No abstract available.
Diagnosis* ; Echocardiography*

Endotracheal intubation is the most useful and safe method to keep airway in general anesthesia. But there are many problems such as severe cardiovascular changes, difficult intubation, larygospasm and tracheal stenosis in using laryngoscope and tracheal intubation. Laryngeal mask airway(LMA) is new method to keep airway and has many advantages such as easy insertion, decreasing cardiovascular changes, insertion without muscle relaxant, decreasing damage of pharynx and laynx and useful in difficult intubation. Cinical study of LMA No. 2 was done in 30 children weighted between 8.9-26 kg, about cardiovascular changes, volume and pressure changes of inflaton cuff, problems and complications during insertion and maintaining of LMA. The result, were follows I) The average time taken to insert the LMA was 7.4+/-3.3 second and 12 case were correct placement at the second attempt to use laryngoscope. 2) The volume of inflation cuff without air leak during positive pressure ventilation with 15cmH2O of peak airway pressure was 7.9+/-0.5ml and inflation cuff pressure at insertion was 40.1+/-15.9 mmHg and increased(p<0.05) continously. 3) Mean arterial pressure was increased(p<0.05) compared with preinduction value and normalize within a minute. Heart rate was incresed(p<0.05) compared with preinduction value and increase was sustained. 4) There were no complications except 1 case of gastric disteesion.
Anesthesia, General ; Arterial Pressure ; Child* ; Heart Rate ; Humans ; Inflation, Economic ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopes ; Pharynx ; Positive-Pressure Respiration ; Tracheal Stenosis

No abstract available.
Amyloidosis*

No abstract available.
Cystadenocarcinoma, Mucinous* ; Mucins*

PURPOSE: The usual technique of temporomandibular joint (TMJ) reduction, recommended by most emergency medicine textbooks, consists of downward forces applied to the mandible. However, it has been the authors' experience that conscious sedation and significant force is required to achieve reduction. For that reason, we designed a new method of TMJ reduction. The purpose of our study is to introduce the new method of TMJ reduction and to compare the traditional method with the new method. METHODS: We performed a prospective, randomized trial with 52 patients who were diagnosed as having a TMJ dislocation. The patients were divided into two groups: the group treated with the traditional method (25 cases) and treated with the new method (27cases). Patients with histories of trauma or inflammatory signs were excluded from this study. The new method is an extraoral approach in which the operator applies the coronoid process on the face in the posteroinferior direction. RESULTS: Age, sex, and history of TMJ dislocation showed no statistical differences between the two groups. Reduction of the TMJ dislocation was achieved in 15 (60.0%) of the traditional method group and in 25 (92.6%) of the new method group (p=0.005). The means of the reduction time were 11.8+/-6.2 sec in the traditional method group and 6.6 +/- 3.3 sec in the new method group (p=0.007). CONCLUSION: The new method was an effective treatment for TMJ dislocation without any sedations. I had a higher success rate and a shorter reduction time than traditional method.
Conscious Sedation ; Dislocations ; Emergency Medicine ; Humans ; Mandible ; Prospective Studies* ; Temporomandibular Joint*

BACKGROUND: Many autopsy studies have shown that the extent of extracranial carotid and coronary artherosclerosis is correlated and B-mode ultrasonographic intima-media thickness(IMT) and histologic IMT have been good correlation. In recent years. as it has been reported that IMT of carotid artery had something to do with risk factors of atherosclerosis and occurrence of coronary artery disease, in this study, we tried to investigate if the grade of atherosclerosis in B-mode ultrasonography of carotid artery could predict coronary artery disease and have something to do with the severity of coronary artery disease. METHODS: We classified the patients who were examined coronary angiography into control group without significant(>50%) stenosis(11 patients) and coronary artery disease(CAD) group(45 patients) according to the existence of significant stenosis, and we subdivided CAD group into single vessel disease(SVD) group(25 patients) and multivessel disease(MVD) group(20 patients). Practicing B-mode ultrasonography of common carotid artery(CCA), carotid artery bifurcation(BIF) and internal carotid artery(ICA), we measured IMT and IMT/L(lumen diameter) of each segment. Adding all values of each segment, we got mean aggregated IMT and mean aggregated IMT/L. RESULTS: 1) As IMT of left BIF in both six segments, control group was 0.55+/-0.16mm, SVD group was 0.71+/-0.36mm and MVD group was 1.02+/-0.61mm. So compared with control group and SVD, MVD group were significantly thick. As IMT/L, control group was 0.07+/-0.02, SVD group 0.08+/-0.05 and MVD group was 0.13+/-0.08. So compared with control group and SVD, MVD group was ignificantly high. 2)IMT of BIF in three segments, control group was 0.59+/-0.16mm, CAD group was 0.82+/-0.47mm and MVD group was 0.90+/-0.54mm. So compared with control group and CAD, MVD group were significantly thick. Also as IMT/L of BIF, compared with control group(0.07+/-0.02) and CAD(0.10+/-0.06), MVD(0.11+/-0.07) group was high.= 3) As mean aggregated IMT, control group was 0.57+/-0.34mm, CAD group was 0.69+/-0.45mm, SVD group was 0.63+/-0.12mm and MVD group was 0.74+/-0.21mm. So CAD group was thicker than control group and MVD group was thicker than SVD group. As mean aggregated IMT/L, control group was 0.07+/-0.03, CAD group was 0.10+/-0.05, SVD group was 0.09+/-0.01 and MVD group was 0.11+/-0.03. So CAD group was higher than control group and MVD group was higher than SVD group. CONCLUSION: These data support use of the mean aggregated B-mode ultrasonographic IMT and IMT/L in carotid bifurcation for correlation with the status of coronary atherosclerosis.
Atherosclerosis ; Autopsy ; Carotid Arteries* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Risk Factors ; Ultrasonography

