Maternal phenylketonuria(PKU) is a disorder which appears when a pregnant woman with PKU doesn't take low phenylalanine diet, phenylalanine level of the fetus rises and interferes with fetal development and can easily result in abortion, low birth weight, microcephaly, cardiac anomaly or mental retardation. To prevent these effects of untreated maternal PKU, low phenylalanine diet should be taken to maintain the serum phenylalanine level less than 10mg/dl throughout the pregnancy. We experienced a case of maternal PKU in a female baby born to a 26-year-old woman with PKU who didn't take low phenylalanine diet until eighth moth of pregnancy. She showed intrauterine growth retardation, ventricular septal defect and patent ductus arteriosus. We report a case of maternal PKU with a brief review.
Adult ; Diet ; Ductus Arteriosus, Patent ; Female ; Fetal Development ; Fetal Growth Retardation ; Fetus ; Heart Septal Defects, Ventricular ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Microcephaly ; Moths ; Phenylalanine ; Pregnancy ; Pregnant Women

In some specific measurement, observations, and analyses of certain aspects of the voice and voice production used in phoniatrics, signs of various laryngeal disorders were identified, indicating that these tools can be used as aids in the diagnosis of laryngeal disorders.
Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Human ; Laryngeal Diseases/diagnosis* ; Middle Age ; Voice Disorders/diagnosis*

OBJECTIVES: The objective of this study was to evaluate the thermic effects, the macronutrient oxidation rates and the satiety of medium-chain triglycerides (MCT). METHODS: The thermic effects of two meals containing MCT or long-chain triglycerides (LCT) were compared in ten healthy men (mean age 24.4 +/- 2.9 years). Energy content of the meal was 30% of resting metabolic rate of each subject. Metabolic rate and macronutrient oxidation rate were measured before the meals and for 6 hours after the meals by indirect calorimetry. Satiety was estimated by using visual analogue scales (VAS) at 8 times (before the meal and for 6 hours after meal). RESULTS: Total thermic effect of MCT meal (42.8 kcal, 8.0% of energy intake) was significantly higher than that (26.8 kcal, 5.1% of energy intake) of the LCT meal. Mean postprandial oxygen consumption was also significantly different between the two types of meals (MCT meal: 0.29 +/- 0.35 L/min, LCT meal: 0.28 +/- 0.27 L/min). There were no significant differences in total postprandial carbohydrate and fat oxidation rates between the two meals. However, from 30 to 120 minutes after consumption of meals, the fat oxidation rate of MCT meal was significantly higher than that of the LCT meal. Comparison of satiety values (hunger, fullness and appetite) between the two meals showed that MCT meal maintained satiety for a longer time than the LCT meal. CONCLUSIONS: This study showed the possibility that long-term substitution of MCT for LCT would produce weight loss if energy intake remained constant.
Calorimetry, Indirect ; Energy Intake ; Humans ; Male ; Meals ; Oxygen Consumption ; Triglycerides* ; Weight Loss ; Weights and Measures

A total 49 strains of Escherichia coli suspected of causative organisms of urinary tract infection were isolated and studies for several properties related to the virulence markers of organisms. Urinary isolates (42.9%) showed higher frequency of mannose resistant hemaglutination (MRHA) with human erythrocytes (O type, Rh+) than stool isolates (13.3%) as a control group. Fifteen strains (30.6%) of urinary isolates and 2 (l3.3%) of stool isolates showed hemolysis on blood agar plate. Fourteen strains (28.6%) of urinary isolates and 5 (33.3%) of stool isolates produced colicin. Twelve strains (52.5%) among 23 strains of positive MRHA reaction and 5 (12.2%) of 41 non-MRHA strains found to be hemolytic effect but the frequency of transferable antimicrobial resistance of non MRHA strains was greater than that of MRHA strains. Three properties of hemaglutination, hemolysis, and colicin production were not transferred to recipient E. coli ML 14lO and/or RG 488 by conjugation whereas the antimicrobial resistance were transferred. There was not any significant difference of the minimal inhibitory concentration of 11 drugs between both groups of hemaglutinating and non-hemaglutinating strains. * A thesis submitted to the Committee of the Graduate School of Kyung Pook National University in partial fulfillment of the requirements for the degree of Master of Medical Science in June 1985.
Agar ; Erythrocytes ; Escherichia coli* ; Escherichia* ; Hemolysis ; Humans ; Mannose ; Urinary Tract Infections* ; Urinary Tract* ; Virulence

Malposition of catheter in the subdural space is a possible complication during attempted epidural anesthesia. We report here an inadvertent subdural block confirmed by the radiographic contrast materiaL Epidural anesthesia was planned for a full-term gravida and epidural catheter was inserted about 3 cm cranially at the level of L1-2. After injection of 19.5 ml local anesthetic, blood pressure was 70/50 mmHg. Fluid was rapidly infused and intravenous ephedrine 10 mg was given. After then, vital signs were well maintained and twin babies were delivered without events. Twentyfive minutes later, she complained chest tightness and became tachypneic. Ketamine 50 mg was given and endotracheal intubation was performed with ease. She obeyed command, but could not open her eyes for some duration. Self respiration returned after 110 minutes and minute ventilation was 6 liter/minute at that time. 160 minutes later, extubation was done and radiological examination was performed using contrast materiaL The cathter tip was positioned in anterior subdural space at T12 level.
Anesthesia, Epidural* ; Blood Pressure ; Catheters ; Ephedrine ; Humans ; Intubation, Intratracheal ; Ketamine ; Respiration ; Subdural Space ; Thorax ; Twins ; Ventilation ; Vital Signs

