No abstract available.
Fetus* ; Humans ; Pregnancy, Twin*

No abstract available.
Cholecystectomy, Laparoscopic* ; Humans ; Mosaicism* ; Myelodysplastic Syndromes* ; Trisomy*

No abstract available.
Animals ; Constitution and Bylaws* ; Mice* ; Oocytes*

BACKGROUND: Reperfusion injury often develops after cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG), and MgSO4 is known to be related to such injury. The goal of this study was to determine the hemodynamic and oxygen metabolic effects of administering MgSO4 after cessating cardiopulmonary bypass during coronary bypass surgery in control and nicardipine infusion groups. METHODS: After obtaining hospital ethics committee clearance, we studied 29 patients with coronary artery disease scheduled for CABG, who were randomly assigned to receive nicardipine (0.5 microgram/kg/min, n = 11) or placebo (n = 18). All patients were administered MgSO4 (60 mg/kg) after the cessation of CPB. The hemodynamic variables and oxygen parameters were recorded and calculated by continuous cardiac output and mixed venous oxygen saturation monitoring, through a thermodilution Swan-Ganz catheter before and 20 minutes after MgSO4 administration. RESULTS: Heart rate was reduced after administering MgSO4 in both groups, and the mean arterial pressure was also reduced in the nicardipine group. The cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, right and left stroke work indices were well-maintained after administering MgSO4. Mixed venous oxygen saturation and other oxygen parameters were maintained without change after MgSO4 administration. CONCLUSIONS: The present study shows that MgSO4 can be used without inducing any significant oxygen metabolism or hemodynamic derangements during CABG. But further work is needed to elucidate the myocardial protective effects of MgSO4.
Arterial Pressure ; Cardiac Output ; Cardiopulmonary Bypass ; Catheters ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Ethics Committees, Clinical ; Heart Rate ; Hemodynamics* ; Humans ; Metabolism ; Nicardipine ; Oxygen ; Reperfusion Injury ; Stroke ; Thermodilution ; Vascular Resistance

URPOSE: To evalvate the role of double-phase spiral CT for T staging of gastric cancers with radiologic-pathologic correlation. MATERIALS AND METHODS: Double-phase spiral CT images of 44 patients of gastriccancers proved by pathologic examination were retrospectively evaluated. We retrospectively classified spiral CTimages of gastric cancers ; classification was from S 0 to S 4 and was based on the degree of change in three multilayered patterns shown in normal gastric wall and whether or not tumor cells had invaded perigastric fattissue. Pathologic classification was based on the T staging of TNM classification for gastric cancers, and wethen correlated these results. RESULTS: In group S1, all of three cases(100%) were proved to be T1 and in groupS2, five(45.5%) of 11 cases were T2. Of five cases with S3 CT findings, three(60%) were proved to be T3s andtwo(40%) were T2. Of 22 cases with S4 CT findings, 19(86.4%) were T3p. Overall sensitivity, specificity, and accuracy were 60.3%, 88. 5%, and 86.9%, respectively. In 35 (79.5%) of the total of 44 cases, the lesions were more enhanced on venous than on arterial phase. CONCLUSION: The accuracy of double-phase spiral CT for T staging of gastric cancers was 86.9%, and in contrast to previous results for conventional or dynamic CT, this level of accuracy was thought to be relatively high. In conclusion, double-phase spiral CT images of gastric cancers were helpful in the diagnosis of T staging.
Classification ; Diagnosis ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, Spiral Computed*

Aggregatibacter aphrophilus, a normal component of oral cavity flora, mostly causes infective endocarditis and only rarely causes spondylitis; no spondylitis cases have been previously reported in Korea. We report a case of pyogenic spondylitis due to A. aphrophilus without endocarditis. A 64-year-old man was admitted for back pain lasting 3 weeks. There was severe tenderness on lumbar spines but no fever. Laboratory evaluation showed leukocytosis and elevated C-reactive protein. Blood cultures were negative. Magnetic resonance imaging showed psoas abscess and vertebral inflammation. Pus was obtained by computerized tomography-guided aspiration from the psoas abscess and inoculated into blood culture bottles. After 5 days of incubation, growth was detected: the isolate was a Gram-negative short rod bacteria identified as A. aphrophilus by the automated system; this was confirmed by 16S ribosomal RNA sequencing. There was no evidence of endocarditis in echocardiography and retinal examination. Back pain persisted despite 8 weeks of antibiotic treatment, so vertebral corpectomy was performed. A. aphrophilus, a rare cause of pyogenic spondylitis, can induce spondylitis without endocarditis. If a patient with pyogenic spondylitis shows negative routine bacterial cultures, fastidious organisms such as A. aphrophilus should be suspected and the blood culture bottles could be used.
Aggregatibacter aphrophilus* ; Back Pain ; Bacteria ; C-Reactive Protein ; Echocardiography ; Endocarditis ; Fever ; Humans ; Inflammation ; Korea ; Leukocytosis ; Magnetic Resonance Imaging ; Middle Aged ; Mouth ; Psoas Abscess ; Retinaldehyde ; RNA, Ribosomal, 16S ; Spine ; Spondylitis* ; Suppuration

