No abstract available.
Asthma* ; Child* ; Emergencies* ; Emergency Service, Hospital* ; Epidemiologic Studies* ; Humans

No abstract available.
Asthma* ; Child* ; Emergencies* ; Emergency Service, Hospital* ; Epidemiologic Studies* ; Humans

No abstract available.
Carcinoma, Squamous Cell* ; Vagina*

No abstract available.
Aged* ; Humans

No abstract available.
Hysterectomy*

BACKGROUND: Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. METHOD: We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure 6-8cmH2O and an expiratory positive airway pressure 3-4cmH2O. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. RESULTS: Pretreatment and after 3 days of treatment, mean PaO2 was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and PaCO2 was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in CT group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean PaO2, PaCO2 and pH respectively. CONCLUSION: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPE), is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.
Appointments and Schedules ; Dyspnea ; Humans ; Hydrogen-Ion Concentration ; Intubation, Intratracheal ; Masks ; Mortality ; Neuromuscular Diseases ; Oxygen ; Positive-Pressure Respiration ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive* ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Rate ; Sensation ; Tracheostomy ; Ventilation* ; Ventilators, Mechanical

Lymphangioleiomyomatosis(LAM) is defined as an abnormal proliferation of smooth muscles in the lung tissue throughout lymphatics, vascular and bronchial structure. A 52-year-old postmenopausal woman was admitted to our hospital for recurrent pneumothorax. She was treated for medroxyprogesterone by LAM 1 month ago. We performed operation of pulmonary partial resection and pleurodesis. The patient is receiving continuous medroxyprogesterone and Leuplin administration, and currently, 6 months after the operation, is still showing good results.
Female ; Humans ; Lung ; Lung Neoplasms ; Lymphangioleiomyomatosis* ; Lymphangioma ; Medroxyprogesterone ; Middle Aged ; Muscle, Smooth ; Pleurodesis ; Pneumothorax*

OBJECTIVE:The goal of this study is to evaluate the clinical outcome of the patients with brainstem cavernous angiomas after treatment with microsurgery or radiosurgery. METHODS:Fifteen patients with brainstem cavernous angiomas were treated at the authors' institution between 1995 and 2003. Clinical record and neuroimaging examinations were retrospectively reviewed. RESULTS: Ten patients underwent microsurgical resection. Radical excision was achieved in all of them. In 6 patients (60%), transitory neurological deterioration or new neurological deficit after immediate postoperative period. The final outcomes at 6-70 months after surgery were improved in 8 patients (80%) and unchanged in 2 (20%) compared with preoperative state. Radiosurgery was performed as an initial treatment in 6 patients. During the follow up period from 5 to 60 months there was neurological improvement in 3 patients and no significant change in 2. One patient developed rebleeding at 60 months after radiosurgery and underwent microsurgical resection. CONCLUSION:Symptomatic cavernous angioma of brainstem can be treated with microsurgical resection with acceptable morbidity. Radiosurgery is an effective alternative for the lesion which is not accessible by surgical approach, however, still there is possibility of rebleeding over long period after radiosurgical treatment. Fatal complication is rare with appropriate surgical approach in well selected patient. Microsurgery should be considered as a treatment with priority for the majority of cases.
Brain Stem* ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Microsurgery ; Neuroimaging ; Postoperative Period ; Radiosurgery ; Retrospective Studies

PURPOSE: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. METHODS: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. RESULTS: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. CONCLUSION: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.
Delivery of Health Care ; Early Detection of Cancer ; Female ; Humans ; Korea ; Mass Screening ; Psychometrics ; Surveys and Questionnaires ; Uterine Cervical Neoplasms ; Weights and Measures

OBJECTIVE: The goal of this study is to provide the clinical data of patients with brainstem cavernous hemangiomas after treatment with microsurgery or radiosurgery after conducting a retrospective analysis of 21 patients at one institution. METHODS: Twenty one patients with brainstem cavernous hemangiomas were treated at the authors' institution between 1995 and 2004 and clinical analysis was performed by retrospective review of medical records and neuroimaging examinations. Thirteen patients underwent microsurgical resection and radiosurgery was performed as an initial treatment in 9 patients. RESULTS: Radical excision was achieved in 12 among 13 patients and transitory neurological deterioration or new neurological deficit developed during the immediate postoperative period in 7 (54%). The final outcomes at 5-70 months after surgery were improved in 11 patients (85%) and worsened in 2 patients (15%) compared with the preoperative state. Radiosurgery was performed in 9 patients. During the follow up period from 5 to 70 months there was neurological improvement in 3 patients, no significant change in 3 and deterioration in 3 patients. Two patients developed rebleeding at 5 months, 60 months respectively after radiosurgery. CONCLUSION: Microsurgery for symptomatic cavernous hemangioma of brainstem can be performed with acceptable morbidity. Fatal complication is rare with careful selection of the optimal operative approach in well selected patients. Radiosurgery is an effective alternative for the lesions which are not accessible by surgical approach, however, there is still a possibility of rebleeding over a long period after radiosurgical treatment and microsurgery should be considered as a treatment with priority for the majority of cases.
Brain Stem* ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Medical Records ; Microsurgery ; Neuroimaging ; Postoperative Period ; Radiosurgery ; Retrospective Studies