S9, Nicotine did not show the mutagenicity by itself and NNK by itself showd the same result; However, dose related mutagenicity was shown in NNK with S9. 2. The number of fibroblasts attached cultured plate surface was measured by MTT procedure. The number of cells in Non-smokers increased at all time periods as compared to those of smoker. 3. Non-smoker's fibroblast treated by NNK or Nicotine was dose-dependently decreased in the number of cells when compared to untreated control. In higher dose, Nicotine showed the cellular toxicity , but NNK did not. 4. No change in the abundance of mRNA for proalpha1 and proalpha2 was shown in Nicotine treated group but in gingival fibroblasts following treatment with NNK, the abundance of mRNA for proalpha1, but not proalpha2 collagen was decreased. 5. The abundance of mRNA for collagenase was decreased when NNK was treated but no change occurred in Nicotine treated group. 6. The effect of NNK and Nicotine in collagenolytic activity showed that ,collagenase activity exclusively react to type I collagen, was increased in both group, but gelatinase exclusively react to type IV collagen was not influenced at all. Collagenase activity of smoker's fibroblast was also increased as much as Nicotine and NNK group. The findings suggest that both of Nicotine and NNK lead gingival fibroblast to decrease in the abundance of collagen. And it seems to be that Nicotine and NNK have independent pathway toward the gingival fibroblast.
Humans

Metastasis of hepatocellular carcinoma (HCC) in the nasal septum is an extremely rare condition. The proper management and the role of surgical intervention are still controversial and there is no evidence-based guideline for this specific condition. The authors of the present study report a case of HCC with sinonasal metastasis, managed by surgery to relieve nasal obstruction and frequent epistaxis. Complete removal of the tumor via endoscopic surgery was performed and the pathology was reported to be consistent with metastatic HCC. No additional treatment modality was considered for the septal lesion. During the 8-month postoperative period, the patient remained alive and satisfied with comfortable nasal breathing. The present case report stresses the importance of interdisciplinary collaboration. Proper consultation between surgeon and oncologist may lead to improved quality of life, even when the patient is in the terminal stage of HCC.
Carcinoma, Hepatocellular ; Cooperative Behavior ; Epistaxis ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum ; Neoplasm Metastasis ; Postoperative Period ; Quality of Life ; Respiration

BACKGROUND: Hepatitis C virus (HCV) RNA quantification is necessary for predicting the therapeutic response and assessing treatment results in patients with chronic HCV infection. Recently, real-time PCR technology for HCV RNA quantification displayed good linearity within the dynamic range. Thus, it is gradually replacing branched-DNA (bDNA) and PCR- hybridization assays. In this study, we evaluated the performance of the Real-QTM HCV quantification kit (biosewoom. Inc., Seoul, Korea) developed in Korea. METHODS: We evaluated the HCV quantification kit for detection limit, specificity, linearity, accuracy, and recovery rate of HCV RNA standard material. The results were analyzed for a correlation with those of Cobas Amplicor HCV Monitor 2.0. RESULTS: The HCV quantification kit showed a high recovery rate of HCV RNA standard material of various concentrations and amplication of HCV RNA equally in all genotypes. Hepatitis B virus and human immunodeficiency virus showed no cross-reactivity with HCV. Within-run and between-run coefficients of variation (CV) were 9.52~15.84% and 9.40~17.53%, respectively. Between-day coefficients of variation were 11.62~18.04%, and detection limit was 44 IU/mL. It showed a good correlation with Cobas Amplicor HCV Monitor 2.0 (R2=0.8954). CONCLUSION: The Real-Q HCV quantification kit showed a good specificity, sensitivity, linearity, and accuracy; therefore, we propose that it is fully adequate for monitoring antiviral therapy in patients with chronic HCV infection.
Chimera ; Genotype ; Hepacivirus ; Hepatitis B virus ; HIV ; Humans ; Limit of Detection ; Organothiophosphorus Compounds ; Real-Time Polymerase Chain Reaction ; RNA ; Sensitivity and Specificity

PURPOSE: We would like to assess the safety and feasibility of extended spleen-preserving distal pancreatectomy with segmental resection of both splenic vessels (SPDP-SRSV) in patients with large, benign and borderline malignant pancreas body tumors. METHODS: We encountered seven extended SPDP-SRSV cases from January 2006 to March 2010. Among them, three were excluded due to combined pylorus-reserving pancreaticoduodenectomy (PPPD). For the extended surgical technique, the pancreas was divided above the confluence of the superior mesenteric vein-splenic vein-portal vein (SMV-SV-PV), and vascular control was achieved at the origin of the splenic artery and the junction of the splenic vein with the SMV. The segments of both splenic vessels were then extracted along with the specimen. RESULTS: All the patients were female with a median age of 57 years (range: 24~70 years). The median tumor size was 5.5 cm (range: 5~11 cm), the median operation time was 362 minutes (range: 337~441 min), the median estimated blood loss was 150 ml (range: 50~300 ml) and the median hospital stay was 9 days (range: 7~20 days). One patient underwent robot-assisted extended Warshaw procedures. No mortality was noted, but one partial intestinal obstruction occurred and this was resolved with conservative management. On the recent follow-up, the CT scans showed no evidence of tumor recurrence or spleen infarction, but newly developed perigastric varix was noted, but it was without variceal bleeding. CONCLUSION: SPDP-SRSV with division of the pancreatic neck portion above the confluence of the SMV-SV-PV in patients with large, benign and borderline malignant pancreatic body tumors appears to be an ideal approach because of the expected long-term survival and preserving the role of the spleen.
Female ; Follow-Up Studies ; Humans ; Infarction ; Intestinal Obstruction ; Length of Stay ; Neck ; Pancreas ; Pancreatectomy ; Pancreaticoduodenectomy ; Recurrence ; Spleen ; Splenic Artery ; Splenic Vein ; Varicose Veins ; Veins

