No abstract available.
Observer Variation*

PURPOSE: We investigated the effect on MK 801 on the development on brain damage, spontaneous recurrent seizures and mossy fiber sprouting in the pilocarpine induced status epilepticus animal model. Methods: Fifty two adult Sprague Dawley male rats(180-240gm) were studied under ketamine/xylazine(87mg/13mg/kg, IP) anesthesia and were implanted at the F3, P3, F4, P4 areas for recording EEG. With a single intraperitoneal(IP) administration of pilocarpine hydrochloride(360mg/kg), 70% developed status epilepticus(SE). When SE was not induced within 1 hour after injection of pilocarpine, the second dose of pilocarpine(175mg/kg, IP) was injected, with 86.6% of success. Results: All studied animals were divided into two large groups, one group was treated with NMDA receptor antagonist, the other was control group. The mean duration of SE was 62.00+/-6.80 minutes in the MK 801(1mg/kg, IP, 30 minutes after SE) treated group, and 61.10+/-7.37 minutes in the control group without any signigicant differences(P>0.05). Neuronal loss(necrosis dominantly) was observed at CA1 and CA3 areas in the control group, with more loss after 6 weeks than 24 or 72 hrs specimens. However, there was no neuronal loss in MK 801 treated group. The protective effect of MK 801 for neuronal injury suggested the glutamate receptor activation was involved in the neuronal injury induced by repeated seizure attack. Spontaneous recurrent seizures(SRS) were observed 70% of animals in the control group, but there were no SRS observed in the MK 801 treated group. The mean scores of mossy fiber sprouting were significantly higher in the control group(2.05+/-0.47) than MK 801 treated group(0.4+/-0.32)(P<0.05). Conclusion: These results suggested that SRS and mossy fiber sprouting were associated with NMDA receptor activation, and NMDA receptor activation had a key role in the epilepsy development.
Adult ; Anesthesia ; Animals* ; Brain* ; Dizocilpine Maleate* ; Electroencephalography ; Epilepsy ; Humans ; Male ; Models, Animal* ; N-Methylaspartate ; Neurons ; Pilocarpine* ; Receptors, Glutamate ; Seizures* ; Status Epilepticus*

The actions and side effcts of the benzodiazepine antagonist flumazenil were evaluated in a clinical study in which midazolam was used as an anesthetir induction agent. Anesthesia was maintained with nitrous oxide-oxygen-fentanyl. Sixty-five adult surgical patients received either 0.3 mg (3 ml) of flumazenil (33 cases) or 3 ml of saline (32 cases) at the conclusion of surgery. Blood pressure, pulse rate, and respiratory rate were checked before premedication, just before, 5 minutes, 30 minutes, and 120 minutes after the administration flumazenil or saline. Also level of consciouseness, orientation in time and space, and cooperativeness along with end tidal carbon dioxide and hemoglobin oxygen saturation were evaluated. Various larboratory parameters were checked before premedication and 24 hours after operation. The results were as follows: 1) The flumazenil group revealed improved level of consciousness, orientation in time and space, and cooperativeness which began just after the administration, and was maintained 30 minutes thereafter. 2) There was no difference in the changes of laboratory parameters between the two groups. 3) The changes of blood pressure, pulse rate, respiratory rate, and SaO2 showed no difference between those two groups. 4) The end tidal concentrations of carbon dioxide after drug administration were significantly lower in the flumazenil group than those of the saline group. 5) Tolerance to flumazenil (0.3 mg) was good without any side effect.
Adult ; Anesthesia* ; Benzodiazepines ; Blood Pressure ; Carbon Dioxide ; Consciousness ; Flumazenil* ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Premedication ; Respiratory Rate

PURPOSE: To determine the effect of intraluminal brachytherapy on stent patency and survival after metallic stent placement in patients with primary bile duct carcinoma. MATERIALS AND METHODS: Twenty-seven patients with primary bile duct carcinoma underwent metallic stent placement; in 16 of the 27 intraluminal brachytherapy with an iridium-192 source (dose, 25 Gy) was the performed. Obstruction was due to either hilar (n=14) or non-hilar involvement (n=13). For statistical comparison of patients who underwent/did not undergo intraluminal brachytherapy, stent patency and survival were calculated using the Kaplan-Meier method and an independent t test. RESULTS: The mean durations of stent patency and survival were 9.1 and 10.0 months respectively in patients who underwent intraluminal brachytherapy, and 4.2 and 5.0 months in those who did not undergo this procedure (p<0.05). The mean durations of stent patency and survival among the 22 patients who died were 7.6 (range, 0.8 -16.1) and 8.3 (range, 0.8-17.3) months, respectively, in the eleven patients who underwent intraluminal brachytherapy, and 4.2 (range, 0.9-8.0) and 5.0 (range, 0.9-8.4) months in those whom the procedure was not performed (p<0.05). CONCLUSION: Intraluminal brachytherapy after stent placement extended both stent patency and survival in patients with primary bile duct carcinoma.
Bile Ducts* ; Bile* ; Brachytherapy* ; Humans ; Stents*

