BACKGROUND: It was recognized that the intake of the whole cow's milk(WCM) early (before 1 year old of age) and large amount in early childhood is related to the iron deficiency, sometimes the iron deficiency anemia in advanced state. To verify the relationship between the variables in the WCM intake and the iron status, we carried out this study. METHODS: Thirty subjects(1 year to 3 years old of age) were classified as a WCM large intake group and a WCM small intake group. The relationship between the WCM commencing age and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large intake group was evaluated and analyzed by the linear regression. Futhermore, the relationship between the value of WCM intake amountxduration/10 and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large and small intake groups was evaluated and analyzed by the linear regression. RESULTS: As the WCM commencing age was earlier, the values of serum ferritin, transferrin saturation and hemoglobin decreased significantly(P<0.05). The values of serum ferritin and transferrin saturation decreased significantly as the value of WCM intake amountxduration/10 increased(P<0.05). But the value of hemoglobin decreased insignificantly as the value of WCM intake amountxduration/10 increased(P>0.1). CONCLUSION: The variables in the intake of WCM influence upon the iron status in early childhood. The early commencing of the WCM(before 1 year old of age) is the worst variable that influences adversely upon the iron status in early childhood. The amount of WCM intake and the duration influence upon the storage iron(serum ferritin and transferrin saturation), but not hemoglobin. In this regard, it is necessary to inform the parents of the correct WCM intake ways to avoid the irreversible recognition impairment and behavioral change.
Anemia, Iron-Deficiency ; Child, Preschool ; Ferritins ; Humans ; Iron* ; Linear Models ; Milk* ; Parents ; Transferrin

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

No abstract available.
Larynx* ; Pharmacology ; Succinylcholine* ; Vecuronium Bromide*

Hepatie hilar ductal carcinoma is relatively rare, but the prognosis is known to be poor because an early diagnosis is difficult. Because the majority of patients are already infiltrated into adjacent organ by itself at the diagnosis, the rate of resectability is low. The best method of treatment is curative resection, and the range of tumor invasion is very important. The preoperative diagnosis is difficult because the cholangiography may be normal in cases of superficial invasion. Multifocal lesions within the biliary tract may be identified in as many as 10 percent of patients, Especially, the papillary type has the best prognosis and is associated with multiple tumors within the bile duct. We report a case that percutaneous transhepatic cholangiogram showed normal distal common bile duct, but the hepatic hilar confluence and ampulla of Vater lesion was confirmed as adenocarcinoma.
Adenocarcinoma ; Ampulla of Vater* ; Bile Ducts ; Biliary Tract* ; Carcinoma, Ductal ; Cholangiocarcinoma* ; Cholangiography ; Common Bile Duct ; Diagnosis ; Early Diagnosis ; Humans ; Pancreas* ; Prognosis

BACKGROUND: Propofol(2,6 diisopropylphenol) is a potent hypnotic currently formulated as an oil-in-water emulsion. Although previous studies reported decreases in arterial pressures and heart rate, no detailed studies of hemodynamic effects of propofol administration alone are available in Korea. This study is to determine the hemodynamic changes induced by doses of propofol. METHODS: Sixty patients(ASA physical status 1 or 2) were divided randomly into three groups as follows: group I, pmpofol 1.5 mg/kg; group 2, propofol 2.0 mg/kg; group 3, propofol 2.5 mg/kg. Heart rate and mean arterial pressure were measured by Datascope 2200I, and cardiac index(CI) and systemic vascular resistance index(SVRI) were obtained by doppler cardiac output monitor(Datascope Accucom 2) at the suprasternal notch before and after induction of propofol. RESULTS: Statistically significant decreases in mean arterial pressure were observed since 2 min after induction. CI was decreased from 2.94+/-0.51 to 2.35+/-0.57 L/min/m(2) at 6 min after induction of propofol 2.5 mg/kg, and no differences among groups. CI was also decreased in group 1 and 2 but without any significance. SVRI was decreased in all groups but there were no significance, and no differences among groups. CONCLUSIONS: The data suggest that the usual doses of propofol do not significantly cause hemodynamic changes, and a decrease in mean arterial pressure is a result of decreased CI and reduced SVRI.
Anesthetics ; Arterial Pressure ; Cardiac Output ; Heart Rate ; Hemodynamics* ; Korea ; Propofol* ; Vascular Resistance

