No abstract available.

PURPOSE: High flow rate (FR) and pressure limit (PL) strategy with time-cycled pressure-limited (TCPL) ventilator is employed routinely in the neonates. Theoretical basis of this strategy is the two-compartment theory that the lung with acute respiratory failure consists of units with different compliance and resistance. But such constant pressure strategy has the risk of ventilator induced lung injury. We compared the ventilatory indices and clinical outcomes of two different strategies, high FR-constant pressure and low FR-constant FR in the ventilator care of the neonates with acute respiratory failure. METHODS: For the neonates born in our hospital and treated with mechanical ventilation from March to August in 1997, two different ventilator strategies were employed randomly with flow control ventilator. In the high-FR group, the FR was fixed at 10 L/ min and the PL was adjusted according to the arterial blood gas analysis (ABGA) results. In the low-FR group, the FR was adjusted to 10 mL/kg of tidal volume. Sixty neonates were enrolled, 32 in high-FR and 28 in low-FR group. Ventilatory indices and clinical outcomes were statistically cornpared in the two groups. RESULTS: Perinatal factors were not different in the two groups. Initial ventilator settings, ABGA results and ventilatory indices were not different. The tidal volume, fraction of inspired oxygen, peak inspired pressure and oxygenation index were higher and dynamic compliance was lower in the high-FR group compared to the low-FR group after 3 to 72 hours of ventilator care. In clinical outcomes, incidences of pulmonary interstitial emphysema, pneumothorax and chronic lung disease were significantly lower in the low-FR group. CONCLUSION: Low-FR with constant FR strategy resulted in better clinical outcomes in the ventilator care of neonates. We conclude that constant FR strategy prevents damage of the better compliant lung units and decreases the incidence of acute and chronic complications of ventilator care.
Blood Gas Analysis ; Compliance ; Emphysema ; Humans ; Incidence ; Infant, Newborn* ; Lung ; Lung Diseases ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency* ; Tidal Volume ; Ventilator-Induced Lung Injury ; Ventilators, Mechanical

Cardiac myxoma is the most common primary tumor of the heart. The tumor contains a variety of cell types that are thought to arise from a focus of primitive pluripotential mesenchymal cells in the area of the fossa ovalis. Throughout the myxoid stroma, there are variable amounts of reticular fivers, collagen, elastic fibers and smooth muscle cells. A 38-year-old female had right atrial myxoma with multiple pulmonary infarcts. In this case, we experienced an unusual degenerative change in the tumor of granulomatous lesion consisting of hemosiderin pigments, foreign body giant cells and peculiar, spheroid, semilunar or bamboo-shaped degenerated elastic fibers. Microscopically it resembles Gamna-Gandy nodule seen in the spleen of chronic passive congestion.
Female ; Humans

The 68 cervical cerclage operations of incompetent internal os of the cervix(IIOC) were performed at the Taegu Catholic Medical Center from Jan. 1, 1990 to Dec. 31, 1995. The results of this study were as follows: 1. The incidence of operation for IIOC was 0.23% of total delivery. 2. Highest number of IIOC was observed in the age group of 25 to 29, and the average number of pregnancy before operation was 4.1. 3. The significant contributory factor was previous history of the induced or spontaneous abortion. 4. In all cases, cerclage method was McDonald operation. 5. The average fetal salvage rate after operation was 82.5% and from the 14th week to 16th week of gestation(43 cases), the success rate of operation was 85%. 6. The causes of operation failure were premature labor in 6 cases(55%), premature rupture of membrane in 3 cases(27%) and abortion in 2 cases(18%) in order.
Abortion, Spontaneous ; Cerclage, Cervical ; Cervix Uteri* ; Daegu ; Female ; Humans ; Incidence ; Membranes ; Obstetric Labor, Premature ; Pregnancy ; Rupture