Central venous catheterization has been frequently used in pediatric patients in wide variety of conditions. Several authors have described about various complication of central venous catheterization in pediatric patients and reported complication rates of 3% to 6%. Knotting of guidewire as a complication of central venous catheterization has been reported in adult patients, but knotting of guidewire has not been reported in infants. Therefore we report an infant who experienced a knotting of guidewire during internal jugular vein catheterization which was successfully removed without any adverse events. We suggest that knot formation is possible in infants and there should be a high suspicion if resistance is felt at the time of catheter advancement.
Adult ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Humans ; Infant ; Jugular Veins

BACKGROUND: Intrathecal labor analgesia using new local anesthetics such as ropivacaine or levobupivacaine becomes more popular by virtues of their safety and decreased motor weakness. However, the analgesic efficacy of the clinically effective intrathecal doses of these new local anesthetics combined with fentanyl has yet to be determined. METHODS: Sixty parturients who requested neuraxial analgesia in early active labor were randomly assigned to either ropivacaine (group R, n = 30) or levobupivacaine (group L, n = 30) group. Group R received 3 mg of intrathecal ropivacaine and the group L received 3 mg of intrathecal levobupivacaine mixed with 20 microg of fentanyl as part of a combined spinal-epidural (CSE) technique. The associated block parameters, such as pain scores, duration of analgesia, the highest levels of the sensory block and motor block scores 30 mins after the injection were compared between two groups. RESULTS: Intrathecal ropivacaine offered shorter analgesia (87 +/- 41 min vs. 122 +/- 56 min, P < 0.05) with lower sensory height (T8.5 vs. T6, P < 0.05) and led to lower incidence of complete analgesia (73 vs. 97%, P < 0.05) compared with intrathecal levobupivacaine. Although motor weakness was comparable in both groups, significantly weak perineal squeezing was noticed in Group L (7 of 30 parturients vs. 16 of 30, P < 0.05). CONCLUSIONS: Clinically relevant doses of intrathecal levobupivacaine in combination with fentanyl as part of a CSE technique provides more effective analgesia than equivalent doses of intrathecal ropivacaine in early labor, but is accompanied by slight motor weakness.
Analgesia* ; Anesthetics, Local ; Fentanyl* ; Incidence ; Injections, Spinal ; Virtues

The purpose of this study was to assess the physical activity level of Korean farmers to establish estimated energy requirements during the off-season. Subjects were 90 healthy males (n = 25) and females (n = 65). Body weight, height and body fat and muscles of subjects were measured. The prevalence of obesity among farmers was 56.7% according to the BMI. The farmers spent about 18 hours 7 minutes (75.5%) in sleeping and resting. The farmers spent about 19 hours 56 minutes (83.1%) out of 24 hours (one day) in "sedentary activities" and spent about 3 hours 56 minutes (16.4%) in "light activities". Physical activity level (PAL, activity coefficient) of female farmers was 1.42 which was not significantly higher than that (1.37) of male farmers. Estimated energy requirements (EER) for farmers who were different in age groups and gender were calculated. For example, the EERs for male and female farmers were 2190 kcal/day and 1712 kcal/day, respectively. The daily energy intakes of male and female farmers were 1803 kcal/day and 1610 kcal/day, respectively. The EER of male farmers was 2190 kcal/day which was significantly higher than that (1803 kcal/day) of the recommended daily energy intake of male farmers. The results of this study suggest that estimated EER of farmers should be modified according to seasonal workload and energy balance of farmers should be evaluated to prevent obesity.
Adipose Tissue ; Body Weight ; Energy Intake ; Energy Metabolism ; Female ; Humans ; Male ; Motor Activity ; Muscles ; Obesity ; Prevalence ; Seasons

BACKGROUND: Laparoscopic cholecystectomy (LC) has traditionally been performed under general anesthesia, however, owing in part to the advancement of surgical and anesthetic techniques, many laparoscopic cholecystectomies have been successfully performed under the spinal anesthetic technique. We hoped to determine the feasibility of segmental epidural anesthesia for LC. METHODS: Twelve American Society of Anesthesiologists class I or II patients received an epidural block for LC. The level of epidural block and the satisfaction score of patients and the surgeon were checked to evaluate the efficacy of epidural block for LC. RESULTS: LC was performed successfully under epidural block, with the exception of 1 patient who required a conversion to general anesthesia owing to severe referred pain. There were no special postoperative complications, with the exception of one case of urinary retention. CONCLUSIONS: Epidural anesthesia might be applicable for LC. However, the incidence of intraoperative referred shoulder pain is high, and so careful patient recruitment and management of shoulder pain should be considered.
Anesthesia, Epidural ; Anesthesia, General ; Cholecystectomy, Laparoscopic ; Feasibility Studies ; Humans ; Incidence ; Pain, Referred ; Patient Selection ; Postoperative Complications ; Shoulder Pain

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation