No abstract available.
Morphine*

Two cases of anesthetic experience with tracheoesophageal fietula with esophageal atresia have-been reported and the literature reviewed. On the fifth day of life, anesthesia was induced and maintained with nitrous oxide-oxygen- halothane using Ohio infant circle absorber, preceded by awake endotracheal intubation with the aid of intramuscular injection of succinylcholine chloride following preliminary oxygenation. Gastro-stomy was performed prior to surgery. Tracheoesophageal fistula was divided and the esophagus anastomosed. In the first case surgical manipulation of the lungs and trachea caused complete airway obstruction and momentary cardiac arrest, which was successfully treated with I.V. calcium gluconate and sodium bicarbonate. Both infants made otherwise uneventful recoveries. The importance of preliminary gastrostomy, atraumatic intubation, maintenance of adequate ventilation and circulation, frequent suctioning of airway secretions, and of treating pulmonary complications have been stressed.
Airway Obstruction ; Anesthesia* ; Calcium Gluconate ; Clinical Study* ; Esophageal Atresia* ; Esophagus ; Gastrostomy ; Halothane ; Heart Arrest ; Humans ; Infant ; Injections, Intramuscular ; Intubation ; Intubation, Intratracheal ; Lung ; Ohio ; Oxygen ; Sodium Bicarbonate ; Succinylcholine ; Suction ; Trachea ; Tracheoesophageal Fistula* ; Ventilation

OBJECTIVE: Among risk factors associated with cerebral infarction, cardiac factors are well known to be very important. However there were only few studies related to correlation between cardiac risk factors and stroke recurrence. So we tried to evaluate cardiac disease as a risk factor of recurrent cerebral infarction. METHOD: Subjects were 118 patients (62 male, 56 female) with cerebral infarction and were divided into first attack group as a control and recurred group. We evaluated the results of transesophageal echocardiographic study and other major risk factors and the results were compared in two groups using X2 test. RESULTS: Control group was 75 patients (39 male, 36 female), and recurred group was 43 patients (23 male, 20 female) and the mean ages were 62.8 years and 66.7 years, respectively. General transesophageal echocardiographic abnormalities were shown in 63 cases (84%) in control group and 40 cases (93%) in recurred group. Among the abnormal transesophageal echocardiographic findings, atherosclerosis of aorta was significantly higher in recurred group (49%) compared to control group (25%) (p<0.05), but there were no significant difference in aortic valve calcification, mitral calcification etc. Among the major risk factors of cerebral infarction, hypertension, diabetes, hyperlipidemia, and alcohol intake showed tendency of high incidence in the recurred group. Patients with abnormal EKG findings concurrent with abnormal transesophageal echocardiographic findings showed in 33 cases (44%) in control group, and 24 cases (56%) in recurred group, but there's no statistical significance. CONCLUSION: Our results do not support the hypothesis that TEE would be able to diagnose the cardiac risk factor for recurred cerebral infarction. However, the prevalence of atherosclerosis of aorta was significantly higher in recurrent group, so further studies would be needed.
Aorta ; Aortic Valve ; Atherosclerosis ; Cerebral Infarction* ; Echocardiography ; Echocardiography, Transesophageal* ; Electrocardiography ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Male ; Prevalence ; Recurrence ; Risk Factors* ; Stroke

