Respiratory distress syndrome (RDS) of preterm infants remains a significant cause of morbidity and mortality despite improvements in neonatal intensive care and artificial ventilatory techniques. After identification of the deficiency of pulmonary surfactant is major pathophysiologic basis in RDS, artificial surfactant replacement therapy in RDS was first successfully tested by Fujiwara and co-workers in 1980. therefore, exogenous surfactant replacement produced exellent results in improved clinical and repiratory status during the acute period and decreased incidence of late complications and mortality. According to comparison of administration timing between early (within 6 hours after birth) and late (after 6 hours)group, early replacement therapy is more effective in improving of clinical course and prognosis. Because of that, early, just after birth, recognition and detection of RDS is also important procedure. There are many investigations and methods for the detection of RDS in prenatal or postnatal period. Among then, stable microbubble rating (SMR) test was a simple method and SMR test has a higher diagnostic accuracy. To determine the relation of the SMR and purified natural surfactant (PNS) concentration in vitro, the author conducted each 5 times test of SMR method according to 5 groups of PNS concentration by using modified Pattle's method. The results were as follows: 1) The mean and standard deviation of SMR according to 5 groups of PNS concentration were 119.4 (15.0in 20mug PL (phospholipid)/ml, 452.2 (160.2 in 40mug PL/ml, 879.0 (93.4 in 60mug PL/ml, 1311.8 (274.8in80mug PL/ml, 1710.6(272.3 in 100mug PL/ml. 2) The regression curve of SMR and PNS concentration showed statistically significant relation(p<0.005). In conclusion, the SMR test was a good method in estimation of surfactant concentration in vitro and also in diagnosis of RDS recognized as a surfactant deficiency. In the future, we expected that prophylactic surfactant replacement therapy. immediate after birth, will be more popular in the field of neonatal care of RDS. So, we recommended the use of this method for early detection and serving optimal care of RDS.
Diagnosis ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Microbubbles* ; Mortality ; Parturition ; Prognosis ; Pulmonary Surfactants*

No abstract available.
Osteotomy*

No abstract available.
Carotid Stenosis ; Endarterectomy, Carotid ; Hypoxia-Ischemia, Brain

Adenoid cystic carcinoma is a rare disease of which incidence is 10-15 % of bartholins gland carcinoma. The clinical presentation is characterized by a vulval mass that existed for a prolonged period to the onset of symptoms, usually infection, pain, and burningsensation Histologically, this tumor is characterized by cribriform pattern cell growing and perineural invasion. The obtaining of clear surgical margins is the most important aspect of treatment. Here we report a case of adenoid cystic carcinoma of the Bartholins gland with a brief review of literature.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Incidence ; Rare Diseases

It has been known that halothane potentiates the effect of muscle relaxants. We electrophysically studied the atterations by halothane in the rat diaphragm. The diaphragm -phrenic nerve preparation was dissected out of the anesthetized rat. In 1% and 2% halothane groups, control determinations were measured on infusion of simple Ringer's solution. Following infusion of halothane-saturated Ringer's solution for 10 minutes, determinations studied were recorded. Transmembrane currents were elucidated using the standard two microelectrode voltage clamp. To determine the mean MEPC amplitude and , 30 MEPC's were first gotten. A series of EPC's were elicited by stimulation of phrenic nerve at 0.4 Hz and 40 Hz. EPC's of both frequencies were used to evaluate the amplitude and quantum content (QC) of EPC. With tetanic stimulation, the degree of rundown was calculated. 1) MEPC amplitudes were reduced under 1% and 2% halothane, to 80.9% and 71.6% respec- tively. of MEPC shortened to 84.1% and 70.7%. 2) Amplitudes of EPC lowered to 65.9% and 49.4% at 0.4 Hz, and 70.7% and 52.2% at 40 HZ. 3) QC of EPC diminished to 81.5% and 70.1% at 0.4 Hz, and 87.2% and 74.1% at 40 Hz. 4) THe degrees of rundown by the tetanic stimulation were augmented to 119.1% and 136.1%. It is concluded that halothane reduced the amplitude and time constant of decay of MEPC, and the amplitude and QC of EPC, and augmented the degree of rundown at tetanic stimulation.
Animals ; Control Groups ; Diaphragm* ; Halothane* ; Microelectrodes ; Phrenic Nerve ; Rats* ; Synaptic Transmission*

No abstract available.

