BACKGROUND: Malpositioning of the endotracheal tube within airway after intubation may results in serious complications, such as accidental extubation and inadvertent endobronchial intubation. Therefore, early detection of malposioning of the endotracheal tube is very impotant for deciding patient's prognosis. METHODS: We assessed the distance from the tip of the endotracheal tube to the carina according to the patient's age, sex, and the time, the location, and the route of intubation. The chest x-ray was taken for 333 patients (men, 226: women, 107) who were admitted to the intensive care unit of Wonju Christian Hospital from march 1, 1995 to February 28, 1996. Chest x-ray was obtained after intubation to verify endotracheal tube position. Appropriate endotracheal tube position on chest x-ray was defined as between 2 and 6 cm above the carina. RESULTS: Of the 333 intubations, 106 (31.8%) endotracheal tubes were inappropriately placed according to the chest x-ray. The percentage of malpositioned endotracheal tubes (<2 cm) was higher in women than in men (11.2% vs. 5.3%, p<0.05), with higher in night (7 PM to 7 AM) than in day (7 AM to 7 PM) (42% vs. 24%, p<0.05). Distance from the carina to the tip of endotracheal tube is 4.34 +/- 1.77cm in women and 5.23 +/- 1.64cm in men. Thus, position of the endotracheal tube in women is deeper than men (p<0.001). CONCLUSIONS: We conclude that the chest x-ray for confirmation of endotracheal tube position after endotracheal intubation may remain the standard of practice. And endotracheal tube position should be carefully assessed immediately after tracheal intubation, particularly in women and at night.
Female ; Gangwon-do ; Humans ; Incidence* ; Intensive Care Units ; Intubation ; Intubation, Intratracheal* ; Male ; Prognosis ; Thorax*

The Bcl-2 protein has been shown to block apoptosis induced by a variety of stimuli. We have performed the experiments which cell death can be blocked by the bcl-2 proto-oncogene under moderate(50-100mM) or high ethanol treatment(400-600mM). As a result of morphological changes, and MTT assay, cell death was blocked by Bcl-2 under 100mM ethanol. However, the results of DNA fragmentation and RT-PCR(ICE, and CPP32), immunoblotting(CPP32, and PARP) for SK-pcDNA3 cells(vector only) and SK-Bcl-2 cells(stably expressed bcl-2 gene) were showen to be no significant differences between two cell lines. These result suggested that cell death induced by ethanol was not followed by apoptosis mechanism, and was blocked by the bcl-2 proto-oncogene with moderate ethanol.
Apoptosis ; Cell Death* ; Cell Line ; DNA Fragmentation ; Ethanol* ; Ice ; Proto-Oncogenes*

PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.
Bile ; Decompression ; Drainage* ; Humans ; Needles*

Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three group and aspirates were categorized into three cytologic groups. The cytologic result was reported benign masses (cytologic group 1) in 71 cases (52%), malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 cases (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benigh masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.
Biopsy ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography

The hypoglycemic effects of four edible plants (Angelicae tenuissimae (A. ten.), Pleurospermum kamtschaticum (P. kam.), Adenophora remotiflora (A. rem.) and Zanthoxylum schinifolium (Z. sch.)) in streptozotocin (STZ)-induced diabetic rats were investigated. Sprague-Dawley male rats weighing 190-230 g were induced diabetes mellitus by the STZ injection (45 mg/kg) into the tail vein and were divided into six groups ; normal, STZ-control and four edible plant groups (A. ten., P kam., A. rem. and Z. sch. groups). Normal and STZ-control groups were fed a AIN-93 diet and four groups of STZ-induced diabetic rats were fed one of each experimental diets containing 10% of the edible plant powder for 4 weeks. Diabetic rats showed the lower weight gain compared to the normal rats. In experimental groups except P. kam., AST activities were close to normal. A. ten. group were lowered ALT activities slightly. The plasma glucose levels of the diabetic experimental groups were significantly decreased at 4th week. The plasma insulin levels in diabetic experimental groups were not significantly different compared to the STZ-control group. The liver glycogen levels in STZ injected rats were significantly lower in compared to the normal rats. However no significant differences were found in response experimental plants intake in diabetic rats. The muscle glycogen were not significantly different among all the groups.
Animals ; Blood Glucose* ; Campanulaceae ; Diabetes Mellitus ; Diet ; Glycogen* ; Humans ; Hypoglycemic Agents ; Insulin ; Liver Glycogen ; Male ; Plants, Edible ; Plants, Medicinal* ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Streptozocin* ; Veins ; Weight Gain ; Zanthoxylum

