BACKGROUND: During general anesthesia the adult patient's tidal volume is determined by patient's weight. Therefore patients with severe ascites, huge abdominal mass or pregnancy have considerable ventilatory change during the operation because the great change in their body weight, that might cause unwanted respiratory alkalosis or acidosis. The purpose of this study is to identify the effects of such changes in ventilation between pre-delivery and post-delivery periods during the cesarean section. METHODS: Eighteen 36weeks or older pregnant patients (ASA 1), scheduled for elective cesarean section under general anesthesia, are selected for the study. PhysioFlex was used for ventilation. Pre-induction maternal gas analysis were performed in all cases. They were randomly divided into two groups according to the ventilator setting for minute ventilation, one set by pre-pregnant weight (Group 1) and the other by pregnant (term) weight (Group 2). Blood gas analysis were performed 5 minutes after induction and 20 minutes after delivery. End-tidal CO2 and inspiratory airway pressure were also measured. RESULTS: All patients show mild hyperventilation with normal acid-base status at pre-induction period. There were no significant differences in arterial PCO2 value between two groups. Group 1 shows mild metabolic acidosis compared with group 2 (by pH at 20 minutes after delivery). CONCLUSION: Term(just prior to operation) body weight rather than pre-pregnant weight is preferable for ventilator setting in the case of cesarean section under general anesthesia.
Acidosis ; Adult ; Alkalosis, Respiratory ; Anesthesia, General* ; Ascites ; Blood Gas Analysis ; Body Weight ; Cesarean Section* ; Female ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation ; Pregnancy ; Pregnancy* ; Respiration, Artificial* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

Impetigo herpetiformis is a rare pustular eruption that may be seen in late pregnancy. It is associated with severe maternal and fetal complications in case of misdiagnosis and delayed treatment. The patient was a 25-years-old multigravida with psoriasis in her past history. At 20weeks gestation, she had been developed erythematous scaly annular patchs with papules and pustules on inner thigh. At 37weeks' gestation, the patient was suffered from a severely pruritic pustular rash with fever and leukocytosis. The skin of the affected areas was biopsied and showed intraepidermal pustular abscess with a neutrophilic infiltrate. Treatment commenced with intravenous fluids, antibiotics, systemic prednisone, steroid creams, and phototherapy(UVB) under the careful fetal well being monitoring. Cesarean section was done due to fetal distress, and a normal healthy male infant was delivered, following which the patient's condition improved rapidly.
Abscess ; Anti-Bacterial Agents ; Cesarean Section ; Diagnostic Errors ; Exanthema ; Female ; Fetal Distress ; Fever ; Humans ; Impetigo* ; Infant ; Leukocytosis ; Male ; Neutrophils ; Prednisone ; Pregnancy* ; Psoriasis ; Skin ; Thigh

OBJECTIVE: To evaluate the effect of IL-10 on development of collagen-induced arthritis, on humoral and cellular immunity and on the endogenous production of IL-10 in DBA/1J mice. METHODS: DBA/1J mice were immunized with chicken type II collagen in Freund s complete adjuvant. Murine recombinant IL-10 was given intraperitoneally twice a week from the day of second immunization (week 3) in doses of 0.002ug, 0. 02ug and 0. 2ug for 3 different groups, respectively. Dexamethasone was injected in one group to suppress the arthritis development and this group was used as negative control group. Levels of anti-collagen antibodies, serum IL-10 and stimulation indices of splenic monocytes to collagen were measured at the end of study. RESULTS: The 0. 02ug IL-10 and 0. 2ug IL-10 treated groups developed earlier and more severe arthritis (week 6 and 8) compared to that of the control group while the 0. 002ug IL-10 group has shown similar course to the control group in terms of incidence and severity of arthritis, At week 10, all groups with or without IL-10 injections developed arthritis with similar degree of severity while dexamethasone group showed far less incidence and severity of arthritis. The serum levels of anti-collagen antibody, IL-10 and spleen monocyte stimulation indices to collagen antigen showed no difference among control group, IL-10 injected groups and dexamethasone injected group. CONCLUSION: This study shows IL-10 could worsen the arthritis in CIA with the dosage used in this study without significant influence on the level of anti-collagen antibodies or stimulation indices of spenic monocyte to collagen.
Animals ; Antibodies ; Arthritis ; Arthritis, Experimental* ; Chickens ; Collagen ; Collagen Type II ; Dexamethasone ; Immunity, Cellular ; Immunization ; Incidence ; Interleukin-10* ; Mice ; Monocytes ; Spleen

