1.The Importance of Initial Mechanical Ventilation Mode in Acute Respiratory Failure: Risk Factors for the Development of Cardiac Arrhythmias.
Young Ju LEE ; Won KIM ; Young Deuk KIM ; Seok Cheon CHEON ; Kyoung Soo LIM
Journal of the Korean Society of Emergency Medicine 2000;11(4):539-545
BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac*
;
Arterial Pressure
;
Heart
;
Heart Rate
;
Humans
;
Hydrogen-Ion Concentration
;
Multivariate Analysis
;
Respiration, Artificial*
;
Respiratory Insufficiency*
;
Risk Factors*
;
Ventilation
;
Ventilators, Mechanical
2.Clinical Study of Intussusception in Childhood Comparison Between Barium Reduction Group and Surgically Treated Group.
Seung Hyun CHEON ; Kyoung Sim KIM ; Young Wook KIM ; Ki Bok KIM
Journal of the Korean Pediatric Society 1989;32(5):630-637
No abstract available.
Barium*
;
Intussusception*
3.Aerobiological Study for Airborne Pollen and Mold in Pusan.
Ming Jung KIM ; Kyoung Whoon CHEON ; Sung Won KIM
Pediatric Allergy and Respiratory Disease 2000;10(2):119-130
PURPOSE: Airborne pollen and mold spores are common causative agents of allergic disease. Atmospheric pollen and spores in one area of Pusan were collected to investigate species, particle amount, seasonal distribution, and of its association with reactivity to skin prick test in children. METHODS: Rotorod sampler was installed on the rooftop of St. Benedict Hospital in Pusan. 24 hour sampling of airborne allergens over a two year period was conducted 6 days/week from July 1, 1997 to June 30, 1999. Those samples were stained with Calberla's fuchsin and were identified, counted under the light microscope (400xfor pollen, 1000xfor mold). The data were compared with the daily weather report and allergy skin test. RESULTS: Major pollens collected were Pinus, Alnus, Juniperus, Betula, Quercus, Artemisia, Ambrosia, and Chenospodium-Amaranthus. The pollen season is relatively short and the pollen dispersed mainly during the period from March to May in case of tree pollen and from August to October in case of grass pollen. Total pollen count ranged from 0 to 1000 grains/m3/day (May 14, 99). The peak pollen season was seen during Spring and Autumn, especially in March and September. Major mold spores counted were Cladosporium, Leptospheria and Alternaria. Mold spore count ranged from 0 to 2,360 spores/m3/day (Oct. 8, 98). Cladosporium was dispersed year-round, but mainly in the October and November, while Leptospheria was dispersed mainly in the period from July to September and Alternaria counts tended to be higher around July. The concentration of mold is roughly correlated with the amount of rainfall, having high spore count in July and August, especially in case of Leptospheria. In terms of positive reaction to skin prick test in children, Alnus and Artemisia were found to be allergen source in early spring and late summer season, respectively. CONCLUSION: Analysis of pollens and mold spores sampled in the atmosphere of Pusan, Korea, for a 2 year period identified 19 species of pollens and 22 species of mold spores with seasonal variation of some clinically important pollen/mold load. Cladosporium, Leptospheria and Alternaria are found to be three major molds, especially from June to October.
Allergens
;
Alnus
;
Alternaria
;
Ambrosia
;
Artemisia
;
Atmosphere
;
Betula
;
Busan*
;
Child
;
Cladosporium
;
Colony Count, Microbial
;
Fungi*
;
Humans
;
Hypersensitivity
;
Juniperus
;
Korea
;
Pinus
;
Poaceae
;
Pollen*
;
Quercus
;
Rosaniline Dyes
;
Seasons
;
Skin
;
Skin Tests
;
Spores
;
Weather
4.Early diagnosis of Aortic Transection or Interruption without Extemal Chest Wound: Two Cases Report.
Seung Baik HAN ; Young Jin CHEON ; Kwang Je BAEK ; Jun Sig KIM ; Jung Taek KIM ; Kwang Ho KIM ; Kyoung SUN
Journal of the Korean Society of Emergency Medicine 1998;9(4):668-673
Aortic transection or interruption is a rare condition which developed after an acute deceleration injury. Its occurrence depends on the location and direction of the force applied and is usually from motor vehicle accident or falling down. The exact incidence of aortic transection in trauma is not known but, when develops, only about 10-15% of the victims can furtive and be transported to the hospital. Even in the survivors, majority of them will be fatal within a few days if a prompt diagnosis and surgical treatments are not made. Aggressive diagnostic work-up is recommended for the patients with high suspicious index, which would salvage the victims with this fatal condition. We report the experience of two cases of aortic transection or interruption following motor vehicle accidents.
