No abstract available.
Funnel Chest*

PURPOSE: Cerebral palsy or hearing disability of hyperbilirubinemic complication was reduced by blood exchange transfusion(BET) and phototherapy(PT). But in spite of these treatment, abnormal Auditory Brainstem evoked Response(ABR) finding after BET or PT and neurodevelopmental defect due to chronic bilirubin encephalopathy were observed. So we have studied risk factors and outcome of chronic bilirubin encephalopathy after BET, and treatment of hyperbilirubinemia. METHODS: We have analyzed clinical characteristics, the finding and change of ABR after BET in 17 hyperbilirubinemic neonates, and in 8 hyperbilirubinemic neonates who were treated by phototherapy and 15 normal control neonates. RESULTS: 1) Mean bilirubin concentraion were 27.5+/-4.1mg/dL in BET group and 22.1+/-2.3 mg/dL in PT group. There were no difference of clinical findings between BET and PT group. 2) Change of ABR (1) Wave I loss resulted in 4 neonates, wave III loss in 3 neonates, and wave V loss in 2 neonates in BET group(P<0.05). (2) Wave I peak latency and hearing threshold in BET group were significantly increased more than normal control group(P<0.01). 3) In 10 neonates(58.8%) among 17 BET group, 4 neonates(50%) in 8 PT group were observed abnormal initial ABR finding after jaundice treatment. Age at treatment and duration of jaundice(interval between onset of jaundice and treatment) in abnormal ABR group were significant prolongation compared with normal ABR group(P<0.05). 4) Chronic bilirubin encephalopathy(CBE) was observed in 3 neonates(17.6%) among 17 BET group and showed higher of bilirubin level than normalized group after BET (31.1mg/dL vs 26.6mg/dL), other clinical findings showed no significant differences. CONCLUSION: Bilirubin level was significantly elevated in CBE more than in BET group and duration of jaundice, age at treatment were longer in abnormal ABR group than in normal ABR group. So not only bilirubin level but also duration of jaundice shoud be considered at jaundice treatment, and ABR has a potential utility in detection of acute brain toxicity of bilirubin and follow up evaluation of bilirubin encephalopathy.
Bilirubin ; Brain ; Brain Stem ; Cerebral Palsy ; Follow-Up Studies* ; Hearing ; Humans ; Hyperbilirubinemia ; Infant, Newborn* ; Jaundice ; Kernicterus ; Phototherapy* ; Risk Factors

BACKGROUND: Relative changes of astroglial volume constitute the major part of brain edema, which is related to delayed neuronal damage. Several factors including glutamate may contribute to astroglial swelling. Intravenous anesthetic, ketamine was known to restore neuronal damage by inhibiting NMDA receptor activity. Therefore, we decided to investigate the effect of ketamine on the astrocyte swelling by glutamate in the present study. METHODS: To analyze cell swelling in vitro, glial cell line, U1242MG was used. The effects of glutamate (1, 2, 3 mM), and glutamate with ketamine (1 mM) on the regulation of astrocyte volume were achieved by flow cytometry system. To eliminate the dead cells from experimental cell suspension and to assess cell viability, fluorescent dye propidium iodide was used. RESULTS: Glutamate addition (1, 2, 3mM) caused astroglial swelling both in calcium present and calcium absent buffer. The difference of cellular swelling dependent on glutamate concentration was only seen in calcium free buffer (p<0.05). Ketamine per se did not affect astroglial volume. However, when it was added to glutamate perfusion, 1 mM ketamine diminished cellular swelling by glutamate during first 10 minutes (p<0.05), and cellular shrinkage by glutamate after 1 hour incubation (p<0.05). CONCLUSIONS: Ketamine (1 mM) is effective in the regulation of astroglial volume alterations induced by glutamate in both short time and long time perfusion.
Astrocytes ; Brain Edema ; Calcium ; Cell Survival ; Flow Cytometry ; Glutamic Acid* ; Ketamine* ; N-Methylaspartate ; Neuroglia ; Neurons ; Perfusion ; Propidium

