No abstract available.
Plasma Exchange* ; Plasma* ; Seoul*

No abstract available.
Plasma Exchange* ; Plasma* ; Seoul*

No abstract available.

No abstract available.
Adipose Tissue ; Surgical Flaps

We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.
Anesthesia* ; Anesthetics ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Nebulizers and Vaporizers ; Respiration ; Syringes

BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.
Anesthesia* ; Anesthetics ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Nebulizers and Vaporizers ; Respiration ; Syringes

Diffuse pulmonary meningotheliomatosis (DPM) is an extremely rare condition. We herein report a unique case of DPM in a 54-year-old woman with a previous history of hepatocellular carcinoma. A chest computed tomography showed diffuse bilateral nodular infiltration, suggesting miliary spread of metastatic hepatocellular carcinoma. The patient underwent a video-assisted thoracoscopic surgery for diagnostic purposes. The cut surface of the lung specimen showed multiple dispersed small nodules, consisting of variably sized nests or whorls of bland epithelioid cells often along the walls of alveolar septa or in a perivascular network within the alveolar interstitium. The tumor cells showed immunoreactivity for epithelial membrane antigen, vimentin, and progesterone receptor. DPM should be included in the differential diagnosis of diffuse multiple small nodules or a reticular pattern in the radiologic studies.
Carcinoma, Hepatocellular ; Diagnosis, Differential ; Epithelioid Cells ; Female ; Humans ; Lung ; Lung Neoplasms ; Meningioma ; Middle Aged ; Mucin-1 ; Receptors, Progesterone ; Thoracic Surgery, Video-Assisted ; Thorax ; Vimentin

BACKGROUND: Amrinone is a nonglycosidic noncatecholamine with both vasodilator and positive inotropic effects that has not been evaluated widely in pediatric patients with intracardiac left to right shunts. The present study was performed to evaluate the hemodynamic effects of amrinone in infants and children with intracardiac left to right shunts. METHODS: Twenty patients (aged 2 months to 24 months) who underwent open heart surgery to correct one or more intracardiac left to right shunts were evaluated. Before cardiopulmonary bypass, a 22 gauge angiocatheter was placed at the main pulmonary artery by surgeons to measure pulmonary arterial pressure. Patients with a mean pulmonary arterial pressure < 25 mmHg were assigned to Group A (n = 10) and > or = 25 mmHg were assigned to Group B (n = 10). Mean systemic arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), central venous pressure (CVP) and heart rate (HR) were measured before loading of amrinone (3 mg/kg), 5 minutes, and 15 minutes after continuous infusion of amrinone (10 microgram/kg). The mean pulmonary arterial pressure to mean systemic arterial pressure ratio (MPAP/MAP) and rates of changes of mean arterial pressure (delta MAP) and mean pulmonary arterial pressure (delta MPAP) were calculated. RESULTS: Amrinone reduced MAP, MPAP, CVP and increased HR. MPAP/MAP increased in Group A but decreased in Group B (P < 0.05). In Group A, delta MAP was significantly greater than that of Group B (P < 0.005). In Group B, delta MPAP was significantly greater than that of Group A (P < 0.005). CONCLUSION: In infants with intracardiac left to right shunts, amrinone reduces MAP, MPAP, CVP and increases HR. Amrinone appears to have a potent vasodilating effect on the pulmonary artery in infants with pulmonary hypertension. However, more hemodynamic measurements such as cardiac output, vascular resistance and doppler echocardiographic study are necessary to evaluate the hemodynamic effects of amrinone precisely.
Amrinone* ; Arterial Pressure* ; Cardiac Output ; Cardiopulmonary Bypass ; Central Venous Pressure ; Child ; Echocardiography ; Heart Rate ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Infant* ; Pulmonary Artery ; Thoracic Surgery ; Vascular Resistance

The immune response to any stimulus is complex, requiring coordinated action by several types of cells in a tightly regulated sequence. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Although regular moderate exercise appears to be important factor for increasing immunity, Athletes are susceptible to illness, in particular upper respiratory track infection, during periods of intense training and after competition. In addition, in elite athletes, frequent illness is associated with overtraining syndrome, a neuroendocrine disorder resulting from excessive training. Through this paper, we want to investigate the effects of exercise on the immunosuppression such as exercise induced lymphopenia, asthma, anaphylaxis, URT (upper respiratory track), and TB (tuberculosis) infection. and also, we want to suggest a direct mechanism, protection and therapy of exercise induced immunosuppression.
Anaphylaxis ; Asthma ; Athletes ; Humans ; Humidity ; Immunosuppression ; Lymphopenia