Although segmental or subsegmental atelectasis may occur during anesthesia, mucous plugging of a mainstem bronchus has been uncommonly reported in anesthetized patients with chronic respiratory disease. However, pulmonary atelectasis following mucous plugging may rarely result normal patients. We report this case of an allegedly healthy patient was developed a left main stem bronchus obstruction, resulting in subsegmental collapse of left lower lung after the induction of general anesthesia.
Anesthesia* ; Anesthesia, General ; Bronchi ; Humans ; Lung ; Pulmonary Atelectasis

PURPOSE: Glucose uptake and glycolytic metabolism are enhanced in cancer cells, and increased expression of glucose transporter 1 (GLUT1) has also been reported. The aim of this study was to investigate GLUT1 expression in human breast tissues and invasive ductal carcinomas. METHODS: We used tissue microarrays consisting of normal breast tissue, ductal hyperplasia, ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastases. We examined GLUT1 expression in the microarrays by immunohistochemistry, reviewed the medical records and performed a clinicopathological analysis. RESULTS: Membranous GLUT1 expression was observed in normal and tumor cells. GLUT1 expression was higher in ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastasis than in normal tissue and ductal hyperplasia (p=0.002). Of 276 invasive ductal carcinomas, 106 (38.4%) showed GLUT1 expression. GLUT1 expression was correlated with higher histologic grade (p<0.001), larger tumor size (p=0.025), absence of estrogen receptor (p<0.001), absence of progesterone receptor (p<0.001), and triple-negative phenotype (p<0.001). In univariate survival analysis, patients with GLUT1 expression had poorer overall survival and disease-free survival (p=0.017 and p=0.021, respectively, log-rank test). In multivariate survival analysis with the Cox proportional hazards model, GLUT1 expression was an independent prognostic factor of poorer overall survival and disease-free survival (p=0.017 and p=0.019, respectively). CONCLUSION: GLUT1 expression seems to play an important role in malignant transformation, and the glycolytic phenotype in invasive ductal carcinoma may indicate aggressive biological behavior and a worse prognosis.
Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Disease-Free Survival ; Estrogens ; Glucose ; Glucose Transport Proteins, Facilitative ; Humans ; Hyperplasia ; Immunohistochemistry ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Phenotype ; Prognosis ; Proportional Hazards Models ; Receptors, Progesterone

Clinical and endoscopic features on 86 patients with acute upper gastrointestinal mucosal lesien were evaluated. Males were predaminant about 3 times of female. Most of patients were in 4 th to 6 th decade. The prevalent locations were proximal part of the stomach and dodenal bulb. Most,freqent chief camplaints was epigastric pain. Eeloscopieally aoute ulcers were characterized by shallow in depth, variant size and shape, rather clear ulcer margin without mucosal fold eonvergence and multiple lesions rather than sigle. The inducing factors of the acute mucosal lesiona whiah were noted were alcohol, HCI, analgesics, herb drug, steroid, antibiotlies and orgaaie ipheephorus.
Analgesics ; Female ; Humans ; Male ; Stomach ; Ulcer

PURPOSE: To clarify the behavior of the lumbar spine under vertical compressive load and follower compressive load and to confirm the effect of the follower load on the stability of the spinal column using finite element method. MATERIALS AND METHODS: Describing follower compression test to overcome underestimation of load carrying capacity, the problem in existing ex-vivo lumbar spine compression test, with finite element analysis, comparing with the result of simple vertical compressive load, we analyze the property of kinetic behavior. After performing finite element modelling about L1-L5 lumbar vertebral column, analyze it about vertical compressive load and follower compressive load. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. With compressive load, change of lumbar spinal curve is so much, that geometrical analysis should be done. RESULTS: Under the follower compressive load, the vertebral column was so stiff that vertical displacement of the upper end plate of L1 was markedly reduced, comparing with that under the simple vertical compressive load. Sagittal rotation of that upper end plate was also decreased in the opposite direction. Compressive load on the intervertebral disc was evenly distributed along the entire column. The bending moment at each disc was reduced in the opposite direction. A lesser A-P shear force occurred at the intervertebral disc. CONCLUSION: As a result of finite element interpretation of lumbar spine, the stability and load carrying capacity was increased largely, and the compressive load was transmitted through the column in a more pattern, when follower compressive load applied. This can provide the basis for explaining the difference of early buckling occurrence reported in ex-vivo testing, and load carrying capacity of the lumbar spine in-vivo, but, for more precise replication of behavior of lumbar spine in-vivo to variable loading. A invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Natural Resources ; Finite Element Analysis ; Intervertebral Disc ; Inventions ; Spine*

BACKGROUND: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. MATERIALS AND METHODS: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. RESULTS: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. CONCLUSION: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Finite Element Analysis ; Intervertebral Disc* ; Inventions ; Spine*

BACKGROUND: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. MATERIALS AND METHODS: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. RESULTS: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. CONCLUSION: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
Finite Element Analysis ; Intervertebral Disc* ; Inventions ; Spine*

Teaching both English in medical field and bioethics to medical students in Korea is becoming more and more important. We have investigated the present status of medical English and bioethics lectures in medical schools in Korea. We have taught bioethics in medical English class and investigated its effect through questionnaire. Less than two thirds of the 35 medical schools in Korea have medical English and /or bioethics lectures. Mainly English medical terms were taught in premedical course in most of the school which needs to be improved. Evaluation of the bioethics lecture in medical English class was responded favorably by the students. In conclusion, teaching bioethics in medical English class in English appears to be an effective way of teaching both English and bioethics in medical field at the same time and a good way of saving time by teaching both simultaneously.
Bioethics* ; Humans ; Korea ; Lectures ; Schools, Medical ; Students, Medical ; Surveys and Questionnaires