OBJECTIVES: This study aimed to identify psychopathologies of sexually abused children and intervening variables of symptom severity. METHODS: Eighty-four school-aged children were identified for sexual abuse from a center for child sexual abuse by psychiatrists, clinical psychologists, and social workers. We analyzed correlations among symptom severity, types of sexual abuse, gender, age, relationship with the abuser, family system, and current and past psychopathologies. RESULTS: The percentage of victims with particular psychiatric disorders (current) were 79.8%. Children without identifiable disorders were 20.2%, but these children had significantly increased scores on self report scales of anxiety (RCMAS), depression (CDI), and withdrawal scores on parental reports of child behavior checklist (K-CBCL). Sixty nine percent of abused children had primary diagnosis related to sexual abuse in DSM-IV diagnositic system. PTSD was 41.7%, depressive disorder was 38.1%, and anxiety disorder was 21.4%. Psychopathologies were more severe if perpetrators were of acquaintance or if victims had previous psychopathologies or parent-child relational problems. Types of primary caregiver and older age were also related to the severity of psychopathologies. CONCLUSION: Present study suggests that most victims of childhood sexual abuse suffer from significant psychological distress. Intervening variables are relationship with the perpetrator, previous mental health status, age of the child, type of the primary care taker, and the quality of parent-child relationship.
Anxiety ; Anxiety Disorders ; Caregivers ; Checklist ; Child Abuse, Sexual ; Child Behavior ; Child* ; Depression ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea* ; Mental Health ; Parent-Child Relations ; Parents ; Primary Health Care ; Psychiatry ; Psychology ; Psychopathology* ; Self Report ; Sex Offenses ; Social Workers ; Stress Disorders, Post-Traumatic ; Weights and Measures

BACKGROUND/AIMS: Hepatic fibrosis in rat induced by thioacet amide shares similar morphological and biochemical characteristics with human liver cirrhosis. Thioacetamide (T AA) initially induces accumulation of collagen in Disse space and eventually leads to macro- and micronodular cirrhos is. Ito cell was believed to play a main role in hepatic fibrosis. And it s activity was known to be regulated by the expression of various genes. But little has been discovered about the upstream signal trans duction pathway of these genes in hepatic fibrosis. The expression of genesrelated to Ito cell activity was regulated by many transcription factors , the activity of which was regulated by protein kinase C( PKC) is oforms. So it is s upposed that PKC could be as s ociated with fibrosis in liver. METHODS: We investigated the correlation of PKC is oforms and It ocell activity in the course of hepatic fibrosis using TAA induced rat liver cirrhosis model. We used six week- old male rats , and administered 0.03% TAA in drinking water. The animals were sacrificed at 9, 20, and 30 weeks after TAA administration. The degree of hepatic fibrosis was evaluated by measuring the total amount of collagen.-SMA immunohist ochemical st aining of liver tissue was done to determine the Ito cell activity. The expression pattern of PKC isoforms was investigated by West ern blotting. RESULTS: In TAA- treated group, collagen cont ent and Ito cell activity did not increase until 30 weeks and 20 weeks of treatment , respectively, while in control group collagen cont ent and Ito cell activity were not detected. Collagen content showed linear correlation with Ito cell activity. This implied that the proliferation of activated Ito cells was prior to the increase of collagen content. In view of expression pattern of PKC is oforms, PKC alpha showed no difference in TAA- treated group and control group. In TAA-treated group, PKCbeta1 exhibited increased level of expression in both particulate and cytosolic forms at 9 weeks, while PKCdelta and PKC epsilon showed striking shift to particulated form. After 20 weeks, all of the PKC beta1, delta, and epsilon degenerated and showed remarkably decreased level of expression. This suggested PKC alpha had no relation to hepatic fibrosis,while PKC beta1, delta, and epsilon, showing activity at 9 weeks, were related to fibrosis og liver. In response to fibrogenic factors, molecules engaged in intracellular signal transduction pathway like PKC beta1, delta, and epsilon, began to change prior to the increase of Ito cell activity, morphologic changes and alterations of collagen content. CONCLUSION: Our results strongly suggest that the activity of PKC isoforms play an important role in early step of hepatic fibrosis, while accompanying Ito cell activity do in later step.
Animals ; Collagen ; Cytosol ; Drinking Water ; Fibrosis ; Hepatic Stellate Cells ; Humans ; Liver Cirrhosis* ; Liver* ; Male ; Protein Isoforms ; Protein Kinase C-epsilon ; Protein Kinases ; Rats ; Signal Transduction ; Strikes, Employee ; Thioacetamide ; Transcription Factors

