No abstract available.
Thanatophoric Dysplasia*

No abstract available.
Budd-Chiari Syndrome ; Humans

BACKGROUND: This study was undertaken to reduce the side effects of epidural morphine through the addition of nalbuphine in 37 cesarean delivery. METHODS: Forty patients were divided into 2 groups; M(control) group: bolus administration of morphine 2 mg in 0.5% bupivacaine and continuous epidural 41 hour-infusion of morphine 7mg, N(experimental) group: bolus administration of morphine 2 mg in 0.5% bupivacaine combined with nalbuphine 10mg and continuous epidural 41 hour-infusion of morphine 7mg combined with nalbuphine 10mg via the Paragon infusor. RESULTS: During the postoperative 48 hours, their pain scores and side effects were recorded at 6, 12, 18, 24, 30, 36, 42 and 48 hours. The analgesic effects were good in two groups(mean VAS <3.0) and pain scores were statistically significant at 18 and 30 hour. The incidence of pruritus, nausea, vomiting and urinary retention was decreased in group N(p<0.05). CONCLUSIONS: We concluded that continuous epidural morphine combined with nalbuphine was one of recommendable methods to reduce side effects of morphine.
Bupivacaine ; Cesarean Section* ; Female ; Humans ; Incidence ; Infusion Pumps ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Urinary Retention ; Vomiting

No abstract available.
Catecholamines* ; Female ; Labor Stage, Second* ; Parturition* ; Plasma* ; Pregnancy ; Supine Position*

No abstract available.
Stomach Neoplasms* ; Stomach*

OBJECTIVE: Posterior lumbar or lumbosacral spinal fusion in degenerative lumbar disease has the problems of adjacent level disease as well as surgical complications. An interspinous device used for dynamic stabilization can also be applied to the adjacent segment for spinal fusion to reduce the severity of these problems. The authors reviewed the adjacent interspinous stabilization using an interspinous spacer(CoflexTM paradigm spine,Germany) combined with posterior lumbar or lumbosacral spinal fusion in degenerative lumbar disease. Method: From January 2007 to July 2008, ten patients with degenerative lumbar disease underwent posterior lumbar or lumbosacral spinal fusion with adjacent interspinous stabilization using CoflexTM. The indications for this type were adjacent segmental disc protrusion, adjacent segmental degenerative changes or high surgical risk groups, such as elderly patients or osteoporotic patients undergoing multiple leveled fusions. CoflexTM was inserted into the adjacent segmental interspinous space. The control group consisted of fifteen patients, who underwent posterior lumbar or lumbosacral spinal fusion without interspinous stabilization. The radiological parameters and clinical outcomes were compared. All patients were followed-up for more than twelve months. RESULTS: The visual analogue scale(VAS) in both groups postoperatively and at the twelve month follow-up were improved. In the CoflexTM group, the postoperative and twelve month follow-up X-ray showed no significant change in posterior disc height, interpedicular height, segmental lordotic angle, flextion-extension angulation and translation and no significant segmental instability. The control group showed a higher level of segmental lordotic angle, translation and a lower posterior disc height, interpedicular height, flextion-extension angulation and three patients showed adjacent segmental instability. CONCLUSION: CoflexTM can be used to stabilize the adjacent segment of spinal fusion in degenerative lumbar disease and might be effective in preventing adjacent segmental degeneration. However, further study will be needed to confirm this observation.
Aged ; Follow-Up Studies ; Humans ; Spinal Fusion

