BACKGROUND: For the diagnosis or evaluation of airway obstruction in bronchial asthma and chronic obstructive lung disorders, various parameters derived from the forced expiratory volume curve and maximal expiratory flow volume cutie have been used. Recently the peak expiratory flow(PEF) measured by the peak flow meter is widely used because of its simplicity and convenience. But there were still no data of the predicted normal values measured by the peak flow meter in Korea. This study was to obtain the predicted normal value of PEF and to know the accuracy of this value 18 predict FEV1. METHOD: The measurements of PEF by the MiniWright peak flow meter and several parameters derived from the forced expiratory volume and maximal expiratory flow volume curves by the Microspiro HI 501(Chest Co.) were done in 129 men and 125 women without previous history of the respiratory diseases. The predicted normal values of parameters according tc the age and the height were obtained, and the regression equation of FEV1 by PEF was calculated. RESULTS: The predicted normal values of PEF(L/min) were 2.45 Age(year)+1.36 Height(cm)+427 in men and -0.96 Age(year)+2.01 Height(cm)+129 in women. FEFmax derived from the maximal expiratory flow volume cutie was less than by 125 L/min in men art 118 L/min in women respectively compared to PEF. FEV,(ml) predicted by PEF was 5.98 PEF(L/min) 303 in men and 4.61 PEF(L/min) 291 in women respectively. CONCLUSION: The predicted normal value of PEF measured by the peak flow meter was calculated and it could be used as a standard value of PEF while taking care of patients with airway obstruction FEV1, the gold standard of ventilatory function could be predicted by PEF to a certain extent.
Airway Obstruction ; Asthma ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Korea ; Lung ; Male ; Maximal Expiratory Flow-Volume Curves ; Reference Values

PURPOSE: This study compared the surgical results of various posterolateral corner sling methods performed through either the fibula head tunnel or tibia tunnel in patients with chronic PLRI (PosteroLateral Rotatory Instability). MATERIALS AND METHODS: Between January 1999 and October 2003, 20 and 19 patients who had undergone surgery for PCL (posterior cruciate ligament) tensioning and an ALB (anterolateral bundle) reconstruction through the fibula head tunnel or tibia tunnel, respectively and were followed up more than 1 year were enrolled in this study. RESULTS: The fibular head tunnel was found to be superior compared with the tibia tunnel method in terms of the operation time (36.5+/-7.5 versus 68.4+/-12.8) (p<0.0001), rotational stability (p= 0.0018) and IKDC objective score (p<0.0001). In the fibula head tunnel group, 85% of patients had an equal to normal or tighter than normal rotational stability in the tibial tunnel group with 63% having an equal to normal or tighter than normal side at the last evaluation. In the IKDC objective score, 85% of patients in the fibula head tunnel group had a rating B or higher at the last evaluation compared with 79% in the tibial tunnel group (p<0.0001). However there were no significant differences in anteroposterior stability and OAK score. CONCLUSION: The modified posterolateral corner sling through the fibula head tunnel produces better results in terms of a posterolateral rotational stability of grade II chronic PLRL in a combined PCL injury than that using the tibia tunnel method.
Fibula ; Head* ; Humans ; Knee* ; Tibia

We describe a case of posterolateral capsular heterotopic ossification requiring a surgical excision after a PCL (Posterior Cruciate Ligament) reconstruction using the modified inlay method and PLCS (posterolateral corner sling) with a tibia tunnel. A 21-year-old female patient had suffered a blunt proximal tibial direct trauma 6 months earlier. She did not experience limb ischemia or a pulse deficit before she visited our out patient clinic. She had not suffered any trauma in other sites, and showed a range of motion of 0 to 30degrees at 4 months after surgery. There was no specific finding on the X-ray images. Arthroscopic adhesiolysis was performed and her range of motion increased to 0 to 120degrees. However, 6 months after the initial operation, she showed ankylosis and heterotopic ossification at the posterior aspect, which was surgically removed at 12 months postoperatively. After the second surgery, there was no recurrence and she showed a 0 to 140degrees range of motion at postoperative 42 months.
Ankylosis ; Extremities ; Female ; Humans ; Inlays* ; Ischemia ; Ossification, Heterotopic ; Osteogenesis* ; Posterior Cruciate Ligament* ; Range of Motion, Articular ; Recurrence ; Tibia* ; Young Adult

BACKGROUND: Atracurium is eliminated by Hofmann elimination and ester hydrolysis, with minimal renal and hepatic excretion. It's action duration is not affected by renal function. Although metabolism of vecuronium is less dependent on the renal function than other steroid type neuromuscular blockers, the action duration of vecuronium is prolonged in renal failure. The purpose of this study is to compare the differences of the action duration of atracurium and vecuronium in patients with renal failure. METHODS: Forty patients with normal renal function and 40 patients with chronic renal failure were assigned to one of four groups: atracurium-normal (n=20, AC group), atracurium-renal failure (n=20, AK group), vecuronium-normal (n=20, VC group), vecuronium-renal failure (n=20, VK group). Anesthesia was induced with thiopental and maintained with the inhalation of nitrous oxide (50%) and isoflurane (0.5~1.5 vol%). Atracurium (0.5 mg/kg) or vecuronium (0.1 mg/kg) was given and endotracheal intubation was performed after twitch response was depressed more than 80%. Neuromuscular blockade was assessed by train-of-four at the adductor pollicis with supramaximal stimulation of ulnar nerve of 2 Hz every 12 sec. The onset time, duration of 5, 25, 50, 75% recovery time and recovery index were checked. RESULTS: Onset of block was not significantly different among four gorups. Recovery time of 5, 25, 50, 75% and recovery index were longer in the both renal failure groups. Action durations in renal failure were not significantly different between AK and VK groups. CONCLUSION: It is concluded that action duration of atracurium and vecuronium are affected by renal function. We would better monitor muscle relaxation and titrate dose of muscle relaxant.
Anesthesia ; Atracurium* ; Humans ; Hydrolysis ; Inhalation ; Intubation, Intratracheal ; Isoflurane ; Kidney Failure, Chronic ; Metabolism ; Muscle Relaxation ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Nitrous Oxide ; Renal Insufficiency* ; Thiopental ; Ulnar Nerve ; Vecuronium Bromide*