OBJECTIVE: To evaluate how to influence static lumbar lordosis by different heel heights in normal adults and patients with spondylolisthesis. METHOD: The lumbolumbar angles, lumbosacral angles and slip angles were examined while standing on barefoot, on heel support with 5 cm heel, and with 10 cm heel in 14 normal adults and 10 patients with first grade of spondylolisthesis. Standing lumbar spine lateral view was performed by one half hour adaptation with corresponding shoe types. RESULT: The lumbolumbar angles (angles between upper margin of 2nd lumbar body and low margin of 5th lumbar body) and the lumbosacral angles (between upper margin of 2nd lumbar body and low margin of 1st sacral body) in normal are 36.8+/-6.5degrees, 50.1+/-9.5degrees on barefoot, 36.0+/-7.3degrees, 49.6+/-7.4degrees on heel support with 5 cm heel, and 36.1+/-7.6degrees, 49.7+/-8.3degrees with 10 cm heel. Lumbolumbar angles and lumbosacral angles in 10 patients with spondylolisthesis 38.8 8.3degrees on barefoot, 47.2+/-10.4degrees on heel support with 5 cm heel, 38.3+/-7.0degrees, 47.7+/-9.2degrees with 10 cm heel. The slip angles in 10 patients with spondylolisthesis are 29.8+/-1.2degrees on barefoot, 30.2+/-1.8degrees on heel support with 5 cm heel, and with 10 cm heel. CONCLUSION: The changes of heel height did not significantly influence the lumbar lordosis in normal adults and patients with spondylolisthesis. There were no significant differences in average slip angle according to heel height in patients with spondylolisthesis were found.
Adult* ; Animals ; Heel* ; Humans ; Lordosis* ; Shoes ; Spine ; Spondylolisthesis*

OBJECTIVE: To evaluate a child who presented bilateral hypoplasia of the thenar eminences and clumsy hands without sensory loss or nocturnal pain. METHOD: A careful history taking, physical examination, plain X-ray and electrophysiologic examination. RESULT: No familial history nor a systemic etiology were identified in this patient. Physical examination revealed a marked flattening of both thenar eminences and weakness of the abductor pollicis brevis and opponens pollicis of both hands. There was no sensory loss nor neurologic abnormality. X-rays of the hands showed thin both proximal end of the first metacarpals. The electrophysiologic examination showed electreical silence of both thenar eminences. History taking, physical examination, X-ray findings and electrophysiologic findings were all compatible with the Cavanagh syndrome. CONCLUSION: A careful history taking, physical examination and electrophysiologic examination are improtant for the diagnosis of congenital carpal tunnel syndrome.
Carpal Tunnel Syndrome* ; Child ; Diagnosis ; Hand ; Humans ; Metacarpal Bones ; Physical Examination

OBJECTIVE: To determine the correlation between osteoporosis and the related factors through retrospective study. METHOD: Data from 1002 patients (834 women and 168 men) were analyzed through medical records [bone mineral density (BMD), age, height (Ht), body weight (BW), body mass index (BMI), and the accompanying conditions]. BMD of lumbar spine (L1-4) and femur (neck, Ward's triangle, trochanter, and shaft) were measured using dual energy x-ray absorptiometry (DEXA) and were correlated with age, Ht, BW, BMI, and accompanying diseases, and fracture incidence. RESULTS: 1) BMD of lumbar spine and femur neck in women significantly correlated with age and that of lumbar spine in men significantly correlated with BMI, Ht, BW. 2) The accompanying conditions in osteoporosis were diabetes mellitus (5.9%), Cushing syndrome (3.7%), oophorectomy (2.8%), hyperthyroidism (2.6%), and chronic renal failure (1.0%). 3) Fracture sites and their incidences were single spine (4.89%), multiple spine (2.99%), and femur (2.0%). 4) Mean BMD and T-score in fracture group was 0.687+/-0.16 g/cm2, 3.51+/-1.3 in lumbar spine and 0.578+/-0.14 g/cm2, 2.70+/-1.1 in femur, respectively. CONCLUSION: Osteoporosis is a major public health problem among the elderly, demanding effective strategic approach for prevention and treatment. We concluded that further studies of male osteoporosis are required.
Absorptiometry, Photon ; Aged ; Body Mass Index ; Body Weight ; Bone Density* ; Cushing Syndrome ; Diabetes Mellitus ; Female ; Femur ; Femur Neck ; Humans ; Hyperthyroidism ; Incidence ; Kidney Failure, Chronic ; Male ; Medical Records ; Osteoporosis* ; Ovariectomy ; Public Health ; Retrospective Studies ; Spine