No abstract available.
Child* ; Dust* ; Humans ; Lymphocytes* ; Pyroglyphidae*

BACKGROUND: A technique that improves the efficiency of alveolar ventilation should decrease the pressure required and reduce the potential for lung injury during mechanical ventilation. High PaCO2 can be permitted to lower airway pressures as in permissive hypercapnia (PH). Intratracheal pulmonary ventilation (ITPV) was developed to allow a decrease in physiological dead space during mechanical ventilation. We compared the effect of hybrid ventilation (HV) as a modification of ITPV with PH on the decrease of tidal volume and airway pressures in rabbits with acute respiratory failure. METHODS: Tracheostomy was performed in 7 rabbits ventilated under volume-controlled mode in the supine position. Arterial blood gas analysis, airway pressures, and dead space ventilation were measured at respiratory rate of 20/min as control values. Oleic acid (OA) of 0.06 ml/kg was injected to induce acute respiratory failure. Tidal volume (VT) was elevated to maintain PaCO2 in the normal range. The same parameters were measured as OA values. Then VT was reduced to the control level to allow PH. HV was initiated by inserting a reverse thrust catheter (RTC) into the endotracheal tube. HV consists of a pressure-controlled mode of mechanical ventilation and ITPV while flushing fresh gas continuously via the RTC. Respiratory parameters were compared under control, OA, PH and HV conditions. RESULTS: Oleic acid injection decreased PaO2 from 401+/-35 mmHg to 129+/-39 mmHg, increased VT from 42+/-5 ml to 52+/-10 ml, and increased VD/VT ratio from 0.65+/-0.07 to 0.71+/-0.07. During PH, the increase in PaCO2 was accompanied by the increase in VD/VT ratio from 0.71+/-0.07 to 0.79+/-0.03 and by the decrease of peak inspiratory pressure (PIP) from 19.4+/-4.0 cmH2O to 16.8+/-3.1 cmH2O. PaCO2 was lowered from 50+/-5 mmHg in PH to 39+/-5 mmHg in HV with a lower VT. VD/VT ratio in HV was as low as that in control. CONCLUSION: HV is an effective and easy-to-use ventilatory modality to reduce PaCO2 and airway pressures by the reduction in VD/VT ratio in acute respiratory failure model.
Blood Gas Analysis ; Catheters ; Flushing ; Hydrogen-Ion Concentration ; Hypercapnia ; Lung Injury ; Oleic Acid ; Pulmonary Ventilation* ; Rabbits* ; Reference Values ; Respiration, Artificial ; Respiratory Insufficiency* ; Respiratory Rate ; Supine Position ; Tidal Volume ; Tracheostomy ; Ventilation

No abstract available.
Cardiomyopathies* ; Peripartum Period*

No abstract available.
Diagnosis* ; Hemoglobinuria*

Byars approach for the repair of hypospadias is simple, sound and has reported the lowest incidence of fistula formation. This procedure has been used in the Department of Urology, College of Medicine, Kyung-pook National University during the last 3 years. During the period, a clinical observation was made on 7 hypospadias patients who had received the 2 stage operation(resection of chordee and uerthroplasty) using Byars procedure. Infection of surgical wound was the most frequent complication, however, fistula formations did not occur in any case. The urinary stream and the states of erection were good in all cases.
Female ; Fistula ; Humans ; Hypospadias* ; Incidence ; Male ; Rivers ; Urology ; Wounds and Injuries

Chlorophenoxy herbicide poisoning is uncommon, but may produce severe sequelae. It's treatment is primarily the same as that used for poisonings with other drugs; gastric lavage, activated charcoal, etc. However, it's secondary treatment to enhance elimination has two options, alkaline diuresis or hemodialysis. We experienced a patient who had been poisoned with chlorophenoxy herbicide and had severe symptoms like comatose mentation, acute renal failure, rhadomyolysis, etc. The patient was treated by hemodialysis for 5 days and recovered from the acute state.
Acute Kidney Injury ; Charcoal ; Coma ; Diuresis ; Gastric Lavage ; Humans ; Poisoning ; Renal Dialysis*

