BACKGROUND: For the diagnosis or evaluation of airway obstruction in bronchial asthma and chronic obstructive lung disorders, various parameters derived from the forced expiratory volume curve and maximal expiratory flow volume cutie have been used. Recently the peak expiratory flow(PEF) measured by the peak flow meter is widely used because of its simplicity and convenience. But there were still no data of the predicted normal values measured by the peak flow meter in Korea. This study was to obtain the predicted normal value of PEF and to know the accuracy of this value 18 predict FEV1. METHOD: The measurements of PEF by the MiniWright peak flow meter and several parameters derived from the forced expiratory volume and maximal expiratory flow volume curves by the Microspiro HI 501(Chest Co.) were done in 129 men and 125 women without previous history of the respiratory diseases. The predicted normal values of parameters according tc the age and the height were obtained, and the regression equation of FEV1 by PEF was calculated. RESULTS: The predicted normal values of PEF(L/min) were 2.45 Age(year)+1.36 Height(cm)+427 in men and -0.96 Age(year)+2.01 Height(cm)+129 in women. FEFmax derived from the maximal expiratory flow volume cutie was less than by 125 L/min in men art 118 L/min in women respectively compared to PEF. FEV,(ml) predicted by PEF was 5.98 PEF(L/min) 303 in men and 4.61 PEF(L/min) 291 in women respectively. CONCLUSION: The predicted normal value of PEF measured by the peak flow meter was calculated and it could be used as a standard value of PEF while taking care of patients with airway obstruction FEV1, the gold standard of ventilatory function could be predicted by PEF to a certain extent.
Airway Obstruction ; Asthma ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Korea ; Lung ; Male ; Maximal Expiratory Flow-Volume Curves ; Reference Values

BACKGROUND: i-gel(TM) is a new single-use supraglottic airway device without an inflatable cuff. This study was designed to compare the usefulness of i-gel(TM) versus a classic laryngeal mask airway (cLMA) in small children. METHODS: Sixty-three children (age range : 4-72 months) were randomly assigned to an i-gel(TM) or cLMA group. We evaluated hemodynamic data, airway sealing ability, the success rate of insertion, and adverse events including an inadvertent sliding out during ventilation. RESULTS: Demographic data and hemodynamic data obtained immediately after the insertion of these devices did not differ between the two groups. The success rates for insertion on the first attempt were 77 and 84% for i-gel(TM) and cLMA, respectively (P = 0.54), and the overall success rates were 87 and 100% respectively (P = 0.14). There were no significant differences in terms of airway leak pressure. The inserted i-gel(TM) inadvertently slid out in 8 of 31 patients but only one sliding out case occurred in the cLMA group (P = 0.02). There were no differences between the groups in terms of other side effects (e.g., coughing, bleeding) associated with the use of i-gel(TM) and cLMA (P = 0.75 and 0.49, respectively). CONCLUSIONS: Oropharyngeal leak pressure and insertion success rate of i-gel(TM) are similar to those of cLMA. However, i-gel(TM) is prone to inadvertent sliding out of the mouth in small children. Therefore, it is recommended that the i-gel(TM) should be secured more tightly to avoid displacement of the device.
Child* ; Cough ; Hemodynamics ; Humans ; Laryngeal Masks* ; Mouth ; Ventilation

BACKGROUND: Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma. METHODS: In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging. RESULTS: 1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%.3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4. CONCLUSIONS: EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.
Biopsy ; Diagnosis ; Digestive System Diseases ; Endoscopy ; Endosonography* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Lymph Nodes ; Neoplasm Metastasis ; Stomach* ; Ultrasonography

It has been known that right side bypass tract ablation is more difficult and has higher recurrence rate than that of left side bypass tract, and often associated with atrioventricular block in patients with septal bypass tract. Multielectrode basket catheter (MBC) allows simultaneous rapid acquisition of numerous electrical signals generated by a selected surface area or volume of myocardium. We experienced two cases of successful catheter ablation of atrioventricular reentrant tachycardia by right septal bypass tract which were mapped by MBC with greater ease.
Atrioventricular Block ; Catheter Ablation* ; Catheters* ; Humans ; Myocardium ; Recurrence ; Tachycardia*

