No abstract available.
Encephalitis* ; Prognosis*

No abstract available.
Chylothorax* ; Chylous Ascites*

BACKGROUND: To assess and report the outcomes of resuscitation, we apply the 1997 published In-Hospital Utstein Style to an actual emergency department. This study was designed to develope the data base for comparing and studing the outcomes of resuscitation. METHODS: This study was carried out in a tertiary hospital from July 1998 to June 1999. The subjects were adult patients over the age of 20 years who received resuscitation at the emergency department. After making out the protocol for the In-Hospital Utstein Style, we gathered data prospectively. RESULTS: Among 51,347 patients, 36 patients received 42 resuscitations. Forty-two(42) cases(100%) had witnessed arrest. Advance life support(ALS) intervention at the time of cardiac arrest included intravenous catheterization, 41cases(97.6 %); intravenous drug injection, 20 cases(47.6%); endotracheal intubation, 20 cases(47.6%); and artificial ventilation, 12 cases(28.6%). Immediate causes of cardiac arrest were respiratory depression, 11 cases(26.2%); hypotension, 11 cases(26.2 %); metabolic, 9 cases(21.4%); and myocardial ischemia/infarction, 5 cases(11.9%). Initial EKG ryhthms were pulseless electrical activity, 31 cases(73.8 %); ventricular tachycardia/fibrillation, 6 cases(14.3%); and asystole, 5 cases(11.9%). the average interval from cardiac arrest to initial defibrillation was 1.8+/-2.2 minutes, and the average interval from cardiac arrest to epinephrine injection was 2.6+/-3.1 minutes. The average duration of resuscitation was 22.6+/-18.4 minutes. Return of spontaneous circulation occured in 26 cases/42 case(61.9%). Of the 2 survivng patients who were discharged, 1 patient is still alive after 6 months, and the other is still alive after 1 year. CONCLUSION: Although the In-Hospital Utstein Style has many complementary factors, its results were very objective thus use of the In-Hospital Utstein Style is recommended for determining the outcomes of resuscitation.
Adult ; Catheterization ; Catheters ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Epinephrine ; Heart Arrest ; Humans ; Hypotension ; Intubation, Intratracheal ; Prospective Studies ; Respiratory Insufficiency ; Resuscitation* ; Tertiary Care Centers ; Ventilation

BACKGROUND: Childhood and adolescent obesity, not only increases the risk of obesity into adulthood but also is a significant culprit affecting health in general. The purpose of this study was to examine the trend in body mass index (BMI) and to investigate the prediction of adolescence overweight from childhood weight status by retrospectively tracking for seven years. METHODS: The subjects, 520 adolescents aged 14 and 15 years, were recruited from a junior high school that is located in Guri-city. The subjects' height and weight measurements were extracted from the school records of annual physical examination. We assessed their BMI over a period of seven years starting at age seven. Other baseline data were obtained by questionnaires which were completed by both the subjects and their parents in 2001. RESULTS: The prevalence of overweight, according to the Korean Pediatric Society guideline, increased at age 7 through 14. The overweight adolescents of age 14 were more likely to have an obese mother. The results showed that 84% of males and 47% of females who were overweight in childhood continued to remain overweight in adolescence. Compared to the non-overweights, the relative risk of becoming an overweight adolescent among overweight boys was 5.7 (95% CI: 4.1~8.1) and among overweight girls was 6.3 (95% CI: 3.4~11.4). CONCLUSION: Approximately 70% of the overweight children continued to remain overweight as adolescents. Therefore, prevention and effective management of obesity during childhood and adolescence are essential.
Adolescent* ; Body Mass Index* ; Child* ; Female ; Humans ; Male ; Mothers ; Obesity ; Overweight* ; Parents ; Pediatric Obesity ; Physical Examination ; Prevalence ; Retrospective Studies* ; Surveys and Questionnaires

