The AMBU bag is a useful equipment at the cardiopulmonary resuscitation (CPR) or the respiratory therapy. The AMBU bag eonsists simply of a self-reflating bag, a patient valve and a inlet valve. The patient valve is a non-rebreathing valve and the self-inflating bag is a recoiled rubber bag. The inlet valve on the posterior site of self-inflstion bag is closed during the bag is squeezed, and opened during the bag is released. During reflation of bag, fresh room air through the one-way valve and fresh oxygen through the orifice for oxygen supply will mix. Therefore the inspiratory oxygen concentration is decided by a speed of re- flation of the self-reflating bag. We measured inspiratory oxygen concentration during AMBU bag ventilation under different inspiration : expiration (I:E) ratio, frequency of venti- lation, ventilatory volume and flow rate of oxygen. The results were that factors increase a inspirstory oxygen concentration are 1) decrease of I:E ratio, 2) decrease of frequency of ventilation, 3) decrease of ventilatory volume, 4) inerease of flow rate. We found that haste of physician makes frequent squeezing of AMBU bag and the haste results a decrease of inspiratory oxygen concentration.
Bays ; Cardiopulmonary Resuscitation ; Humans ; Oxygen* ; Respiratory Therapy ; Rubber ; Ventilation*

In a double-blind clinical study, single-dose lumbar epidural blockade was instituted in 45 healthy patients undergoing cesarean section. Patients were randomly assigned to one of three groups. Each group received treatment with a different local anesthetic solution used were 2.0% Lidocaine HCL 20 ml in group I, 0.5% Bupivacaine HCL 20 ml in group II and Lidocaine-Bupivacaine Mixture in the ratio of 1:1 20 ml in group III The injections were made at the third lumbar interspace. The local anesthetic was injected directly through 176 Tuohy needle at 1 ml/s with the bevel directed cephalad(11 ml) and caudad(9 ml), The onset times were fastest in group I and slowest in group III. The durations were shortest in group L The times reguired to reach the highest level in group I and III were shorter than group II. The Apgar scores and blood pressure changes were similar in the diifferent groups. The frequency of pain sense was highest in group II. It is concluded that Lidocaine and Lidocaine-Bupivacine Mixture are superior to Bupivacaine for lumbar epidural blockade for cesarean section.
Blood Pressure ; Bupivacaine* ; Cesarean Section* ; Female ; Humans ; Lidocaine* ; Needles ; Pregnancy

Bilateral hypoglossal nerve palsy is a rare clinical presentation. We report a case of central skull base osteomyelitis (SBO) presenting with complete tongue paralysis in a 53-year-old man who was not diabetic or immunocompromised. Magnetic resonance imaging demonstrated characteristic features including abnormal contrast enhancement in the clivus (T1-weighted images). Blood tests revealed elevated acute-phase reactants and leukocytosis, which prompted prolonged antibiotic treatment. He responded well to the antibiotics, which together with typical clinical and imaging findings led to the diagnosis of bacterial SBO.
Acute-Phase Proteins ; Anti-Bacterial Agents ; Cranial Fossa, Posterior ; Hematologic Tests ; Humans ; Hypoglossal Nerve ; Hypoglossal Nerve Diseases ; Leukocytosis ; Magnetic Resonance Imaging ; Middle Aged ; Osteomyelitis ; Paralysis ; Skull ; Skull Base ; Tongue

BACKGROUND: Diastolic function can be assessed by Doppler-derived left ventricular(LV) filling patterns. E/A ratio<1 and prolongation of isovolumic relaxation time(IVRT) are diagnostic of impaired relaxation of left ventricle during diastole. In early stage of acute myocardial infarction, myocardial stiffness can normalize the E/A ratio and mask the Doppler indexes of abnormal relaxation in patients with acute myocardial infarction. METHODS: LV filling patterns were studied with Doppler echocardiography in 10 healthy subjects and 27 patients with recent acute myocardial infarction. Cardiac catherterization was performed in the 11+/-2 days after onset of acute myocardial infarction and left ventricular end-diastolic pressure(LVEDP) and myocardial stiffiness index(MSI) were studied. RESULTS: In patients with acute myocardial infarction, IVRT was significantly prolonged ; E/A ratio and deceleration time were decreased but not significantly different from those of normal subjects. In the patient's group of E/A>1,IVRT and atrial filling fraction(AFF) were significantly shortened, and LVEDP was significantly increased, compared to those of the patient's group of E/A<1. But ejection fraction was similar in both groups. In the patients with acute myocardial infarction, E/A ratio and LVEDP showed good correlation(r=0.64, p<0.05). MSI was increased in the patient's group of E/A>1 and also was well correlated with LVEDP(r=0.8, p<0.05). CONCLUSIONS: Thus we conclude that normal of increased E/A ratio in recent acute myocardial infarction may reflect increased LVEDP due to increased myocardial stiffness.
Deceleration ; Diastole ; Echocardiography* ; Echocardiography, Doppler ; Heart Ventricles ; Humans ; Masks ; Myocardial Infarction* ; Relaxation

