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*

Two hundred sixty two patients of the essential blepharospasm and hemifacial spasm were treated with Botulinum toxin A (Oculinum(R)). A total of 620 treatments was given injections over a 3-year period. A reduction in spasm intensity was noted in most patients, and the mean response time of the essential blepharospasm and hemifacial spasm were 144.2 days and 172.3 days, respectively, There was no clear relationship between age, sex, toxin dose or preinjected spasm intensity, the amount of spasm reduction, and the mean response time. The mean respone time had no difference from the first through the fourth treatments; but in hemifacial spasm, the mean response time of the second treatment was longer than that of first, third and fourth treatments. The lagophthalmos and superficial punctate keratitis were the most frequent complications. As a result of the injection to avoid the center of the upper and lower eyelids, the frequency of complications could be minimized. There was no clear difference in the beneficial effect and the mcidence of complication (lagophthalmos) between toxin stored in the vaccum and in the non-vaccum state. Patients who were treated with lidocaine mixed toxin had a less effective result than those with saline-mixed toxin.
Blepharospasm* ; Botulinum Toxins* ; Eyelids ; Hemifacial Spasm* ; Humans ; Keratitis ; Lidocaine ; Reaction Time ; Spasm

OBJECTIVES: This study was performed to investigate the distribution of apolipoproteins A-I and B among Korean employees and their partners. METHODS: The study population consisted of 7,633 men and women (4,578 men and 3,054 women) residing in Seoul and Kyung-gee Do, with an average age of 43.5+/-8.3 years. Blood samples were collected following at least 12 hours of fasting. Apolipoproteins A-I and B were measured using a Behring Nephelometer analyzer. The body mass index (BMI) for each participant was calculated as weight (kg) divided by height squared (m2). Information on health-related behaviors such as exercise, alcohol intake, and smoking habits was collected through selfadministrated questionnaires. RESULTS: The mean concentrations of Apo A-I were 132.6+/-22.3 mg/dL and 142.9+/-24.8 mg/dL in the men and women, respectively. The concentration of Apo A-I increased significantly across all age categories of men. The mean concentrations of Apo B were 101.7+/-23.2 mg/dL and 87.8+/-23.5 mg/dL in the men and women, respectively, and Apo B increased significantly across all age categories for both the men and women. Exercise and BMI were major determinants for Apo A-I and B levels. The 10th percentile of Apo A-I concentration was 109 mg/dL in the men and 113 mg/dL in the women, and the 90th percentile of Apo B concentration was 131 mg/dL in the men and 118 mg/dL women. CONCLUSIONS: For the prevention of coronary artery disease, we recommend that for individuals in the 10th percentile of concentration for Apo A-I and the 90th percentile of concentration for Apo B, active preventive interventions such as weight loss and exercise should be taken. This study, within its limitations, may be useful for evaluating apolipoprotein A-I and B concentrations in Korean adults.
Spouses ; Smoking ; Questionnaires ; Middle Aged ; Male ; Korea/epidemiology ; Humans ; *Health Behavior ; Female ; Exercise ; Coronary Arteriosclerosis/blood/*prevention & control ; Body Mass Index ; Apolipoproteins B/*blood ; Apolipoprotein A-I/*blood ; Alcohol Drinking ; Adult

OBJECT: It is to evaluate the priority area for effective eye care service to the aged population of rural comniunity at present and in future. METHOD: Number of aged group surveyed on 60 and over 60 years age that, counted 531 among the total 580 patients. Visual acuity was tested and refractive error was measured by Retinornax (Nikon, Japan) . Ocular examination was performed to determine the causes of visual impairment. This survey was conducted under the auspices of the Korean Foundation for Prevention of Blindness with assistance of the Seoul National University Postgraduate School of Public Health from 1994 to 1996 at the Public Health Center of Chun-Cheon, Kang-Won Do(Province). RESULTS: Age distribution showed the sixties (60-69) 49,3%, the seventies (70-79) 33.9%, and the eighties (80) 16.8%. Proportion of visual acuity of 0.7 or upper in the better eyes constituted 32.2% and of 0.2 or worse 19.4%. Causes of visual impairnnente consisted of refractive errors 35. 9%, cataract 35. 9%, macular degeneration 7, 4%, and corneal opacity 3.9% in order. Contributed modes of care were spectacles 27.9%, surgeries 23.9% (cataract, operation, pterygium removal etc.), and medical treatment 23.9%. DISCUSSION: Surgery of the aged population in rural comrnunity of Chun-Cheon revealed the most. prevalent. causes of visual impairment as the refractive errors and cataract. It is suggested that. the most effective eye care would be provided systemically based 0 the result of the epidemiological study on the various ocular disorders.
Age Distribution ; Blindness ; Cataract ; Corneal Opacity ; Epidemiologic Studies* ; Eyeglasses ; Gangwon-do ; Humans ; Macular Degeneration ; Pterygium ; Public Health ; Refractive Errors ; Seoul ; Vision Disorders ; Visual Acuity

