In clinical practice, creatinine clearance (Ccr) remains the most commonly used laboratory assessment of glomerular function despite methodological and technical problems of urine collection. Schwartz et al. in 1976, reported that an accurate estimate of glomerular filtration rate (GFR) could be obtained from the simple determinations of plasma creatinine (Per) and body length (L): GFR (ml/min/1.73m2)=kL (cm)/Per (mg/100 ml), (k=constant). The subject of this study were 81 children admitted to our pediatric department from July, 1985 to June, 1987 and they were divided into three groups; group I, from 1 to 5 years old, group II, from 6 to 10 years old, group III, from 11 to 15 years old. The results were as following: 1) Measured creatinine clearance Ccr(M), ml/min/1.73m²) were 109.73±9.97 in group I, 108.26±9.02 in group II, 96.20±4.72 in group III and 105.48±5.23 in all age group. 2) Measured k(k(M)) obtained from CcrM=k Ht/Pcr were 0.49±0.03 in group I, 0.48±0.02 in group II, 0.43±0.02 in group III, and 0.47±0.02 in all age group (Ht; height). 3) Linear equations and correlation coefficient between Ht/Pcr (x) and Ccr (y) were y=0.82x-65.63 (r=0.99) in group I, y=0.61x-23.46(r=0.72) in group II, y=0.18x+54.44 (r=0.54) in group III and y=0.58x-22.13 (r=0.81) in all age group. 4) Ccr(E) was again estimated from linear equations between Ht/Pcr and Ccr(M) and k(E) was calculated with Ht/Pcr and Ccr(E) were 0.48±0.01 in group I, 0.49±0.01 in group II, 0.43±0.01 in group III and 0.47±0.00 in all age group. 5) Consistent values of k(E) and k(M) were highly significant as 95~97.5% in group I and II, 90~95% in group III and 97.5~99% in all age group. In summary, we could estimate GFR with height, plasma creatinine and measured k(k(M)) according to the age in easy and rapid way.
Child* ; Creatinine* ; Glomerular Filtration Rate* ; Humans ; Plasma* ; Urine Specimen Collection

No abstract available.
Female ; Ovary* ; Teratoma*

Postoperative atrial arrhythmia after thoracotomy is relatively common, with a reported incidence ranging from 8% to 30%. These arrhythmias may cause hypotension, congestive heart failure and lengthen the period of postoperative hospitalization. The most important precipitating factor is atrial dilation and identified risk factor is an advanced age of the patient. The effect of various prophylactic regimens to reduce atrial arrhythmias is controversial. We report a case of postoperative atrial fibrillation in a 73 year-old female patient undergoing repair of esophageal hiatal hernia.
Aged ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Female ; Heart Failure ; Hernia, Hiatal* ; Hospitalization ; Humans ; Hypotension ; Incidence ; Precipitating Factors ; Risk Factors ; Thoracotomy

OBJECTIVE: This study was conducted to develop and to validate the Korean version of Delirium Rating Scale-Revised-98 (K-DRS-98), which is a scale for diagnosing delirium and evaluating its severity. METHOD: After developing the K-DRS-98, 102 patients were rated by it among 4 diagnostic groups, such as delirium (N=25), dementia (N=27), schizophrenia (N=25) and others (N=25). To test for reliability, K-DRS-98 was independently administered by two psychiatrist. To test for validity, Korean version of Mini-Mental State Examination (MMSE-K) and Clinical Global Impression (CGI) were administered simultaneously. Statistical analysis was done with SPSS window version 12 package and statistical significance was p<0.05. RESULT: Internal consistencies (Cronbach alpha) of two raters were 0.867 and 0.858, respectively. Inter-rater reliability (kappa) was 0.893 for severity items of K-DRS-98 and kappa value of diagnosis items was 0.969. In Delirium group, Pearson correlation coefficients (gamma) of K-DRS-98 were -0.682 for MMSE-K and 0.667 for CGI. In comparison Delirium group with Others, ANOVA post hoc multiple comparison LSD was statistically significant (p<0.001). The cutoff score to diagnosis of delirium can be recommended 16 for severity items and 21.5 for total score, respectively. CONCLUSION: The K-DRS-98 was showed good reliability and validity for the assessment of delirium. The K-DRS-98 is an easy and useful tool for diagnosing delirium and assessing its severity.
Delirium* ; Dementia ; Diagnosis ; Humans ; Lysergic Acid Diethylamide ; Psychiatry ; Reproducibility of Results ; Schizophrenia

