No abstract available.
Fever*

This study was conducted to investigate the effect of the NutriPlus+ Program and to observe how the improved statuses were maintained after the program's termination. The subjects were infants and their parents, who have participated in the NutriPlus+ Program conducted by South Healthcare Center in Po-hang for longer than six months, during the period 2007 - 2010. The survey was conducted with questionnaires, and scores were tabulated from each question. After the intervention of the program, scores representing degrees of nutrition knowledge and nutrition attitude increased. The rate of nutritional risk by anthropometric measurement decreased, and the prevalence rate of anemia was significantly decreased as well. The number of subjects lacking any nutrients, except for iron and vitamin C, decreased, which indicates that the NutriPlus+ Program was effective. After enough time had passed after the intervention's completion; however, the scores of nutrition knowledge and nutrition attitude decreased. The number of subjects with low height and weight (proportional to their age) relatively decreased, and the prevalence rate of anemia increased slightly. The number of subjects lacking in energy and calcium consumption increased as well, which indicates that the effect of the NutriPlus+ Program was not maintained after the program's termination.
Anemia ; Ascorbic Acid ; Calcium ; Delivery of Health Care ; Humans ; Infant ; Iron ; Parents ; Prevalence ; Surveys and Questionnaires

No abstract available.
Abscess* ; Reoperation*

OBJECTIVES: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. METHODS: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=41.50+/-13.16 yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=43.67+/-12.11 yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age 44.93+/-12.38 yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=45.87+/-12.44 yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. RESULTS: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were 991.1+/-27.1 and 875.8+/-22.0 ms (p=0.016), standard deviation of NN interval (SDNN) was 85.4+/-6.6 and 112.8+/-5.4 ms (p=0.022), SDNN index was 57.5+/-5.2 and 87.6+/-4.2 (p<0.001), total power was 11,893.5+/-1,359.9 and 18,097.0+/-1,107.2 ms2 (p=0.008), very low frequency (VLF) was 7,534.8+/-1,120.1 and 11,883.8+/-912.0 ms2 (p=0.035), low frequency (LF) was 2,724.2+/-327.8 and 4,351.6+/-266.9 ms2 (p=0.003). CONCLUSIONS: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.
Acceleration ; Anoxia ; Arousal ; Autonomic Nervous System ; Cardiovascular System ; Heart ; Heart Rate ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

No abstract available.
Pregnancy*

PURPOSE: Recently, the bispectral index monitor has been promoted as an objective measure of sedation depth during pediatric procedural sedation in the emergency department (ED). However, rectal administration of thiopental sodium for pediatric procedural sedation has not been validated. METHODS: Patients aged one to seven years and undergoing primary closure procedures for simple facial and hand laceration in the ED were enrolled. Procedural sedation was performed by rectal administration of thiopental sodium. The bispectral index score and the Ramsay Sedation Scale were recorded every 10 minutes during sedation. The investigator and treating physician were blinded to bispectral index scores, which were later correlated with the Ramsay Sedation Scales values. Receiver operator characteristic (ROC) curves were conducted to determine the ability of the bispectral index score to discriminate various thresholds of sedation depth. RESULTS: One hundred thirty paired measurements were obtained from 12 patients. The Spearman's correlation coefficient for paired measurements, was -0.906 (95% confidence interval: [-9.8] ~ [-8.1], p<0.001). ROC curve analysis demonstrated a high discriminatory power for bi-spectral index scores in predicting the level of sedation, with areas under the curve at least 0.95 for all Ramsay Sedation Scale thresholds. CONCLUSION: Bispectral index monitoring can serve as a useful, objective measure of sedation depth in pediatric procedural sedation with rectal administration of thiopental sodium in the ED.
Administration, Rectal ; Consciousness Monitors* ; Emergencies* ; Emergency Service, Hospital* ; Hand ; Humans ; Lacerations ; Research Personnel ; ROC Curve ; Thiopental* ; Weights and Measures