This survey comparing the primary causes of eye disease and visual impairment between rural and urban areas was conducted from the beginning of February through May of 1989. The outcome of that research on 686 residents (1372 eyes) of Buan-Kun, Chunbuk, and 997 residents (1994 eyes) of Dobong-Ku, Seoul, is as follows: 1. Of the basic ocular affections, pterygium was the most prevalent in Baun-Kun with 178 eyes (13.0%), while allergic and chronic conjunctivitis were in the majority in Dobong-Ku with 170 eyes (8.5%). 2. In causes of visual impairment, refractive error showed to be the main one in both Buan-Kun with 135 eyes (9.8%) and Dobong-Ku with 132 eyes (6.6%). 3. In rate of blindness, Buan-Kun had 7.0% monocular blindness and 3.2% of binocular blindness, while 4.1% of monocular blindness and 1.7% of binocular blindness were found in Dobong-Ku. 4. In causes of blindness, cataract (51.1%) was followed by macular degeneration (17.4%), corneal opacity (13.0%), and vascular retinopathy (9.8%) in Buan-Kun, while cataract (56.0%), macular degeneration (6.7%), corneal opacity (6.7%), and phthisis (6.7%) were recorded in that order in Dobong-Ku.
Adolescent ; Adult ; Aged ; Blindness/epidemiology ; Child ; Child, Preschool ; Eye Diseases/*epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Korea/epidemiology ; Male ; Middle Aged ; Random Allocation ; Vision Disorders/*epidemiology

Although meningioma is a common and benign intracranial tumor, meningioma en plaque is a rare tumor, especially in the cranial vault. Meningioma en plaque(MEP) usually occurs in the area of the sphenoid wing, and it causes cosmetic and visual problems, as well as the problems that are due to its mass effect. The authors present here a case of convexity meningioma en plaque that involved the skull and scalp with diffuse hyperostosis as the presenting salient radiological findings, which caused marked intraoperative bleeding.
Hemorrhage ; Hyperostosis* ; Meningioma* ; Scalp ; Skull*

Granulomatous mycosis fungoides is a rare type of cutaneous T-cell lymphoma. The patients with this illness do not present with distinct clinical findings, so the diagnosis depends on the demonstration of a malignant lymphoid infiltration in combination with a granulomatous tissue reaction. A 38-year-old woman presented with erythematous to purple-colored, focally atrophic, scaly plaques on the right inguinal area and diffuse erythematous scaly patches and multiple erythematous papules on the trunk. The histopathological findings showed non-necrotizing granulomatous infiltrates admixed with an atypical lymphocytic component and epidermotropism. Herein, we report a case of granulomatous mycosis fungoides.
Adult ; Female ; Granuloma ; Humans ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides

A case of chordoid meningioma occurring in a 61-year-old woman who did not have a Castleman's disease is presented. The patient had suffered from headache and motor dysphasia. Laboratory findings are normal. The tumor, located in the left frontal region and associated with peritumoral edema, was totally resected. Surgical specimen revealed a solid mass with irregular surface that measured 3.5 x 4.5 x 4cm. Immunohistochemical staining revealed that the tumor cells expressed epithelial membrane antigen(EMA) focally, but not S-100 protein and glial fibrillary acid protein (GFAP), and the Ki-67 proliferative index of the tumor was 9%. The neoplasm was diagnosed chordoid meningioma of the World Health Organization(WHO) grade II. After total resection, her preoperative headache and dysphasia were disappeared.
Aphasia ; Edema ; Female ; Giant Lymph Node Hyperplasia ; Glial Fibrillary Acidic Protein ; Headache ; Humans ; Membranes ; Meningioma* ; Middle Aged ; S100 Proteins ; World Health ; World Health Organization