PURPOSE: The present study examined the etiology and risk factors of the early breast-feeding jaundice and the usefulness of auditory brainstem response test as early predictor of kernicterus. METHODS: Medical records of neonatal jaundice in newborn admitted to Daegu Fatima Hospital between September 2005 and May 2006 were analyzed prospectively. Infants were grouped according to feeding method:breast feeding group (breast feeding only, n=23), mixed feeding group (breast feeding mainly plus addition of fomula feeding, n=13). RESULTS: There were no significant differences in gestational age, birth weight, sex, duration of phototherapy, serum bilirubin and hemolytic evidence between the two study groups. First visiting day of life at out patient department was significantly delayed in breast feeding group (8.7+/-3.6 day) compared to mixed feeding group (6.0+/-1.9) (P=0.009). Weight loss was significantly severe in breast feeding group compared to mixed feeding group (P<0.05). In auditory brainstem response test, loss of Wave V in 3 cases was observed and recoverd after blood exchange transfusion in follow up test. Wave III latency had significant correlation to serum bilirubin in auditory brainstem response test (70 dB) (P=0.002). CONCLUSION: Our study suggest that further education about breast feeding and follow up within the first postnatal week would be necessary for early detection and prevention of early breast-feeding jaundice. Test of serum bilirubin and auditory brainstem response would be helpful in determination of blood exchange transfusion.
Bilirubin ; Birth Weight ; Breast Feeding ; Daegu ; Education ; Evoked Potentials, Auditory, Brain Stem* ; Follow-Up Studies ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Jaundice* ; Jaundice, Neonatal ; Kernicterus* ; Medical Records ; Phototherapy ; Prospective Studies ; Risk Factors ; Weight Loss

BACKGROUND: Leukocyte-endothelial adhesion molecules have been implicated in the pathogenesis of inflammatory disease. ICAM-1, VCAM-1 and E-selectin are cell surface adhesion molecule on vascular endothelial cells. They are up-regulated by inflammatory cytokines and regulate the adhesion and migration of leukocytes across the endothelium. Tuberculosis, a granulomatous disorder is an infection caused by Mycobacterium tuberculosis. The clinical manifestations of tuberculosis are dependent on the cellular immune response to tubercule bacilli. Circulating adhesion molecules are probably formed by cleavage and release into the circulation of the extracellular domain of the membrane bound form. The elevated levels of circulating adhesion molecules have been reported in numerous disease state. To evaluate their role as markers of disease activity in tuberculosis, we measured a sE-selectin, sVCAM-1 and sICAM-1 levels in the serum with seventies of mild, moderate and far advanced pulmonary tuberculosis. METHODS: The control and test groups were divided as follows. Group I: control(n=5), Group II: atients with mild pulmonary tuberculosis(n=12), Group III: patients with moderate pulmonary tuberculosis(n=20), Group IV patients with far advanced pulmonary tuberculosis(n=19). Serum sICAM-1, sVCAM-1 and sE-selectin were measured by ELISA kit. RESULTS: Serum soluble adhesion molecules are elevated in patients with pulmonary tuberculosis. Circulating ICAM-1 levels were significantly elevated in patients with moderate and far advanced pulmonary tuberculosis when compared with control group. When compared with control group, serum sVCAM-1 levels showed significant elevation in patients with mild, moderate and far advanced pulmonary tuberculosis. Serum sE-selectin levels were significantly elevated in patients with far advanced pulmonary tuberculosis when compared with control group. CONCLUISON: These results suggest that sICAM-1, sVCAM-1, and sE-selectin may be invloved lix the pathogenesis of tuberculosis. And, particularly, sICAM-1 and sVCAM-1 may be useful markers of the disease activity.
Cytokines ; E-Selectin ; Endothelial Cells ; Endothelium ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunity, Cellular ; Intercellular Adhesion Molecule-1 ; Leukocytes ; Membranes ; Mycobacterium tuberculosis ; Tuberculosis ; Tuberculosis, Pulmonary* ; Vascular Cell Adhesion Molecule-1

