BACKGROUND: the prediction on changes in the lung function after lung surgery would be an important indicator in terms of the operability and postoperative complications. In order to predict the postoperative FEV1 - the commonly used method for measuring changes in lung function- a comparison between the quantitative CT and the perfusion lung scan was made and proved its usefulness. MATERIAL AND METHOD: The subjects included 22 patients who received perfusion lung scan and quantitative CT preoperatively and with whom the follow-up of PFT were possibles out of the pool of patients who underwent right lobectomy or right pneumonectomy between June of 1997 and December of 1999. The FEV1 and FVC were calibrated by performing the PFT on each patient and then the predicted FEV1 and FVC were calculated after performing perfusion lung scan and quantitative CT postoperatively. The FEV1 and FVC were calibrated by performing the PFT after 1 week and after 3 momths following the surgery. RESULTS: There was a significant mutual scan and the actual postoperative FEV1 and FVC at 1 week and 3 months. The predicted FEV1 and FVC(pneumonectomy group : r=0.962 and r=0.938 lobectomy group ; r=0.921 and r=913) using quantitative CT at 1 week postoperatively showed a higher mutual relationship than that predicted by perfusion lung scan(pneumonectomy group : r=0.927 and r=0.890 lobectomy group : r=0.910 and r=0.905) The result was likewise at 3 months postoperatively(CT -pneumonectomy group : r=0.799 and r=0.882 lobectomy group : r=0.934 and r=0.932) CONCLUSION: In comparison to perfusion lung scan quantitative CT is more accurate in predicting lung function postoperatively and is cost-effective as well. Therefore it can be concluded that the quantitative CT is an effective method of replacing the perfusion lung scan in predicting lung function post-operatively. However it is noted that further comparative analysis using more data and follow-up studies of the patients is required.
Follow-Up Studies ; Humans ; Lung* ; Perfusion* ; Pneumonectomy ; Postoperative Complications

The glucose uptake rate by Fasciola hepatica was a mean value of 9.62 +/- 0.54 micro-mole/hr/g, and total CO(2) production rate by the flukes averaged 24.28 +/- 4.26 micro-mole/hr/g wet wt. The relative specific activity of respiratory CO(2) showed a mean value of 79.89 +/- 1.78 per cent. The rate of CO(2) production derived from medium C(14)-glucose was a mean of 19.55 +/- 3.56 micro-mole/hr/g of we wt. Therefore, the average value of 32.72 +/- 4.8 percent of glucose utilized by the flukes from the medium C(14)-glucose was oxidized to respiratory CO(2). The tissue concentration of glycogen in F. hepatica was a mean of 38.36 +/- 2.91 mg/g or 3.84 +/- 0.29 %/g of wet wt, and the turnover rate of glycogen pool was a mean of 1.6+/-0.22 %/hr or 0.65 +/- 0.13 mg/hr/g. The average value of 37.26 +/- 3.86 per cent of glucose utilized by the fluke from the medium C(4)-glucose was incorporated to the glycogen. These data account for that approximately 70 per cent of the utilized glucose by the flukes participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen.
parasitology-helminth-trematoda-Fasciola hepatica ; glucose ; biochemistry ; autoradiograhy ; glycogen ; CO(2)

Blunt chest trauma can cause various types of cardiac injuries such as myocardial contusion,cardiac ruptrue, valvular or papillary muscle injuries, and pericardial or coronary artery injuries. Complete rupture of both papillary muscles accompanied by left ventricular(LV) rupture following blunt chest trauma to our knowledge has not been previously reported. A 40-year-old female was referred because of severe dyspnea and anterior chest pain which occured immedicately after blunt chest trauma. Echocardiography demonstrated a moderate pericardial effusion as well as rupture of both papillary muscle with severe mitral regurgitation. Hemopericardium and a complets tear of the anterolateral papillary muscle at the mid portion were observed. The posteromedial papillary muscle was totally transected at the attachment site of LV wall and accompanied by external rupture of left ventricle at that site. Mitral valve replacement and primary repair of LV ruptrue was performed successfully. In the case we report, complete rupture of both papillary muscles developed after blunt chest trauma and LV rupture occurred as the papillary muscle was torn from the LV wall.
Adult ; Chest Pain ; Coronary Vessels ; Dyspnea ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Papillary Muscles* ; Pericardial Effusion ; Rupture* ; Thorax*

