Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

PURPOSE: The objective of this study is to investigate the work performances and the factors contributing to the work performance of nutrition teachers and school dieticians according to employment status in Daejeon and Chungcheongnamdo. METHODS: A survey was conducted among 415 school dieticians from selected elementary, middle, and high schools in the area. This survey was used for analysis of the general characteristics and the status of working and foodservice environments. The frequency of occurrence was measured using the chi2-test while analysis of differences in work performance of 57 variables grouped according to 12 categories by mean +/- SD was performed using student t-test. In addition, a regression analysis was performed to assess the influence of occupational (working and foodservice) environment on work performances. RESULTS: All 14 environmental factors including general characteristics were different between nutrition teachers and school dieticians. In 12 of 57 variables there were significant differences in work performance between the two groups. When compared using average work performance, 5 domains showed significant difference in work performance between the two groups. These 5 domains were other works (T = 6.050), dietary habit guide (T = 4.789), menu (nutrition) management (T = 3.524), foodservice administration and evaluation (T = 2.757), and production and service management (T = 2.588). Overall, the work performances of nutrition teachers were comparably higher than those of school dietitians. A correlation analysis between occupational (working or foodservice) environments and work performances of the two groups showed that the work performances of nutrition teachers were influenced by the number of employees, number of students, meal frequency a day, annual salary, age, foodservice years of school, and school type. CONCLUSION: Meanwhile, the work performances of school dieticians were influenced by the number of students, number of employees, meal frequency a day, work hour, education level, age, school type, and service years as a dietitian.
Education ; Employment ; Food Habits ; Humans ; Meals ; Nutritionists* ; Salaries and Fringe Benefits

A total of 110 computed tomographic scans of the brain in pediatric population were reviewed. They wereretrospectively analyzed focusing on the ventricular dilatation, widening of subdural space in frontal region andprominence of cerebral sulci in hemisphere. The results were compared with clinical recored. In the measurementbicaudate ventricular index waas above 0.18, which ws considered ventricular dilatation. The subdural space in thefrontal region and teh prominent cerbral sulci in the hemisphere were visualized among the cases aged over twoyears with clinical evidence of cerbral problem is pediatric population. The diagnostic application of CT to thecases of cerebral disorder in pediatric population is highly recommended.
Brain ; Dilatation ; Subdural Space

STUDY DESIGN: Retrospective study. PURPOSE: This retrospective study aimed to determine the incidence of adjacent level new fractures in a sandwich constellation (one or two untreated vertebrae between two cemented vertebrae) compared with that in other constellations formed by two-level percutaneous vertebroplasty (PVP). It also aimed to investigate the potential factors contributing to adjacent new fractures in a sandwich constellation. OVERVIEW OF LITERATURE: There are few studies regarding the intervening intact vertebral body between two cemented vertebrae. Clinical data from previous studies investigation this sandwich situation, too, have been vague. METHODS: Clinical data were obtained from 132 patients who had two cemented vertebral bodies, irrespective of whether they had undergone one or two PVP sessions between January 2013 and June 2016 at a single institution. Cases with one or two intact vertebral levels between the two cemented vertebrae were classified into group 1 (n=47), and cases with two consecutive cemented bodies or more than three levels of intervening configurations were classified into group 2 (n=85). Demographic data and radiological parameters for new fractures after PVP were compared between the two groups, and the rates of subsequent adjacent fractures were investigated. RESULTS: The incidence of single-level sandwich constellations was quite uncommon (7.7%). The overall incidences of adjacent fracture were 29.8% (14/47) in group 1 and 14.1% (12/85) in group 2. This difference was statistically significant (p=0.03). Approximately 80% (11/14) of the adjacent new fractures in group 1 developed at an intervening level. The patient demographics and radiological parameters for subsequent fractures after PVP did not statistically correlate with the risk of adjacent new fractures in group 1. CONCLUSIONS: Because they were subjected to double-load shifts, sandwich constellations were prone to re-fractures after PVP. These vertebral configurations required more aggressive management for osteoporosis.
Demography ; Humans ; Incidence ; Osteoporosis ; Retrospective Studies ; Spine ; Vertebroplasty

No abstract available.
Orbit* ; Orbital Cellulitis*

No abstract available.
alpha-Fetoproteins* ; Birth Weight* ; Immunoglobulins* ; Parturition*