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

PURPOSE: To evaluate the efficacy of intravitreal bevacizumab and subsequent trabeculectomy with mitomycin C (MMC) for neovascular glaucoma (NVG) in eyes that underwent previous 23-gauge transconjunctival sutureless vitrectomy (TSV). METHODS: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with NVG who underwent trabeculectomy with MMC after intravitreal bevacizumab (1.25 mg/0.05 mL) injection and compared the surgical outcomes according to 23-gauge TSV history. Surgical success was defined as an intraocular pressure (IOP) of ≥6 mm Hg and ≤21 mm Hg without additional glaucoma surgery or loss of light perception. The main outcome measures were postoperative IOP control, visual acuity, and complications. RESULTS: A total of 27 patients (27 eyes) were included; 12 patients with 23-gauge TSV history (TSV group) and 15 patients without vitrectomy history (nonvitrectomized group). The cumulative probability of success after trabeculectomy with MMC was 82.5% and 73.3% after one year for the TSV group and the nonvitrectomized group, respectively (p = 0.523). Mean IOP decreased from 37.3 ± 9.0 mm Hg preoperatively to 12.8 ± 6.2 mmHg at the final visit in the TSV group (p = 0.002). Mean IOP decreased from 40.3 ± 9.7 mm Hg preoperatively to 17.8 ± 11.7 mm Hg at the final visit in the nonvitrectomized group (p = 0.001). Preoperative and final IOP were not significantly different between the two groups. Complications were comparable between the groups. CONCLUSIONS: Intravitreal bevacizumab injection and subsequent trabeculectomy with MMC is an effective method for controlling IOP in patients with NVG associated with sutureless vitrectomy.
Glaucoma ; Glaucoma, Neovascular* ; Humans ; Intraocular Pressure ; Medical Records ; Mitomycin* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Trabeculectomy* ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate the efficacy of intravitreal bevacizumab and subsequent trabeculectomy with mitomycin C (MMC) for neovascular glaucoma (NVG) in eyes that underwent previous 23-gauge transconjunctival sutureless vitrectomy (TSV). METHODS: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with NVG who underwent trabeculectomy with MMC after intravitreal bevacizumab (1.25 mg/0.05 mL) injection and compared the surgical outcomes according to 23-gauge TSV history. Surgical success was defined as an intraocular pressure (IOP) of ≥6 mm Hg and ≤21 mm Hg without additional glaucoma surgery or loss of light perception. The main outcome measures were postoperative IOP control, visual acuity, and complications. RESULTS: A total of 27 patients (27 eyes) were included; 12 patients with 23-gauge TSV history (TSV group) and 15 patients without vitrectomy history (nonvitrectomized group). The cumulative probability of success after trabeculectomy with MMC was 82.5% and 73.3% after one year for the TSV group and the nonvitrectomized group, respectively (p = 0.523). Mean IOP decreased from 37.3 ± 9.0 mm Hg preoperatively to 12.8 ± 6.2 mmHg at the final visit in the TSV group (p = 0.002). Mean IOP decreased from 40.3 ± 9.7 mm Hg preoperatively to 17.8 ± 11.7 mm Hg at the final visit in the nonvitrectomized group (p = 0.001). Preoperative and final IOP were not significantly different between the two groups. Complications were comparable between the groups. CONCLUSIONS: Intravitreal bevacizumab injection and subsequent trabeculectomy with MMC is an effective method for controlling IOP in patients with NVG associated with sutureless vitrectomy.
Glaucoma ; Glaucoma, Neovascular* ; Humans ; Intraocular Pressure ; Medical Records ; Mitomycin* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Trabeculectomy* ; Visual Acuity ; Vitrectomy*

It is well known that the murine T helper cell clones are divided by their lymphokine secretory activities. One is the Th-1 cell, producing IL-2 and IFN after stimulation and the other is the Th-2 cell, producing the IL-4 and IL-5. This study was undertaken to evaluate the immunomodulatory properties of the bacterial lipopolysaccharide(LPS) on the lymphokine production in vivo and in vitro. The results were as follows: There were no effects on the lymphokine secretion by the in vitro treatment of the LPS. The in vivo treatment of the LPS decreases the capability of the production of IL-2 and IFN , whereas it increases the capability of IL-4 production. The altered capacity of the lymphokine production was recovered about 2 weeks after the treatment of the LPS. There were no differences on the lymphokine production between E-coli LPS and salmonella LPS. The capacity of the lymphokine production was the same in the treatment of a non-heated LPS or heated-LPS. The lymphokine production of the mice which were desensitized by the long term treatment of the LPS was not different from the control mice. The in vitro treatment of RU486 can block the alterations of the lymphokine production after the treatment of the LPS. In summary, one can tell that the LPS increases the secretion of the IL-4 through the endogenous secretion of the glucocorticoids.
Animals ; Clone Cells ; Glucocorticoids ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Mice ; Mifepristone ; Salmonella ; T-Lymphocytes* ; T-Lymphocytes, Helper-Inducer

No abstract available.
Mitral Valve*

OBJECTIVE: The purpose of this study is to evaluate the effectiveness and safety of aerobic exercise program in cardiac patients. METHOD: Twenty patients participated in 6 weeks of aerobic exercise with telemetry monitoring as an outpatient rehabilitation program. For the comparison of physiologic changes, we used graded exercise test (GXT) by means of modified Bruce protocol before and in 6 weeks after aerobic exercise training. Exercise prescription for cardiac rehabilitation was composed of intensity, mode, frequency and duration. By use of EKG telemetry and monitoring of blood pressure and Borg RPE (ratings of perceived exertion) scale, we were monitored patients status during exercise. RESULTS: In six weeks after aerobic exercise training, the hemodynamic and metabolic responses were improved and statistically significant parameters were as follows: exercise time, maximal METs, resting heart rate, maximal heart rate, submaximal rate pressure product, maximal expired volume, maximal oxygen consumption rate and anaerobic threshold. CONCLUSION: We concluded that six week cardiac rehabilitation program is useful and safe to improve the aerobic capacity for cardiac patients.
Anaerobic Threshold ; Blood Pressure ; Electrocardiography ; Exercise Test ; Exercise* ; Heart Rate ; Hemodynamics ; Humans ; Outpatients ; Oxygen Consumption ; Prescriptions ; Rehabilitation ; Telemetry