In the developed countries in Europe and the United States, The spinal tuberculosis is of no serious problem due to the developed anti-tuberculotic agents and the advanced operative techniques. However, in Korea poor economic and other conditions prevent many patienta from getting proper treatments for spinal tuberculosis. We analysed 45 cases of spinal tuberculosis who were treated at our department during three years from June, 1972 to June, 1975 by operative treatment and being compared with these results that obtained conservative treatment. The results were obtained as follows; 1. There was most common in below 9 years old (28.9%) and common age incidence was below 35 years old (68.8), The sexual incidence was 22 in male and 23 in female. 2. Lower thoracic and upper lumbar were mostly involved, i.e thoracic (52.2%), lumbar (32.7%), thoraco-lumbar in orders. 3. Two affected vertebra was most common in 33 cases, number of affected vertebra averaged 2.5. 4. In laboratory finding, E.S.R. that was 50–60 mm/hr. in average of then admission wss shifted as normal range of 10–20 mm/hr. after cure of 5–6 months. 5. In 28 cases of operative treatment, anterior spinal fusion was done in 19 cases (67.9%), posterior spinal fusion in 8 cases(28.6%), one case(3.5%) was treated by thoracotransversectomy. 6. In consequence of pathologic exaraination and A.F.B. stain, the case of tuberculotic constitution was 18 in tissue pathology, and that of positive reaetion was 9 in direct smear for A.F.B. 7. The case that tuberculosis was limited at spine and was not found in other organs was 27, it got from 60% of the whole. 8. Average kyphotic angle of the thoracic region after operation was 4.3°, in 6 months was reduction of 1.8°, that of lumbar region after operation was 1.2°, in 6 months was reduction after operation was reduction of 0.7°, as change of radiologic kyphosis. 9. As a result of being cured during 18 months by operative or conservative methods, not a case is found in activity.
Constitution and Bylaws ; Developed Countries ; Europe ; Female ; Humans ; Incidence ; Korea ; Kyphosis ; Lumbosacral Region ; Male ; Pathology ; Reference Values ; Spinal Fusion ; Spine ; Tuberculosis ; Tuberculosis, Spinal ; United States

PURPOSE: The purpose of study was to identify violence episodes by patients and/or their guardians and responses from emergency room nurses. METHOD: A convenient sample of 172 emergency nurses was selected from general hospitals with more than 200 beds. A survey design was used and data were collected from October 2 to October 11, 2006. using self-report questionnaires which were developed by the authors. Descriptive statistics, with the SPSS PC program were used to analyze the data. RESULTS: The majority of nurses (97.1%) had experienced violence by patients or their guardians in the previous month. Violence offenders who were drunk comprised 68.6% of total offenders. Causes of violence were delays in examination and treatment (59.9%). The major coping behavior in dealing with violence episodes was ignoring (40.1%). Responses to violence experienced by emergency nurses were rated as 2.39. Response to violence according to general characteristics of the nurses showed no statistically significant differences. CONCLUSION: Considering the high prevalence of violence experienced by emergency nurses, hospitals must develop and manage preventive education programs and policy.
Adaptation, Psychological ; Criminals ; Education ; Emergencies* ; Emergency Service, Hospital* ; Hospitals, General ; Humans ; Prevalence ; Surveys and Questionnaires ; Violence*

BACKGROUND: A prototype airway management device, a laryngeal tube, has been recently introduced in Korea. This study was designed to assess the efficacy of the laryngeal tube for airway management under general anesthesia. METHODS: We studied thirty-six ASA physical status I and II patients undergoing general anesthesia. Anesthesia was induced with sleep dose propofol 2.0 mg/kg i.v., supplemented with fentanyl 1 microgram/kg, and maintained with 50% nitrous oxide and propofol. After inserting the laryngeal tube, its cuff was inflated using a balloon cuff gauge until the intracuff pressure reached approximately 65 cmH2O. Adequacy of ventilation was assessed by observing the end tidal carbon dioxide wave form, chest wall movement and by stethoscope auscultation. Oropharyngeal leak pressure was also measured. Changes in heart rate, blood pressure, end-tidal carbon dioxide, airway pressure and oxygen saturation before induction, before insertion, 2, 5 and 10 minutes after insertion and 5 minutes after incision were recorded. RESULTS: The first time success rate at achieving an effective airway was 30 in 36 (83%). The mean leak pressure was 22.9+/-4.6 mmHg. Heart rate, blood pressure, oxygen saturation, end-tidal carbon dioxide and airway pressure values remained stable during laryngeal tube insertion and during the surgical procedure. CONCLUSIONS: We conclude that the laryngeal tube is easy to place, allows adequate ventilation and has a lower incidence of complications. It may offer an alternative device for the oxygenation of non-intubated patients undergoing general anesthesia.
Airway Management ; Anesthesia ; Anesthesia, General* ; Auscultation ; Blood Pressure ; Carbon Dioxide ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Korea ; Nitrous Oxide ; Oxygen ; Propofol ; Stethoscopes ; Thoracic Wall ; Ventilation