Immunologic responses of infants and younger children differ from those of adults. Therefore, application of different pretransplant strategies for antibody depletion in younger ABO-incompatible transplant recipients is appropriate. A 12-month-old male infant with end stage renal disease after acute tubular necrosis was scheduled to undergo kidney transplantation from an ABO-incompatible living donor. He did not undergo pretransplant plasmapheresis, as the titer of the anti-ABO antibody was less than 1:4. After kidney transplantation, posttransplant renal function and anti-ABO titers were stable until posttransplant 2 years.
Adult ; Child ; Humans ; Infant ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Living Donors ; Male ; Necrosis ; Plasmapheresis* ; Transplantation

BACKGROUND: Vasoconstricting drugs such as dopamine, phenylephrine (PE) and epinephrine constrict normoxic lung vessels preferentially, thereby disproportionately increasing normoxic lung pulmonary vascular resistance (PVR) and inhibit hypoxic pulmonary vasoconstriction (HPV). In this study, we evaluated the effect of PE on HPV and arterial oxygenation. METHODS: This study was performed on 21 patients undergoing thoracotomy. After induction of anesthesia, Swan-Ganz catheter was inserted. After one lung ventilation was started, systolic blood pressure (SBP) of the patient was reduced to 100 mmHg using inhalation anesthetic agent and then the blood pressure was raised up to 140 mmHg by PE infusion. Hemodynamic variables were measured and arterial blood gas was analyzed at the start of one lung ventilation (control), SBP of 100 mmHg and SBP of 140 mmHg. RESULTS: The mean dose of PE infused was 5.9 +/- 3.8 microgram/kg. Infusion of PE did not increase pulmonary vascular resistant index (PVRI) significantly and did not reduce arterial PO2. There was no statistically significant difference in intrapulmonary shunt fraction (Qs/Qt) between the time of low and high blood pressures. CONCLUSION: Pulmonary vasomotor changes induced by PE are minimal and so should not affect the distribution of blood flow during one lung ventilation. On the basis of this result, PE appears to a reasonable vasoconstrictor to be used in patients undergoing thoracotomy.
Anesthesia ; Blood Pressure ; Catheters ; Dopamine ; Epinephrine ; Hemodynamics ; Humans ; Hypertension ; Inhalation ; Lung ; One-Lung Ventilation* ; Oxygen* ; Phenylephrine* ; Thoracotomy ; Vascular Resistance ; Vasoconstriction*

BACKGREOUND: The pneumonectomy may depress the right ventricular (RV) function transiently. The thermodilution ejection/volumetric catheter is known to be most useful method assessing the changes in RV performance during pulmonary resection. The purpose of this study was to examine the RV function during and immediately after pneumonectomy using thermodilution methods. METHODS: 16 patients undergoing pneumonectomy were studied. After induction of anesthesia, a multilumen thermodilution catheter mounted with a rapid response thermister was inserted. Using computer system, RV ejection fraction (RVEF), cardiac output, and RV end-diastolic volume (RVEDV) were measured when the patient was in lateral position (control), after one lung ventilation (OLV) and the main pulmonary artery ligated, and at the completion of resection. Arterial blood gases were analyzed and pulmonary vascular resistance (PVR) was calculated. RESULTS: Systolic pulmonary blood pressure (SPAP)(28.3 +/- 6.2 mmHg) increased compared to the control (24.6 +/- 5.9) without a significant change of PVR. No statistically significant difference was found in either RVEF or RVEDV at each times. CONCLUSIONS: Our study demonstrate the pneumonectomy do not depress the RV function immediately and RVEF do not show any correlation with PVR or RVEDV.
Anesthesia ; Blood Pressure ; Cardiac Output ; Catheters ; Computer Systems ; Gases ; Humans ; One-Lung Ventilation ; Pneumonectomy* ; Pulmonary Artery ; Thermodilution ; Vascular Resistance ; Ventricular Function, Right*

