No abstract available.
Insect Bites and Stings*

We would like to correct the affiliation for the first author.

BACKGROUND: We evaluated the changes in heart rate variability (HRV) in elderly patients with or without hypertension before and after combined spinal-epidural anesthesia (CSE). METHODS: Elderly hypertensive (group H, n = 28) and non-hypertensive patients (group C, n = 32) were recruited. We analyzed the spectral components of HRV, total power (< or = 0.4 Hz), low and high frequency power expressed as natural logarithm (LnTP, LnLF, and LnHF), normalized HF (HFnorm), normalized LF (LFnorm), and LF/HF ratio, from 5-minute electrocardiography recordings. We also measured blood pressures (systolic; SBP, diastolic; DBP, mean; MAP), heart rate (HR) and analgesia level before and after CSE. Each group was divided into two subgroups (< or = T7 [L] or > or = T6 [H]) according to fixed analgesia level. RESULTS: Before CSE, group H showed significantly lower LnLF than that of group C (P < 0.05). Fifteen and 10 min after CSE, decrease of SBP and increase of HR in group HH were significantly greater compared with group CL and lesser with group CH, respectively. LnTP, LnLF and LnHF in both control groups (CL and CH) were significantly decreased 15-20 min after CSE compared with pre-CSE values. LnLF and LnHF in group HH were significantly lower than those in group HL 10-15 min after CSE. But there were no significant changes of LFnorm, HFnorm and LF/HF in all four groups. CONCLUSIONS: The group H showed significantly lower LnLF than that of group C before CSE. In group HH, LnLF and LnHF were significantly lower than those in group HL 10-15 min after CSE, but the balance of the autonomic nervous system was not changed significantly.
Aged* ; Analgesia ; Anesthesia* ; Autonomic Nervous System ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Hypertension

PURPOSE: To describe radiologic differences between tuberculous pleural effusion and empyema on the basis of computed tomography(CT). MATERIALS AND METHODS: We reviewed retrosepectively CT findings of 50 patients with pathologically and grossly proved empyema. Twenty-two patients had empyema, and 28 patients had tuberculous pleurisy. RESULTS: CT findings known to be useful in differentiating tuberculous pleural effusion from empyema (1) contour and extent of pleural thickening, (2) mediastinal pleural involvement, (3)accumulation of extrapleural tissue and (4) change of ipsilateral thoraic volume of empyema. However, none of the above findings were helpful in the differential diagnosis of empyema. CONCLUSION: The differentation of tubrculous pleurisy from pyogenic empyema may be not possible with CT findings only.
Diagnosis, Differential ; Empyema* ; Humans ; Pleural Effusion* ; Pleurisy ; Tuberculosis, Pleural

BACKGROUND/AIMS: The p53 mutations have been described as the most common genetic alteration during development and progression of malignancy in a wide range of human cancers. Mutant p53 proteins have a prolonged half-life accounting for increased levels of p53 protein frequently detected in tumors. This can induce the production of anti-p53 in the senzn of patients with HCC. We determined the relationship of serum anti-p53 with p53 expression in the liver tissue of chronic liver disease and the correlation of serum anti-p53 with serum alpha- fetoprotein(AFP) in patients with HCC. METHODS: In sera of same patients, we analysed the anti- p53 using ELISA system As controls we tested 50 healthy individuals and 20 patients with chronic hepatitis. Immaiohistochemical study for the presence of mutant p53 was performed on liver tissue from 50 patients with cirrhosis and 30 patients with HCC using monoclonal antibody clone DO-7 and LSAB kit by ABC method. RESULTS: Anti-p53 was positive in 9(30%) of 30 patients with HCC. Among nine patients with positive anti-p53, only two patients had detectable p53 expression in their tumor tissues. Anti-p53 was positive in 5(10%) of 50 patients with liver cirrhosis. The AFP was elevated in 21(70%) of 30 patients with HCC. Among the 9 AFP- negative HCC patients, 4(44.4%) were found to be positive for anti-p53. P53 expression was detectable in 9(30%) of 30 HCCs and 1(3.3%) of RO surrounding non-tumorous cirrhotic tissues. CONCLUSION: Mese findings suggest that anti-p53 was not correlated with the status of p53 expression in liver tissue and serological testing for anti-p53 antibody may be complementary to serum AFP for diagnosing of HCC with normal serum AFP.
Carcinoma, Hepatocellular ; Chronic Disease* ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Half-Life ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases ; Liver* ; Serologic Tests