BACKGROUND: The decisive factors influencing the eradication of H. pylori still remain unclear. It was our aim to assess H.pylori eradication rate with proton pump inhibitor based triple therapy and investigate the clinical characteristics and endoscopic factors. METHODS: We investigated 106 male patients with H.pylori- positive peptic ulcer. The patients were treated with a 1-week regimen composed of omeprazole, amoxicillin and clarithromycin. THe success of the treatment was evaluated by histology at least 4 weeks after completion of therapy. Endoscopic factor and clinical factors influencing H.pylori eradication were assessed. RESULTS: The overall eradication of H.pylori was successful in 87 of 106 patients (82%). The eradication rate was higher in those who drink or smoke, with gastric ulcer, less than 50 years old but these factors did not significantly influence the outcome of treatment. CONCLUSIONS: H.pylori eradication rate with omeprazole, amoxicillin, and clarithromycin did not differ from other studies. These results suggest that factors such as smoking, drinking, age and ulcer site did not influence the eradication rate of H.pylpori.
Amoxicillin ; Clarithromycin ; Drinking ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Middle Aged ; Omeprazole ; Peptic Ulcer* ; Proton Pumps ; Smoke ; Smoking ; Stomach Ulcer ; Ulcer

BACKGROUND: Maintenance of volume status and treatment of hypovolemia constitute an important component of anesthetic management. A Pulse oxymeter providing a continuous display of the pulse waveform offers a new method of estimating relative volume status during positive pressure ventilation. This study was undertaken to use the pulse wave variance of a plethysmographic signal measured from a pulse oximeter as a useful tool in the assessment of volume status. METHODS: Forty patients underwent general anesthesia with controlled positive pressure ventilation. After induction, the fluid infusion rate was 100 cc/hr until the dura was opened. During the operation, fluid losses were not replaced until hemodynamic variables were printed out. In addition to standard monitoring,the arterial pressure was monitored with a radial artery catheter. Systolic pressure variation (SPV) was defined as the maximum variation in peak systolic pressure during the respiratory cycle and measured in mmHg. Plethysmographic pulse wave variation (PWV) was defined as the maximum variation in the waveform peaks during the respiratory cycle and measured in millimeters from the printed output of the pulse oximeter. SPV and PWV were printed out right after induction and right before dura opening. In addition to SPV and PWV, other hemodynamic variables (HR, MAP, CVP) were obtained. RESULTS: Heart rate, SPV and PWV increased before the dura opening compared with those after induction. PWV correlated well with SPV after fluid losses CONCLUSIONS: A Pulse oximeter which is a standard monitor in anesthesia provides a useful, noninvasive and inexpensive adjunct to the more invasive estimators of volume status.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure* ; Catheters ; Heart Rate ; Hemodynamics ; Humans ; Hypovolemia ; Positive-Pressure Respiration ; Radial Artery

BACKGROUND: The sodium concentration in the central nervous system may play an important role in cardiovascular function and body fluid regulation. The purpose of this investigation was to examine the effects of intracerebroventricular (ICV) infusion of hypertonic NaCl solutions on the cardiovascular responses in normotensive and 2-kidney, 1 clip (2K1C) renal hypertensive rats. METHODS: 2K1C hypertension was made by clipping the left renal artery and were used 4 weeks later. Age-matched control rats received a sham treatment. Under thiopental (50 mg/kg, IP) anesthesia, both isotonic and hypertonic NaCl solutions (0.15 M, 0.6 M and 1.2 M) were ICV applied, while blood pressure and heart rate (HR) responses were continuously monitored. RESULTS: Central administration of hypertonic NaCl solution caused an elevation in mean arterial pressure (MAP) and HR in both normotensive and 2K1C hypertensive rats. The response magnitude in the blood pressure was positively correlated to the NaCl concentration in normotensive rats, while the pressor responses to hypertonic NaCl were comparable regardless of the concentration of NaCl in hypertensive rats. Despite of the HR responses were similar in between two groups, the magnitude of the MAP increases were more elevated in hypertensive than in normotensive control rats. Isotonic NaCl solution, when centrally applied, caused an elevation in blood pressure only in hypertensive rats. CONCLUSION: These results indicate that the central sensitivity to sodium chloride is altered in 2K1C renal hypertensive rats.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Body Fluids ; Central Nervous System ; Heart Rate ; Hypertension ; Hypertension, Renal ; Infusions, Intraventricular* ; Placebos ; Rats* ; Renal Artery ; Sodium ; Sodium Chloride ; Thiopental