OBJECTIVES: The purpose of this investigation was to study the health status of apartment guards and associated factors. MATERIALS AND METHODS: This investigation was conducted for 1 month starting from August, 1997. Study population in this cross-sectional survey consisted of 182 guards of apartments located throughout the district of Taegu. Each subject completed a questionnaire about his general characteristics, health behaviors, job descriptions, subjective GIT symptoms and somatization and depression using Symptom Checklist-90-Reversion (SCL-90-R) by self administrated questionnaire and personal interview). RESULTS: Study subjects had one or more GIT symptoms(53.3%), somatization symptoms(83.5%) and depression symptoms(79.7%). The mean scores of GIT, somatization and depression symptoms were not different among the age groups and based on marital status, respectively, but, significantly different by education level(p<0.05). The mean scores of GIT, somatization and depression symptoms were not different among the age groups and hased on marital status, respectively, but, significantly different by regular diet and by the subject's health status(p<0.05). The mean scores of GIT, somatization and depression symptoms were not different by duration of shift work, by job tenure and by the number of managed houses but, those of somatization and depression symptoms were significantly different by level of job satisfaction(p<0.05). CONCLUSION: The health statuses of guards at apartments were different from other shift workers because of health worker effects and characteristics of their jobs.
Cross-Sectional Studies ; Daegu ; Depression ; Diet ; Education ; Health Behavior ; Humans ; Job Description ; Marital Status ; Surveys and Questionnaires

PURPOSE: Intimal hyperplasia is a pathologic condition that is commonly observed with the atherosclerotic change of blood vessels; this condition is usually observed after arterial operation and interventions such as angioplasty, endaterectomy and bypass grafting, and it remains a major cause for hindering for arterial patency. It is a multiple processes that includes smooth muscle cell migration, proliferation, and expression of extracellular matrix proteins, such as fibronectin. Nitric oxide (NO) has been found to possess many different vasoprotective properties: inhibition of platelet aggregation and adherence, inhibition of leukocyte chemotaxis, inhibition of vascular smooth muscle cell proliferation and migration, inhibition of endothelial cell apoptosis and stimulation of endothelial cell growth. Overexpression of nitric oxide synthase (NOS) in the vascular wall has been used to regulate vasomotor function, prevent neointimal formation after balloon injury or vein grafting, and to prevent transplant vasculopathy. NOS gene transfer to the vascular wall holds great promise as a means of controlling local vascular function. METHOD: We investigated whether the inducible NOS (iNOS) gene transfer to the arterial wall has an inhibitory effect on intimal hyperplasia after endothelial denudation and on the change of the level of extracellular matrix fibronectin expression in the rabbit common carotid artery. Rabbits were divided into three groups: the saline only (without injury) normal group, the injury + saline intima injury group, and the injury + recombinant adenoviral vector encording human iNOS (AdiNOS) gene transfer group (n=5 per group). AdiNOS (1.6x10(10) plaque-forming units [pfu]) were used for the iNOS gene delivery and the virus was intraluminally infected to the balloon-injured common carotid arterial wall for 20 minutes. The NO levels were assessed in the blood of all the animals at the three time point: before-, 1 hr after-, and 14 days after the surgical procedures. The left common carotid arteries were harvested from the animals at 14 days after balloon injury and they were then assessed for fibronectin expression and intimal hyperplasia. RESULT: 14 days after AdiNOS infection, the NO levels were increased 67% in the gene transfer group compared with those levels obtained before the gene transfer (333.5+/-11.5 vs. 557.4+/-72.1, respectively, P<0.05), and the intima/intima+media ratio and the FN expression were reduced by 60% and 50%, respectively, in the gene transfer group compared with the intima injury group (41.5+/-5.6 vs. 16.6+/-2.8, respectively, P<0.05 and 307.9+/-38.3 vs. 154.3+/-20.2, respectively, P<0.05). CONCLUSION: Our results show that iNOS gene transfer to the arterial wall resulted in increased NO levels in the blood, and the procedure greatly inhibited intimal hyperplasia and it reduced fibronectin expression in the arteriaql wall.
Angioplasty ; Animals ; Apoptosis ; Blood Vessels ; Carotid Arteries* ; Carotid Artery, Common ; Cell Proliferation ; Chemotaxis, Leukocyte ; Endothelial Cells ; Extracellular Matrix ; Extracellular Matrix Proteins ; Fibronectins* ; Humans ; Hyperplasia* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II* ; Platelet Aggregation ; Rabbits ; Transplants ; Veins