BACKGROUND: We evaluated the value of neutrophil-lymphocyte count ratio (NLCR) in patients admitted to the Emergency Department (ED) with suspected nursing home acquired pneumonia (NHAP). METHODS: From May 2011 to January 2013, 116 patients admitted to the ED with suspected NHAP were retrospectively studied. The clinical characteristics, C-reactive protein (CRP), white blood cell count, neutrophil count, lymphocyte count, and NLCR were assessed. CURB-65 score was used to calculate disease severity. General ward or intensive care unit (ICU) admissions, and 72-hour and 30-day mortality for each infection marker was assessed. RESULTS: The 116 patients had a median age of 77 years. As the CURB-65 score increased from 0-1 (low risk), to 2-3 (moderate risk), and to 4-5 (high risk), the NLCR consistently increased (mean, 6.9, 8.89, and 16.22, respectively). The difference between the moderate and high risk groups was significant (p=0.008). The NLCR (mean+/-standard deviation) was high in patients with NHAP (10.28+/-8.81) and increased even more for patients admitted to the ICU (15.69+/-14.81) or who died within 72-hour (15.63+/-9.57). NLCR showed the trend of higher value in ICU admission (p=0.072), and CRP was significantly different between ICU and general ward admission (p=0.007). CONCLUSION: NLCR at ED admission correlated with NHAP severity and was comparable to the traditional infection marker. NLCR can be assessed simply and added to the assessment tools to determine the severity of pneumonia during ED admission.
C-Reactive Protein ; Emergencies ; Humans ; Intensive Care Units ; Leukocyte Count ; Lymphocyte Count ; Mortality ; Neutrophils ; Nursing Homes* ; Nursing* ; Patients' Rooms ; Pneumonia* ; Retrospective Studies

PURPOSE: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. MATERIALS AND METHODS: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. RESULTS: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. CONCLUSION: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.
Arthrography ; Arthroscopy ; Atrophy ; Elbow ; Follow-Up Studies ; Humans ; Muscular Atrophy ; Patient Satisfaction ; Physical Examination ; Prospective Studies ; Rotator Cuff ; Shoulder ; Tendons

PURPOSE: We evaluated the correlation of the anatomic parameters of the acromion those represent on the magnetic resonance image (MRI) of impingement syndrome. MATERIALS AND METHODS: From June, 2004 to December, 2005, 71 cases were surgically proven to be impingement syndrome, and the anterior acromial hooking angle, the lateral acromial hooking angle (AAHA and LAHA) and the acromial hooking index (AHI: the sum of the AAHA and LAHA) were compared to 16 control cases. At the same period, 55 cases were surgically proven to be partial or full thickness rotator cuff tear, and age, gender and twelve anatomic parameters, including the acromial type, the acromial angle, the anterior covering, the acromial slope, the AAHA, the lateral acromial angle, the acromial torsional angle, the lateral acromial angulation, the LAHA, the lateral covering, the acromiohumeral distance and the AHI were assessed. RESULTS: The AAHA and AHI were increased as impingement syndrome proceeded. The acromial type and acromial angle, and the AAHA, LAHA and AHI showed significant differences between the controls and the rotator cuff tear patients on univariant analysis. On multivariant analysis, gender was most strongly correlated with rotator cuff tear. Age, AAHA and the acromial angle showed similar correlation, respectively. CONCLUSION: The coronal acromial shape is correlated with rotator cuff tear, and it is important to correct the lateral acromial shape when performing acromioplasty.
Acromion ; Humans ; Magnetic Resonance Spectroscopy ; Rotator Cuff

A number of complications during the use of double-lumen endobronchial tubes are reported, specifically tracheobronchial rupture, a rare but serious complication. Risk factors associated with tracheobronchial rupture include inexperienced endoscopists, intubating stylets, multiple vigorous attempts at intubation, overdistension of the tracheal or bronchial cuff with high pressure, position change with an inflated cuff, and anatomical abnormality. We report 2 cases of tracheobronchial rupture which occurred during the use of double-lumen endobronchial tubes.
Intubation ; One-Lung Ventilation* ; Risk Factors ; Rupture*

