BACKGROUND: Systemic arterial hypotension is relatively common following initiation of cardiopulmonary bypass (CPB). Decreased blood viscosity is induced by acute normovolemic hemodilution (ANH) and by the use of crystalloid oxygenator prime. The purpose of this paper is to study the effect of ANH on mean arterial pressure, perfusion flow index and PaO2/FiO2 upon initiation of CPB, and on homologous blood usage during CPB in coronary artery bypass grafting (CABG) surgery. METHODS: We reviewed 30 patients constituting an ANH group, and 30 patients in a control group who had undergone CABG surgery within the past 2 years. In the ANH group, 1 or 2 units of fresh autologous whole blood were sequestrated following induction of anesthesia. We compared mean arterial pressure, perfusion flow index, PaO2/FiO2, and hematocrit on the initiation of CPB, and homologous blood usage during and post CPB periods between the groups. RESULTS: Upon initiation of CPB, hematocrit in the ANH group was significantly less than in the control group, but there was no significant difference in mean arterial pressure, perfusion flow index or PaO2/FiO2 between the groups. The use of homologous blood during CPB in the ANH group was not significantly higher than in the control group. CONCLUSIONS: Acute intraoperative normovolemic hemodilution in CABG surgery was safely performed without significant hypotension and increased homologous blood usage during CPB.
Anesthesia ; Arterial Pressure ; Blood Viscosity ; Cardiopulmonary Bypass* ; Coronary Artery Bypass* ; Coronary Vessels* ; Hematocrit ; Hemodilution* ; Humans ; Hypotension ; Oxygen ; Oxygenators ; Perfusion

BACKGROUND: The smoking rate of Korean male workers is top in the world. To establish the effective smoking cessation strategy, we conducted a study to evaluate the factors associated with smoking and smoking cessation. METHODS: We surveyed 509 male workers in a university hospital about age, marital status, drinking, exercise level and checked their awareness and seriousness for diseases due to smoking, benefits from smoking cessation, motivation derived from massmedi and books and their will to quit smoking by self-administerd questionnaire. RESULTS: The significant factors associated with smoking cessation were higher education (OR=1.85, 95% CI 1.26-2.74), non-religion (OR=0.56, 95% CI 0.38-0.83), drinking (OR=0.40, 95% CI 0.27-0.61), awareness (OR=1.30, 95% CI OR=1.03-3.25) and seriousness (OR=1.29, 95% CI 1.19-1.39) for smoking related disease, benefit (OR=1.21, 95% CI 1.16-1.27), and barrier (OR=0.78, 95% CI 0.74-0.83), motivation (OR=1.21, 95% CI 1.12-1.30), and the will to quit smoking (OR=1.70, 95% CI 1.56-1.85). CONCLUSION: This study suggested that effective smoking cessation program should be based on awareness and seriousness due to smoking related diseases, health benefit and barrier to quitting smoking, company's support, the individual's will to quit and various motivation methods.
Drinking ; Education ; Humans ; Insurance Benefits ; Male* ; Marital Status ; Motivation ; Smoke* ; Smoking Cessation* ; Smoking* ; Surveys and Questionnaires

Cytophagic histiocytic panniculitis is a rescently described histiocytic disorder. It is characterized by the presence of fever, pancytopenia, and subcutaneous nodules resulting from the infiltration of lympho-histiocytes in the dermis and subcutaneous adipose tissue. The characteristic findings is presence of bean-bag histiocytes containing phagocytized red blood cells, lymphocytes, and platelets. We experienced two cases of cytophagic histiocytic panniculitis with hard and erythematous subcutaneous nodules. These skin lesions exhibited infiltration of the subcutaneous tissue by large, benign histiocytes with cytophagic features. Hemophagocytic histiocytes were observed in the cervical lymph node in case 1, and bone marrow in case 2. One patient is alive, while the other one died with hemorrhagic complications.

BACKGROUND: Pediatric cardiopulmonary bypass (CPB) often results in increased capillary permeability and accumulation of excess total body water, which can lead to multiple organ dysfunctions. Recently, modified ultrafiltration (MUF) has been used during pediatric cardiac surgery to limit various deleterious effects of CPB. We investigated the effects of MUF on lung compliance and gas exchange in pediatric open heart operations. METHODS: Fifteen pediatric open heart surgery patients were evaluated. Lung compliance (dynamic compliance), arterial oxygen tension (PaO2), arterial to end-tidal carbon dioxide tension difference (Pa-ETCO2), systolic blood pressure (SBP), heart rate, and hematocrit (Hct) were measured. Measurements were made after induction of anesthesia, after CPB, after MUF and after sternal closure. RESULTS: Lung compliance, PaO2, SBP and Hct increased significantly after MUF compared to after CPB. After sternal closure, lung compliance decreased significantly from the value following MUF. PaO2, SBP, Hct decreased significantly after CPB compared to the values obtained after induction of anesthesia. Pa-ETCO2 and heart rate did not change significantly. CONCLUSIONS: Modified ultrafiltration increases lung compliance, PaO2, SBP and Hct. MUF is an excellent option for improving cardiopulmonary function immediately following pediatric cardiopulmonary bypass.
Anesthesia ; Blood Pressure ; Body Water ; Capillary Permeability ; Carbon Dioxide ; Cardiopulmonary Bypass ; Heart ; Heart Rate ; Hematocrit ; Humans ; Lung Compliance* ; Lung* ; Oxygen ; Thoracic Surgery* ; Ultrafiltration*

