It is ironic that John Gibbon's interest in the development of CPB was stimulated by his experience with a fatal case of pulmonary embolism. Massive pulmonary embolism is a siginificant cause of death in hospital, despite improvement in patient management in recent years. In Korea, none of the reports was detailed the anesthetic management of this group of physiologically compromised patients. So we describe an approach to the anesthetic management of a patients with chronic embolic occlusion of the pulmonary artery, who underwent successful pulmonary embolectomy.
Cause of Death ; Embolectomy* ; Humans ; Iron ; Korea ; Pulmonary Artery ; Pulmonary Embolism

BACKGROUND: Continuous positive airway pressure (CPAP) during spontaneous breathing has contributed greatly to the management of the neonatal respiratory distress syndrome and adult respiratory failure associated with acute lung disease. CPAP systems may be grouped into two general categories, demand flow CPAP system and continuous flow CPAP system. The purpose of this study was to evalute the respiratory effects of continuous flow CPAP system compared with demand flow CPAP system. METHODS: Cardiorespiratory values were measured in twelve respiratory failure patients on demand flow CPAP system and continuous flow CPAP system made by authors. CPAP level and FIO2 were maintained at the same level for both modalities. RESULTS: Changing from demand flow CPAP to continuous flow CPAP was associated with significant decrease in tidal volume(demand flow CPAP 450+/-153.0 ml, continuous flow CPAP 338+/-73.8 ml), airway pressure fluctuation(demand flow CPAP 6.4+/-1.2 cmH2O, continuous flow CPAP 2.4+/-0.7 cmH2O) and improvement in arterial oxygen partial pressure (demand flow CPAP 90.0+/-20.9 mmHg, continuous flow CPAP 105.9+/-24.6 mmHg). There were no significant changes in other cardiorespiratory values, such as arterial blood pressure, heart rate and respiratory rate. CONCLUSIONS: These results suggest that continuous flow CPAP system may be a beneficial modality in the management of respiratory failure patients compared to demand flow CPAP system.
Adult ; Arterial Pressure ; Continuous Positive Airway Pressure ; Heart Rate ; Humans ; Lung Diseases ; Oxygen ; Partial Pressure ; Respiration ; Respiratory Distress Syndrome, Newborn ; Respiratory Insufficiency ; Respiratory Rate

OBJECTIVE: The aim of our study was to define the prevalence, demographic data, selection of the medical services and disability of the patients with self-reported arthritis which were based on the data of National Health and Nutrition Survey (NHNS) conducted by Korea Institute for Health and Social Affairs (KIHASA) and Ministry of Health and Welfare in 1998. MEHTODS: By a stratified multistage probability sampling method, 200 sample districts which consisted of total 13,523 households were selected all over the country. The investigation started with a basic household survey which was completed in 12,189 households with exclusion of non-kinship family. The Health Interview Survey was subdivided to 5 parts including the basic household survey (n=39,060), the diseases survey (n=26,448), and the disability survey (n=694). RESULTS: An estimated 8.0% of Koreans had some form of self-reported arthritis in 1998 and this proportion was higher than that of other chronic medical conditions such as peptic ulcer disease, hypertension, and diabetes mellitus (DM) -7.0%, 4.5%, and 2.2%, respectively. Arthritis was more prevalent among people with female, increasing age, lower income (less than 500 thousand \ per month), lower educational attainment (less than 9 years), and lower standard of living. Especially, arthritis ranked first in prevalence as the cause of the chronic disease in the population aged over 45 years, with the prevalence rate of 22.6%. People with arthritis were more likely to report functional limitations such as activities of daily living (ADL) and instrumental activities of daily living (IADL) (5.4%), compared with people who had other musculoskeletal diseases, such as low back pain (3.8%), and herniated intervertebral disc (2.8%). The loss of productivity from arthritis was estimated to reach 0.25% of gross domestic product (GDP) amounts to won 1,133 billion per year which was remarkably higher than that of cardiovascular diseases or cancers. CONCLUSION: Arthritis has a major impact on the health profile of our population. High burden of arthritis in our society should be considered as an important factor in planning health care services and setting research priorities.
Activities of Daily Living ; Arthritis* ; Cardiovascular Diseases ; Chronic Disease ; Delivery of Health Care ; Diabetes Mellitus ; Efficiency ; Epidemiology ; Family Characteristics ; Female ; Gross Domestic Product ; Humans ; Hypertension ; Intervertebral Disc ; Korea* ; Low Back Pain ; Musculoskeletal Diseases ; Nutrition Surveys ; Peptic Ulcer ; Prevalence* ; Socioeconomic Factors

BACKGROUND: Although several hospital-based stroke studies were published, there has not been any reliable data representing the clinical characteristics of stroke in Korea. We analyzed the clinical characteristics of patients with ischemic stroke registered in the Korean Stroke Registry (KSR), which is the largest prospective hospital-based nation-wide stroke registry in Korea. METHODS: The KSR provided standardized protocols for collecting data, which includes the data of demographics, subtypes of stroke, risk factors, and neurological outcome at discharge. The brain imaging studies, including CT or MRI, were performed in all cases. RESULTS: KSR registered 10,811 patients of acute ischemic stroke between Nov. 2002 and Jun. 2004. The large-artery atherosclerosis was the most common subtype (37.3%), followed by small vessel occlusion (30.8%). Hypertension (65.4%) was the most common risk factor, followed by smoking (34.5%) and diabetes (28.3%). Although most of the hypertensive and diabetic patients had been diagnosed before the stroke, less than 45.4% and 32.5% of them were under regular control. The steno-occlusive lesion of extracranial carotid artery was only 29.3% and the ratio of intra- to extracranial artery disease was more than 2 in KSR. Only 20.5% of patients were admitted within 3 hours after stroke onset and 2.1% were treated with intravenous thrombolysis. In-hospital case-fatality was 5.2%, which is relatively comparable to those of previous studies. CONCLUSIONS: The KSR provided informative data in understanding the clinical characteristics of ischemic stroke in Korea. Further analysis of KSR will facilitate clinical trials and development of guidelines for the management of stroke patients.
Arteries ; Atherosclerosis ; Carotid Arteries ; Cerebrovascular Disorders ; Demography ; Epidemiology ; Humans ; Hypertension ; Korea ; Magnetic Resonance Imaging ; Neuroimaging ; Prospective Studies* ; Registries ; Risk Factors ; Smoke ; Smoking ; Stroke*