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

No abstract available.
Orbit* ; Orbital Cellulitis*

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.
Male ; Penis* ; Replantation*

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

The objective of this study was to investigate how to improve job satisfaction for dietitians and nutrition teachers by identifying influencing factors in Daejeon and Chungnam Province, South Korea. A survey was conducted among school foodservice dietitians and nutrition teachers from selected primary, middle and high school in the area. This survey consisted of general characteristics, status of their job, job satisfaction, work satisfaction and work performance. In this study we found current state of general characteristics and status of their job according to frequency analysis and the level of work satisfaction, work performance and job satisfaction using descriptive statistics. The t-test, ANOVA and Duncan-test were also conducted in order to searching for tendency of job satisfaction according to the general characteristics and the status of their job. Pearson's correlation was carried out in order to find correlation with job satisfaction. Also, factors, which influenced job satisfaction according to regression analysis, were drawn. We describe the difference of job satisfaction between irregular dietitians and nutrition teachers as well. Besides we discussed the improvement of dietitians' (nutrition teachers') work environment to raise their job satisfaction through this study.
Humans ; Job Satisfaction ; Republic of Korea

No abstract available.
Pregnancy* ; Purpura*

BACKGROUND: This study was undertaken to reduce the side effects of epidural morphine through the addition of nalbuphine in 37 cesarean delivery. METHODS: Forty patients were divided into 2 groups; M(control) group: bolus administration of morphine 2 mg in 0.5% bupivacaine and continuous epidural 41 hour-infusion of morphine 7mg, N(experimental) group: bolus administration of morphine 2 mg in 0.5% bupivacaine combined with nalbuphine 10mg and continuous epidural 41 hour-infusion of morphine 7mg combined with nalbuphine 10mg via the Paragon infusor. RESULTS: During the postoperative 48 hours, their pain scores and side effects were recorded at 6, 12, 18, 24, 30, 36, 42 and 48 hours. The analgesic effects were good in two groups(mean VAS <3.0) and pain scores were statistically significant at 18 and 30 hour. The incidence of pruritus, nausea, vomiting and urinary retention was decreased in group N(p<0.05). CONCLUSIONS: We concluded that continuous epidural morphine combined with nalbuphine was one of recommendable methods to reduce side effects of morphine.
Bupivacaine ; Cesarean Section* ; Female ; Humans ; Incidence ; Infusion Pumps ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Urinary Retention ; Vomiting