No abstract available.
Animals ; Female* ; Gonadotropin-Releasing Hormone* ; Haloperidol* ; Humans ; Rats*

The postmortem stature was measured in 57 Korean adult males (age range: 20-86 years old, mean: 52.3 years old) in supine position. After dissection of the corpses, we measured the maximum length of the remaining limb-bones (humerus, radius, ulna, femur, tibia and fibula). The correlation coefficients between the stature and each limb-bone length were calculated. Simple regression equations for estimating stature from each limb-bone length and multiple regression equations from the combination of limb-bone lengths were also obtained.
Adult ; Aged ; Aged, 80 and over ; Body Height* ; Bone and Bones/anatomy & histology* ; Extremities/anatomy & histology* ; Human ; Male ; Middle Age ; Regression Analysis

Ventriculoperitoneal(VP) shunting has been associated with a variety of complications. CSF ascites secondary to VP shunting is very rare. We report a case of 68-year-old man with VP shunt in whom subclinical peritoneal infection presented with ascites. The patient was treated successfully with antibiotics and removal of the shunt. CSF ascites complicating VP shunt is reviewed and the pathogenesis of this condition is discussed.
Aged ; Anti-Bacterial Agents ; Ascites* ; Humans ; Ventriculoperitoneal Shunt*

A 41-year-old female complaining of easy fatigue, headache, thickened extremities and deepened facial folds was admitted to the hospital. As early as 6 years ago, she had been told by family members that her voice was changed and both hands was thickened. Cranial plain radiography indicated ballooning of sella turcica. Sella MRI disclosed 2.2cm sized pituitary tumor with suprasellar extension. The pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The postoperative course was uneventful until hyponatremia with sudden headache and respiratory arrest was developed. The case was due to hyponatremic encephalopathy on the basis of the clinical course and symptoms, and 3% hypertonic saline was infused for 12 hours until the hyponatremia was corrected. We have experienced a mortality case of hyponatremic encephalopathy in which surgieal removal of a pituitary tumor from a female acromegalic patient in menstruant period was followed by the sudden occurrence of hyponatremia, which in turn was later associated with marked brain edema.
Adult ; Brain Edema ; Extremities ; Fatigue ; Female ; Hand ; Headache ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Mortality ; Pituitary Neoplasms ; Radiography ; Sella Turcica ; Voice

BACKGROUND: About 60~70% of hospital isolates of staphylococci are resistant to methicillin. The level of resistance varies from low to high depending upon the genetic background of the strains. The purpose of this study was twofold : (i) to understand the relationship between beta-lactamase and methicillin-resistance genes(mecA, mecI, mecR1, femA) and the level of resistance and (ii) to survey the distribution of mec regulator genes(mec I, mecR1) among methicillin-resistant staphylococci. METHODS: Eighty-three isolates of Staphylococus aureus and 29 of coagulase-negative staphylococci(CNS) at Catholic University Hospital were examined. The level of methicillin resistance was studied using disk diffusion test and agar dilution test. MecA, mecI, mecR1, and femA genes detected by polymerase chain reaction. RESULTS: beta-lactamase production was significantly high in S. aureus and CNS isolates with low-level resistance. MecA and mecR1 genes amplification correlated with the level of resistance in S. aureus and CNS isolates. There was no correlation between the level of resistance and mecI and fem A genes amplification in S. aureus and CNS isolates. Methicillin- resistant S. aureus isolates showed more variety in mec regulator region than methicillin-resistant CNS isolates. CONCLUSION: From this study, we conclude that mecR1 gene could be considered as one of the important factors influencing the level of methicillin resistance in staphylococcal strains.
Agar ; beta-Lactamases ; Diffusion ; Genes, vif ; Methicillin Resistance* ; Methicillin* ; Polymerase Chain Reaction

An avulsion fracture of the second metacarpal base by the extensor carpi radialis longus is rare. There have been only 7 reports (in 10 patients) of this injury in the literature. We report upon a case of avulsion fracture of the second metacarpal base, which was treated successfully by open reduction and internal fixation.

BACKGROUND: Opioid tolerance may involve activation of the N-methyl-D-aspartate (NMDA) system. The possible involvement of the NMDA system suggests that one of the NMDA receptor antagonists, magnesium may be a useful adjunct to opioids for the treatment of postoperative pain following remifentanil infusion. METHODS: For this study, 70 patients scheduled for major abdominal surgery under remifentanil-based anesthesia were randomly allocated into groups that received either magnesium sulfate (group M) or saline (group C) intravenously. The patients in the group M received 25% magnesium sulfate at a dose of 50 mg/kg in 100 ml of saline, and those in the group C received an equal volume of saline prior to the induction of anesthesia. In addition, patients in both groups received 10 mg/kg/h infusion of either magnesium sulfate (group M) or an equal volume of saline (group C) until the end of surgery. Pain was assessed using a visual analog scale at 30 min, and 6, 12, 24, and 36 hours after operation. The time to the first use of postoperative analgesic and cumulative analgesic consumption in both groups were also evaluated. RESULTS: The visual analog scale scores for pain and cumulative analgesic consumption were significantly lower in the group M than in the group C. The time to the first use of postoperative analgesic was significantly shorter in group C than in the group M. CONCLUSIONS: Use of the NMDA-receptor antagonist, magnesium sulfate as an adjuvant analgesic reduced postoperative pain in patients undergoing major abdominal surgery under remifentanil-based anesthesia.
Analgesics, Opioid ; Anesthesia ; Humans ; Magnesium ; Magnesium Sulfate ; N-Methylaspartate ; Pain, Postoperative ; Piperidines

