No abstract available.
Anencephaly* ; Humans ; Pregnancy, Twin* ; Twins*

We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a use ful noninvasive means of monitoring cerebrohemodynamics in normal pretem neonates and flow change of sick babies.
Infant ; Male ; Female ; Infant, Newborn ; Humans

No abstract available.
Intervertebral Disc*

BACKGROUND: The arterial baroreflex is a key mechanism involved in blood pressure (BP) homeostasis and serves as a pressure buffer system against increase and decrease in BP. In contrast to awake patients, little has been known about correlations among METHODS assessing spontaneous baroreflex sensitivity (SBRS) during general anesthesia. The aim of present study was to compare SBRS obtained from sequence method and transfer function analysis (TFA), and examined their relationship to vagal cardiac function in patients during sevoflurane general anesthesia. METHODS: 20 patients were anesthetized with 1 MAC sevoflurane with 50% N2O and mechanically ventilated at 0.25 Hz. 5 min beat-to-beat BP and electrocardiogram were recorded to assess sequence BRS and TFA BRS from spontaneous RR interval and systolic BP fluctuation. We derived 4 proposed indices (Sequence BRS, low frequency (LF) BRS, high frequency (HF) BRS, and average BRS). RESULTS: The indices were correlated with each other significantly and the Bland-Altman method demonstrated that sequence BRS was in close agreement with each other except LF BRS. The indices were also correlated highly with HF heart rate variability representing vagal cardiac function. CONCLUSIONS: SBRS was related to vagal cardic function. Because of the correlations and agreements between these two METHODS, it may employ them except for LF BRS during sevoflurane general anesthesia.
Anesthesia* ; Anesthesia, General ; Baroreflex* ; Blood Pressure ; Electrocardiography ; Heart Rate ; Homeostasis ; Humans

PURPOSE: Chromosomal aberration has an effect on the lives of both patients and families. Peripheral blood chromosomal analysis is useful to make a diagnosis and counsel the patient with chromosomal abnormality. We studied the cases with peripheral blood chromosomal analyses and investigated the positivity of peripheral blood chromosomal analysis. METHODS: We analyzed 650 patients with chromosomal analyses in Ajou University Hospital during the past 10 years. We used a high-resolution banding technique to diagnose the chromosomal aberrations. RESULTS: The male to female ratio of the patients was 1.1 : 1. Among 650 patients, 108 patients had chromosomal aberrations(16.6%). Fifty seven out of 313 patients with the congenital anomalies or dysmorphologies had chromosomal aberrations. twenty six out of 166 patients with hematologic disorders had chromosomal aberrations. Fifteen out of 109 patients with developmental delay had chromosomal aberrations. Four out of 24 patients with seizures had chromosomal aberrations. Six out of 39 patients with the aberrant perinatal histories had chromosomal aberrations. CONCLUSION: Peripheral blood chromosomal analysis is an important diagnostic method in managing patients with chromosomal aberrations. Further advanced chromosomal staining and molecular genetic methods will raise the detection rate of chromosomal aberration and be useful in managing patients with chromosomal abnormalities.
Chromosome Aberrations ; Diagnosis ; Female ; Humans ; Male ; Molecular Biology ; Seizures

BACKGROUND: This study assessed the changes in the heart rate variability (HRV) indices, which are used to measure the autonomic nervous system function during general anesthesia (GA), and compared the result of the awake state. METHODS: Patients undergoing an explo-laparotomy were anesthetized with either isoflurane (Group I, n = 20) or sevoflurane (Group S, n = 20) added to a mixture of nitrous oxide and oxygen. Frequency-domain analysis of the HRV indices using fast Fourier transformation (FFT) resulted in a power spectrum with a very low (VLF), low (LF), and high frequency (HF) and calculated normalized LF (nuLF), normalized HF (nuHF), and LF/HF ratios before and after GA. Time-domain analysis was performed and the pNN50 (proportion of successive RR intervals [RRI] > 50 ms in relation to the total RRI), RMSSD (root mean square of the successive differences in the RRI), standard deviation 1 (SD1) and standard deviation 2 (SD2) from the Poincare plots, HRV triangular index, and TINN (triangular interpolation of NN interval histogram) were also calculated before and after GA. RESULTS: The VLF, LF, HF, nuLF, and LF/HF ratio during GA decreased by 45.2, 95.1, 83.1, 27.3, and 17.4%, respectively, compared with the awake state. However, the nuHF significantly increased. The RMSSD, pNN50, SD1, SD2, HRV triangular index, and TINN also decreased 62.0, 69.2, 62.0, 61.7, 62.4, and 52.4%, respectively. Groups I and S produced similar alterations in the studied parameters during GA. CONCLUSIONS: GA reduced all the HRV indices studied except for the nuHF.
Anesthesia, General* ; Autonomic Nervous System ; Fourier Analysis ; Heart Rate* ; Heart* ; Humans ; Isoflurane ; Nitrous Oxide ; Oxygen

