No abstract available.
Renal Insufficiency*

Vimentin is an intermediate filament protein normally expressed in mesenchymal cells, but the evidence of the aberrant expression of vimentin in epithelial cancer cells suggests that the vimentin expression might be related to local invasiveness and metastatic potential. There have been a few previous studies on the vimentin expression in human cervical carcinogenesis using in vivo and in vitro models. We examined the immunohistochemical vimentin expression in various squamous epithelial neoplasms of the uterine cervix, including the cervical intraepithelial neoplasia group (n=25), the microinvasive squamous cell carcinoma group (n=15), the invasive squamous cell carcinoma group (n=15) and the metastatic squamous cell carcinoma group (n=8). Vimentin positivity was significantly higher in the invasive than in the intraepithelial group, and in the cases with lymph node metastasis than in those without metastasis, suggesting a relationship between the vimentin expression and progression of the uterine cervical epithelial tumors.
Carcinogenesis ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Female ; Humans ; Intermediate Filaments ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial* ; Vimentin*

BACKGROUND: There have been no studies of airway management strategies for difficult intubation and cannot intubate, cannot ventilate (CICV) situations in Korea. This study was intended to survey devices or methods that Korean anesthesiologists and intensivists prefer in difficult intubation and CICV situations. METHODS: A face-to-face questionnaire that consisted of a doctor's preference, experience and comfort level for alternative airway management devices was presented to anesthesiologists and intensivists at study meetings and conferences from October 2014 to December 2014. RESULTS: We received 218 completed questionnaires. In regards to difficult intubation, the order of preferred alternative airway devices was a videolaryngoscope (51.8%), an optical stylet (22.9%), an intubating laryngeal mask airway (11.5%), and a fiber-optic bronchoscope (10.6%). One hundred forty-two (65.1%) respondents had encountered CICV situations, and most of the cases were identified during elective surgery. In CICV situations, the order of preferred methods of infraglottic airway management was cricothyroidotomy (CT) by intravenous (IV) catheter (57.3%), tracheostomy by a surgeon (18.8%), wire-guided CT (18.8%), CT using a bougie (2.8%), and open surgery CT using a scalpel (2.3%). Ninety-eight (45%) of the 218 respondents were familiar with the American Society of Anesthesiologists' difficult airway algorithm or Difficult Airway Society algorithm, and only 43 (19.7%) had participated in airway workshops within the past five years. CONCLUSION: The videolaryngoscope was the most preferred device for difficult airways. In CICV situations, the method of CT via an IV catheter was the most frequently used, followed by wire-guided CT method and tracheostomy by the attending surgeon.
Airway Management ; Bronchoscopes ; Catheters ; Congresses as Topic ; Education ; Intubation* ; Intubation, Intratracheal ; Korea* ; Laryngeal Masks ; Methods ; Surveys and Questionnaires ; Tracheostomy

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide

Chronic subdural hematoma usually occurs as a consequence of minor trauma. But, chronic subdural hematoma of occupational origin has not been reported yet in Korea. We experienced a case of chronic subdural hematoma induced by repeated trauma to the head. The patient was a 45-year-old male. He complained of repeated headache and nausea. By the computed tomogram, he diagnosed as chronic subdural hematoma and took the operation. He was not an alcoholism and had no intracranial disease nor coagulopathy. We studied all possibilities through working environment and personal environment survey. As a result, we decided the case as an example of cumulative trauma disorder to the head by occupational origin. We report a case of chronic subdural hematoma in the worker exposed repeated head trauma of occupational origin.
Alcoholism ; Craniocerebral Trauma ; Cumulative Trauma Disorders ; Head* ; Headache ; Hematoma, Subdural, Chronic* ; Humans ; Korea ; Male ; Middle Aged ; Nausea

Regionalization of high-risk perinatal care has been advocated because intensive care for small and ill newborn infants lowers mortality and morbidity. This report is based on analysis of admissions to the Neonatal Intensive Care unit (NICU) at the Wonju christian Hospital during the 4-year period from January, 1988 to December, 1991. There were 786 inborn infants and 1155 outborn infants admitted to the NICU. The results of our study follow; 1) Mean gestational ages were 36.8 weeks in inborn infants and 39.0 weeks in outborn infants. Mean birth weight was 2.5kg in inborn and 3.0kg in outborn infants. 2) The high-risk maternal factors, such as cesarian section delivery, eclampsia, preeclampsia, multiple pregnancy and placental anomaly were significantly more frequent in inborn infants than in outborn infants. 3) Perinatal sphyxia, HMD and transient tachypnea of newborn (TTN) were more common in inborn than in outborn infants, but pneumonia, meconium aspiration syndrome, and seizure were more common in outborn infants. 4) The positivity of bacterial cultures in blood and urine was higher in outborn infants than in inborn infants. The most frequently isolated microorganism was staphylococcus species in both inborn and outborn infants. 5) Hospital days, duration of TPN, duration of mechanical ventilation, frequency of seizure, and frequency of transfusion were longer or more frequent in inborn than in outborn infants. 6) Mortality rate was higher in inborn infants than in outborn infants. 7) In outborn infants, mortality rate was higher in infants whose transporting time was longer than 2 hours than for infants within 2 hour distances. However, this difference was not statistically significant. 8) These findings suggest that many lower birth weight and severly ill infants were not transported to the NICU of Wonju Christian Hospital perhaps due to poor transport systems, distance or socio-economic status. In conclusion, the improvement of transporting systems and socio-economic conditions will be required within this region.
Birth Weight ; Eclampsia ; Female ; Gangwon-do ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Critical Care ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Mortality ; Perinatal Care ; Pneumonia ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Respiration, Artificial ; Seizures ; Staphylococcus ; Transient Tachypnea of the Newborn

