BACKGROUND: High-frequency jet ventilaion is considered a reliable technique for anesthesia and critical care including respiratory failure but there are adverse reactions such as carbon dioxide retension and dry of respiratory mucosa. The purpose of this study was to confirm the effects of combined high- frequency jet ventilation (HFJV) and converntional mechanical ventilation (CMV) on the cardiovascular system, arterial blood gases tension and mean airway pressure in 9 Korea mongrel dogs with pulmonary edema induced by oleic acid. METHODS: During CMV with 20 breaths/minute, 10 ml/kg of tidal volume and F1O2 1.0, parameers were evaluated (base line value). When pulmonary edema was developed, HFJV was applied initially with 120 breaths/minute, inspiratory time 30% and driving pressure 40 psi F1O2 1.0 for 60 minutes (control value) and thereafter simultaneous use of CMV was applied with the tidal volume of 10 ml/kg and each respiratory rate 8, 4, 2, 1, 0.5 per minute for 30 minutes. RESULTS: Combined application of HFJV and CMV (above repiratory rate 1 per minute) achieved the improvement of oxygenation and carbon dioxide elimination, and Paw was decreased without undesirable effects on cardiovascular system in case of the induced pulmonary edema. CONCUSIONS: From above results we recommanded that HFJV combined with CMV may be a useful method of treatment for respiratory failure.
Anesthesia ; Animals ; Carbon Dioxide ; Cardiovascular System ; Critical Care ; Dogs* ; Gases ; High-Frequency Jet Ventilation* ; Korea ; Oleic Acid* ; Oxygen ; Pulmonary Edema* ; Respiration, Artificial* ; Respiratory Insufficiency ; Respiratory Mucosa ; Respiratory Rate ; Tidal Volume ; Ventilation

BACKGROUND: Even though surgery and anesthesia give stress to patients, adequate anesthesia could attenuate stress reactions and minimize side effects from these reactions. Abnormal glucose homeostasis is well documented side effect during anesthesia, especially when inhalational anesthetics are used. We planned this study to investigate and compare the effects of two popular anesthetics-between propofol, intravenous anesthetics, and enflurane, inhalational agents on blood glucose level. METHODS: Adult patients free of diabetes mellitus and any other endocrine disease were randomly allocated into two groups. In both groups, anesthesia was induced with 2.5% pentothal sodium 5 mg/kg and succinylcholine 1 mg/kg. After intubation, propofol 6~10 mg/kg with 50 % N2O-O2 mixture 4 liter were used for maintenance in one group (Group P). In other group, enflurane 1.5~2% with 50% N2O-O2 mixture 4 liter were used (Group E). Hartmann's solutions were used for maintenance fluid in both groups. Blood glucose levels were measured at preintubation period, postintubation 5, 10, 15 minutes and just-preincision period. Blood glucose level at admission was regarded as control value and statistical analysis was done by Student's t-test. RESULTS: In group E, there was significant increase of the blood glucose level about 23 minutes after induction but in group P, there was no significant increase of glucose level during entire experimental time. Blood glucose levels were higher from postintubation 5 minutes to just-preincision period with statistical significance in group E than group P. CONCLUSIONS: Propofol maintained stable blood glucose level compared to enflurane during general anesthesia.
Adult ; Anesthesia ; Anesthesia, General ; Anesthetics ; Anesthetics, Intravenous ; Blood Glucose* ; Diabetes Mellitus ; Endocrine System Diseases ; Enflurane* ; Glucose ; Homeostasis ; Humans ; Intubation ; Propofol* ; Sodium ; Succinylcholine ; Thiopental

The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion.
Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Critical Illness ; Diabetes Mellitus/diagnosis/drug therapy ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Humans ; Kidney Failure, Chronic/diagnosis/therapy ; Liver Cirrhosis/diagnosis/therapy ; Peptic Ulcer/*therapy ; Risk Factors

Primary cardiac sarcoma is rare, and intimal sarcoma is an extremely rare and highly lethal disease. We report a case of a 62-year-old woman who was incidentally diagnosed with a primary cardiac sarcoma originating from the left atrial appendage and extending to the left superior pulmonary vein. The location of the tumor was very complicated, posing a major challenge for complete resection. We successfully performed complete resection of the cardiac sarcoma via cardiac autotransplantation with left pneumonectomy. The patient recovered uneventfully, without any adjuvant therapy as of 6 months postoperatively. Autotransplantation of the heart may be suggested as a reasonable surgical option for extensive left atrial tumors.