No abstract available.
Male ; Penis* ; Replantation*

The objective of this study is to investigate various jobs and foodservice environments, as well as work performances of school foodservice dietitians and nutrition teachers in accordance to the years of service in Daejeon and Chungnam provinces. A survey was conducted among school foodservice dietitians and nutrition teachers; a total of 415 from selected elementary, middle and high schools in the areas. In this study, we surveyed the participants and analyzed the current state of general characteristics, status of their job environments and foodservice environments by frequency, and the averages and differences in work performance with regard to 12 work parts and 57 works using one-way ANOVA and Duncan's multiple range test according to the years of service. Six parts among 12 work parts were significantly different in work performance according to the years of service. The 6 work parts were menu (nutrition) management, utensil recovery and management, sanitation management, foodservice administration & evaluation, dietary habit guide, and other works. The 11-15 years group ranked as the top on the total score and means of work performance. While the 16-years or more group, 6-10 years group, and under 5 years group followed consecutively. Correlation analysis between job or foodservice environments and work performances showed that work performances of school dietitians were mostly influenced by employment status, education level, and annual salary among the variables of job or foodservice environments. Other works, dietary habit guides and menu management were mostly influenced by variables of job and foodservice environments.
Education ; Employment ; Food Habits ; Humans ; Nutritionists ; Salaries and Fringe Benefits ; Sanitation

This study investigates the relationship of smoking on daily intake of nutrients and snacks in the Chungnam and Daejeon high school students. Up to date scientific nutrition education and counseling programs in the regular school system is needed for a professional nutrition education teacher. The primary objective of this study was to provide useful information to nutrition education teachers. A survey was conducted with 400 high school students in the Chungnam and Daejeon areas. 381 out of 400 questionnaires were analyzed with SPSS 12.0K. The subjects were composed of 49.8% male, 50.1% female and 40.9% regular high school students, 59.1% business high school students and smokers 43.1%, non-smokers 56.9%. 43.4% of smokers had been smoking since middle school. On analysis of daily nutrient intakes, 16 out of 19 nutrients except animal calcium, Vitamin A and Vitamin C were much more consumed by the smoking group than the non-smoking group non-significantly. Especially vegetable fat and Vitamin E were higher in the smoking group than the non-smoking group(p < 0.05). The intake ratio of carbohydrates: protein: fat was similar in the two groups (smoking group 55 : 15 : 29, nonsmoking group 56 : 15 : 28). Intakes of Vitamin B1 and potassium in comparison with the Korean dietary reference intakes (KDRI) were under 50% in both groups. However, sodium was taken over 200% compared to KDRI in both groups. Intakes of Vitamin C in the smoking group were as low as 76.5% in comparison to KDRI. Smokers need to increase the intakes of Vitamin C considering that smokers need to intake Vitamin C two times than non-smokers. Nutrient intakes from snacks in the smoking group were higher than the non-smoking group. Nutrients that originated from snacks which took over 20% among daily nutrient intakes were 12 nutrients (energy, fat, carbohydrate, calcium, P, Fe, K, Vitamin B1, Vitamin B2, Vitamin C, Vitamin E, dietary fiber) in the smoking group compared to 7 nutrients (energy, vegetable protein, fat, carbohydrate, calcium, Vitamin B2, Vitamin C) in the non-smoking group. The smoking group was significantly paying more money for snacks each month than the non-smoking group was (p < 0.01). Periods of consumption were irregular in the smoking group(p < 0.05) and the smoking group was used to taking snacks in the morning compared to the non-smoking group. The smoking group preferred sweets and high calorie food over other snacks in comparison of the non-smoking group. The nonsmoking group had better eating habits than the smoking group
Animals ; Ascorbic Acid ; Calcium ; Commerce ; Counseling ; Eating ; Female ; Humans ; Male ; Potassium ; Riboflavin ; Smoke ; Smoking ; Snacks ; Sodium ; Thiamine ; Vegetable Proteins ; Vegetables ; Vitamin A ; Vitamin E ; Vitamins

This paper reviewed structure and current status of laws related to patient safety using patient safety law matrix to promote systematic approach in legal system of patient safety. Laws related to patient safety can be divided into three areas: laws for preventing; laws for knowing about; and laws for responding. In the case of Korea, gaps are especially prominent in the areas of laws for knowing about and responding. Patient safety law which will be enacted in July 2016 will fill the gap in the area of laws for knowing about. This law will be comprehensive law, covering the full spectrum of laws related to patient safety. However, after reviewing current patient safety law in Korea, the following drawbacks were identified: absence of code for grasping the current patient safety level; absence of code for mandatory reporting in patient safety reporting system; and absence of code for privilege about patient safety work product. Furthermore we need wider discussions about covering issues of open disclosure, apology law, coroners system, and complaint management system in patient safety law.
Coroners and Medical Examiners ; Disclosure ; Hand Strength ; Humans ; Jurisprudence ; Korea* ; Mandatory Reporting ; Patient Safety* ; Risk Management