Background: Posterior femoral condylar osteophytes were frequently observed in patients with the ultra-congruent (UC) deepdish design prosthesis. Therefore, the purpose of the present study was to verify the clinical relevance of osteophyte formation in the UC design. Methods: From March 2014 to February 2018, a comparative study was conducted on 96 knees using the UC design. They were divided into 2 groups (group 1: osteophyte +, group 2: osteophyte –). Intraoperative findings, indirect femoral rollback assessment using 30° flexion and active full flexion lateral radiographs, serial change of the osteophyte, and outcomes were compared. Results: The mean follow-up period was 49.35 ± 3.47 months in group 1 and 47.52 ± 3.37 months in group 2. Posterior component coverage was significantly different between the groups: group 1 exhibited more underhang and group 2 exhibited more overhang (p = 0.022). On the indirect assessment of the femoral rollback, there was a statistically significant difference in deep flexion and change in distance (p < 0.001 and p < 0.001, respectively). There was no statistical difference between the 2 groups in the American Knee Society knee and function score, and group 2 showed significant improvement in pain compared to group 1 in Western Ontario and McMaster University Arthritis Index pain score (p = 0.029). Conclusions Posterior condylar osteophyte formation was related to posterior impingement. It was more frequently observed in the underhang of the femoral component and insufficient femoral rollback. In addition, it changed with time and caused negative effects, including a gradual decrease in flexion and more pain.

BACKGROUND AND OBJECTIVES: In this study we investigated the association between the polymorphism of apolipoprotein E and the development of myocardial infarction, and assessed whether this polymorphism produces any changes of plasma lipid level. SUBJECTS AND METHODS: A total of 182 patients participated in this study and were divided into two groups; 91 patients with myocardial infarction (MI group) and 91 patients with no known heart disease (control group). For both groups we analyzed the clinical parameters, the changes of plasma lipid level and the degree of polymorphism of apolipoprotein E. RESULTS: Total cholesterol, triglyceride and LDL cholesterol levels were significantly higher in the MI group, while the HDL cholesterol level was significantly lower. Compared with the control group, the frequency of epsilon2 allele was significantly lower while that of epsilon3 allele was significantly higher in the MI group. As for the control group, the triglyceride level was significantly higher in the patients with epsilon 2 allele than in those without epsilon 2 allele, and the total cholesterol level was significantly higher in the patients with epsilon 4 allele than in those without epsilon 4 allele. In the MI group, the plasma lipid levels were not significantly different from those in the control group. CONCLUSION: We suggested that apolipoprotein E polymorphism could affect the lipid metabolism as well as the development of myocardial infarction. However further study is needed in patients with myocardial infarction.
Alleles ; Apolipoproteins E ; Apolipoproteins* ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Heart Diseases ; Humans ; Lipid Metabolism ; Lipoproteins ; Myocardial Infarction* ; Plasma ; Triglycerides

Three QIAG93 strains, QIAG9301, QIAG9302 and QIAG9303 that have been identified as Getah virus (GETV) are analyzed in this study. The morphological features of three virus isolates were observed by using electron microscopy, suggesting that the QIAG9301, QIAG9302 and QIAG9303 isolate can be classified as tentative member of Alphavirus species in the Semliki Forest complex. The full length of the structural polyprotein gene of each QIAG93 isolate (QIAG9301, QIAG9302 and QIAG9303) was determined that are identical in size, comprising 3759 nucleotides that encoded 1253 amino acids. The sequence analysis of the structural polyprotein gene, including the C, E3, E1, 6K and E2 domain, showed that each QIAG93 isolate shares >98.9% sequence identity. The phylogenetic analysis and evolutionary distance (ED) estimation based on the structural polyprotein gene sequence showed that the QIAG9301 isolate is closely related to GETV South Korea strain (99.9% sequence identity and ED value 0.001) and Chinese GETV YN0540 strain (99.3% sequence identity ED value 0.007) than other Alphavirus species analyzed in this study. Both QIAG9032 and QIAG9303 isolate exhibited genetically close relationship with Mongolian GETV LEIV17741MPR strain (at least 99.3% sequence identity and mean ED value 0.0065). Therefore, our findings will be valuable for molecular epidemiological analyses of GETV in Korea and contribute to a further study on pathogenicity of three QIAG93 isolates in animals.
Alphavirus* ; Amino Acids ; Animals ; Asian Continental Ancestry Group ; Humans ; Korea* ; Microscopy, Electron ; Molecular Epidemiology ; Nucleotides ; Sequence Analysis ; Trees ; Virulence

