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

No abstract available.
Aspergillosis*

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

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

The development of drug resistance is a major obstacle in effective cancer chemotherapy. Multidrug resistance(MDR) is a widely studied phenomenon of interest to both clinicians and research workers because many different cancer chemotherapeutic agents are involved and the genetic basis of MDR is understood to a large extent. Several studies show that the P-glycoprotein (P-gp), multidrug resistance-associated protein(MRP), glutathione-s-transferase-pi(GST-pi), and DNA topoisomerase II(topo II) have a complex role for the malignant phenotypes and MDR. Clearly, there is a need to investigate links between the diverse characteristics of tumors and the emergence of drug resistance. We have therefore used reverse transcription-polymerase chain reaction(RT-PCR) assay to analyze expressions of MDR-related genes including the mdr1, MRP, topo II and GST-t gene in normal testis and testis tumors. The results are as follows: 1. The expression levels of topo II and GST-n genes in testis tumors, especially in the nonseminomatous germ cell tumor(NSGCT), were significantly higher than in normal testis(p=0.015 and 0.025, respectively). 2. The MDR-related gene expressions in testis tumors did not appear to be correlated with stage(p>0.05 in each case) and chemotherapy status(p>0.05 in each case). 3. MRP expression levels in primary tumors were much higher than in metastatic tumors. 4. In NSGCT, the coexpressions of the topo II and GST-r or MRP genes were significantly correlated but, seminoma showed no correlation between MDR-related genes in the same sample. Although the mechanism of these connection are not known, the results suggest that these expression patterns and higher GST-rexpression in NSGCF compared to seminoma confer diverse characteristics including difference in the presentation of tumor markers and the responsiveness to chemotherapy on NSGCF and seminoma.
DNA Topoisomerases, Type I ; DNA Topoisomerases, Type II ; Drug Resistance ; Drug Therapy ; Gene Expression* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; P-Glycoprotein ; Phenotype ; Seminoma ; Testis* ; Biomarkers, Tumor

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

Meralgia paresthetica is a syndrome consisting of numbness, pain, tingling, burning and/or a variety of other paresthesias on the distribution of the lateral femoral cutaneous nerve (LFCN) of the thigh. We report a case of meralgia paresthetica in a 41-year-old woman who complained of the symptoms of pain, burning sensation, and dysesthesia which occurred whilst standing up without any other constitutional symptoms. The authors suspect that frequent. and persistent squatting may play a role in the development of the present symptoms.
Adult ; Burns ; Female ; Humans ; Hypesthesia ; Paresthesia ; Sensation ; Thigh