Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we divided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be reduced to reduce hospital cost in korea. we thought that the korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the united states. This study presents some limitations such as on insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can possibly affect LOS, However, this study reports an important trend in LOS from 1984 to 1994.
Diagnosis-Related Groups ; Fee-for-Service Plans ; Hospital Bed Capacity ; Hospital Costs ; Hospitals, Public ; Humans ; Internal Medicine ; Korea* ; Length of Stay* ; Ownership ; United States

BACKGROUND: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.
Antibodies* ; Blood Transfusion ; Coombs Test ; Female ; Humans ; Korea* ; Mass Screening ; Pregnant Women* ; Prevalence*

BACKGROUND: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.
Antibodies* ; Blood Transfusion ; Coombs Test ; Female ; Humans ; Korea* ; Mass Screening ; Pregnant Women* ; Prevalence*

Essential hypertension is an important public health problem in Korea-being common, asymptomatic, easily treatable, and often leading to lethal complication in left untreated. The number of patients with hypertension has been significantly increased, and this factor may be an importnat one responsible for the increase in cardivascular mortality during past 20 years in Korea. As the drug therapy for hypertension needs longer period, it is very important to evaluate the efficacy and the adverse effects. Thirty patients(17 men and 13 womon) with essential hypertension were evaluated in this study. All patients had received oral Isradipine 1.25~2.5mg b.i.d. for 8 weeks. 1) The systolic and diastolic pressure were decreased significantly(166.8+/-9.0mmHg vs 147.3+/-12.0mmHg, p<0.001 and 100.3+/-4.0mmHg vs 90.3+/-6.1mmHg, p<0.001, respectively) 2) Heart rate, body weight, laboratory tests, chest X-ray, ECG studies were not changed significantly. 3) The systolic pressure was lowered by 20mmHg or more in 17 cases(56.7% of total), and the diastolic pressure was lowered by 10mmHg or more in 20 cases(66.7% of total) at 8 weeks after Isradipine administration. 4) The adverse effects of Isradipine were edema in 3(10%), constipation in 2(6.7%), headache in 2(6.7%), and insomnia, dizziness and dry mouth in 1 patient respectively, and none of them discontinued Isradipine administration due to adverse effects. In many patients with essential hypertension there is an effective response to Isradipine, even though there may be some mild adverse effects.
Blood Pressure ; Body Weight ; Constipation ; Dizziness ; Drug Therapy ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension ; Isradipine ; Korea ; Male ; Mortality ; Mouth ; Public Health ; Sleep Initiation and Maintenance Disorders ; Thorax

Oxygen*

BACKGROUND: Alopecia areata (AA) is a non-scarring, autoimmune, inflammatory hair loss on the scalp and/or body. This disease affects both adults and children but there are limited data on AA in children than AA in adults. OBJECTIVE: The purpose of this retrospective study is to evaluate the clinical characteristics, disease associations and psychosomatic dynamics of pediatric AA for the past 5 years. METHODS: A retrospective study was performed on 120 out-patients under 14 years old who are diagnosed as alopecia areata in the department of dermatology from March, 2007 to February, 2012. RESULTS: The proportion of pediatric group in total alopecia areata was 20.2% (120/595). According to clinical records, the alopecia areata were of 111 patients (79.9%) followed by those with alopecia universalis (4 patients; 2.8%) and alopecia totalis (5 patients; 3.6%). The ratio of males (57 patients; 47.5%) to females (63 patients; 52.5%) was 1 : 1.11. Alopecia areata was seen most frequently in the school age group (69 patients; 57.5%) and the duration period was less than one year in most cases (79.2%). Family history of alopecia areata was observed in 10.8% (13/120). The only child or eldest child being overloaded with homework and has deficient parent-child relationships including familial discord was accounted as the most susceptible group. A multiple bald patch was 51.4% in alopecia areata and the most common associated disease was atopic dermatitis (26 patients; 21.7%). CONCLUSION: We observed several clinical features of the pediatric AA, including epidemiology, clinical characteristics and disease associations. This study provided useful data for future research regarding AA in children.
Adult ; Alopecia ; Alopecia Areata ; Child ; Dermatitis, Atopic ; Dermatology ; Female ; Hair ; Humans ; Male ; Only Child ; Outpatients ; Parent-Child Relations ; Retrospective Studies ; Scalp

No abstract available.
Chronic Disease ; Glycemic Index

Hydrofluoric acid(HF) burn is characterized by progressive tissue necrosis and severe pain. A 31 year old employee in the semiconductor industry came in contact with the 50% aqueous HF through a pin hole in the thumb of his protective gloves. About 2 hours after exposure, h noted deep, severe burning, excruciating pain and svtelling of right thumb. Thereafter, clark bluish eclematous necrotic patches were visible through the nail plate and on the distal end of right thumb. Pain was not effectively relieved by digital nerve block.
Adult ; Burns* ; Gloves, Protective ; Humans ; Hydrofluoric Acid* ; Necrosis ; Nerve Block ; Semiconductors ; Thumb

No abstract available.
Humans ; Hypersensitivity* ; Skin*