BACKGROUND: The atheroma in aorta has been emphasized as a potential source of cerebral embolism after the wide use of TEE. But in Korea there has been no report on the frequency of the aortic atheroma in patients with cerbral infarctions. METHODS: Using transesophageal echocardiography, we evaluated aortic atheroma in the thoracic aorta of 44 patients with cerbral infarctions. The aortic atheroma was defined as a raised lesion with an irregular surface of echo shadow. RESULTS: The aortic atheromas were detected in 7 patients(16%) out of 44 patients with cerebral infarction. However, it were detected in only 3 patients out of 71 patients without cerebral infarction. The size of the lesions reaged from 6mm to 16mm(mean 10+/-3.5) and mobility were seen in 2 patients. The lesions were distributed throughout the thoracic aorta. CONCLUSION: Aortic atheroma is a potential source of cerebral infarction. TEE is a useful procedure for the evaluation of the patients with an undetermined cause of cerebral infarction.
Aorta ; Aorta, Thoracic ; Cerebral Infarction* ; Echocardiography, Transesophageal ; Humans ; Infarction ; Intracranial Embolism ; Korea ; Plaque, Atherosclerotic*

BACKGROUND/AIMS: Deterioration of renal function in cirrhotic patients with spontaneous bacterial peritonitis (SBP) is a predictor for in-hospital mortality; however, the clinical significance of renal dysfunction during bacterial infection other than SBP is unknown. The aim of this study was to investigate the prevalence and clinical significance of renal dysfunction due to bacterial infections other than SBP in patients with liver cirrhosis. METHODS: Retrospective data from inpatients with bacterial infections other than SBP were analyzed. RESULTS: Eighty patients were recruited for the analysis. The types of infections included that of urinary tract (37.5%), pneumonia (23.8%), biliary tract (20%), cellulitis (12.5%), and bacteremia of unknown origin (6.3%). Renal dysfunction developed in 29 patients (36.3%), of which 11 patients had irreversible renal dysfunction. The initial MELD score, neutrophil count, albumin, and blood pressure were significant risk factors in the univariate analysis, whereas only the MELD score was an independent risk factor for the development of renal dysfunction (p<0.001) after multivariate analysis. CONCLUSIONS: The prevalence of renal dysfunction during bacterial infection other than SBP in patients with liver cirrhosis was 36.3%, and its development was related to the severity of the liver disease. Occurrence of irreversible renal dysfunction seemed to affect the prognosis of these patients.
Bacteremia ; Bacterial Infections ; Biliary Tract ; Blood Pressure ; Cellulitis ; Humans ; Incidence ; Inpatients ; Liver Cirrhosis ; Liver Diseases ; Multivariate Analysis ; Neutrophils ; Peritonitis ; Pneumonia ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors ; Urinary Tract

Monoclonal gammopathies are associated with a wide range of renal diseases, including cast nephropathy, light chain amyloidosis, monoclonal immunoglobulin deposition diseases, and so on. We describe seven cases of monoclonal gammopathies involving kidney. The mean age was 61.6+/-3.6 years and male to female ratio was 1:1.3. Among 7 patients, diagnoses were cast nephropathy with light chain deposition disease, two light chain deposition diseases, three light chain amyloidosis and light chain deposition disease with light chain amyloidosis. Two cases were monoclonal gammopathy of undetermined significance and three cases were multiple myeloma in five cases underwent bone marrow biopsy. It showed that renal function was severly decreased in light chain deposition disease. It is clear that monoclonal gammopathies show various renal disease and clinical course in our cases. It is necessary to do renal biospy for adequate diagnosis and treatment even to old patients suspecting monoclonal gammopathy.
Amyloidosis ; Biopsy ; Bone Marrow ; Diagnosis ; Female ; Humans ; Immunoglobulins ; Kidney* ; Male ; Monoclonal Gammopathy of Undetermined Significance ; Multiple Myeloma ; Paraproteinemias*