PURPOSE: There have been repoty on radiological features of lower respiratory track infection in infants and children caused by RSV(respiratory syncytial virus) in KOREA. The aims of this study were to summarize radiological features of lower respiratory tract infection caused by common viral agents other than RSV and to find any specific radiological features which might provide clue to the etiologic diagnosis. MATERIALS AND METHODS: We retrospectively analyzed radiological features in 51 children with symptoms of lower respiratory tract infection and identification of viral agents(except RSV). They included parainfluenza (n=22), adenovirus(n=16), influenza A(n--11), influenza B(n=2) virus infections. The mean age of the patients was 23 months. RESULTS: Major radiological findings of viral lower respiratory tract infection were bilateral parahilar peribronchial infiltration(62%), bilateral overaeration(60%), atelectasis(59%)(segmental or subsegmental atelectasis(43%), Iobar atelectasis(16%)) and patchy or confluent consolidation(20%). Pleural effusion was seen in only one case and hilar adenopathy was not observed in any of them. In the cares of adeno virus, consolidation was seen in 5 cases(31%) including 3 cases919%) of extensive confluent consolidations and overaerations were less frequent findings(44%) than in other viruses. In 24 patients with radiological follow up for more than 1 week, consolidation improved most rapidly, while was persistent atelectasis. CONCLUSION: The major radiologic features in vital lower respiratory tract infection(except RSV) were overinflation, bilateral peribronchial infiltration and atelectasis. In adenoviral infection, confluent consolidations which are usually seen in bacterial pneumonia were more common findings than in other viral lower respiratory tract infections.
Child ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Influenza, Human ; Korea ; Paramyxoviridae Infections ; Pleural Effusion ; Pneumonia, Bacterial ; Pulmonary Atelectasis ; Respiratory System* ; Respiratory Tract Infections ; Retrospective Studies

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide

BACKGROUND: Ventricular remodeling after myocardial infarction increase mortality and morbidity. Two-dimensional echocardiography in acute myocardial infarction provides a useful diagnostic tool for evaluation of ventricular remodeling. The aims of this study were to verify whether follow-up two-dimensional echocardiography could detect ventricular enlargement after acute myocardial infarction and to find early echocardiographic predictors and clinical charateristics of ventricular enlargement. METHODS: Two-dimensional echocardiography was done prospectively at 2 week, 3 month, and 6 month after the first Q-wave acute myocardial infarction in 18 patients. The control group was 11 patients of a normal chest roentgenogram and echocardiogram who were studied for chest pain or arrhythmia. The patients were divided by the mean value of the control group left ventricular end-diastolic volume index(LVEDVI) 56.8ml/m2. The group A was more than 60ml/m2(the control group LVEDVI 56.8ml/m2) and the group B was less than 60ml/m2 of LVEDVI at 2 week post myocardial infarction. The left vantricular volume was measured by the modified disk method at the apical four chamber view. The wall motion abnormality of left ventricle was examined by the recommendation of the American Society of Echcardiography. RESULTS: The left vntricular end-diastolic volume and the left ventricular end-systolic volume were enlarged after 3 month of acute myocardial infarction in the group A compare with those of the control group. There was no ventricular enlargement during 6 month after myocardial infarction in the group B. The frequency of ventricular enlargement was increased in anterior myocardial infarction. There was no difference in left ventricular ejection fraction at 2 week post myocardial infarction between the group A(51.4+/-15.7%) and the group B(50.8+/-10.3%). The wall motion score index more than 1.5 at 2 week post myocardial infarction means the enlarged LVEDVI more than 60ml/m2 and the group of ventricular enlargement. CONCLUSION: The left ventricular enlargement could be diagnosed by the follow-up two-dimensional echocardiography in acute myocardial infarction. The echocardiographic early predictors of ventricular enlagement were the left ventricular end-diastolic volume greater than 60ml/m2 and increased wall motion score index more than 1.5 at 2 week post myocardial infarstion. The anterior myocardial infarction was the electrocardiographic predictor of ventricular dilatation. Therefore these early predictors could identify the patients of ventricular enlargement and these patients could be a candidate of follow-up echocardiography and of a specific treatment for limiting ventricular remodeling.
Arrhythmias, Cardiac ; Chest Pain ; Dilatation ; Echocardiography* ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mortality ; Myocardial Infarction* ; Prospective Studies ; Stroke Volume ; Thorax ; Ventricular Remodeling