PURPOSE: Valproic acid is effective and safe in adults and children for the treatment of a variety of seizure types. But, according to the recent reports, this drug induce hyperandrogenism, obesity, and polycystic ovaries, particularly when the medication is started before the age of 20. This research was designed to study the effect of valproic acid on ovary of pubertal child. METHODS: The sample group consisted of 23 girls who were diagnosed to epilepsy by our department of pediatrics, and were taking valproic acid from January 2000 to July 2000. They were evaluated reproductive endocrine function with the serum sex hormones and ultrasonographic study of ovary. RESULTS: 1) The mean serum sex hormones concentration of prepubertal, pubertal, and postpubertal girls taking valproic acid were belong to the normal range of reference values of textbook of Nelson and Park's report. 2) The obesity were seen in two of the 23 girls taking valproic acid. 3) The rate of polycystic ovaries in normal girls with regular menstruation has been reported in 9%, but, in our report, polycystic ovaries were seen in five of the 20 girls taking valproic acid(25%). CONCLUSION: Ultrasonographic study of ovaries is required for the girls taking valproic acid. If the problems from the polycystic ovary are developed on patients taking valproic acid, the substitution of other anticonvulsant drug for valproic acid may be required. However, further study was needed to clarify whether this ovarian morphologic changes were elicited by valproic acid or not.
Adult ; Child* ; Epilepsy ; Female ; Gonadal Steroid Hormones ; Humans ; Hyperandrogenism ; Menstruation ; Obesity ; Ovary* ; Pediatrics ; Reference Values ; Seizures ; Valproic Acid*

BACKGROUND: Prevalence of bee venom allergy in Korea is unknown, OBJECTIVE: We performed a cross-sectional study to evaluate the prevalence of bee venom allergy and importance of risk factors, such as age, sex, and atopy, in the development of the allergic reaction in children and adults living in rural area of Cheju Island. Swbject and METHOD: The prevalence was investigated in subjects with 1,054 children and 370 adults (701 male, 723 female), aged 7-87 years, living in rural area of Cheju Island. A history particularly focused on the systemic reactions after the bee stings was taken in all subjects. Skin prick test,s to common inhalant allergens, including house dust mites, fungi, tree, grass, mugwort and ragweed pollen, cockroach, animal epithelium, Japanese cedar pollen, and citrus red mite were performed. RESULT: The prevalence of bee venom allergy was 5.8% (mild systemic reactions 5.0%, severe systemic reactions 0.8% ). The prevalence was higher in adults than in children (10.2% vs. 5.0%, g = 12.0, p<0.01). Among the children, the prevalerlce wB.S Signifcantly higher ill male than in female (8.6% vs. 1.3%, x=28.7, p<0.01), but no significant diffecence was noted between male and female in adults (10.0% vs. 10.3%, p>0.05). The prevalence of bee venom allergy was not significantly different between subjects with positive skin reaction and those with negative skin reaction to inhalant allergens (6.4% vs. 5.4% ), Conclasion'. The prevlence of bee venom allergy in inhabitants of rural area of Cheju Island is 5.8% (mild systemic,' 5.0%, severe systemic reaction. 0.8%), and bee venom allergy was more common in adults than in children, and in male children than in female children.
Adult* ; Allergens ; Ambrosia ; Animals ; Artemisia ; Bee Venoms* ; Bees* ; Bites and Stings ; Child* ; Citrus ; Cockroaches ; Cross-Sectional Studies ; Cryptomeria ; Epithelium ; Female ; Fungi ; Humans ; Hypersensitivity* ; Jeju-do* ; Korea ; Male ; Mites ; Poaceae ; Pollen ; Prevalence* ; Pyroglyphidae ; Risk Factors ; Skin

