Postoperative hypoxemia has been well known is adults but not in infants and children, although they are potentially more susceptible to airway closure and to disturbances in pulmonary gas exchange. We measured blood gas parameters of capillary blood in 30 cases of ASA physical status class l infants and children breathing room air, before and after general anesthesis for superficial surgical procedures. The blood samples were taken preoperatively, on arrival and 4~6 minutes later in the recovery room. The results are as follows: 1) The blood gas parameters on arrival in the recovery room showed significant change in pH nad PCO2(p<0.01) and increased PCO2(p<0.01) in comparison with preoperative gases. 2) The blood gas parameters checked at 4~6 minutes later in the recovery room showed insignificant differences from preoperative values of PO2 and SO2, but significantly increased PCO2 and decreased pH(p<0.01). 3) As a results of this study, it is suggested that for the safe management of patients, supplementary oxygen be provided for at least 10 minutes in the early recovery period to all pediatric patients.
Adult ; Anesthesia, General* ; Anoxia* ; Blood Gas Analysis ; Capillaries ; Child* ; Gases ; Humans ; Hydrogen-Ion Concentration ; Infant ; NAD ; Oxygen ; Pulmonary Gas Exchange ; Recovery Room ; Respiration

The use of external fixator is popular in the treatment of open tibial fracture, severe comminuted fracture and segmental fracture, which minimizes further soft tissue injury and provides rigie fixation. The purpose of this study was to determine the complications and effectiveness of external fixation for treating the fractures of tibia. 33 patients with tibial fracture had been treated with external fixator from April 1993 to April 1994 at the orthopaedic department of Kang Dong Catholic General Hospital. We analysed 23 cases(21 patients) which could be followed up more than 12 months. The results were as follows; 1. Average duration with external fixator was 15.1 weeks. 2. Average time of bone union was 22.9 weeks. 3. 6 cases of pin tract infection were developed and they were treated with curettage and drainage, local antibiotics therapy, pin translation, or removal of external fixator. 4. The delayed union were developed in 5 cases, angulation deformity in 1 case, chronic osteomyelitis in 2 cases and soft tissue defect in 1 case. 5. Secondary operations caused by delayed union, valgus deformity, skin defect and bone exposure, were performed in 6 cases. 6. The use of external fixator provided good result in open fracture, intraarticular comminuted fracture, segmental fracture, and multiple injury, but chronic osteomyelitis and articular stiffness were developed in some cases.
Anti-Bacterial Agents ; Congenital Abnormalities ; Curettage ; Drainage ; External Fixators ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Multiple Trauma ; Osteomyelitis ; Skin ; Soft Tissue Injuries ; Tibia ; Tibial Fractures

Venous thromboembolism is well known as one of the rare but serious adverse effects of combined oral contraceptives (COCs). The COCs with third and fourth generation progestogens were found to have higher risk of venous thrombosis than those with second generation progestogens. We present a case of pulmonary embolism in a 23-year-old nulligravid woman who was using COCs containing the third generation progestogen (desogestrel). At the time of presentation of the adverse effect, she had been using the COCs for 4 months. She had no additional risk factors for thrombosis such as smoking, surgery, tumor as well as genetic factors. This case demonstrates even young women in otherwise good health may be at risk of venous thromboembolism from low-dose formulations of COCs as an over-the-counter drug. We describe this case with a brief review of literatures.
Contraceptives, Oral* ; Contraceptives, Oral, Combined ; Desogestrel* ; Female ; Humans ; Progestins ; Pulmonary Embolism* ; Risk Factors ; Smoke ; Smoking ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis ; Young Adult

