No abstract available.
Child* ; Epilepsy* ; Humans

No abstract available.
Hysterectomy*

An Eighty-year-old female patient was transferred to the operating room for hip arthroplasty under the general anesthesia. Immediately after injection of two units of methylmethacrylate bone cement into the intramedullary canal, systolic blood pressure rapidly decreased and cardiac arrest occurred. The patient was turned to the supine position and was successfully resuscitated with intravenous administration of fluids, injection of epinephrine and external cardiac massage. In the intensive-care unit, she was treated for acute pulmonary edema. Three days later, postoperative delirium was developed. She spoke incoherently, was disoriented, and showed impairment of memory and attention. She was treated with haloperidol, lorazepam and sedative drug, five days later recovered. The patient was discharged to home without any sequelaes, but she died due to pneumonia two months later postoperatively at home.
Administration, Intravenous ; Aged* ; Anesthesia, General ; Arthroplasty* ; Blood Pressure ; Delirium* ; Epinephrine ; Female ; Haloperidol ; Heart Arrest* ; Heart Massage ; Hip* ; Humans ; Lorazepam ; Memory ; Methylmethacrylate ; Operating Rooms ; Pneumonia ; Pulmonary Edema ; Supine Position

An Eighty-year-old female patient was transferred to the operating room for hip arthroplasty under the general anesthesia. Immediately after injection of two units of methylmethacrylate bone cement into the intramedullary canal, systolic blood pressure rapidly decreased and cardiac arrest occurred. The patient was turned to the supine position and was successfully resuscitated with intravenous administration of fluids, injection of epinephrine and external cardiac massage. In the intensive-care unit, she was treated for acute pulmonary edema. Three days later, postoperative delirium was developed. She spoke incoherently, was disoriented, and showed impairment of memory and attention. She was treated with haloperidol, lorazepam and sedative drug, five days later recovered. The patient was discharged to home without any sequelaes, but she died due to pneumonia two months later postoperatively at home.
Administration, Intravenous ; Aged* ; Anesthesia, General ; Arthroplasty* ; Blood Pressure ; Delirium* ; Epinephrine ; Female ; Haloperidol ; Heart Arrest* ; Heart Massage ; Hip* ; Humans ; Lorazepam ; Memory ; Methylmethacrylate ; Operating Rooms ; Pneumonia ; Pulmonary Edema ; Supine Position

BACKGROUND: When the insertion of endotracheal tube (ETTs) though the nostril, the tube may be encountered some resistance. Forcing ETTs into the nasal cavity develope mucosal and soft tissue injuries and subsequent epistaxis during passage of the tube even when vasoconstictor and/or lubricant tube are employed. Therefore, We determined whether nasopharyngeal airway (NPA) insertion reduces the incidence of epistaxis and increase the ease of the tube advancement in the nasal cavity during nasotracheal intubation. METHODS: Two hundred adult patients who schesuled for elective surgery were divided into two groups, control (n=100), and NPA (n=100). The NPA insertion group received an armored tube after nasoparyngeal airway inserts, while control group received a plain armored tube. All patients in both groups was inserts ETTs by conventional nasotracheal insertion techniques. RESULT: The NPA insertion group had a significantly low incidence of epistaxis (11%) than control group (34%) (p<0.05). But, provided not easier passage during nasotracheal intubation than control group. CONCLUSION: We conclude that nasophryngeal airway reduces the incidence of epistaxis during nasotracheal intubation, but not to increase easy passage of the tube advancement.
Adult ; Control Groups ; Epistaxis* ; Humans ; Incidence* ; Intubation* ; Nasal Cavity ; Soft Tissue Injuries

BACKGROUND: When the insertion of endotracheal tube (ETTs) though the nostril, the tube may be encountered some resistance. Forcing ETTs into the nasal cavity develope mucosal and soft tissue injuries and subsequent epistaxis during passage of the tube even when vasoconstictor and/or lubricant tube are employed. Therefore, We determined whether nasopharyngeal airway (NPA) insertion reduces the incidence of epistaxis and increase the ease of the tube advancement in the nasal cavity during nasotracheal intubation. METHODS: Two hundred adult patients who schesuled for elective surgery were divided into two groups, control (n=100), and NPA (n=100). The NPA insertion group received an armored tube after nasoparyngeal airway inserts, while control group received a plain armored tube. All patients in both groups was inserts ETTs by conventional nasotracheal insertion techniques. RESULT: The NPA insertion group had a significantly low incidence of epistaxis (11%) than control group (34%) (p<0.05). But, provided not easier passage during nasotracheal intubation than control group. CONCLUSION: We conclude that nasophryngeal airway reduces the incidence of epistaxis during nasotracheal intubation, but not to increase easy passage of the tube advancement.
Adult ; Control Groups ; Epistaxis* ; Humans ; Incidence* ; Intubation* ; Nasal Cavity ; Soft Tissue Injuries

