No abstract available.
Gestational Age* ; Mortality

BACKGROUND: Mannitol is widely used in neurosurgical patients and may induce an increase in serum potassium concentration according to doses and administration rates with unknown mechanism. The treatment of hyperkalemia is aimed at eliminating the causes and includes calcium, sodium bicarbonate, glucose with insulin, loop diuretics and hyperventilation. This study was undertaken to observe the effects of hyperventilation on the serum potassium concentration following infusion of mannitol (2.0 gm/kg). METHODS: We studied 30 patients who were operated brain aneurysm clipping surgery and were divided into 3 groups (n=10). In control group, mild hypocapnia was maintained (PaCO2, 32 2 mmHg) before and after mannitol infusion. In group I, moderate hypocapnia was maintained (PaCO2, 27 2 mmHg) before and after mannitol infusion. In group II, mild hypocapnia (PaCO2, 32 2 mmHg) was maintained before 30 minutes of mannitol infusion and moderate hypocapnia (PaCO2, 27 2 mHg) after mannitol infusion. We started infusion of 20% mannitol with a dosage of 2.0 gm/kg, 15~20 min after cranium was opened. RESULTS: The changes of serum potassium were as follows (Mean SD mEq/l) (just before and 15min, 30min, 60min after mannitol infusion): 3.79 0.48, 4.66 0.60, 4.44 0.48, 4.13 0.40 (Control group), 3.62 0.18, 3.63 0.42, 4.14 0.51, 3.95 0.33 (Group I), 3.76 0.20, 3.91 0.15, 4.11 0.30, 4.04 0.23 (Group II). After 15 minutes of mannitol infusion, the serum potassium levels of group I and II were lower than that of control group (p<0.05) and there was no significant difference between group I and II. CONCLUSIONS: These results suggest that hyperventilation may blunt the increase in serum potassium concentration following rapid infusion of high dose mannitol.
Calcium ; Glucose ; Humans ; Hyperkalemia ; Hyperventilation* ; Hypocapnia ; Insulin ; Intracranial Aneurysm ; Mannitol* ; Potassium* ; Skull ; Sodium Bicarbonate ; Sodium Potassium Chloride Symporter Inhibitors

Recurrent pericarditis is rare in children and is considered idiopathic in most cases. Its course is chronic, and preventing recurrences is important for the patient's quality of life. Although a treatment strategy in pediatric recurrent pericarditis has not yet been established, non-steroidal anti-inflammatory drugs (NSAIDs) are the most common treatment for management of this condition, followed by corticosteroids, colchicine, immunosuppressive agents, immunoglobulins, and interleukin-1β receptor antagonists (e.g. anakinra). Herein, we report a case of recurrent pericarditis with pericardial effusion in a 5-year-old child who presented with fever and epigastric pain. He responded poorly to NSAIDs and corticosteroid therapy, but was successfully treated with colchicine.
Adrenal Cortex Hormones ; Anti-Inflammatory Agents, Non-Steroidal ; Child ; Child, Preschool ; Colchicine ; Fever ; Humans ; Immunoglobulins ; Immunosuppressive Agents ; Pericardial Effusion ; Pericarditis ; Quality of Life ; Recurrence

Purpose: The purpose of this study is to find out the meaning of self-care experiences of family members of mentally ill patients and describe its essential structure. Methods: The Giorgi's phenomenological research methodology was used. Six families participated in this study. In-depth individual interviews were used to collect data from October to December in 2021. Results: Five clusters of themes were identified. They were “Selfless life”, “Life on shaky grounds”, “Attempts to escape from the suffering”, “Moving forward on self-care path”, and “Happiness blooming in being together”. Conclusion The findings suggest that mental health care professionals should provide educational programs to enable families of patients with mental illness to recognize the necessity for self-care and discover ways to take care of themselves. In addition, it is necessary to develop policies to expand patient management services at mental health welfare centers so that families of patients with mental illness can secure time for self-care.

Recurrent pericarditis is rare in children and is considered idiopathic in most cases. Its course is chronic, and preventing recurrences is important for the patient's quality of life. Although a treatment strategy in pediatric recurrent pericarditis has not yet been established, non-steroidal anti-inflammatory drugs (NSAIDs) are the most common treatment for management of this condition, followed by corticosteroids, colchicine, immunosuppressive agents, immunoglobulins, and interleukin-1β receptor antagonists (e.g. anakinra). Herein, we report a case of recurrent pericarditis with pericardial effusion in a 5-year-old child who presented with fever and epigastric pain. He responded poorly to NSAIDs and corticosteroid therapy, but was successfully treated with colchicine.

Purpose: The purpose of this study was to examine the suffering experienced by the primary caregiver of people with mental disabilities in community dwellings to explain the fundamental structure thereof. Methods: The Giorgi’s phenomenological research methodology was used. Three male subjects and five female subjects participated in this study. The data were collected September-December, 2019 through in-depth individual interviews, and analysis based on the Giorgi’s method. Results: Four clusters of themes were identified. They are: “Mental disability came as a burden of pain”, “Painful time from caring due to being mentally recoiled and being hurtful”, “My life is broken by illness”, and “Hope discovered in the midst of pain”. Conclusion The findings provide deeper understanding and insight into the suffering experienced by primary caregivers for people with mental disabilities in community dwellings. A comprehensive program encompassing psychological and social aspects must be developed to facilitate resolving the problem of the suffering experienced by the primary caregiver for people with mental disabilities.

