No abstract available.
Positron-Emission Tomography and Computed Tomography*

No abstract available.
Positron-Emission Tomography and Computed Tomography*

BACKGROUND: Electroconvulsive therapy (ECT) that works by electrically inducing grand mal seizure is an effective therapy for patients with major psychosis and affective disorders. But ECT may produce intense stimulation of the central nervous system resulting in hypertension and tachycardia. Such an acute hyperdynamic state may be undesirable because of possible cardiovascular complications. We compared the ability of different bolus doses of esmolol to blunt the hemodynamic effects of ECT. METHODS: Twenty ASA physical status 1~2 patients were enrolled in a crossover design study to determine the effects of two standard esmolol bolus doses (0.5 mg/kg and 1.0 mg/kg) on the hemodynamic response and seizure duration during ECT. In each patients receiving esmolol or placebo, arterial pressure, heart rate, seizure duration and peripheral oxygen saturation (SpO2) were recorded. RESULTS: The seizure duration with placebo was 43 +/- 9 sec, esmolol 0.5 mg/kg bolus dose was 39 +/- 14 sec and esmolol 1.0 mg/kg bolus dose was 39 +/- 12 sec, but it was not significant. Compared with esmolol 0.5 mg/kg bolus dose, esmolol 1.0 mg/kg bolus dose decreased blood pressure and heart rate during ECT more effectively. CONCLUSIONS: Esmolol 1.0 mg/kg bolus dose was considered to be the better dose in blunting the hyperdynamic response during ECT without shortening of seizure duration.
Arterial Pressure ; Blood Pressure* ; Central Nervous System ; Cross-Over Studies ; Electroconvulsive Therapy* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypertension ; Mood Disorders ; Oxygen ; Psychotic Disorders ; Seizures ; Tachycardia

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Head* ; Hemiarthroplasty* ; Necrosis*

This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

PURPOSE: To compare the efficacy and safety of CT-guided automated gun biopsy with those of fine needleaspiration biopsy of pulmonary lesions. MATERIALS AND METHODS: Under CT guidance, we performed automated gunbiopsies in 115 cases of 109 patients and fine needle aspiration biopsies in 119 cases of 108 patients withpulmonary lesions. Between the two methods, we compared the diagnostic rate, diagnostic accuracy and frequency ofcomplications according to the depth and diameter of pulmonary lesions. RESULTS: The overall diagnostic rates ofautomated gun biopsy and fine needle aspiration biopsy were 76.5% (88/115) and 64.7% (77/119) respectively. Therewas a significant statistical difference (p=0.048), especially in the case of malignant lesions less than 3 cm(p=0.027) and more than 6 cm (p=0.008) in maximal diameter. The diagnostic accuracy of automated gun biopsy andfine needle aspiration biopsy showed significant statistical difference only in malignant lesions more than 6cm inmaximal diameter (p=0.008), and in the lesions located from 1 cm to less than 3cm from the pleura (p=0.030), asseen on CT. There was no significant statistical difference in the frequency of complications. CONCLUSION:Automated gun biopsy of pulmonary lesions under CT guidance is safe, with complications rate comparable to thoseof fine needle aspiration biopsy. A higher overall diagnostic rate can be achieved by automated gun biopsy than byfine needle aspiration biopsy. For the diagnosis of pulmonary lesions under CT guidance, automated gun biopsy istherefore a more useful procedure than fine needle aspiration biopsy.
Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Diagnosis ; Humans ; Needles ; Pleura

Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

PURPOSE: To evaluate the efficacy and safety of levetiracetam adjunctive therapy for reducing the rate of seizure frequency in children with intractable pediatric epilepsy. METHODS: We reviewed the medical records of 86 patients with intractable pediatric epilepsy who visited our hospital between March 1989 and February 2009. Levetiracetam was included in the previous anticonvulsant regimen for at least 6 months and the reduction in the rate of seizure frequency was determined in follow-up examinations. We analyzed demographic data, seizure types, antiepileptic drug history, levetiracetam dose, adverse effects of levetiracetam therapy, treatment outcome, electroencephalogram findings, etc. RESULTS: More than 50% reduction in the seizure frequency was observed in 62 of the 86 (72.1%) patients; 44 patients (51.1%) became seizure free, while the seizure frequency increased in 5.8% patients. The associations between seizure reduction rate and age, associated diseases, seizure types, and seizure frequency before treatment were not significant. However, the duration of disease, dose of levetiracetam, duration and frequency of anticonvulsant administration before levetiracetam therapy were significantly correlated. Electroencephalogram findings and the cause of epilepsy showed partial correlation. Forty (46%) patients showed adverse symptoms; the symptoms in the order of their frequency were somnolence, hyperactivity, irritability, aggressiveness, tiredness, etc. CONCLUSION: The findings of our study provide the evidence that levetiracetam adjunctive therapy is efficacious and well tolerated in various refractory childhood epilepsy cases.
Child ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Humans ; Medical Records ; Piracetam ; Seizures ; Treatment Outcome

For the distant metastasis of differentiated thyroid cancers, such as papillary thyroid carcinoma, follicular thyroid carcinoma, and Hurthle cell carcinoma, radioiodine therapy is one of the standard treatment methods after total thyroidectomy. Radioiodine is accumulated in thyroid cells and thyroid cancer cells through sodium iodide symporter which is located in the membrane of cells. This molecular target specific therapy renders a better prognosis and less adverse effects. Radioiodine 131I emits gamma ray for imaging and beta ray for treatment at the same time, we can monitor patients' specific distribution of radioiodine, which let us know unexpected metastasis lesions or differentiated status of thyroid cancer cells. In this article, I reviewed practical points of view about radioiodine therapy for distant metastasis of thyroid cancers such as methods for administration of radioiodine, patients' preparation before radioiodine treatment, follow up of patients, adverse effects, and radiation safety issues.
Adenocarcinoma, Follicular ; Beta Particles ; Carcinoma ; Enzyme Multiplied Immunoassay Technique ; Follow-Up Studies ; Gamma Rays ; Humans ; Ion Transport ; Linear Energy Transfer ; Membranes ; Neoplasm Metastasis ; Organothiophosphorus Compounds ; Prognosis ; Sodium Iodide ; Symporters ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: Long term oral medications of anticonvulsants are inevitable in pediatric epilepsy patients. Therefore special attention is needed for the complications caused by these medications. Hyponatremia is a well known complication of carbamazepine(CBZ) and oxcarbazepine(OXC), but researches in pediatric patients are rare. This is a study about the development of hyponatremia during the use of these two anticonvulsants in pediatric epilepsy patients and other factors also involved in it. METHODS: We studied serum sodium levels of 267 pediatric patients who were treated with either CBZ or OXC in our hospital from January 2003 to December 2006. Hyponatremia was defined as Na+<138 mEq. Moderate hyponatremia was defined as Na+<130 mEq. Factors thought to be involved in the development of hyponatremia were studied also. These included age, sex, EEG and radiologic test results, use of any other medications, etc. RESULTS: Among the 267 pediatric patients treated with CBZ or OXC, there were 18 cases (6.7%) of moderate hyponatremia and 28 cases(10.5%) of mild hyponatremia. Sex, age, type of seizure, EEG and radiologic test results did not affect the development of hyponatremia. But combination therapy with other anticonvulsants resulted in an increase of hyponatremia. CONCLUSION: We recommend that serum sodium levels should be checked regularly of the pediatric patients taking CBZ or OXC, especially patients treated with additional drugs (combination therapy).
Anticonvulsants ; Carbamazepine ; Electroencephalography ; Epilepsy ; Humans ; Hyponatremia ; Seizures ; Sodium