This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section ; Female ; Heart Rate ; Humans ; Intraoperative Awareness ; Ketamine* ; Memory ; Pregnancy ; Skin ; Thiopental*

42 patients with the clinical evidences of endocarditis were examined by echocardiography. In 28 of 42 cases(66.7%) vegetation was present, whereas in 14(33.3%) vegetation was not visualized. Alpha-hemolytic streptococcus was the most common infecting organism(47.6%) and rheumatic heart disease was the most common predisposing heart disease(47.6%). Patients with echocardiographically demonstrable vegetation had a higher incidence of congestive heart failure compared to the patients without vegetation(75.0% vs. 21.4% p<0.05). But major embolism was not significantly different in the two groups. Mortality was higher in the patients with vegetation than in the patients without it(39.3% vs. 0%, p<0.05). Among vegetation positive patients, mortality was highest in aortic valve patients.(58.3%) So patietns with aortic valve vegetation should be regarded as high risk group and early surgical intervention should be considered if indicated. The causes of mortality were congestive heart failure(45.5%), cerebral embolism(36.4%), myocardial infarction(9.1%) and ventricular tachycardia(9.1%) in decreasing frequency.
Aortic Valve ; Echocardiography* ; Embolism ; Endocarditis ; Endocarditis, Bacterial* ; Estrogens, Conjugated (USP) ; Heart ; Heart Failure ; Humans ; Incidence ; Mortality ; Rheumatic Heart Disease ; Streptococcus

This report is concerned with our clinical experience of 150 cases of anesthesia for open heart surgery at department of anesthesiology, In chon Gil hospital from Februry, 1990 to April, 1993. The results were as follows ; 1) Among 150 cases, 68 cases (45.3%) were congenital heart disease and 82 cases (54.7%) were acquired heart disease. 62 cases (41.3%) were males and 88 cases (58.7%) were females. 2) Glycopyrrolate, diazepam, morphine, were used as premedicants. 3) Fentanyl, ketamine, diazepam, thiopental sodium were used as induction agents and injected singly or in combination. 4) In congenital cyanotic heart diseases, ketamine was used as main anesthetic agent. In other heart diseases, fentanyl, isoflurane, diazepam were used. 5) Vecuronium was used for intubation and maintenance of muscle relaxation. 6) Overall mortality rate was 3.3% (5 cases) and the causes of death were low cardiac output, respiratory insufficiency, mediastinal infection.
Anesthesia ; Anesthesiology ; Cardiac Output, Low ; Cause of Death ; Diazepam ; Female ; Fentanyl ; Glycopyrrolate ; Heart Defects, Congenital ; Heart Diseases ; Heart* ; Humans ; Incheon ; Intubation ; Isoflurane ; Ketamine ; Male ; Morphine ; Mortality ; Muscle Relaxation ; Respiratory Insufficiency ; Thiopental ; Thoracic Surgery* ; Vecuronium Bromide

The objective of this study was conducted to investigate growth and development status of infants fed soy-based formulas over 3 months. The height and weight were measured and Z-scores were calculated by using standard of the same age groups. Their mothers were interviewed using questionnaires including general and environmental characteristics, total food intakes, soy based formula intakes and Ewha infant development screening test. Main results were as follows: 1) Nutrient intake levels of subjects were similar to or more than the level of Korean Recommended Dietary Allowances except for intakes of vitamin E (79.89% RDA), and the average status of nutrient intakes of infants were fairly good. 2) Z-scores of height for age (HAZ) and Z-scores of weight for age (WAZ), Kaup index, WLI and Ewha Infant Developmental Screening Test score of subjects were in the normal growth range. 3) There were no significant differences among soy based formula intake percentile groups in HAZ, WAZ, Kaup index, WLI and Ewha Infant Developmental Screening Test score. 4) Total energy intake was positively correlated with HAZ (p < 0.01), WAZ (p < 0.01), and WLI (p < 0.05) in infants less than 12 month. Also, soy based formula energy intake was positively correlated with HAZ (p < 0.05) in infants less than 12 month. However, energy and soy based formula intake levels of infants over 12 month were not significant among variables. Considering results of this study, infants fed soy-based formulas over 3 months showed normal growth and development status. Further studies are needed to evaluate long-term growth and development in infants fed soy based formulas.
Child ; Child Development ; Energy Intake ; Growth and Development* ; Humans ; Infant* ; Mass Screening ; Mothers ; Recommended Dietary Allowances ; Vitamin E ; Vitamins

Background: Hemiarthroplasty is frequently used to treat displaced femoral neck fractures in elderly patients, but it has a higher risk of postoperative dislocation. We introduced the posterior approach and inferior capsulotomy (PAICO) to enhance joint stability after bipolar hemiarthroplasty for femoral neck fracture. We evaluated whether the PAICO would have a lower dislocation rate than the conventional posterior approach with superior capsulotomy. Methods: From January 2021 to December 2021, we prospectively recruited 25 patients (25 hips) aged 50 years or older who underwent bipolar hemiarthroplasty for femoral neck fractures due to low-energy trauma as the PAICO group. We compared the PAICO group with a historical control group who had undergone hemiarthroplasty in 7 institutes between 2010 and 2020. The primary endpoint was dislocation within 1 year after the surgery. We compared data from the PAICO group with the data from the historical control group from the Korean Hip Fracture Registry which was carried out in South Korea. Results: A total of 25 patients (25 hips) were enrolled in the present study; 3,477 patients (3,571 hips) who underwent bipolar hemiarthroplasty were reviewed as the historical control group. In the PAICO group, we observed no dislocation, whereas the dislocation rate in the control group was 1.3%. Conclusions In patients with displaced femoral neck fractures, the PAICO approach demonstrated comparable results in operation time and complication rates when compared to bipolar hemiarthroplasty using superior capsulotomy. Notably, there were no observed cases of dislocation among patients who underwent the PAICO approach. We recommend this PAICO approach to surgeons using the posterior approach, hoping to prevent dislocation in bipolar hemiarthroplasty.

Human bone marrow mesenchymal stem cells (MSCs) expanded in vitro exhibit not only a tendency to lose their proliferative potential, homing ability and telomere length but also genetic or epigenetic modifications, resulting in senescence. We compared differential methylation patterns of genes and miRNAs between early-passage [passage 5 (P5)] and late-passage (P15) cells and estimated the relationship between senescence and DNA methylation patterns. When we examined hypermethylated genes (methylation peak > or = 2) at P5 or P15, 2,739 genes, including those related to fructose and mannose metabolism and calcium signaling pathways, and 2,587 genes, including those related to DNA replication, cell cycle and the PPAR signaling pathway, were hypermethylated at P5 and P15, respectively. There was common hypermethylation of 1,205 genes at both P5 and P15. In addition, genes that were hypermethylated at P5 (CPEB1, GMPPA, CDKN1A, TBX2, SMAD9 and MCM2) showed lower mRNA expression than did those hypermethylated at P15, whereas genes that were hypermethylated at P15 (MAML2, FEN1 and CDK4) showed lower mRNA expression than did those that were hypermethylated at P5, demonstrating that hypermethylation at DNA promoter regions inhibited gene expression and that hypomethylation increased gene expression. In the case of hypermethylation on miRNA, 27 miRNAs were hypermethylated at P5, whereas 44 miRNAs were hypermethylated at P15. These results show that hypermethylation increases at genes related to DNA replication, cell cycle and adipogenic differentiation due to long-term culture, which may in part affect MSC senescence.
Bone Marrow Cells/*metabolism ; *DNA Methylation ; Gene Expression Profiling ; Gene Expression Regulation ; Humans ; Mesenchymal Stromal Cells/*metabolism ; MicroRNAs ; Molecular Sequence Annotation ; Primary Cell Culture ; Promoter Regions, Genetic ; Reproducibility of Results ; Signal Transduction ; Telomere Shortening

BACKGROUND: The occurrence of an outbreak of food-borne infectious disease requires a hospital to do extended role. There has been no report of an outbreak and an outbreak management of food-borne infectious diseases in a hospital. Therefore, this report of an outbreak and management of Shigellosis in the hospital would help others to manage further cases. METHODS: This was a descriptive study for an infection control program for food-borne infectious diseases in a hospital. RESULTS: There was a shigellosis outbreak at a university hospital in Seoul between December 3 and 30, 2001, Five hundred eighty four were affected, of which 81 cases were suspected and 86 cases were confirmed Shigella sonnei in fetal culture. The source of infection was identified as a lunch box or seaweed rolled rice that was contaminated and was supplied from the S-catering facility. The infection control team had developed the various strategies to control the outbreak and implemented them. The strategies included an epidemiology investigation, the removal of infection sources, medical treatment and isolation of patients, education and management of public relationship, environmental control, withdrawal of medical students' training, prevention and control of asymptomatic cases, intensive care unit strong financial support, analysis and management various data and the construction of cooperation and reporting system with the public health system CONCLUSION: This outbreak was controlled by effective team approach. The effective management of an outbreak of food-borne infectious diseases requires a systematic infection control, public relationship strategies for the reputation of the hospital, and the cooperation with a public health system.
Communicable Diseases ; Dysentery, Bacillary* ; Education ; Epidemiology ; Financial Support ; Humans ; Infection Control* ; Intensive Care Units ; Lunch ; Public Health ; Seaweed ; Seoul ; Shigella sonnei

