Balloon-tipped, flow-directed (Swan-Ganz) catheters are used commonly for monitoring of cardiac function in patients undergoing cardiac surgical procedures. We report a case of pulmonary hypertension with hypoxemia which may be caused by incorrect positioning of pulmonary artery catheter (PAC) during CABG. Pulmonary arterial pressure (PAP) of 70/40 mmHg which was nearly high as systemic pressure was measured when we tried to wean patient from cardiopulmonary bypass. But, TEE (transesophageal echocardiography) showed nonspecific finding. PAP decreased soon and maintained about 33/16 mmHg for a few minutes. But, the PAP elevated high to 70/40 mmHg again and the arteral oxygen tension (PaO2) decreased to 61.2 mmHg. When we withdrew the PAC to the depth of 35 cm, the PAP and systolic pressure returned to normal range and PaO2 elevaed to 320 mmHg. End tidal CO2 was elevated from 30 mmHg to 35 mmHg.
Anoxia* ; Arterial Pressure ; Blood Pressure ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Catheters* ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Hypertension, Pulmonary* ; Oxygen ; Pulmonary Artery ; Reference Values

No abstract available.
Colon* ; Colonic Neoplasms* ; Humans ; Sparganosis* ; Ultrasonography*

No abstract available.
Nevus*

BACKGROUND: The improved technique for cardiopulmonary resuscitation(CPR) has resulted in the survival of many patient who experienced cardiac arrest. However, mortality in resuscitated patients is high, and the survival rate without brain damage is very low. Various neurological examination models, neuro-imaging techniques, electrophysiological procedures, and biochemical tests have been studied with respect to the detection of cerebral damage and outcome, but an early, reliable prediction of individual outcomes is still uncertain. METHODS: We studied twenty patient who had been in a coma for more than 24 hours after CPR, Somatosensory evoked potentials(SEP) were measured within the first three days after CPR. RESULTS: Of the twenty patients, seven patients(35%) had a good outcome, and thirteen patients(65%) had a bad outcome. Of the eleven patients with loss of the cortical evoked potential's N20 peak, all had a bad outcome. CONCLUSION: SEPs are of great benefit in prognostic evaluation after CPR.
Brain ; Cardiopulmonary Resuscitation* ; Coma* ; Evoked Potentials, Somatosensory* ; Heart Arrest ; Humans ; Mortality ; Neurologic Examination ; Survival Rate

Total hip replacement arthroplasties(THRA) have been done in 19 patients(31 hips), who were diagnosed ad ankylosing spondylitis from January, 1984 till July, 1993 at Seoul National University Hospital. All patients were male; 12 patients were affected bilaterally. Modified New York criteria was used as diagnostic criteria. HLA B27 antigen was positive in 18 cases(95%). The thoracolumbar spine and sacroiliac joint were affected in all cases and cervical spine was affected in five patients, among them, fiberoptic laryngoscopic intubation was needed in four cases. The trastrochanteric approach was used in 19 cases, which have severe limitation of motion and deformity of the acetabulum. For the prevention of postoperative heterotopic ossification, low dose radiation therapies were done in 10 cases of the risk group. The average follow-up period was three year and eleven months(two year-seven year and 10 months). Harris hip score and radiographs were obtained at each follow-up. The mean preoperative Harris hip score was 50(19–90), and finally, the mean Harris hip score was 87(68–96). Loosening of endoprothesis was noted in 3 cases and heterotopic ossification in 5 hips. Ischial enthesopathy was observed in 13 cases. Among the hips which had heterotopic ossification, four were class Ι by Brooker's classification and only one was class Ⅲ. No nonunion was observed in the cases which had trochanteric osteotomy expect breakage of wire in 4 cases. In THRA of ankylosing spendylitis, we obtained good result clinically and radiologically. In severely affected cases, we had used transtrochanteric approach and obtained good result due to better operative field. The incidence of heterotopic ossification was not significant and the prophylactic low dose radiation therapy seems to be effective in risk group.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Hip ; HLA-B27 Antigen ; Humans ; Incidence ; Intubation ; Male ; Ossification, Heterotopic ; Osteotomy ; Rheumatic Diseases ; Sacroiliac Joint ; Seoul ; Spine ; Spondylitis, Ankylosing

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

OBJECTIVE: Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. METHOD: Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X-ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. RESULTS: The ratio between male and female was 4:1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 1 30patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%) got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. CONCLUSION: In the case of weigt loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs enen though drug sensitivity restlts show sensitivity to some of them. Proper time for surgical intervention should not be delayed.
Academies and Institutes ; Busan ; Compliance ; Diagnosis ; Drug Resistance ; Female ; Hospitals, Chronic Disease* ; Humans ; Male ; Parents ; Prevalence ; Public Health ; Retreatment ; Retrospective Studies ; Thorax ; Treatment Outcome ; Tuberculosis* ; Tuberculosis, Pulmonary* ; Weight Loss ; X-Ray Film

We intended to evaluate the Young's modulus of trabecular bone and apparent density from Computed Tomography(CT) and Spherical Indentation test and to quantify relation ship between them. The distal femurs(31 age, male, left and right) were prepared for exprimentatin and were embedded with repect to anatomical orientation. Then the specimens were scnned at 1 mm intervals on GE9800 CT scanner and the Hounsfield Units(HU, or CT number) were extracted from each CT image. After scanning, the bones were sectioned with diamond saw, producing 8 mm cubes of trabecular bone(72 eachs) from the metaphyseal region of both distal femur. The cubes were mechanically tested in inferior-superior(IS), anteriorposterior(AP), and medial-lateral(ML) direction with custom-made device, Spherical Indentatin Tester. After testing, the real apparent density of specimens were measured. The results of this study showed that the IS modulus was singificantly greater than both the AP and ML modulus and the AP modulus was also greater than ML modulus significantly(p<0.01). A linear relation ship between HU and real apparent density was found to be significant(R2=0.68) and significant power relationship between the apparent density and the tangent moduli(either by CT or physical measures) was also found.
Diamond ; Elastic Modulus* ; Femur ; Humans* ; Male ; Ships

No abstract available.
Allografts* ; Fibroblasts*

No abstract available.
Snake Bites* ; Snakes*