The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital, from Jan. 1991 to Dec. 1993. A variety of prognostic factors that influence mortality were observed. The locaton of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH, 19 cases(26%) showed dilated 4th ventricular hemorrage and higher mortality rate(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001). The mortality rate was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). THe group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR), hydrocephalus, surrounding edema edema around the heamtoam, and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma, whether or not the volume of hematoma is more than 30cc, IVH, dilated 4th ventricular hemorrhage, Graeb's score of more than 7, GCS of less than 9, midline shift of more than 10mm, and reactivity of pupillary light reflex.
Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Edema ; Ganglion Cysts* ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Prognosis ; Reflex ; Thalamus

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

No abstract available.

No abstract available.
Nose* ; Papilloma, Inverted* ; Paranasal Sinuses*

No abstract available.
Humans ; Sinusitis*

Protozoa of the genus Cryptosporidium are small coccidian parasite known to infect the mucosal epithelium of a variety of animals including human, causing fatal course in immunodeficient patients as well as self-limited illness in healthy individuals. Various life cycle stages including trophozoite, meront, merozoite, gametocyte and oocyst in infected mucosa are a diagnostic feature. Electron microscopy (EM) provides sufficient findings for genus and species identification of this parasitic organism. The authors presented scanning and transmission EM findings of Cryptosporidium parvum infection in two children: one with acute lymphoblastic leukemia and the other without any evidence of immune compromise.
Animals ; Child ; Cryptosporidium parvum ; Cryptosporidium* ; Epithelium ; Humans* ; Intestines* ; Life Cycle Stages ; Merozoites ; Microscopy, Electron ; Mucous Membrane ; Oocysts ; Parasites ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Trophozoites

The antiphospholipid antibodies are characterized by prolonged phospholipid-dependent coagulation test (known as APTT or Russel viper venom), thrombosis, thrombocytopenia, and fetal loss. The association of antiphospholipid antibodies with one or more of these characteristic clinical features has been termed the i antiphospholipid syndrome. We have experienced a case of successful live birth after treated a woman with heparin and aspirin who has experienced spontaneous abortion four times with antiphospholipid antibodies and present it with the review of literature.
Abortion, Spontaneous ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Aspirin ; Female ; Heparin ; Humans ; Live Birth* ; Pregnancy ; Thrombocytopenia ; Thrombosis

BACKGROUND:We experienced unintentional hyperventilation during mechanical ventilation in infants under general anesthesia. It is very difficult to decide upon respiratory rate or tidal volume for adequate ventilation without respiratory gas monitoring. During pulmonary ventilation using a Mapleson D circuit, the utilization of high fresh gas flow dilutes the expired gas and causes an underestimation of end-tidal CO2. We undertook to find a proper respiratory rate (RR) with a fixed tidal volume during controlled ventilation in infant general anesthesia. METHODS: We studied 50 infants weighing below 10 kg during general anesthesia. An uncuffed endotracheal tube was selected 3.5 or 4.0 mm (inner diameter). After intubation with midazolam, thiopental sodium and vecuronium, controlled ventilation was applied: total fresh gas flow 3 L/minute, peak inspiratory pressure 15-20 cmH2O, and RR 19 or 20/minute. Arterial blood gas analysis was done 20 minutes later. We calculated the RR for a PaCO2 of 36 mmHg according to the equation: RR (applied) = estimated RR x estimated PaCO2/ideal PaCO2. In addition, linear regression was performed to analyze the relation between age and RR. RESULTS: The estimated regression equation for RR using Pearson's correlation coefficient was as follows: RR = 22.835 - 0.415 x age (months). CONCLUSIONS: The equation (RR = 22.835 - 0.415 x age [months]) could be used as an index for safe ventilatory management without severe hyper- or hypo-carbia in infants during general anesthesia.
Anesthesia, General* ; Blood Gas Analysis ; Humans ; Hyperventilation ; Infant* ; Intubation ; Linear Models ; Midazolam ; Pulmonary Ventilation ; Respiration, Artificial ; Respiratory Rate* ; Thiopental ; Tidal Volume ; Vecuronium Bromide ; Ventilation*

No abstract available.
Cleft Palate* ; Humans

No abstract available.
Paranasal Sinuses*