No abstract available.
Extracorporeal Circulation* ; Heart* ; Potassium* ; Thoracic Surgery*

No abstract available.

No abstract available.

No abstract available.

In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.
Adult ; Catheters ; Disinfectants ; Extracorporeal Membrane Oxygenation ; Female ; Fibrosis ; Humans ; Humidifiers* ; Inhalation ; Inhalation Exposure ; Intensive Care Units ; Korea ; Lung Injury* ; Lung Transplantation* ; Lung* ; Oxygen Inhalation Therapy ; Respiration, Artificial ; Survivors

BACKGROUND: The purpose of this study was to evaluate whether physicians' practice was adequate for the diagnosis and treatment of osteoporosis in patients with proximal humeral fracture over the age of 50 years, which is one of major osteoporotic fractures. METHODS: A retrospective nation-wide cohort study was performed using data collected in 2010 by the Korean Health Insurance Review Agency. The incidences of fractures around the hip, spine, and proximal humerus in patients more than 50 years of age, the frequencies of diagnostic bone density scan for osteoporosis, and the prescription for the osteoporosis medication were analyzed and compared. RESULTS: A search of database identified 48,351 hip fractures, 141,208 spine fractures, and 11,609 proximal humeral fractures in patients more than 50 years of age in 2010. Among these patients, 12,097 (25.0%) of hip fractures, 41,962 (29.7%) of spine fractures, and 1,458 (12.6%) of proximal humeral fractures underwent diagnostic bone density scan (p < 0.001); 4,773 (9.9%) of hip fractures, 27,261 (19.3%) of spine fractures, and 639 (5.5%) of proximal humeral fractures were managed with at least one medication approved for the treatment of osteoporosis (p < 0.001). Furthermore, 1,217 (2.5%) of hip fractures, 7,271 (5.2%) of spine fractures, and 188 (1.6%) of proximal humeral fractures received diagnostic bone density scans as well as osteoporosis medications (p < 0.001). Younger patients (50–69 years of age) were less likely to be evaluated and managed for osteoporosis relative to older patients (≥ 70 years of age) (p < 0.001); and men were less likely to be evaluated and managed for osteoporosis relative to women (p < 0.001). CONCLUSIONS: Current physicians' practice pattern may be inadequate for the diagnosis and treatment of osteoporosis in patients of proximal humeral fractures over the age of 50 years. Additional study and educational programs are necessary to improve this care gap, beginning with physicians who are responsible for the fracture treatment and shoulder diseases.
Aged ; Bone Density ; Bone Density Conservation Agents/therapeutic use ; Female ; Humans ; Male ; Middle Aged ; *Osteoporosis/complications/diagnosis/drug therapy/epidemiology ; Retrospective Studies ; Shoulder Fractures/*complications/*epidemiology

Severe acute respiratory distress syndrome (ARDS) is a life-threatening disease with a high mortality rate. Although many therapeutic trials have been performed for improving the mortality of severe ARDS, limited strategies have demonstrated better outcomes. Recently, advanced rescue therapies such as extracorporeal membrane oxygenation (ECMO) made it possible to consider lung transplantation (LTPL) in patients with ARDS, but data is insufficient. We report a 62-year-old man who underwent LTPL due to ARDS with no underlying lung disease. He was admitted to the hospital due to influenza A pneumonia-induced ARDS. Although he was supported by ECMO, he progressively deteriorated. We judged that his lungs were irreversibly damaged and decided he needed to undergo LTPL. Finally, bilateral sequential double-lung transplantation was successfully performed. He has since been alive for three years. Conclusively, we demonstrate that LTPL can be a therapeutic option in patients with severe ARDS refractory to conventional therapies.
Extracorporeal Membrane Oxygenation ; Humans ; Influenza, Human* ; Lung Diseases ; Lung Transplantation* ; Lung* ; Middle Aged ; Mortality ; Pneumonia* ; Respiratory Distress Syndrome, Adult*

PURPOSE: Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of acute kidney injury after SCT in children. METHODS: The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. RESULTS: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.0%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 pateints died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. CONCLUSION: Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kidney injury.
Acute Kidney Injury ; Bone Marrow ; Fetal Blood ; Humans ; Renal Insufficiency ; Stem Cell Transplantation ; Stem Cells

PURPOSE: This study was performed to improve cardiopulmonary resuscitation(CPR) training strategies for occupational groups, through the analysis of first responders' characteristics, knowledge and attitudes concerning CPR. METHODS: The occupational groups expected to have some training on rescue and emergency care in Korea were regarded as the first responders. In particular, this study focused on nurse-teachers, traffic policemen, and industrial safety supervisors, taxi drivers and restaurant workers as potential first responders, clerical workers comprised the control group. The subjects were given a questionnaire to answer over the internet. RESULTS: First responders' knowledge on CPR was significantly higher than that of the control group. First responders' attitude on CPR was more affirmative compared with the control group. In first responder group, nurse-teachers, traffic policemen and industrial safety supervisors had a higher fund of knowledge and more positive attitudes when compared to taxi drivers and restaurant workers. CONCLUSION: More training for first responders in CPR and emergency care is required given the likelihood of medical emergencies arising while on duty. Taxi drivers and restaurant workers' knowledge on CPR were found to be inadequate based on our survey questionnaire. Thus, it is necessary to strengthen CPR training for these individuals and groups.
Cardiopulmonary Resuscitation* ; Emergencies ; Emergency Medical Services ; Financial Management ; Humans ; Internet ; Korea ; Occupational Groups ; Surveys and Questionnaires ; Restaurants

BACKGROUND: Thoracoscopic sympathicotomy is an effective treatment in essential hyperhidrosis. However,many patients suffer from compensatory hyperhidrosis. Compensatory hyperhidrosis is avery uncomfortable problem,but the mechanisms underlying compensatory hyperhidrosis are not completely understood. MATERIAL AND METHOD: From May 1999 to June 2001,25 cases of thoracoscopic sympathicotomy at the 2nd rib for facial hyperhidrosis and 116 cases of thoracoscopic sympathicotomy at the 3rd rib for palmar hyperhidrosis were performed in 141 patients.All of the patients were divided into noncompensatory sweating(NCS)and compensatory sweating(CS)group.Each group was investigated according to age,sex,body surface area(BSA), level of sympathicotomy and occupation. RESULT: The global rate of compensatory hyperhidorsis were 64.5%(91/141).There was no difference between the two groups for BSA,level of sympathicotomy and occupation.Mean age showed 23.2 years old in NCS group and 26.4 years old in CS group(p=0.09).In CS group,46 cases were male(50.5%)and 45 cases were female(49.5%)and in NCS group,19 cases were male(38.0%)and 31 cases were female(62.0%) (p=0.16). CONCLUSION: There were no available statistical data,but there was the fact that old age and male patients had the tendency for compensatory hyperhidrosis.If we have more patient group and consider the patient's family history or psychiatric pr obl ems ,we will have mor evaluable data for compensatory hyperhidrosis.
Humans ; Hyperhidrosis* ; Male ; Occupations ; Ribs