PURPOSE: To compare and analyze intraoperative and postoperative complications of corneal flap in the LASIK procedures using different types of manual microkeratomes (MLK, LSK, disposable Barron). METHODS: Eight hundred sixty-two eyes were retrospectively evaluated to study the effects of 3 different microkeratomes on the frequency of complications, managements, and postoperative best visual acuity. The eyes were grouped according to the microkeratomes used in making corenal flap: Group 1 (334 eyes) treated with MLK(SCMD, USA); Group 2 (256 eyes), LSK(Moria, France); Group 3 (272 eyes), disposable Barron(Katena, USA). RESULTS: Mean follow-up period was 6.3 months and mean age was 29.2 years (range 20 39). Complications of corneal flap were observed in 74(7.9%) of 862 eyes. Intraoperative flap complications occurred in 15 eyes (4.5%), 6 eyes (2.4%) and 3 eyes (1.2%) in each group, respectively. The postoperative flap complications were observed in 24 eyes (7.2%), 17 eyes (6.7%) and 9 eyes (3.3%) in each group. The postoperative best corrected visual acuity decreased by 2 lines or more in 2 eyes (0.6%), 1 eye (0.4%) and none (0%) of each group. CONCLUSIONS: The incidence of corneal flap-related complications by manual microkeratomes was relatively low. Disposable Barron microkeratome showed the lowest complication rate in our series. It also has an advantage of easy maneuverability, and reproducibility (equal size and thickness of corneal flap).
Follow-Up Studies ; Incidence ; Keratomileusis, Laser In Situ* ; Postoperative Complications ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluate the outcome of posterior continuous curvilinear capsulorhexis (PCCC) performed simultaneously with cataract surgery to inhibit after-cataract. METHODS: Among patients who underwent phacoemulsification and posterior chamber intraocular lens implantation from December 1999 through December 2001, we had followed on 94 eyes of 80 patients who underwent PCCC intraoperatively and 100 eyes in 92 patients without PCCC as control group. Both groups were divided into 4 categories: nonproliferative diabetic retinopathy(NPDR); uveitis; below 60 years without ocular and systemic disease; over 60 years without ocular and systemic disease. Preoperative and postoperative visual acuity and complications were analyzed from 6 months to 12 months. RESULTS: There was statistically no difference in the best corrected visual acuity at 6 months between PCCC and control group in all categories. Transient increase in the intraocular pressure was noted in 5 eyes (5%) of PCCC group and 3 eyes (3%) in control group. Vitreous prolapse into anterior chamber was found in 2 eyes (2%) of PCCC group. Cystoid macular edema was found in only 1 eye (1%) in NPDR patients of PCCC group. Progression of diabetic retinopathy was found in 1 eye (5.6%) and 3 eyes (12.5%) in each group respectively. There was no statistically significant difference in progression of diabetic retinopathy after surgery between the two groups. CONCLUSIONS: Primary PCCC is a safe procedure to perform in patient who has a predisposition to after-cataract.
Anterior Chamber ; Capsulorhexis* ; Cataract ; Diabetic Retinopathy ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular ; Macular Edema ; Phacoemulsification ; Prolapse ; Uveitis ; Visual Acuity

A case of total spondyloptosis of the cervical spine at C6-7 level with cord compression is described in a 51-year-old male. Because the bodies of C6 and 7 were tightly locked together, cervical traction failed. Then the patient was operated on by a posterior approach. Posterior stabilization and fusion were performed by C4-5 lateral mass and C7-T1 pedicle screw fixation and rod instrumentation with bridging both C4-5's rods to the C7-T1's extended ones. After C6 total laminectomy and foraminotomy, the C6 body was returned to its proper position. Secondly, anterior stabilization and fusion were performed by C6-7 discectomy with a screw-plate system. A postoperative lateral plain radiograph showed good realignment. In this case, we report the clinical presentation and discuss the surgical modalities of C6-7 total spondyloptosis and the failed close reduction.
Diskectomy ; Foraminotomy ; Humans ; Laminectomy ; Male ; Middle Aged ; Spine ; Traction

PURPOSE: Postoperative wound infection accounts for approximately 15% of all hospital infections. Methicillin-resistant Staphylococcus aureus (MRSA) infections are 14% of the domestic hospital infections and this is increasing in incidence over time. The aim of this study was to retrospectively evaluate the relationship between wound dehescence after urologic surgery and MRSA infection. MATERIALS AND METHODS: Thirty patients (25 males and 5 females) who experienced wound dehescence after urologic surgery were subdivided into two separate groups; the MRSA group and non-MRSA group, and they were retrospectively analyzed via a chart review according to the age of the patients, the associated disease, the hepatic or renal functional status, the admission duration, the use of preoperative antibiotics and the number and duration of inserted catheters. RESULTS: The mean age of the MRSA group and the non-MRSA group was 62.6+/-12.4 years and 59.3+/-19.9 years, respectively (p=0.235). The elapsed operative time in the MRSA group and non-MRSA group was 355.8+/-99.5 minutes and 305.8+/-90.2 minutes, respectively (p=0.021). Contrary to 35.2+/-23.6 days of catheter duration in the MRSA group, that of the non-MRSA group was 14.6+/-8.5 days (p=0.007). The tendency for MRSA infection was observed for an increased duration of drain placement, a decreased hepatic or renal function and the preoperative antibiotic use. The extent of admission was obviously longer for the MRSA group (39.6+/-23.5 days) than for the non-MRSA group (28.9+/-9.9 days) (p=0.013). CONCLUSIONS: Wound dehescence assocated with MRSA infection is intimately related to the elapsed operative time and the period of catheter-insertion, which in turn increases the number of admission days.
Anti-Bacterial Agents ; Catheters ; Cross Infection ; Humans ; Incidence ; Male ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus* ; Operative Time ; Retrospective Studies ; Staphylococcus aureus ; Surgical Wound Infection ; Wound Infection ; Wounds and Injuries*

