A 68 year old, ASA physical status 11, hypertensive male patient underwent open reduction, angulated blade plate fixation, and bone graft of femur intertrochanteric fracture due to non-union. Anesthesia was induced with thiopental and succinylcholine and maintained with vecuronium- Halothane-nitrous oxide-oxygen. Three uints whole blood was transfused and any significnat change in vital signs and EKG were not found during 4 hours operation. Soon after the patient was recovered. But he was found to be hemiplegia and sensory disturbance on the next day. Brain CT revealed infarction of middle cerebral artery territory. He expired 7 days following the surgery despite strenuous supportive measure.
Aged ; Anesthesia ; Brain ; Cerebral Infarction* ; Electrocardiography ; Femur ; Hemiplegia ; Humans ; Infarction ; Male ; Middle Cerebral Artery ; Succinylcholine ; Thiopental ; Transplants ; Vital Signs

Increasing the pH of local anesthetic solution with sodium bicarbonate has been known to hasten its onset of action. This study was designed to verify the effect of pH adjustment of bupivacaine on caudal anesthesia. Forty adult male patients having caudal block for perianal surgery were randomly assigned to four groups(n=l0) as follows. Group 1: control, 0.5% bupivacaine 20ml+0.6ml saline Group 2: 0.5% bupivacaine 20 ml+0.1% epinephrine 0.1 ml+0.5ml saline Group 3: 0.5 bupivacaine 20ml+5% sodium bicarbonate 0.5ml+0.1 ml saline Group 4: 0.5% bupivacaine 20 ml+5% sodium bicarbonate 0.5ml+0.1% epinephrine 0.1 ml The pH of prepared solution of each group is 6.23+/-0.032, 5.95+/-0.028, 7.35+/-0.054, 6.92+/-0.067 respectively. The time of onset of anesthesia (time between the completion of anesthetic injection and loss of temperature sensation at S4, S5 dermatome) was significantly rapid in group 3 followed by group 4. The time of onset of surgical anesthesia (time between the completion of anesthetic injection and loss of pain sensation by pin-prick test at S4, S5 dermatome) was significantly rapid in group 3.
Adult ; Anesthesia ; Anesthesia, Caudal* ; Bupivacaine* ; Epinephrine ; Humans ; Hydrogen-Ion Concentration* ; Male ; Sensation ; Sodium Bicarbonate

Murine norovirus (MNV) is a non-enveloped virus with a positive-sense RNA genome and causes lethal infection in mice. MNV has been used as a model virus for human norovirus (NV) whose in vitro cell culture system has not been available to date since MNV and NV are genetically related. In this study, the genome replication of MNV was investigated using strand-specific RT-PCR in RAW264.7 cells. Reverse transcription (RT) using a sense primer followed by PCR showed that negative-sense RNAs were first detected in RAW264.7 cells between 6 and 9 [3 and 6] hours post infection (h.p.i.). However, these negative-sense RNAs were not detected when cells were treated with a translation inhibitor cycloheximide. Then, RT with an antisense primer followed by PCR was performed to detect positive-sense RNAs. RT-PCR results revealed that the amount of positive-sense RNAs began to increase from 9 [6] h.p.i., indicating the accumulation of the newly synthesized (+)RNA genome. Furthermore, cycloheximide abrogated the increase of newly made RNAs during MNV infection. In conclusion, strand-specific RT-PCR using a sense or antisense primer, in combination with cycloheximide treatment, enabled us to detect positive-sense and negative-sense RNAs selectively and provided a useful tool to understand the replication cycle of MNV.
Animals ; Cell Culture Techniques ; Cycloheximide ; Genome ; Humans ; Mice ; Norovirus ; Polymerase Chain Reaction ; Reverse Transcription ; RNA ; Viruses

PURPOSE: Vitamin D deficiency is still common in pregnant women and infants, especially preterm infants. This study evaluated the prevalence, characteristics, and prenatal and postnatal complications associated with vitamin D deficiency in preterm infants. METHODS: Preterm infants (gestational age of <32 weeks, delivered between January 2014 and December 2014) were divided into two groups according to umbilical cord blood 25-hydroxyvitamin D concentrations (deficiency group, <20 ng/mL; non-deficiency group, ≥20 ng/mL), and associated factors were evaluated. RESULTS: The mean concentration of 25-hydroxyvitamin D in the preterm infants was 14.3±9.7 ng/mL. 80% (78 out of 98) of subjects had vitamin D deficiency (<20 ng/mL), and 45% (44 out of 98) of preterm infants had a severe vitamin D deficiency (<10 ng/mL). No seasonal variation was observed in 25-hydroxyvitamin D concentration. Mean gestational age and birth weight were lower in the deficiency group. The serum calcium and alkaline phosphatase (ALP) concentrations, which reflect bone metabolism, were significantly different between the two groups, but not the serum phosphorous concentrations. Maternal prenatal complications and infant complications were not significantly different between the two groups. CONCLUSION: The prevalence of vitamin D deficiency is high, and it is a persistent problem among Korean mothers and their newborn infants, especially preterm infants. Thus, it is important to prevent vitamin D deficiency by early detection of the deficiency and supplementation of vitamin D.
Alkaline Phosphatase ; Birth Weight ; Calcium ; Female ; Fetal Blood ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Metabolism ; Mothers ; Pregnant Women ; Prevalence ; Seasons ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*