No abstract available.
Diagnosis*

Although most gynecologists had prescribed estrogen with or without progestin for their menopausal patients before the publication of Women's health Initiative (WHI) trial findings, only 35 to 40% of women ever started hormone therapy (HT) and many discontinued it, because of perceived side effects and discomfort. HT will not likely to be regularly prescribed in the future given the recommendations by several groups against long-term use for chronic diseases after the release of the findings of the WHI. Consequently, many postmenopausal women have turned to botanical dietary supplements containing phytoestrogen as an alternative to HT. Although there are numerous studies in the literature over the last decade trying to address the efficacy of phytoestrogens on bone health in animal models and in humans, the efficacy of phytoestrogens as bone-protective agents in vivo remains unclear. Differences in the bioactivities of individual phytoestrogens, differences in bioavailability and metabolism of phytoestrogens within different study populations, and imprecise reporting of the form and dose of phytoestrogens provided in intervention studies may have leaded to the disparity in study results. However, the preventive effect of phytoestrogens for bone loss is promising. This review discusses the effects of phytoestrogens on bone metabolism and their roles on the prevention and treatment of postmenopausal osteoporosis.
Biological Availability ; Chronic Disease ; Dietary Supplements ; Estrogens ; Female ; Humans ; Clinical Trial ; Metabolism ; Models, Animal ; Osteoporosis ; Osteoporosis, Postmenopausal ; Phytoestrogens ; Postmenopause ; Publications ; Women's Health

Objective: To investigate whether serum 25-hydroxyvitamin D [25(OH)D] level is associated with ovarian reserve markers in secondary amenorrhea (SA) patients. Methods: Sixty-three women diagnosed with SA were recruited during 12 months from the initiation of this prospective observational study. Serum 25(OH)D levels, serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) were estimated in study participants and ovarian reserve markers were compared between participants with vitamin D deficiency and those with normal vitamin D levels. Results: Of the 63 participants, 27 (42.9%) were vitamin D deficient (<20 ng/mL) and 36 (57.1%) had normal vitamin D levels. The mean AMH levels and AFC were 10.86±8.94 µ/L and 15.23±7.65 in the vitamin D deficient group, and 7.24±5.62 µ/L and 12.30±6.95 in the normal vitamin D group. Univariate and multivariate linear regression analysis of log10 transformed AMH and AFC with serum 25(OH)D adjusted for age and body mass index confirmed no association between vitamin D levels and AMH levels or AFC. There was also no correlation between serum 25(OH)D and AMH levels or AFC in all participants. However, participants with vitamin D deficiency had an increased chance of having polycystic ovarian syndrome (PCOS) as cause of SA than those with normal vitamin D levels (adjusted odds ratio, 7.559; 95% confidence interval, 1.28–44.65; P=0.026) after adjustment for clinical factors by logistic regression model. Conclusion There was no correlation between serum 25(OH)D levels and ovarian reserve markers in SA patients, but vitamin D deficiency may be linked to PCOS patients.

Objective: To investigate whether serum 25-hydroxyvitamin D [25(OH)D] level is associated with ovarian reserve markers in secondary amenorrhea (SA) patients. Methods: Sixty-three women diagnosed with SA were recruited during 12 months from the initiation of this prospective observational study. Serum 25(OH)D levels, serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) were estimated in study participants and ovarian reserve markers were compared between participants with vitamin D deficiency and those with normal vitamin D levels. Results: Of the 63 participants, 27 (42.9%) were vitamin D deficient (<20 ng/mL) and 36 (57.1%) had normal vitamin D levels. The mean AMH levels and AFC were 10.86±8.94 µ/L and 15.23±7.65 in the vitamin D deficient group, and 7.24±5.62 µ/L and 12.30±6.95 in the normal vitamin D group. Univariate and multivariate linear regression analysis of log10 transformed AMH and AFC with serum 25(OH)D adjusted for age and body mass index confirmed no association between vitamin D levels and AMH levels or AFC. There was also no correlation between serum 25(OH)D and AMH levels or AFC in all participants. However, participants with vitamin D deficiency had an increased chance of having polycystic ovarian syndrome (PCOS) as cause of SA than those with normal vitamin D levels (adjusted odds ratio, 7.559; 95% confidence interval, 1.28–44.65; P=0.026) after adjustment for clinical factors by logistic regression model. Conclusion There was no correlation between serum 25(OH)D levels and ovarian reserve markers in SA patients, but vitamin D deficiency may be linked to PCOS patients.

