PURPOSE: To find the effects of semi-Fowler's position on the post-operative recovery for patients with laparoscopic abdominal surgery in recovery room. METHOD: The research was performed by nonequivalent control group non-synchronized quasi-experimental design. The subjects are forty patients who had laparoscopic abdominal surgery in a hospital from Aug. thru Nov. of 2003. Post-recovery scores and O2 saturation degree were measured. The experimental group was place in semi fowler's position while the control group was placed in supine position. The homogeneity between the control group and experimental group was analyzed using the Chi-square, and the hypothesis were tested using t-test. RESULT: 1. The patients in the experimental group placed in semi fowler's position showed significant higher post-recovery scores than those in the control group who were in a supine position. 2. The patients in the experimental group who were in semi Fowler's position showed no significant higher O2 saturation degree than those in the control group who were in supine position. CONCLUSION: Based on the results described above, it is considered that the semi-Fowler's position might be effective in enhancing the post-operative recovery score of the patients with laparoscopic abdominal surgery in recovery room.
Humans ; Laparoscopy ; Postoperative Care ; Recovery Room* ; Supine Position

OBJECTIVE: Neonatal blood pressure is one of the vital signs used to assess the general health of a newborn infant. But, it is difficult to measure and varies according to the model of sphygmomanometer, the used method, the postconceptional age, birth weight, asphyxia, postnatal age and activity. We have assessed the rnean value of blood pressure(BP) according to postconceptional age. Variations caused by the postconceptional age, birth weight, body surface area(BSA), postnatal age, and sex were analyzed to determine the rnost important factor influencing the neonatal BP. METHODS: This study included 448 normal fullterm infants and healthy preterm infants born from Jan. 1995 to Aug. 1997 at Ewha Dongdaemoon and Mokdong Hospital. The BP was taken on day 1, 3, 5 with the oscillometric device(Dinamap 1846 critikon Inc.), for premature infants BP was followed up every week afterward. RESULTS: The neonatal BP was related to the postconceptional age(R=0.204, P<0.05), BSA(R =0.191, P<0.05), birth weight(R=0.183, P<0.05) and the postnatal age in fullterm infants(R=0.022, P<0.05) but not with the sex of the infant. The postconceptional age was the most significant variable among those influencing the BP. The normal value of the systolic and the diastolic BP was expressed as mean+/-2SD according to the postconceptional age, less than 28 weeks(n=27) systolic/diastolic pressure 50.4+/-23.1mmHg/26.2+/-12.8mmHg, 28-32weeks(n= 63) 60.1+/- 30.6mmHg/33.6+/-16.7mmHg, 32-36weeks(n = 139) 63.2+/- 20.4mmHg/37.7+/- 19.8 mmHg, 36- 40weeks(n=543) 65.6+/-18.5mmHg/38.6+/-17.3mmHg, more than 40weeks(n= 136) 67.7+/-16,9mmHg/39.3+/- 15.8mmHg. The increase in blood prssure with the postconceptional age was statistically significant. CONCLUSION: The normal range of neonatal BP, especially preterm infants, was presented, and it would be much valuable for the evaluation of BP in neonate if standardized by postconceptional age.
Asphyxia ; Birth Weight ; Blood Pressure* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Parturition ; Reference Values* ; Sphygmomanometers ; Vital Signs

In order to study the exposure level of silica dust and the effects of silica dust on ventilatory function, respirable dust samples were collected by personal air samplers using NIOSH method 0500 from the selected foundry operations, and ventilatory function tests were performed on 209 male foundry workers and 239 male control subjects. Ventilatory indices such as forced vital capacity (FVC) , one-second forced expiratory volume (FEV1), ratio of FEV1 to FVC(FEV1 %), maximal mid-expiratory flow(MMF), peak expiratory flow rate (PEFR) and maximal expiratory flow at 25, 50 and 75 % of expired FVC (FEF25, FEF50, FEF75 were obtained by analyzing forced expiratory spirogram and maximal expiratory flow-volume curve which were simultaneously measured by Vitalography in standing position. The results were as follows : 1. The average quartz concentrations of respirable dust were the highest in melting operation (0.079 mg/m3) and followed by molding operation (0.051 mg/m3), finishing operation (0.041 mg/m3) and coremaking operation (0.023 mg/m3) in the descending order. 2. No significant differences for mean values of all ventilatory indices expressed as percent of predicted value were demonstrated between smokers and nonsmokers In foundry workers and control subjects. 3. Mean values of all ventilatory indices except FVC of foundry workers were significantly lower than those of control subjects. 4. Mean values of FEV1 %, MMF, FEF25, FEF50 and FEF75 expressed as percent of predicted value tended to decrease with increasing cumulative dust exposure. 5. In foundry workers, proportions of workers with low MMF, FEF50 and FEF75 were markedly higher than those with other indices, and were significantly increased with increasing cumulative dust exposure. 6. In foundry workers, 2 workers(1.0 %) were diagnosed as silicosis and the profusion of radiographic opacities were category 1/0 and q type. With the above considerations in mind, it suggested that increasing exposure of silica dust be associated with progressive deterioration in ventilatory function of an obstructive nature and that MMF, FEF50 and FEF75 be more sensitive indices in the detection of the early obstructive changes of air flow of workers exposed to silica dust.
Dust* ; Forced Expiratory Volume ; Freezing ; Fungi ; Humans ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Peak Expiratory Flow Rate ; Quartz ; Silicon Dioxide* ; Silicosis ; Vital Capacity

No abstract available.
Fasting* ; Female ; Humans

OBJECTIVES: Subacute thyroiditis is a nonsuppurative inflammation of thyroid gland and is probably caused by a cytopathic virus. Typical clinical symptoms and features of subacute thyroiditis vary widely during the course of illness. It has a clinical course, evolving from hyperthyroidism through a temporary hypothyroidism to recovery. However, the final outcome of this disease remains unpredictive in some patients. Permanet hypothyroidism occurs infrequently. METHODS: Thirty-three patients proven to have subacute thyroiditis at the Ewha Womans University Hospital from September 1993 to November 1995 were studied. We analyzed their clinical features, laboratory findings, and duration of recovery to cha- racterize the course of the disease. RESULTS: 1) Total 33 patients were studied: 31 patients were female and 2 patients were male. Their mean age was 42.6+/-8.3 years old. The peak months were August through October in this study. 2) Initial mean ESR was 73.0+/-35.2mm/hr, mean T3 was 217.3+/-73.9ng/dl, mean T4 was 15.2+/-8.5microgram/ dl, and TSH was 0.06+/-0.09microIU/ml. The positive rates of antithyroglobulin and anitmicrosomal antibodies were 31% and 6% respectively, and TSH receptor antibody was elevated in one patient. 3) In the thyroid scan, 91% showed both lobes nonvisualisation, and 9% showed one lobe nonvisualization. Radioactive iodine uptake(RAIU) at 24 hour was 2.4+/-3.3%. 4) With the predisolone therapy, 90% of patients completely recovered, 57% of these patients had no hypothyroid phase and remaining 33% of them had hypothyroid phase during course of the disease. Three of the patients had permanent hypothyroidim. 5) The average duration of recovery was 3.2+/-1.4 months and it has no correlation with initial thyroid hormone levels, antithyroid antibodies and duration of steroid administration. CONCLUSION: There was no historical, physical, laboratory findings that help us predict those patients likely to have an exacerbation of the disease.
Antibodies ; Female ; Humans ; Hyperthyroidism ; Hypothyroidism ; Inflammation ; Iodine ; Male ; Prednisolone ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Subacute

No abstract available.