BACKGROUND: Early oral intake (EOI) associated with early recovery of normal bowel function has been shown to be an important determinant for improving patients' satisfaction. We investigated the tolerability of EOI and its effects on the recovery of bowel function after epidural anesthesia. METHODS: A prospective randomized trial of patients undergoing lower extremities surgery under epidural anesthesia was performed. A liquid drink was given to 150 patients in the EOI group 1 hours after surgery, and to 150 patients in the delayed oral intake (DOI) group 8 hours after surgery. We recorded presence of bowel sounds immediately after operation, symptoms of ileus, time to the first flatus, time to the first defecation, degree of appetite before the first meal, and patients' satisfaction. RESULTS: There was no significant difference in the presence of immediate postoperative bowel sounds, the degree of appetite before the first meal, mild ileus, and severe ileus between groups. Time to the first flatus and time to the first defecation in the EOI group were shorter than those of the DOI group. The patients' satisfaction in the EOI group was higher than that of the DOI group. CONCLUSIONS: For uncomplicated patients undergoing lower extremities under epidural anesthesia, beginning oral hydration as early as 1 hour after the operation is safe and well tolerated and resulting in faster recovery of bowel function and higher patients' satisfaction.
Anesthesia, Epidural ; Appetite ; Defecation ; Flatulence ; Humans ; Ileus ; Lower Extremity ; Meals ; Prospective Studies

BACKGROUND: Acute renal failure(ARF) is a serious complication of rhabdomyolysis after multiple trauma, and may increase morbidity and mortality. The aim of this study was to elucidate predicting factors for the development of ARF induced by rhabdomyolysis at an early stage of multiple trauma. METHODS: This prospective, observational study was conducted at the emergency department of a level I trauma center. Patients with acute multiple trauma, whose plasma levels of creatine phosphokinase(CPK) were higher than 1,000 IU, were included in this study. We excluded patients with any history of myocardial infarction, stroke, underlying renal disease, and/or infectious disease. We collected clinical and laboratory data including age, heart rate, mean arterial blood pressure, injury severity score, serum myoglobin, lactic dehydrogenase, creatine phosphokinase, and base excess. Collected data were compared between patients who had ARF and patients who did not have ARF. RESULTS: Eighty-eight patients were enrolled in this study. Eighteen patients(20.5%) developed ARF. The injury severity score(ISS)(p=0.001), the base excess(p<0.001), CPK(p=0.003), and myoglobin(p<0.001) were higher in patients with ARF than in patient without ARF. Logistic regression analysis revealed that early predictors for ARF were high ISS, high base excess, high CPK, and high myoglobin. CONCLUSION: We could identify early predicting factors for acute renal failure induced by rhabdomyolysis, these factors included ISS, serum CPK and myoglobin, and base excess in the arterial blood gas analysis performed at the emergency department.
Acute Kidney Injury* ; Arterial Pressure ; Blood Gas Analysis ; Communicable Diseases ; Creatine ; Creatine Kinase ; Emergency Service, Hospital ; Heart Rate ; Humans ; Injury Severity Score ; Logistic Models ; Mortality ; Multiple Trauma* ; Myocardial Infarction ; Myoglobin ; Observational Study ; Oxidoreductases ; Plasma ; Prospective Studies ; Rhabdomyolysis* ; Stroke ; Trauma Centers

A visual stimulus elicits a complicated series of potentials from the human cortex. The visual evoked potential test has advantages in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity, displace surrounding structures or change vascular supply. A sequence of four wave component(I, II, III, IV) that occured in the 100 msec following the flash stimulation can be recorded from scalp electrodes in 20 patients with focal lesions of the visual conducting system using computer averaging techniques. 1) 20 patients presenting with visual symptoms were classified as four groups according to the locations of the lesions in visual pathway : optic nerve lesion(8 cases), chiasmatic lesion(5 cases), optic tract or radiation lesions(4 cases) and visual cortical lesion(3 cases). 2) In optic neuritis, wave patterns of VEP was suppressed markedly in I(P30~40 msec) and II(N50~60 msec) wave components and in the optic nerve injuries, flat wave patterns were noted. 3) In chiasmatic lesions, VEP showed mild prolongation of latency(wave II, N50~60 msec) throughout and mild supperssion of the amplitudes of the wave components presented. On stimulation of one eye, latency and amplitude of the contralateral sided eye were markedly delayed and suppressed. 4) VEP of optic tract and optic radiation lesions showed marked prolongation and suppression of wave pattern in late components(wave II, III). In multiple sclerosis, VEP abnormality was presented in early state(N80~90 msec). 5) In the visual cortical lesions, the wave patterns of the VEP were almost symmetrically flat on both side. Serial evaluation of the VEP could provide good information for the evaluation of visual pathway lesions and functional recovery marker.
Electrodes ; Electrophysiology ; Evoked Potentials, Visual* ; Humans ; Multiple Sclerosis ; Optic Nerve ; Optic Nerve Injuries ; Optic Neuritis ; Scalp ; Visual Pathways*