PURPOSE: Hematuria is a frequently encountered clinical problem in kidney graft recipients. The causes are variable, may be benign or malignant, but imperative to affect long- term graft function and survival. We have evaluated renal recipients who had hematuria using a newly defined algorithm. METHODS: We evaluated 1060 renal transplant recipients from March 1, 1992 to February 28, 2000. In 93 recipients, hematuria was transitory and spontaneously resolved within 3 months. We tried to identify the cause of persistent hematuria in 126 recipients. Patients were evaluated with plain x-ray, sonography, cystoscopic examination and/or graft biopsy. RESULTS: The mean duration of hematuria onset after transplantation was 17.81+/-14.6 months (4-70 months). The causes of gross hematuria were urolithiasis (n= 15), benign bladder mucosal bleeding (n=3), bladder cancer (n=2) and kidney cancer from an original kidney (n=1). Graft kidney biopsies were performed in 96 patients and the results were as follows: chronic rejection in 18, IgA nephropathy in 16, cyclosporine toxicity in 8, acute rejection in 5, focal segmental glomerulosclerosis in 3, the other glomerulonephritis in 2, and tubular atrophy and interstitial fibrosis in 19 patients. Combined pathologic findings were detected in 15 patients. In 8 patients, no pathological diagnoses were made. We were unable to evaluate 9 patients due to patient's refusal. CONCLUSION: The causes of hematuria after kidney transplantation are variable from benign to malignant disease. If the cause of hematuria is uncertain on ultrasonographic examination, cystoscopic examination and/or graft biopsy should be performed for making a definite diagnosis.
Atrophy ; Biopsy ; Cyclosporine ; Diagnosis ; Disulfiram ; Fibrosis ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulosclerosis, Focal Segmental ; Hematuria* ; Hemorrhage ; Humans ; Kidney ; Kidney Neoplasms ; Kidney Transplantation ; Transplantation ; Transplants ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urolithiasis

Oncocytoma is a neoplasm consisting of oncocytes that is found in the salivary gland, kidney, and thyroid. Adrenocortical oncocytoma is particularly uncommon, and most cases reported are benign and nonfunctioning. Here, we report a 20 cm adrenal mass associated with necrosis that was identified as an oncocytic adrenocortical tumor with uncertain malignant potential through histopathological evaluation after its resection.
Adenoma, Oxyphilic ; Adrenal Gland Neoplasms ; Kidney ; Necrosis ; Oxyphil Cells ; Salivary Glands ; Thyroid Gland ; Uncertainty

Although Korean influenza virus isolates have been genetically associated with the vaccine strains of the corresponding year, influenza B viruses have prevailed almost every year in Korea during the past decades. We have analyzed the genetic characteristics and evolutionary patterns of the haemagglutinin (HA) 1 domains of influenza B viruses isolated during 1988-1999 using direct RT-PCR and sequencing. Phylogenetic analysis of influenza B viruses isolated in Korea indicated that antigenically and genetically distinguishable strains of the lineage II and lineage III variants had been cocirculated. Variants prevailed in early 1990s are represented in 1996/97 and 1998/99 and some different variants have been cocirculated geographically and prevailed concurrently in Korea. All HA1s of Korean isolates have amino acid substitutions mainly in the region between position 124 and 310, which was previously proposed an immunodominant region. Insertion-deletion patterns of the HA gene revealed that Korean influenza B viruses were evolved from Lee40 with different manner between lineage II and III viruses. Lineage III viruses were also divided into two groups as conserved group and inserted group, in relation to Lee40. But lineage II viruses had evolved with directional pattern. Antigenic index proposed that influenza B isolates prevailed since 1996/97 seasons might had emerged from the antigenic variants of a Seo1697-like virus and that new variants might appear from the lineage II viruses resulting in persistent prevalence in Korea.
Amino Acid Substitution ; Influenza B virus* ; Influenza, Human* ; Korea* ; Orthomyxoviridae ; Prevalence ; Seasons