This study was conducted to investigate the safety of the umbilical venous blood for antologous transfusion in the premature newborn babies. Umbilical venous blood was collected with aseptic technique immediately after delivery from 270 healthy mothers admitted to the Yeungnam University Hospital between March 1,1992 and August 31,1992 . The volume of the blood and the time taken for collecting the blood were measured. Also the hematological and biochemical changes of the blood during storage in the refrigerator of blood band and the incidence of bacterial contamination were studied. It took 67.6+/-25.9 seconds on the average for collecting the blood from an umbilical vein and the average volume of the blood was 77.1+/-23.2ml which would be sufficient volume for one time transfusion of 10ml/kg of packed red blood cells for the neonates. The hemoglobin and hematocrit values did not change significantly during storage for three weeks. Thus significant hemolysis did not seem to occur during storage. However, platelet counts decreased significantly from 248+/-59x10E3/mm3 to 193+/-47x10E3/mm3(p<0.01). Although plasma calcium level was not changed (8.4+/-0.9mg/dL), sodium was decreased significantly from 184.3+/-11.1mEq/L to 170.9+/-13.9mEq/L(p<0.01) and potassium was incresed from 5.0+/-1.0mEq/L to 26.7+/-4.8mEp/L.(p<0.01). Plasma glucose level was decreased from 521.7+/-106.7mg/dL to 294.3+/-120.8mg/dL (p<0.01), blood pH and bicarbonate concentrations were decreased significantly from 6.825+/-0.110 to 6.378+/-.087 and from 13.5+/-1.6mEq/L to 2.1+/-1.0mEq/L respectively (p<0.01). The smear of the umbilical venous blood and peripheral blood of the neonates stained by KleihauerBetke method revealed no significant differences in the percentages of adult red blood cells. Also there were no differences in the percentages of adult ted blood calls in the umbilical venous blood samples according to time for collection. The degree of decrement of hemoglobins (1.2gm/dL) after delivery in the mothers who had sampling of the umbilical venous blood was not different from that in the mothers who didn't hava sampling. The bacterial contamination rate of the umbilical venous blood was 3.5% (95% confidence interval was from 0.7 to 6.3). It seems to be safe to use the umbilical venous blood in the neonates for autologous transfusion but confirmation of bacterial contamination by culture is necessary.
Adult ; Blood Glucose ; Calcium ; Erythrocytes ; Hematocrit ; Hemolysis ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Infant, Newborn* ; Mothers ; Plasma ; Platelet Count ; Potassium ; Sodium ; Umbilical Veins

Repeated throwing of baseballs by juvenile pitchers is known to cause damages to bone and cartilage as well as soft tissue in the involved upper extremity. Authors present 4 cases of osteochondral lesion at capitellum of the humerus as a result of repeated insult by throwing baseballs in the juvenile pitchers. Pain and limitation of extension of the affected elbow were the commonest symptoms. Cystic change or osteochondral loose body was found on plain X-ray. Treatment consisted of rest and analgesic administration in the patient who has no loose body, while in case of having loose body it was removed surgically without further treatment to the crater. In spite of the rapid relief of the pain by these treatment, limitation of extension persisted for considerable period of time. It is strongly suggested not to overlook elbow pain in young adolescent whose bone is still growing and who can hardly withstand repeated insult to prevent the development of baseball elbow.
Adolescent ; Baseball ; Cartilage ; Elbow ; Humans ; Humerus ; Osteochondritis ; Upper Extremity

A total of 53 gastric adenomas from endoscopically biopsied gastric mucosa were examined histopathologically. The average age at the time of endoscopic biopsy was 59 years, and gastric adenomas were found to be more frequent in the aged, particularly above the age of 50. The majority of adenomas occurred at the antrum. Concerning the shape of the adenomas, Yamada type II was more frequent (55%). All adenomas were accompanied by varying degree of intestinal metaplasia, and this findings suggest that gastric adenoma develops from intestinal metaplasia. In adenomas with severe atypia (grade III), endocrine cells (argyrophil and argentaffin cells) were markedly decreased or absent. Gastric adenocarcinomas coexistent with adenoma were seen in 5 (9.4%) out of 53 cases, and were more frequent in male than female patients (sex ratio, 4:1) and the average age was 61.4 years. It is suggested that there is a necessity of thorough follow-up study for definitive correlation between gastric adenoma and adenocarcinoma.
Adenocarcinoma ; Adenoma* ; Biopsy ; Endocrine Cells ; Female ; Follow-Up Studies ; Gastric Mucosa ; Humans ; Male ; Metaplasia ; Stomach

