Eclampsia is a syndrome characterized by pregnancy-induced hypertension, edema, proteinuria, and generalized tonic-clonic convulsions, occurring between 20 and 40 weeks of gestation or within 48 hours of postpartum. A convulsion that shows up more than 48 hours after delivery is late postpartum eclampsia. A 40-year-old woman was admitted due to a headache and generalized tonic-clonic seizures in 14 days of postpartum. Two months prior to the admission, she had been admitted to the hospital because of mild proteinuria. Her blood pressure on arrival was 160/100 mmHg. There were no focal neurologic signs. She was given lorazepam and valproate sodium intravenously and her convulsion was stopped. A brain MRI showed multiple bilateral high signal intensities in the both deep white matter and the parieto-occipital cortex. Cerebral angiography showed a diffuse vasospasm. We report a patient with late postpartum eclampsia occurring 14 days after parturition whose seizures was accompanied by preceding headache and proteinuria as a pre-eclamptic sign.
Adult ; Blood Pressure ; Brain ; Cerebral Angiography ; Eclampsia* ; Edema ; Female ; Headache ; Humans ; Hypertension, Pregnancy-Induced ; Lorazepam ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Parturition ; Postpartum Period* ; Pregnancy ; Proteinuria ; Seizures ; Valproic Acid

No abstract available.
Echocardiography* ; Humans ; Mitral Valve*

PURPOSE: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. METHODS: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. RESULTS: The infants' mean gestational age and weight at birth were 33.1±2.1 weeks and 1,842±470 g, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. CONCLUSION: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.
Analgesia ; Gestational Age ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Milk, Human ; Oxygen ; Pacifiers ; Parturition ; Retinopathy of Prematurity ; Sucrose ; Surgical Instruments ; Water

Background/Aims: Chitosan, a natural polymer widely used in the biomaterials field, has been proposed as a potential submucosal injection solution. The purpose of this study was to compare the performance and efficacy of aqueous chitosan solution and commercialized submucosal injection fluids using a three-dimensional sensor and to evaluate the efficacy of the measured parameters. Methods: Normal saline (0.9% NaCl), as a control, Eleview ® (Poloxamer 188), Blue Eye TM (0.4% hyaluronic acid), and aqueous chitosan solution (2.0%) were injected into the submucosa of porcine stomachs ex vivo. The mucosal elevation height, elevated surface area, and angle of the tangent of the submucosal fluid cushion were measured using a three-dimensional sensor. The rates of change for each variable were calculated, and the correlation between parameters was analyzed. Tissue specimens were stained with hematoxylin and eosin. Results: All variables exhibited the highest values under chitosan injection. The mucosal elevation height rate of change differed significantly between normal saline and chitosan solution (p=0.024). The elevated surface area rates of change for normal saline and Eleview® were significantly different from those for TS-905 and chitosan solution (p=0.006 and p=0.009, respectively). Further, height, area, and angle showed a positive correlation (p<0.001). A histological examination revealed an even distribution of aqueous chitosan within the submucosa without tissue damage. Conclusions Aqueous chitosan was superior to normal saline and Eleview® and was noninferior to TS-905. A three-dimensional sensor and the measured parameters were effective and useful for evaluating the performance of submucosal fluids.