BACKGROUND: This study was performed to evaluate the effects of pretreatment with intralipos on the cardiovascular toxicity caused by continuous intravenous infusion with bupivacaine. METHODS: Fourteen healthy white rabbits were selected for this study and divided into the control group (n = 7) (normal saline administered for 30 minutes) and the intralipos pretreated group (n = 7) (intralipos administered for 30 minutes). The cardiovascular toxic effect during the continuous intravenous infusion of bupivacaine was observed between the control and the intralipos group by meaning the changes in mean arterial pressure, heart rate and electrocardiogram. RESULTS: In intralipos group, mean arterial pressure significantly increased after intralipos infusion for 30 minutes as compared with the control values (P < 0.05). The time intervals for 25, 50, 75 and 100% decrease in mean arterial pressure and heart rate and the onset time of the first QRS modification and dysrhythmia during continuous intravenous infusion of bupivacaine were significantly prolonged in the intralipos group compared with the control group (P < 0.05). The time intervals for 100% decrease in heart rate after the stop of bupivacaine administration was significantly prolonged in the intralipos group compared with the control group (P < 0.05). CONCLUSIONS: The present study suggests that prophylactic intravenous infusion with intralipos prevents the cardiovascular toxicity caused by bupivacaine in rabbits.
Arterial Pressure ; Bupivacaine* ; Electrocardiography ; Heart Rate ; Infusions, Intravenous ; Rabbits*

Patients with diabetes or chronic renal failure may develop profound hypotension after anesthesia induction. In a patient with chronic renal failure, inappropriate dialysis may aggravate the hypotension. Combined autonomic neuropathy in diabetes mellitus is the main cause of the undesirable changes in blood pressure after anesthesia induction. We report a case of hypotension refractory to fluid replacement and inotropes in a patient with chronic renal failure for 10 years and diabetes mellitus for 5 years. The patient received hemodialysis on the day before surgery and had developed various symptoms suggestive of autonomic neuropathy (i.e., dizziness on standing, esophageal spasm, intermittent diarrhea).
Anesthesia ; Blood Pressure ; Diabetes Mellitus ; Diabetic Neuropathies ; Dialysis ; Dizziness ; Esophageal Spasm, Diffuse ; Humans ; Hypotension ; Kidney Failure, Chronic ; Renal Dialysis

This paper reports a novel method for reconstructing the medial patellofemoral ligament (MPFL) using hamstring tendon autografts, based on the results of an anatomical study by cadaveric dissection. Five fresh frozen cadaveric knees were studied. MPFL was found present in all cases, and the average length was 54 mm (49.6-59.3 mm). The shape of the MPFL was triangular wherein the femoral attachment was narrow and the patellar attachment was relatively broad. The MPFL was less stiff and a weaker structure compared to the other ligaments. This study could refl ect a novel surgical technique for the MPFL reconstruction with its anatomical and biomechanical properties. The study population comprises of 9 patients (5 males and 4 females) who underwent primary MPFL reconstruction at our clinic between April 2008 and February 2010. The mean follow-up period was 17.6 months. The Kujala score improved signifi cantly from 51.1 points to 81.4 points (p<0.001), the Lysholm score improved signifi cantly from 47.8 points to 84.9 points (p<0.001) and the Tegner activity level improved signifi cantly from 2.9 to 5.1 (p<0.001). There was no case of recurrent dislocation and complications according to the short term follow-up results. Our novel soft tissue fixation method using double bundle reconstruction with hamstring tendon autografts would not only be an anatomic reconstruction but also would be effective for reconstruction of the MPFL.
Cadaver ; Dislocations ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Male ; Patellar Dislocation ; Tendons ; Tissue Fixation

No abstract available.
Humans ; Lung*

No abstract available.
Humans ; Lung*

BACKGROUND: The atheroma in aorta has been emphasized as a potential source of cerebral embolism after the wide use of TEE. But in Korea there has been no report on the frequency of the aortic atheroma in patients with cerbral infarctions. METHODS: Using transesophageal echocardiography, we evaluated aortic atheroma in the thoracic aorta of 44 patients with cerbral infarctions. The aortic atheroma was defined as a raised lesion with an irregular surface of echo shadow. RESULTS: The aortic atheromas were detected in 7 patients(16%) out of 44 patients with cerebral infarction. However, it were detected in only 3 patients out of 71 patients without cerebral infarction. The size of the lesions reaged from 6mm to 16mm(mean 10+/-3.5) and mobility were seen in 2 patients. The lesions were distributed throughout the thoracic aorta. CONCLUSION: Aortic atheroma is a potential source of cerebral infarction. TEE is a useful procedure for the evaluation of the patients with an undetermined cause of cerebral infarction.
Aorta ; Aorta, Thoracic ; Cerebral Infarction* ; Echocardiography, Transesophageal ; Humans ; Infarction ; Intracranial Embolism ; Korea ; Plaque, Atherosclerotic*