No abstract available.

We present a case of metastatic giant cell carcinoma of the thyroid in small intestine presenting as an unusual polypoid growth, and its ultrastructure and immunohistochemical reaction to thyroglobulin were investigated. The patient was a 63 years old female who received a segmental resection of ileum for intestinal obstruction, one year after a radical neck dissection and thyroidectomy for anaplastic (giant cell variant) carcinoma with a focus of papillary tumor of the thyroid. In the segmentally resected ileum, there were three conglomerated round intraluminal polypoid tumor masses in close approximation which measured 4.5 cm, 2.5 cm and 2 cm respectively. The histological features were similar to those of thyroid lesion, being predominantly made of anaplastic giant and spindle cells in haphazard arrangement. Ultrastructure of pleomorphic spindle cells and multinucleated giant cells demonstrated numerous mitochondria with tubular cristae, rough endoplasmic reticula and a few membrane-bound dense granules. Peroxidase-antiperoxidase method against thyroglobulin revealed strong positive staining on papillary carcinoma and weak positivity on both giant cells and spindle cells of the anaplastic carcinoma. The above observations confirm that multinucleated giant cells of small intestine originate from metastatic giant cell carcinoma of the thyroid.
Female ; Humans ; Neoplasm Metastasis

OBJECTIVE: We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. METHODS: We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. RESULTS: PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were 3.6+/-2.9 and 5.4+/-6.4 in the unresected PARS group, 5.8+/-2.1 and 11.3+/-7.1 in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. CONCLUSION: The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.
Arthrodesis ; Body Mass Index ; Humans ; Neurologic Manifestations ; Spine

PURPOSE: An accurate, objective scoring system to assess the severity of community-acquired pneumonia (CAP) could be helpful to physicians in predicting patient mortality and improving decisions regarding hospitalization. However reports on the severity scoring system for prediction of mortality in patients with CAP in Korea are rare. The aim of this study was to propose a new modified severity scoring system based on a previously validated A-DROP for CAP and to compare it with pneumonia severity index (PSI), CURB- 65 and A-DROP. METHODS: The medical records of 364 patients admitted with CAP via ED from January 2013 through August 2014 were reviewed retrospectively. The demographic data, comorbidities, laboratories, PSI class, CURB-65 score, and A-DROP score were reviewed. The authors investigated a modification factor by comparing the survivors with the nonsurvivors. RESULTS: The study subjects were composed of 264 men and 100 women, with a mean age of 66.2+/-15.2 years. The overall 30-day mortality was 9.6%. The areas under the receiver operating characteristic (ROC) curves for prediction of 30-day mortality in patients with CAP were 0.803 (95% confidence interval (CI): 0.739-0.868), 0.734 (95% CI: 0.652-0.816) and 0.747 (95% CI: 0.662-0.833) for PSI, CURB-65 and A-DROP respectively. The new DROP-70 scoring system which includes age> or =70 years is a simple modified version of the A-DROP. The area under the ROC curves of DROP-70 was 0.774 (95% CI: 0.698-0.850). CONCLUSION: A new severity scoring system, DROP-70, could be a useful index for predicting 30-day mortality in patients with community-acquired pneumonia.
Comorbidity ; Female ; Hospitalization ; Humans ; Korea ; Male ; Medical Records ; Mortality ; Pneumonia* ; Prognosis* ; Retrospective Studies ; ROC Curve ; Survivors