No abstract available.

OBJECTIVES: The purposes of this study were to estimate the effect of mandibular advancement device (MAD) and to evaluate the influence of the advancement amount of mandible in the application of MAD for obstructive sleep apnea (OSA) patients. METHODS: From the patients who were diagnosed as OSA by polysomnographic study at Seoul National University Bundang Hospital from January 2007 to February 2009, the patients who chose MAD as treatment option were included in this study. All the patients' data including clinical records and polysomnographic studies (both pre- and post-treatment) were reviewed and analyzed. RESULTS: Successful results were obtained in 65 patients of 86 patients (75.6%). In the follow-up period, mild discomfort of anterior teeth or temporomandibular joint (TMJ) were described in 28 patients, especially in the cases the amount of mandibular advancement were more than 7.0 mm. There was no direct relationship between the amount of mandibular advancement and clinical outcome. CONCLUSION: MAD was effective treatment option for the OSA patients regardless of severity. For the prevention of potential dental complications, the amount of mandibular advancement should be considered at the time of MAD treatment.
Adenine Nucleotides ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Advancement ; Mycophenolic Acid ; Sleep Apnea, Obstructive ; Temporomandibular Joint ; Tooth

Congenital tuberculosis is an infection that is established in the fetus by hematogenous spread or by the aspiration or inhalation of infected amniotic fluid either before or during labor. The diagnosis can be confirmed only if both the tuberculous nature of the lesion and the antenatal origin of the infection can be proved. The authors analysed roentgen findings of two cases of pulmonary tuberculosis, thought to be congenital; 1. Diffuse distribution of nodular densities and some confluent densities were seen in the entire lungs in the inital film.The pulmonary markings were decreased in some degree. 2. Air bronchogram was noted. 3. Hepatosplenomegaly was associated.
Amniotic Fluid ; Diagnosis ; Female ; Fetus ; Inhalation ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary

Although ultrasonography replaced many invasive studies in biliary tract diseases, direct cholangiography does still play an important role in the diagnosis and management of choledocholithiasis. Endoscopoic retrograde cholangiography (ERC) is regarded as the best method in evaluation of exact extent of the disease and its frequent complication, cholangitis. Authors analysed 56 cases of choledocolithiasis diagnosed by ERC and compared these with ERC in 18 cases of normal, 22 cases of cholecystitis, 15 cases of clonorchiasis and 9 cases of parenchymal diseases of liver. The results are as follows; 1. ERC findings of choledocholithiasis are filling defects by stoneor stones, dilation of common hepatic as well as common bile ducts and findings of cholangitis. 2. ERC findings of cholangitis are dilatation of larger intrahepatic biliary radicles and acute peripheral tapering, decrease of arborization, increased or right angle branching pattern, straightening and rigidity as well as irregular narrowing of intrahepatic biliary trees. This findings are observed in majority of choledocholithiasis. 3. Over9mm in diameter at intraprancreatic portion of common bile duct was regarded as abnormal, with 95% sensitivity,85% specificity and 91% diagnostic accuracy by decision matrix analysis. 4. In the presence of dilatation of CBD and findings of cholangitis in ERC, one should consider choledocholithiasis in spite of absence of stone defect.
Biliary Tract Diseases ; Cholangiography ; Cholangitis ; Cholecystitis ; Choledocholithiasis ; Clonorchiasis ; Common Bile Duct ; Diagnosis ; Dilatation ; Liver ; Methods ; Sensitivity and Specificity ; Trees ; Ultrasonography

Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.
Aorta ; Arteries ; Bradycardia ; Cause of Death ; Chest Pain ; Diagnosis ; Emergencies ; Heart Rupture* ; Hematoma ; Humans ; Infarction ; Myocardial Infarction ; Rupture ; Shock ; Transplants

We campared radial and femoral arterial blood pressure in 20 patients, ranging in age from 1-27 years, during and after cardiopulmonary bypass for repair of congenital heart disease. Differences in systolic arterial pressure, mean arterial pressure, diastolic arterial pressure were measured between femoral and radial artery pressure at specfied time (30 min after induction, 10 min after rewarming, 10 min after aortic declamping, 30 min after aortic declamping). This study failed to demonstrate the overt inaccuracy of radial arterial pressure measurement during cardiopulmonary bypass, but we could find the tendency that radial artery pressure may be measured inconsistently during and after cardiopulmonary bypass and altered peripheral resistance may contribute to this inconsistency.
Arterial Pressure* ; Cardiopulmonary Bypass* ; Heart Defects, Congenital ; Humans ; Radial Artery ; Rewarming ; Vascular Resistance