Accurate placernent of double-lumen endobronchial tube is essential for successful one lung anesthesia We studied 58 adult patients (38 males and 20 females) undergoing thoracic surgery under one lung anesthesia. We used the fiberoptic bronchoscope as an "introducer" over which the double lumen tube was advanced under direct vision. Correct position of the left side double-lumen endobronchial tube at supine position was determined by direct vision of cephalad surface of the bright blue bronchial cuff immediately below the carina. Correct position of the right side double lumen endobronchial tube at supine position was determined by direct vision of the right upper lobe bronchial orifice through the right upper labe ventilation slot. After the patient was repositioned, the position of the double lumen endobronchial tube was rechecked by fiberoptic bronchoscope. The results were as follows; 1) There was a significant correlation of correct depth of left and right double lumen endobronchial tube at supine position with height for both male and female patients. 2) Left side double lumen endobronchial tube: 58% of total cases (20 Case of 38 Case) were displaced by turning of the patient from supine to the lateral decubitus position. 3) Right side double lumen endobronchial tube: 65% of total cases (13 Case of 20 Case) were displaced by turning of the patient from supine to the lateral decubitus position.
Adult ; Anesthesia ; Bronchoscopes ; Female ; Humans ; Lung ; Male ; Supine Position ; Thoracic Surgery ; Ventilation

BACKGROUND: Recent interest in the use of normothermic blood cardioplegia is based on theoretical advantages over the traditional method of hypothermic myocardial protection. These reported advantages are a decrease in intraaortic balloon pump use, greater incidence of return to normal sinus rhythm, greater immediate cardiac outputs, and less time weaned from bypass after removal of the aortic cross-clamp. In addition to these advantages, normothermic blood cardioplegia offers the promise to resuscitate the ischemic myocardium and reduce the morbidity and mortality for patients with high-risk disease. This study was designed to compare the effects of cold crystalloid and normothermic blood cardioplegia on the postoperative recovery. METHODS: To evaluate the efficacy of cold versus normothermic cardioplegia, forty-four patients scheduled to undergoing valvular replacement surgery were selected to receive intermittent cold(4degrees C) crystalloid cardioplegia(n=22), group I or continuous normothermic(37degrees C) blood cardioplegia(n=22), group II. Cardiopulmonary bypass(CPB) and aortic cross-clamp(ACC) times were measured during the operation and patients were evaluated postoperatively for serum electrolytes, arterial blood gas analysis, blood pressure, heart rate, complications, ventilator periods and ICU stay. RESULTS: The ACC and CPB times were significantly longer in group II(165.9+/-44.8 min, 210.9+/-60.2 min) compared with group I(121.2+/-38.7 min, 149.7+/-38.1 min)(p<0.01). Group II patients had significantly higher serum potassium level(5.2+/-0.8 mEq/L) than group I(4.3+/-0.4 mEq/L) on the first postoperative day(p<0.01). ICU stay and ventilator period were not significantly different in two groups. There was no significant difference in postoperative complications and mortality rates between two groups. CONCLUSIONS: These results suggest that the continuous normothermic blood cardioplegia may be useful in myocardial protection during cardiac operation.
Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Electrolytes ; Heart Arrest, Induced* ; Heart Rate ; Heart* ; Humans ; Incidence ; Mortality ; Myocardium ; Postoperative Complications ; Potassium ; Thoracic Surgery* ; Ventilators, Mechanical

PURPOSE: This study aimed to investigate the current status of Internet websites dealing with atopic dermatitis and to evaluate the quality of their contents using an evaluation tool. METHODS: The words "atopic dermatitis" were searched with the four most commonly used Internet search engines between July and August of 2005. The searched websites included commercial medical instrument, oriental medicine, community (i.e., health portal), and medical institution sites. However, we assessed with the evaluation tool, the quality of the contents of only those sites that provided some description of atopic dermatitis-related symptoms, doctor consultations, and treatment and management. RESULTS: A total of 104 web sites were searched. Among them, commercial medical nstrument sites were the most common [53 sites (51%)], followed by oriental medicine sites [28 sites (26.9%)]. The quality of each of these 82 site's contents was analyzed. At the community sites, the purpose of the site's existence was clearer, but the reliability of information was relatively poor, as compared with the other site types. Among the various types of informations on atopic dermatitis, treatment and management, of the greatest interest to users, showed only a low-accuracy rating on the qualitative assessment. CONCLUSION: Commercial medical instrument sites predominated among the four types of site that providing atopic dermatitis-related information in internet. Having assessed the quality of contents of all of the four types of site, we showed that the accuracy of complementary alternative medical information was low. In this regard, it is deemed necessary to formulate a standard for finding and managing correct information.
Delivery of Health Care ; Dermatitis, Atopic ; Internet ; Medicine, East Asian Traditional ; Referral and Consultation ; Search Engine