BACKGROUND: Unilateral lung hyperinflation develops in lungs with asymmetric compliance, which can lead to vital instability. The aim of this study was to investigate the respiratory dynamics and the effect of airway diameter on the distribution of tidal volume during mechanical ventilation in a lung model with asymmetric compliance. METHODS: Three groups of lung models were designed to simulate lungs with a symmetric and asymmetric compliance. The lung model was composed of two test lungs, lung1 and lung2. The static compliance of lung1 in C15, C60, and C120 groups was manipulated to be 15, 60, and 120 ml/cmH₂O, respectively. Meanwhile, the static compliance of lung2 was fixed at 60 ml/cmH₂O. Respiratory variables were measured above (proximal measurement) and below (distal measurement) the model trachea. The lung model was mechanically ventilated, and the airway internal diameter (ID) was changed from 3 to 8 mm in 1-mm increments. RESULTS: The mean ± standard deviation ratio of volumes distributed to each lung (VL1/VL2) in airway ID 3, 4, 5, 6, 7, and 8 were in order, 0.10 ± 0.05, 0.11 ± 0.03, 0.12 ± 0.02, 0.12 ± 0.02, 0.12 ± 0.02, and 0.12 ± 0.02 in the C15 group; 1.05 ± 0.16, 1.01 ± 0.09, 1.00 ± 0.07, 0.97 ± 0.09, 0.96 ± 0.06, and 0.97 ± 0.08 in the C60 group; and 1.46 ± 0.18, 3.06 ± 0.41, 3.72 ± 0.37, 3.78 ± 0.47, 3.77 ± 0.45, and 3.78 ± 0.60 in the C120 group. The positive end-expiratory pressure (PEEP) of lung1 was significantly increased at airway ID 3 mm (1.65 cmH₂O) in the C15 group; at ID 3, 4, and 5 mm (2.21, 1.06, and 0.95 cmH₂O) in the C60 group; and ID 3, 4, and 5 mm (2.92, 1.84, and 1.41 cmH₂O) in the C120 group, compared to ID 8 mm (P < 0.05). CONCLUSIONS: In the C15 and C120 groups, the tidal volume was unevenly distributed to both lungs in a positive relationship with lung compliance. In the C120 group, the uneven distribution of tidal volume was improved when the airway ID was equal to or less than 4 mm, but a significant increase of PEEP was observed.
Airway Obstruction ; Compliance ; Lung Compliance* ; Lung* ; Positive-Pressure Respiration ; Positive-Pressure Respiration, Intrinsic ; Respiration, Artificial ; Tidal Volume ; Trachea ; Ventilation

No abstract available.
Child ; Child, Orphaned* ; Humans

Nine patients of mean age 47.8 years, with suspected sinus node dysfunction, underwent extensive electrophysiological studies. Sinus bradycardia(6the electrophysiological study, AH and HV intervals were prolonged in 2/9 and 1/9 patients, respectively. Maximal sinus node recovery times were prolonged in 7/9 patients, ranging from 1,330 msec to 12,330msec. Sinoatrial conduction times measured by atrial premature stimulation technique were prolonged in 5/7 patients, ranging from 137msec to 310 msec. And sinoatrial conduction time measured by continuous pacing technique also revealed prolonged value in 4/6 patients ranging from 140 msec to 195 msec. The effective refractory periods, of atrium were prolonged in 6/8 patients (320 msec to 470 msec). The effective and functional refractory periods of AV node were prolonged in 3/8 patients (440 csec to 490 msec) and 4/8 patients (530 msec to 560 msec), respectively. Retrograde VA conduction could be observed in 3/7 patients and ventricular effective refractory periods were normal in 7/7 patients. Atrial flutter was induced in 1/9 patients by electric stimulation during electrophysiological study. Above data suggest that the electrophysiological study is very useful in assessing the sinus node function and other electrophysiological properties in sick sinus syndrome patients and also suggest that the data could be utilized in choosing the proper mode of artificial pacemaker for each patient.
Atrial Flutter ; Atrioventricular Node ; Electric Stimulation ; Humans ; Pacemaker, Artificial ; Sick Sinus Syndrome* ; Sinoatrial Node