OBJECTIVE: To determine whether the age of the first exposure to substances influences the characteristics of substance abuse. METHOD: Ninety seven adolescent boys in a substance abuse treatment facility were evaluated by using questionnaires, individual diagnostic interviews, and psychology tests. They were classified into 3 groups, preadolescence group(PA), early adolescence group(EA), and middle adolescence group (MA) according to the age of the first exposure to substances, and the data were statistically analyzed by SPSS 9.0. RESULTS: The average age was 16.4+/-1.2 years. There were 39 in PA, 29 in EA, and 29 in MA. In comparison to EA, PA showed higher frequency in substance use, substance dependence, and positive family history of alcohol abuse. In comparison to MA, PA had higher frequency in troubles in interpersonal relationship, functional impairment, dependence on substances, withdrawal symptoms, amount of alcohol and gas consumed, positive family history of alcohol abuse. presence of comorbid psychiatric disorders, and higher score in K-subscale of MMPI. PA also used more variety of substances more frequently, and had shorter duration before starting the second substance. In comparison to MA, EA showed higher frequency of substance use, functional impairment, trouble in interpersonal relationship, diagnoses of substance dependence, and shorter duration before starting the second substance. However, less EA were from disorganized families. Among the 3 groups, there were no statistically meaningful differences in combined use of alcohol, trial of abstinence, duration of abstinence, child abuse history, family support, intelligence, and frequency and duration of running away from home. CONCLUSION: Earlier exposure to substances may lead to more serious problems of drug abuse. Earlier drug prevention education for adolescents should be provided.
Adolescent* ; Alcoholism ; Child ; Child Abuse ; Diagnosis ; Education ; Humans ; Intelligence ; MMPI ; Psychology ; Surveys and Questionnaires ; Running ; Substance Withdrawal Syndrome ; Substance-Related Disorders*

The brachial plexus block is a valuable method of providing anesthesia for the surgery of forearm and hand. Common technique for brachial plexus block include axillary, supraclaviculer, and interscalene approaches. The supraclavicular brachial plexus block offers adventages, ie, high success rate, rapid onset of action and relatively complete block over axillary and interscalene approach, but may be associated with pneumothorax. We marked the P point which was placed on the upper margin of clavicle that crossed the first rib on the chest PA film and marked on the skin of the patient and inserted 23G scalp needle at that point to the first rib. We performed this modified technique of supraclavicular brachial plexus block using chest PA film in 20 patients and there was no incidence of pneumothorax after this block but general anesthesia was sdministered in one case because of incomplete block. We recommend that this modified technique guided by chest PA film for supraclavicular block is simple, reliable and may reduce the incidence of pneumothorax and to increase the success rate in difficult case such as patient with extremely obesity.
Anesthesia ; Anesthesia, General ; Brachial Plexus* ; Clavicle ; Forearm ; Hand ; Humans ; Incidence ; Needles ; Obesity ; Pneumothorax ; Ribs ; Scalp ; Skin ; Thorax*

BACKGROUND: Cardiovascular instability after induction of intravenous anesthetics may be explained partly by direct negative inotropic effects. We studied the effects of etomidate and propofol on the inward calcium currents (ICa) of rat ventricular myocytes using the whole-cell voltage-clamp technique. METHODS: ICa was elicited by progressively depolarizing cells from -40 to -50 mV. The peak amplitude of ICa was measured before, during and after the administration of equimolar concentrations of etomidate and propofol. RESULTS: Exposure to etomidate and propofol produced a concentration-dependent inhibition of ICa.; 1, 10, 100 and 300 micrometer of etomidate decreased the peak ICa (mean +/- SEM) by 14.5 +/- 6.3, 25.9 +/- 9.4, 31.9 +/- 12.1, 42.5 +/- 8.8% and 1, 10, 100 and 300 micrometer of propofol decreased the peak ICa by 15.7 +/-3.4, 21.3 +/-2.5, 59.2 +/-2.0, 69.9 +/-2.8%, respectively. COCLUSIONS: These results suggest that etomidate and propofol have a direct negative inotropic effect via inhibition of inward calcium currents in rat ventricular myocytes.
Anesthetics, Intravenous ; Animals ; Calcium* ; Etomidate* ; Muscle Cells* ; Patch-Clamp Techniques ; Propofol* ; Rats*

OBJECTIVE: To investigate the pattern of exon deletions in Korean patients with Duchenne muscular dystrophy (DMD), and to find the correlation of the exon-deletion with clinical symptoms or laboratory findings. METHOD: Genomic DNA of the nine children with DMD were analyzed by the sets of multiplex PCR and one singlet PCR in total of fifteen primers of the dystrophin gene. The primers were made from the promotor, and the exons 3, 4, 6, 8, 12, 13, 43, 44, 47, 48, 50, 51, 52 and 60 of the dystrophin gene, respectively. RESULTS: Eight out of nine patients revealed exon deletions. The exon 3 was most commonly deleted (6 patients), and exon 48, 50 and 60 were second most common (2 patients). The exons 4, 6, 13, 44, 47 and 52 were not deleted in all patients. CONCLUSION: We found that the exons 3, 48, 50 and 60 are frequently deleted in Korean patients with DMD. The pattern of deletion was not correlate with clinical symptoms or laboratory findings.
Child ; DNA ; Dystrophin* ; Exons* ; Humans ; Multiplex Polymerase Chain Reaction ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction