No abstract available.
Cartilage, Articular* ; Child* ; Finger Joint* ; Fingers* ; Humans ; Transplants*

No abstract available.
Humans

We define acute respiratory failure(ARF) as present whenever the ratio of arterial oxygen tension (PaO2) and inspired oxygen concentrarion(FiO2) is below the normal predicted range for the patient's age and/or the arterial carbon dioxide tension(PaCO2) is above 45 in the absence of respiratory compention for metabolic alkalosis. Adult respiratory distress syndrome(ARDS) which is associated with shock, trauma, infection, inhalation of toxic gas, aspiration of gastric content and drugs etc, first received wide-spread attention in 1967. ARDS is a descriptive term that is characterized by a combination of refractory hypoxemia and severly decreased lung compliance. Numerous specific incidents or illnesses may be complicated by, or associated with ARDS. Early diagnosis and improvement in physiological therapy including PEEP therapy have been successful in treating the early and mild episodes of ARDS. This report describes three cases of ARF following anesthesia and reviews the literature.
Adult ; Alkalosis ; Anesthesia* ; Anoxia ; Carbon Dioxide ; Early Diagnosis ; Humans ; Inhalation ; Lung Compliance ; Oxygen ; Respiratory Insufficiency* ; Shock

Aneurysms of the coronary arteries are rare. They may be due to atheroselerosis, mucocutaneous lymph node syndrome, mycotic emboli, syphilis or trauma and occasionally they are congenital. The prognosis appears to be poor and death can occur suddenly from rupture of the aneurysm, peripheral coronary embolism or bacterial endocarditis. Recently surgical treatment has been successful. In a 5 year old patient with ventricular septal defect, two aneurysmal sacs located at the cardiac crux and just posterior to it was proved by coronary angiography and MRI, and successfully excised at operation.
Aneurysm* ; Child, Preschool ; Coronary Angiography ; Coronary Vessels* ; Embolism ; Endocarditis, Bacterial ; Heart Septal Defects, Ventricular ; Humans ; Magnetic Resonance Imaging ; Mucocutaneous Lymph Node Syndrome ; Prognosis ; Rupture ; Syphilis

Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal disorder characterized by chronic abdominal pain and bowel habit change. Its specific pathophysiologic mechanism underlying IBS is not known; however, it is generally accepted that IBS symptoms represent dysregulation at multiple levels of the brain-gut axis. IBS symptoms are manifested by abnormal motor reactivity to various stimuli, and low sensation and pain thresholds. Recently, a variety of new findings have been reported which suggests low-grade inflammation or immune activation is present in IBS patients, including post-infectious IBS. The immune activation can generate various symptoms such as abdominal pain, bloating, and diarrhea that may result from motor dysfunction and visceral hypersensitivity. Anti-inflammatory therapy with either antibiotics or probiotics seems to be effective in reducing the symptoms of IBS. While this pathophysiologic approach to the management of IBS is in its infancy, it is evident that the immune activation deserves further attention in IBS.
Abdominal Pain ; Anti-Bacterial Agents ; Axis, Cervical Vertebra ; Diarrhea ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Inflammation ; Irritable Bowel Syndrome ; Pain Threshold ; Probiotics ; Sensation

Preoxygenation is routine preior to induction of general anesthesia for the purpose of maintaining oxygenation during laryngoscopy and tracheal intubation. A common method of preoxygenation is 3~5 minutes of 100% O2 breathing. In some emergency states, ther may not be adequate time for a full 3~5 min of preoxygenation. REcently, Gold and some others showed that four maximally deep inspirations of 100% O2 within 30 seconds are as effective as 5 minutes of inhaltion of 100% O2 for increasing the PaO2. We compared the changes of arterial blood gas between a group which took deep breaths for 1 minute with 100% O2 and a group breathing spontaneously for 5 minutes with 100% O2.
Anesthesia, General ; Emergencies ; Humans ; Intubation ; Laryngoscopy ; Oxygen ; Respiration