BACKGROUND: Although the first coronary Wallstent implantation ushered in a new era in interventional cordiology with the purpose of circumventing the two major limitations of coronary balloon angioplasty, early acute occlusion and late restenosis, the previous investigators have reported a high rate of subacute occlusion after Wallstent implantation. However, recent studies have reported a low incidence rate of subacute closure and restenosis using the newly modified coronary Less Shortening in aortocoronary vein grafts. The present study reports the immediate results of the Less Shortening Wallstent Implantation for 21 diffuse native coronary lesions in 20 patients. METHODS: Twenty patients were enrolled at the Yonsei Univ. Cardiovasular Center of medical College, Yonsei University in Seoul, Korea from March 1996 through May 1996. The specific angiographic criteria for enrollment included at least 75% diameter stenosis, according to the estimate of two investigatior ; a lesion that was 20mm or more in lenght and a vessel diameter of at least 2.5mm. Bail-out procedure was performed in the case of abrupt closure or threatened closure, defined as a dissection and over 50% residual stenosis of the artery. RESULTS: The coronary Less Shortening Wallstents were successfully implanted in the 21 diffuse coronary lesions(more than 20mm in length) of the 20 patients(pts), including 7 pts of acute myocardial infarction, 11 pts of unstable angina, and 2 pts of stable angina. Angiographic results after Less Shortening Wallstent were 3.0+/-0.3mm in minimal luminal diameter(MLD), 6.7+/-10.8% diameter stenosis(DS) comparing with pre-stent implantation MLD and DS, respectively, 0.3+/-0.4mm and 89.9+/-8.4%. During the in-hospital phase, no major cardiac event occurred except 2 cases of transmural myocardial infarction, including one of stent thrombosis and one of side branch occlusion, despite of inclusion of 7 cases of threatened occlusion in the long lesion. The peristent spasms were observed in 11 among 21 lesions, although long term significance of peristent spasm is not defined. The relative risk for peristent spasm were 10 times higher when larger stents(expanded stent diameter/reference artery diameter>1.7) were implanted. There was no peristent spasm when stents of which expanded stent diameter 1.4 times smaller than reference artery size ware used. CONCLUSION: The results of this introductory study suggest that new Less Shortening Wallstent may reduce the requirement of multiple stent in the long lesion and a lower rate of thrombotic occusion in comparison to its prototype. Further large scale long term follow-up study is needed to evaluate the role of new Less Shortening Wallstent.
Angina, Stable ; Angina, Unstable ; Angioplasty, Balloon, Coronary ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease* ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Myocardial Infarction ; Phenobarbital ; Research Personnel ; Seoul ; Spasm ; Stents ; Thrombosis ; Transplants ; Veins

BACKGROUND: Though caudal block is a relative simple technique, it has not been widely used in adults because of a high failure rate. We assumed that any tests to quantify the changes of sympathetic tone in the affected areas would be excellent indicators of successful block. We tested the usefulness of two candidates (pulse oximetry plethysmographic waveform amplitude measured at 5th toe and calf minus 5th toe skin temperature gradient) as indicators of successful caudal block. METHODS: In 45 adult patients undergoing anal surgery with caudal block, these two variables were simultaneously measured at 2-min intervals for 20 min. A two-fold increase in the plethysmographic waveform amplitude from baseline and skin temperature gradient of 0oC were predefined as test criteria of successful block. RESULTS: While the sensitivity, specificity, positive predictive value, and negative predictive value of the skin temperature gradient test were 45.9%, 100%, 100%, and 9.1%, those of the plethysmographic waveform test were 86.5%, 100%, 100%, and 28.6%. The plethysmographic waveform test showed a significantly higher discriminative capacity than the skin temperature gradient test (94.9% vs. 48.7%, P < 0.05) CONCLUSIONS: Unlike the skin temperature gradient test, the plethysmographic waveform test showed a considerably high validity in detecting successful block. Considering its simple and real time monitoring potentials together with a high failure rate of caudal block in adults, we cautiously recommend it as a supplemental diagnostic tool to predict successful block, especially when verbal communication with patient is difficult.
Adult ; Humans ; Oximetry* ; Sensitivity and Specificity ; Skin Temperature* ; Skin* ; Toes

BACKGROUND AND OBJECTIVES: It is unclear whether rhinovirus infections promote mucus secretion in airway epithelial cells. Increase of mucin gene expression and mucin production is associated with mucus hypersecretion. We therefore investigated the effect of rhinovirus infection on mucin gene expression in airway epithelial cells. MATERIALS AND METHOD: The effect of rhinovirus-16 infection on the gene expression of MUC- 5AC, MUC5B, MUC6, MUC7, and MUC8 was evaluated using semi-quantitative reverse transcription polymerase chain reaction in A549 cells. RESULTS: Rhinovirus significantly increased MUC5AC, MUC7, and MUC8 messenger ribonucleic acid (mRNA) expressions in A549 cells, but it did not significantly affect the expression of MUC5B and MUC6 mRNA. CONCLUSION: This results show that rhinovirus may induce mucus secretion in airway epithelial cells.
Epithelial Cells ; Gene Expression ; Mucins ; Mucus ; Polymerase Chain Reaction ; Reverse Transcription ; Rhinovirus ; RNA ; RNA, Messenger