PURPOSE: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). METHODS: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. RESULTS: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. CONCLUSION: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.
Abdomen ; Abdominal Injuries ; Emergencies ; Emergency Service, Hospital ; Hemoperitoneum ; Humans ; Laparotomy ; Mass Screening ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). METHODS: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. RESULTS: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. CONCLUSION: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.
Abdomen ; Abdominal Injuries ; Emergencies ; Emergency Service, Hospital ; Hemoperitoneum ; Humans ; Laparotomy ; Mass Screening ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

OBJECTIVE: To compare motor evoked potential stimulated by round coil with that stimulated by butterfly coil. METHOD: Thirty control subjects were studied using magnetic stimulation by round coil and butterfly coil. Stimulation sites were cortex, cervical spine and lumbar spine. Recording electrodes were located on biceps brachii, abductor digiti minimi and tibialis anterior muscles. RESULTS: There were no significant differences between latencies of motor evoked potentials using round coil and those using butterfly coil in all tested muscles. In all muscles, amplitudes were significantly higher in stimulation with round coil than with butterfly coil. Above results were shown in both cortical and spinal motor evoked potentials. There were significant correlations between latencies of motor evoked potentials, heights, and arm lengths. CONCLUSION: We can record motor evoked potentials more easily with round coil than butterfly coil.
Arm ; Butterflies* ; Electrodes ; Evoked Potentials, Motor* ; Muscles ; Spine

BACKGROUND: Residual muscle paralysis after anesthesia is reduced with the advent of intermediate-acting neuromuscular blocking drugs, yet the incidence is as high as about 10 percent. Opioids in patient-controlled analgesia (PCA) may cause respiratory depression and other problems after anesthesia. The purpose of this study is to evaluate the influence of PCA on the SPO2, TOF ratio, head-lift and tongue protrusion during recovery room stay following intraoperative muscle relaxants. METHODS: 120 patients aged from 20 to 65 in ASA class I and II were divided into control or PCA groups. All patients received rocuronium (0.9 mg/kg) or atracurium (0.5 mg/kg) for tracheal intubation, and maintenance of relaxation was done with atracurium 0.2 mg/kg/hr during inhalation anesthesia. Reversal of block was done with pyridostigmine 0.15 mg/kg and glycopyrrolate 0.2 mg. SpO2, TOF ratio, 5 sec-head lift, tongue protrusion tests were evaluated in the recovery room. RESULTS: IV-PCA did not influence the incidence of residual block, SPO2, TOF ratio during recovery room stay for 20 minutes, but influenced negatively 5 sec-head lift test, tongue protrusion test only immediately after arrival at the recovery room. CONCLUSIONS: Since IV-PCA decreased the ability to perform head-lift and tongue protrusion early postoperatively, it is recommended that patients with IV-PCA should be carefully managed against the risk of aspiration or upper respiratory obstruction during their early recovery room stay.
Analgesia, Patient-Controlled* ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Inhalation ; Atracurium ; Glycopyrrolate ; Humans ; Incidence ; Intubation ; Neuromuscular Blockade ; Paralysis ; Passive Cutaneous Anaphylaxis ; Pyridostigmine Bromide ; Recovery Room ; Relaxation ; Respiratory Insufficiency ; Tongue

Epidural blood patch is an effective management for treatment of severe post-dural puncture headache. Here we describe a case of a patient with hip fracture, who was complained regarded as having suspicious post-dural puncture headache after epidural anesthesia, but it failed to be treated with 4 times of epidural blood patch, and later was diagnosed with multiple metastatic brain tumor.
Anesthesia, Epidural ; Blood Patch, Epidural ; Brain Neoplasms* ; Brain* ; Headache ; Hip ; Humans ; Post-Dural Puncture Headache*

