A two days old female baby was transferred to our hospital from local clinic due to respiratory difficulty. The baby was born at 38 weeks gestation through cesarian section in the clinic. At birth, the body weight of the baby was 2280 grams and the Apgar score at 1 minute and 5 minute were 5 and 7. The child had frothing about the nose and mouth, and regurgitated the first feeding almost immediately. Coughing and mild cyanosis were associated with regurgitation. She was diagnosed as distal tracheo-esophageal fistula with proximal esophageal atresia and transferred to our hospital for further evaluation and corrective surgery. She had no other congenital anomaly. The most common defect consists of a blind upper esophageal pouch and a fistula between the lower esophagus and trachea. The preferred surgical approach for treatment of the newborn with this disease is ligation of the defect and primary anastomosis of the esophageal segments by an extra-pleural approach. Proper placement of the tracheal tube is critical. It should be above the carina but below the tracheoesophageal fistula. Nitrous Oxide should be used with caution in a neonate without a gastrostomy, as diffusion of this gas into the distended stomach would be undesirable. The emergency operation was done under general anesthesia. She was tolerable anesthesia and operation. Special respiratory care and continuous antibiotic administration were done. She discharged 18 days later without significant pulmonary complication or sequelae.
Anesthesia ; Anesthesia, General ; Apgar Score ; Body Weight ; Child ; Cough ; Cyanosis ; Diffusion ; Emergencies ; Esophageal Atresia* ; Esophagus ; Female ; Fistula ; Gastrostomy ; Humans ; Infant, Newborn ; Intubation, Intratracheal ; Ligation ; Mouth ; Nitrous Oxide ; Nose ; Parturition ; Pregnancy ; Stomach ; Trachea ; Tracheoesophageal Fistula*

No abstract available.
Cervix Uteri* ; Female ; Pregnancy*

We recently encountered a patient with membranous obstruction of the inferior vena cava in whom the left superior intercostal and hemiazygos veins were dilated. At chest radiography, the dilation simulated the presence of a second aortic knob and descending thoracic aorta lateral to the originals, and an "aorta-in-aorta" appearance was thus created.
Aorta, Thoracic ; Humans ; Radiography ; Radiography, Thoracic* ; Thorax* ; Veins* ; Vena Cava, Inferior

Gefitinib is regarded as a relatively safe agent for the treatment of an advanced non-small cell lung cancer (NSCLC). Pulmonary toxicity such as interstitial lung disease associated with gefitinib is uncommon with an estimated all time incidence around 1% worldwide. Moreover, a case of gefitinib associated with pulmonary cystic changes has not been reported yet. In this report we present a case of progressive multiple air cystic changes in both lungs in a patient with NSCLC and intrapulmonary metastases who underwent a gefitinib therapy.
Antineoplastic Agents/*adverse effects ; Brain Neoplasms/secondary ; Carcinoma, Non-Small-Cell Lung/*drug therapy/secondary ; Cysts/*chemically induced ; Female ; Humans ; Lung/pathology ; Lung Diseases/*chemically induced ; Lung Diseases, Interstitial ; Lung Neoplasms/*drug therapy ; Middle Aged ; Quinazolines/*adverse effects

Thrombus-in-transit appears to increase the risk of mortality compared to pulmonary embolism alone and can require alteration in therapeutic plan. We present the case of a biatrial thromboembolus caught in transit across a patent foramen ovale diagnosed by intraoperative transesophageal echocardiogram in a 69-year-old female with acute pulmonary embolism and subsequent acute cerebral infarction. We suggest that echocardiography should be performed in a patient with suspected pulmonary thromboembolism to evaluate right heart function and diagnose emboli in transit.
Aged ; Cerebral Infarction ; Echocardiography ; Female ; Foramen Ovale, Patent* ; Heart ; Humans ; Mortality ; Pulmonary Embolism* ; Thrombosis*

BACKGROUND: Cisatracurium is a nondepolarizing muscle relaxant. It less likely release histamine and has better cardiovascular stability. It presumably undergoes pH and temperature- dependent, nonenzymatic chemical process, Hofmann reaction. In vitro studies, Hofmann reaction was enhanced with increasing pH, but, in vivo the influence of acid-base imbalance is not well defined. METHODS: To evaluate the effects of acid-base imbalance on the neuromuscular blockade of cisatracurium in the cat, we induced acid-base imbalance and performed cumulative dose-response studies. RESULTS: ED50 of the cisatracurium was significantly reduced in all groups. Dose-response curves from all acid-base imbalance groups did not have significant differences in slopes. But, all showed shift-to-left when compared with control curve, showing decreased ED50. Duration of action was not affected. Recovery index was significantly changed in respiratory and metabolic alkalosis. CONCLUSIONS: It may be concluded that acid-base imbalance significantly augmented the potency of cisatracurium, but, changes of recovery index in this study may be resulted from systemic instability such as unstable hemodynamic state by the prolonged experiment.
Acid-Base Imbalance* ; Alkalosis ; Animals ; Cats* ; Chemical Processes ; Hemodynamics ; Histamine ; Hydrogen-Ion Concentration ; Neuromuscular Blockade*