PURPOSE: Although breast milk is considered the best source of nutrition for infants because of its superiority over powdered milk, there are circumstances when breast milk is unavailable. Committee on Nutrition of the Korean Pediatric Society conducted an investigation into the current status of formula feeding in Korea. METHODS: This investigation was conducted using questionnaires produced by our committee and distributed to mothers of children under the age of two who were using formula feeding at 10 university hospitals and 22 public health centers nationwide between March 1999 to September 1999. A comparative analysis according to location, birth order, mother's occupation, education, housing tenure and normal birth status was performed on all 2696 questionnaires using the chi-square test. RESULTS: Formula feeding was found in 49.4% and formula feeding combined with breast milk were 21.5% of the respondents. The percentage of formula feeding was higher in working mothers who underwent a Cesarean section in metropolitan areas. The inadequacy of breast milk was the most common reason for feeding powdered rnilk followed by the unhealthy condition of the mother and mother's return to work. Of those investigated, 94.9% said that they changed products at each stage as recommended by the manufacturer. Promotions for special formulas were more active in metropolitan areas than other areas, and 57.7M said that they used special formulas based on recornmendations by the doctor and acquaintances(15.5%) or after seeing an advertisement(14.0%). CONCLUSION: This investigation revealed that many rnothers were misinformed concerning formula feeding and pediatricians should provide mothers with education, shedding light on proper feeding methods.
Birth Order ; Cesarean Section ; Child ; Surveys and Questionnaires ; Education ; Feeding Methods ; Female ; Hospitals, University ; Housing ; Humans ; Infant* ; Korea ; Milk ; Milk, Human ; Mothers ; Occupations ; Parturition ; Pregnancy ; Public Health ; Return to Work

OBJECTIVE: Macrosomia is associated with increased birth injury and neonatal morbidity as well as a higher rate of cesarean delivery. Our purpose was to determine whether induction of labor after sonographic diagnosis of fetal macrosomia could improve maternal and neonatal outcome. STUDY DESIGN: The hospital records of 180 patients who delivered of an inFant with birth weight over 4000 gm were reviewed. The subjects were divided into three groups based on obstetric management as follows.. expectant management after sonographic diagnosis of fetal macrosomia(group I), induction of labor(group lI), unexpected patients who were underestimated of fetal weight(estimated fetal weight<90th percentile) (groupIII), Patients who underwent elective cesarean delivery and complicated with diabetes were excluded. Outcome variables for comparison in three groups were mode of delivery, 5 minute Apgar score below 7, presence of cephalohematoma, clavicular fracture, brachial plexus injury, and intraventricular hemorrhage. RESULTS: One hundred eighty patients who eligible for the study, of whom 32 patients were included to group I, 57 patients to group lI, and 91 patients to group Ill, respectively. The cesarean rate within elective induction group was 49%, which was significant higher than the 16% rate in expectant management group and 19% in unexpected group(p<0.05). The observed rates of cephalohematoma, clavicular fracture and 5 min Apgar score below 7 were not significantly different in three groups. CONCLUSIONS: There was an significant increased cesarean delivery rate without improvement in neonatal outcomes or reduction in birth injury among pregnancies in which labor was electively induced after sonographic diagnosis of fetal macrosomia. Elective induction of labor should be discharged in cases with fetal macrosomia.
Apgar Score ; Birth Injuries ; Birth Weight ; Brachial Plexus ; Diagnosis* ; Female ; Fetal Macrosomia* ; Hemorrhage ; Hospital Records ; Humans ; Infant ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Ultrasonography*

PURPOSE: Body mass index(BMI), skinfold thickness and arm circumference are commonly used to evaluate obesity in children. There is a need for new standards of these items on Korean children. We performed this study to provide up-to-date reference percentile values and percentile charts for these three items. METHODS: Standardized measurements of height, weight, skinfold thickness(triceps, subscapular) and arm circumference on a total of 31,188 infants and children from age 1 to 18 years during January to December 1998 were used to calculate percentile values and to develop smoothed percentile charts. RESULTS: The mean BMI increased with age and showed similar values in both sexes, but 95th percentile values were slightly higher for boys than girls. The percentile values of BMI were consistently higher than those reported previously in Korea, particularly for the 95th percetile values. Triceps and subscapular skinfold thickness showed significant increase compared with previous studies and significantly higher for females than males. Arm circumference also showed significant increase compared with the previous studies. It was significantly higher for males than females. BMI was more closely related with arm circumference than skinfold thickness. CONCLUSION: The percentile values and percentile charts of BMI, skinfold thickness and arm circumference will allow pediatricians to evaluate obesity in Korean children.
Arm* ; Body Mass Index* ; Child* ; Female ; Humans ; Infant ; Korea ; Male ; Obesity ; Skinfold Thickness*

Taxol, an anticancer drug, blocks cell division by stabilizing microtubules. However, taxol has distinct cell-cycle-independent effects. For example, taxol and bacterial LPS induce strikingly similar responses in murine microglial cells. Here, we report that taxol, like LPS, provides a ""second"" signal for murine microglial cell activation to induce tumoricidal activity. Tumoricidal activity determined by MTT assay appeared that taxol or LPS alone weakly activated microglial cells to kill P815 mastocytoma cells, whereas combinations of taxol or LPS with IFN-r synergized to activate macrophages to lyse tumor cells in a dose dependent manner. Secretion of nitric oxide (NO) correlated with tumor cell killing, and the activated microglial cells failed to kill tumor cell targets in the presence of N'-monomethyl-L-arginine (N'MMA), a competitive inhibitor of NO synthase (NOS). Treatment of the cells with anti-TNF-a neutralizing antibodies clearly blocked taxol plus IFN-r induced tumoricidal activity as well as NO production. Collectively, the data illustrate the potential for taxol to activate microglial cell mediated-antitumor mechanisms in addition to its better characterized role as an anti-mitotic agent.
Antibodies, Neutralizing ; Cell Division ; Homicide ; Macrophages ; Mastocytoma ; Microglia ; Microtubules ; Nitric Oxide Synthase ; Nitric Oxide* ; Paclitaxel*