In this study, high frequency oscillatory ventilator was designed and constructed. Using designed by phase-lock loop system, in order to accurately and easily treat both the outlet volume and rpm. A system has been designed and is being evaluated using CD4046A PLL IC. We use this PLL IC for the purpose of motor controls. The device consists of PLL system, pumping mechanism, piston, cylinder, and special crank shaft are required. This system characteristics were as follows: 1) Frequency: 20-1800 rpm 2) Outlet air volume: 1-50 cc
Ventilators, Mechanical*

OBJECTIVE: To identify the usefulness of both the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) and Denver Developmental Screening Test II (DDST-II) in preterm babies with neurodevelopmental impairment, considering the detection rate as regulation of criteria. METHODS: Retrospective medical chart reviews which included the Bayley-III and DDST-II, were conducted for 69 preterm babies. Detection rate of neurodevelopmental impairment in preterm babies were investigated by modulating scaled score of the Bayley-III. The detection rate of DDST-II was identified by regarding more than 1 caution as an abnormality. Then detection rates of each corrected age group were verified using conventional criteria. RESULTS: When applying conventional criteria, 22 infants and 35 infants were detected as preterm babies with neurodevelopmental impairment, as per the Bayley-III and DDST-II evaluation, respectively. Detection rates increased by applying abnormal criteria that specified as less than 11 points in the Bayley-III scaled score. In DDST-II, detection rates rose from 50% to 68.6% using modified criteria. The detection rates were highest when performed after 12 months corrected age, being 100% in DDST II. The detection rate also increased when applying the modified criteria in both the Bayley-III and DDST-II. CONCLUSION: Accurate neurologic examination is more important for detection of preterm babies with neurodevelopmental impairment. We suggest further studies for the accurate modification of the detection criteria in DDST-II and the Bayley-III for preterm babies.
Developmental Disabilities ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Mass Screening ; Neurologic Examination ; Pilot Projects* ; Premature Birth ; Retrospective Studies ; Weights and Measures

OBJECTIVE: To investigate appropriate treatment time and useful bone turnover markers (BTMs) for monitoring bone turnover during the postmenopausal period, we analyzed changes of two bone resorption markers; serum carboxyterminal telopeptide of collagen I (s-CTX), urine deoxypyridinoline (u-DPD), one bone formation marker; serum osteocalcin (s-OC), and bone mineral density (BMD) in Korean postmenopausal women. METHODS: Seventy-eight menopausal women were divided into three groups according to postmenopausal period: group I (0–5 years), group II (6–10 years), group III (≥10 years). All groups were subdivided into an osteoporosis group (T-score≤-2.5) and a non-osteoporosis group (T-score>-2.5). BTMs such as s-CTX, u-DPD, s-OC, and BMD (g/cm²) were measured by dual-energy X-ray absorptiometry (DXA) in all patients. Analysis of variables among groups based on the postmenopausal period was performed using ANOVA. RESULTS: There was significant negative correlation between BMD and postmenopausal period. The levels of all BTMs including s-CTX, u-DPD, and s-OC were highest in group II and the increased levels of all BTMs subsequently declined in group III. The levels of BTMs were higher in the osteoporosis groups than in the non-osteoporosis groups in all subjects. It was statistically significant that the level of s-CTX in group I was higher in the osteoporosis group than in the non-osteoporosis group. CONCLUSION: This study showed that bone resorption and bone formation were the highest 5–10 years after menopause, and s-CTX is more useful than u-DPD among the bone resorption markers. It’s important to measure serially both BMD and BTM within 10 years after menopause for accurate diagnosis and management for postmenopausal osteoporosis.
Absorptiometry, Photon ; Bone Density* ; Bone Remodeling ; Bone Resorption ; Collagen ; Diagnosis ; Female ; Humans ; Menopause ; Osteocalcin* ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Postmenopause*