[Objective] The aim of this study was to investigate the effects of Joksamni (ST 36) combination on NADPH-diaphorase, neuronal nitric oxide synthase (nNOS), neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) in the cerebral cortex of spontaneously hypertensive rat.
[Methods] The experimental groups were divided into four groups : Normal, Joksamni (ST 36), Joksamni (ST 36) + Eumneungcheon (SP 9), and Joksamni (ST 36) + Gokji (LI 11). Needles were inserted into acupoints at the depth of 0.5 cm with basic insertion method. Electroacupuncture was done under the condition of 2 HZ electrical biphasic pulses with continuous rectangular wave lasting for 0.2 ms until the muscles produced visible contractions. Such stimulation was applied continuously for 10 minutes, 1 time every 2 days for 10 sessions of treatments. Thereafter we evaluated changes in NADPH-d positive neurons histochemically and changes in nNOS, NPY and VIP positive neurons immunohistochemically.
[Results] The optical densities of NADPH-d positive neurons of the Joksamni (ST 36) + Eumneungcheon (SP 9) group in all areas of cerebral cortex and Joksamni (ST 36) + Gokji (LI 11) group in primary somatosensory cortex, visual cortex, auditory cortex, perirhinal cortex were significantly increased as compared to the Joksamni (ST 36) group.
The optical densities of NADPH-d positive neurons of the Joksamni (ST 36) + Gokji (LI 11) group were sig-nificantly decreased as compared to the Joksamni (ST 36) + Eumneungcheon (SP 9) group with the exception of primary somatosensory cortex.
The optical densities of nNOS positive neurons of the Joksamni (ST 36) + Eumneungcheon (SP 9) group in all areas of cerebral cortex and Joksamni (ST 36) + Gokji (LI 11) group in auditory cortex, perirhinal cortex, insular cortex were significantly increased as compared to the Joksamni (ST 36) group. The optical densities of nNOS positive neurons of the Joksamni (ST 36) + Gokji (LI 11) group were significantly decreased in all areas of cerebral cortex as compared to the Joksamni (ST 36) + Eumneungcheon (SP 9) group.
The optical densities of NPY positive neurons of the Joksamni (ST 36) + Gokji (LI 11) group were signifi-cantly decreased in primary motor cortex, primary somatosensory cortex, cingulate cortex as compared to the Joksamni (ST 36) and Joksamni (ST 36) + Eumneungcheon (SP 9) groups.
The optical densities of VIP positive neurons of the Joksamni (ST 36) + Eumneungcheon (SP 9) group were significantly increased in all areas of cerebral cortex except f or cingulate cortex as compared to the Joksamni (ST 36) group. The optical densities of VIP positive neurons of the Joksamni (ST 36) + Gokji (LI 11) group were significantly decreased in auditory cortex, cingulate cortex, perirhinal cortex as compared to the Joksamni (ST 36) + Gokji (LIII) group were significantly decreased in all areas of cerebral cortex as compared to the Joksamni (ST 36) + Eumneungcheon (SP 9) group.
[Conclusions] The result demonstrated that electroacupuncture on Joksamni (ST 36) and its combination change the activities of the NO system and peptidergic system in the cerebral cortex of SHR and that acupoint combination is one of the important parameters for the effects.