Vast quantities of data are generated through the health care process. While many studies to analyze the multiple database are being tried in the business area, a few studies have been done in medical area. We tried to study the seasonal variation of tests using two hospital data on mass screening. We received 79772 data from Seoul Joongang Hospital and 12330 data from Ajou University Hospital, and changed from text file to DBF. Inpromptu and Powerplay were used as the tools of data warehousing. The modeling and analysis was done effectively through the tools. The tests of seasonal variation were 6 items.
Commerce ; Delivery of Health Care ; Mass Screening* ; Seasons ; Seoul

3 cases of azygos lobe were found during dissection at Chungnam National University of Korea in 2000 ~2001. All the azygos lobes located at the right upper lobe, and azygos fissures began from the upper anterior part of hilum, curved laterally and postieriorly around the apical portion of right lung toward the upper posterior part of hilum. Each azygos vein of 3 cases ran along the azygos fissure in its base, forming azygos arch, and ended into the superior vena cava at the level of 2nd costal cartilage. Bronchopulmonary dissection revealed the B 1 a and B 1 b supplying the azygos lobe in all cases.
Azygos Vein ; Cartilage ; Chungcheongnam-do ; Korea ; Lung ; Vena Cava, Superior

No abstract available.
Humans ; Prevalence* ; Renal Dialysis*

BACKGROUND: General anesthesia alters autonomic nervous system activity. Evaluation of the autonomic nervous system activity using heart rate variability and so, evaluating the anesthetic depth was tried. METHODS: In thirty patients undergoing gynecological surgery under general inhalational anesthesia with enflurane, a 10-minute EKG was perioperatively acquired during main incidents. The heart rate variability was analyzed and expressed as 5-minute signals. RESULTS: In an analysis of the frequency area adopting the heart rate variability, both low and high frequencies represented the effects of the autonomic nervous system, but the low and high frequencies, their ratio and 1/f noise were not valuable in estimating the depth of anesthesia before, during and after the operation. The detrended fluctuation analysis also proved unsuitable for the estimation of the anesthetic depth during an operation. CONCLUSIONS: The signal using heart rate variability reflects the parameter of the autonomic nervous system during operations.
Anesthesia* ; Anesthesia, General ; Autonomic Nervous System ; Electrocardiography ; Enflurane ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Humans ; Noise

PURPOSE: We investigate the effect of osteoprotegerin (OPG) on activation of osteoclastogenesis and NF-kappaB activation by PMMA (Polymethyl methacrylate) particles in osteoclast precursor cells. MATERIALS AND METHODS: Osteoclast precursor cells (CSF-1 dependent) were obtained from whole bone marrow of C57BL mouse. Four experiments included 1) different dose of RANKL (Receptor Activator of NF-kappaB ligand) treatment (0, 1, 10, 40 ng/ml) 2) PMMA treatment +/- RANKL 3) PMMA treatment with different dose of RANKL 4) PMMA treatment +/- OPG. After treatments, cultured cells were stained with TRAP (Tartrate resistant alkaline phosphatase). The activity of NF-kappaB DNA nuclear translocation was detected by EMSA (electrophoretic mobility shift assay). RESULTS: The experiments with RANKL on osteoclast precursors differentiation demonstrated a dose-dependent stimulation of osteoclastogenesis (p<0.05). Control cultures without RANKL had no osteoclasts, while maintenance in 1 ng/ml of RANKL results in low level osteoclast formation. PMMA particles activated osteoclastogenesis in RANKL-primed osteoclast precursor cells. And the effect of particles on osteoclastogenesis were dependent on RANKL concentration (p<0.03). OPG treatment significantly decreased osteoclast formation and NF-kappaB DNA binding activity by PMMA particles in osteoclast precursor cells. CONCLUSION: OPG inhibits activation of osteoclast formation and NF-kappaB DNA binding activity by PMMA particles through RANK-RANKL pathway.
Animals ; Bone Marrow ; Cells, Cultured ; DNA ; Electrophoretic Mobility Shift Assay ; Mice ; Mice, Inbred C57BL ; NF-kappa B* ; Osteoclasts* ; Osteoprotegerin ; Polymethyl Methacrylate*