PURPOSE: The purpose of this study was to evaluate the effects of theophylline in preterm infants with apnea on glucose homeostasis and insulin values. METHOD: In this prospective study, level of glucose and insulin were measured from peripheral blood of 8 neonates(1,450+/-114gm, 31+/-2.1week), who were admitted from April 1, 1997 to July 30, 1997 in Neonatal Intensive Care Unit of Wonkwang University Hospital, for apnea of prematurity(> 20 sec with bradycardia and/or cyanosis) were given aminophylline intravenously. Blood samples were collected at pretreatment, posttreatment 2hours, 1-2days, 3-4days, 5-7days and posttreatment 48hours, and compare to those of the 8 control neonates(1,711+/-232gm, 32+/-1.7week). RESULTS: The results were as follows: 1) Plasma glucose values were significantly higher in the treatment group than those of the control group at 1-2days(104.67+/-20.39mg/dL vs 83.43+/-15.86mg/dL) and 3-4days(111.0+/-32.39mg/dL vs 79.25+/-14.03mg/dL)(p<0.05). 2) Plasma glucose values which were increased at 1-2days(104.67+/-20.39mg/dL)and 3-4days(111.0+-32.39mg/dL), were significantly higher than pretreatment values(66.33+/-31.19mg/ dL)(p<0.02), but were not increased to the level of hyperglycemia(> 125mg/dL). 3) The mean posttreatment glucose levels drawn at 48hours after discontinuation of theophylline was significantly decreased to the values of pretreatment values compared to those of the 1-2days and 3-4days(p<0.01). 4) Insulin concentrations were also increased insignificantly when blood glucose were increased in the treatment group compared with control group. CONCLUSION: In conclusion, intravenous administration of theophylline produces hyperglycemia significantly, including an increase in a serum insulin. But, clinically significant hyperglycemia(> 125mg/dL) was not noted. So, plasma glucose may not need to be monitored in preterm apneic infants receiving theophylline. But, further studies are need to elucidate the effect of theophylline considering the serum toxic level of theophylline.
Administration, Intravenous ; Aminophylline ; Apnea* ; Blood Glucose* ; Bradycardia ; Glucose ; Homeostasis ; Humans ; Hyperglycemia ; Infant ; Infant, Newborn ; Infant, Premature* ; Insulin* ; Intensive Care, Neonatal ; Plasma* ; Prospective Studies ; Theophylline

Changes of power spectrum of R-R interval variabilty during recovery from N2O-O2 - halothane anesthesia have been studied in 20 patients. Power spectral analysis of R-R intervals during awake period and recovery period have been performed with newly developed R-R interval variability, we compared the power of each frequency range(low: 0.04-0.08 Hz, middle 0.10-0.15 Hz, high: above 0.3 Hz) between awake period and recovery period. There was no difference between awake period and recovery period in the power of low and high frequency ranges, but there was remarkable difference in power of midfrequency range. During awake period the power of midfrequency range changed with cyclic pattern, but there was no cyclic change during recovery period even after the regain of consciounss(30+/-3.2 min.). The power of midfrequency range during recovery period began to change with cyclic pattern only after 45 minutes. It is concluded that the power of midfrequency range is useful index of recovery from N2O-O2 -halothane anesthesia.
Anesthesia* ; Halothane ; Humans

Analysis of R-R interal variability is a useful method of obtaining many information about cardiovascular control mechanisms. Among the many methods of analyzing R-R variability, power spectral analysis(PSA) is said to be the most powerful and acurate tool. Although application of computer techniques in analysing R-R interval variability were introduced, as most of the studies on the R-R interval variability have been off-line and invasively, they were not suitable for practical use. So we prepared a program for non-invasive on-line perioperative assessment of R-R interval variability. We used Turbo C++(ver 1.0, Borland International, USA) and Turbo Assembler(ver 2.0, Borland International, USA) for programing. Data were collected by A/D converter(PCL 718,, Taiwan) by interrupt mode and transferred to TBM386 compatibie computer with VGA color monitor. By applying PSA to R-R interval variation, we can get an almost as confident information about the cardiovascular system as analysis of arterial waveform, In addition to this we can get data that requires very reduced momory size, and get them non-invasively. So analysing R- R interval variability may be the most suitable method for on-line continuous assessment of cardiac parameters.
Cardiovascular System

No abstract available.
Arteriovenous Fistula* ; Humans ; Renal Dialysis*