BACKGROUND: Fanconi's anemia(FA) is an autosomal recessive disease characterized by aplastic anemia and congenital malformations. As up to 30% of patients have no physical stigmata, the modern diagnosis of FA rests on chromosomal breakage of patient's cells induced by chemical clastogens such as diepoxybutane(DEB) or mitomycin-C(MMC). METHODS: We reviewed the clinical manifestations, laboratory findings, diagnostic methods, treatment and outcome of 6 patients diagnosed to have a FA at the Chonnam University Hospital for the last 6 years. RESULTS: Six cases(16.2 %) were found to have FA among 37 aplastic children who were diagnosed during the same period. The mean age at diagnosis was 6.3 years which was the usual onset of hematologic findings. All patients had features of aplastic anemia, and had one or more anomalies, such as low birth weight, hyperpigmentation, cafeau-lait spots, mental retardation, developmental delay, peculiar face(broad nasal bases, epicanthal folds, micrognathia), polydactyly, microcephaly, short stature, and dislocation of hip. We found increased breaks in cultured cells with DEB and MMC in 5 cases tested. The median duration of follow-up was 30 months. Oxymetholone and prednisolone treatment was partially beneficial in three cases. Immunosuppressive treatment with ALG/ATG was not successful in two cases tried. Four cases are living now, without transfusion in three. Two patients were died of disseminated fungal infection and transplant-related problems, respectively. CONCLUSIONS: Fanconi's anemia should be sought carefully in any patients with aplastic anemia because the prognosis, treatment modality, and the approach to bone marrow transplantation are quite different when the hematologic disorder is inherited rather than acquired.
Anemia, Aplastic ; Bone Marrow Transplantation ; Cells, Cultured ; Child ; Christianity ; Chromosome Breakage ; Diagnosis ; Dislocations ; Fanconi Anemia* ; Follow-Up Studies ; Hip ; Humans ; Hyperpigmentation ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Jeollanam-do ; Microcephaly ; Mitomycin ; Mutagens ; Oxymetholone ; Polydactyly ; Prednisolone ; Prognosis

No abstract available.
Bone Marrow Transplantation* ; Bone Marrow* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Recurrence*

Metastatic cancer of the esophagus is unusual, Toreson discovered 19 in 599 autopsies on carcinoma patients, an incidence of 3.2%, Most of the patients had primary tumors of the lung, stomach, larynx or breast. Contiguous spread of tumor into the esophagus may produce an ulcerative lesioin resembling primary cancer of the esophagus, as examplified by the direct extension of tumor from the gastric cardia. These tumors may produce esophageal symptoms, notable dysphagia, and present no particular problem to the endoscopist because the ulcerative tumor in the lumen of the eaophagus makes diagnosis easy. Unusuually these tumor will extend into the esophagus submucosally producing submucosal nodules or cicatricial stricture of the esophagus without ulceration inito the lumen. This increases the diagnostic problems because of the difficulty of obtaining a endoscopic biopsy. We experienced a case of multiple nodular metastatic esophageal carcinoma, which was submucosally extended from the stomach cancer, confirmed by endoscopic biopsy. So we report this case with brief review of the previous litera- tures.
Autopsy ; Biopsy ; Breast ; Cardia ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Esophageal Neoplasms ; Esophagus ; Humans ; Incidence ; Larynx ; Lung ; Stomach Neoplasms* ; Stomach* ; Ulcer

Pseudomembranous colitis (PMC) was first described by Finney as postoperative diphtheritic enteritis in 1893 and was known to be associated with antibiotics by Reiner et al in 1952. Most cases of antibiotic-associated PMC are now associated with cytotoxigenic C. difficile. The association of PMC several antibiotics is well docamented; however, its association with clindamycin appeared to be most striking. We experienced a male patient who developed tarry stool, abdominal pain and diarrhea after having recieved clindamycin for two weeks. The PMC diagnosed by colonofiberscopy with biopsy and C. difficile was identified by tissue-culture study. The patient was treated by oral vancomycin and healed. Described here a case of PMC with some review of literature.
Abdominal Pain ; Anti-Bacterial Agents ; Biopsy ; Clindamycin ; Clostridium difficile* ; Clostridium* ; Diarrhea ; Enteritis ; Enterocolitis, Pseudomembranous* ; Humans ; Male ; Strikes, Employee ; Vancomycin