BACKGROUND: Intermittent rhythmic delta activity (IRDA) is classified as a nonspecific abnormal EEG pattern. IRDA is clinically associated with alteration of consciousness, hydrocephalus, cerebral edema, deep midline lesions, subcortical lesions, and tumors of the posterior fossa and the third ventricle. Frontal IRDA(FIRDA) is usually seen in patients over age 15 years, whereas occipital IRDA(OIRDA) occurs mainly in children. We have investigated the clinical feature and significance of IRDA in children. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 36 children with IRDA of EEG concerning diagnosis, neurologic examination, classification of epilepsy, and CT & MRI findings. RESULTS: 1) The location of the IRDA was frontal(FIRDA) in 11 of 36(30.5%), occipital(OIRDA) in 20 of 36(55.6%) and mixed in 5 of 36(13.9%) patients. 2) Thirty of 36(83.3%) have epilepsy (including 1 each with MELAS and tuberous sclerosis), 4 of 36(11.1%) have migraine and 2 of 36(11.1%) patients have meningitis. 3) Sixteen of 30(53.3%) have partial or partial with secondary generalized seizure, 10 of 30(33.3%) have generalized seizure and 4 of 30(13.3%) patients with epilepsy have absence seizure. 4) Neuroimaging studies (CT or MRI scan) were performed in 27 cases. Among 27 cases of studies, 6 cases(22.2%) were abnormal including; two cases of infections, and each case of infarction, venous angioma, arachnoid cyst, cortical atrophy, and tuberous sclerosis, respectively. CONCLUSIONS: IRDA may be considered an epileptiform pattern in childhood and FIRDA is frequently seen in children than previous reports.
Arachnoid ; Atrophy ; Brain Edema ; Child* ; Classification ; Consciousness ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Absence ; Hemangioma ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging ; Medical Records ; MELAS Syndrome ; Meningitis ; Migraine Disorders ; Neuroimaging ; Neurologic Examination ; Retrospective Studies ; Seizures ; Third Ventricle ; Tuberous Sclerosis

No abstract available.
Holoprosencephaly*

No abstract available.
Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn

No abstract available.
Anemia, Aplastic* ; Hepatitis*

No abstract available
Hemodynamics*

No abstract available.
Fascioliasis* ; Humans*

BACKGROUND: Anesthesia and surgery may exacerbate liver function in patients with pre-existing liver disease so it is important to choose less hepatotoxic anesthetics in patients with chronic liver disease. METHODS: This study was designed to examine the postoperative liver function test in 150 patients after hepatectomy with portal triad clamping through retrospective chart review. Patients were divided into an isoflurane group (group I, n = 56) and a propofol group (group P, n = 57) by used anesthetics for maintaining anesthesia. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase, alkaline phosphatase, total bilirubin, albumin, and prothrombin time were checked at preoperation, and postoperatively at 1, 3, 7 and 14 days in the two groups. Indocyanine retention rate (ICG-R15) was measured at preoperation, and postoperatively at 1 and 7 days. RESULTS: AST values increased postoperatively at 1, 3, 7, and 14 days compared with preoperation. ALT values increased postoperatively at 1, 3 and 7 days compared with preoperation and there was difference between group I (443.8 +/- 52.1 U/L) and group P (202.7 +/- 24.7 U/L) at postoperative 1 day. Other values had no significant difference between the two groups. CONCLUSIONS: Though it might need a well controlled study to find the differences in effect between isoflurane and propofol on the postoperative liver function test, we concluded that total intravenous anesthesia using propofol is also one of the safest anesthetic methods for hepatic resection with minimal hepatotoxicity.
Alanine Transaminase ; Alkaline Phosphatase ; Anesthesia ; Anesthesia, Intravenous ; Anesthetics ; Aspartate Aminotransferases ; Bilirubin ; Constriction* ; Hepatectomy ; Humans ; Isoflurane* ; L-Lactate Dehydrogenase ; Liver Diseases ; Liver Function Tests* ; Liver* ; Propofol* ; Prothrombin Time ; Retrospective Studies

BACKGROUND: Sevoflurane is the most recently available volatile agent which permits the rapid induction with its nonirritant nature. The goal of this study was to compare the hemodynamic responses of sevoflurane induction and maintenance period with those of fentanyl-midazolam/isoflurane anesthesia for CABG. METHODS: Twenty-eight patients who underwent CABG were given anesthesia, and were randomly assigned to receive sevoflurane (Sevo Group, n = 15) or fentanyl-midazolam/isoflurane (Iso-Fent Group, n = 13), as induction and maintenance agents. In the Sevo group, anesthesia was induced with two or three deep breaths of 7.5% sevoflurane, and maintained with 2% sevoflurane after intubation. The Iso-Fent Group received fentanyl 5microgram/kg and midazolam 0.2 mg/kg with oxygen for induction and maintained with 0.8% isoflurane and 5microgram/kg/hr of fentanyl by infusion. All were given vecuronium as a muscle relaxant. Cardiac and oxygen metabolic profiles were measured before and 10 minutes after tracheal intubation. RESULTS: Before induction, there was no difference between Sevo and Iso-Fent group in terms of cardiac and oxygen metabolic profiles. After intubation, mean arterial pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, heart rate and mixed venous oxygen saturation in the Sevo group were higher than in the Iso-Fent group (P < 0.05). The ST-segment changes in the EKG monitoring was unremarkable during anesthesia induction in either group. CONCLUSIONS: For the induction and early anesthesia maintenance in patients undergoing CABG surgery, sevoflurane may be a substitute for fentanyl-midazolam/isoflurane without any significant hemodynamic changes.
Anesthesia* ; Arterial Pressure ; Coronary Artery Bypass* ; Coronary Vessels* ; Electrocardiography ; Fentanyl ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Isoflurane ; Metabolome ; Midazolam ; Oxygen ; Pulmonary Wedge Pressure ; Vecuronium Bromide

Clinical and Bacteriological studies were carried out on 57 cases of infants and children with shigellosis who were cared from January, 1976 to December, 1980 in our hospital. The results were as follows: 1. The age distribution revealed the range between 6 months and 5 years(85% of all) with sex ratio of 30(53%) of male and 27(47%) of female, 1.1:1. 2. The peak incidence was noted in summer, althought there were occurrence throughout the year, even in winter. 3. On bacteriological studies, Shigellan flexneri was isolated most frequenty(90%) and Shigella sonnei was the next(8.8%). 4. Only 8.3% of Shigella strains were resistant to ampicillin between 1976 and 1977 but resistance increased to 76.7% in 1980. Gentamicin and Kanamycin which are aminoglycosiides were quite effectived but their use was limited becauseof their nephrotoxicity. 5. The average duration from the onset to the clinical improvement including stool character in the 32 ampicillin treated patients was 3.6 days and in the 25 rifampin treated patients was 2.2 days. Rifampin was effective in eradicating the shigella stralins and stool cultures taken at 7th therapeutic day remained negative in all 25 rifampin treated patients but yielded growth of shigella strains in 13 ampicillin treated patients. There was no doubt that rfaimpin was superior to ampicillin for bacillary dysentry. 6. One of these 57 cases was expired and motality rate was 1.8%.
Age Distribution ; Ampicillin ; Child ; Dysentery, Bacillary* ; Female ; Gentamicins ; Humans ; Incidence ; Infant ; Kanamycin ; Male ; Rifampin ; Sex Ratio ; Shigella ; Shigella sonnei

BACKGROUND: Recent studies demonstrated that volatile anesthetics suppress the NO-cGMP system in the vascular system. It has been known that the hemodynamic changes produced by volatile anesthetics in septic patients are mediated by upregulation of iNOS leading to excessive release of NO. The mechanisms underlying suppression of the NO-cGMP system by anesthetics are still controversial. It has been elucidated that nitric oxide synthase (NOS) plays a major role in the regulatory function in the L-arginine-NO system. So we examined the effects of NOS inhibitor (L-NAME, aminoguanidine) and NO scavenger (hydroxocobalamin) on vascular smooth muscle contractile function in lipopolysaccharide (LPS)-treated rat aorta during halothane administration. METHODS: Aortic ring preparations were obtained from LPS-treated (1.5 mg/kg, ip, for 18 h) rats. We evaluated the effects of hydroxocobalamin, L-NAME and aminoguanidine on contractile responses to phenylephrine during halothane (1 & 2 MAC) administration respectively. Statistical significances (P<0.05) were analyzed according to data characterictics by repeated measures ANOVA test and student's t-test. RESULTS: The contractile responses to phenylephrine in LPS-treated rats aorta were significantly (P<0.05) increased in the presence of hydroxocobalamin and L-NAME. During the halothane (1 and 2 MAC) administration, the contractile responses to phenylephrine in LPS-treated rats aorta were increased significantly (P<0.05) in the presence of hydroxocobalamin and L-NAME. CONCLUSIONS: From these results, it is suggested that hydroxocobalamin and L-NAME may be useful in the therapy of septic shock.
Anesthetics ; Animals ; Aorta ; Halothane* ; Hemodynamics ; Humans ; Hydroxocobalamin* ; Muscle, Smooth, Vascular ; NG-Nitroarginine Methyl Ester* ; Nitric Oxide Synthase ; Phenylephrine ; Rats* ; Shock, Septic ; Up-Regulation