No abstract available.
Animals ; Capsaicin* ; Ganglia, Spinal* ; Rats*

Background: Postpartum thyroiditis is a painless, destructive lymphocytic inflammation of the thyroid gland that occurs during the postpartum period and is associated with a high prevalence of serum thyroid autoantibodies. Clinical symptoms and laboratory fi#ndings of postpartum thyroiditis vary widely during the course of illness and the final outcome of this disease remains unpredictive in some patients. The purpose of this study is to investigate the clinical course and the predictors of the outcome of the disease. Methods: Thirty-eight patients proven to have postpartum thyroiditis at the Ewha Womans University Hospital were studied. We analyzed their clinical features, laboratory findings and duration of recovery to characterize the course of the disease. Results: Their mean age was 29.0±3.3 years and the time of diagnosis was 4.9±1.9 months after delivery. The prevailed months of delivery were November through January in this study. Twenty six patients were hypothyroid and 12 were thyrotoxic at initial thyroid function. The positive rates of antithyroglobulin and anitmicrosomal antibodies were 92%, 67% in the hypothyroid group and 75%, 67% in th thyrotoxic group respectively. TSH receptor antibodies were negative in all patients. In the hypothyroid group the titers of antimicrosomal antibodies were significantly higer than the thyrotoxic group. The titers of antimicrosomal antibodies were positively correlated with serum TSH and negatively correlated with serum T4. In all patients, the titers in thyroid function tests returned to the normal range without long-term hypothyroidism. Conclusion: The titers of antimicrosomal antibodies were significantly higher in the hypothyroid group than the thyrotoxic group. Thus the titers of antimicrosomal antibodies can help guide the physician in the care of patients with postpartum thyroiditis who will probably be hypothyroid. In this study, we were surprised that all patients became euthyroid without permanent hypothyroidism.
Antibodies ; Autoantibodies ; Clinical Study ; Diagnosis ; Female ; Humans ; Hypothyroidism ; Inflammation ; Postpartum Period ; Postpartum Thyroiditis ; Prevalence ; Receptors, Thyrotropin ; Reference Values ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis

PURPOSE: To assess the value of MR imaging compared to CT for the staging of gastric carcinoma when body-wrap-around surface coil, intravenous glucagon, motion suppression technique and effervescent granules are used. MATERIAL AND METHOD: CT and MRI were performed for thirty-five patients with gastric carcinoma. Postcontrast CT scan was performed immediately after oral effervescent granules and Buscopan were given. Before MR imaging, BWA surface coil was wrapped around the upper abdomen. T1 coronal, sagittal and axial SE images (TRITE=400/15 msec) were obtained immediately after oral effervescent granules and glucagon were given. Respiratory compensation and presaturation techniques were used for each imaging. Three radiologists evaluated independently for randomly mixed 70 sets of CT and MR images. The signal intensity of gastric mass and enlarged lymph nodes were compared to the signal intensity of the adjacent pancreas, liver and spleen to evaluate any discriminating features between them. RESULTS: The accuracy in the diagnosis of pancreatic invasion was 83.8% on MRI and 74.3% on CT (p < 0.05). The accuracy of MRI and CT was 77.1% and 72.4% in detecting of gastric tumor respectively (p > 0.05), 73.3% and 68.6% in gastric serosal invasion (p> 0.05), 50.5% and 42.9% in lymph node metastasis (p > 0.05). The gastric mass and enlarged lymph nodes were hypointense to the intensity of pancreas and liver in more than 78% of cases. CONCLUSION: MRI was comparable to CT scan for the staging of gastric carcinoma. Therefore, MRI could be used as an alternative or adjunctive diagnostic modality in the staging of gastric carcinoma.
Abdomen ; Butylscopolammonium Bromide ; Compensation and Redress ; Diagnosis ; Glucagon ; Humans ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pancreas ; Spleen ; Tomography, X-Ray Computed

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.
Cardiopulmonary Resuscitation ; Clinical Alarms ; Comorbidity ; Critical Care ; Emergencies* ; Humans ; Intensive Care Units ; Internal Medicine ; Korea* ; Length of Stay ; Monitoring, Physiologic ; Mortality ; Observational Study ; Patients' Rooms ; Pilot Projects* ; Retrospective Studies ; Vital Signs