BACKGROUND: Since 1982, many countries has reported outbreaks or sporadic cases caused by enterohaemorrhagic Escherichia coli (EHEC) serogroup strains, mainly E. coli O157:H7 type strain. However, systemic investigation about EHEC agents, including E. coli O157:H7, have not been done in Korea. Therefore, we investigated serogroup and verotoxin productivity of E. coli strains isolated from diarrheal patients and estimated risk of human infection in comparison with the EHEC strains isolated from cow, pig, and food material in Korea. METHODS: Diarrheal patient stool samples were collected and E. coli strains were isolated, according to biochemical characteristics. In order to isolate E. coli O157:H7, D-Sorbitol negative E. coli strains were selected. Serogrouping of the E. coli isolates was done by agglutination test. Verocytotoxin productivity was investigated by polymerase chain reaction (PCR) and reversed passive latex agglutination (RPLA). Human infection risk was estimated in comparison with EHEC strains isolated from cow, pig and food materials in Korea. RESULTS: Twenty-five E. coli strains were isolated from the diarrheal patients who were suspected to be infected with EHEC. However, none of these E. coli strains produced verocytotoxin. Out of 25 E. coli isolates, 16 serogroups of E. coli O1, O6, O8, O15, O20, O25, O26, O28, O29, O44, O86a, O119, O126, O128, O152 and 157:H- were found. In each of the E. coli O157:H- and O25 serogrorps 3 strains were found. CONCLUSION: None of 25 E. coli isolated from diarrheal patients who were suspected of EHEC infection produced verocytotoxin producing E. coli have been reported recently in Korea.
Agglutination ; Agglutination Tests ; Disease Outbreaks ; Efficiency* ; Enterohemorrhagic Escherichia coli ; Escherichia coli* ; Escherichia* ; Humans ; Korea* ; Latex ; Polymerase Chain Reaction ; Shiga Toxins

PURPOSE: We tried to evaluate whether high resolution chest CT with a 1,024 matrix has a significant advantage in image quality compared to a 512 matrix. MATERIALS AND METHODS: Each set of 512 and 1024 matrix high resolution chest CT scans with both 0.625 mm and 1.25 mm slice thickness were obtained from 26 patients. Seventy locations that contained twenty-four low density lesions without sharp boundary such as emphysema, and forty-six sharp linear densities such as linear fibrosis were selected; these were randomly displayed on a five mega pixel LCD monitor. All the images were masked for information concerning the matrix size and slice thickness. Two chest radiologists scored the image quality of each arrowed lesion as follows: (1) undistinguishable, (2) poorly distinguishable, (3) fairly distinguishable, (4) well visible and (5) excellently visible. The scores were compared from the the aspects of matrix size, slice thickness and the different observers by using ANOVA tests. RESULTS: The average and standard deviation of image quality were 3.09 (+/-.92) for the 0.625 mmx512 matrix, 3.16 (+/-.84) for the 0.625 mmx1024 matrix, 2.49 (+/-1.02) for the 1.25 mmx512 matrix, and 2.35 (+/-1.02) for the 1.25 mmx1024 matrix, respectively. The image quality on both matrices of the high resolution chest CT scans with a 0.625 mm slice thickness was significantly better than that on the 1.25 mm slice thickness (p < 0.001). However, the image quality on the 1024 matrix high resolution chest CT scans was not significantly different from that on the 512 matrix high resolution chest CT scans (p = 0.678). The interobserver variation between the two observers was not significant (p = 0.691). CONCLUSION: We think that 1024 matrix image reconstruction for high resolution chest CT may not be clinically useful.
Emphysema ; Fibrosis ; Humans ; Image Processing, Computer-Assisted* ; Masks ; Observer Variation ; Thorax* ; Tomography, X-Ray Computed*

No abstract available.
Korea* ; Salmonella*

No abstract available.
Adenocarcinoma* ; Myxoma*