OBJECTIVES: The purpose of this study was to examine the prevalence of allergic rhinitis between urban areas in the adjacent areas to a steel industrial complex and rural areas and the impact of pollutants in the industrialized city on allergic rhinitis. METHODS: From July 28 to August 9 of 2008, 1,043 residents of urban and rural areas in a local community had enrolled in health screening and questionnaire survey. One thousand thirty-three patients also underwent a skin prick test. Prevalence rates of allergic rhinitis were calculated according to residential areas, and the used statistical analysis were Fisher's exact test and chi-square test. RESULTS: In a survey, the fraction of adults, who complained of sneezing, nasal obstruction and rhinorrhea, during a recent 1 year period, showed the significant difference between urban (30.5%) and rural areas (22.4%). The fractions of positive skin prick tests were not different between two areas in each age group. The prevalence of allergic rhinitis was 8.4% in urban areas and 6.9% in rural areas. Considering the age groups, the adults group only showed the significantly higher prevalence of allergic rhinitis in urban areas (8.2% vs. 3.7%). CONCLUSIONS: Unlike the children and adolescents groups, the prevalence of allergic rhinitis in adults group was higher in the industrialized urban areas.
Adolescent ; Adult ; Child ; Humans ; Mass Screening ; Nasal Obstruction ; Prevalence* ; Rhinitis* ; Skin ; Skin Tests ; Sneezing ; Steel

PURPOSE: To evaluate the activated zone of the supplementary motor area through motor and sensorystimula-tion of both hands by fMRI. MATERIALS AND METHODS: Twenty-four healthy volunteers, ranging in age from 20to 30 years, served as sub-jects. They were divided into four groups and performed one of the four activationtasks : complex movement, fine movement, touch sensation, heat sensation. Complex movement consisted of a fingertask in which sub-jects flexed and extended all fingers repeatedly in union, without the fingers touching eachother(group I). Fine movement involved a thumb task in which subjects flexed and extended the thumb repeatedlywithout touch-ing the other fingers(group II). Touch sensation consisted of a palm task in which another personrepeatedly drew a circle on the subject 's palm (group III), and heat sensation involved of a palm task in whichsubject 's palm was touched by another person with a 40 degreeC water-bag (group IV). F-MRI was conducted on acommer-cial 1.5-T scanner equipped with echo-planar imaging. After overlapping images were obtained using aZ-s-core, and the mean/curve in the MR devices was evaluated, the activated zone of the supplementary motor RESULTS: Thirty-two of 48 images(20 of the 24 men) revealed activated zones in the supplementary motor area. Ingroup I, activation was observed in five subjects, in three of whom it was bilateral (contralateral activation).In group II, activation was observed in five subjects, in one of whom it was bilateral. In group III, activationoccurred in five subjects(bilateral in four, and contralateral in three), and In group IV, activation was alsoob-served in five ; in three of these it was bilateral. CONCLUSION: Using fMRI, and in association with motor andsensory tasks, the supplementary motor area was activated in 66.7% of healthy volunteers (32/48).
Brain* ; Echo-Planar Imaging ; Fingers ; Hand ; Healthy Volunteers ; Hot Temperature ; Humans ; Magnetic Resonance Imaging* ; Sensation ; Thumb

PURPOSE: This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy in early breast cancer. MATERIALS AND MEHTODS: We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. In the BCT group, all patients received whole breast irradiation to a total dose of 45~50 Gy/5~6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1%) patients in BCT and 40 (45.5%) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19~111 months). Log rank test was used to estimate the prognostic factors for treatment failure. RESULTS: Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5%) in the mastectomy group and 10 patients (11.8%) in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT. Five patients failed at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of 5 BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2nd primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade in the mastectomy group were risk factors for treatment failure (p<0.05). CONCLUSION: Although further careful follow-up is necessary to confirm the trends evident in this series, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Mastectomy* ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Risk Factors ; Survival Rate* ; Treatment Failure

Clear cell sarcoma of the kidney(CCSK) is one of the rare malignant renal tumors in childhood and is different from Wilms tumor by its pathologic features, clinical manifestations and propensity to metastasize to the skeletal system and brain. We report a case of CCSK on the right kidney in a 14-month-old girl presented with abdominal distention and palpable huge abdominal mass on physical examination, followed by metastasis to the rib on the left upper thorax. After right nephrectomy, chemotherapy with National Wilms Tumor Study DD regimen(vincristine+dactinomycin+adriamycin) was continued without any evidence of relapse until the last follow-up, 1 year after beginning chemotherapy. A brief review of related literatures was made.
Brain ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Infant ; Kidney* ; Neoplasm Metastasis ; Nephrectomy ; Physical Examination ; Recurrence ; Ribs ; Sarcoma, Clear Cell* ; Thorax ; Wilms Tumor