The study was undertaken to determine the most adequate tidal volume when used volume preset ventilator during anesthesia. The thirty patients were received controlled mechanical ventilation with constant inspiratory pressure of 10 cmH2O and respiratory frequency of 12/minute. The results were as follows: 1) The PH was 7.39±0.01 and it is within normal limit. 2) The PaCO2 was 34.0±0.6 mmHg and it is a slightly hyperventilatory state. 3) The PaO2 was 228.0±8.2 mmHg. 4) The Buffer base was 20.7±0.3 mEq/L and it is a slightly buffer base deficient state. From the above results. We concluded that if patients were fully relaxed during general anesthesia, it is desirable to maintain the inspiratory pressure of anesthetic mechanical ventilator to 10 cmH2O for adequate alveolar ventilation.
Anesthesia ; Anesthesia, General ; Humans ; Hydrogen-Ion Concentration ; Respiration, Artificial ; Tidal Volume ; Ventilation ; Ventilators, Mechanical*

No abstract available.
Hearing Loss* ; Hearing* ; Uveomeningoencephalitic Syndrome*

Injuries to extensor tendons can be as serious as those of digital flexors. These injuries require accurate approximation, appropirate splinting and careful mobilization. Scarring which always occurs following injury can provoke greater problems in digital extensor injuries than in flexor tendons. The loss of 2mm of excursion of extensor tendon at level of the proximal interphalangeal joint may results in a 50 percent loss of motion of the finger. A special problem associated with extensor tendon healing is loss of gliding. This study was carried was carried out to evaluate the results of the extensor injuries according to their etiology, location and type of treatment. Seventy six lesions in fifty patients treated for extensor tendon injuries were analysed for the comparison of the results of specific treatment. The follow up was from 1 to 3 years with average of 19 months. Following results were obtained. l. Among 50 patients, 16 cases (32%) were acute and 34 cases (68%) were chronic. 2. The etiology were crushing in 19 cases (30%), knife or glass in 20 cases (40%), and avulsion in 8 cases (16%) etc. 3. Mallet finger were observed in 14 tendons, buttonhole in 10 tendons. Nine tendons were injured at the metacarpophalangeal level and 16 tendons were injured at wrist level. 4. Percentage of satisfactory result which means less than 15 degrees of extension loss were 68.1 % in primary repair and plication, and 30.7% in tendon transfer or graft. 5. Prognosis was better when the lesion was proximal to MP joint, and results were more favorable in primary repair and plication than tendon transfer graft.
Cicatrix ; Fingers ; Follow-Up Studies ; Glass ; Humans ; Joints ; Prognosis ; Splints ; Tendon Injuries ; Tendon Transfer ; Tendons ; Transplants ; Wrist

OBJECTIVES: Schizophrenia manifests a variety of interindividual differences in therapeutic response to antipsychotics. This might be attributable to dopamine and serotonin receptors that a important target for various antipsychotics, and the D3 receptor(DRD3) alleles they carry. The purpose of our study was to investigate whether the plasma levels of homovanillic acid(HVA) and 5-hydroxyindoleacetic acid(HIAA), and the polymorphism of DRD3 can be held as a predictor of treatment response ni chronic schizophrenic patients. METHODS: Therapeutic response for 16 korean schizophrenia patient treated during 48 weeks were assessed by PANSS used as the clinical symptom rating scales. The levels of concentration of HVA and 5-HIAA were examined by HPLC at baseline and at 48 weeks. We classified the polymorphism of DRD3 receptor using amplifying by polymerase chain reaction(PCR). RESULTS: Neither concentrations of HVA and 5-HIAA nor genotype of dopamine 3 receptor were not significantly associated with the therapeutic response. But, the patients who has A1 alleles of DRD3 gene showed poor therapeutic responses. CONCLUSION: A1 allele of DRD3 gene is associated with poor prognosis of chronic schizophrenia.
Alleles ; Antipsychotic Agents ; Chromatography, High Pressure Liquid ; Dopamine* ; Genotype ; Homovanillic Acid ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Prognosis ; Receptors, Dopamine D3* ; Receptors, Serotonin ; Schizophrenia ; Weights and Measures

The present study was intended to define the relationship of radiological findings and pathological types ofprimary lung cancer. The 85 cases were selected after confirmation of the cell types by bronchoscopic biopsy,cervical lymph node or thoracotomy biopsy and lung resection. Results of the study were presented below. 1.Primary lung cancer is frequently developed after 4th decade and males were affected more frequently than femaleswith ratio of 2 to 1. 2. The frequencies of pathologic cell types of lung cancer were presented as follows.Squamous cell carcinoma 40% Adenocarcinoma 25% Undifferentiated cell carcinoma 30% Alveolar cell carcinoma 5% 3.The findings of plain chest radiograph were presented as follows. In squamous cell carcinoma, hilar enlargement orhilar mass is the most frequent finding (53%) with atelectasis(26%) or obstructive pneumonitis(26%). Inadenocarcinoma, pleural effusion is accompained about half of cases (53%). In undifferentiated cell carcinoma,hilar mass with mediastinal widening and pleural effusion is frequent finding.
Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Biopsy ; Carcinoma, Squamous Cell ; Humans ; Lung Neoplasms ; Lung ; Lymph Nodes ; Male ; Pleural Effusion ; Radiography, Thoracic ; Thoracotomy

