One lung ventilation(OLV) during thoracotomy is frequently used for the purpose of facilitating surgical exposure by collapsing the lung in the operative hemithorax. But severe hypoxemia may occur during OLV inspite of higher inspired oxygen concentration. This study was performed to evaluate the effect of positive end-expiratory pressure(PEEP) level to the ventilated lung on the arterial oxygenation in the thoracotomy patients(n-10) who showed PaO2 below 100 mmHg during one lung ventilation (OLV) at the F1O2 = 1.0 . After measuring control value of arterial blood gas(ABGA), peak inspiratory pressure and hemodynamic parameter (mean arterial pressure and heart rate), PEEP device 5 cmH2O and then 10 cmH2O was applied to the expiratory breathing circuit for 10 min at each pressure setting. Data of above parameter was collected after 10 min each PEEP application. There were no siginificant changes in the mean arterial pressure and heart rate between control, PEEP 5 cmH2O and PEEP 10 cmH2O. Although PaO2 did not significantly increased with PEEP 5 cmH2O compared to control value, the application of PEEP 5cmH2O increased PaO2 in 6 patients and decreased in 4 patients. In the PEEP 10 cmH application, PaO2 was significantly improved compared to control and PEEP 5 cmH2O values (78.4+/-11.6 mmHg, 84.6+/-19.2 mmHg vs. 95.3+/-18.5 mmHg). It is concluded that it may be necessary to adjust PEEP level to the ventilated lung to improve oxygenation when hypoxemia occurs during OLV.
Anesthesia* ; Anoxia ; Arterial Pressure ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Lung* ; One-Lung Ventilation ; Oxygen* ; Positive-Pressure Respiration* ; Respiration ; Thoracotomy

Isolated left main coronary ostial stenosis is a very rare condition. In the majority of cases there are coexisting diseases in multiple coronary vessels. Here, a case of isolated left main coronary ostial stenosis due to an acute angle take-off, with clockwise rotation of the coronary sinus, confirmed by cardiac MRI is presented. A 44-year old female patient presented with an exertional and stabbing anterior chest pain. The patient had no premedical history. A coronary angiogram showed an isolated left main coronary ostial stenosis due to an acute take-off of the left main coronary artery. A cardiac MRI showed an acute angle take-off of the left main coronary artery, with clockwise rotation of the coronary sinus. The patient underwent surgical angioplasty of the coronary ostia, with a patch of autologous pericardium. This acute angle take-off may be due to rotation of the coronary sinus.
Adult ; Angioplasty ; Chest Pain ; Constriction, Pathologic* ; Coronary Sinus* ; Coronary Stenosis ; Coronary Vessels ; Female ; Humans ; Magnetic Resonance Imaging* ; Pericardium

BACKGROUND/AIMS: The reported prevalence of antibiotic resistance in Helicobacter pylori infection has been increasing. However, recent trends in the eradication rates of H. pylori using first-line triple regimens are rarely reported. Therefore, we determined the trend in the H. pylori eradication rates in a single center for the most recent 9 years in Daegu and Kyungpook provinces, Korea. METHODS: From January 1999 through December 2007, the eradication rates in 615 H. pylori-positive patients who received one-week triple regimens were evaluated retrospectively according to year and ulcer location. RESULTS: The overall H. pylori eradication rate was 81.6%. The eradication rate from the years 1999 to 2007 was 76.3, 78.3, 82.8, 88.5, 77.8, 91.7, 84.8, 75.4, and 83.7%, respectively, based on the per-protocol analysis. No definite evidence of a decreasing tendency of the eradication rate was seen over the 9 years (p=0.760). Furthermore, there was no significant difference in the eradication rate according to ulcer location. CONCLUSIONS: There is no decreasing trend in the H. pylori eradication rate over the past 9 years in Daegu and Kyungpook provinces. However, the eradication rates are not satisfactory, and further investigation is needed to develop more effective regimens.
Drug Resistance, Microbial ; Helicobacter ; Helicobacter pylori ; Humans ; Korea ; Prevalence ; Retrospective Studies ; Ulcer