PURPOSE: Intravenous immunoglobulin (IVIG) is effective for the treatment of idiopathic thrombocytopenic purpura (ITP) in children. Recently, several reports have been published that show its impact on the absolute neutrophil count. The present study was performed to confirm these findings. METHODS: Data on 26 ITP patients were analyzed. Patients with febrile illness or increased C-reactive protein levels at presentation, which would influence the neutrophil counts, were excluded to determine the sole impact of IVIG. In addition, patients who received steroid treatment were also excluded. RESULTS: Sixteen boys and ten girls were analyzed. For patients who received an IVIG dose of 0.4 g/kg/day (n=17), the absolute neutrophil count (ANC) measured next day was significantly decreased. For patients who received an IVIG dose of 1 g/kg/day (n=9), the ANC measured the next day was also significantly decreased. However, the decrease was more profound in the high-dose group compared to the low-dose group. Among six cases with profoundly decreased ANC greater than 1,000/ mm3, four patients (67%) received IVIG at a dose of 1 g/kg/day. All four cases with increased ANC were treated with IVIG dose of 0.4 g/kg/day, and three cases (75%) among them had a febrile reaction during IVIG administration. None of the cases with decreased ANC had a febrile reaction. No cases had infectious complications reported. CONCLUSION: IVIG treatment for ITP patients appears to suppress the ANC. This decrease of ANC was more pronounced when a higher dose of IVIG was used. Some cases with increased ANC counts after IVIG use were found only in low-dose IVIG group, and was associated with febrile reactions during IVIG use.
C-Reactive Protein ; Child* ; Female ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Neutrophils* ; Purpura, Thrombocytopenic, Idiopathic*

BACKGROUND: Although the efficacy of morphine in a neuropathic pain state is somewhat controversial, spinally administered morphine reversed the tactile allodynia in a previous animal study. Using a behaviorial test, we examined the involvement of serotonergic and adenosine receptors in the mechanism of the antiallodynic action of the intrathecal morphine by injection of serotonergic and adenosine antagonist in a rat model of neuropathic pain induced by a spinal nerve ligation. METHODS: Male Sprague-Dawley rats were prepared with a tight ligation of the left lumbar 5th and 6th spinal nerve and a chronic lumbar intrathecal catheter implantation. Morphine 1 microgram was administered intrathecally to attenuate the tactile allodynia. Methysergide 10 microgram and 30 microgram, theophylline 20 microgram was administered intrathecally before and after the injection of morphine in order to investigate the reversal of an increased allodynic threshold by morphine. The allodynic thresholds for the left hindpaw withdrawl to von Frey hairs were assessed and converted to %MPE. RESULTS: The tactile allodynic threshold was significantly increased by 1 microgram of intrathecal morphine (P < 0.05). Methysergide 10 microgram and 30 microgram, but not theophylline 20 microgram, reversed significantly the antiallodynic effect of intrathecal morphine in pre- and post-treatment (P < 0.05). CONCLUSIONS: The results suggested that the mechanism of tactile antiallodynia induced by intrathecal morphine appears to be mediated by serotonin receptor system at the spinal level in the rat model of spinal nerve ligation.
Adenosine ; Animals ; Catheters ; Hair ; Humans ; Hyperalgesia ; Ligation* ; Male ; Methysergide* ; Models, Animal ; Morphine* ; Neuralgia* ; Rats, Sprague-Dawley ; Receptors, Purinergic P1 ; Serotonin ; Spinal Nerves* ; Theophylline*

Adrenal insufficiency, which is related to hemodynamic instability and increased mortality, has been reported in patients with advanced liver disease regardless of the presence of septic conditions. In this regard, the hepatoadrenal syndrome has been recently proposed as adrenal insufficiency in critically ill patients with liver disease. We describe here a 67-year-old female patient with hepatic failure and adrenal insufficiency. The patient showed stable vital signs and no evidence of sepsis preoperatively. Despite hydrocortisone replacement and inotropics administration, severe intraoperative hemodynamic instability was observed. Hydrocortisone administration was continued postoperatively, nevertheless inotropics could not be tapered. On postoperative day 11, the patient died due to pneumonia and septic shock. Hepatoadrenal syndrome may have played a key role in her severe hemodynamic fluctuation and poor outcome, reinforcing the importance of adrenal function in the liver transplantation surgery.
Adrenal Insufficiency ; Critical Illness ; Female ; Hemodynamics ; Humans ; Hydrocortisone ; Liver ; Liver Diseases ; Liver Failure ; Liver Transplantation ; Pneumonia ; Sepsis ; Shock, Septic ; Vital Signs

OBJECTIVE: A system for reinforcing the patient safety has been established based on RFID (Radio Frequency Identification) technology in order to minimize a variety of potential medical errors which can take place in hospitals. The system is intended to prevent simple errors or misunderstandings attributed to manifold surgery, transfusion, and medication errors. METHODS: The RFID system was developed and established in one general hospital. The system was applied to managing the patient in the run-up to surgery during anesthesia preparation, transfusion, and anticancer medications, of which procedure information and the patient information are rechecked for assurance, respectively. RESULTS: With regard to the technological aspects, the system used 13.56 MHz of spectrum bandwidth and tags complying with ISO 15693 standard. The tag readers varied with the work, PDAs in the intensive care unit, and laptop computers in the anesthesiology department and on the general wards. After applying the system, we surveyed user's usage and satisfaction. CONCLUSION: The results of our survey indicated a high level of satisfaction with the RFID system in terms of reinforcing the patient's safety in medical environments. Respondents stated that patients were likely to wear an electronic bracelet, even if inconvenient, with their information revealed on the wrist and while going through extended medical procedures. Nurses had intentions to utilize the RFID system for managing hospital assets and tracking patients. A revitalization of the RFID system would be network stability, including the network environment, as well as quantitative effectiveness analysis.
Anesthesia ; Anesthesiology ; Surveys and Questionnaires ; Electronics ; Electrons ; Hospitals, General ; Humans ; Hypogonadism ; Intensive Care Units ; Intention ; Medical Errors ; Medication Errors ; Mitochondrial Diseases ; Ophthalmoplegia ; Patient Safety ; Patients' Rooms ; Radio Frequency Identification Device ; Track and Field ; Wrist