Although liver transplantation (LT) is the only effective treatment option for hepatopulmonary syndrome (HPS), the post-LT morbidity and mortality have been high for patients with severe HPS. We performed post-LT embolotherapy in a 10-year-old boy who had severe type I HPS preoperatively, but he failed to recover early from his hypoxemic symptoms after an LT. Multiple embolizations were then successfully performed on the major branches that formed the abnormal vascular structures. After the embolotherapy, the patient had symptomatic improvement and he was discharged without complications.
Child ; Combined Modality Therapy ; Echocardiography ; Embolization, Therapeutic/*methods ; Hepatopulmonary Syndrome/diagnosis/*therapy ; Humans ; *Liver Transplantation ; Male ; Oximetry ; Positron-Emission Tomography ; *Pulmonary Artery ; Tomography, X-Ray Computed

BACKGROUND: An immediate examination of ocular movement is required during strabismus surgery. The aim of this study was to determine the effect of the level of sedation on the recovery of patients undergoing a target controlled propofol infusion with a bolus of fentanyl for strabismus surgery. METHODS: Twenty-one outpatients scheduled to undergo strabismus surgery were assigned randomly to one of two groups. In both groups, sedation was induced with a bolus of fentanyl 1microgram/kg intravenously followed by an infusion of propofol with a target concentration of 1.0microgram/ml. The target concentration was increased or decreased by 0.1 microgram/ml steps until the patient reached and maintained the observer's assessment of alertness/sedation (OAA/S) scale score of 3 (group A) or 4 (group B). The supplemental analgesics consisted of fentanyl 25-50microgram bolus injection. The target concentration of propofol, the total dose of fentanyl, delayed awakening, and recovery time were recorded. RESULTS: The mean target concentration of propofol (mean +/- SD) in group A (1.8 +/- 0.4microgram/ml) was significantly higher than that of group B (1.3 +/- 0.4microgram/ml) (P<0.05). There were no significant differences in the total dose of fentanyl, delayed awakening and recovery time between the two groups. There was an an increasing trend in the recovery time with the total dose per kilogram of body weight of fentanyl (Spearman's correlation coefficient, r = 0.384, P = 0.086). CONCLUSIONS: The levels of sedation did not affect the recovery time in patients during target propofol infusion with a bolus of fentanyl. However, the addition of fentanyl tended to prolong the recovery time.
Analgesics ; Body Weight ; Fentanyl* ; Humans ; Outpatients ; Propofol* ; Strabismus*

OBJECTIVES: This study was performed to determine the relationships among Health concern, health practice and health status of the disabled. METHODS: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. RESULTS: Health concern had a significant and positive relationship with health practice(p<0.05) and health practice also had a significant and positive relationship with self-rated health status(p<0.05) in men and women. To determine the structural model of the Health concern, health practice, health status and sociodemographic variables, the covariance structural analysis was used. In men, age, economic status, medical security type, educational level and type of disability had significant direct effects on Health concern(T>2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect on health status(T>2.0). In men and women, health practice was significantly increased with increasing Health concern and the more health practice, the higher health status(T>2.0). CONCLUSIONS: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.
Daegu ; Disabled Persons ; Female ; Health Education ; Health Policy ; Health Promotion ; Humans ; Male ; Models, Structural ; Surveys and Questionnaires

BACKGROUND: A portable glucometer is commonly used to immediately check the blood glucose level. In the anesthetic field, some blood gas analyzers can also give a rapid indication of the blood sugar level but the accuracy is unknown. Therefore, this study assessed the accuracy of the blood glucose values measured by either a blood gas analyzer or portable glucometer. METHODS: Venous blood from diabetic patients was used to measure the glucose level with either a blood gas analyzer or a portable glucometer. The difference and 5% deviation from reference values was analyzed. These values were also assessed using a Bland-Altman plot and clinical significance was examined using a Clarke error grid. RESULTS: The differences from the reference values were smaller using the blood gas analyzer (1.3 +/- 7.8 mg/dl) than using the portable glucometer (-5.1 +/- 16.7 mg/dl)(P < 0.01). 73.4% of the values measured by the blood gas analyzer and 40.0% of those measured by the portable glucometer were within 5% of the reference value. The 95% limits of agreement in the difference ranged from -14.3 to 16.9 in the blood gas analyzer and -38.5 to 28.2 in the portable glucometer. Error grid analysis showed that 100% of the values measured by the blood gas analyzer were located in zone A. When locating the values measured using the portable glucometer, 95.6% were located in zone A, and the remaining 4.4% are located in zone B. CONCLUSIONS: The blood gas analyzer measures the blood glucose more accurately than the portable glucometer. However, the blood glucose values measured by the portable glucometer are clinically acceptable.
Blood Glucose* ; Glucose ; Humans ; Reference Values