BACKGROUND: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). METHODS: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O. RESULTS: In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit). CONCLUSIONS: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.
Cardiopulmonary Resuscitation* ; Manikins* ; Models, Theoretical ; Positive-Pressure Respiration ; Thorax ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

No abstract available.
Child* ; Humans ; Measles*

Malignant neoplasm associated with chronic empyema is rare. Most squamous cell carcinomas of the pleura may occur in association with chronic persistent empyema, with or without pleurocutaneous fistula. We report a case of squamous cell carcinoma associated with chronic empyema caused by a metallic foreign body.
Carcinoma, Squamous Cell* ; Empyema* ; Fistula ; Foreign Bodies ; Pleura

PURPOSE: We investigate the risk factors of recurrence after first intussusception. METHODS: We have studied the relationship of the clinical features and ultrasonographic findings and the risk of recurrent intussusception in 97 patients with reduced intussusception including 22 recurrent intussusception who admitted at the department of pediatrics at Ewha Womans University Mok-dong hospital from September 1993 to Feburary 1996. RESULTS: 1) The overall recurrence rate of intussusception in this study was 16.9%. 2) The interval between the first and second attack was within 24 hours in 53.8%. 3) There were no stastistically significant difference in age and sex, antecedent illness, clinical symptoms and sings, type of intussusception and radiologic findings on simple abdomen. 4) There were stastistically significant difference in the average duration of symptom above 12 hours, infolding lymph node in target sign, outer hypoechoic diameter above 8mm, swelling on ileocecal valve and terminal ileum after reduction(wall thickness> 3mm) on ultrasonographic findings and number of trial of reduction more than 3 times between the nonrecurrent and recurrent groups. 5) In stepwise logistic regression analysis, hypoechoic outer rim thickness above 8mm in target sign, swelling of ileocecal valve and terminal ileum after reduction on ultrasonographic findings and number of trial of reduction more than 3 times contributed significantly to the prediction of recurrence of intussusception. CONCLUSIONS: Recurrent intussusception can be predicted by hypoechoic outer rim thickness above 8mm in target sign, swelling of ileocecal valve and terminal ileum after reduction on ultrasonographic findings and number of trial of reduction more than 3 times.
Abdomen ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception* ; Logistic Models ; Lymph Nodes ; Pediatrics ; Recurrence ; Risk Factors* ; Ultrasonography*

Nineteen revision total knee arthroplasties (TKAs) performed from March 1991 to March 1995 were evaluated to determine the clinical and roentgenographic results and the problems in revision TKA. The mean age was 63 years (range, 23-85 years) and the mean follow-up time was 19 months (range, 12 months-4.4 years). The primary revisions were done in eighteen knees and a re-revision, in one. Four revision TKAs were performed for failed unicompartmental arthroplasty and fifteen, for failed TKA. The mean interval from initial to revision TKA was 4.1 years (range, 3.3 years-5 years) in failed unicompartmental arthroplasty and 5.7 years (range, 4 months-14 years) in failed TKA. The initial diagnosis was degenerative arthritis in 16 knees, tuberculous arthritis in two and rheumatoid arthritis in one. The main cause of revision for both of the failed unicompartmental arthroplasties and failed TKAs was aseptic loosening. The HSS knee score improved from 43+/-14 to 82+/-7 in the failed unicompartmental arthroplasties and from 46+/-16 to 79+/-14 in the failed TKAs. The clinical success rate of revision TKA was 78%. The coronal tibiofemoral angle improved from valgus 0.2degrees to valgus 5.1degrees. At final follow-up, radiolucent line greater than 2mm in width was found around femoral component in one knee. In our series, four complications were occurred. One knee was fused due to mas-sive bone loss and ipsilateral femur shaft fracture. Deep wound infections were developed in two knees and loss of fixation after tibial tuberosity osteotomy in one. In conclusion, significant improvements of clinical and radiological results were achieved in revision TKA but the success rate was relatively low and the complication rate was relatively high compared with primary TKA. So, especially appropriate skillful surgical techniques and postoperative cares were required to overcome the soft tissue problem and infection which was encountered in revision TKA.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Diagnosis ; Femur ; Follow-Up Studies ; Knee* ; Osteoarthritis ; Osteotomy ; Wound Infection