Lesch-Nyhan disease (LND) is a rare X-linked recessive inherited purine metabolic disorder that accompanies neurodevelopmental problems. Neurofibromatosis type 1 (NF1) is a relatively common autosomal dominant inherited genetic disorder characterized by tumors in various systems. Some children with NF1 also accompanies neurodevelopmental problems.Here, we describe a 5-year-old boy with a maternally inherited pathogenic variant in NF-1 and hypoxanthine-guanine phosphoribosyltransferase (HPRT ). He was referred for severe neurodevelopmental impairment and hyperuricemia. His mother was diagnosed with NF1 and the patient was also suspected of having NF1 because of cafe au lait macules. He had dystonia, rigidity, cognitive deficit, and speech/language impairment. Serum and urine uric acid concentrations were elevated. He had more severe neurodevelopmental delay than patients with only NF1, so his clinical symptoms could not be fully understood by the disease alone. To find the cause of his neurologic symptoms and hyperuricemia, the patient and his mother underwent a whole-exome sequencing test. As a result, the pathogenic variant c.151C>T (p.Arg51Ter) in HPRT1 was identified as hemizygote in the patient and heterozygote in his mother. The pathogenic variant c.7682C>G (p.Ser2561Ter) in NF-1 was identified as heterozygotes in both of them. Although the clinical symptoms of both diseases were overlapping and complicated, genetic testing was helpful for accurate diagnosis and treatment. Therefore, we suggest to consider preemptive genetic evaluation if there are symptoms not sufficiently explained by known existing diseases. And it is considered valuable to review this rare case to understand the clinical course and possible synergic effects of these diseases.

PURPOSE: To evaluate the effectiveness of simultaneous phacoemulsification, pars plana vitrectomy, the removal of posterior intraocular foreign body(IOFB), and primary intraocular lens implantation(IOL). METHODS: Simultaneous phacoemulsification, pars plana vitrectomy, the removal of posterior IOFB, and primary IOL implantation were performed in 10 eyes of 10 patients with ocular perforation and traumatic cataract due to posterior IOFB. The results showed no retinal detachment and endophthalmitis based on retrospective analysis. RESULTS: The follow-up period ranged from 3 to 45months(mean 19.6 months). In 8 eyes(80%), the final visual acuity was better than 0.9 but in remaining 2 eyes, it was less than 0.5 due to postoperative retinal detachment. There were enlargement of posterior capsule rupture and vitreous prolapse into anterior chamber in 2 cases, and lens dislocation into the vitreous cavity in 1 case during phacoemulsification. IOL was implanted into the bag in 4 eyes and into the ciliary sulcus without scleral fixation in remaining 6 eyes. CONCLUSIONS: Simultaneous phacoemulsification, pars plana vitrectomy, the removal of IOFB, and primary IOL implantation is a relatively safe operation. It provides rapid rehabilitation of the visual acuity and helps to save time and money in selected patients without the large posterior capsule rupture, retinal detachment, endophthalmitis and injury of macula and center of cornea due to IOFB.
Anterior Chamber ; Cataract ; Cornea ; Endophthalmitis ; Follow-Up Studies ; Foreign Bodies* ; Humans ; Lens Implantation, Intraocular* ; Lens Subluxation ; Lenses, Intraocular* ; Phacoemulsification* ; Prolapse ; Rehabilitation ; Retinal Detachment ; Retrospective Studies ; Rupture ; Visual Acuity ; Vitrectomy*