BACKGROUND: The protease inhibitor aprotinin reduces blood loss and homologous blood usage after a cardiac operation. The aim of the present study was to investigate the effect of low- and high-dose aprotinin on thromboelastography (TEG) variables and to examine the relationship between the clinical effect of aprotinin and the TEG variables in coronary artery bypass grafting surgery (CABG). METHODS: Twenty-three patients scheduled for an elective CABG were randomly assigned to receive either high does (group H, n = 12) or low does (group L, n = 11) aprotinin. TEG variables, and a coagulation profile test at baseline and arrival in ICU were performed. Amount of blood loss, homologous blood transfusion and heparin requirements were measured. RESULTS: In group L, there were significant increases in r time and k time and significant decreases in MA and alpha angle after aprotinin administration. In group H, just k time after aprotinin administration was significantly increased compared with baseline data. There were no significant differences in amount of blood loss and allogenic blood transfusions between the two groups. There was not a significant correlation between TEG variables and amount of blood loss in both groups. Interestingly a siginificant negative correlation between the length of cardiopulmonary bypass and MA was noted in group H (r = -0.63; P < 0.05). CONCLUSIONS: In CABG patients, aprotinin preserves platelet function more significantly in the high-dose aprotinin group. In addition, TEG variables indicated a later clot formation in the low dose aprotinin group.
Aprotinin* ; Blood Platelets ; Blood Transfusion ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Heparin ; Humans ; Protease Inhibitors ; Thrombelastography*

This study was conducted to investigate osteopenia and osteoporosis prevalence of radius and tibia using Quantitative Ultrasound (QUS) and to identify affecting factors of osteoporosis. A total of 4,340 women aged 40 - 69 years, living in Ansung (rural) and Ansan (mid-sized) area, and free of illnesses affecting bone metabolism participated in the community-based cohort study. Among them 4,059 subjects measured radius bone density and 4,089 measured tibia. The T-score threshold, defined as < -1.0 and < or = -2.5, was used to identify subjects with osteopenia and osteoporosis by WHO criteria. The crude prevalence of osteoporosis in radius and tibia was 8.4% and 23.3% respectively; after adjustment for age, it changed 6.3% and 18.8%. In simple logistic regression analysis, the prevalence of osteoporosis increased by aging, non-marital status, low education, low income. Otherwise, high intakes of Ca/P, thiamin, riboflavin, vitamin B6, and vitamin E were decreased osteoporosis prevalence. Compared to the normal BMI (body mass index) group (18.5 < or = BMI < 23), the odds ratio (ORs) of the low BMI group (BMI < 18.5), and high BMI groups (BMI 25 - 30, BMI > or = 30) were significantly increased. The OR of osteoporosis decreased across increasing quartiles of intakes of Ca, P and Ca/P. Therefore, maintaining normal BMI and increasing Ca intake and Ca/P ratio may have a beneficial effect on bone health of Korean women.
Aging ; Bone Density ; Bone Diseases, Metabolic ; Cohort Studies* ; Education ; Female ; Genome* ; Gyeonggi-do ; Humans ; Logistic Models ; Metabolism ; Odds Ratio ; Osteoporosis* ; Prevalence* ; Radius* ; Riboflavin ; Tibia* ; Ultrasonography* ; Vitamin B 6 ; Vitamin E ; Vitamins

A 76-year-old Korean woman visited to emergency room because of respiratory arrest and admitted to intensive care unit of the hospital. Severe hypothyroidism was diagnosed after repeated failure of weaning mechanical ventilator. Respiratory arrest and weaning failures were considered to be associated with hypoventilation due to hypothyroidism. She was recovered and weaned from mechanical ventilation after replacement of thyroid hormone. Severe hypothyroidism may be a cause of respiratory failure or weaning failure.
Aged ; Emergency Service, Hospital ; Female ; Humans ; Hypothyroidism* ; Hypoventilation ; Intensive Care Units ; Respiration, Artificial ; Respiratory Insufficiency* ; Thyroid Gland ; Ventilators, Mechanical ; Weaning

