No abstract available.
Humans ; Inpatients*

No abstract available.

In evaluating the early state of shock patients and their response to treatment, generally vital signs or additional hemodynamic values were used. Vital signs are easily obtained and repetitious values or continous monitoring is possible, whereas it cannot evaluate the patient's status properly nor is it a good prognostic factor. Meanwhile, additional hemodynamic values are obtained from pulmonary artery catheterization. But this procedure is difficult to proceed in the emergency room. Since central venous oxygen saturation has the advantage of being easily obtained and acts as a good prognostic factor for shock patients, we intended to prove its efficacy. From 1997 May to October, 50 patients admitted to Yonsei University Young Dong Severance Hospital in shock state, with systolic blood pressure below 90mmHg, were evaluated. Central venous catheter was inserted to obtain central venous oxygen saturation, serum lactate, base excess value, and its' initial value compared with the prognosis. The central venous oxygen saturation and base excess were low, while serum lactate value was high in the nonsurvival group. And in ROC(relative operating characteristic) curve, the AUC(area under curve) of central venous oxygen saturation was larger than the others. In comparing the MOF(multi-organ failure) group with the non-MOF group, the MOF group had a lower central venous oxygen saturation and base excess, and a higher serum lactate level, whereas in ROC curve, the AUC of base excess was larger than the others. Therefore, in estimating the prognosis of shock patients, the early central venous oxygen saturation proved to be a good prognostic factor.
Area Under Curve ; Blood Pressure ; Catheterization, Swan-Ganz ; Central Venous Catheters ; Emergency Service, Hospital ; Hemodynamics ; Humans ; Lactic Acid ; Oxygen* ; Prognosis ; ROC Curve ; Shock* ; Vital Signs

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

No abstract available.
Aspergillosis*

Purpose: To report the surgical skills needed, and the clinical results of, minimally invasive hip surgery with dynamic hip screws and the comparison with the classical technique in stable pertrochanteric fractures of the femur. Materials and Methods: Thirty-two patients with pertrochanteric fractures of the femur who were treated with dynamic compression hip screws between April 1999 and March 2004, and were evaluated retrospectively, and were followed up for more than 12 months. 16 cases were treated with a classical dynamic hip screw technique and 16 cases with a minimally invasive technique in random order. The mean age was 73.2 years, and there were 11 males and 21 females. The operative times, total hemovac bleeding loss, functional scores, and average hemoglobin decrease ratios were evaluated. The clinical assessments were performed with the Harris Hip Score (HSS) and bony union was evaluated with serial follow-up plain radiographs. Results: The average operative time was 63.9 minutes with the classical technique and 42.5 minutes with the minimally invasive technique. The total average hemovac blood loss was 640 cc with the classical technique and 143 cc with the minimally invasive technique. Clinically, the HHS was an average of 85.9 and 89.2 in groups 1 and 2, respectively, by the last follow-up and there were no statistically significant differences between the two groups (P <0.05) The hemoglobin decrease ratio was the same in both groups and there was no nonunion. Conclusion: Minimally invasive dynamic hip screw insertion was useful in stable pertrochanteric fractures, because it decreased blood loss and operative times; and there were no changes in fracture healing and functional outcomes.
Female ; Femur ; Follow-Up Studies ; Fracture Healing ; Hemorrhage ; Hip* ; Humans ; Male ; Operative Time ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