Polypoid tumors of the gallbladder are diagnosed very rarely in children; there are only 13 cases of childhood gallbladder polyps reported in the medical literature worldwide. Unlike those found in adults that consist mostly of cholesterol, polypoid tumors in children tend to have variable pathologic features. For pediatric patients, cholecystectomy is recommended either when the polyp is larger than 1 cm or when it causes significant symptoms. But close observation with serial abdominal sonography is sufficient in most asymptomatic pediatric patient. Recently, we experienced a 15-year-old boy with gallbladder polyps who presented with recent onset abdominal pain and nausea. A cholecystectomy using peritoneoscope was performed. The pathologic examination of the polyp revealed a tubular adenoma.
Abdominal Pain ; Adenoma ; Adolescent ; Adult ; Child* ; Cholecystectomy ; Cholesterol ; Gallbladder ; Humans ; Laparoscopes ; Male ; Nausea ; Polyps* ; Urinary Bladder*

BACKGROUND: Most surgeons prefer delivering cardioplegia alternatively via the aortic root and coronary sinus in patients undergoing coronary artery bypass graft surgery (CABG). Recently, some surgeons have delivered cardioplegia via the grafted vessel to the obstructed right coronary artery in order to preserve right ventricular function whenever retrograde cardioplegia is delivered. Thus, we have compared the effect on right ventricular preservation between the aforementioned two methods after cardiopulmonary bypass in patients undergoing a right CABG. METHODS: Twenty-eight patients undergoing an elective CABG with significant right coronary artery obstructive disease were allocated into 2 groups. In the alternative cardioplegia delivery group (A-group), cold blood cardioplegia was delivered via the aortic root and coronary sinus alternatively. In the simultaneous cardioplegia delivery group (S-group), cold blood cardioplegia was delivered via the coronary sinus and grafted vessel to the obstructed right coronary artery simultaneously. Hemodynamic measurements were obtained pre-bypass, at pericardial closure and at sternal closure. Data recorded included right ventricular ejection fraction, right ventricular volume index and right and left ventricular hemodynamics. RESULTS: There was no significant difference in the right ventricular ejection fraction between the two groups at pre-bypass, pericardial closure and sternal closure. In both groups, the right ventricular ejection fraction and cardiac index were not decreased, and the left ventricular ejection fraction was higher at pericardial closure than pre-bypass. However, in both groups, there was a decrease in the right andleft ventricular stroke work index and right ventricular stroke volume index at sternal closure. CONCLUSIONS: We have concluded that simultaneous cardioplegia delivery via the coronary sinus and grafted vessel to the obstructed right coronary artery was not superior to the alternative cardioplegia delivery via the aortic root and coronary sinus for preservation of right ventricular function in patients undergoing a right CABG.
Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Sinus ; Coronary Vessels* ; Heart Arrest, Induced* ; Hemodynamics ; Humans ; Stroke ; Stroke Volume ; Transplants ; Ventricular Function, Right

Recent genomewide association studies of large samples have identified genes that are associated with blood pressure. The Global Blood Pressure Genetics (Global BPgen) and Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) consortiums identified 14 loci that govern blood pressure on a genomewide significance level, one of which is CASZ1 confirmed in both Europeans and Asians. CASZ1 is a zinc finger transcription factor that controls apoptosis and cell fate and suppresses neuroblastoma tumor growth by reprogramming gene expression, like a tumor suppressor. To validate the function of CASZ1 in blood pressure, we decreased Casz1 mRNA levels in mice by siRNA. Casz1 siRNA reduced mRNA levels by 59% in a mouse cell line. A polyethylenimine-mixed siRNA complex was injected into mouse tail veins, reducing Casz1 mRNA expression to 45% in the kidney. However, blood pressure in the treated mice was unaffected, despite a 55% reduction in Casz1 mRNA levels in the kidney on multiple siRNA injections daily. Even though Casz1 siRNA-treated mice did not experience any significant change in blood pressure, our study demonstrates the value of in vivo siRNA injection in analyzing the function of candidate genes identified by genomewide association studies.
Aging ; Animals ; Apoptosis ; Asian Continental Ancestry Group ; Blood Pressure ; Cell Line ; Cohort Studies ; Gene Expression ; Genome ; Heart ; Humans ; Kidney ; Mice ; Neuroblastoma ; RNA, Messenger ; RNA, Small Interfering ; Transcription Factors ; Veins ; Zinc Fingers