Diamino-diphenyl-sulfone (Dapsone) is widely used in the treatment of leprosy and a variety of blistering skin diseases. It sometimes has adverse side effects with common usual doses, such as skin, nervous system, gastrointestinal tract, liver, kidney and hematologic toxicity. One of these side effects is a rare but serious hypersensitivity reaction called dapsone syndrome, which occurs several weeks after the initial administration of the drug and results in unpredictable, sometimes fatal outcomes. This report deals with a 13-year-old girl's case with typical features of dapsone syndrome that included fever, exfoliative dermatitis, jaundice, hemolytic anemia and pleural effusion after being treated with dapsone for four weeks.
Adolescent ; Anemia ; Anemia, Hemolytic ; Blister ; Dapsone* ; Dermatitis, Exfoliative ; Fatal Outcome ; Fever ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Jaundice ; Kidney ; Leprosy ; Liver ; Nervous System ; Pleural Effusion ; Skin ; Skin Diseases

BACKGROUND: Experimental evidence indicates that ginseng modulate the nociceptive transmission. Authors examined the role of adrenergic and cholinergic receptors on the antinociceptive action of Korean red ginseng against the formalin-induced pain at the spinal level. METHODS: Catheters were inserted into the intrathecal space of male Sprague-Dawley rats. Fifty microl of 5% formalin solution was injected to the hindpaw for induction of pain and formalin-induced pain (flinching response) was observed. The role of spinal adrenergic and cholinergic receptors on the effect of Korean red ginseng was assessed by antagonists (prazosin, yohimbine, atropine and mecamylamine). RESULTS: Intrathecal Korean red ginseng produced a dose-dependent suppression of the flinching response in the rat formalin test. All of prazosin, yohimbine, atropine and mecamylamine antagonized the antinociception of Korean red ginseng. CONCLUSIONS: Spinal Korean red ginseng is effective against acute pain and facilitated pain state evoked by formalin injection. All of alpha 1, alpha 2, muscarinic and nicotinic receptors may play an important role in the antinociceptive action of Korean red ginseng at the spinal level.
Acute Pain ; Animals ; Atropine ; Catheters ; Formaldehyde ; Humans ; Male ; Mecamylamine ; Pain Measurement ; Panax ; Prazosin ; Rats ; Rats, Sprague-Dawley ; Receptors, Cholinergic ; Receptors, Nicotinic ; Spinal Cord ; Yohimbine

OBJECTIVES: To evaluate the clinical significance of abnormal bronchi originating from the trachea or main bronchi. METHODS: 21 patients (male:female ratio, 13:8; mean age, 58.2 years, range 34-77), who were diagnosed with major tracheobronchial anomalies by bronchoscopy from January 2001 to March 2005, were enrolled in this study. The anomalous bronchi consisted of 13 tracheal bronchi and 8 cardiac accessory bronchus. The clinical features, bronchoscopic findings, and outcomes were analyzed retrospectively. RESULTS: Common symptoms, including hemoptysis, cough and dyspnea, resulted from the underlying lung disease regardless of the bronchial anomalies. In this series of 13 tracheal bronchi, 7 cases originated from the trachea within 1cm of the carina (carinal type) and 6 cases originated at a higher level(tracheal type). Most patients had favorable outcome with conservative treatment for the underlying lung disease. CONCLUSION: Most tracheobronchial anomalies are found incidentally in the process of diagnosing lung disease. The clinical outcome of patients with a bronchial anomaly depends on the underlying lung disease.
Bronchi* ; Bronchoscopy ; Cough ; Dyspnea ; Hemoptysis ; Humans ; Lung Diseases ; Retrospective Studies ; Trachea*