The purpose of the present study was to determine the preventive effects of combined interventional trial of fish oil treatment and exercise training on insulin resistance of skeletal muscle in high-fat fed rats. Male Wistar rats were randomly divided into chow diet (CD), high-fat diet (HF), high-fat diet with fish oil (FO), high-fat diet with exercise training (EX), and FO+EX groups. The rats in control group were fed chow diet containing, as percents of calories, 58.9% carbohydrate, 12.4% fat, and 28.7% protein. High-fat diet provided 32% energy as lard, 18% as corn oil, 27% as carbohydrate and 23% as casein. The fish oil diet had the same composition as the high fat diet except that 100 g menhaden oil was substituted for corn oil. Insulin sensitivity was assessed by in vitro glucose transport in the soleus muscle after diet treatment and treadmill running for 4 weeks. While the FO or EX only partially prevented insulin resistance on glucose transport and visceral obesity induced by high-fat diet, these interventions completely corrected hyperinsulinemia and hyperglycemia from the high-fat diet. The rats in the FO+EX showed normalized insulin action on glucose transport, plasma chemicals and visceral fat mass. Insulin-mediated glucose transport was negatively associated with total visceral fat mass (r=-0.734; p<0.000), plasma triglyceride (r=-0.403; p<0.05) and lepin (r=-0.583; p<0.001) concentrations with significance. Multiple stepwise regression analysis showed that only total visceral fat mass was independently associated with insulin-mediated glucose transport (r=-0.668; p<0.000). In conclusion, combined interventional trial of FO+EX recovered insulin resistance on glucose transport of skeletal muscle induced by high-fat diet. Visceral fat mass might be more important factor than plasma TG and leptin to induce insulin resistance on glucose transport of skeletal muscle in high-fat fed rats.
Animals ; Caseins ; Corn Oil ; Diet ; Diet, High-Fat* ; Glucose* ; Humans ; Hyperglycemia ; Hyperinsulinism ; Insulin Resistance ; Insulin* ; Intra-Abdominal Fat ; Leptin ; Male ; Muscle, Skeletal* ; Obesity, Abdominal ; Plasma ; Rats* ; Rats, Wistar ; Running ; Triglycerides

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus oral dinoprostone for labor induction at term. METHODS: One hundred of patients at term were randomized to receive either 50microgram of misoprostol vaginally every 4 hours or dinoprostone 0.5mg orally every 1 hour for the maximum of six doses. Intravenous infusion of oxytocin was administered under such circumferences as the patient did not go into active labor after maximum dose, SROM was developed without an adequate contraction pattern, or the patient had arrest of dilatation(no change in cervical dilatation for 2 hours). We compared the frequency of oxytocin augmentation, administration to delivery interval, vaginal delivery rate within 12 hours and 24 hours, intrapartum complications, induction failure, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: The average interval from administration to delivery was shorter in the misoprostol group(739.4+/-372.4min vs 1087.7+/-765.1min, p<0.05), but the interval from administration to vaginal delivery of each group was similar(724.3+/-375.4min vs 800.3+/-697.0min). Regarding the frequency of vaginal delivery within 24 hours, however, misoprostol group was higher than dinoprostone group(88% vs 56%, p<0.001). And oxytocin augmentation of labor occurred less commonly in misoprostol group than in dinoprostone group(20% vs 76%, p<0.05). Any statistically significant difference in intrapartum complications, mode of delivery, and neonatal or maternal adverse outcome was not appeared between these two group. CONCLUSION: Vaginal misoprostol is as effective and safe as oral dinoprostone for cervical ripening and induction of labor at term. In addition, vaginal misoprostol contributes the curtailment of labor induction expenditure due to its moderate price; misoprostol costs 100 won per 50microgram.
Cervical Ripening ; Dinoprostone* ; Female ; Health Expenditures ; Humans ; Infusions, Intravenous ; Labor Stage, First ; Misoprostol* ; Oxytocin ; Pregnancy

