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*

In the 88 cases of biliary disease, which was proven in Seoul Red Cross Hospital from Jan. 1980 to Dec. 1981,comparative studies were made with oral and IV cholecystocholangiographic findings and ultrasonographic findings.The resuslts were ; 1. In the 18 cases of GB stones, there are 17 cases (94.4%) of positive findings incholecysto-cholangiography with detection of stone in 7 cases (38.9%), while in sonographic study, 16 cases(88.9%) are shown positive findings with detection of stones in 11 cases (61.1%). 2. In the 17 cases of acalculouscholecystitis, the diagnostic accuracy is 88.2% in cholecystocholangiography and 64.7% in sonography. 3. In the 7cases of CBD stones, all cases are shown positive findings in cholecystocholangiography with detection of stone inonly one case (14.3%), while 6 cases (85.7%) of positive findings are shown in sonography with detection stone inall cases. 4. I.V. cholanagiography is more accurate diagnsotic procedure rather than oral GB study in the casesof poor or non-functioning GB. 5. Sonography is the choice of procedure in the diagnosis of stones, while in thecases of colecystitis, cholecystocholangiography is more useful diagnostic procedure.
Diagnosis ; Red Cross ; Seoul ; Ultrasonography

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has become a one of the most important causes of nosocomial infections, and use of vancomycin for the treatment of MRSA infection has increased. Unfortunately, vancomycin-resistant enterococcus have been reported, as well as vancomycin-resistant S. aureus. Arbekacin is an antibacterial agent and belongs to the aminoglycoside family of antibiotics. It was introduced to treat MRSA infection. We studied the clinical and bacteriological efficacy and safety of arbekacin compared to vancomycin in the treatment of infections caused by MRSA. MATERIALS AND METHODS: This was a retrospective case-control study of patients who were admitted to tertiary Hospital from January 1st, 2009 to December 31st, 2010, and received the antibiotics arbekacin or vancomycin. All the skin and soft tissue MRSA infected patients who received arbekacin or vancomycin were enrolled during the study period. The bacteriological efficacy response (BER) was classified with improved and failure. The improved BER was defined as no growth of MRSA, where failure was defined as growth of MRSA, culture at the end of therapy or during treatment. Clinical efficacy response (CER) was classified as improved and failure. Improved CER was defined as resolution or reduction of the majority of signs and symptoms related to the original infection. Failure was defined as no resolution and no reduction of majority of the signs and symptoms, or worsening of one or more signs and symptoms, or new symptoms or signs associated with the original infection or a new infection. RESULTS: Totally, 122 patients (63/99 in arbekacin, 59/168 in vancomycin group) with skin and soft tissue infection who recieved arbekacin or vancomcyin at least 4 days were enrolled and analysed. The bacteriological efficacy response [improved, arbekacin vs vancomycin; 73.0% (46/63), 95% confidence interval (CI) 60.3 to 83.4% vs 83.1% (49/59), 95% CI 71.0 to 91.6%] and clinical efficacy response [improved, arbekacin vs vancomycin; 67.2% (41/61), 95% CI 52.0 to 76.7% vs 78.0% (46/59), 95% CI 65.3 to 87.7%] were similar between the two groups (P=0.264, 0.265). The complication rate was significantly higher in the vancomycin group [29/59(49.2%), 95% CI 35.9 to 62.5%] than arbekacin [10/63(15.9%), 95% CI 8.4 to 29.0%] (P<0.001). CONCLUSIONS: Arbekacin could be considered as an alternative antibiotics for vancomycin in skin and soft tissue infection with MRSA. However, further prospective randomized trials are needed to confirm this finding.
Anti-Bacterial Agents ; Case-Control Studies ; Cross Infection ; Dibekacin ; Enterococcus ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Tertiary Care Centers ; Vancomycin

We have experienced a case of dup (3q) syndrome in the neonate who had a multiple congenital anomalies of hypertrichosis, hypertelorism, upslanting palpaberal fissures, anteverted nostrils, long philtrum, micrognathia, downturned corners of the mouth, highly arched palate, short, webbed neck, clinodactyly, rocker-bottom feet, dermal sinus. Cytogenetic studies showed a duplication 3q21-->qter regions. Chromosome study of relatives is extremely important for counseling because only 25% of cases represented de novo duplications. We reported the case with the review of the associated literatures.
Counseling ; Cytogenetics ; Foot ; Humans ; Hypertelorism ; Hypertrichosis ; Infant, Newborn ; Lip ; Mouth ; Neck ; Palate ; Spina Bifida Occulta