The success of accelerating the onset of neuromvacular blocking drugs by giving them in divided doses encouraged others to attempt the same "priming principle" using reversal agents. Naguib et al and Abdulatif et al demonstrated that the reversal time(time to reach a TOF of 0.75) was reduced when the reversal agent was administered in divided doses at T, 10% of control. But Donati et al and Szalados et al either could not detect any differences in the rate of reversal when anticholinestereses were administered in divided doses. This study hes been conducted to evaluate the reversal effects of neostigmine or pyridostigmine with priming principle in the rabbit after pancuronium injection when pro- found relaxation(PTC=0) was confirmed. Rabbits(n=60) were randomly allocated to 4 groups. After pancuranium 0.2mg/kg IV, the onset and recovery times were evalusted. When the profound relaxation(PTC=0) was confirmed at Smin. after pancuronium injection, neostigmine 50 ug/kg and atropine sulfate (atropine) 20 ug/kg were injected in group 1. At thst time, neostigmine 10/kg and atropine 4 ug/kg were injected and after 3min. neostigmine 40/kg and atropine 16 ug/kg were injected in group 2. At that time, pyridostigmine 250 ug/kg and atropine 20 ug/kg were injected in group 3. At that time, pyridostigmine 50 ug/kg and atropine 4 ug/kg were injected and after 3min. pyridostigmine 200 ug/kg and atropine 16 ug/kg were injected in group 4. The results were as follows :. 1) The time until 75% recovery of twitch amplitude was 53.1+/-12.4min. in group 1, 44.9+/-212.1min. in group 2, 54.9+/-9.7min. in group 3 and 48.2+/-7.1min. in group 4. The reversal times were tended to reduce when the reversal agents were administered with "priming principle" at the profound relaxation. 2) At the profound relaxation the reversal effects of neostigmine were greater than that of pyridostigmine.
Atropine ; Cholinesterase Inhibitors* ; Muscle Relaxation* ; Neostigmine ; Pancuronium ; Pyridostigmine Bromide ; Relaxation

BACKGROUND: According to the report that KCNK activity in transfected COS-7 and HEK-293 cells was modulated by volatile anesthetics and activation of KCNK channels by neuroprotectants, the importance of KCNK2 were emphasized. In this study, we studied the effect of halothane and isoflurane on KCNK2 in the KCNK2 transfected HEK-293 cells. METHODS: Multiple patch clamp experiments with halothane and isoflurane were conducted to characterize KCNK2 in the KCNK2 transfected HEK-293 cells. KCNK2 cDNA were transiently transfected with FuGENE6 transfection reagents and whole cell recordings were made using predesigned pulse protocol. RESULTS: KCNK2 transfected HEK cells exhibited rapid rising, a time-independent, non-inactivating, outward-rectifying currents and had no threshold for activation by voltage. Multiple patch clamp experiments showed the presence of outward-rectifying K+ selective channels with a conductance of 1.31 +/- 0.59 nS (n = 16) at positive potentials. Recordings of halothane 448microM (-2 MAC) increased outward currents from control by 218% in standard saline perfusate (n = 4, P<0.05, paired t-test) and that of isoflurane 822microM (-3 MAC) increased outward currents by 172% in standard saline perfusate (n = 12, P<0.05, paired t-test). Channel activity enhanced during the duration of the exposure to volatile anesthetics returned to the baseline quickly upon wash. CONCLUSIONS: Considering the activation of KCNK2 by neuroprotectants such as riluzole and PUFA, we might think of the possibility of halothane and isoflurane as neuroprotectants because these anesthetics activated background K+ channels in KCNK2 transfected HEK-293 cells.
Anesthetics ; DNA, Complementary ; Halothane* ; Indicators and Reagents ; Isoflurane* ; Neuroprotective Agents ; Riluzole ; Transfection