No abstract available.
Anxiety ; Cellular Phone ; Humans ; Impulsive Behavior

No abstract available.
Anxiety ; Cellular Phone ; Humans ; Impulsive Behavior

The purpose of the study is to research the side effects of chemotherapy which are experienced by cancer patients, theirself-care behaviors to manage the side effect symptoms, and to for provide the fundamental knowledge basis for nursing intervention and self-care education. The subjects were 15 cancer patients receiving chemotherapy in 2 university hospitals. The side effects and self-care behaviors were categorized into 7 themes. 1) First theme Patients experienced nausea, vomiting, alteration in appetite, constipation, diarrhea, and indigestion. Patients used emetics, ate sweets, fruits, drank alcohol and cold veberages to deal with nausea and vomiting. They took their favorites, and yogurt and medicine, and an easily digestible diet to decrease the side effects on digestive function. 2) Second theme Patients experienced oral-dryness & stomatitis. Patients consumed water, candy a warm food and various beverages. 3) Third theme, To cope with changed sense of taste, patient ate their favorite foods, and to help offset alteration in tactile sense they used massage. Concerning changed sensitivity to decreased temperature, ultraviolet treatment and various means of keeping warm were used. To deal with the changed sense of smell and hearing, they avoided noise and bad odors as much as possible. 4) Fourth theme Patients experienced discoloured skin and alopecia. Patients wore appropriate clothes to hide it. To deal with alopecia, they used hats, head kerchief, and positive thinking. 5) Fifth theme Patients experienced weight loss, URI symptoms, fatigue, pain, insomnia and they took various food health products, medicines, and naps. 6) Sixth theme Patients experienced musculoskeletal changes and decreased amounts and range of activities. They did self-care behaviors such as taking baths, exercising etc. 7) Seventh theme Patients felt varing level of anxiety and for this they had fellowship with support companies and used religion, self-control, and positive thinking. From the above research, it can be concluded that : Patients used self-care behaviors which were not proved in effectiveness and education for the prevention and management of the related side effects of chemotherapy was not effective, either.
Alopecia ; Anxiety ; Appetite ; Baths ; Beverages ; Candy ; Constipation ; Diarrhea ; Diet ; Drug Therapy ; Dyspepsia ; Education ; Emetics ; Fatigue ; Fellowships and Scholarships ; Fruit ; Head ; Hearing ; Hospitals, University ; Humans ; Massage ; Nausea ; Noise ; Nursing ; Odors ; Self Care* ; Skin ; Sleep Initiation and Maintenance Disorders ; Smell ; Stomatitis ; Thinking ; Vomiting ; Water ; Weight Loss ; Yogurt