BACKGROUND: Adrenal medullary transplants into the subarachnoid space have been demonstrated to reduce pain sensitivity. This analgesia most likely results from the release of neuroactive substances, particularly catecholamines and opioid peptides from the transplanted cells into spinal cord. METHODS: Isolated bovine chromaffin cells were encapsulated with alginate and poly-L-lysine prior to implantation into rat's subarachnoid space to protect them from host immune system. And then catecholamines from encapsulated chromaffin cells were measured quantitatively in vitro by High Performance Liquid Chromatograph. The animals were randomized into 2 groups, one of which received microencapsulated chromaffin cells and the other empty capsules. The effects of such implants were evaluated on the pain behavior resulting from a chronic constriction injury of the rat sciatic nerve for 30 days. RESULTS: Catecholamine concentration in cerebrospinal fluid (CSF) was analyzed. Data (mean SD) are considered significant at P <0.05 (ANOVA for repeated measure and Dunnett's test). Continuous release of catecholamine and met-enkephalin with responsiveness to nicotine stimulation was measured from encapsulated cells in vitro. A significant reduction of allodynic response to acetone evaporation was observed in the animals implanted with cell loaded capsules compared to control animals with empty capsules. Catecholamine concentration in CSF was higher in the cell loaded capsule group. There were no complications related to implantation. CONCLUSION: We found that encapsulated chromaffin cells released continuously catehcolamines and opioids peptides in vitro and in the CSF. Those results may prove chromaffin cell's anagesic effect indirectly.
Acetone ; Analgesia ; Analgesics, Opioid ; Animals ; Capsules ; Catecholamines* ; Cerebrospinal Fluid ; Chromaffin Cells* ; Constriction ; Drug Compounding ; Enkephalin, Methionine ; Immune System ; Nicotine ; Opioid Peptides ; Peptides ; Rats ; Sciatic Nerve ; Spinal Cord ; Subarachnoid Space

BACKGROUND: The combination of local anesthetics and opioids in the spinal anesthesia has a synergic analgesic effect. Therefore, we compared intraoperative conditions and clinical effects of low dose (5 mg) bupivacaine added with fentanyl versus a conventional dose(10 mg) of bupivacaine in spinal anesthesia for a transurethral resection of the prostate (TURP). METHODS: Forty five ASA class 1 and 2 patients scheduled for a TURP were randomly divided into three groups. Group B (n = 15) received bupivacaine 10 mg, group BF (n = 15) received bupivacaine 5 mg added with fentanyl 20microgram, and group BFE received bupivacaine 5 mg added with fentanyl 20microgram and 0.2 mg epinephrine. Blood pressure and heart rate were recorded every 5 minutes before and after spinal anesthesia. Sensory blockade was measured by a pin-prick test and motor blockade was evaluated by the Bromage motor scale. Side effects including pruritus, nausea, vomiting, respiratory depression, and intraoperative pain were observed. RESULTS: The duration of sensory and motor blockade in group BF was significantly shorter than in group B and group BFE (P<0.05). Without statistical significance, hypotension (6.7%) and bradycardia (13.3%) were observed in group B and pruritus (26.7%) and nausea (13.3%) occurred in all patients who received fentanyl. CONCLUSIONS: The addition of fentanyl 20microgram to low dose bupivacaine 5 mg resulted in short lasting motor and sensory block, compared with conventional dose bupivacaine 10 mg. Therefore, we concluded that the clinical application of this method could provide adequate analgesia with early discharge and no serious side effects for TURP patients.
Analgesia ; Analgesics, Opioid ; Anesthesia, Spinal* ; Anesthetics, Local ; Blood Pressure ; Bradycardia ; Bupivacaine* ; Epinephrine ; Fentanyl* ; Heart Rate ; Humans ; Hypotension ; Nausea ; Prostate* ; Pruritus ; Respiratory Insufficiency ; Transurethral Resection of Prostate ; Vomiting

PURPOSE: The purpose of this study was to investigate factors influencing depression among mothers-in-law in multicultural families. METHODS: For this study, 159 participants from multicultural familieswere recruited through administrative units of the B. & U. Metropolitan City and G. Province. Data related to acculturation stress, resilience, and depression were collected fromApril to August 2014 and analyzed through t-test, one-way ANOVA, Pearson correlation coefficients, and regression analysis with the SPSS/WIN 22.0 for Windows program. RESULTS: The participants had a moderate level of acculturation stress (2.43+/-0.75: range 1~5) and resilience (4.74+/-1.14: range 1~7). About 58% of the participants had depression. The results of stepwise multiple regression analysis indicated that mothersin-law's depression was affected by resilience (beta=-1.17, p<.001), acculturation stress (beta=0.85, p=.026), perceived economic level (beta=-0.83, p=.016), difficulty in physical activity (beta=-0.62, p=.027), relationship satisfaction (beta=-0.51, p=.035), and education level (beta=-0.48, p=.033). The explanatory power of these factors was 35%. CONCLUSION: The findings indicated the need to lower the level of depression by enhancing resilience and reducing acculturation stress among mothers-in-law in multicultural families. Future research to reduce depression among mothers-in-law inmulticultural families should consider how to enhance resilience and reduce acculturation stress.
Acculturation* ; Aged ; Depression* ; Education ; Humans ; Motor Activity ; Resilience, Psychological

Background: Venipuncture is one of the one of the most commonly performed, minimally-invasive procedures; however, it may lead to peripheral nerve injury. Here, we describe the diagnosis, treatment, and prognosis of two self-reported cases of nerve injury during venipuncture with the aim of drawing attention to possible needle-related nerve injuries.Case: Two anesthesiologists in our hospital experienced an injury of the lateral antebrachial cutaneous branch of the musculocutaneous nerve during venipuncture. Immediately, they underwent ultrasound examinations and nerve blocks with oral medication, resulting in full recovery. Conclusions Ultrasonography is important for the early and confirmative diagnosis of a nerve injury during venipuncture, and for immediate treatment with a nerve block. Moreover, it is imperative for both the practitioner and the patient to be aware of the possible complication of nerve injury after venipuncture.