A hilar cholangiocarcinoma is a cholangiocarcinoma occurring at the confluence of the right and left hepatic bile ducts which is called as Klatskin tumor. Because hilar cholangiocarcinoma is the most common form of extrahepatic bile duct cancer (EBDC), the epidemiology and risk factors of hilar cholangiocarcinoma are similar to those of EBDC. In Korea, overall incidence of EBDC is 5.1/100,000 individuals without a significant change during past 10 years. Most of cases occur in patients over the age of 50 and the incidence is 1.78 times higher in men than women. The etiology of EBDC has not been clearly defined. A number of pathologic conditions, however, resulting in either acute or chronic biliary tract epithelial injury may predispose to malignant change. Chronic biliary tract parasitic infection, such as Clonorchis sinensis and Opisthorchis viverrini, has been identified as a risk factor of EBDC and hilar cholangiocarcinoma. Other clear risk factors of EBDC are primary sclerosing cholangitis and choledochal cyst. However, there are no enough evidences whether primary sclerosing cholangitis and choledochal cyst are the definite risk factors of hilar cholangiocarcinoma or not.
Bile Ducts ; Bile Ducts, Extrahepatic ; Biliary Tract ; Cholangiocarcinoma ; Cholangitis, Sclerosing ; Choledochal Cyst ; Clonorchis sinensis ; Female ; Humans ; Incidence ; Klatskin's Tumor ; Korea ; Male ; Opisthorchis ; Risk Factors

BACKGROUND: Spinal cord ischemia initiates a deleterious cascade of biochemical events that ultimately result in an increased intracellular calcium concentration. Many papers have been published on this topic but without a clear consensus on the best way of minimizing the problem. For the further study of preventing neurological injury after spinal ischemia, the proper animal model is necessary. In this study we compared spinal ischemia time on neurologic and histopathologic outcome, and inflammatory gene expression in transient spinal ischemia. METHODS: Rats were anesthetized with halothane, and divided into 4 groups:12.5 minutes of spinal ischemia (Group 1), 15 minutes of spinal ischemia (Group 2), 17.5 minutes of spinal ischemia (Group 3), and 20 minutes of spinal ischemia (Group 4). Spinal ischemia was produced by both induced hypotension and thoracic aortic cross clamping. After spinal ischemia neurologic scores were assessed after 1, 3, 6, and 24 hours. After 24 hours, rats were euthanized and spinal cords were removed for histopathologic assessment and an assay of TNF-alpha and IL-1 mRNA. RESULTS: The neurologic scores worsened according to the ischemia time. The histopathologic scores correlated well with the neurologic scores. The TNF-alpha and IL-1 mRNA expression results of group 2 were larger than those of group 1. There were no significant differences between group 2, group 3, and group 4. CONCLUSIONS: Inflammatory gene expressions are increased during transient spinal ischemia. After 15 minutes of ischemia, no further increase of mRNA expression was shown. The 15 minutes of spinal ischemia was sufficient for the spinal ischemic study in rats.
Animals ; Calcium ; Consensus ; Constriction ; Gene Expression ; Halothane ; Hypotension ; Interleukin-1 ; Ischemia* ; Models, Animal ; Rats* ; RNA, Messenger* ; Spinal Cord ; Spinal Cord Ischemia ; Tumor Necrosis Factor-alpha

No abstract availble.
Autoimmune Diseases/*drug therapy ; Glucocorticoids/*therapeutic use ; Humans ; Pancreatitis, Chronic/*drug therapy/immunology

It is now well known that vascular diseases, including hypercholesterolemia, atherosclerotic vascular disease, and diabetes mellitus are major causes for erectile dysfunction(ED). Despite the introduction of oral phosphodiesterase-5 inhibitors in the treatment of ED, new therapeutic strategies are warranted. Current therapies have two shortcomings. First, every currently approved non-surgical treatment option for ED requires planning prior to intercourse. Second, there is a need for increased treatment efficacy for patients with moderate to severe ED. Gene therapy may well address both of these areas, as the ultimate goal of the therapy is the restoration of physiologic erections following normal endogenous signals, in the absence of the any other form of therapy. The penis is a convenient organ for local gene therapy because of its external location, ubiquity of endothelial-lined spaces, slow circulation in the flaccid state, and gap junctions between smooth muscles, which ensure wide distribution of injected genes inside the penis. Many gene therapy approaches have focused on the NO/cGMP pathway, angiogenic factors, neurotrophic factors, potassium channels, the RhoA/Rho-kinase system, etc. Various viral and nonviral vectors as well as genetically engineered cells have been used as gene delivery vehicles for the transfer of genetic material to the target cell or tissues. In contrast to its use in cancer, the application of gene therapy for a non-life threatening disease, such as ED, requires a higher safety level and more knowledge of secure and efficacious vectors for gene transfer. The preclinical data from recent studies in several ED models are quite impressive and encouraging. Gene therapy interventions to restore erectile function may represent an exciting new therapeutic strategy for the future treatment of ED.
Angiogenesis Inducing Agents ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Diabetes Mellitus ; Erectile Dysfunction* ; Gap Junctions ; Genetic Therapy* ; Humans ; Hypercholesterolemia ; Male ; Muscle, Smooth ; Nerve Growth Factors ; Penis ; Potassium Channels ; Treatment Outcome ; Vascular Diseases