No abstract available.
Child* ; Humans ; Humerus*

BACKGROUND: Community-acquired pneumonia(CAP) remains a leading cause of morbidity and mortality worldwide. Recently, the evolution of drug-resistant microorganisms has become a serious problem in CAP management. Specific antimicrobial therapy is the cornerstone of CAP management. However, obtaining an accurate etiologic diagnosis clinically is not easy and empirical antimicrobial treatment is usually administered prior to the correct microbiologic diagnosis. In this study, the clinical usefulness of empirical CAP treatment was investigated. METHODS: A total 35 cases were studied prospectively over a 16-month period in Mokpo Catholic Hospital from Dec. 1995 to Mar. 1997. The microbiologic diagnosis was made by sputum, blood culture, a specific serum antibody test and an immunologic study. RESULTS: The causative organisms were isolated in 10 (30%) out of 33 cases: 8 cases and 1 case on the sputum culture and blood culture respectively, and 1 case by an indirect hemagglutinin test. 12 cases had underlying diseases: pulmonary tuberculosis 4, alcoholism 4, diabetes mellitus 3, and liver cirrhosis 1. Antimicrobial treatment was given empirically and all cases recovered. CONCLUSION: A definite microbiologic diagnosis before commencing the appropriate treatment in CAP is not straightforward. Empirical therapy according to a clinical assessment is important and helpful. However, every effort to make the correct etiologic diagnosis should be taken.
Alcoholism ; Diabetes Mellitus ; Diagnosis ; Hemagglutinins ; Jeollanam-do* ; Liver Cirrhosis ; Mortality ; Pneumonia* ; Prospective Studies ; Sputum ; Tuberculosis, Pulmonary

BACKGROUND: Preoxygenation is routine prior to rapid sequence induction of general anesthesia for a cesarean section. The aim of this study was to evaluate the preoxygenation techniques of tidal volume breathing (TVB) and deep breathing (DB) for a cesarean section. METHODS: One hundred twenty ASA I and II patients scheduled for a cesarean section under general anesthesia participated in the study. Preoxygenation was performed with 5, 7, and 10 L/min 100% oxygen. The following techniques were tested: 1) normal TVB for a 5-min period (TVB/5 min) and 2) DB for a 2-min period (4 DB/0.5 min, 8 DB/min, 12 DB/1.5 min and 16 DB/2 min). Inspired (FIO2) and end-tidal oxygen fraction (FETO2), end-tidal carbon dioxide pressure (ETCO2) and oxygen saturation (SpO2) were measured at 0.5-min intervals. RESULTS: During TVB, FETO2 increased rapidly between 0.5 and 3.5 min and plateaued by 3.5 min at 78.5%, 83.3% and 90.8% with 5, 7 and 10 L/min 100% oxygen, respectively. Four DB/0.5 min increased FETO2 to 64.7%, 67.2% and 72.3% at 5, 7, and 10 L/min 100% oxygen, respectively. As compared with four DB/0.5 min, the values of FETO2 with TVB/1.5 min and TVB/2 min were high at 7, 10 and 5 L/min 100% oxygen. CONCLUSIONS: We concluded that TVB/2 min was more effective than four DB/0.5 min in achieving preoxygenation but eight DB/min could be used in case of an emergent operation.
Anesthesia, General ; Carbon Dioxide ; Cesarean Section* ; Female ; Humans ; Oxygen ; Pregnancy ; Respiration* ; Tidal Volume*

Ankylosis ; Arthroplasty ; Humans ; Jaw ; Joint Diseases ; Mandibular Condyle ; Prostheses and Implants ; Temporomandibular Joint Disorders ; Temporomandibular Joint

BACKGROUND: Indicator that can predict pleural thickening in pleural tuberculosis has not been known clearly. By the previous study, patients with pleural thickening > or =10 mm had significantly lower glucose and pH values and higher lysozyme and TNF-alpha values than those with pleural thickening <10 mm, but interferon-gamma (IFN-gamma) values were not significantly different. We studied the relationship between pleural thickening and biochemical, or immunologic finding in initial pleural fluid. METHODS: We followed up 22 patients who had been diagnosed as pleural tuberculosis. four patients (18.1%) had pleural thickening > or =10 mm and 12 patient (54.5%) had pleural thickening > or =3 mm. Initial pleural fluid protein, LDH, pH, glucose and IFN-gamma, Interleukin-1alpha (IL-1alpha) were studied. RESULTS: Pleural fluid levels of protein, LDH, glucose, and IFN-gamma were not statistically significant different not only between the group of pleural thickening > or =3 mm and the group of pleural thickening <3 mm, but also between the group of pleural thickening > or =10 mm and the group of pleural thickening <10 mm. The pleural fluid IFN-gamma level, the group with pleural thickening > or =3 mm (85.9+/- 37.1 U/mL) was significantly higher than without thickening (44.8+/-32.0 U/mL) (p< 0.05) and the group with pleural thickening> or =10 mm (106.9+/-8.6 U/mL) was significantly higher than without thickening (58.5+/-8.6 U/mL)(p< 0.001). CONCLUSION: Although patient number of our study was smaller than the previous study, IFN-gamma level in initial pleural fluid of pleural tuberculosis may be considered as the predictive factor of pleural thickening.
Glucose ; Humans ; Hydrogen-Ion Concentration ; Interferon-gamma ; Interleukin-1alpha ; Muramidase ; Pleural Diseases ; Tuberculosis, Pleural* ; Tumor Necrosis Factor-alpha