Deceleration
;
Diagnosis
;
Early Diagnosis*
;
Humans
;
Incidence
;
Motor Vehicles
;
Survivors
;
Thorax*
;
Wounds and Injuries*
5.Solitary Juvenile Polyps and Colonoscopic Polypectomy in Children.
Kyoung Whoon CHEON ; Jae Young KIM ; Sung Won KIM
Journal of the Korean Pediatric Society 2003;46(3):236-241
PURPOSE: This study was performed to know the clinical profile and effectiveness of colonoscopic polypectomy in patients with solitary juvenile polyp. METHODS: This study included 19 children, aged 1.8 to 11.4 years, who underwent colonoscopic polypectomy and histologically proven solitary juvenile polyps between March 1998 and August 2002. We analyzed their detailed history, clinical manifestations, colonoscopic examination, method of anesthesia and results of colonoscopic polypectomy. RESULTS: The mean age of the 19 cases was 4.7+/-2.8 year. The male to female ratio was 1 : 1.1.Hematochezia, the main indication of colonoscopy, was present in all cases. Combined symptoms were mucoid stool or diarrhea(42%), abdominal pain(26%), constipation(11%) and anal fissure(11%). Anemia(Hb <10 g/dL) in four cases recovered spontaneously after polypectomy. Complications associated with premedication, sedation and colonoscopy itself did not occur. Bleeding developed in two cases(11%) after polypectomy. One of them was controlled with hemoclipping. The main site of polyps was the rectosigmoid colon in 15 cases(79%). The size of the polyps ranged from 0.5 to 3.5 cm. The interval between the onset of symptoms and polypectomy was from 0.1 to 42 months. CONCLUSION: Juvenile polyps are a common cause of benign, chronic and recurrent rectal bleeding. Colonoscopic polypectomy is a simple, safe and effective therapeutic method. So earlier colonoscopy might avoid uneffective treatment and prevent untoward problems such as fear of parents and anemia.
Anemia
;
Anesthesia
;
Child*
;
Colon
;
Colonoscopy
;
Female
;
Hemorrhage
;
Humans
;
Male
;
Parents
;
Polyps*
;
Premedication
6.The problems of rural interhospital transfer of injured patients to a referal emergency center.
Kyoung Soo LIM ; Young Sik KIM ; Moo Eob AHN ; Sung Oh HWANG ; Nam Cheon CHO ; Sung Joon KANG
Journal of the Korean Society of Emergency Medicine 1992;3(1):44-53
No abstract available.
Emergencies*
;
Humans
7.Role of CT in evaluating rectal cancer: on the aspect of perirectal fat infiltration and lymph node involvement.
Seung Yon BAEK ; Moon Gyu LEE ; Jin Cheon KIM ; Kyoung Sik CHO ; Yong Ho AUH ; Young Il MIN
Journal of the Korean Radiological Society 1992;28(5):733-738
Twenty seven patients with known rectal cancer were evaluated with CT and CT findings were correlated with surgical and pathologic results on the aspect of perirectal fat infiltration and lymph node involvement. The accuracy in assessment of perirectal fat infiltration was 77.8% (21 of 27); sensitivity, 73.3% (11 of 13); specificity, 83.3% (10 of 12). In the detection of lymph node involvement, lymph nodes were divided into five groups according to the arterial teritories. Overall accuracy in the evaluation of lymph node involvement was 86.7%. Accuracy of peritumoral lymph node involvement was 51.9% (14 of 27); sensitivity, 42.9%(9 of 21); specificity 83.3% (5 of 6). Accuracy of internal iliac lymph node involvement was 88.9% (24 of 27); sensitivity, 85.7% (6 of 7); specificity, 90.0% (18 of 20). Of the common and external iliac lymph node, accuracy was 100% (27 of 27); sensitivity, 100% (2 of 2); specificity, 100% (25 of 25). Of the aortic bifurcation and mid sacral lymph node, accuracy was 92.6% (25 of 27); sensitivity, 50% (2 of 4); specificity, 100% (23 of 23). In regard to the inferior mesenteric lymph node, no lymphadenopathy was found on CT and pathologic results. In conclusion, CT has limited value in evaluating rectal cancer but with the satisfactory outcome in assessment of perirectal fat infiltration and lymph node, involvement except peritumoral node preoperative CT is useful in the evaluation of rectal cancer.
Humans
;
Lymph Nodes*
;
Lymphatic Diseases
;
Rectal Neoplasms*
;
Sensitivity and Specificity
8.A case of solid and papilary tumor of pancreas.
