PURPOSE: Pediatric cardiac arrhythmias are increasing but there is no normal values of cardiac electrophysiologic studies(EPS) in Korean children. So we performed cardiac EPS in children undergoing cardiac catheterization for mild congenital heart disease without cyanosis and ECG abnormality. METHODS: We studied 24 children(male : 9, female : 15) with mild congenital heart disease(PDA : 10, VSD : 8, ASD : 6, age range 1.8 years to 9.3 years, mean 4.3 years). All studies were performed under propofol intravenous anesthesia. Fifteen minutes after cardiac angiography, two elctrophysiologic catheters were inserted through the right femoral vein into the right atrial appendage and His hundle area. Using atrial pacing with various cycle lengths for 30 seconds, we evaluated the sinus node recovery time(SNRT) and corrected sinus node recovery time(CSNRT) and atrioventricular block cycle length(AVBCL). Using atrial extrastimuli during sinus rhythm and paced 8 atrial rhythm, we evaluated the atrioventricular node effective refractory period(AVNERP) and total sinoatrial conduction time(TSACT). RESULTS: Baseline sinus cycle length was 661 +/- 107 msec. SNRT and CSNRT were 955 +/- 181 msec, 264 +/- 68 msec each. AVBCL and AVNERP were 365 +/- 56 msec, 264 +/- 63 msec each. TSACT was 220 +/- 55 msec. CONCLUSION: Considering the importance of pediatric cardiac arrhythmias, we have to have the normal EPS values in Korean children. But it is impossible to perform a invasive EPS for normal children without heart disease. So we believe that these measured values in children with mild congenital heart disease may be used as the normal value in Korean children.
Anesthesia, Intravenous ; Angiography ; Arrhythmias, Cardiac ; Atrial Appendage ; Atrioventricular Block ; Atrioventricular Node ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Child* ; Cyanosis ; Electrocardiography ; Female ; Femoral Vein ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Propofol ; Reference Values ; Sinoatrial Node

OBJECTIVE: To estimate the motor unit numbers in normal adult hand muscles using manual incremental technique and F-wave technique. METHOD: We estimated the motor unit numbers in abductor pollicis brevis muscles of twenty normal adults. In manual incremental technique, we estimated the motor unit numbers using motor unit count program setted in electrodiagnostic equipment (Dantec, Keypoint). In F-wave technique, we estimated the motor unit numbers dividing maximal M-potential amplitude by mean amplitude of surface motor unit action potential. RESULTS: There was no significant difference of motor unit numbers between right and left abductor pollicis brevis in both manual incremental and F-wave technique. Motor unit numbers using F-wave technique were significantly greater than motor unit numbers using manual incremental technique. CONCLUSION: The difference of motor unit numbers using manual incremental technique and F-wave technique was considered as a difference of functional electrical stimulation. F-wave technique was more physiologic and functional method of motor unit numbers estimation than manual incremental technique.
Action Potentials ; Adult* ; Electric Stimulation ; Hand ; Humans ; Muscles

BACKGROUND: Electroconvulsive(ECT) or electroshock therapy(EST) remains controversial and its indications are still the subject of discussion. Despite both medical and legal opposition, it is still widely practiced. The aim of ECT is to produce a grand mal seizure rather than the electrical stimulus which is responsible for the therapeutic effect. This causes widespread physiological changes, particularly affecting the cardiovascular and nervous system. The anesthetic agents for ECT should provide a smoooth rapid induction, a rapid recovery and attenuation of the physiologic effect of ECT. METHODS: Propofol(1 mg/kg) and thiopental sodium(2 mg/kg) were compared as anesthetic agents for ECT in 20 patients on four occasions in a repeated measure crossover study. In each patients receiving propofol or thiopental sodium on different occasions, arterial pressure, heart rate, seizure duration and recovery time were recorded. RESULTS: The incidence of discomfort on injection was significantly higher with propofol (47.5%) compared to thiopental sodium (2.5%). The duration of seizure with propofol was 37+/-11.3 sec and thiopental sodium was 41.2+/-11.6 sec but it was not significant(P=0.11). The increase in systolic and diastolic arterial pressure and heart rate were higher with thiopental sodium. Recovery time was significantly shorter with thiopental sodium (476.5+/-47.7 sec) compares to propofol (506.6+/-62.2 sec) (P<0.05). CONCLUSIONS: Propofol is more effective than thiopental sodium at obtunding the hypertensive to ECT without causing significant hypotention.
Anesthetics ; Arterial Pressure ; Cross-Over Studies ; Electroconvulsive Therapy* ; Electroshock ; Heart Rate ; Humans ; Incidence ; Nervous System ; Propofol* ; Seizures ; Thiopental*

BACKGROUND: Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation. METHODS: This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed. RESULTS: The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant. CONCLUSIONS: Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.
Body Mass Index* ; Hospitalization ; Humans ; Intensive Care Units ; Lung Transplantation* ; Medical Records ; Oxygen ; Respiration ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Tidal Volume ; Ventilator Weaning* ; Weaning

The temporomandibular joint (TMJ) is unique among joints in the human body, since it can be dislocated without external force. Manipulation of the upper airway other than laryngoscopy is a risk factor in patients who have a history of habitual dislocation of the TMJ. The case report illustrates that severe limitation of the jaw opening ("closed lock") requiring manipulation for restoration may occur during induction of general anesthesia.
Anesthesia* ; Anesthesia, General ; Dislocations ; Human Body ; Humans ; Jaw* ; Joints ; Laryngoscopy ; Risk Factors ; Temporomandibular Joint