BACKGROUND: Photodynamic therapy is a viable option for lung cancer treatment, and many studies have shown that it is capable of inducing cell death in lung cancer cells. However, the precise mechanism of this cell death has not been fully elucidated. To investigate the early changes in cancer cell transcription, we treated A549 cells with the photosensitizer DH-I-180-3 and then we illuminated the cells. METHODS: We investigated the gene expression profiles of the the A549 lung cancer cell line, using a DEG kit, following photodynamic therapy and we evaluated the cell viability by performing flow cytometry. We identified the genes that were significantly changed following photodynamic therapy by performing DNA sequencing. RESULTS: The FACS data showed that the cell death of the lung cancer cells was mainly caused by necrosis. We found nine genes that were significantly changed and we identified eight of these genes. We evaluated the expression of two genes, 3-phosphoglycerate dehydrogenase and ribosomal protein S29. The expressed level of carbonic anhydrase XII, clusterin, MRP3s1 protein, complement 3, membrane cofactor protein and integrin beta 1 were decreased. CONCLUSION: Many of the gene products are membrane-associated proteins. The main mechanism of photodynamic therapy with using the photosensitizing agent DH-I-180-3 appears to be necrosis and this may be associated with the altered production of membrane proteins.
Antigens, CD46 ; Carbonic Anhydrases ; Cell Death ; Cell Line ; Cell Survival ; Clusterin ; Complement System Proteins ; Flow Cytometry ; Gene Expression Profiling ; Gene Expression* ; Lung Neoplasms* ; Lung* ; Membrane Proteins ; Necrosis ; Phosphoglycerate Dehydrogenase ; Photochemotherapy* ; Photosensitizing Agents ; Ribosomal Proteins ; Sequence Analysis, DNA ; Transcriptome*

BACKGROUND AND OBJECTIVES: Allergic rhinitis is a common condition that has been treated using various methods. Nevertheless, it remains an intractable condition in some cases. We evaluated the long-term efficacy of radiofrequency ablation (RFA) therapy for drug-resistant allergic rhinitis. MATERIALS AND METHODS: Eighteen patients with allergic rhinitis were enrolled in this prospective interventional study. Their subjective symptoms and objective findings were assessed using a visual analogue scale and acoustic rhinometry before and after RFA therapy. Postoperative follow-up was carried out at 1, 3, 6, and 12 months. RESULTS: Nasal obstruction and rhinorrhea were improved significantly (p<0.001 and p=0.015, respectively), and these effects continued for 12 months after RFA therapy. However, the effects on nasal itching and sneezing did not last throughout the year of the study. Patients' overall satisfaction scores declined at 12 months. On acoustic rhinometry, the minimal cross-sectional area and the total nasal volume did not show improvement, and there were no correlations with the subjective symptoms. Most of the complications associated with the RFA procedure were minimal and resolved within 4 weeks. CONCLUSION: RFA is a safe, simple, and effective procedure for relieving nasal obstruction and rhinorrhea for at least 12 months in drug-resistant allergic rhinitis.
Follow-Up Studies ; Humans ; Nasal Obstruction ; Prospective Studies ; Pruritus ; Rhinitis ; Rhinitis, Allergic, Perennial ; Rhinometry, Acoustic ; Sneezing

BACKGROUND: The cognitive function is impaired in patients with hypoxemic chronic obstructive pulmonary disease (COPD). However, there are conflicting results regarding the cognitive function in patients with non-hypoxemic COPD. COPD patients also have sleep disorders. This study examined the cognitive function in non-hypoxemic COPD patients, and nocturnal sleep was assessed in COPD patients with a cognitive dysfunction. METHODS: Twenty-eight COPD patients (mean age, 70.7 years) with an oxygen saturation > 90%, and 33 healthy control subjects (mean age, 69.5 years) who had visited for a routine check-up were selected. The neurocognitive tests were performed using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Neuropsychological Battery. RESULTS: The scores of the word list recall test (p=0.03) and the word list recognition test (p=0.006) in the COPD group were significantly lower than those in the control group. Nine patients showed a significantly impaired cognitive function. Seven of these underwent polysomnography, which revealed apnea-hypopnea indices > or = five per hour in five patients. The median oxygen desaturation index and median limb movement index were 3.6/h and 38.6/h, respectively. CONCLUSION: These results suggest that the verbal memory function is impaired in non-hypoxemic COPD patients. Six out of seven COPD patients with an impaired cognitive function had sleep disorders of sleep apnea and/or periodic limb movements during sleep.
Alzheimer Disease ; Extremities ; Humans ; Memory ; Oxygen ; Polysomnography ; Pulmonary Disease, Chronic Obstructive* ; Sleep Apnea Syndromes ; Sleep Wake Disorders