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: Platelet refractoriness has been reported to occur in 30-70% of multitransfused patients. This can result by either immune or nonimmune mechanisms. The predominant immune cause of platelet refractoriness is alloimmunization to HLA class I antigens. Recently, acid-treated platelets have been used in a few patients with platelet refractoriness due to HLA alloantibodies. However, the effect of acid-treated platelets has not been consistent. The aim of this study was to evaluate the in vivo survival of acid-treated, HLA-eluted platelets in HLA-immunized rabbits. METHODS: For in vivo survival test, 14 New Zealand White rabbits were studied. Four rabbits were in the nonimmunized control and 10 were immunized by weekly transfusions of human pooled platelets for six weeks. The HLA-immunized group was separated into two groups with transfusion of acid-treated platelets and untreated platelets. The survival of transfused platelets in rabbits with immunization and control group was estimated by a flow cytometer using FITC-labeled anti-CD42a. We also examined the HLA re-expression in acid-treated platelets due to regeneration and adsorption of HLA from human plasma. RESLUTS: The half-life of untreated platelets in nonimmunized rabbits was 11.8 +/- 3.7 hr. The half-life of acid-treated platelets in rabbits with HLA antibodies was 9.5 +/- 5.5 hr and the half-life of untreated platelets in rabbits with HLA antibodies was 5.9 +/- 2.9 hr. The difference between untreated platelets in the nonimmunized control group and acid-treated platelets in rabbits with HLA antibodies was statistically insignificant (p=0.221). Re-expression of HLA-A,B,C by endogenous resynthesis occurred continuously, and after 24 hrs it reached 84% of pre-elution level. Adsorption of HLA antigens from human plasma was completed within four hrs. CONCLUSIONS: Acid-treated, HLA-eluted platelets may be applicable for the patients with refractoriness to platelet transfusion, especially, in case of unavailability of HLA-compatible donors and fatal bleeding such as intracranial hemorrhage and pulmonary hemorrhage. However, the post-transfusion increment of the platelet count could not be maintained over 24 hrs because of the endogenous resynthesis of HLA antigens.
Adsorption ; Antibodies ; Blood Platelets ; Half-Life ; Hemorrhage ; Histocompatibility Antigens Class I ; HLA Antigens ; Humans ; Immunization ; Intracranial Hemorrhages ; Isoantibodies ; Plasma ; Platelet Count ; Platelet Transfusion ; Rabbits* ; Regeneration ; Tissue Donors

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

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*

No abstract available.
Dexmedetomidine* ; Propofol*