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*

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

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

The authors examined the induntivity of sister chromatid exchanges (SCE) in peripheral lum-phocytes on the personnel working in the operating room and analyzed the factors associated with it to obtain data for their monitoring health status. The results obtained were as follows; 1) Average inductivity of SCE in peripheral lymphocytes of operating room perssonnel exposed to anesthetic gases was 7.85 per cell; it was significantly higher than in those who were not exposed (p< 0.05). 2) The inductivity of SCE in peripheral lymphocytes by age group and exposure duration was not statically significant (p<0.05). 3) The inductivity of SCE in the subjects with a smoking habit was significantly higher than those without a smoking habit (p<0.05). 4) There was no significant difference in the inductivity of SCE between the subjects with a drinking habit and those without it (p>0.05). 5) It is possible that the high inductivity of SCE in operating room personnel who both with drink and smoke was due to more the influence of their smoking than their drinking.
Anesthetics, Inhalation ; Drinking ; Gases* ; Humans ; Lymphocytes* ; Operating Rooms* ; Siblings* ; Sister Chromatid Exchange* ; Smoke ; Smoking

There are many article about hepatitis B antigen vaccination and protection against the hepatitis B viruses for medical people, however there are no article about surgical patients who had hepatitis B surface antigen. This study was performed to evaluate the eligibility for anesthesia and surgery of hepatitis B surface antigen positive patients by comparing pre-and post-operative liver function tests. Thirty hepatitis B surface antigen positive patients who were scheduled for surgery were selected for this study and another thirty hepatitis B surface antigen negative patients who were also scheduled for surgery were selected for the control group. AS result were concluded that the hepatitis B surface antigen positive patient who doesn't have active hepatitis is eligible for anesthesia and surgery.
Anesthesia* ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Liver Function Tests ; Vaccination

BACKGROUND: The aim of this study was to compare the effect of propofol with succinylcholine and thiopentone with succinylcholine on serum potassium concentration during induction of general anesthesia. METHODS: Forty patients scheduled for elective surgery were allocated at random into two groups, one to receive propofol with succinylcholine or other to receive thiopentone with succinylcholine. We measured serum potassium concentration at preinjection and at 1, 5 and 10 minutes after injection of propofol with succinylcholine or thiopentone with succinylcholine respectively. RESULTS: There was significant increase in the serum potassium concentrations at 1, 5 and 10 minutes after injection of propofol-succinylcholine and thiopentone-succinylcholine compared with those before injection in two groups. No significant difference in serum potassium concentrations was observed between the two groups. CONCLUSIONS: The changes in serum potassium due to injection of propofol and succinycholine were very similar to those found during injection of anesthesia with thiopentone and succinylcholine. It was reassuring that such small changes of serum potassium occur when propofol-succinycholine and thiopentone-succinylcholine were used and that these changes within normal ranges were unlikely to be of clinical significance.
Anesthesia ; Anesthesia, General ; Humans ; Potassium* ; Propofol ; Reference Values ; Succinylcholine ; Thiopental

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