No abstract available.
Kidney Transplantation*

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

PURPOSE: Asphyxia is the most common cause of neurologic sequelae in perinatal period. We hoped to help other clinicians by investigating factors affecting neurologic outcome in asphyxiated term babas. METHODS: A clinical study of factors affecting neurologic outcome was made on 120 patients, who were asphyxiated term baby. They admitted to neonatal intensive care unit of Chungnam National University Hospital from January, 1995 to December, 1996. RESULTS: There was no significant correlation in neurologic outcome and gestational age, delivery type, sex, birth weight, one minute Apgar score. Five minute Apgar score had influence on neurologic outcome. Presence of acidemia had influence on neurologic outcome. Mental status and seizure influenced on neurologic outcome. Poor neurologic outcome was prone to come in the presence of prolonged duration of abnormal mental function or a repetitive seizure not controlled immediately. There was poor neurologic outcome in the patients who have abnormal findings on EEG, CT, and neurosonography. In addition, there was poor neurologic outcome in congenital heart disease patients. All of above had statistical significance. CONCLUSION: Now, we can obtain much benefit by monitoring clinical course such as five minute Apgar score, mental change, and seizure. And, we can obtain much benefit by monitoring acidemia and perform EEG, CT and neurosonography.
Apgar Score ; Asphyxia ; Birth Weight ; Chungcheongnam-do ; Electroencephalography ; Gestational Age ; Heart Defects, Congenital ; Hope ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Seizures

We have reserched the relationship of their clinical pictures and factors related to the risk of recurrence of 75 patients with simple or complex febrile convulsions, who were admitted to the Departmenrt of Pediatrics, Chungnam National University Hospital from January 1987 to July 199. The 75patient were followed up and consisted of the 55 patients with initial or non-recurrent febrile convulsions and the othere 20 patients with recurrent febrile convulsions. The results were of follows; 1) The age of first episodes was under the 6 years in 94.6% and the first episode under the 12 months was 14.6% in initial cases and 55% in recurrent cases. 2) There were family history of convulsive disorder in 40% of recurrent cases, compared to 10.9% of initial cases. 3) In gestational age, there was no significant difference between initial and recurrent cases. 4) In sex distribution, the boys (66.7%) outnumbered the girls(33.7%) and the ratios was 2:1. Among the recurrent cases of 20 patients, the boys(90%) were much more than the girls(10%). 5) The patients of low birth weight had more febrile convulsions than large birth weight in both initial and recurrent cases. 6) There was no significant difference between initial and recurrent cases in the causes of febrile convulsion. 7) In abnormal EEG findings, recurrent cases were 30% more than 7.3% of initial cases. 8) There was no significant difference of number of seizure during a day in both initial and recurrent cases 9) In episodes of duration over 15 minutes, recurrent cases were 40% more than 23.7% of initial cases. 10) The resident of urban was 78.6% and of rural was 21.4%. 11) The types of convulsion were generalized in 92% of total cases and focalized in 8%. In the focal types, recurrent cases (15%) were much more than initial cases (5.5%). 12) In occurrence of seizures in body temperature above 40 degrees C, it was 5.5% in initial cases, whereas it was 20% in recurrent cases. 13) 13) There was no significant difference between initial and recurrent cases on fever duration before seizure.
Birth Weight ; Body Temperature ; Chungcheongnam-do ; Electroencephalography ; Fever ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Pediatrics ; Recurrence* ; Seizures ; Seizures, Febrile* ; Sex Distribution

No abstract available.

Is superselective embolization of the brain AVMs, the possibilities of adjacent normal brain tissue damage necessitates preembolic evaluation. The authors performed the Sodium Amytal test on 15 patients with brain AVMs. In the AVM patients with negative Amytal test(30 cases), all patients showed normal pattern on EEG and neurologic examinations after embolization Among the five patients with positive Amytal test, three cases showed neurologic deficit and the others two didn't. In eleven patients. Repeated embolization without the Amytal test were done. Among them, 5 cases showed neurlogic deficit and the others were quite normal. In conclusion, the Amytal test is a useful method of evaluation of the risk to damage normal brain tissue which are supplied by superselected feeding vessels. Combining the EEG with this test is a sensitive and objective method in evaluating patients following the Amytal test. And it is essential to performed the Amytal test for repeat embolization procedures.
Amobarbital* ; Arteriovenous Malformations* ; Brain* ; Electroencephalography ; Humans ; Methods ; Neurologic Examination ; Neurologic Manifestations

