No abstract available.
Anemia, Iron-Deficiency* ; Erythropoietin* ; Iron* ; Tumor Necrosis Factor-alpha*

BACKGROUND: To reduce the disadvantages with both epidural and spinal block, a combined spinal epidural(CSE) technique was introduced by Brownridge in 1981. The effect of the combined spinal-epidural block was compared with the spinal block for elective cesarean section. METHODS: Fifty healthy parturients were randomly divided into a spinal(n=20) group and a CSE(n=30) group. In the spinal group, 0.5 ml of 5% meperidine(25 mg) mixed with 40~50 mg of 5% hyperbaric lidocaine was injected into the subarachnoid space . In the CSE group, 0.5 ml of 5% meperidine also was injected into the subarachnoid space through a long 26-gauge Quincke needle, which was introduced through an 18-gauge Tuohy needle. An epidural catheter was then inserted and 1.5% lidocaine 7~9 ml was given. RESULTS: 1) The mean time interval from the end of drug injection to T4 sensory block was 3.6?1.0 min in the CSE block and 3.6?1.2 min in the spinal block. The mean level of peak sensory block was T3.3?0.6 in the CSE block and T3.5?0.5 in the spinal block. The time interval between the end of drug injection and Bromage scale 0 of the CSE block(62.1?27.9 min) was significantly (p<0.0001) shorter than the spinal block(102.1?24.0 min). Hypotension ocurred in 14 patients(47%) of the CSE block and 10 patients(50%) of the spinal block. The surgical analgesia was exellent or good in both groups. CONCLUSIONS: The CSE block using meperidine and hyperbaric lidocaine for cesarean section resulted in rapid onset, good surgical analgesia and rapid motor recovery. And incidence of hypotension of the both groups was not significantly different.
Analgesia ; Anesthesia, Epidural* ; Catheters ; Cesarean Section* ; Female ; Hypotension ; Incidence ; Lidocaine* ; Meperidine* ; Needles ; Pregnancy ; Subarachnoid Space

OBJECTIVES: Autism is a complex neurodevelopmental spectrum disorder with a strong genetic component. Previous neurochemical and genetic studies have suggested the possible involvement of the serotonin system in autism. Tryptophan 2,3-dioxygenase(TDO2) is the rate-limiting enzyme in the catabolism of tryptophan, which is the precursor of serotonin synthesis. The aim of this study was to investigate the association between the TDO2 gene and autism spectrum disorders(ASD) in a Korean population. METHODS: The patients were diagnosed with ASD on the basis of the DSM-IV diagnostic classification outlined in the Korean version of the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. The present study included the detection of four single nucleotide polymorphisms(SNPs) in the TDO2 gene(rs2292536, rs6856558, rs6830072, rs6830800) and the family-based association analysis of the single nucleotide polymorphisms in Korean ASD trios using a transmission disequilibrium test(TDT) and haplotype analysis. The family trios of 136 probands were included in analysis. 87.5% were male and 86.0% were diagnosed with autism. The mean age of the probands was 78.5+/-35.8 months(range: 26-264 months). RESULTS: Two SNPs showed no polymorphism, and there was no significant difference in transmission in the other two SNPs. We also could not find any significant transmission in the haplotype analysis(p>.05). CONCLUSION: We could not find any significant statistical association between the transmission of SNPs in the TDO2 gene and ASD in a Korean population. This result may not support the possible involvement of the TDO2 gene in the development of ASD, and further exploration might be needed to investigate other plausible SNP sites.
Appointments and Schedules ; Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Haplotypes ; Humans ; Male ; Metabolism ; Polymorphism, Single Nucleotide ; Serotonin ; Tryptophan

No abstract available.
Humans ; Neutrophils* ; Phagocytosis* ; Stomach Neoplasms*

Esmolol is rapid ultrashort-acting, cardioselective beta1-adrenergic blocker and that is used for attenuation of acute hypertension associated with rapid sequence induction of general anesthesia. A 35-year-old severe preeclamptic patient was scheduled for elective cesarean section. After preoxygenation, anesthesia induced with using penthotal sodium 250 mg, esmolol 25 mg, and succinylcholine 62.5 mg for endotrachial intubation. We detected to increase airway resistance during manual ventilation. Breathing sound was auscultated wheezing and ronchi. And then cyanosis was developed and oxygen saturation was decreased to below 75%. After 20 min, patient's color was returned to pink and patient's self-respiratory function was good. Bronchospasm occured because that beta-adrencergic blockade with esmolol, by leaving the parasympathetic and alpha-adrencrgic influence relatively unopposed. We report bronchospasm after esmolol 25 mg was injeected for attenuation of acute hypertensive response for cesarean section of preeclamptic patient with rapid sequence induction of general anesthesia.
Adult ; Airway Resistance ; Anesthesia ; Anesthesia, General ; Bronchial Spasm* ; Cesarean Section ; Cyanosis ; Female ; Humans ; Hypertension ; Intubation ; Oxygen ; Pregnancy ; Respiratory Sounds ; Sodium ; Succinylcholine ; Ventilation