OBJECTIVE: To estimate changes in body mass index (BMI) during the treatment of acute manic patients, we retrospectively analyzed the medical records of patients admitted to Inha University Medical Center between January 1997 and December 2005. METHODS: Ninety-nine patients were divided into six groups according to their treatment regimens: monotherapy with lithium or divalproex and combination therapy with lithium and haloperidol, lithium and olanzapine, divalproex and haloperidol, or divalproex and olanzapine. Their demographic and clinical characteristics were assessed on admission, and the BMI was measured on admission and every week for 4 weeks after treatment. RESULTS: The combination therapy groups of lithium and olanzapine and divalproex and olanzapine had significant increases in BMI in proportion to the exposure time to medication (p=0.000), and there was no significant difference in the increase in BMI between these two groups. The normal weight group tended to have a greater increase in BMI than the overweight and obesity groups (p=0.078). CONCLUSION: The combination of a mood stabilizer (lithium or divalproex) with olanzapine is associated with a greater increase in BMI than are other treatment regimens in the acute manic phase of bipolar I disorder. More attention to weight gain is needed in the prescription of medications in acute manic patients and further studies are needed.
Academic Medical Centers ; Antipsychotic Agents* ; Bipolar Disorder* ; Body Mass Index ; Haloperidol ; Humans ; Lithium ; Medical Records ; Obesity ; Overweight ; Prescriptions ; Retrospective Studies ; Valproic Acid ; Weight Gain

Transient osteoporosis of the hip (TOH) associated with pregnancy is a rare, self- limiting skeletal disorder affecting women, usually in the third trimester, which resolves spontaneously within several months postpartum. Magnetic resonance imaging (MRI) is used primarily for early diagnosis and monitoring the disease progression. Early differentiation from more aggressive conditions such as avascular osteonecrosis, septic coxitis, arthritis, osteomyelitis with long-term sequela is essential to avoid unnecessary treatment. Unilateral involvement of TOH is common. To our knowledge, there has been no case with bilateral involvement of TOH during pregnancy in Korea. We report a rare case with bilateral TOH associated with pregnancy.
Arthritis ; Disease Progression ; Early Diagnosis ; Female ; Hip ; Humans ; Korea ; Magnetic Resonance Imaging ; Osteomyelitis ; Osteonecrosis ; Osteoporosis ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Third

No abstract available.
Chickenpox ; Herpesvirus 3, Human*

No abstract available.
Brain* ; Conus Snail* ; Dermoid Cyst* ; Magnetic Resonance Imaging ; Rupture

Hemophagocytosis refers to the pathologic finding of activated macrophages engulfing erythrocytes, leukocytes, platelets, and their precursor cells. Hemophagocytic syndrome (HS) (more properly referred to as hemophagocytic lymphohistiocytosis) is a distinct clinical entity characterized by fever, pancytopenia, splenomegaly, and hemophagocytosis in the bone marrow, spleen, and lymph nodes. HS is associated with a variety of viral, bacterial, fungal, and parasitic infections, as well as with collagen vascular diseases and malignancies. Epstein-Barr virus (EBV)-associated HS is almost always a fatal disease. The authors present a case of EBV-associated HS. The patient had fever and hepatosplenomegaly and showed pancytopenia, jaundice, and positive EBV viral markers in serum, positive EBV DNA in the liver biopsy specimen, and hemophagocytosis in the bone marrow. The patient died unexpectedly 1 month after admission. We report the details of this case of fatal EBV-associated hemophagocytic syndrome along with a brief review of the literature.
Biomarkers ; Biopsy ; Blood Platelets ; Bone Marrow ; Collagen ; DNA ; Erythrocytes ; Fever ; Herpesvirus 4, Human ; Humans ; Jaundice ; Leukocytes ; Liver ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic ; Macrophages ; Pancytopenia ; Spleen ; Splenomegaly ; Vascular Diseases

OBJECTIVE: This study was performed to evaluate the clinical efficacy of high risk HPV DNA test using PCR for the detection of high-grade CIN or invasive cancer from patients with ASCUS or LSIL on Papanicolaou smear. METHODS: Sixty one patients with a Papanicolaou smear report of atypical squamous cells of undetermined significance or a low-grade squamous intraepithelial lesion underwent Cervical colposcopy and directed cervical biopsy and human papillomavirus test by PCR. We compared the detection rate of the high grade CIN and invasive cancer by Papanicolaou smear method only with that of both Papanicolaou smear and HPV PCR method. and we decided to be significant when P value was below 0.05 by SAS (v 6.02) program. RESULTS: The detection rate of high risk HPV DNA was 50.8% (31/61). The detection rate of high risk HPV DNA in high grade CIN and invasive cancer was 84.2% (16/19). Higher the grade of biopsy, more the detection rate of high risk HPV DNA. False negative rate which appeared high grade CIN or invasive cancer by biopsy was 31.2% (19/61) in Papanicolaou smear method only and 4.9% (3/61) in both Papanicolaou smear and HPV DNA method. CONCLUSION: We thought that additional HPV DNA test was useful to dectect behind high grade CIN or invasive cancer when the Papanicolaou smear result was ASCUS or LSIL.
Biopsy ; Colposcopy ; Diagnosis* ; DNA ; Human Papillomavirus DNA Tests* ; Humans ; Papanicolaou Test ; Polymerase Chain Reaction