BACKGROUND: It has been reported that Mentha arvensis water extract (MAWE) inhibited systemic anaphylaxis and histamine release from the rat peritoneal mast cells (RPMC) by compound 48/80. OBJECTIVE AND METHOD: This study was undertaken to determine the inhibitory effects of immunoglobulin E (IgE)-mediated anaphylactic reaction by MAWE. This paper deals with an evaluation of the effect of MAWE on the anti-dinitrophenyl (DNP) IgE antibody induced anaphylactic reaction in rats. We also investigated the influence of MAWE on anti-DNP IgE antibody-induced tumor necrosis factor-alpha (TNF-alpha) production. RESULTS: MAWE inhibited passive cutaneous anaphylaxis (PCA) when intravenously, intrap- eritoneally, and orally administered. MAWE dose-dependently inhibited histamine release from RPMC activated by anti-DNP IgE antibody. Moreover, MAWE had an inhibitory effect on anti-DNP IgE antibody induced TNF-alphaproduction from RPMC. CONCLUSION: These results suggest that MAWE inhibits the IgE-mediated anaphylactic reaction in rats.
Anaphylaxis* ; Animals ; Histamine Release ; Immunoglobulin E ; Immunoglobulins ; Mast Cells ; Mentha* ; Passive Cutaneous Anaphylaxis ; Rats* ; Tumor Necrosis Factor-alpha ; Water

In obsterics and gynecology laparoscopic surgery is increasing in numbers and gaining wide popularity replacing classical laparotomy and is becoming new trend in surgical fields. Laparoscopic surgery is favoured over the classical laparotomy because of numerous advantages but it can cause complications by insuffulatory CO2 to induce artificial pneumoperitoneum. Therefore, wide knowledges and thorough understandings of anesthesiologist on the prevention of complications and their treatments are essential. Authors present one case that the patient developed subcutaneous emphysema and ateleciasis on right upper lobe, pulmonary edema in left side lung resulting from inadvertent one lung ventilation during laparoscopic hysterectomy under general anesthesia and on trendelenberg position.
Anesthesia, General* ; Gynecology ; Humans ; Hysterectomy* ; Laparoscopy ; Laparotomy ; Lung ; One-Lung Ventilation* ; Pneumoperitoneum, Artificial ; Pulmonary Edema ; Subcutaneous Emphysema*

Vibrio cholerae non-O1/O139 strains are the organisms that are biochemically indistinguishable from V. cholerae but do not agglutinate in Vibrio cholerae O1 and O139 antisera. V. cholerae non-O1/O139 strains are associated with gastroenteritis and extraintestinal infections such as bacteremia, peritonitis and wound infections. Gastroenteritis by V. cholerae non-O1/O139 is uncommon in Korea. We isolated V. cholerae non-O1/O139 from a stool specimen of a one year-old female with diarrhea and high fever.
Bacteremia ; Cholera ; Diarrhea ; Female ; Fever ; Gastroenteritis* ; Humans ; Immune Sera ; Korea ; Peritonitis ; Vibrio cholerae O1 ; Vibrio cholerae* ; Wound Infection

Burkholderia cepacia is a highly virulent pathogen known to cause opportunistic infections in immunocompromised patients. It accelerates lung disease and causes necrotizing pneumonia with associated severe sepsis, known as cepacia syndrome. In particular, lung transplant recipients infected with Burkholderia cepacia show higher mortality after lung transplantation than those who are not infected with this organism. Due to broad-spectrum antibiotic resistance, a combination therapy should be used according to the results of the susceptibility test. This bacterial infection is rare in Korea, and no case was reported in lung transplant recipients. However, we report a case of pneumonia caused by Burkholderia cepacia after lung transplantation. As Burkholderia cepacia was grown from a sputum culture, the patient was treated initially with a combination of meropenem and trimethoprim/sulfamethoxazole and then ceftazidime and trimethoprim/sulfamethoxazole as a result of leukopenia. After antibiotics treatment for 20 days, sputum cultures became negative for Burkholderia cepacia and the patient successfully recovered.
Anti-Bacterial Agents ; Bacterial Infections ; Burkholderia ; Burkholderia cepacia ; Ceftazidime ; Cystic Fibrosis ; Drug Resistance, Microbial ; Humans ; Immunocompromised Host ; Korea ; Leukopenia ; Lung ; Lung Diseases ; Lung Transplantation ; Opportunistic Infections ; Pneumonia ; Sepsis ; Sputum ; Thienamycins

We experienced a case of gelatinous transformation of bone marrow in a patient with congestive heart failure in malnutrition. The biopsy findings of bone marrow were gelatinous transformation, a condition characterized by disruption of marrow architecture, fat atrophy, and deposition of hyaluronic acid. Gelatinous transformation is often mistaken as representing edema, necrosis, or amyloidosis.
Amyloidosis ; Atrophy ; Biopsy ; Bone Marrow* ; Edema ; Estrogens, Conjugated (USP)* ; Gelatin* ; Heart Failure* ; Humans ; Hyaluronic Acid ; Malnutrition* ; Necrosis