The authors performed a study of 32 patients who had undergone anterior lumbar interbody fusion using allograft with posterior pedicular instrumentation. The clinical outcomes were evaluated and the radiographs were analyzed with respect to graft subsidence, interspace collapse, graft collapse, sagittal angle and fusion status. In 71% of the levels there was a loss of disc space height during the follow-up, with 18% of the levels being narrower than their preoperative height at late follow-up. Significant(more than 3mm) subsidence and collapse were noted in three and four levels respectively. Approximately 84% of the 32 patients had satisfactory results and a radiological fusion was obtained in 88.2% of the 34 levels. We consider the pedicle screw fixation improves the retention of interspace distraction and the fusion rate of allograft in anterior lumbar interbody fusion.
Allografts* ; Follow-Up Studies ; Humans ; Spine ; Transplants

PURPOSE: This study was performed to compare the radiographic results of femoral tunnels made through the tibial tunnel and through the anteromedial portal. MATERIALS AND METHODS: From March 1996 to September 1997, fifty-five reconstructions of anterior cruciate ligament were performed. Group I (femoral tunnel through tibial tunnel) was composed of 30 cases and group II (femoral tunnel through anteromedial portal) was consisted 25 cases. On postoperative anteroposterior and lateral radiographs of knees, five angles were measured : APD/LD (angle between longitudinal axis of femoral bone block of patella tendon bone graft and that of interference screw in anteroposterior view/ lateral view), AFT (the angle between longitudinal axis of femoral tunnel and that of tibial tunnel in anteroposterior view), APFT/LFT (the angle between longitudinal axis of femoral tunnel and that of femoral shaft in anteroposterior view/ lateral view) and the graft tunnel mismatch was evaluated. RESULTS: Average APD was 1.30+/-3.13 degree in group I and 0.52+/-1.85 degree in group II (P>0.05), average LD was 4.97+/-7.62 degree and 1.48+/-3.30 degree (P<0,05), average AFT was 12.40+/-7.29 degree and 19.48+/-8.49 degree (P<0.05), average APFT was 15.33+/-6.95 degree and 14.32+/-7.33 degree (P>0.05), and average LFT was 36.57+/-5.20 degree and 39.64+/-6.48 degree (P>0.05), respectively. CONCLUSIONS: We concluded that making a femoral tunnel through the anteromedial portal decreased the divergence between the femoral interference screw and femoral bone block of patella tendon-bone autograft.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Axis, Cervical Vertebra ; Knee ; Patella ; Patellar Ligament ; Transplants

PURPOSE: To evaluate the clinical outcome and reliability of mixed bone in the process of posterior spinal fusion for the treatment of thoracolumbar spine fractures. In order to eliminate donor site morbidity which is linked to the use of autogenous bone graft, a new surgical procedure mixing autogenous bone chips that were obtained from local decortication of the posterior element of the spine with highly purified calf bone (Lubboc) is studied. MATERIALS AND METHODS: We followed up 9 patients who had undergone autogenous bone graft and 9 patients who had undergone mixed bone graft for more than 12 months out of 33 patients who underwent posterior spinal fusion for thoracolumbar spine fractures between July 1993 and July 1997. RESULTS: Radiographic results indicated solid bony union in 17 of 18 cases regardless of the graft materials. Based on each follow-up evaluation, it was found that the increase in kyphotic angle was related to elapsed time rather than to the type of graft materials. CONCLUSIONS: It appears that the new surgical method of bone graft with highly purified calf bone can be a reliable alternative for achieving stable posterior spinal fusion as long as bone chips large enough to fill the interlamina space can be obtained.
Follow-Up Studies ; Heterografts* ; Humans ; Spinal Fusion* ; Spine* ; Tissue Donors ; Transplants*

During the last 18 years only a small number of successful replantation of lower extremities severed by trauma have been reported. In this paper we report the first successful case of replantation of completely amputated thigh In Korean literature. A 31-year-old man was admitted to Kyung Hee Unlversity Hospital on February 27th 1976, approximately 1 hour after accident in which the left thigh was completely amputated 15 cm above the knee joint. Circulation was restored 6 hours after amputation through anastomosis of the femoral vein, artery, great saphenous vein, profunda femoris artery and vein. The continuity of sciatic nerve was reestablished by secondary furnicular suture 7 week after injury. About 4 years and 7 months after injury the patient could walk without pain and returned to his occupation. Thre was a almost complete return of motor and sensory function of the posterior tibial nerve.
Adult ; Amputation ; Arteries ; Femoral Vein ; Humans ; Knee Joint ; Lower Extremity ; Microsurgery ; Occupations ; Replantation ; Saphenous Vein ; Sciatic Nerve ; Sensation ; Sutures ; Thigh ; Tibial Nerve ; Veins