BACKGROUNDS/AIMS: Pancreaticoduodenctomy (PD) is associated with high rates of postoperative morbidity and mortality. Although many studies have shown that early postoperative enteral nutrition improves postoperative outcomes, limited clinical information is available on postoperative early oral feeding (EOF) after PD. The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD. METHODS: Clinical outcomes were investigated in 131 patients who underwent PD between 2003 and 2013, including 81 whose oral feeding was commenced within 48 hours (EOF group) and 50 whose oral feeding was commenced after resumption of bowel movements (traditional oral feeding [TOF] group). Postoperative complications, energy intake, and length of stay (LOS) were reviewed. RESULTS: Demographic factors were similar in the two groups. The EOF group had a significantly shorter LOS (25.9+/-8.5 days vs. 32.3+/-16.3 days; p=0.01) than the TOF group. The rates of anastomotic leak (1.2% vs. 16%, p=0.00) and reoperation (3.7% vs. 20%, p=0.01) were significantly lower in the EOF group. In the clinically acute phase from postoperative day 1 to day 5, the mean daily calorie intake (847.0 kcal vs. 745.6 kcal; p=0.04) and mean daily protein intake (42.2 g vs. 31.9 g; p=0.00) in the EOF group were significantly higher than that in the TOF group. CONCLUSIONS: Postoperative EOF is a clinically safe, feasible, and effective method of nutritional support after PD.
Anastomotic Leak ; Demography ; Energy Intake ; Enteral Nutrition ; Humans ; Length of Stay ; Mortality ; Nutritional Support ; Pancreaticoduodenectomy* ; Postoperative Complications ; Reoperation

BACKGROUND: Etomidate is a rapid acting sedative agent used for the induction of general anesthesia. One of the side effects of etomidate limiting its usage is myoclonus. This study was designed to determine whether a small dose of midazolam decreases the incidence of myoclonus after infusion of etomidate. METHODS: Eighty ASA physical status 1 or 2, 16-60 year old patients undergoing elective surgery were randomly allocated into two groups. Group 1 (n = 40) received normal saline 0.04 ml/kg and group 2 (n = 40) received midazolam 0.04 mg/kg 3 minutes before the administration of etomidate 0.3 mg/kg. We measured and compared the incidence, severity, onset time and duration of myoclonus, and blood pressure and heart rate. RESULTS: There were significant differences in the onset time and severity of myoclonus, but no significant differences in the incidence and duration of myoclonus. Systolic blood pressure was significantly higher in group 1 than group 2 at 3 minutes after pretreatment drug administration, immediatly after etomidate administration and 3 minutes after etomidate administration. CONCLUSIONS: An infusion of 0.04 mg/kg midazolam 3 minutes before etomidate decreases the severity of myoclonus and the onset of myoclonus.
Anesthesia, General ; Blood Pressure ; Etomidate* ; Heart Rate ; Humans ; Incidence ; Midazolam* ; Myoclonus*

No abstract available.
Nausea* ; Ondansetron* ; Vomiting*

No abstract available.
Brain* ; Choriocarcinoma* ; Female ; Neoplasm Metastasis* ; Pregnancy

This study was performed using mealtime atmosphere to characterize the food ecology of Korean children residing in different regions of Korea. A total of 705 elementary school students, 347 girls and 358 boys, were divided into three groups according to the areas where they lived, which included Seoul (n = 230), provincial cities (n = 273) and rural areas (n = 202). The subjects were asked to fill out questionnaires which were categorized to determine various factors related to food ecology, life styles, and health related symptoms. The average age of the study subjects was 11.5 years. The results showed that the average height (p < 0.01), weight (p < 0.01) and body mass index (BMIs)(p < 0.01) of the rural group were significantly lower than those of the Seoul and provincial city groups. A significantly higher proportion (10.4%) of the rural group was from disfunctional families, including single parent families, than those of the Seoul (1.7%) or provincial city (4.4%) groups. However, a larger number of children from Seoul ate alone, did not enjoy their meals, and hardly talked to each other during breakfast time, compared to those from the provincial city or rural areas. Also, the proportion (33.0%) of 'good' in balance of meal was the lowest (33.0%) in Seoul of the three areas (p < 0.01). Most of the children answered that they liked having breakfast and dinner with the whole family. In conclusion, the food ecology of elementary children differed according to the regions in which they resided. Although children from Seoul had higher BMIs, their nutritional intake was not satisfactory, and their undesirable food ecology could be a contributing factor.
Atmosphere ; Body Mass Index ; Breakfast ; Child* ; Ecology* ; Female ; Humans ; Korea ; Life Style ; Meals ; Seoul ; Single-Parent Family ; Surveys and Questionnaires