PURPOSE: To investigate the measured values of the talus in Koreans. MATERIALS AND METHODS: We measured 88 tali from 44 cadavers that have been donated between December 2012 and December 2015. Of the cadavers, 27 were male and 17 were female. Their mean age was 73 years. The length and width of the talus were measured using a digital goniometer and vernier caliper. RESULTS: The values of cadaveric measurement, mean maximal width and length, width and length of the dome anterior, width and length of the posterior facet, height and length of the trochlear medial facet, and height and length of the trochlear lateral facet were 43.6±2.6 mm, 56.5±3.3 mm, 32.5±2.0 mm, 42.2±2.7 mm, 22.2±2.2 mm, 34.7±2.0 mm, 15.3±1.3 mm, 33.3±2.9 mm, 25.3±3.3 mm, and 30.8±2.4 mm for men and 38.9±1.6 mm, 53.6±2.4 mm, 27.9±2.1 mm, 37.4±3.2 mm, 20.6±0.8 mm, 31.9±1.2 mm, 13.6±2.6 mm, 28.4±2.5mm, 24.9±2.1 mm, and 28.9µ1.4 mm for women, respectively. The size of the talus showed an accuracy of 86% when anteroposterior diameter was greater than 59 mm. A difference in the size of the right and left talus was not observed. The mean inclination and declination angles were 24.4°±4.2° and 28.2°±5.4° for men, and 24.6°±3.6° and 24.7°±6.7° for women (p=0.980, p=0.018), respectively, at least 15°, which showed a big difference for every object up to 37°. CONCLUSION: This paper, to the best of our knowledge, is the first study to measure the talus in Koreans. There were differences by gender and ethnicity in the in measured talus values. The measurements were smaller than European-Americans and greater than Japanese.
Asian Continental Ancestry Group ; Cadaver* ; Female ; Humans ; Male ; Talus*

BACKGROUND: It has been demonstrated that within 2 weeks following acute myocardial infarction (AMI), exercise-induced ST-segment depression (STD) indicates subendocardial ischemia in the viable myocardium within infarcted or remote area from the infarction. Exercise-induced ST-segment elevation (STE) in leads with abnormal Q wave is associated with left ventricular dysfunction or aneurysm rather than transmural ischemia. We studied whether each pattern of ST-segment shift on exercise ECG during recovery phase following AMI is correlated with the perfusion status of infarcted myocardium evaluated by myocardial contrast echocardiog-raphy (MCE), regardless of findings of coronary angiography (CAG). METHOD: Study population was consisted of 25 patients with AMI (anteior wall: 11 patients, inferior wall: 14 patients, mean age=57.3+/-8.9years). Patients underwent exercise ECG and coronary angiography at 10 days post-AMI. After CAG, sonicated Hexabrix was injected into both coronory arteries alternatively and 2-D echocardiography was taken in parasternal short axis, apical 4, and 2 chamber views. To analyze the echocardiographic image semiquantitively, left ventricle was divided into 20 segments and perfusion status was graded as good, partial, and no opacification. RESULT: All patients with exercise-induced STE (n=8) in Q-leads had patent infarcted-related artery and poor collaterals on CAG, which was associated with poor or no opacification of infarcted myocardium on MCE. Patients with exercise-induced STD (n=9) frequently had closed infarct-related artery (67%), but good opacification of infarcted myocardium was shown by retrograde perfusion via collaterals, which was commonly seen in patients with multivessel disease. CONCLUSION: In early recovery phase of acute myocardial infarction, exercise-induced ST elevation in Q leads was associated with poor perfusional status in infarcted myocardium, even with patent infarct-related artery on CAG, while exercise-induced ST depression was frequently seen in the good perfusional status despite of closed infarted-related artery, which was commonly observed in patients with multivessel disease.
Aneurysm ; Arteries ; Axis, Cervical Vertebra ; Coronary Angiography ; Depression ; Echocardiography ; Electrocardiography ; Heart Ventricles ; Humans ; Infarction ; Ioxaglic Acid ; Ischemia ; Myocardial Infarction* ; Myocardium* ; Perfusion* ; Ventricular Dysfunction, Left

BACKGROUND: It has been demonstrated that within 2 weeks following acute myocardial infarction (AMI), exercise-induced ST-segment depression (STD) indicates subendocardial ischemia in the viable myocardium within infarcted or remote area from the infarction. Exercise-induced ST-segment elevation (STE) in leads with abnormal Q wave is associated with left ventricular dysfunction or aneurysm rather than transmural ischemia. We studied whether each pattern of ST-segment shift on exercise ECG during recovery phase following AMI is correlated with the perfusion status of infarcted myocardium evaluated by myocardial contrast echocardiog-raphy (MCE), regardless of findings of coronary angiography (CAG). METHOD: Study population was consisted of 25 patients with AMI (anteior wall: 11 patients, inferior wall: 14 patients, mean age=57.3+/-8.9years). Patients underwent exercise ECG and coronary angiography at 10 days post-AMI. After CAG, sonicated Hexabrix was injected into both coronory arteries alternatively and 2-D echocardiography was taken in parasternal short axis, apical 4, and 2 chamber views. To analyze the echocardiographic image semiquantitively, left ventricle was divided into 20 segments and perfusion status was graded as good, partial, and no opacification. RESULT: All patients with exercise-induced STE (n=8) in Q-leads had patent infarcted-related artery and poor collaterals on CAG, which was associated with poor or no opacification of infarcted myocardium on MCE. Patients with exercise-induced STD (n=9) frequently had closed infarct-related artery (67%), but good opacification of infarcted myocardium was shown by retrograde perfusion via collaterals, which was commonly seen in patients with multivessel disease. CONCLUSION: In early recovery phase of acute myocardial infarction, exercise-induced ST elevation in Q leads was associated with poor perfusional status in infarcted myocardium, even with patent infarct-related artery on CAG, while exercise-induced ST depression was frequently seen in the good perfusional status despite of closed infarted-related artery, which was commonly observed in patients with multivessel disease.
Aneurysm ; Arteries ; Axis, Cervical Vertebra ; Coronary Angiography ; Depression ; Echocardiography ; Electrocardiography ; Heart Ventricles ; Humans ; Infarction ; Ioxaglic Acid ; Ischemia ; Myocardial Infarction* ; Myocardium* ; Perfusion* ; Ventricular Dysfunction, Left

BACKGROUND: In acute myocardial infarction, left ventricular remodeling, which was influenced by infarct size, location, and patency of infarct related artery(IRA), is a important prognostic factor for chronic heart failure and survival. Recently, several reports suggested that patent IRA does not always mean true myocardial reperfusion, and myocardial contrast echocardiography(MCE) may be a useful tool for assessing infarct size and viability of infarcted myocardium. So, we investigated the association between the degree of myocardial reperfusion assessed by MCE and long term change of left ventricular volume in acute anterior wall myocardial infarction patients who had patent IRA. METHODS: The study population was consisted of 17 patients with first acute anterior wall myocardial infarction patients who had patent left anterior descending artery by thrombolytic therapy or rescue PTCA. MCE was done immediately after coronary angiography within two weeks of myocardial infarction onset and analyzed by semiquantitative method to get opacification index. For analysis of left ventricular ejection fraction, wall motion abnormality and left ventricular volume, echocardiogram was taken within 2 weeks of myocardial infarction oneset and 9 months later in each case. Wall motion abnormality was quantified as wall motion index. According to serial changes of left ventricular volume, patients were divided into two groups ; group 1(less than 10% increase of LV volume at follow-up compared to intial echocardiographic exam) and group 2(more than 10% increase of left ventricular volume). We compared the opacification index of infarcted myocardium, wall motion abnormality, and ejection fraction between the two groups. RESULTS: Initial left ventricular volume and ejection fraction were not different between group 1 and group 2, but the opacification index was lower and initial wall motion index higher in group 2 than group 1. Opacification index, wall motion index, ejection fraction and left ventricular volume were closely correlated in the whole cases. By multivariate ananlysis, opacification index was the only significant factor predicting left ventricular volume increment. CONCLUSION: Myocardial reperfusion, which is closely correlated with ejection fraction and wall motion abnormality, acts as a independent predictor of left ventricular dilatation after acute anterior wall myocardial infarction. This result suggests that assessment of microvascular integrity with myocardial contrast echocardiography may be a valuable indicator to predict long-term change of left ventricular volume, although this is suggestive result in a limited number of patients.
Anterior Wall Myocardial Infarction* ; Arteries ; Coronary Angiography ; Dilatation ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Myocardial Infarction ; Myocardial Reperfusion* ; Myocardium ; Stroke Volume ; Thrombolytic Therapy ; Ventricular Remodeling

Anti-glomerular basement membrane antibody mediated rapidly progressive glomerulonephritis is a rare autoimmune disease. It is characterized by acuterenal failure and crescentic glomeruli with linear immune deposits along glomerular basement membrane mediated by anti-GBM antibodies. We report a case of a sixty-years-old man with generalized edema and hematuria. On admission, BUN/Creatinine was 118/19.6 mg/dL, Hb was 10.2 g/dL. On urinalysis, protein was 3+, and many RBCs were found. Renal biopsy specimen which contained 8 glomeruli showed active cellular crescent formation in all glomeruli. On immunofluorescent staining specimen, there were 4 glomeruli which showed strong IgG linear staining along the glomerular basement membrane and mild C3 & C1q deposit along the capillary walls. The titer of anti-GBM antibody was 123 EU by ELISA (normal: <10 EU). We treated with high dose of corticosteroid and plasmapheresis, but renal function was not recovered even after 3 months of hemodialysis.
Antibodies ; Autoimmune Diseases ; Basement Membrane* ; Biopsy ; Capillaries ; Edema ; Enzyme-Linked Immunosorbent Assay ; Glomerular Basement Membrane ; Glomerulonephritis ; Hematuria ; Hemorrhage* ; Immunoglobulin G ; Plasmapheresis ; Renal Dialysis ; Urinalysis

Exercise-induced anaphylaxis (EIA) is a medical emergency in that it derives from a physical allergy. We reported a case of food-independent EIA based on history and laboratory data. A 40-year-old male patient was presented with generalized urticaria, angioedema, and syncope after jogging. He had suffered from allergic rhinitis for 25 years. Increased level of serum tryptase was noted. Mast cell activation might be suggested in the pathophysiologic mechanism of EIA.
Adult ; Anaphylaxis* ; Angioedema ; Emergencies ; Humans ; Hypersensitivity ; Jogging ; Male ; Mast Cells ; Rhinitis ; Syncope ; Tryptases* ; Urticaria

BACKGROUND AND OBJECTIVES: The mechanism by which atrial fibrillation (AF) electrically converts to sinus rhythm remains undefined. The purpose of this study was to assess in detail the electrograms recorded during cardioversion using direct current (DC) shock. SUBJECTS AND METHODS: In 23 patients with AF (chronic n=20, paroxysmal n=3, M:F=15:8, 50 - 70 years old), electrograms were recorded simultaneously from a 20-pole electrode catheters (Duo-deca, DAIG) in the right atrial free wall and the coronary sinus immediately after DC shock given transthoracically. The activation patterns following 45 trials consisting of 23 successful and 22 unsuccessful cardioversion were analyzed. RESULTS: Two distinct patterns following successful cardioversion were observed; either immediate resumption of normal sinus rhythm (n=5, 21%), or one or two activations immediately after shock preceded normal sinus rhythm (n=18, 79%). The energy levels of the two patterns were not significantly different (260 J, 250 J, respectively). Four patterns following unsuccessful cardioversion were noted; unchanged (n=10, 45%), converted to atrial flutter (n=4, 18%), production of three or four beats of more coordinated complexes and reverted to AF (n=5, 22%), and converted to sinus rhythm transiently and reinitiated AF by one or two atrial premature beats (n=3, 13%). The magnitude of the DC shock applied at these 4 different patterns was 196 J, 240 J, 264 J, and 340 J, respectively in which low energy levels made a simultaneous depolarization of the entire atria unlikely. CONCLUSION: Distinct activation patterns were identified following successful and unsuccessful cardioversion using DC shock for AF. These observations suggest that total depolarization of the entire atria is not a prerequisite for the conversion of AF into sinus rhythm.
Atrial Fibrillation* ; Atrial Flutter ; Cardiac Complexes, Premature ; Catheters ; Coronary Sinus ; Electric Countershock* ; Electrodes ; Humans ; Shock