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*

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

BACKGROUND: The arterial baroreflex is a key mechanism for maintaining blood pressure homeostasis. Low-dose atropine (LDA) causes bradycardia, either by acting on the sinoatrial node or due to its effect on central muscarinic receptors, which increases vagal activity. We evaluated the effect of LDA on baroreflex sensitivity (BRS) in healthy awake subjects. METHODS: We assessed changes in RR interval (RRI) and systolic blood pressure (SBP), power spectral densities of heart rate variability (HRV) and systolic blood pressure variability (SBPV), and spontaneous BRS by using transfer function analysis before and after LDA (2microgram/kg) in 17 healthy volunteers. RESULTS: LDA induced not only bradycardia but also increased of the high-frequency (HF) component of HRV, RMSSD (root mean squared successive difference interval), and pNN50 (percentage of sinus cycles differing from the preceding cycle by > 50 ms). The HF and LF components of SBPV remained unchanged. Spontaneous BRS determined by transfer function analysis increased significantly (P < 0.05), and changes in BRS were significantly associated with changes in the HF component of HRV (P < 0.05). CONCLUSIONS: LDA increased vagal cardiac function and arterial baroreflex in awake subjects. This result suggests that increased vagal cardiac function by LDA application is related to baroreflex increase.
Atropine* ; Baroreflex* ; Blood Pressure ; Bradycardia ; Healthy Volunteers ; Heart Rate ; Homeostasis ; Receptors, Muscarinic ; Sinoatrial Node

BACKGROUND: Mechanical allodynia is generally resulted from nerve damage by direct injury or inflammation. Thus, this study was designed to compare the antiallodynic effect of morphine, brimonidine and rilmenidine in two models of neuropathic pain, that is, induced by nerve ligation and neuritis. METHODS: Rats were prepared with tight ligation of the L5/L6 spinal nerves (SNL group) or with Freund's complete adjuvant (FCA) administration evoked sciatic inflammatory neuritis (SIN group). Antiallodynic effects by intrathecal morphine, brimonidine and rilmenidine were measured by applying von Frey filaments to the lesioned hind paw. Thresholds for withdrawal response were assessed and converted to % MPE to obtain an effective dose 50% (ED 50) and a dose response curve. RESULTS: Either SNL group or SIN group showed marked mechanical allodynia in the lesioned hind paw. Antiallodynic effects of morphine were different between two groups. That is ED 50 was 0.16 microgram (SIN) and 8.12 microgram (SNL), and dose response curve of the SIN group shifted left from that of the SNL group. The difference between SIN and SNL groups was statistically significant (P < 0.05). With the brimonidine or rilmenidine administration, ED 50 s were 0.12 microgram (SNL) and 0.37 microgram (SIN) and 2.16 microgram (SIN) and 11.46 microgram (SNL), respectively. And the shift to left of dose response curve from the SNL group is more prominent with rilmenidine administration. CONCLUSIONS: These results suggest morphine and rilmenidine showed a better effect on reducing the mechanical allodynia induced by FCA administration.
Animals ; Hyperalgesia ; Inflammation ; Ligation ; Morphine ; Neuralgia ; Neuritis ; Oxazoles ; Quinoxalines ; Rats ; Spinal Nerves ; Brimonidine Tartrate

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*

BACKGROUND: The sequence method of determining baroreflex sensitivity (BRSSEQ) has been reported to correlate poorly with the phenylephrine method of determining BRS in individuals with attenuated BRS. Inhalation anesthetics are also known to decrease BRS. We therefore assessed the effect of varying the systolic blood pressure (SBP) and R-R interval (RRI) thresholds on BRSSEQ values and compared these results with the BRS obtained by the modified Oxford technique (BRSMODOX). METHODS: The average number of valid sequences and BRSSEQ values were derived by varying the SBP threshold from 0.5 to 2.5 mmHg and the RRI threshold from 1 to 6 ms, and the relation of BRSSEQ values to BRSMODOX values using sequential administration of nitroprusside and phenylephrine was assessed in 40 healthy individuals during sevoflurane anesthesia. RESULTS: Increasing either the SBP thresholds or RRI thresholds resulted in a decrease in the number of valid sequences. As the SBP thresholds were decreased and the RRI thresholds were increased, BRSSEQ values increased. When the SBP threshold exceeded 1 mmHg, no significant correlations were observed between BRSSEQ and BRSMODOX values. Significant correlations between the two methods were observed for an SBP threshold of 0.5 mmHg and RRI thresholds of 1, 2, 3 and 4 ms. Biases between the two methods were 2.1, 2.1, 0.4, and 0.4 ms/mmHg for 0.5 mmHg and 1, 2, 3 and 4 ms. CONCLUSIONS: These findings suggest that adjusting the SBP threshold to 0.5 mmHg and the RRI threshold to 3 or 4 ms may improve BRSSEQ validity during sevoflurane anesthesia, when compared to BRSMODOX.
Anesthesia* ; Anesthetics, Inhalation ; Baroreflex* ; Bias (Epidemiology) ; Blood Pressure* ; Nitroprusside ; Phenylephrine

PURPOSE: To evaluate a scoring system based on ultrasonographic findings as a means of distinguishing between benign and malignant solid breast masses. MATERIALS AND METHODS: Histopathologically confirmed benign (n=102) and malignant (n=73) breast masses which ultrasonographic findings of histopathologic masses were reviewed for shape, border, internal echo, boundary echo, posterior echo, lateral echo, and ratio of transverse to anteroposterior diameter. There were statistically significant (p < 0.001 ; chi-square test) differences in each feature for benign and malignant lesions. The findings suggesting benignancy, equivocality, and malignancy of the masses were scored as 0, 1, and 2 respectively. The scores for all features were summed for each lesion. An ROC curve was obtained. RESULTS: When the score was 6, five benign and seven malignant cases were found. Scores of 0 and 1 indicated benign masses and a score above 11, malignancy. The turning point was a score of 6, so a score above 7 suggests malignancy. CONCLUSION: A ultrasonographic scoring system can be used to characterise breast masses. A score of a mass above 7 suggests probable malignancy and a score below 5 suggests benignancy.
Breast* ; ROC Curve ; Ultrasonography*