OBJECTIVE: The purpose of this study was to establish the effect of oligohydramnios and intrauterine infection on fetal and umbilical blood flows in patients with preterm premature rupture of membranes (PPROM). METHODS: Pulsed-wave Doppler imaging was used to determine the pulsatility index (PI) in the fetal renal, descending aorta, middle cerebral and umbilical arteries in 62 patients with PPROM. Amniocentesis was performed in 38 patients with PPROM. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasma. The patients with PPROM were divided into two groups according to the presence (n=21) or absence (n=41) of oligohydramnios and the presence (n=14) or absence (n=24) of intrauterine infection. Oligohydramnios was defined as the largest single pocket that measured <2 cm in the vertical plane. Data was expressed as multiples of the median (MOM) adjusted for gestational age, and statistical analysis was conducted with nonparametric statistics. RESULTS: 1) Fetuses with the presence of oligohydramnios had significantly lower MOM of PI of the fetal renal artery and higher MOM of PI of the fetal descending aorta than those without this condition (MOM of PI of the fetal renal artery: median [range]; 0.030 [-0.532, 0.404] vs. 0.167 [-0.357, 2.81] p=0.03. MOM of PI of the fetal decending aorta: median [range]; 0.085 [-0.160, 0.470] vs. -0.120 [-0.587, 0.548] p=0.004). 2) There was a significantly negative relationship between the largest single vertical pocket and MOM of PI of the fetal descending aorta (r=-0.283, p=0.03). 3) There were no significant differences in the MOM of PI of the fetal middle cerebral artery and umbilical artery between the two groups of patients. 4) Amniotic fluid culture was positive in 37% (14/38). 5) There were no significant differences in the MOM of PI of the fetal middle cerebral, renal artery, descending aorta and umbilical arteries between patients with and without the intrauterine infection. CONCLUSION: Blood flow of the fetal renal artery and descending aorta, but not the middle cerebral and umbilical arteries, were affected by oligohydramnios in patients with PPROM but intrauterine infection did not affect the blood flow of the fetal and umbilical arteries in fetuses with PPROM.
Amniocentesis ; Amniotic Fluid ; Aorta ; Aorta, Thoracic ; Bacteria, Anaerobic ; Female ; Fetal Blood* ; Fetus ; Gestational Age ; Humans ; Membranes* ; Middle Cerebral Artery ; Mycoplasma ; Oligohydramnios* ; Pregnancy ; Renal Artery ; Rupture* ; Umbilical Arteries*

Spontaneous bacterial peritonitis (SBP) is a life-threatening complication in patients with ascites caused by advanced liver disease. While gram negative bacteria, such as Escherichia coli and Klebsiella pneumonia are the common pathogens, Listeria monocytogenes has been recognized as a very rare pathogen. Empirical treatment with third generation cephalosporins does not provide adequate antibiotics coverage against L. monocytogenes. Diagnosis is often delayed as it requires confirmation from ascitic fluid culture. Herein, we describe the first case of SBP caused by L. monocytogenes in a patient with advanced alcoholic liver cirrhosis in Korea. Clinicians should be aware of the atypical pathogens, especially in patients with inadequate response to empirical antibiotics.
Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Ascites/microbiology ; Humans ; Listeria monocytogenes/*physiology ; Listeriosis/*diagnosis/drug therapy ; Liver Cirrhosis, Alcoholic/*diagnosis ; Male ; Middle Aged ; Peritonitis/*diagnosis/*microbiology

PURPOSE: The purpose of this study is to analyze the treatment strategies of patients with endoscopic retrograde cholangiopancreatography (ERCP)-related perforations. This is a retrospective study. METHODS: We experienced 13 perforations associated with ERCP. We reviewed the medical recordsand classified ERCP-related perforations according to mechanism of injury in terms of perforating device. Injury by endoscopic tip or insertion tube was classified as type I, injury by cannulation catheter or sphincterotomy knife as type II, and injury by guidewire as type III. RESULTS: Of four type I injuries, one case was managed by conservative management after primary closure with a hemoclip during ERCP. The other three patients underwent surgical treatments such as primary closure orpancreatico-duodenectomy. Of five type II injuries, two patients underwent conservative management and the other three cases were managed by surgical treatment such as duodenojejunostomy, duodenal diverticulization and pancreatico-duodenectomy. Of four type III injuries, three patients were managed conservatively and the remaining patient was managed by T-tube choledochostomy. CONCLUSION: Type I injuries require immediate surgical management after EPCP or immediate endoscopic closure during ERCP whenever possible. Type II injuries require surgical or conservative treatment according to intra- and retro-peritoneal dirty fluid collection findings following radiologic evaluation. Type III injuries almost always improve after conservative treatment with endoscopic nasobilliary drainage.
Catheterization ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Humans ; Retrospective Studies