Kyoung Bum KIM ; Hae Won CHEON ; Ji Hee PAK ; Kee Hyoung LEE ; Kwang Chul LEE ; Young Chang TOCKGO
Journal of the Korean Pediatric Society 1993;36(12):1765-1769
We report a cases of solid and papillary neoplasm of the pancreas, which is a rare pancreatic tumor. we described clinical characteristics, sonographic, computed tomographic and pathologic finding. The tumors had a smooth, enhanced capsule and variable architecture. The tumor was distributed tail of pancreas without local invasion. the origin of the tumor is probably from a multipotential stem cell of the pancreas. Neoplasm usually behave like a very low grade malignancy, so that complete removal is the treatment of choice for the tumor arising anywhere in the pancrease. This unusual tumor should be considered in the differential diagnosis of a young female with pancreatic mass.
Diagnosis, Differential
;
Female
;
Humans
;
Pancreas*
;
Pancrelipase
;
Stem Cells
;
Ultrasonography
9.Oral allergy syndrome in pollen - sensitized patients.
You Sook CHO ; Yeun Jeong LIM ; Jae Cheon LEE ; Seoung Ho KIM ; Mi Kyoung LIM ; Bin YOO ; Hee Bom MOON
Journal of Asthma, Allergy and Clinical Immunology 1998;18(3):458-465
BACKGROUND: Oral allergy syndrome(OAS) is composed of it,ching sense and edema in oral cavity, lips, throat, pharynx, and larynx following eating some fresh fruits or vegetables. It has been known that most of patients with OAS are allergic to pollens. Common epitopes were found among pollens, fruits and vegetables. Although OAS is a common farm of food allergy in adults, this is the first epidemiologic study of OAS in Korea. MATERIAL AND METHOD: One hundred and fifty one patients who showed positive skin reaction to pollens were telephone-interviewed. Investigation of the prevalence and clinical manifestations of OAS was possible in 81 patients. RESULT: The prevalence of OAS among these patients was 34.6% (28/81). OAS was found in 24(48%) out of 50 patients sensitized to tree pollens, whereas 4(13%) of 31 grass or weed pollen-sensitized paients had OAS. Most common causative food was apple and all of 17 apple- OAS patients were sensitized to tree pollens. Peach was the second common food and 14 of 15 peach-OAS patients were sensitized to tree pollens. Besides oral symptoms, rhinitis, asthma, diarrhea, nausea, vomiting or generalized urticaria were accompanied in half of the OAS patients (14/28). Some patients showed OAS to some unique Korean foods such as dropwort, taro and Aster. CONCLUSION: OAS was very common in pollen-sensitized patients. Larger epidemiologic studies are needed to find unique Korean foods and their antigensm causing OAS.
Adult
;
Asthma
;
Colocasia
;
Diarrhea
;
Eating
;
Edema
;
Epidemiologic Studies
;
Epitopes
;
Filipendula
;
Food Hypersensitivity
;
Fruit
;
Humans
;
Hypersensitivity*
;
Korea
;
Larynx
;
Lip
;
Mouth
;
Nausea
;
Pharynx
;
Poaceae
;
Pollen*
;
Prevalence
;
Prunus persica
;
Rhinitis
;
Skin
;
Urticaria
;
Vegetables
;
Vomiting
10.CT evaluation of colon carcinoma: Emphasis on distant lymph node invasion and liver metastases.
Kyung Il CHUNG ; Kyoung Sik CHO ; Moon Gyu LEE ; Seung Yeon BAEK ; Yong Ho AUH ; Jin Cheon KIM
Journal of the Korean Radiological Society 1993;29(1):118-125
Even though the value of computed tomography (CT) used to detect the colon carcinoma with minimal invasion is limited, its usefulnes sin the evaluation of the extent of disease such as hepatic metastasis or distant lymph node invasion has been emphasized. To examine the role of CT in the evaluation of colon carcinoma, CT scans obtained during the past 2 years in 56 patients with surgically proven colon carcinoma were reviewed and the findings correlated with pathologic results. The sensitivity and accuracy of CT for pericolic fat infiltration were 86, 58 and 80% respectively. Those of regional node were 60, 83 and 75% and distant node 67, 100 and 95%. Liver metastases showed sensitivity, specificity and accuracy of 83, 98, 96% and peritoneal metastases 67, 94 and 89% respectively. CT detected local invasion with fair degree of accuracy but the true value of CT lie in the detection of distant invasions such as liver and distant lymph node metastases thereby leading to preclusion of unnecessary procedures and implementation of appropriate precedures.
Colon*
;
Humans
;
Liver*
;
Lymph Nodes*
;
Neoplasm Metastasis*
;
Sensitivity and Specificity
;
Tomography, X-Ray Computed
;
Unnecessary Procedures