In treatment of right ventricular failure with pulmonary hypertension, milrinone has not only an inotropic effect but also a vasodilating effect, thus, recently, it has been widely used. Recent studies have reported on the direct stimulation effects of doxapram on the central nervous system. A 91-year-old female underwent hemiarthroplasty under spinal anesthesia. When transported to the recovery room, right ventricular failure, cardiogenic shock, and mental deepening occurred. After stabiliz-ing vital signs, milrinone, doxapram was administered. We report on the effective use of milrinone for acute right ventricular failure and the active use of doxapram for reduced consciousness and hypoventilation.

A paradoxical response in tuberculosis is defined as clinical and radiological worsening of previous lesions or development of new lesions after initial improvement during the process of anti-tuberculous treatment. The authors report on a patient who developed massive pleural effusion as a paradoxical response after 8 weeks of anti-tuberculous treatment. The patient’s symptoms were improved with thoracostomy without any change of anti-tuberculous medications. If symptoms worsen during the process of anti-tuberculous treatment, drug resistance, non-compliance, or other diseases should be excluded first. If it is regarded as a paradoxical response, the treatment plan need not be changed except for additional conservative treatment.

Pulmonary angiography has been regarded as the gold standard tool for diagnosis of pulmonary embolism. However, due to its invasive nature and the development and growing availability of non-invasive diagnostic imaging tests, such as computed tomographic pulmonary angiography, the role of pulmonary angiography in diagnosis of pulmonary embolism has waned rapidly, so that pulmonary angiography has become a state-of-the-art procedure available in a decreasing number of centres. Pulmonary angiography is the definitive diagnostic test, but complications of this procedure, including puncture site prob-lems, cardiac arrhythmia, and cardiac or vessel injury have been reported. However, few cases of cardiac vein rupture during pulmonary angiography have been reported. Here we report on a case of cardiac vein rupture which occurred during pulmo-nary angiography in an 82-year-old woman who underwent pulmonary angiography.

Acute pulmonary embolism (PE) is a common and often catastrophic disease. Early diagnosis and treatment of PE is im-portant, however, prompt diagnosis is difficult due to nonspecific clinical manifestations. On the other hand, syncope may develop as a presenting symptom of PE, and defecation activity could trigger PE. In Korea, PE associated with defecation has not been previously reported. We report on a case of acute massive PE presenting as defecation syncope in a 26-year-old female with a serous borderline tumor of the ovary.

Combined oral contraceptives (OCs) are a common method of contraception; however, they are associated with a twofold to sixfold increased risk of venous thrombosis (VT). The association between estrogen-containing OCs and VT is well established. After the first generation progestogens, new progestogens were developed. However, the risk of VT is higher for users of OCs with third generation progestogens than for those using second generation progestogens. We experienced a patient, a 25-year-old young woman with chest pain after taking third generation OCs. We performed chest computed tomography (CT) and lower extremity venogram CT. She was diagnosed with a pulmonary thromboembolism and deep vein thrombosis. She was treated with low molecular weight heparin and warfarin for six months. We report on this case with a review of the relevant literature.

Fatal pulmonary embolism occurs in 0.1% to 0.26% of cases of spine fusion surgery. Early diagnosis of pulmonary embolism is difficult, and delay in treatment can lead to a fatal outcome. We report on a case of symptomatic pulmonary embolism which developed after induction of general anesthesia in a patient who had been immobile because of a previous spinal operation one week prior to this. Despite a negative preoperative ultrasound examination for deep vein thrombosis, the patient had developed a pulmonary embolism, which was diagnosed using intraoperative transesophageal echocardiography. Despite intensive cardiopulmonary resuscitation and thrombolytic therapy, the patient died within a few hours of diagnosis.

Traditionally, Ligustrum lucidum fruits (LL) is one of the well-known oriental herb used in the treatment of skin and lung inflammation. This study investigated anti-inflammatory effects of LL in the pathogenesis of acute pulmonary inflammation in mice. Acute pulmonary inflammation was induced by intratracheal instillation of cigarette smoke condensate (CSC) and lipopolysaccharide (LPS) 5 times within 12 days in mice. LL extract was administered orally at a dose of 50 or 200 mg/kg. Administration of LPS and CSC significantly elevated airway hyperresponsiveness (AHR) to mice, and increased in the levels of inflammatory cells and mediators in mice. However, the LL extract significantly reduced the elevated AHR, and the increase of neutrophils, CD4+/CD3+ cells and CD8+/CD3+ cells, along with reducing the expression of TNF-α, IL-6, and MIP-2. Moreover, the LL extract alleviated the infiltration of inflammatory cells in expanded airway walls histologically. These results indicate that the LL extract has an inhibitory effects on acute pulmonary inflammation and AHR in murine model, and plays a crucial role as a immunomodulator which possess anti-inflammatory property.

Pulmonary embolism (PE) still has a high associated mortality. Anticoagulation should be continued until the benefit of preventing recurrent PE is outweighed by the risks of bleeding. Furthermore, D-dimer values and residual clot burden may predict recurrent thromboembolic events in patients that have completed anticoagulation therapy. The authors describe the case of a 69-year-old female who suffered multiple recurrent PE on aspirin, her medical history included idiopathic PE, and she had been on anticoagulant for a considerable time before switching to aspirin. It is important the possibility of recurrent PE be borne in mind to prevent secondary prevention, and that other treatment options be considered in cases of recurrent PE.

Objectives: This study is aimed at identifying the influential factors on the pulmonary function of ordinary residents in the surrounding areas of Yeosu Industrial Complex. Methods: The PFT (Pulmonary Function Test) was conducted on the target residents numbering 989 people (male 361, female 628). The exposed group (813 people) resided within the radius of 5km from Yeosu Industrial Complex and the control group (176 people) resided in the radius of more than 15 km from May 2007 to November 2007. The survey also took into account other factors including personal characteristics, life habits, respiratory diseases and allergic symptoms, medical histories, and the living environments of the residents in order to further identify influential factors on pulmonary function. Result: When comparing the PFT values of the exposure groups to the control group of the same city, values of the exposure groups were meaningfully lower with an %FEV1 of 107.05% and %FVC of 100.28%. Conversely, the control group reported an %FEV1 and %FVC of 107.26% and 102.85% respectively, indicating that ambient air pollutants reduce lung function. The odds ratio of asthma diagnosis history increased when a subjects residence was close to a heavily trafficked road, traffic amount was huge, a bed was used, and the family had less than four members. However the results were not statistically meaningful. The odds ratios of abnormal pulmonary function were statistically higher among those with asthma(OR=4.29, CI=1.75-10.56), wheezing (OR=2.59, CI=1.24-5.41), and nasal congestion (OR=2.87, CI=1.36-6.08) (p<0.01). The factors affecting FEV1 were symptoms including asthma, passive smoking and allergic eye disease (R2=0.049, p<0.001). For the FVC symptoms including asthma (R2=0.014, p<0.001) were measured. The analysis showed that FVC decreased with increases in O3 and CO(p<0.01). Furthermore, FEV1 decreased with increases in O3(p<0.01). Conclusions: These results will provide preliminary data for establishing responsive measures to protect the health of residents in industrial complexes from air pollution, and to develop lasting environmental health policies.