, Si-Hoon Park, Hong-Keun Cho, Gil Ja Shin In order to elucidate the important factors for refractoriness following repeated exercise in exercise-induced asthma(EIA), we investigated the relationship between the change of bronchial hyper-reactivity to methacholine during the refractory period and the degree of refractoriness following the exercise.
Ten EIA patients were tested. First visit included methacholine bronchial provo-cation test(MBPT) followed by exercise 1 and repeated MBPT separated by a 60 min. On seco-nd visit, exercise 3 were repeated after 60 min of exercise 2, and refractoriness was measured.
The maximal broncial constriction measured by FEV1 was 22.6±4.2% and this reaction was recovered over 95% within 60 min. Methacholine PC20(PC20M) was decreased after exercise in six from 10 EIA patients. There was no significant relationship between the degree of exercise induced bronchial-constriction and the chagne of PC20 after exercise. The bronchial hyper-reactivity to methacholine was in--creased after exercise even with the refracto-riness in some of EIA patients.
Refractoriness followed by repeated exercise does not seem to be due to the decreased bronchial hyper-reactivity.
Citations
, Jae Jin Han, Yong Soon Won Inflammatory reaction is the one of deteriorating causes of pulmonary function after cardiopulmonary bypass. And leukocytes play a major role in inflammatory reaction by producing cytotoxic oxygen free radicals, initiating complement cascade, and so on. We tested the hypothesis that reducing the circulating leukocyte by using leukocyte poor RBC(LPR) in priming solution, and low-dose aprotinin which reduces whole body inflammatory response can reduce inflammatory reaction and results in less release of cytokines and preserving better pulmonary function after cardiopulmonary bypass.
In a prospective, randomized study, 23 children undergoing open heart surgery were investigated. LPR was used in 8 patients(group 1), 8 patients received low-dose aprotinin(50,000 KIU per body weight in priming solution, group 2) and 7 patients were control group (group 3). Patients with complex heart diseases, body weight over 10kg, palliative surgery, and residual defect after surgery were excluded from this study. CBC, interleukin 6, and granulocyte elastase were analyzed after 60 minutes of cardiopulmonary bypass, and (A-a)DO2(alveolar arterial oxygen difference) was measured postoperatively.
There was no statistically significant difference in interleukin 6 level, granulocyte elastase level, (A-a)DO2, intubation period, mortality, pulmonary complication, and WBC count at postoperative 1st day.
Our results suggested that LPR in priming solution and low-dose aprotinin have little influence on the inflammatory reaction and pulmonary function deterioration caused by cardiopulmonary bypass. Although LPR in priming solution can reduce circulatory leukocyte, the leukocytes increase rapidly after initiation of cardiopulmonary bypass, so that reducing leukocytes by LPR use has little influence on the inflammatory reaction.
, Tae-Hee Won Hyperhidrosis is a condition with excessive sweating, which has a strong negative impact on the quality of life. The purpose of this study was to evaluate the initial results of video-assisted thoracoscopic sympathectomy for hyperhidrosis.
From May of 1996 to March of 1998, video-assisted thoracoscopic sympathectomy were performed for 35 hyperhidrosis(23 were males and 12 were females). Age ranged from 14 to 39 years(average 22.1years). The average operation time and hospital stay were 120 minutes and 3.3days respetively.
Immediate and complete relief of symptom were observed in all except 1 patient. There was no mortality or life-threatening complications. Complications included 5 compensatory sweating (14%), 5 pneumothorax(14%), 2 postoperative pain(5.7%) and 1 lung tissue injury(2.9%).
Thoracoscopic sympathectomy is an efficient, safe and minimally invasive surgical method for hyperhidrosis.
The cleft lip nose deformity is caused by multiple factors that include displa-cement of the lower laterial cartilage, with flattening and false lengthening on the cleft side with shifts of the columella, septum and underlying skeletal base. Many plastic surgeons have felt that early rhinoplasty in cleft lip interferes with the growth of nose, causes increased deformity. Then this study was performed to find the result of the early surgery in the clefe nasal recon-struton.
The alar cartilage was repositioned by freeing it from the skin and nasal lining without its exposure through the incision of cleft lip repair and shifting it to a new position at the time of pirmay cleft lip repair. The repositioned lower lateral cartilage was stabilized in its new position by using through and througn sutures tied over stents. These stent sutures went through the skin, cartilage and nasal lining. The nasal soft tissues were released from the skele-tal base, reshaped.
Improvement in the cleft nasal deformity is noted in most cases. Especially the colu-mella inclination was completely corrected. The nasal dome on the cleft side shows the good contour and projection of the tip, which projects in an equal fashion to the concleft side. The nasal alar symmetry with equal projection of the lobule was observed on the cleft and noncleft side.
Early surgical correction of cleft lip nose deformity doesn't interferes with the growth of nose and promotes more normal grown by early proper contour and position of the lower lateral cartilage. It is more important to take better psychological development and good self-image before the adverse effedct of deformity cause damage.
, Jung Sun Kim, Sung Nam Cho, Young Sook Park This article is investigating the general status of hospital computerization and doctors' reactions to these changes in four general hospitals. Both quantitative and qualitative data were collected from two university-affiliated hospitals and two private general hospitals in Seoul. The questionnaire survey was conducted in 1996, and the data contain 81 doctors from four hospitals. We also collected in-depth-interview data from 8 doctors in these hospitals. We revewed the general status of information system and utilization level in general hospitals and analyzed doctors' response to these changes focusing on four areas of medical care ; 1) jobs and functions of the doctors in patient care; 2) doctors' autonomy and their status ; 3) doctors' relations with other personnel; and 4) the quality of medical care. The results are :
1) The general status of information system in general hospitals are limited to the comput-erization of the administrative part, and thus very few hospitals employ information system directly to the patient care.
2) In terms of doctors' job and functions, the computerization of the administrative part of hospital works increased the efficiency of doctors' patient care in charting, keeping and sear-ching data, but put more burden on them for doing double jobs of hand-writing and comput-erization.
3) The autonomy of doctors and their status have not been noticeably changed in the process so far, but there appears a possibility that doctors could defend themselves to the manager's control over them through information system.
4) The computerization of the hospital works tends to reduce an unnecessary face-to-face interaction, which is expected to facilitate communications in the hospital. There are also some changes in the relationship between doctors and semi-professional personnels such ans, nurse and medical technicians.
5) Doctors pointed out that a few positive effects of the computerization on the quality of medical care on patients' side have emerged and thus expected improvement in the quality of medical care in the future.
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