PURPOSE: To evaluate the accuracy of a model made using the computer-aided design/computer-aided manufacture (CAD/CAM) milling method and 3D printing method and to confirm its applicability as a work model for dental prosthesis production. MATERIALS AND METHODS: First, a natural tooth model (ANA-4, Frasaco, Germany) was scanned using an oral scanner. The obtained scan data were then used as a CAD reference model (CRM), to produce a total of 10 models each, either using the milling method or the 3D printing method. The 20 models were then scanned using a desktop scanner and the CAD test model was formed. The accuracy of the two groups was compared using dedicated software to calculate the root mean square (RMS) value after superimposing CRM and CAD test model (CTM). RESULTS: The RMS value (152±52 µm) of the model manufactured by the milling method was significantly higher than the RMS value (52±9 µm) of the model produced by the 3D printing method. CONCLUSION: The accuracy of the 3D printing method is superior to that of the milling method, but at present, both methods are limited in their application as a work model for prosthesis manufacture.
Dental Models ; Dental Prosthesis ; Methods ; Printing, Three-Dimensional ; Prostheses and Implants ; Tooth

PURPOSE: Although breast milk is considered the best source of nutrition for infants because of its superiority over powdered milk, there are circumstances when breast milk is unavailable. Committee on Nutrition of the Korean Pediatric Society conducted an investigation into the current status of formula feeding in Korea. METHODS: This investigation was conducted using questionnaires produced by our committee and distributed to mothers of children under the age of two who were using formula feeding at 10 university hospitals and 22 public health centers nationwide between March 1999 to September 1999. A comparative analysis according to location, birth order, mother's occupation, education, housing tenure and normal birth status was performed on all 2696 questionnaires using the chi-square test. RESULTS: Formula feeding was found in 49.4% and formula feeding combined with breast milk were 21.5% of the respondents. The percentage of formula feeding was higher in working mothers who underwent a Cesarean section in metropolitan areas. The inadequacy of breast milk was the most common reason for feeding powdered rnilk followed by the unhealthy condition of the mother and mother's return to work. Of those investigated, 94.9% said that they changed products at each stage as recommended by the manufacturer. Promotions for special formulas were more active in metropolitan areas than other areas, and 57.7M said that they used special formulas based on recornmendations by the doctor and acquaintances(15.5%) or after seeing an advertisement(14.0%). CONCLUSION: This investigation revealed that many rnothers were misinformed concerning formula feeding and pediatricians should provide mothers with education, shedding light on proper feeding methods.
Birth Order ; Cesarean Section ; Child ; Surveys and Questionnaires ; Education ; Feeding Methods ; Female ; Hospitals, University ; Housing ; Humans ; Infant* ; Korea ; Milk ; Milk, Human ; Mothers ; Occupations ; Parturition ; Pregnancy ; Public Health ; Return to Work

PURPOSE: Body mass index(BMI), skinfold thickness and arm circumference are commonly used to evaluate obesity in children. There is a need for new standards of these items on Korean children. We performed this study to provide up-to-date reference percentile values and percentile charts for these three items. METHODS: Standardized measurements of height, weight, skinfold thickness(triceps, subscapular) and arm circumference on a total of 31,188 infants and children from age 1 to 18 years during January to December 1998 were used to calculate percentile values and to develop smoothed percentile charts. RESULTS: The mean BMI increased with age and showed similar values in both sexes, but 95th percentile values were slightly higher for boys than girls. The percentile values of BMI were consistently higher than those reported previously in Korea, particularly for the 95th percetile values. Triceps and subscapular skinfold thickness showed significant increase compared with previous studies and significantly higher for females than males. Arm circumference also showed significant increase compared with the previous studies. It was significantly higher for males than females. BMI was more closely related with arm circumference than skinfold thickness. CONCLUSION: The percentile values and percentile charts of BMI, skinfold thickness and arm circumference will allow pediatricians to evaluate obesity in Korean children.
Arm* ; Body Mass Index* ; Child* ; Female ; Humans ; Infant ; Korea ; Male ; Obesity ; Skinfold Thickness*