The methods of treatment of discoid meniscus have been in controversy and there are so many reports which represent different results. We analyzed the results of the 91 knees with discoid menisci of 84 patients who had been treated with arthroscopic partial or total meniscectomy, open partial or total meniscectomy, semi-arthroscopic total menisceetomy form June 1982 to Dec. 1987. The puropse of this paper is to present the indication and prognosis of the each method of treatment. There were 45 cases of male, 46 cases of female, and 10 patients were affected both knee. 2 patients who had served arthroscopic partial meniscectomy were reoperated by arthroscopic total meniscectomy due to recurrence of symptom. We classified the types of tear into 7 classes and observed the clinical characteristics and results. The methods we applied were arthroscopic total meniscectomy 40 cases, semi-arthroscopic total meniscectomy 25 cases, arthroscipic partial meniscectomy 16 cases, open partial meniscectomy 3 cases, open total meniscectomy 2 cases, and conservative treatment after arthroscopic diagnosis 5 cases. The follow up cases were 56, and period of follow up was ranged form 11 months to 5 years and 4 months (av. 2 years and 8 months). The results were followings : l. 71.4% of the patients were placed between 11 years and 30 years old, and there was no sexual difference. 2. 11.9% of the patients were affected bilaterally. 3. The commonest clinical symptom and physical sign was clik (67%) and quadriceps muscle atrophy (48.4%) 4. Diagnostic accuracy of knee arthrogram was 88%, but it could not demonstrate the type of tear. In arthrographic finding, the older the patient, the thinner the meniscus was. 5. The commonest type of tear was type V(34.1%) and it was followed by type II (19.8%). 6. There was no difference between the long term results of arthroscopic and semi-arthroscopic total meniscectomy. 7. The results of total meniscectomy is better than partial meniscectomy.8. The method of treatment should be chosen according to the type of terar, so partial meniscectorny is recommended for type II, IV and total meniscictomy is recommended for type III, IV, V and VI. 9. Less hospitalization, earlier recovery, and better result were obtained by the arthroscopic or semi-arthroscopic total meniscectomy.
Atrophy ; Clinical Study ; Diagnosis ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Knee ; Male ; Methods ; Prognosis ; Quadriceps Muscle ; Recurrence ; Tears

We report three cases of neuroendocrine tumors of the lung characterized by large pleomorphic cell with frequent mitosis, which show neuroendocrine differentiation by both light microscopy or electron microscopy and iminunohistochemistry. These tumors have been categorized as large cell neuroendocrine carcinoma by Travis et al.(1991) in contrast with non-small cell lung cancer with neuroendocrine differentiation. In the latter, neuroendocrine differentiation is not evident by light microscopy and must be demonstrated by imunohistochemstry or by electron microscopy. The prognosis of large cell neuroendocrine carcinoma, together with non-small cell lung cancer with neuroendocrine differentiation, appears to be worse than cancer without neuroendocrine differentiation and intermediate between atypical carcinoid and small cell lung cancer. Larger numbers of patients will be needed to demonstrate significant differences in survival.
Lung Neoplasms

BACKGROUND: It has been known that arterial carbon dioxide tension is 4~5 mmHg higher than end-tidal carbon dioxide tension in healthy adults during general anesthesia. But negative arterial to end-tidal PCO2 difference was reported in pregnant patients undergoing cesarean section. The purpose of this study was to elucidate the difference between arterial and end-tidal PCO2 in anesthetized patients with reduced functional residual capacity. METHODS: 90 patients were divided into 3 groups i.e. control group (n=30), obese group (n=20, body weight more than 20% greater than ideal weight), pregnant group (n=40). All patients had no cardiac or respiratory abnormalities and never smoked. Arterial blood gas analysis and measurement of end-tidal PCO2 were done 20 minutes after induction of anesthesia in control and obese group and just before uterine incision and 20 minutes after fetal delivery in pregnant group. RESULTS: There were significant correlations between arterial and end-tidal PCO2 in all groups. The incidences of negative arterial to end-tidal PCO2 difference were 10% in control group, 40% in obese group, 42.5% in pregnant group (p<0.05). CONCLUSION: From this study, it is concluded that patients with reduced functional residual capacity have more incidences of negativity than normal patients in the values of arterial to end-tidal PCO2 difference during general anesthesia. So when the tight control of PaCO2 is required in patients with reduced FRC, we recommend to measure PaCO2 for better anesthetic management.
Adult ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Body Weight ; Carbon Dioxide* ; Carbon* ; Cesarean Section ; Female ; Functional Residual Capacity* ; Humans ; Incidence ; Pregnancy ; Smoke

No abstract available.

No abstract available.
Acoustics*