PURPOSE: Obesity has recently emerged as a significant health problem in the pediatric population, and the prevalence of non-alcoholic fatty liver disease is increasing in tandem with a significant rise in childhood obesity. Therefore, this study was conducted to clarify the risk factors of non-alcoholic steatohepatitis in obese children. METHODS: We enrolled 84 obese children who visited the pediatric obesity clinic at Yeung-Nam university hospital. The patients were divided into two groups based on their alanine aminotransferase (ALT) level (separated at 40 IU/L), and the mean of ages, total cholesterol levels, HDL-cholesterol levels, LDL-cholesterol levels, triglyceride (TG) levels, as well as the mean obesity index, and body fat percentage of the two groups were then compared. RESULTS: When the mean of ages (10.5+/-1.6 vs. 10.7+/-2.0 years), total cholesterol levels (183.0+/-29.1 vs. 183.7+/-31.3 mg/dL), HDL-cholesterol levels (53.0+/-10.2 vs. 55.7+/-13.0 mg/dL), LDL-cholesterol levels (113.4+/-30.2 vs. 113.0+/-30.0 mg/dL), triglyceride levels (99.4+/-62.9 vs. 114.2+/-47.3 mg/dL), obesity indexes (44.7+/-12.2 vs. 47.9+/-15.1%), and body fat percentages (32.7+/-5.0 vs. 34.0+/-4.8%) of group 1 (ALT< or =40 IU/L) were compared with those of group 2 (ALT> or =41 IU/L), no significant differences were observed (p>0.05). However, hypertriglyceridemia (TG> or =110 mg/dL) was more frequent in group 2 than in group 1 (p=0.023). CONCLUSION: TG may be an important risk factor in non-alcoholic steatohepatitis and further study regarding the risk factors in non-alcoholic steatohepatitis is required.
Adipose Tissue ; Alanine Transaminase ; Child ; Cholesterol ; Fatty Liver* ; Humans ; Hypertriglyceridemia ; Obesity ; Pediatric Obesity* ; Prevalence ; Risk Factors* ; Triglycerides

PURPOSE: Obesity has recently emerged as a significant health problem in the pediatric population, and the prevalence of non-alcoholic fatty liver disease is increasing in tandem with a significant rise in childhood obesity. Therefore, this study was conducted to clarify the risk factors of non-alcoholic steatohepatitis in obese children. METHODS: We enrolled 84 obese children who visited the pediatric obesity clinic at Yeung-Nam university hospital. The patients were divided into two groups based on their alanine aminotransferase (ALT) level (separated at 40 IU/L), and the mean of ages, total cholesterol levels, HDL-cholesterol levels, LDL-cholesterol levels, triglyceride (TG) levels, as well as the mean obesity index, and body fat percentage of the two groups were then compared. RESULTS: When the mean of ages (10.5+/-1.6 vs. 10.7+/-2.0 years), total cholesterol levels (183.0+/-29.1 vs. 183.7+/-31.3 mg/dL), HDL-cholesterol levels (53.0+/-10.2 vs. 55.7+/-13.0 mg/dL), LDL-cholesterol levels (113.4+/-30.2 vs. 113.0+/-30.0 mg/dL), triglyceride levels (99.4+/-62.9 vs. 114.2+/-47.3 mg/dL), obesity indexes (44.7+/-12.2 vs. 47.9+/-15.1%), and body fat percentages (32.7+/-5.0 vs. 34.0+/-4.8%) of group 1 (ALT< or =40 IU/L) were compared with those of group 2 (ALT> or =41 IU/L), no significant differences were observed (p>0.05). However, hypertriglyceridemia (TG> or =110 mg/dL) was more frequent in group 2 than in group 1 (p=0.023). CONCLUSION: TG may be an important risk factor in non-alcoholic steatohepatitis and further study regarding the risk factors in non-alcoholic steatohepatitis is required.
Adipose Tissue ; Alanine Transaminase ; Child ; Cholesterol ; Fatty Liver* ; Humans ; Hypertriglyceridemia ; Obesity ; Pediatric Obesity* ; Prevalence ; Risk Factors* ; Triglycerides