OBJECTIVES: Tumor markers have been clinically used to diagnose and monitor the progression of various tumor or to assess their response to therapy. This study focuses on the evaluation of tumor markers in Chronic renal failure patients, compared with normal controls. METHODS: The following 9 kinds of serum tumor markers, such as carcinoembryonic antigen(CEA), squamaus cell carcinoma-related antigen(SCC), CYFRA 21-1, CA(carbohydrate antigen) 125, CA 19-9, alpha-fetoprotein(AFP), prostate specific antigen(PSA), human chorionic gonadotropin(hCG) and CA 72-4 were measured in 56 persons without chronic renal failure(CRF) as controls, in 132 patients with chronic renal failure(56 patients on conservative management, 41 patients on chronic hemodialysis, and 35 patients on CAPD) who did not present any evidences of neoplasia. RESULTS: 1) The mean level of CEA in CRF patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than that of patients on conservative management(p<0.05). 2) The mean level of SCC in CRF patients was significantly higher than that of controls(p<0.001), and the mean levels of SCC did not differ significantly among three groups of CRF patients. 3) The mean level of CYFRA in CI4F patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than those of patients on conservative management and on CAPD respectively (p<0.05). 4) The mean level of CA 125 in CRF patients was significantly higher than that of controls (p<0.001), and that of CRF patients on CAPD was significantly lower than that of controls(p<0.05). 5) Positive percent for CYFRA 21-1 in all CRF patients was 89.7%, and SCC 82.9%, CEA 60.3%, CA 125 48%, CA 19-9 22.4%, PSA 7.9%, CA 72-4 6.1%, hCG 4.7% and AFV 3.2% respectively. CONCLUSION: The present study shows that tumor markers such as CEA, SCC, CYFRA 21-1, CA 19-9 and CA 125 are elevated above reference values in a substantial number of patients according to the reference values commonly used in normal persons, making them unreliable for monitoring malignancies in uremic patients. While the other tumor markers such as AFP, PSA, hCG and CA 72-4 are reliable for the same purpose. These results must be taken into account when serum levels of tumor markers are measured in CRF patients
Chorion ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory ; Prostate ; Reference Values ; Renal Dialysis ; Biomarkers, Tumor*

PURPOSE: To evaluate the reliability and clinical usefulness of ultrasonography in the temporomandibular joint (TMJ). MATERIALS AND METHODS: Parasagittal and paracoronal 1.5 T MR images and 7.5 MHz ultrasonographs of 40 TMJs in 20 asymptomatic volunteers were obtained. Disc position using MR imaging was evaluated and the distance between the lateral surface of mandibular condyle and the articular capsule using MR image and ultrasonograph of 27 TMJs with normal disc position was measured and compared. Intraobserver and interobserver measurements reliability was evaluated by using interclass correlation coefficients (ICC) and measurement error. Also, the distance measured on ultrasonographs was compared, according to mouth position and disc postion. RESULTS: The normal disc position was found in 27 of 40 asymptomatic joints. At the intraobserver reliability of measurement, ICC at the closed and open mouth position were 0.89 and 0.91. The measurement error was 0.4% and 0.5%. At the interobserver reliability, ICC at the closed and open mouth position were 0.92 and 0.81. The measurement error was 0.4% and 0.7%. At the TMJ with normal disc position, the distances between the lateral surface of mandibular condyle and the articular capsule measured on MR images and ultrasonographs were 2.0+/- 0.7 mm, 1.8+/-0.5 mm, respectively (p<0.05). On the ultrasonographs, the distances at open mouth position were 1.2+/-0.5 mm (p<0.05). At the TMJ with medially displaced disc, the distances at the closed and open mouth position were 1.3+/-0.3 mm and 0.9+/-0.2mm(p<0.05). CONCLUSION: The results suggest ultrasonography of TMJ is a reliable imaging technique for assessment of normal disc position.
Joint Capsule ; Joints ; Magnetic Resonance Imaging ; Mandibular Condyle ; Mouth ; Temporomandibular Joint* ; Ultrasonography ; Volunteers