OBJECTIVES: Controversial arguments exists on both the case for and against on the accumulation of mitochondrial DNA (mtDNA) deletion in association to tissue and age. The debate continues as to whether this mutation is a major contributor to the phenotypic expression of aging and common degenerative diseases or simply a clinical insignificant epiphenomenon. The objective of this study was to determine whether the accumulation of mtDNA deletion is correlated with age-related and tissue-specific variation. MATERIALS AND METHODS: One hundred and fifty-seven tissues from blood, ovary, uterine muscle, and abdominal muscle were obtained from patients ranging in age from 31~60 years. After reviewing the clinical reports, patients with mitochondrial disorder were excluded from this study. The tissues were obtained at gynecological surgeries with the consent of the patient. Total DNA isolated from blood, ovary, uterine muscle, and abdominal muscle was amplified by two rounds of PCR using two pairs of primers corresponding to positions 8225-8247 (sense), 13551-13574 (antisense) for the area around deleted mtDNA and 8421-8440 (sense), 13520-13501 (antisense) for nested PCR product. A statistical analysis was performed by c2-test. RESULTS: About 0% of blood, 94.8% of ovary, 71.4% of uterine muscle, and 86.1% abdominal muscle harbored mtDNA deletion. When we examined the proportion of deleted mtDNA according to age deletion rate was 90% of ovary, 63.6% of uterine muscle, 77.7% of abdominal muscle in thirties and 100% of all tissue in fifties. CONCLUSION: The findings of this study suggest that the mtDNA deletion is varied in tissue-specific pattern and increases with aging.
Abdominal Muscles ; Aging ; Animals ; DNA ; DNA, Mitochondrial* ; Female ; Gynecologic Surgical Procedures ; Humans ; Mice ; Mitochondrial Diseases ; Myometrium ; Ovary ; Polymerase Chain Reaction

BACKGROUND: Postpartum thyroiditis(PPT) is one of syndromes of thyroid dysfunction that occurs in the first year after parturition. Reported incidence of PPT is 3.9-8.2% of postpartum women in several studies from different countries. The fact that 52-100% of patients with PPT have thyroid autoantibodies, and that lymphocytic infiltration of thyroid gland is the characteristic pathological feature of PPT suggest that PPT is an autoimmune disease. High iodine intake in short term period is known to aggrevate the experimental autoimmune thyroiditis. This study was performed to investigate the incidence and clinical features of PPT in Korean postpartum women who usually ingest excessive amount of idine in immediate postpartum period and to investigate the predictive value of thyroid autoantibodies in the development of PPT in them. METHOD: Between March 1996 and February 1997, 99 women without previous history of any thyroid disease who delivered babies at Boramae hospital were enrolled. Thyroid function parameters(T3, T4, free T4, TSH), thyroid autoantibodies(anti-microsomal antibody, anti-thyroglobulin antibody) and urinary iodine excretion were measured prospectively before and 1, 3 months after delivery. Dietary iodine intake during postpartum period was evaluated by questionnaire, and clinical parameters were followed up. RESULTS: During 3 months of observation, PPT developed in 8.1%(8/99) of postpartum women. Five cases had typical course having thyrotoxic phase and the other 3 cases had hypothyroid phase without toxic phase. However, only one of those required thyroid hormone replacement therapy in the latter group. There were no differences in age, baseline thyroid function parameters, parity, percent cases with family history of thyroid disease between those developed PPT (n=8) and those did not develop PPT(n=91). Duration of high iodine intake(3.8 +- 0.5 wk. vs. 3.7 +- 0.8 wk., p>0.05), total ingested amount of high iodine diet(77 +- 28 vs. 79 +- 24 bowels of miyokguk, p)0.05), and the urinary iodine excretion(1.9 +- 1.4 mg/g creatinine vs. 3.7 +- 3.7mg/g creatinine, p0.05) at 1 month postpartum were not different between two groups. Of 99 total subjects, anti-microsomal antibody(AMA) was present in 13.1%(13/99) before delivery in their sera. Positive predictive value of the presence of AMA before delivery in predicting the development of PPT was 30.8%. CONCLUSION: The fact that incidence of PPT in normal Korean postpartum women who usually have high iodine intake in immediate postpartum period is not higher than those of other countries, and that there was no difference in the amount of iodine intake between those developed PPT and those did not suggest that high iodine intake in immediate postpartum period do not influence on the incidence of PPT. The presence of AMA before delivery had low specificity in prediction of development of PPT, so the measurement of AMA seems not to be a useful screening test.
Autoantibodies ; Autoimmune Diseases ; Creatinine ; Female ; Hormone Replacement Therapy ; Humans ; Incidence* ; Iodine* ; Mass Screening ; Parity ; Parturition ; Postpartum Period* ; Postpartum Thyroiditis* ; Prospective Studies ; Surveys and Questionnaires ; Sensitivity and Specificity ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis, Autoimmune