The clinical value of the pre-(165 pts) and post-operative(149 pts) serum levels of carcinoembryogenic antigen(CEA) in 190 patients(pts) with colorectal cancer was investigated, who had a curative surgery and an abnormally elevated levels of CEA (> or=5 ng/ml) at Department of General Surgery, Chonbuk National University Hospital during 1989 to 1996. The results are as follows: 1) The preoperative positive rates of CEA level were 49(29.7%) of 165 patients, so preoperative CEA level measurement was no usefulness for screening test of colorectal cancer. The incidence of preoperatively elevated CEA levels in Dukes stages A, B, C, and D were 0, 28.6, 32.8 and 42.9% respectively, There was significant association between increased proportion of patients with preopertive serum CEA(> OR = 5 ng/ml) and the progressive stages of colorectal cancers(P<0.05). 2) There was no significant association between the frequency of abnormal CEA level and histologic differentiation of tumor. 3) The recurrence rate was 16.4% and 30.6% in patients with preoperative CEA < 5 ng/ml and > OR =5 ng/ml, respectively(p<0.05). 4) In patients with recurrence, the lymph node positive group(70.6%) was larger than the negative(29.4%)(p<0.05), and preoperative positive rate of CEA value was 44%. 5) The recurrence rate in Dukes stages A, Bl, B2, Cl, C2, and D were 0, 8.7, 12.7, 16.7, 32.3, and 90.0% respectively(p<0.01). 6) There was no significant association between the frequency of abnormal CEA level and location of tumor. 7) The recurrence rate was 12.3% and 65.7% in patients with postoperative CEA < 5 ng/ml and > OR = 5 ng/ml, respectively(p<0.01). 8) In patients with metastasis, postoperative positive rate of CEA level was 63%(p< 0.01).
Colorectal Neoplasms ; Humans ; Incidence ; Jeollabuk-do ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Recurrence

Total abdominal hystrectomy is the most common surgery of Gynecology. It's complication are taken very important. Although neuropathy, especially femoral nerve injury, is rare, recently we have experienced a case of femoral neuropathy after total abdominal hystrectomy. We present this case with a brief review of literature.
Femoral Nerve* ; Femoral Neuropathy ; Gynecology

A pancreatic pseudocyst is a relatively rare complication of pancreatitis. Various factors, such as inflammatory process or trauma, are among the possible cause of pancreatitis. A pancreatic pseudocyst is often defined as a localized collection of pancreatic juice in the retroperitoneal area surrounded by a fibrous membrane devoid of an epithelial lining. The hospital records of 52 cases of pancreatic pseudocyst treated at Kyungpook National University Hospital from 1976 through 1994 were reviewed and analysed. The results are as follows : 1) The age distribution of these cases showed that 57.7% occurred in the 3rd and the 4th decades. The male to female ratio was 3.7 : 1 2) The etiology of the pseudocysts was pancreatitis in 46.2% of the cases and trauma, unknown etiology, pancreatic cancer and hyperlipidemia, in that order, in the other cases. 3) Abdominal pain was the most common symptom (86.4%); a palpable mass (65.4%), abdominal tenderness (65.3%) also occurred. 4) Abdominal C.T. and Ultrasonogram has a diagnostic accuracy as 100%, and U.G.I. showed a diagnostic accuracy of 76.5%. 5) Among the 52 cases, 30 cases received surgical treatment 13 cases were treated by percutaneous catheter drainage. 6) With respect to the operative procedure, internal drainage was performed in 18 cases (60%), external drainage in 8 cases (26.7%), excision in 3 cases (10.0%), and O & C in 1 case (3.3%). 7) Thirteen percutaneous catheter drainage procedures were performed, and the success rate was 92.3%.
Abdominal Pain ; Age Distribution ; Catheters* ; Drainage* ; Female ; Gyeongsangbuk-do ; Hospital Records ; Humans ; Hyperlipidemias ; Male ; Membranes ; Pancreatic Juice ; Pancreatic Neoplasms ; Pancreatic Pseudocyst* ; Pancreatitis ; Surgical Procedures, Operative ; Ultrasonography