We present a case of a 44 year-old man with histiocytic sarcoma arising from the rectum. Histiocytic sarcoma is a rare type of malignant lymphoma, comprising less than 0.5% of all non-Hodgkin's lymphomas (NHLs). In this case, the tumor was a polypoid mass, measuring 2.5 x 2 cm. On microscopic examination, it was composed of many bizarre multinucleated cells and sheets of xanthomatous histiocytes. There were also areas with spindle cells arranged in a storiform pattern. Extensive metastases to regional lymph nodes were found, and combined adjuvant chemotherapy was administered after complete resection.
Adult ; Chemotherapy, Adjuvant ; Histiocytes ; Histiocytic Sarcoma* ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; Neoplasm Metastasis ; Rectum* ; Sarcoma

BACKGROUND: The expressions of galectin-3, cytokeratin 19, p53, and Ki-67 in papillary carcinoma (PC), follicular carcinoma (FC), follicular adenoma (FA), and nodular hyperplasia (NH) are characteristic for the differential diagnosis between benign and malignant thyroid tumors. METHODS: The expressions of the four markers were evaluated in PC (n=37), FC (n=12), FA (n=22), and NH (n=23) by immunohistochemical staining. RESULTS: Statistical analyses revealed that galectin-3 was significantly expressed in the malignant tumor cells of PC and FC, while CK19 was expressed only in PC. CONCLUSION: These results show that galectin-3 is useful in differential diagnosis between malignant and benign thyroid lesions, especially between FC and FA in the patients over 20 years old, and indicate that CK19 is valuable in differentiating between follicular variant of PC and FC and between PC and papillary area of nodular hyperplasia.
Adenoma ; Carcinoma, Papillary ; Diagnosis, Differential* ; Galectin 3* ; Humans ; Hyperplasia ; Keratin-19* ; Keratins* ; Thyroid Gland* ; Young Adult

Isolated ACTH deficiency is a uncommon disorder causing secondary adrenocortical insufficiency. Less than 200 cases have been reported in the world. The major clinical manifestations are hypoglycemia, weight loss, hypotension, anemia, weakness, nausea, inability to excrete water load, and hyponatremia. A 56-year-old male was admitted because of weakness, fatigue, nausea and vomiting. He was pallor and not associated with hyperpigmentation. The basal plasma ACTH and cortisol levels were 8.30 pg/ml and 0.6 ug/dl. The serum cortisol did not response to rapid ACTH stimulation test. On combined pituitary stimulation test, the cortisol did not response to insulin-induced hypoglycemia. Other anterior pituitary hormones showed normal responses except elevated prolactin level. Six months after glucocorticoid replacement therapy, the elevated basal prolactin level returned to normal. Brain MRI did not show any anatomic abnormalities of the sellar and suprasella area. We report a case of isolated ACTH deficiency accompanied by hyperprolactineia, which respond to glucocorticoid replacement therapy.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Anemia ; Brain ; Fatigue ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperprolactinemia* ; Hypoglycemia ; Hyponatremia ; Hypotension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nausea ; Pallor ; Pituitary Hormones, Anterior ; Plasma ; Prolactin ; Vomiting ; Water ; Weight Loss

No abstract available.
Lymphangioma* ; Mediastinal Cyst*

BACKGROUND: Middle cerebral artery (MCA) steno-occlusive disease is known to be more common in Eastern than in Western, however, clinical characteristics have not been well documented. We aimed to find clinical characteristics of isolated MCA disease comparing with other MCA steno-occlusive disease. METHODS: Patients with lesion in M1 portion of MCA divided into three groups by angiographic finding ; isolated MCA stenosis (IMCAS, n=39), isolated MCA occlusion (IMCAO, n=29), and multiple (ICA, BA or VA) steno-occlusion involving MCA (Combined, n=48). Patients with evidence of cardioembolic MCA occlusion and Moyamoya disease were excluded. We analyzed clinical features, neuroimaging findings, and prognosis retrospectively. RESULTS: MRI showed large deep (36%), small deep (26%), cortical (21%), and mixed (cortical & deep, 15%) infarct in IMCAS group ; mixed (38%), large deep (21%), small deep (17%), and cortical (17%) infarct in IMCAO group ; large deep (31%), cortical (23%), small deep (17%), and no lesion (17%) in Combined group. Site of MCA steno-occlusion on angiogram was middle (44%), distal (39%), and proximal (18%) in IMCAS group ; proximal (48%), middle (35%), and distal (17%) in IMCAO group ; middle (42%), proximal (31%), and distal (27%) in Combined group. Patient's neurologic status, assessed by NIHSS, during first 7 days was 'not changed' or 'worsening' (>93%) in all 3 groups. Neurologic outcome at 3 months later was improving (65%) in IMCAS group by modified Rankin scale. CONCLUSIONS: Isolated MCA stenotic disease was not significantly different from iso-lated MCA occlusion group or Combined group in clinical features, neuroimaging findings, and prognosis.
Constriction, Pathologic ; Humans ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; Moyamoya Disease ; Neuroimaging ; Prognosis ; Retrospective Studies