Esmolol is rapid ultrashort-acting, cardioselective beta1-adrenergic blocker and that is used for attenuation of acute hypertension associated with rapid sequence induction of general anesthesia. A 35-year-old severe preeclamptic patient was scheduled for elective cesarean section. After preoxygenation, anesthesia induced with using penthotal sodium 250 mg, esmolol 25 mg, and succinylcholine 62.5 mg for endotrachial intubation. We detected to increase airway resistance during manual ventilation. Breathing sound was auscultated wheezing and ronchi. And then cyanosis was developed and oxygen saturation was decreased to below 75%. After 20 min, patient's color was returned to pink and patient's self-respiratory function was good. Bronchospasm occured because that beta-adrencergic blockade with esmolol, by leaving the parasympathetic and alpha-adrencrgic influence relatively unopposed. We report bronchospasm after esmolol 25 mg was injeected for attenuation of acute hypertensive response for cesarean section of preeclamptic patient with rapid sequence induction of general anesthesia.
Adult ; Airway Resistance ; Anesthesia ; Anesthesia, General ; Bronchial Spasm* ; Cesarean Section ; Cyanosis ; Female ; Humans ; Hypertension ; Intubation ; Oxygen ; Pregnancy ; Respiratory Sounds ; Sodium ; Succinylcholine ; Ventilation

No abstract available.
Ependymoma*

BACKGROUND: The analgesic efficacy and safety of transdermal fentanyl patch(TDFP) combined with intravenous ketorolac administration were evaluated. METHODS: TDFP releasing 75 mcg/h (Group 1) or 50 mcg/h (Group 2) or placebo (Group 3) were applied to 60 women at 2 hours before abdominal gynecologic surgery. Postoperatively, patients self-administered intravenous ketorolac as required using patient controlled analgesia. Each group was assessed following 48 hours with respect to vital signs, VAS pain score, satisfaction score, side effects, and cumulative ketorolac use. RESULTS: After operation, pain score and ketorolac demand were significantly lower and satisfaction score and side effects were significantly higher in TDFP group (Group 1, 2) than control group (Group 3). CONCLUSIONS: If TDFP is applied 2 hour before surgery, combined with a bolus dose of 200 mcg i.v. fentanyl at induction of anesthesia and ketorolac i.v. infusion in the postoperative period, it provides a significant degree of background analgesia without respiratory depression.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Hysterectomy* ; Ketorolac* ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

PURPOSE: The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes. METHODS: A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses. RESULTS: 29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents. CONCLUSION: Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.
Databases, Factual ; Deglutition ; Deglutition Disorders/*diagnosis ; Humans ; Nursing Homes ; Sensitivity and Specificity

PURPOSE: The purpose of this study was to examine the effects of case-base learning (CBL) using video on clinical decision-making and learning motivation. METHODS: This research was conducted between June 2009 and April 2010 as a nonequivalent control group non-synchronized design. The study population was 44 third year nursing students who enrolled in a college of nursing, A University in Korea. The nursing students were divided into the CBL and the control group. The intervention was the CBL with three cases using video. The controls attended a traditional live lecture on the same topics. With questionnaires objective clinical decision-making, subjective clinical decision-making, and learning motivation were measured before the intervention, and 10 weeks after the intervention. RESULTS: Significant group differences were observed in clinical decision-making and learning motivation. The post-test scores of clinical decision-making in the CBL group were statistically higher than the control group. Learning motivation was also significantly higher in the CBL group than in the control group. CONCLUSION: These results indicate that CBL using video is effective in enhancing clinical decision-making and motivating students to learn by encouraging self-directed learning and creating more interest and curiosity in learning.
*Decision Making ; Education, Nursing, Baccalaureate ; Female ; Humans ; Male ; Motivation ; Problem-Based Learning ; Program Evaluation ; Questionnaires ; Students, Nursing/*psychology ; Videotape Recording ; Young Adult