In recent years the rate of the spine Injury tends to be on the increase year by year as the rate of traffic and industrial accidents are increased. During industrial, sports and automobile accidents are occurred, the various forces were exerted by the mechanism, “flexion, extension, flexlon-rotation, vertlcal compression and shearing.” These exercise their effects on the vertebral bodies, the neural arches and intervertebral disc and the contents of the spinal cord, depending on direction and intensity of the trauma, and the posture and muscular attitude existent at the movement. Once the neurological Iesion has been diagnosised and the type of vertebral injury has been established and particularly after a decision has been made as to whether the spinal injury is stable or unstable, a rational method of treatment can be decised upon: Our treatment consists of providing the best condition for recovery from the spine injury, preventlng further neurologlcal damage in the unstable area, achieving stable bone and llgament heallng ln satisfactory position, preventing metabolic compllcations from being fatal, mobllizing the patient early, and rehabilitating to provide maximum fuctlonal independence with the remaining-muscle power avallablc to the cord injury patient. One hundred and fifty seven spine fracture and dislocation patients were clinically observed and evaluated from Jan. 1972 to Dec. 1978 in our study. The result of this study may be summerized as follows: 1. Out of the patients, there were 135 male and 22 female cases. The ratio between male and female was 6.1:1. The majority (84.7%) of the spine injuries was found in the age of 20 to 50 years. Fifty-two percent of the cases was caused by industrial accidents. 2. The most common site of the lesion occurred between T-11 and L-2 vertebrae (71.8%). 3. In cervical injury, fracture dislocation type was most common (50%), and especially, pure dislocation by extension mechanism was 12.5% but in thoracolumbar iniury, simple anterior wedge compression fracture was most common (66.6%) and there were no pure dislocations just like cervical spine injury cases. 4. Fifty seven cases of the total were complicated by paraplegia, of which 62.5% in cervical region and 31.6% in thoracolumbar region were noticed. The most frequent type of the injury in which paraplegia developed was the fracture dislocation (73.8%) and the most common site of the lesion was between the T-12 and the L-2 vertebrae. 5. Open reduction was performed in 9 cases out of 24 cervical spine injury patients and in 41 cases out of 133 thoracolumbar injury patients. 6. Prognosis of neurologic recovery in initially complete lesion was poor, regardness of treatment. In the cervical lesion cases there were no patients who were recovered. But in the other sites about 10.5% of initially complete lesion showed partial neural recovery comparing to 62.5% of initially incomplete lesions. 7. Progressive deformity is often noted as a complication of spine fracture or dislocation when solid fusion fails to develop. The increment of kyphosis after treatment is as follows: Simple wedge fracture
Accidents, Occupational ; Automobiles ; Catheterization ; Catheters ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Female ; Fractures, Compression ; Humans ; Intervertebral Disc ; Kyphosis ; Laminectomy ; Male ; Methods ; Paraplegia ; Posture ; Prognosis ; Spinal Cord ; Spinal Injuries ; Spine ; Sports ; Urinary Bladder

Since the placenta is an organ composed of blood vessels, it is not surprising that its primary neoplasm would be a vascular tumor. Placental tumors, primary or secondary, have been known to interfere with placental function. Chorioangioma(primary tumor of the placenta), which is the most common of them, occurs with an incidence for clinically significant ranges from 1~2.8:10000 births. These tumors are benign and are not usually associated with clinical sequelae unless they are larger than 5cm in long diameter. About one third of the large chorioangiomas may be associated with the maternal and fetal complications. For diagnosis of these lesions, the ultrasonography was used. If the chorioangioma is suspected, color doppler study is informative to confirm the presence of the vascular channels. We reviewed ultrasonograms and clinical records of seven patients who had been diagnosed as placental chrioangioma. The appropriate diagnostic tests and treatment can then be initiated in order to prolong gestation and decrease fetal mortality and morbidity.
Blood Vessels ; Diagnosis ; Diagnostic Tests, Routine ; Fetal Mortality ; Hemangioma* ; Humans ; Incidence ; Parturition ; Placenta* ; Pregnancy ; Prenatal Diagnosis* ; Ultrasonography