BACKGROUND: Cadmium, an environmental pollutant, has implicated in the pathogenesis of cardiovascular diseases. Biochemical and pathophysiological changes characterized by arterial hypertension, accelerated cholesterol plaque formation on arterial walls, cardiac conduction abnormalities, and reduction in myocardial contractility have been reported in experimental animals chronically exposed to low concentration of cadmium. This study was undertaken to evaluate the ultrastructural changes of the cardiac muscle in rats exposed to cadmium chloride and to ascertain whether these changes are modified after discontinuation of cadmium feeding. METHOD: Wistar strain rats(body weight 200~250gram) were injected intraperitoneally once weekly with 3.75mg/kg of cadmium chloride for 10 weeks and were sacrificed at 1 day, 1 week and 2 weeks after discontinuation of cadmium administration. RESULT: Ultrastructure if rat cardiac muscle fibers after cadmium administration revealed that mitochondria were increased in number and their cristae were severely damaged. Cardiac myofibrils and myofilaments were reduced. Z-disc were partly dislocated and A-bands and I-bands were not clearly defined. Irregularly arranged intercalated disc and disrupted sarcolemma were also found. These structural alterations resulting from cadmium feeding were partly reduced after removal of cadmium exposure for 2 weeks. These structural alterations resulting from cadmium feeding were partly reduced after removal of cadmium exposure for 2 weeks. CONCLUSIONS: It is suggested that exposure to cadmium chloride was associated with cardiac ultrastructural changes which might be responsible for physiologic abnormalities and these alterations may be partly reversible after discontinuation of cadmium administration.
Animals ; Cadmium Chloride* ; Cadmium* ; Cardiovascular Diseases ; Cholesterol ; Hypertension ; Mitochondria ; Myocardium* ; Myofibrils ; Rats* ; Sarcolemma

The abnormalities of left ventricular ejection patterns have been studied using echocardiography, contrast angiography, radionuclide angiography, and apex cardiography in patients with various heart disease. Recently it has been recognized that diastolic impairment may occur in the absence of abnormal systolic performance in hypertension, valvular heart disease, ischemic heart diseases, and cardiomyopathies. In order to identify whether diastolic dysfunction can develop without systolic dysfunction, we evaluated patterns of left ventricular filling and ejection by echocardiography in 10 chronic mitral regurgitations without pulmonary congestion symptom, who were confirmed by cardiac catheterization. Indices of left ventricular systolic function, including ejection fraction, fractional shortening, ejection rate, mean velocity of circumferential fiber shortening, and preejection period/left ventricular ejection time revealed no significant difference in mitral regurgitation patients compared with normal control group. Diastolic parameters, including atrial emptying index,mean velocity of circumferential fiber lengthening, rapid filling period, and rapid filling velocity were changed significantly in mitral regurgitation. There were no significant alterations in blood pressure and heart rate between two groups. It is concluded that impaired diastolic performance may be frequently encountered in patients with chronic mitral regurgitation and intact systolic function.
Angiography ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathies ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart Diseases ; Heart Rate ; Heart Valve Diseases ; Humans ; Hypertension ; Kinetocardiography ; Mitral Valve Insufficiency* ; Myocardial Ischemia ; Radionuclide Angiography ; Ventricular Function, Left*

BACKGROUND: Topoisomerase II (topo II) is a major target of anthracyclines and epipodophyllotoxins for anticancer treatment. The expression of topo II is low in drug resistant cell lines. High levels of glutathione S-transferase (GST)pi have been associated with emergence of cell lines resistant to alkylating agents or adriamycin. METHODS: By immunostaining with paraffin embedded bone marrow tissues, the expression of topo II alpha and GSTpi was investigated in 51 patients with acute myeloid leukemia (AML), and the relation of topo II alpha and GSTpi expression to treatment response in 29 patients with AML following induction chemotherapy was also evaluated. RESULTS: Topo II positive cells varied from less than 1% to 60% of leukemic cells and 20 (39.2%) were negative for topo II (positive cells<10%). Treatment response following chemotherapy was not related to topo II. 26 (51.0%) were positive for GSTpi. GSTpi expression was related to treatment resistance of the patients following chemotherapy. In the patients who showed both topo II alpha negative and GSTpi positive, the frequency of treatment resistance following chemotherapy was high. CONCLUSIONS: This study suggests that immunostaining of topo II alpha and GSTpi with the bone marrow paraffin sections of AML patients can be useful to predict the treatment response following chemotherapy and that further study including more patients with prospective study may substantiate topo II alpha and GSTpi as multidrug resistant markers.
Alkylating Agents ; Anthracyclines ; Bone Marrow ; Cell Line ; DNA Topoisomerases, Type II* ; Doxorubicin ; Drug Resistance, Multiple ; Drug Therapy ; Glutathione S-Transferase pi* ; Glutathione Transferase* ; Glutathione* ; Humans ; Immunohistochemistry ; Induction Chemotherapy ; Leukemia, Myeloid, Acute* ; Paraffin ; Podophyllotoxin