PURPOSE: To evaluate the therapeutic efficacy of phacoemulsification in treating phacomorphic glaucoma. METHODS: We observed 25 eyes of 25 patients who had undergone phacoemulsification and intraocular lens implantation for the treatment of phacomorphic glaucoma. Intraocular pressure (IOP), best corrected visual acuity (BCVA), depth of anterior chamber, management and complications between preoperative and postoperative periods were analyzed retrospectively. RESULTS: The mean IOP was 49.0 +/- 10.6 mmHg (range: 31~70 mmHg) before the operation and 13.2 +/- 2.8 mmHg (range: 8~20 mmHg) at 36 months after surgery (Paired T-test, p<0.0001). We could not find any case with increased IOP in our series for more than 3 years. The postoperative IOP decreased significantly the day after surgery (Paired T-test, p<0.0001). Improvement of postoperative visual acuity was remarkable from the first week after operation (Paired T-test, p<0.0001). Postoperatively, the visual acuity was improved except for one eye with preoperative visual acuity of no light perception. Especially, BCVA in 15 cases (60%) was above 20/40. Preoperatively, the anterior chambers were extremely shallow (average: 1.5 +/- 0.3 mm) by the swollen lens, and the average postoperative anterior chamber depth increased significantly by 2.6 +/- 0.1 mm on A-scan. The ratio of lens thickness to axial length factor was 2.5 +/- 0.1, indicating the shallow anterior chamber. Continuous postoperative medical treatment for IOP control was needed in one case, where peripheral anterior synechiae were observed by gonioscopy immediately after surgery. CONCLUSIONS: Phacoemulsification is a very safe and effective procedure for the treatment of phacomorphic glaucoma.
Anterior Chamber ; Glaucoma* ; Gonioscopy ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification* ; Postoperative Period ; Retrospective Studies ; Visual Acuity

OBJECTIVES: The family caregivers of patients with dementia experience high caregiver burden. This study aims to investigate the prevalence of depression in family caregivers of dementia patients and to reveal whether or not the depression is affected by caregiver burden.METHODS: Multi-stage cluster sampling was adopted in this study. Interviews were conducted face-to-face with 18-year-old and older people living in the community from June to November 2016. Korean version of Composite International Diagnostic Interview(K-CIDI) was applied to assess the prevalence of one-year MDD of the subjects. It also examined whether caregivers in the survey lived with the dementia patients, whether they were caregiving the dementia patients themselves, and which relationship they had.RESULTS: Cross-analysis was conducted on the relationships in MDD and caregiver burden according to demographic factors, with a total of 5,102 respondents in the study. Prevalence of one-year MDD was 8.2% for sons and daughters and 50% for spouses with dementia. Among the families who had caregiver burden with dementia, prevalence of one-year MDD was 12.9%. Elderly and small numbers of family were also significantly associated with the prevalence of one-year MDD.CONCLUSION: The prevalence of one-year MDD of the family caregivers of patients with dementia was higher than without that of patients according to family relation and caregiver burden. Caregivers who were elderly and had two or fewer family members had more caregiver burden and higher prevalence of one-year MDD.
Adolescent ; Aged ; Caregivers ; Dementia ; Demography ; Depression ; Depressive Disorder, Major ; Family Relations ; Humans ; Korea ; Nuclear Family ; Prevalence ; Spouses ; Surveys and Questionnaires

Objective The aim of this study was to evaluate the clinicopathologic findings of eight patients with primary cancer of fallopian tube diagnosed and treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center for nine years. Methods Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and survival of patients were reviewed retrospectively. Results The patients with primary cancer of fallopian tube constituted 0.4% of all gynecologic malignancies encountered during this period. The age of patients ranged 42 to 70 years(mean+/- S.D.; 53.9+/-9.9) and half of patients were postmenopausal and two patients were nulliparous. Patients were treated by simple or radical hysterectomy and bilateral salpingoophorectomy with or without omentectomy and five patients received postoperative chemotherapy. The FIGO surgical stages of the patients were I(4 cases), II(2 cases), III(1 case) and IV(1 case). There were 3 cases of adenocarcinoma, 3 cases of malignant mixed Mullerian tumor, 1 case of undifferentiated carcinoma and 1 case of serous cystic tumor of low malignancy potential. Serum CA 125 values were followed during treatment and decreased during clinical remission and increased at the time of tumor progression. The mean follow-up duration was 24.3(+28.3) months and 7 patients were alive free of disease and one patients with stage Ic died of the disease. Conclusion Primary fallopian tube cancer is an extremely rare malignancy of the female genitalia and preoperative diagnosis of this disease is difficult. Cytoreductive surgery and postoperative combination chemotherapy seem to be effective treatment and CA 125 value could reflect the disease status during the treatment and follow-up of patients.
Adenocarcinoma ; Carcinoma ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Genitalia, Female ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies ; Ulsan