Bleeding from esophageal or gastric varix is the most critical and life-threatening complication of portal hypertension and the most common cause of deaths in the patients with cirrhosis. In the management of variceal bleeding, the various therapeutic interventions including operation and nonoperative procedure were tried, but neither of management was successfully achieved. Between February 1992 and November 1994, we performed endoscopic injection sclerotherapy(EIS) in 35 cirrhotic patients who had recently bled from esophageal varices and had a past history of esophageal variceal bleeding in Chonbuk National Univesity Hospital. Among 35 patients, 32 were male and 3 were female. The underlying severity of liver disease was graded A, B or C according to modification of Child-Pugh classification. EIS was repeated every 1 week until the esophageal varices had been complete obliterated and removed. To investigate the effects of esophageal varix eradication by EIS on combined peri- cardial varix, endoscopic examinations were performed both before procedure and after complete EIS sessions and this study was performed to examine a changes of combined pericardial varices after EIS procedure for the treatment of esophageal varices bleeding secondary to portal hypertesion. We reviewed medical records and compared changes or sizes of pericardial varices before and after EIS procedure. Mean follow up peiod was 61 days. Total number of 162 EIS for variceal eradication were performed. Mean session for eradication of esophageal varices was 4.6 per person, mean amount of injected sclerosant was 8.3cc(1-18cc), mean duration of EIS was 39 days, and mean follow up was 62 days after complete EIS procedure. In total 162 EIS procedure, complications associated with EIS including substernal discomfort 53.7%(n=87), substernal chest pain 45.7%(n=74), fever 4.9%(n=8), dysphagia 14.2%(n=23) and pleural effusion 3.1%(n=5), were transient and not required specific management. During the follow-up period, complete disapperance of pericardial varix or reduction of size was appeared in l8 cases(51.4%) among total 35 patients. No significant changes of variceal size before and after procedure were l6 cases(45.7%) and only 1 case(2.9%) was more aggravated. So, these results suggest that EIS procedure of esophageal varix on pericardial varix seems either to improve or to maintain the severity of the pericardial gastric varix without aggravation.
Cause of Death ; Chest Pain ; Classification ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Ethanolamine* ; Female ; Fever ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension, Portal ; Jeollabuk-do ; Liver Diseases ; Male ; Medical Records ; Oleic Acid* ; Pleural Effusion ; Sclerotherapy* ; Varicose Veins

Bleeding from esophageal or gastric varix is the most critical and life-threatening complication of portal hypertension and the most common cause of deaths in the patients with cirrhosis. In the management of variceal bleeding, the various therapeutic interventions including operation and nonoperative procedure were tried, but neither of management was successfully achieved. Between February 1992 and November 1994, we performed endoscopic injection sclerotherapy(EIS) in 35 cirrhotic patients who had recently bled from esophageal varices and had a past history of esophageal variceal bleeding in Chonbuk National Univesity Hospital. Among 35 patients, 32 were male and 3 were female. The underlying severity of liver disease was graded A, B or C according to modification of Child-Pugh classification. EIS was repeated every 1 week until the esophageal varices had been complete obliterated and removed. To investigate the effects of esophageal varix eradication by EIS on combined peri- cardial varix, endoscopic examinations were performed both before procedure and after complete EIS sessions and this study was performed to examine a changes of combined pericardial varices after EIS procedure for the treatment of esophageal varices bleeding secondary to portal hypertesion. We reviewed medical records and compared changes or sizes of pericardial varices before and after EIS procedure. Mean follow up peiod was 61 days. Total number of 162 EIS for variceal eradication were performed. Mean session for eradication of esophageal varices was 4.6 per person, mean amount of injected sclerosant was 8.3cc(1-18cc), mean duration of EIS was 39 days, and mean follow up was 62 days after complete EIS procedure. In total 162 EIS procedure, complications associated with EIS including substernal discomfort 53.7%(n=87), substernal chest pain 45.7%(n=74), fever 4.9%(n=8), dysphagia 14.2%(n=23) and pleural effusion 3.1%(n=5), were transient and not required specific management. During the follow-up period, complete disapperance of pericardial varix or reduction of size was appeared in l8 cases(51.4%) among total 35 patients. No significant changes of variceal size before and after procedure were l6 cases(45.7%) and only 1 case(2.9%) was more aggravated. So, these results suggest that EIS procedure of esophageal varix on pericardial varix seems either to improve or to maintain the severity of the pericardial gastric varix without aggravation.
Cause of Death ; Chest Pain ; Classification ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Ethanolamine* ; Female ; Fever ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension, Portal ; Jeollabuk-do ; Liver Diseases ; Male ; Medical Records ; Oleic Acid* ; Pleural Effusion ; Sclerotherapy* ; Varicose Veins