BACKGROUND: Telomerase activity in precancerous conditions of lung adenocarcinomas has not been well studied. This study is designed to investigate the role of telomerase in premalignant lesions of urethane-induced mouse lung adenocarcinoma. METHODS: We harvested A/J mouse lung tissues at 3, 6, 9, 12, 28, 41, and 48 weeks after intraperitoneal urethane treatment, and classified each lesion in terms of histologic findings. We examined telomerase activity using a modified version of the telomeric repeat amplification protocol assay using both gel-based and enzyme linked immunosorbent assay methods. An immunohistochemical analysis of proliferating cell nuclear antigen (PCNA) was performed. RESULTS: In urethane-induced mouse lung tissues, it was sequentially developed from hyperplasia, adenoma, and eventually to adenocarcinoma. Telomerase activity began to show a positive level in tissues with no histologically visible nodule after urethane administration. It revealed a statistically significant increase in hyperplasia compared to the "control" lung tissue (p<0.05), which was proportionally elevated relative to adenoma and adenocarcinoma. There was a direct correlation between telomerase activity and the PCNA labeling index (p<0.05). CONCLUSIONS: The elevation of telomerase activity in normal-appearing lung lesions is thought to be a possible marker of early detection of pulmonary adenocarcinoma.
Adenocarcinoma ; Adenoma ; Animals ; Cell Transformation, Neoplastic ; Enzyme-Linked Immunosorbent Assay ; Hyperplasia ; Lung ; Mice ; Precancerous Conditions ; Proliferating Cell Nuclear Antigen ; Telomerase ; Urethane

A 56-year old female who had an atrial septal defect with tricuspid regurgitation received a patch repair and tricuspid annuloplasty. During weaning from cardiopulmonary bypass (CPB), bright red blood filled the endotracheal tube and breathing circuit. We suctioned the blood through the endotracheal tube. The bleeding was massive (about 400 ml) but the airway could be cleared with endotracheal suction. We irrigated endotracheal tube with normal saline with phenylephrine. The weaning of CPB was done and protamine was administered. The bleeding ceased when protamine was administered. Weaning from CPB was accomplished uneventfully. We found a little bleeding in the right main stem bronchus by flexible bronchoscopy but did not do any more procedures. In the intensive care unit, the patient had stable vital signs and good respiratory function. The patient was extubated without any problems at postoperative 1 day and transferred to ward without any complications.
Bronchi ; Bronchoscopy ; Cardiopulmonary Bypass* ; Female ; Heart Septal Defects, Atrial ; Hemoptysis* ; Hemorrhage ; Humans ; Intensive Care Units ; Middle Aged ; Phenylephrine ; Respiration ; Suction ; Tricuspid Valve Insufficiency ; Vital Signs ; Weaning

The objective of this study was to evaluate the relationship between beta-galactosidase activity in urine, in serum and urinary N-acetyl-beta-glucosarminidase activity as an early indicator of renal effect and mercurT concentration in urine and blood, reflecting the intensity of exposure to or the amount of body burden of mercury. This study was carried out among 70 workers exposed to mercury vapor and 63 non-exposed workers as a reference. The results were as follows ; 1. The mean concentration of urinary mercury (43.5 microgram/1) in exposed subjects was about nine times higher than that of non-exposed subjects, but the mean values of blood mercury were not different from each other 2. The mean values of beta-galactosidase activity in urine (119.7micromoleMU/h/g creatinine) and in blood (73.7 moIMU/H/l) of mercury-exposed subjects were significantly higher than those of non-exposed subjects. 3. In mercury-exposed subjects, beta-galactosidase activities in urine (r=0.38, p<0.01) and in serum (r=0.26, p<0.05) were correlated to urinary mercury concentration, but not to blood mercury concentration. The urinary excretion of beta-galactosidase activity was closely associated with urinary mercury concentration in the result of the multiple regression analysis. 4. The urinary beta-galactosidase activity in exposed subjects increased as the urinary mercury increased, and in the exposed subjects with more than 50microgram/1 of urinary mercury was highly related to urinary beta-galactosidase activity(r=0.47, p<0.05). 5. Among exposed subjects with more than 50microgram/l of urinary mercury, 20.0% of them showed abnormal value of urinary beta-galactosidase activity.
beta-Galactosidase* ; Body Burden

This study was performed to estimate the rate of boosted reaction in the two-step tuberculin skin test (TST) and to evaluate the associated factors among military personnel of South Korea, which has an intermediate burden of tuberculosis (TB) and a routine bacille Calmette-Guerin (BCG) vaccination policy. Two-step TST was performed on 264 military personnel who did not have a history of close contact to TB. Subjects with a negative reaction to the first test of <10 mm had a second TST applied 1 week later on the other forearm. A positive result (> or =10 mm) on the initial TST was observed in 126 (48%) of the subjects. A boosted reaction on the second TST developed in 32 (23%) of the 124 subjects with a negative initial TST. In multiple logistic regression analysis, the size of the initial TST reaction was the only factor associated with a boosted reaction on the second TST. The high rate of boosted reaction among healthy adults in South Korea suggests that two-step TST should be performed to assess the baseline TST reactivity in settings with an intermediate burden of TB and routine BCG vaccination policy, especially among subjects with an initial TST reaction that is > or =5 mm.
Adult ; BCG Vaccine/*administration & dosage ; Humans ; Hypersensitivity/*diagnosis ; Incidence ; Korea/epidemiology ; Logistic Models ; Male ; Middle Aged ; *Military Personnel/statistics & numerical data ; Prevalence ; *Tuberculin Test ; Tuberculosis, Pulmonary/*diagnosis/epidemiology/prevention & control