Purpose: Exogenous epidermal growth factor (EGF) causes apoptosis in EGF receptor (EGFR)–overexpressing cell lines. The apoptosis-inducing factors could be a therapeutic target. We aimed to determine the mechanism of EGF-induced apoptosis using a genome-wide clustered regularly interspaced short palindromic repeats (CRISPR)-based knockout screen. Materials and Methods: Two-vector system of the human genome-scale CRISPR knockout library v2 was used to target 19,050 genes using 123,411 single guide RNAs (sgRNAs). Recombinant human EGF (100 nM) or distilled water four times was administered to the experimental and control groups, respectively. The read counts of each sgRNA obtained from next-generation sequencing were analyzed using the edgeR algorithm. We used another EGFR-overexpressing cell line (A549) and short hairpin RNAs (shRNAs) targeting five EGF-resistance genes for validation. DUSP1 expression in A431, A549, and HEK293FT cells was calculated using reverse transcription–quantitative polymerase chain reaction. Results: We found 77 enriched and 189 depleted genes in the experimental group using the CRISPR-based knockout screen and identified the top five EGF-resistance genes: DDX20, LHFP, REPS1, DUSP1,<.i> and KRTAP10-12. Transfecting shRNAs targeting these genes into A549 cells significantly increased the surviving fractions after EGF treatment, compared with those observed in the control shRNA-transfected cells. The expression ratio of DUSP1 (inhibits ERK signaling) increased in A431 and A549 cells after EGF treatment. However, DUSP1 expression remained unchanged in HEK293FT cells after EGF treatment. Conclusion The CRISPR-based knockout screen revealed 266 genes possibly responsible for EGF-induced apoptosis. DUSP1 might be a critical component of EGF-induced apoptosis and a novel target for EGFR-overexpressing cancers.

Recently, along with technology development of endoscopic equipment, a stent has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. To this end, optimal factors are simulated for the stent structure and mechanical reaction and verified using finite element analysis. In order to compare to present commercialized product such as Zilver (Cook, Bloomington, Indiana, USA) and S.M.A.R.T (Cordis, Bridgewater Towsnhip, New Jersey, USA), mechanical impact factors were determined through Taguchi factor analysis, and flexibility and expandability of all the products including ours were tested using finite element analysis. Also, important factors were sought that fulfill the optimal condition using central composition method of response surface analysis, and optimal design were carried out based on the important factors. From the centra composition method of Response surface analysis, it is found that importat factors for flexibility is stent thickness (T) and unit area (W) and those for expandability is stent thickness (T). In results, important factors for optimum condition are 0.17 mm for stent thickness (T) and 0.09 mm2 for unit area (W). Determined and verified by finite element analysis in out research institute, a stent was manufactured and tested with the results of better flexibility and expandability in optimal condition compared to other products. Recently, As Finite element analysis stent mechanical property assessment for research much proceed. But time and reduce expenses research rarely stent of optimum coditions. In this research, Important factor as mechanical impact factor stent Taguchi factor analysis arrangement to find flexibility with expansibility as Finite element analysis. Also, Using to Center composition method of Response surface method appropriate optimized condition searching for important factor, these considering had design optimized. Production stent time and reduce expenses was able to do the more coincide with optimum conditions. These kind of things as application plan industry of stent development period of time and reduce expenses etc. be of help to many economic development.
Academies and Institutes ; Finite Element Analysis ; Indiana ; New Jersey ; Pliability ; Stents

Recently, the mathematical analysis of stent simulation has been improved, with the help of development of various tool which measure mechanical property and location of stent in artery. The most crucial part of the stent modeling is how to design ideal stent and to evaluate the interaction between stent and artery. While there has been great deal of researches on the evaluation of the expansion, stress distribution, deformation of the stent in terms of the various parameters, few verification through computer simulation has been performed about deformation and stress distribution of the stent. In this study, we have produced the corresponding results between experimental test using Universal Testing Machine and computer simulation for the ideal model of stent. Also, we have analyzed and compared stress distribution of stent in the cases of that with membrane and that without membrane. The results of this study would provide minimum change of plan and good quality for ideal stent replacing damaged artery through the analysis using computer simulation in the early stage of stent design.
Alloys ; Arteries ; Collodion ; Computer Simulation ; Exercise Test ; Finite Element Analysis ; Membranes ; Stents