OBJECTIVES: This study aimed to develop dietary education textbooks for elementary school students by focusing on the three core values of environment, health and gratitude from the National Food Education Plan. METHODS: The contents of textbooks and teacher's guidebooks were developed with brainstorming of the authors as well as consultation with experts and by considering not only the three core values of environment, health, and gratitude, but also the performance indicators of the 2nd National Food Education Plan and the key competencies and creative convergence approach of the 2015 revised national curriculum. RESULTS: A total of 12 different dietary education textbooks named ‘Good Dietary Life Guide’ and the teachers' guidebooks from the first to the sixth grade of elementary school were developed. The textbooks were fundamentally developed connecting the three core values, the outcome indices of the 2nd National Food Education Plan and the key competences of the 2015 revised national curriculum. Various educational activities such as thinking, debate, writing, cooperative learning, experience, practice were included to promote students' participation. These books could be utilized in every field of dietary education targeting elementary students such as creative experiential activity, convergent classes (integrated subjects, Practical arts, Social studies, Science, Moral education and Korean), after school classes, rural experience, general agricultural education, after-school child care services and community child care centers. CONCLUSIONS: The continuous and repetitive use of the textbooks from the first to the sixth grade would contribute to the improvement of food habits and the personalities of elementary school students, and consequently make the students grow up as healthy citizens.
Child ; Child Care ; Curriculum ; Education ; Food Habits ; Humans ; Learning ; Thinking ; Writing

BACKGROUND: The pediatric CPR is rather uncommon practice than adult CPR in emergency room. Therefore, few interest and studies were focused in pediatric CPR. The object of this study is to make an analysis about pediatric CPR performed within hospital setting. METHOD: From January 1. 1990 to December 31. 1996, a total of 59 patients, less than 15-year-old, who received cardiopulmonary resuscitation were subject of this study. The study was done retrospective chart analysis for sex, age, weight, the place of cardiac arrest, initial EKG rhythms, endotracheal tube size, the causes of arrest, CPR time, ROSC, the amount and types of CPR drugs used during resuscitation. Wilcoxon rank sum test and chi2 test were used to compare the dose of drugs during CPR in each group. RESULTS: There were no statistical difference between ROSC and non-ROSC group in place of arrest, initial EKG rhythms, CPR time, dosage of CPR drugs. CONCLUSION: The uniform reporting guideline of pediatric advanced life support should be used for future pediatric CPR study, such as Utstein style guideline in pediatric CPR.
Adolescent ; Adult ; Cardiopulmonary Resuscitation* ; Electrocardiography ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Resuscitation ; Retrospective Studies

BACKGROUND: The efficiency of lipid extraction by different kinds of solvents from stratum corneum may vary. OBJECTIVE: To assess the efficiency of lipid extraction by several solvents from the stratum corneum, the total lipids weights were measured by an electronic microbalance, and lipids compositions of a stratum corneum were analyzed by thin layer chromatography(TLC) after pretreatment of several solvents, respectively. METHODS: Stratum corneums separated fro circumcised prepuce were pretreated with acetone, petroleum ether, or distillecl water for 10 minutes. Lipids of stratum corneum were extracted with methanol chlorofonn-H,O mixture(4: 2: 1.6, v/v, Bligh Dyer solvent). Lipids weights were weighed, and the ratio of lipid weight and wet weight of stratum corneum were measured. TLC was performed and lipids compositions were quantitated by photodensitometer. Lipids extraction in viva was performed on both forearms. After two times stripping with sellotape, lipids were extrected with the solvents using cup method. These were dried and lipids weights were weighed. RESULTS: The efficiency of lipid extraction from the stratum corneum of circumcised prepuce were acetone, petroleum e1 her, and distilled water in decreasing order. All groups were similar in the compositions of the stratum corneum lipids except for those of cholesterol esters and sphingolipids. The efficiency of lipid extraction from in vivo skin were ranked in order from petroleurn ether, acetone, down to distilled water. The efficiency of lipid extraction of petroleum ether and acetone were higher than that of distilled water. CONCLUSION: The efficiency of lipid extraction is influenced by the kinds of solvents as well as the materials and the methods of extraction.
Acetone ; Cholesterol Esters ; Ether ; Forearm ; Methanol ; Petroleum ; Skin ; Solvents* ; Sphingolipids ; Water ; Weights and Measures

Nevus lipomatosus superficialis presented as soft, yellowish papules or cerebriform plaques occurring usually on the buttock or thigh, less often on the ear or scalp. We herein report a case of nevus lipomatosus superficialis on the leg.
Buttocks ; Ear ; Leg* ; Nevus* ; Scalp ; Thigh