No abstract available.
Heart Septal Defects, Atrial*

No abstract available.

No abstract available.

No abstract available.

SIMV (synchronized intermittent mandatory ventilation) is a volume assisted mode which a patient inspiratory demand results in a clinician-controlled tidal volume and flow rate. However, PSV (pressure support ventilation) has the ability to augment spontaneous breaths with a variable amount of inspiratory positive pressure with a clinician-selected level of inspiratory airway pressure. To compare the effects of SIMV and PSV on respiratory function, experiments were performed on 12 stable patients during the weaning process and tidal volume, airway pressure, arterial blood gas tensions, blood pressure, and heart rates were measured during SIMV, and after 2 mins after removal of mechanical ventilation support. The same measurement as SIMV (except mandatory respiratory rates) were performed during PSV. The PSV level was reduced in the 5 cm2O step every 10-15 mins. The results of respiratory parameters and hemodynamic data showed that tidal volume, blood pressure, heart rates, and arterial blood gas tensions were similar, but there were significantly lower ventilatory rates, lower peak airway pressure and lower mean airway pressure during PSVmax than SlMV, and PSV resulted in improved patient comfort. It was concluded that PSV could be used to unload the patients ventilatory muscles and provide an appropriate level of mechanical ventilation support similar to SIMV weaning approaches.
Arterial Pressure ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Respiration, Artificial ; Respiratory Muscles ; Tidal Volume ; Ventilation* ; Weaning*

No abstract available.
Thorax*

A 48 year old man, has been suffering from a growing chondrosarcoma of sternum which has deeply invading the anterior mediastinum. He underwent wide resection of the chest wall tumor including a 4 cm free margin of normal tissue on all portions. The tumor was 15 X 16 X 10 cm in size arising from sternum and include both proximal one third of the clavicle and the 1st, 2nd, and 3rd costal cartilages. The resected skeletal defect in the anterior wall was very large after wide resection of the tumor and reconstructed due to paradoxical chest wall movement with sandwich like method of double over lapping Marlex mesh and methylmethacreylate, and steel wires. The soft tissue reconstructive procedure was done with myocutaneous flap transposition use of pectoralis muscle. But the patient go infected with tuberculosis in the mediastinum two months after the operation. We had removed all of previously inserted prosthetics and performed curettage and drainage. Recently we experienced a case with giant chondrosarcoma of the sternum associated with tuberculous mediastinitis. The patient had an uneventful postoperative course and was discharged with adjuvant treatment such as antituberculous medication for 1 year.
Cartilage ; Chondrosarcoma* ; Clavicle ; Curettage ; Drainage ; Humans ; Mediastinitis* ; Mediastinum ; Middle Aged ; Myocutaneous Flap ; Pectoralis Muscles ; Polypropylenes ; Steel ; Sternum ; Thoracic Wall* ; Thorax* ; Tuberculosis

Arterial thrombosis is relatively rare compared with venous thrombosis in nephrotic syndrome. However, the assessment of its pathogenesis and risk factors in individual patient with nephrotic syndrome is necessary to allow appropriate prophylactic management because it is a potentially serious problem. Hereby, with review of the literature, we report a case of a 53 yr-old man with cerebral infarction associated with nephrotic syndrome due to focal segmental glomerulosclerosis during the course of treatments with diuretics and steroid. It reveals that the hypercoagulable state in nephrotic syndrome can be associated with cerebral infarction in adults. Prophylactic anticoagulants can be considered to reduce the risk of serious cerebral infarction in nephrotic patients with risk factors such as severe hypoalbuminemia and on diuretics or steroid treatment, even in young patients regardless of types of underlying glomerular diseases.
Cerebral Infarction/epidemiology/*etiology/pathology ; Human ; Male ; Middle Aged ; Nephrotic Syndrome/*complications/epidemiology ; Risk Factors

Langerhans' Cell Histiocytosis(LCH) is a disease of unknown origin, characterized by abnormal proliferation of Langerhans' cells. Previously, it has been called histiocytosis X, which included eosinophilic granuloma, Hand-Sch ller-Christian's disease, and Letterer-Siwe disease. Any organs or tissues such as skin, lymph nodes, bone and bone marrow can be involved. However, LCH of chest wall is rarely reported in our country. We experienced a 18 month old male child, who had osteolytic lesion involving the rib with axillary lymph node metastasis. The tumor was confirmed as LCH after surgery.
Bone Marrow ; Child ; Eosinophilic Granuloma ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Infant ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Ribs ; Skin ; Thoracic Wall* ; Thorax*

BACKGROUND: Staple closure of bronchial stump was compared with manual suture closure among 100 cases of pneumonectomy during the recent 5-year period. We have reviewed the incidence of bronchpleural fistula between autosutured group and manual sutured group. MATERIAL AND METHOD: During the recent 5-year period, 100 patients underwent pneumonectomy at Hanyang University Hospital. Staple closure of bronchial stump was performed in 65 patients and manual suture in 35 patients. There were 55 males and 10 females in the autosutured group, and 26 males and 9 females in manual sutured group, which showed no significant statistical difference between the two groups. The mean ages of patients for autosutured group and manual sutured group were 56.7+/-10.3 years and 61.4+/-9.2 years, respectively, which showed no significant statistical difference between the two groups. There were 38 cases of left pneumonectomy and 27 cases of right pneumonectomy in autosutured group, and 22 cases of left pneumonectomy and 13 cases of right pneumonectomy in manual sutured group. There were 53 cases of malignancy and 12 cases of benign imflammatory disease in autosutured group, and 27 cases of malignancy and 7 cases of benign imflammatory disease in manual sutured group. RESULT: The incidence of bronchopleural fistula was 6.1% in autosutured group and 5.7% in manual sutured group. The incidence of other postoperative complication between the two groups showed no significant statistical difference. CONCLUSION: The incidence of bronchopleural fistula between autosutured group and manual sutured group was not different stastically. Both method for closure of bronchial stump can be performed in pneumonectomy.
Female ; Fistula* ; Humans ; Incidence ; Male ; Pneumonectomy* ; Postoperative Complications ; Surgical Staplers ; Sutures*