BACKGROUND: Infusion of pentastarch, with or without dopamine, has been used for cardiovascular support during epidural anesthesia, especially for maintaining normotension. The purpose of this study was to evaluate the effects of dopamine on hemodynamics, estimated hepatic blood flow, and the extraction ratio of indocyanine green during thoracic epidural anesthesia with the infusion of pentastarch. METHODS: Thirty healthy rabbits, weighing 2.5 - 3.5 kg, were evenly divided into three groups during thoracic epidural anesthesia; The control group received normal saline (10 ml/kg/hr), the pentastarch group received pentastarch (10 ml/kg/hr), and the dopamine group received pentastarch (10 ml/kg/hr) and a dopamine infusion (5 microgram/kg/min). Thoracic epidural block was done at T5 level with 0.4 ml/kg of 1% lidocaine. Hepatic blood flow was estimated by measuring the clearance of indocyanine green according to the constant infusion method before and 30 and 60 minutes after epidural anesthesia. The extraction ratio of indocyanine green, heart rate, mean arterial pressure, central venous pressure and splanchnic vascular resistance were also measured at the same time in the three groups. RESULTS: Heart rates, mean arterial pressures, estimated hepatic blood flow and splanchnic vascular resistance were unchanged but central venous pressure increased significantly at 30 and 60 minutes after epidural anesthesia in the dopamine group. The extraction ratio of indocyanine green remained unchanged 30 and 60 minutes after epidural anesthesia in all groups. CONCLUSIONS: Combined therapy with pentastarch and dopamine infusion can keep the cardiovascular stability, hepatic blood flow and splanchnic vascular resistance constant during thoracic epidural anesthesia in rabbits.
Anesthesia, Epidural* ; Arterial Pressure ; Central Venous Pressure ; Dopamine* ; Heart Rate ; Hemodynamics ; Hydroxyethyl Starch Derivatives ; Indocyanine Green ; Lidocaine ; Rabbits* ; Vascular Resistance

OBJECTIVES: The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. MATERIALS AND METHODS: Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. RESULTS: By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. CONCLUSION: The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors.
Drinking ; Follow-Up Studies ; Humans ; Lymph Nodes ; Medical Records ; Mouth Neoplasms* ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Smoke ; Smoking ; Surgery, Oral ; Survival Rate*

BACKGROUND AND OBJECTIVES: Vascular brachytherpy known to be an effective method in the prevention of restenosis following percutaneous coronary intervention (PCI). In this study we observed the effects of a radioisotope-loaded stent in a porcine model. MATERIALS AND METHODS: Holmium-166 ((166)Ho) was loaded onto the stent surface using impregnated polyurethane, and placed the stents into 7 porcine coronary arteries. Four weeks after stent overdilation injury, histopathological examination was performed. RESULTS: The absorbed dose of (166)Ho to the coronary artery, from the 158.5+/-140.9 microCi (166)Ho stent, was about 141 Gy at a depth of 0.5 mm, which was calculated by Monte Carlo EGS 4 Code. The mean external, and internal elastic lamina areas, the luminal and neointimal areas and the histopathological area stenosis in the 7 porcine coronary arteries were 7.6+/-2.8 mm2, 4.7+/-1.6 mm2, 2.4+/-1.4 mm2, 2.3+/-1.6 mm2 and 49.4+/-24.9%, respectively. The histopathological findings revealed remarkable inflammatory reactions and thrombosis in two of the porcine coronary arteries. CONCLUSION: (166)Ho radioactive loaded stents, using impregnated polyurethane, may inhibit neointimal hyperplasia, but the problems of stent thrombosis and inflammation should be solved.
Constriction, Pathologic ; Coronary Restenosis ; Coronary Vessels ; Hyperplasia ; Inflammation ; Percutaneous Coronary Intervention ; Phenobarbital ; Polyurethanes ; Radioisotopes ; Stents* ; Thrombosis