This study was conducted to evaluate the effect of PTSD on memory funtion and hippocampal volume, and to identify major variables correlated to hippocampal volume and memory function. Thirty four Vietnam veterans were collected for this study, among whom eighteen were PTSD patients and sixteen were combat control subjects. The author used Impact of Event Scale(IES), Combat Exposure Scale(CES), Hamilton Depression Rating Scale(HDRS) and Beck Depression Inventory(BDI). Korea Memory Assessment Scale(K-MAS) was assessed for memory function. Magnetic resonance imaging(MRI) was used to measure hippocampal volume. There were significant differences between PTSD and Non-PTSD veterans in IES, HDRS and BDI. Significant difference was found in verbal memory and total memory of K-MAS between PTSD and Non-PTSD veterans. There was significant difference in hippocampal volume between PTSD and Non-PTSD veterans. Short term memory, verbal memory and total memory were positively correlated to hippocampal volume. Hippocampal volume was negatively correlated to IES, HDRS, and BDI. These results suggest that PTSD severity be associated with hippocampal atrophy and memory dysfunction. Reduced or smaller hippocampal volume may be preexisting risk factor for stress exposure or the development of PTSD on combat exposure.
Atrophy ; Depression ; Hippocampus ; Humans ; Korea ; Memory* ; Risk Factors ; Stress Disorders, Post-Traumatic* ; Veterans ; Vietnam

We Reviewed 10 hypertensive children with pheochromocytoma retrospectively and the following results were obtained. 1) Out of 10 patients, 7 were male and 3 female. Age ranged from 5.5 years to 13.8 years and their median age was 9.9 years. 2) They complained of sweating, lethargy, headache. or chest pain and so on. Hypertension were noticed in all patients. Heart murmurs were detected in 7 patients and hypertensive retinopathy in 70%. 3) The three cases arised at extraadrenal gland and bilaterality was seen in 3 patients. In the view of diagnosis, abdominal sonography, computerized tomography and urine VMA test revealed the sensitivity of 100%. But MIBG scan showed 60% in sensitivity. 4) Waiting for operation, their hypertension were controlled by adrenergic blockers or calcium channel blockers. They received tumorectomy successfully except one who was in hypertensive state after operation and followed up through OPD. In conclusion high suspicion for the existence of pheochromocytoma from the clinical manifestations should be entertained in any pediatric patients and biochemical and imaging studies were mandatory. Furthermore, for the accurate localization of tumors, several imaging studies should be collaborated.
3-Iodobenzylguanidine ; Adrenergic Antagonists ; Calcium Channel Blockers ; Chest Pain ; Child* ; Diagnosis ; Female ; Headache ; Heart Murmurs ; Humans ; Hypertension ; Hypertensive Retinopathy ; Lethargy ; Male ; Pheochromocytoma* ; Retrospective Studies ; Sweat ; Sweating

PURPOSE: A microscopic hematuria is a common finding on urine examination, with a prevalence rate of between 0.5 and 1.6% in urine samples from children. Although there are many causes of an asymptomatic microscopic hematuria, the vast majority of causes are diagnosed as idiopathic or benign, which are not indicative of significant renal disease. This study was performed to determine the value of standard laboratory and radiological evaluations of asymptomatic microscopic hematuria in children. MATERIALS AND METHODS: Between January 2001 and December 2003, a retrospective study of 150 children with an asymptomatic microscopic hematuria, who visited the Hanyang University Guri Hospital, was conducted. The mean age was 10.2 years old, with a male to female ratio of 83:67. The diagnostic studies reviewed included; blood urea nitrogen, serum creatinine, complete blood count, liver function test, serum electrolyte, serum coagulation test, serum complement concentration, serum immunoglobulin, antinuclear antibody, ultrasonography, intravenous urogram and renal biopsy. RESULTS: 5 diseases (3.3%), 2 nephrologic and 3 urologic, were diagnosed in 150 cases. For the nephrologic diseases, two children were diagnosed with thin basement membrane disease, and for the urologic diseases, one child was diagnosed with a renal stone, with a further two diagnosed with renal cysts. CONCLUSIONS: In this study, a microscopic hematuria was a benign finding in the vast majority of children. Because of the high false positive rate for a hematuria in the urinary mass screening, this does not seem to be an appropriate exclusive method for evaluating the etiology of a microscopic hematuria. We recommend that basic diagnostic studies, including urinalysis with dysmorphic RBC and ultrasonography, for the evaluation of children with an asymptomatic microscopic hematuria. If no abnormality was found in children using the basic diagnostic study, and in those with no family history of renal disease, proteinuria, and hypertension, it may be rational that doctors periodically follow up with routine urinalysis.
Antibodies, Antinuclear ; Basement Membrane ; Biopsy ; Blood Cell Count ; Blood Urea Nitrogen ; Child* ; Complement System Proteins ; Creatinine ; Female ; Follow-Up Studies ; Hematuria* ; Humans ; Hypertension ; Immunoglobulins ; Liver Function Tests ; Male ; Mass Screening ; Prevalence ; Proteinuria ; Retrospective Studies ; Ultrasonography ; Urinalysis ; Urologic Diseases

The authors report a case of chylous ascites in a two month old boy with massive ascites. He was managed with repeated therapeutic paracentesis and skimmed milk feeding. A marked improvement was resulted in clinical symptoms and laboratory findings at the time of discharge to be followed-up at the outpatient service. A brief review of literatures is included
Ascites ; Chylous Ascites* ; Humans ; Infant* ; Male* ; Milk ; Outpatients ; Paracentesis

BACKGROUND: Pretreatment of systemic ketamine reduced pain behaviors in some animal models with persistent pain. However, a clinically relevant preemptive analgeisic effect of systemic ketamine is controversial. The purpose of this study was to examine the preemptive effect of systemic ketamine in rats undergoing a plantar incision. METHODS: Ketamine (10, 30, or 100 mg/kg) or a saline vehicle was administered subcutaneously 30 minutes before an incision was made. Withdrawal thresholds to calibrated von Frey filaments adjacent to the wound were measured before incision and from 2 hours to postoperative 6 days after incision. To evaluate the effectiveness of an extension of antinociceptive treatment into the initial postoperative period, 30 mg/kg ketamine or a saline vehicle 30 minutes before an incision was made was administered subcutaneously followed by injection of 5 more of the same drug or vehicle every 1 hour. The development of pain behavior was also evaluated before incision and from 30 minutes after last drug injection to postoperative 6 days. RESULTS: In saline vehicle-treated rats, mechanical hyperalgesia was persistent through day 1 after surgery and then gradually returned to the preincisional value. Thirty mg/kg ketamine increased the withdrawal threshold at 2 hours. One hundred mg/kg ketamine caused a motor block at 2 hours and increased the withdrawal threshold at 2.5 and 3 hours. A repeated injection of 30 mg/kg ketamine caused a motor block during the first 2 hours, and reduced hyperalgesia at 3 and 4 hours after the last drug injection. However, there were no significant differences in withdrawal thresholds among the groups at all subsequent times. CONCLUSIONS: Antinociceptive treatment of systemic ketamine covers the period of surgery and the initial postoperative period by reducing early pain behavior, but had no impact on subsequent measures of hyperalgesia. Therefore, a preemptive effect of systemic ketamine in postoperative pain seems unlikely.
Analgesia* ; Animals ; Hyperalgesia ; Ketamine* ; Models, Animal* ; Pain, Postoperative ; Postoperative Period ; Rats* ; Wounds and Injuries

BACKGROUND: This study was performed to determine the effect of a endotracheal intubation & induction of anesthesia using propofol 2.0 mg/kg or 2.5 mg/kg and fentanyl 2 g/kg without succinylcholine chloride. Also we have compared this method with technique using succinylcholine 1.5 mg/kg and thiopental sodium 5 mg/kg. METHODS: They were divided into 3 groups as follows: group 1, succinylcholine 1~1.5 mg/kg and thiopental sodium 5 mg/kg; group 2, propofol 2 mg/kg and fentanyl 2 microgram/kg; group 3, propofol 2.5 mg/kg and fentanyl 2 microgram/kg. Systolic arterial pressure (SAP) and diastolic arterial pressure (DAP), and heart rate (HR) were measured before induction, after induction, after tracheal intubation immediately, at 1, 2, 3, and 5min. after tracheal intubation in all patients. The incidence of adverse effects and the quality of condition for intubation were measured in all patients. RESULTS: There were significant increases in SAP, DAP, HR after intubation in group 1 but significant decreases in SAP, DAP after induction and at 5min. after intubation in group 2 and group 3. The incidence of adverse effects, and the quality of condition for intubation were no significant difference between group 1 and group 3. CONCLUSIONS: From the above result, use of propofol 2.5 mg/kg and fentanyl 2microgram/kg provided a satisfactory alternative to succinylcholine and thiopental sodium for rapid sequence induction of anesthesia.
Anesthesia ; Arterial Pressure ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Propofol ; Sodium* ; Succinylcholine ; Thiopental

OBJECTIVES: Posttraumatic stress disorder(PTSD) has devastating effects on multiple aspects of the quality of life(QoL). Therefore, the purpose of this study is to compare the QoL between PTSD group and non-PTSD group, and identify the variables affecting the QoL of the Vietnam War veterans. METHODS: We recruited 39 veterans with PTSD and 43 veterans without PTSD, all of whom had deployed to the Vietnam War. We used the Korean version of Mini International Neuropsychiatric Interview-Plus, the Korean version of Clinician-Administered PTSD Scale, Combat Exposure Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument abbreviated version. We used independent samples t-test to identify the differences between PTSD and non-PTSD group in each domains of the quality of life. We also used stepwise multiple linear regression analysis to figure out the variables affecting the QoL of the Vietnam War veterans. RESULTS: In the PTSD group, all domains of the QoL and the QoL total score(p<0.01) were significantly lower than those in the non-PTSD group. In the Vietnam War veterans, PTSD, major depressive disorder and education levels were the variables affecting the QoL. Among these, PTSD uniquely explained the QoL of the overall and general health(beta=-1.411, R2=0.180), the physical health domain(beta=-2.806, R2=0.089) and the total score (beta=-11.479, R2=0.104). CONCLUSIONS: These results suggest that among the Vietnam War veterans, the QoL of the PTSD group is significantly lower than that of the non-PTSD group. Among the combat exposed veterans, PTSD may be one of the main reasons that affect the multiple domains of the QoL.
Depressive Disorder, Major ; Humans ; Linear Models ; Quality of Life ; Stress Disorders, Post-Traumatic ; Veterans ; Vietnam ; World Health Organization