OBJECTIVE: To investigate the disability identity and life satisfaction according to the severity of disability in the spinal cord injured persons resident in the community. METHOD: The subjects of this national wide study were 397 spinal cord injured persons resident in the community. We investigated their disability identity, life satisfaction, depression, social integration and social support. The questionnaire included the newly developed disability identity scale to evaluate the disability identity, that consisted of five sub-scales (personal worth, self-acceptance with the disabled, individual civil right, common cause and external barriers) and 23 questions. The subjects were divided into four groups according to severity of disability: motor complete tetraplegia, motor incomplete tetraplegia, motor complete paraplegia and motor incomplete paraplegia. RESULTS: The scores of life satisfaction, depression and social support were not different according the four groups. However the disability identity scale of the motor incomplete paraplegia was lower than motor complete tetraplegia or motor complete paraplegia (p<0.05). The sub-scale score of the personal worth and self-acceptance were lower in less severely disabled persons. As the disability identity scale was higher, social integration (r=0.478, p=0.000), and social support (r=0.465, p=0.000) were moderate and the depression was negative (r=-0.252, p=0.000). Conclusion: Less severely disabled persons showed lower disability identity. Disability identity scale was significantly correlated with higher social integration, higher social support and lower depression score. The newly developed disability identity scale will be a useful tool for the evaluation of the psychological status and planning the rehabilitation strategy for spinal cord injured persons.
Civil Rights ; Depression ; Disabled Persons ; Humans ; Paraplegia ; Quadriplegia ; Surveys and Questionnaires ; Spinal Cord ; Spinal Cord Injuries

PURPOSE: To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibular disorder (TMD) patients. MATERIALS AND METHODS: 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra- and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. RESULTS: Osteophyte (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior and medial surfaces of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78-0.84), but interobserver agreement was fair (k=0.45). CONCLUSION: CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.
Cone-Beam Computed Tomography* ; Humans ; Jeollabuk-do ; Mandibular Condyle* ; Osteophyte ; Sclerosis ; Temporomandibular Joint ; Temporomandibular Joint Disorders

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of ear infections. We attempted to evaluate the clinical usefulness of arbekacin in treating chronic suppurative otitis media (CSOM) by comparing its clinical efficacy and toxicity with those of vancomycin. Efficacy was classified according to bacterial elimination or bacteriologic failure and improved or failed clinical efficacy response. Ninety-five subjects were diagnosed with CSOM caused by MRSA. Twenty of these subjects were treated with arbekacin, and 36 with vancomycin. The bacteriological efficacy (bacterial elimination, arbekacin vs. vancomycin: 85.0% vs. 97.2%) and improved clinical efficacy (arbekacin vs. vancomycin; 90.0% vs. 97.2%) were not different between the two groups. However, the rate of complications was higher in the vancomycin group (33.3%) than in the arbekacin group (5.0%) (P=0.020). In addition, a total of 12 adverse reactions were observed in the vancomycin group; two for hepatotoxicity, one for nephrotoxicity, eight for leukopenia, two for skin rash, and one for drug fever. It is suggested that arbekacin be a good alternative drug to vancomycin in treatment of CSOM caused by MRSA.
Adult ; Aged ; Anti-Bacterial Agents/administration & dosage ; Chronic Disease ; Dibekacin/administration & dosage/*analogs & derivatives ; Female ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus/*drug effects ; Middle Aged ; Otitis Media, Suppurative/diagnosis/*drug therapy/microbiology ; Staphylococcal Infections/diagnosis/*drug therapy/microbiology ; Treatment Outcome ; Vancomycin/*administration & dosage ; Young Adult

Exposure to various particles and fibers can result in lung inflammation that may progress to fibrosis, even lung cancer for which there is no effective clinical treatment now. The mechanism involved in pulmonary injury has not been well defined ; however, most current evidence implicates a central role for alveolar macrophages (AM) in this process. Also apoptosis or programmed cell death is regarded as a mechanism which is related with the pulmonary fibrosis. We propose that the cytotoxic potential of various particles may be evaluated by measuring lactic dehydrogenase (LDH) from particle co-cultured supernatant and theses particles may induce the characteristics of apoptosis, DNA ladder. We analyzed rat AM culture media which was incubated for 3 days with the same concentration (10 ug/ml) of silica(Si), chrysotile(Ch), crocidolite(Cr), ceramic fiber(CF), rock wool(RW) and glass wool (GW). And each particles (50ug/cm(2)) was incubated with A549 (pneumocyte in tracheal epithelium) cell lines for 24 hours to confirm the DNA ladder. Additionally, silica induced apoptosis in vivo was confirmed by electromicroscopic observation. The results were as follows; 1. Silica, asbestos and man-made mineral fibers (MMMF) co-cultured with AM showed the increase of LDH significantly with the time interval of 24, 48, 72 hours except for ceramic fiber in 48 and 72 hours and crocidolite in 72 hours. 2. Silica, asbestos and man-made mineral fibers (CF, GF) showed the characteristics of apoptosis, DNA ladder, which was induced by incubating A549 cell with each particles for 24 hours in vitro 3. Apoptotic alveolar macrophage was observed the findings of zeiosis (membrane blebbing), condensation of nuclear chromosome and many vacuoles in cytoplasm, electomicroscopically.
Animals ; Apoptosis* ; Asbestos* ; Asbestos, Crocidolite ; Cell Death ; Cell Line ; Ceramics ; Culture Media ; Cytoplasm ; DNA ; Fibrosis ; Glass ; Lung Injury ; Lung Neoplasms ; Macrophages, Alveolar ; Mineral Fibers* ; Oxidoreductases ; Pneumonia ; Pulmonary Fibrosis ; Rats ; Silicon Dioxide* ; Vacuoles ; Wool

Exposure to various particles and fibers can result in lung inflammation that may progress to fibrosis, even lung cancer for which there is no effective clinical treatment now. The mechanism involved in pulmonary injury has not been well defined ; however, most current evidence implicates a central role for alveolar macrophages (AM) in this process. Also apoptosis or programmed cell death is regarded as a mechanism which is related with the pulmonary fibrosis. We propose that the cytotoxic potential of various particles may be evaluated by measuring lactic dehydrogenase (LDH) from particle co-cultured supernatant and theses particles may induce the characteristics of apoptosis, DNA ladder. We analyzed rat AM culture media which was incubated for 3 days with the same concentration (10 ug/ml) of silica(Si), chrysotile(Ch), crocidolite(Cr), ceramic fiber(CF), rock wool(RW) and glass wool (GW). And each particles (50ug/cm(2)) was incubated with A549 (pneumocyte in tracheal epithelium) cell lines for 24 hours to confirm the DNA ladder. Additionally, silica induced apoptosis in vivo was confirmed by electromicroscopic observation. The results were as follows; 1. Silica, asbestos and man-made mineral fibers (MMMF) co-cultured with AM showed the increase of LDH significantly with the time interval of 24, 48, 72 hours except for ceramic fiber in 48 and 72 hours and crocidolite in 72 hours. 2. Silica, asbestos and man-made mineral fibers (CF, GF) showed the characteristics of apoptosis, DNA ladder, which was induced by incubating A549 cell with each particles for 24 hours in vitro 3. Apoptotic alveolar macrophage was observed the findings of zeiosis (membrane blebbing), condensation of nuclear chromosome and many vacuoles in cytoplasm, electomicroscopically.
Animals ; Apoptosis* ; Asbestos* ; Asbestos, Crocidolite ; Cell Death ; Cell Line ; Ceramics ; Culture Media ; Cytoplasm ; DNA ; Fibrosis ; Glass ; Lung Injury ; Lung Neoplasms ; Macrophages, Alveolar ; Mineral Fibers* ; Oxidoreductases ; Pneumonia ; Pulmonary Fibrosis ; Rats ; Silicon Dioxide* ; Vacuoles ; Wool

Osteoporosis is a known major health problem and a serious disease of the bone, there has been a great need to develop more and newer animal models for this disease. Among animal models used for testing drug efficacy, the minipig model has become useful and effective due to its close similarity with humans (validity), particularly with the pharmacokinetics of compounds via subcutaneous administration, the structure and function of the organs, the morphology of bone and the overall metabolic nature. Based on these advantages, we sought to develop a new animal model of osteoporosis using micropig, which differs from other miniature pigs in the genetic background. Female micropigs were used for the induction of a moderate osteoporosis model by bilateral ovariectomy (OVX) and compared with shamoperated animals. For osteoporosis evaluation, clinical biomarkers such as blood osteocalcin (OSC) and parathyroid hormone (PTH) levels were measured, as well as bone mineral density (BMD) using micro-computed tomography (micro-CT). Compared to sham, OVX animals have decreased blood OSC level, while the blood PTH level increased in blood sera. In addition, we observed the significantly decreased BMDs of tibia region in OVX animals. Based on these results, we report that the micropig model developed in this study can be used to develop a new and effective medical method for diagnosis and treatment of osteoporosis.
Animals ; Biomarkers ; Bone Density ; Female ; Humans ; Models, Animal ; Osteocalcin ; Osteoporosis ; Ovariectomy ; Parathyroid Hormone ; Salicylamides ; Swine ; Swine, Miniature ; Tibia