Four cases of newborn with tension pneumothorax induced by a conventional ventilator were admitted to our nursery from January 1. 1992 to June 30. 1992 and they were managed by high frequency ventilator (Infrasonic Infant Star Ventilator). In contrast, four cases of newborn with tension pneumothorax who were continuously on the conventional ventilator, were included as a control group. They were admitted to our nursery from July 1. 1991 to december 31. 1991 and they were managed by conventional ventilator with conservative treatment. 1) In the control group, who were continuously managed by the conventional ventilator after thoracostomy with water seal drainage, we changed ventilator setting appropriately in control group but they had poor arterial blood gas analysis. The arterial blood gas analysis within 24hr/within 72hr in control group were pH 7.192/7.195, Paco2 72.15/82.25, PaO2 78.92/83.875, HCO3-26.975/27.925 and conventional ventilator care did not show any definite benefit for improvement of arterial blood gas analysis and tension pneumothorax as well. 2) Two cases in control group expired on the 6th day of thoracostomy without any resolution of tension pneumothorax. 3) In contrast, four cases with tension pneumothorax managed by high frequency ventilator were improved. Tension pneumothorax and arterial blood gas analysis to normalize from 6hr of high frequency ventilation and four cases of tension pneumothorax were completely reabsorbed within 4days.
Blood Gas Analysis ; Drainage ; High-Frequency Ventilation* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn ; Nurseries ; Pneumothorax* ; Thoracostomy ; Ventilators, Mechanical*

BACKGROUND: The dose-responses of neuromuscular blocking agents may be influenced by many factors including age and inhalation anesthetics. This study was designed to determine the dose-response relationships of a new, short-acting muscle relaxant, mivacurium during nitrous oxide-halothane or nitrous oxide-enflurane anesthesia in two age groups, infants and 1 to 6 years old preschool children. METHODS: Neuromuscular blockade was monitored by recording the accelerographic activity of the adductor pollicis muscle resulting from supramaximal stimulation at the ulnar nerve at 2 Hz for 2 seconds at 10-second intervals. To estimate dose-response relationships, 24 infants or children of two anesthetic subgroups for each age group received single bolus doses of 45~100 g/kg of mivacurium. The ED50 and ED95 were estimated from linear regression plots of log-dose vs probit of twitch depression. The lag time, onset time and maximal depression of twitch height for the selective medium dose were mesured. RESULTS: The ED50 and ED95 for the infants group were 38.2 and 53.3 g/kg during halothane anesthesia, and 29.8 and 48.6 g/kg during enflurane anesthesia, respectively. And, those for preschool children group were 49.4 and 90.7 g/kg during halothane anesthesia, and 32.3 and 81.4 g/kg during enflurane anesthesia, respectively. There was a parallelism of the dose-response curve between halothane and enflurane anesthesia in either age group. Also, there was statistically significant difference in the maximal twitch depression for the selective medium dose of mivacurium between halothane and enflurane anesthesia in either group. CONCLUSIONS: The potency of mivacurium during enflurane anesthesia is higher than that during halothane anesthesia in infants and preschool children, and during either inhalation anesthesia the dose of mivacurium is less required in infants than preschool children.
Anesthesia* ; Anesthesia, Inhalation ; Anesthetics, Inhalation ; Child ; Child, Preschool* ; Depression ; Enflurane* ; Halothane* ; Humans ; Infant* ; Linear Models ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Ulnar Nerve

No abstract available.
HLA-DR Antigens* ; Polymerase Chain Reaction*

No abstract available.
Humans ; Physicians, Family*

No abstract available.
HLA-DR Antigens* ; Polymerase Chain Reaction* ; Spermatozoa*

MR imaging was performed in 40 patients of aortic disease from March 1988 to February 1990. Transverse, coronal and oblique sagital views were obtained with ECG gating and even echo technique using 0.5 T and 2.0 T MR systems. In 12 patients of aortic aneurysm, the location, the size and the extent of aneurysm could be assessed in all cases. In the cases of six abdominal aortic aneurysm, the relation of aneurysm to renal arteries was evaluated. In 18 cases of aortic dissection, the extent of involvement as well as associated abnormalities was well evaluated in all cases. In the 8 cases of congenital aortic anomalies, the vascular anatomy was well demonstrated. However, the abnormalities of major branches could not be assessed with MR imaging especially in 2 cases of Takayasu's arteritis. With our experiences, MR imaging is regarded as a primary diagnostic modality for aortic disease and expected to be developed as the alternative measure to the angiography in the future.
Aneurysm ; Angiography ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Aortic Diseases* ; Electrocardiography ; Humans ; Magnetic Resonance Imaging* ; Renal Artery ; Takayasu Arteritis

Tracheobronchopathia osteochondroplastica (TO) is a rare benign disease of trachea characterized by numerous osseocartilaginous nodules protruding into the tracheobronchial lumen. The etiology of TO is unknown; however, an association with upper respiratory diseases such as atrophic rhinitis has been suggested. The authors report a case of TO with atrophic rhinitis with related literatures.
Osteochondrodysplasias ; Rhinitis, Atrophic ; Trachea ; Tracheal Diseases

PURPOSE: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). METHODS: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. RESULTS: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. CONCLUSION: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.
Abdomen ; Abdominal Injuries ; Emergencies ; Emergency Service, Hospital ; Hemoperitoneum ; Humans ; Laparotomy ; Mass Screening ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). METHODS: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. RESULTS: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. CONCLUSION: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.
Abdomen ; Abdominal Injuries ; Emergencies ; Emergency Service, Hospital ; Hemoperitoneum ; Humans ; Laparotomy ; Mass Screening ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Backgroud: In one-lung ventilation using the left-sided double-lumen tube (LDLT), it is important to place the LDLT in correct position to maintain adequate ventilation. We investigated the frequency of and the factors affecting the LDLT malposition in endotracheal intubation. Methods: Ninety one (55 male and 36 female) patients were observed. After endotracheal intubation, using 35 and 37 Fr. sized Robertshaw type LDLT, auscultation and fiberoptic bronchoscope were performed to make sure the correct position of LDLT. The heights, weights, age, and sex were noted. The lengths and diameters of trachea, and the angles and diameters of both bronchi on chest x-ray were measured for comparison. Results: Normal in auscultation and gross malposition were 87.9% and 12.1%. Among those normal in auscultation, normal in bronchoscope, advancing and removing fine malposition were 66.2%, 18.8% and 15.0%, respectively. The angle of left bronchus is 37.71+/-4.60degrees in normal in ausculation and 37.71+/-4.60degrees in gross malposition. The length of trachea is 13.41+/-0.90 cm in normal in bronchoscope, 14.49+/-0.78 cm in advancing fine malposition and 11.86+/-0.35 cm in removing fine malposition. The patient's height is 167.27+/-7.12 cm in normal in brochoscope, 172.45+/-6.67 cm in advancing fine malposition and 163.12+/-6.54 cm in removing fine malposition. Conclusions: The angle of left bronchus is a factor affecting gross malposition. And the length of trachea and the patient's height are factors affecting fine malposition. Thus it is necessary to obtain in advance information on patient's height, length of trachea and angle of left bronchus on chest x-ray, to reduce the occurrence of the LDLT malposition.
Auscultation ; Bronchi ; Bronchoscopes ; Humans ; Incidence* ; Intubation, Intratracheal ; Male ; One-Lung Ventilation ; Thorax ; Trachea ; Ventilation ; Weights and Measures