While lipomas are common in the rest of the body, intracranial lipomas are rare condition which are usually found in the midline of the brain. The majority of these lesions show few or even no symptoms and hardly ever produce alarming neurological defects. We experienced a case of corpus callosum lipoma in a 7 year old boy, who has had headache and loss of consciousness twice. He was diagnosed by skull x-rays and brain CT. We made a brief review of literatures. @PG 428.
Brain ; Child ; Corpus Callosum ; Headache ; Humans ; Lipoma* ; Male ; Skull ; Unconsciousness

Phthalic anhydride (PA) is widely used in the production of alkyd and unsaturated polyester resins. It has been reported that some workers exposed to PA have developed dermatitis, rhinitis and asthma. The authors intended to investigate the prevalence of PA induced allergic diseases and to develop preventive measures of occupational diseases. Forty-five male workers from PA production and handling were selected as an exposure group. Forty-four male workers not handling PA at the same factory were chosen as a reference group. A symptom questionnaire, doctor's examination, eosinophil count, serum-total IgE and PA-specific IgE were done on the subjects. There were no significant differences in age, educational level, tenure or smoking habits between groups. Most clinical symptoms were significantly more frequent among the exposure group than the reference group: sneezing(62.2 %), rhinorrhea(57.8 %), nasal stuffiness(53.3 %), coughing(44.4 %) and nasal itching(35.6 %) were the major symptoms among the exposure group (p<0.01, p<0.05). There were no significant differences in eosinophil count and serum-total IgE between groups but the mean level in PA-specific IgE, in the exposure group, was statistically significantly higher than the reference group (p<0.01). Abnormal rates of eosinophil count, serum-total IgE and PA-specific IgE were not significantly different from each other. The prevalence rate was 68.9 % (31 cases) for allergic rhinitis in the exposure group, statistically significantly higher than the reference group (p<0.01). The prevalence rate was 6.7 %(3 cases) for bronchial asthma and contact dermatitis in the exposure group, not more statistically significant than the reference group. In the exposure group, the prevalence rate for age, educational level, tenure, smoking habits and use of protective devices are not statistically significant. In PA-specific IgE, sensitivity is 10.8 %, specificity is 100.0 %, positive predictability is 100.0 % and negative predictability is 61.2 % when criteria point is 3.5 KU/l or above. As a result, it was recognized that the exposure group had a high prevalence of PA induced allergic rhinitis. Also, in diagnosis of PA induced allergic diseases, medical histories and specific symptoms were the most important where as eosinophil count, serum total IgE are the only indirect informations. PA-specific IgE has been needed to evaluate the meanings more.
Asthma ; Dermatitis ; Dermatitis, Contact ; Diagnosis ; Eosinophils ; Humans ; Immunoglobulin E ; Male ; Occupational Diseases ; Occupations ; Polyesters ; Prevalence* ; Protective Devices ; Questionnaires ; Rhinitis ; Sensitivity and Specificity ; Smoke ; Smoking

OBJECTIVES: As health care workers suffer from various hazards in hospital, an occupational safety and health program is very important to them. This study was conducted to investigate the status of the occupational safety and health programs of several hospitals in Korea. METHODS: We conducted a questionnaire survey on 941 hospitals in Korea. All questionnaires were posted to the department of general affairs at each hospital and responses were received from 108 hospitals (11.5%). Eight responses were excluded because of insufficient data and the remaining 100 questionnaires were analyzed. The collected data were evaluated using the SPSS 10.0 statistical package and the demands for occupational safety and health programs between two groups were analyzed by RIDIT analysis. RESULTS: The study subjects were 53 general hospitals and 47 hospitals. An occupational safety and health committee, infection control committee, safety manager, health manager, activities for vaccination, reports for needle stick injury and records related to occupational injury were more likely to be present in general hospitals than hospitals (p<0.05). Demands for occupational safety and health were higher in general hospitals than hospitals. Especially, demands for measurement of working environment, improvement of ventilatory system, management of chemical materials and supply of protective equipment were significantly higher in general hospitals than hospitals (p<0.05). CONCLUSIONS: We concluded from the findings of our study that occupational safety and health programs are not yet sufficient in Korean hospitals. So, we expect that special management, policies and laws for health care workers will be promulgated.
Delivery of Health Care ; Hospitals, General ; Infection Control ; Jurisprudence ; Korea* ; Needles ; Occupational Health* ; Occupational Injuries ; Questionnaires ; Vaccination

Schizencephaly, first described by Yakovlev and Wadsworth in 1946, is a rare congenital anomaly characterized by gray matter-lined clefts that extend through the entire cerebral hemisphere, from the ependymal lining of the lateral ventricle to the subarachnoid space. Clinically, patients with schizencephaly present motor dysfunction such as hemiparesis, seizures, and variable developmental delay. Absence of septum pellucidum, gray matter heterotopia, polymicrogyria, and hypoplasia of optic nerves were also frequently found to be associated with schizencephaly. We experienced a case of open-lip schizencephaly in a one-day-old male infant with wide, tense fontanel, which was confirmed by MRI.
Cerebrum ; Humans ; Infant ; Lateral Ventricles ; Lip* ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development* ; Optic Nerve ; Paresis ; Seizures ; Septum Pellucidum ; Subarachnoid Space ; Transcutaneous Electric Nerve Stimulation