PURPOSE: To evaluate the histological changes of the synovial membrane treated by 166Ho-Chitosan complex in collagenase induced arthritis of the knee in the rabbit. MATERIAL AND METHOD: Arthritis was induced in sixteen rabbits by intra-articular injection of 1mg collagenase II and then treated by intra-articular injection of 0.4mCi 166Ho-Chitosan complex 2weeks later. The radioisotope scan was checked in each rabbit for the distribution and extra-articular leakage of the 166Ho-Chitosan complex. The synovial tissues from the femorotibial joints were evaluated for serial histological changes 2, 4, 8, 12 weeks after the 166Ho-Chitosan complex injetion. RESULTS: Two weeks after 166Ho-Chitosan complex administration, inflammatory cells such as giant cells, lymphocytes, histiocyte, and fibroblasts appeared in the subsynovial stroma. The most synovial cells were necrotized. Four weeks after 166Ho-Chitosan complex administration, the inflammatory cells were decreased and many fibroblasts appeared on the subsynovial stroma. There was neovasculization in the synovial membrane 4 weeks after administration. The fibers of collagen were noticed in the synovial membrane and subsynovial stroma at 8 weeks. There was no synoviocyte in the synovium and the thickness of fibrosis was increased at 12weeks. There were fragmentation of the nucleoli of synoviocyte and endothelial cell on the transmission electron microscope (TEM) . CONCLUSION: This study suggests that the synovial membranes treated by 166Ho-Chitosan complex in the collagenase induced arthritis of the knee in the rabbit show early radiation damage and then subsequently develop the fibrosis, and no synovial cell regeneration was observed until 12 weeks.
Arthritis* ; Collagen ; Collagenases* ; Endothelial Cells ; Fibroblasts ; Fibrosis ; Giant Cells ; Histiocytes ; Injections, Intra-Articular ; Joints ; Knee* ; Lymphocytes ; Rabbits ; Regeneration ; Synovial Membrane

Essential osteolysis is very rare, slowly progressive disease. Its etiology and pathophysiology is still unknown. Only one case has been reported in Korea. We experienced one case of essential osteolysis associated with renal insufficiency involving bilateral carpal, metacarpal, tarsal, metatarsal bones, elbow, ankle. We report a case of 24-year-old female who had manifestations of essential osteolysis with renal insufficiency with brief review of literatures.
Ankle ; Elbow ; Female ; Humans ; Korea ; Metatarsal Bones ; Osteolysis, Essential* ; Renal Insufficiency ; Young Adult

Acromegaly is associated with an increased risk for a variety of cancers such as colon cancer, prostate cancer and breast cancer. However, there have been few reports of gastric cancer developing in an acromegaly patient. A 66-year-old man suffered with diabetes mellitus and hypertension for 15 years, and he visited the endocrinology department due to dizziness. On physical examination, the biochemical studies and the sella MRI, he showed the typical features of acromegaly with pituitary microadenoma. During the cancer screening studies to find the cause of anemia, early gastric cancer was diagnosed by pathologic examination of the tissue biopsies. We described the summary of characteristics of the patient and reviewed literature.
Acromegaly* ; Aged ; Anemia ; Biopsy ; Breast Neoplasms ; Colonic Neoplasms ; Diabetes Mellitus ; Dizziness ; Early Detection of Cancer ; Endocrinology ; Growth Hormone ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Physical Examination ; Prostatic Neoplasms ; Stomach Neoplasms*

Single coronary artery is rare and the application of coronary angioplasty to these arteies presents unique technical challenge. As technical advances in the guiding catheter and balloon system occur, more challenging lesions including anomalous coronary artery are able to be treated. Correct guiding catheter selection is important to ensure adequate access to the anomalous vessel and provide support to cross the lesion. This report describes successful angioplasty with stent in right coronary artery of single ostium coronary anomaly in a patient presenting with an acute myocardial infaction.
Angioplasty ; Catheters ; Coronary Vessels* ; Humans ; Myocardial Infarction* ; Stents*

BACKGROUND: Elevation in plasma homocysteine has been widely studied as an independent risk factor for atherosclerosis. And epidemiologic studies have demonstrated that the persons who take the folate and vitamin B6 have lower incidence of atherosclerotic vascular disease and lower plasma homocysteine level. But, not yet the effects of vitamin B6 and folate on the level of plasma homocysteine and brachial artery dilation on healthy subjects was not evaluated. METHODS: We evaluated the effects of 50 mg of vitamin B6 and 1 mg of folate on endothelial function, plasma homocysteine levels to one healthy postmenoausal woman and nineteen men in a randomized, double-blind, placebo-controlled, crossover design. RESULTS: In our study, supplement of vitamin B6 and folate significantly lowered plasma homocysteine level (placebo : folate =6.56 +1.55 micromol/L vs. 5.37 +1.04 micromol/L, p=.001). But, there were no statistically significant increament of flow-mediated dilation (FMD) compared to placebo (placebo : folate =5.12 +3.26% vs. 6.69 +2.60%, p=.070) and there were no significant correlation between the improvement of homocysteine level and increament of flow mediated dilation on healthy subjects. CONCLUSION: Compared to persons with absolute or relative hyper-homocysteinemia, our study did not show such favorable effects in healthy persons. So further studies must to be held to discover the effect of folate and vitamine B6 in healthy persons.
Atherosclerosis ; Brachial Artery* ; Cross-Over Studies ; Female ; Folic Acid* ; Homocysteine* ; Humans ; Incidence ; Male ; Plasma* ; Risk Factors ; Vascular Diseases ; Vitamin B 6* ; Vitamins*

Spontaneous coronary artery dissection (SCAD) is a rare disease that occurs most commonly in young people, especially in peripartum or postpartum women. It is usually catastrophic and fatal. The etiology of dissection is still under discussion. Possible factors are inflammation, changes of flow dynamics, and preexisting intima lesions. The treatment of choice for spontaneous coronary artery dissection is still not settled. The authors report a twenty-nine year-old woman with coronary lesions diagnosed as spontaneous coronary artery dissection which developed during exercise and was treated with intracoronary stenting.
Coronary Vessels* ; Female ; Humans ; Inflammation ; Peripartum Period ; Postpartum Period ; Rare Diseases ; Stents*