Silica is known as a promising osteoconductive material, and polycaprolactone is a bioactive and degradable material. The purpose of this study was to monitor the differentiation of MC3T3-E1 cells cultured on the layer-built silica/poly caprolactone non-woven fabric produced by electrospinning. Non-woven fabric (silica, polycaprolactone, PSP, SPS) was made by electrospinning and they were inserted in the 48 well cell culture plate. MC3T3-E1 cells were prepared by subculture. Cells were seeded to each well 1x10(5) concentration per well. Dulbecco's modified eagle medium with 10% FBS and 1% antibiotic-antimycotic solution was used. Confocal laser scanning microscope was taken 4 hours after incubation (95% air, 5% CO2, 37degrees C). Cell proliferation was monitored by spectrophotometer on 1, 7, 14 days, and the morphology of the growing cells was observed by field emission scanning electron microscope. To monitor the differentiation of osteoblasts on the materials, MC3T3-E1 cells were incubated in 48 well culture plate after seeding with the density of 1x10(5) concentration. Then ELISA kit & EIA kit were used on to assess osteocalcin and osteopontin expression respectively. The other conditions were the same as above. MC3T3-E1 cells were proliferated well on all of the materials. There were no statistical differences among them. The osteopontin expression of silica, PSP, SPS was significantly higher than other groups on day 3 (p<0.05), but after that time, there were no statistically signigicant differences. The osteocalcin expression was significantly higher in silica and PSP than other groups on day 14. These findings show that PSP was as good as silica on the effect of osteoblast differentiation. The PSP non-woven fabric may have the possibility as bone graft materials.
Cell Culture Techniques ; Cell Proliferation ; Eagles ; Enzyme-Linked Immunosorbent Assay ; Osteoblasts ; Osteocalcin ; Osteopontin ; Silicon Dioxide ; Transplants

BACKGROUND: Despite continous efforts to improve the prehospital trauma care system in Korea, the preventable death rate has been reported to be high. The purpose of this study was to evaluate the prehospital trauma care system in Seoul by analyzing 119 rescue databases. METHODS: The 119 rescue data bases of 22,275 trauma patients, who were transported to the secondary and tertiary hospital in Seoul by Seoul 119 rescue services from January 1, 2000 to December 31, 2000, were analyzed. RESULTS: The response time(mean 3.7 min.) showed no time, weekly, and regional variations. However, the transport time from field to hospital showed was high in the morning rush hour(7:00 to 10:00 am), and was gradually decreased and the lowest between 10:00 pm and 7:00 am. There was also a regional variation in the transport time, which was short in the central area and long in the peripheral area of Seoul. Prehospital cares were given to the 10,999 trauma patients(49.4%). Of the 464 unresponsive patients(2%), only 236 patients were identified in transported hospitals. The outcomes of these unresponsive patients were DOA(54%), survival(19%), death in ER(14%), transfer to other hospitals(8%), and death after admission(5%) in order. CONCLUSION: We suggest that this study may be helpful to the establishment and improvement of the prehospital trauma care system as well as the determination of the adequate numbers and locations of trauma center in Seoul.
Humans ; Korea ; Mortality ; Reaction Time ; Seoul* ; Tertiary Care Centers ; Trauma Centers

Pazopanib is a potent multitargeted tyrosine kinase inhibitor that has been shown to have good efficacy in patients with renal cell carcinoma. A previous phase II trial demonstrated that short-term pazopanib administration was generally well tolerated and showed antitumor activity in patients with early-stage non-small cell lung cancer. Herein, we report on the case of a 66-year-old man with simultaneous metastatic squamous cell carcinoma of the lung and renal cell carcinoma who was treated with pazopanib. The patient showed an unexpected partial response and experienced a 10-month progression-free survival without significant toxicity. To the best of the authors' knowledge, this is the first report of pazopanib treatment in a non-small cell lung cancer patient in Korea. The results in this patient suggest that pazopanib may be a valid treatment option for advanced non-small cell lung cancer.
Aged ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Renal Cell ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Drug Therapy ; Humans ; Korea* ; Lung ; Lung Neoplasms ; Protein-Tyrosine Kinases