No abstract available.
Humans ; Rhinitis* ; Skin Tests* ; Skin*

BACKGROUND: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). METHODS: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O. RESULTS: In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit). CONCLUSIONS: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.
Cardiopulmonary Resuscitation* ; Manikins* ; Models, Theoretical ; Positive-Pressure Respiration ; Thorax ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

PURPOSE: We investigate the risk factors of recurrence after first intussusception. METHODS: We have studied the relationship of the clinical features and ultrasonographic findings and the risk of recurrent intussusception in 97 patients with reduced intussusception including 22 recurrent intussusception who admitted at the department of pediatrics at Ewha Womans University Mok-dong hospital from September 1993 to Feburary 1996. RESULTS: 1) The overall recurrence rate of intussusception in this study was 16.9%. 2) The interval between the first and second attack was within 24 hours in 53.8%. 3) There were no stastistically significant difference in age and sex, antecedent illness, clinical symptoms and sings, type of intussusception and radiologic findings on simple abdomen. 4) There were stastistically significant difference in the average duration of symptom above 12 hours, infolding lymph node in target sign, outer hypoechoic diameter above 8mm, swelling on ileocecal valve and terminal ileum after reduction(wall thickness> 3mm) on ultrasonographic findings and number of trial of reduction more than 3 times between the nonrecurrent and recurrent groups. 5) In stepwise logistic regression analysis, hypoechoic outer rim thickness above 8mm in target sign, swelling of ileocecal valve and terminal ileum after reduction on ultrasonographic findings and number of trial of reduction more than 3 times contributed significantly to the prediction of recurrence of intussusception. CONCLUSIONS: Recurrent intussusception can be predicted by hypoechoic outer rim thickness above 8mm in target sign, swelling of ileocecal valve and terminal ileum after reduction on ultrasonographic findings and number of trial of reduction more than 3 times.
Abdomen ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception* ; Logistic Models ; Lymph Nodes ; Pediatrics ; Recurrence ; Risk Factors* ; Ultrasonography*

No abstract available.
Pelger-Huet Anomaly*

PURPOSE: Nebulized selective beta2-adrenoreceptor agonists have been widely used in acute asthma and selectively in acute bronchiolitis. However, nebulized salbutamol have been reported to cause arterial oxygen desaturation in some of the acute bronchiolitis and severe asthma patients. This may be the results of a paradoxical bronchoconstriction linked to acidic and hyper-osmolar nebulized salbutamol solution and etc. We assessed the changes in arterial oxygen saturation by percutaneous pulse oxymeter during and after nebulization of salbutamol solution and compared the effect of 100% oxygen with the compressed air as a driving gas. METHODS: This study was performed in 80 mild to moderate wheezy children(bronchiolitis 51, asthma 29) who were admitted to Pediatrics department of of EWHA from January 1992 to October 1993. The study children are randomly assigned to be nebulized by compressed air or 6l/min of 100% oxygen as a driving gas. The arterial oxygen saturation, wheeze score, retraction score, and heart rate were recorded before nebulization, post-nebulization, 5, 10, 15 and 30minutes. RESULTS: 1) Arterial oxygen saturation decreased significantly at post-nebulization five minutes only in bronchiolitis, treated with salbutamol nebulization without oxygen(p<0.01). Salbutamol nebulization, with oxygen (6l/min) has not changed arterial oxygen saturation both in bronchiolitis and asthma(p>0.05). 2) Wheeze score decreased significantly at post-nebulization 5-30minutes in asthma but not in bronchiolitis whether nebulized salbutamol with or without oxygen(p<0.05). 3) Retraction score increased significantly at post-nebulization 0-5minutes or unchanged in bronchiolitis but significantly decreased in asthma at 10-30minutes(p<0.05). 4) There were no significant change in heart rate and respiratory rate in both groups(p>0.05). CONCLUSIONS: Significant fall in arterial oxygen saturation was noted only in bronchiolitis treated with salbutamol nebulization without oxygen. In bronchiolitis, oxygen (6l/min) is better than compressed air as a driving gas during salbutamol nebulization to prevent hypoxemia.
Albuterol* ; Anoxia ; Asthma ; Bronchiolitis ; Bronchoconstriction ; Child* ; Compressed Air ; Heart Rate ; Humans ; Infant* ; Oxygen* ; Pediatrics ; Respiratory Rate

Nineteen revision total knee arthroplasties (TKAs) performed from March 1991 to March 1995 were evaluated to determine the clinical and roentgenographic results and the problems in revision TKA. The mean age was 63 years (range, 23-85 years) and the mean follow-up time was 19 months (range, 12 months-4.4 years). The primary revisions were done in eighteen knees and a re-revision, in one. Four revision TKAs were performed for failed unicompartmental arthroplasty and fifteen, for failed TKA. The mean interval from initial to revision TKA was 4.1 years (range, 3.3 years-5 years) in failed unicompartmental arthroplasty and 5.7 years (range, 4 months-14 years) in failed TKA. The initial diagnosis was degenerative arthritis in 16 knees, tuberculous arthritis in two and rheumatoid arthritis in one. The main cause of revision for both of the failed unicompartmental arthroplasties and failed TKAs was aseptic loosening. The HSS knee score improved from 43+/-14 to 82+/-7 in the failed unicompartmental arthroplasties and from 46+/-16 to 79+/-14 in the failed TKAs. The clinical success rate of revision TKA was 78%. The coronal tibiofemoral angle improved from valgus 0.2degrees to valgus 5.1degrees. At final follow-up, radiolucent line greater than 2mm in width was found around femoral component in one knee. In our series, four complications were occurred. One knee was fused due to mas-sive bone loss and ipsilateral femur shaft fracture. Deep wound infections were developed in two knees and loss of fixation after tibial tuberosity osteotomy in one. In conclusion, significant improvements of clinical and radiological results were achieved in revision TKA but the success rate was relatively low and the complication rate was relatively high compared with primary TKA. So, especially appropriate skillful surgical techniques and postoperative cares were required to overcome the soft tissue problem and infection which was encountered in revision TKA.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Diagnosis ; Femur ; Follow-Up Studies ; Knee* ; Osteoarthritis ; Osteotomy ; Wound Infection

We report a two-generation Korean family in which 2 siblings have congenital cataract and phenotype i. This report is a first case in Korean people and shows the evidence suggesting the linkage of Ii blood group with a recessive form of congenital cataracts.
Cataract* ; Humans ; Phenotype* ; Siblings*

Purpose: Triple-negative breast cancer (TNBC) represents a major clinical challenge due to its aggressive and metastatic behavior and the lack of available targeted therapies. Therefore, therapeutic strategies are needed to improve TNBC patient management. Recently, atezolizumab and nab-paclitaxel chemotherapy has been approved by the Food and Drug Administration for the first-line treatment of patients with locally advanced and metastatic TNBC. The programmed death-ligand 1 (PD-L1) immunohistochemical SP142 assay was also approved as a companion diagnostic device for selecting TNBC patients for atezolizumab treatment. This study aimed to evaluate and compare the analytical performance of the PD-L1 22C3/SP263 assays in comparison with the SP142 assay for ≥ 1% immune cells (ICs). Methods: Immunohistochemical expression for the PD-L1 22C3/SP263 assays, in comparison with the SP142 assay, was analyzed for the ≥ 1% ICs in 95 TNBCs. Results: At the 1% cut-off value, the proportions of positive cases were 52.6% for the SP142 assay in infiltrating ICs and 50.5% and 52.6% for the 22C3 and SP263 assays in tumor cells, respectively. The PD-L1 SP263 assay had the highest while the PD-L1 22C3 assay had the lowest total positive expression rate at all cut-off values. The concordance rate between the assays was highest at a 1% cut-off value and decreased when the cut-off value increased.The concordance rate between the SP142 and SP263 assays at 1% cut-off was high, while in comparison, the concordance rate between the SP142 and 22C3 assays at 1% cut-off was relatively lower. Conclusion This study demonstrates that although the 22C3 assay at a 1% cut-off value compared with the PD-L1 SP142 assay at the clinically relevant cut-off shows comparable but not interchangeable analytical performance, the analytical performance of the SP263 assay at a 1% cut-off value shows interchangeable performance with the PD-L1 SP142 assay at the clinically relevant cut-off.

Visualization of coronary collaterals in coronary arteriography performed in vivo constitutes an important finding, and particularly in the presence of coronary artery disease, it allows observations related to the hemodynamic consequences of the disease process. Undoubtedly, the presence of collateral flow indicates that a compensatory mechanism has developed to ameliorate the detrimental effect of blood flow cessation due to obstruction of the arterial pathways. By definition, intracoronary collaterals are connections between branches of the same coronary artery. In general, in a coronary arteriogram obtained in vivo, their incidence is lower than that of intercoronary collaterals. We experienced a case of intracollateral circulation, seen extending from the aneurysm through the first segment filled with the right ventricular branch like vessels (OC, Seg 1. CL, intra. Seg 1-2. ANl, Seg 1. CL, inter. Seg 4-8.). Intercollaterals originated from the distal circumflex branch of the left coronary artery, passing through a posterior descending branch and later filled the right ventricular branch of the right coronary artery (OC, Seg 15. LSmd, Seg 6. ANm, Seg 6-7. CL, inter. Seg 15-4.) in a 9-year-old male with Kawasaki disease.
Aneurysm ; Angiography ; Child ; Constriction, Pathologic* ; Coronary Artery Disease ; Coronary Vessels ; Hemodynamics ; Humans ; Incidence ; Male ; Mucocutaneous Lymph Node Syndrome*

OBJECTIVES: The aim of this study was to emphasize the necessity of a standard in segmentation threshold and algorithm for measuring volume and surface area of mastoid air cell system (MACS). METHODS: First, we obtained axial computed tomography scans of 54 normal temporal bones from 27 subjects. Then, we manipulated Hounsfield units (HU) image data in DICOM (digital imaging and communications in medicine) files directly using our program. The volume and surface area of MACS were computed and compared at segmentation thresholds (HU) from -700 to 0 at intervals of 50 using 2 algorithms; square pixel based (SP) algorithm and marching square (MS) algorithm. RESULTS: No significant difference was found between the volumes computed by SP and MS algorithms at each segmentation threshold. The surface area computed by SP algorithm, however, was significantly larger than that by MS algorithm. We could minimize this significant difference through a modification of the SP algorithm. As the lower HU threshold value was set, the smaller volume was measured. The surface area showed a plateau at a threshold of approximately -200 HU. The segmentation threshold had greater influence on the measured volume of MACS than the algorithm did. CONCLUSION: A standard method for measuring volume and surface area of MACS is thought to be necessary. We suggest that the MS algorithm and -200 HU of the threshold could be a standard in the measurement of volume and surface area of MACS.
Mastoid* ; Organ Size ; Temporal Bone