We herein report two patients with epidermolysis bullosa acquisita(EBA), who had showed the atypical clinical features. A 25-year-old male presented with multiple pruritic vesicles, erosion and crusts which occurred more severely on the face than any other sites of the skin and healed with atrophic scar formation. Histopathologically, there was a subepidermal neutrophilic blister with moderate perivascular lymphohistiocytic infiltrates in the dermis, and the diagnosis of EBA was confirmed by means of direct immunofluorescence and salt-split direct immunofluorescence test performed on the perilesional skin. The other patient was a 24-year-old female who had had multiple painful ulcerative lesions on the oral mucosa for 4 months. After then, vesicles and bullae developed to progressively generalize to the anterior neck, chest and lower leg. Histolopathologic examination of peribullous skin showed a subepidermal bulla with neutrophils and eosinophils. The salt-split skin direct immunofluence test showed IgG and IgM binding to the dermal side only. We diagnosed this patient as nonscarring inflammatory EBA. Both patients were treated with prednisolone, colchicine, and dapsone resulting in clinical improvement, but their skin lesions recurred several months after discontinuing medication.
Adult ; Blister ; Cicatrix ; Colchicine ; Dapsone ; Dermis ; Diagnosis ; Eosinophils ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Male ; Mouth Mucosa ; Neck ; Neutrophils ; Prednisolone ; Skin ; Thorax ; Ulcer ; Young Adult

Transient tachypnea of the newborn(TTN) is a benign self-limited disease characterized by early onset and rapid recovery of tachypnea although it may occasionally have a more prolonged and protracted course. A retrospective clinical study was mad on 29 neonates with TTN admitted to NICU of Pohang St. Mary's Hospital from January 1992 to June 1993. The results were as follows: 1) TTN(36.2%) was the most common cause of respiratory distress in the neonate followed by idiopathic respiratory distress syndrome(23.8%), pneumonia(18.8%), meconium aspiration syndrome(6.2%), perinatal asphyxia(6.2%), polycythemia(3.8%), anemia(1.2%), persistent fetal circulation(1.2%), paroxysmal supraventricular tachycardia(1.2%) and tracheoesophageal fistula(1.2%) 2) TTN was more frequent in the male term infants but can occur in premature(41.4%) and low birth weight infants(34.5%). 3) The associated perinatal conditions were oxytocin-induction(8 cases, 27.6%), Cesarean delivery(10 cases, 34.5%) and asphyxia(7 cases, 24.2%) 4) Arterial blood gas analysis showed respiratory acidosis in 3 cases and metabolic acidosis in 3 cases but none of TTN showed hypoxia unresponsive to oxygen 5) Chest X-ray showed hyperaeration in 10 cases(34.5%), increased pulmonary vascularity in 8 cases(27.6%), hyperaeration and increased pulmonary vascularity in 6 cases(20.6%) and cardiomegaly in 12 cases(53%). 6) Tachypnea usually appeared within 6hours and abated by 48-72hours but sustained more than 73hours in 7 cases(24.1%) 7) In majority of cases, maximal respiratory rates were below 100 rates/min and administered oxygen concentrations were 20-40%, and their mean values were 81 rates/min, 37.6% respectively. 8) TTN with more prolonged course(> or=48hours) was associated with low birth weight infants, prematurity and higher respiratory rates(> or=100 breaths a minute)(p<0.05).
Acidosis ; Acidosis, Respiratory ; Anoxia ; Blood Gas Analysis ; Cardiomegaly ; Gyeongsangbuk-do ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Meconium Aspiration Syndrome ; Oxygen ; Respiratory Rate ; Retrospective Studies ; Tachypnea ; Thorax ; Transient Tachypnea of the Newborn*