No abstract available.
Antiemetics* ; Cisplatin* ; Dexamethasone* ; Humans ; Lorazepam* ; Metoclopramide* ; Ondansetron*

Analysis and prediction of the care charges related to colorectal cancer in Korea are important for the allocation of medical resources and the establishment of medical policies because the incidence and the hospital charges for colorectal cancer are rapidly increasing. But the previous studies based on statistical analysis to predictthe hospital charges for patients did not show satisfactory results. Recently, data mining emerges as a new technique to extract knowledge from the huge and diverse medical data. Thus, we built models using data mining techniques to predict hospital charge for the patients. A total of 1,022 admission records with 154 variables of 492 patients were used to build prediction models who had been treated from 1999 to 2002 in the Kyung Hee University Hospital. We built an artificial neural network (ANN) model and a classification and regression tree (CART) model, and compared their prediction accuracy. Linear correlation coefficients were high in both models and the mean absolute errors were similar. But ANN models showed a better linear correlation than CART model (0.813 vs. 0.713 for the hospital charge paid by insurance and 0.746 vs. 0.720 for the hospital charge paid by patients). We suggest that ANN model has a better performance to predict charges of colorectal cancer patients.
Algorithms ; Colorectal Neoplasms/*economics/epidemiology ; Comparative Study ; *Decision Trees ; *Hospital Charges ; Humans ; Incidence ; Korea/epidemiology ; *Models, Econometric ; *Neural Networks (Computer) ; Predictive Value of Tests

Several studies have reported that heavy metals have a relation with osteoporosis and osteoporotic fractures. In this study, we investigated the association between heavy metal exposure status, as assessed by serum major heavy metals such as lead (Pb), cadmium (Cd), and mercury (Hg) and bone mineral density (BMD) status among Korean adults. A total of 64 adults participated in this study and were assigned to one of three study groups based on the T-score of spine BMD: a normal group (n = 21, T-score > -1), osteopenia group (n = 29, -2.5 < T-score < or = -1) and osteoporosis group (n = 14, T-score < or = -2.5). We also assessed serum levels of heavy metals (Pb, Cd and Hg) by using atomic absorption spectrometer (AAS) and daily nutrient and food intakes for 3 days by using 24-hr recall method in the subjects. The mean age was significantly higher in the osteoporosis group compared with the osteopenia and normal groups (p < 0.001). There was no significant difference in serum levels of Pb, Cd and Hg among the three groups after adjusting for age. Daily intakes of energy, nutrients were not significantly different among the three groups. The osteoporosis group consumed significantly higher fish and shellfish than the other groups (p < 0.05). In the correlation analysis controlling for age, sex, BMI, and BMD status, the serum Cd level was significantly negatively correlated with intake of cereals, milks and total food. In summary, we did not find a direct association between serum heavy metal levels and BMD status. However, negative relationships were found between serum heavy metal levels and intake of some foods.
Absorption ; Adult ; Bone Density ; Bone Diseases, Metabolic ; Cadmium ; Edible Grain ; Eating* ; Humans ; Metals, Heavy* ; Milk ; Osteoporosis ; Osteoporotic Fractures ; Shellfish ; Spine

The Korean Association of Urogenital Tract Infection and Inflammation and the Korea Disease Control and Prevention Agency regularly update, revise, and develop new content for the Korean sexually transmitted infection (STI) guidelines. These professional bodies respond to changing epidemiological trends and evolving scientific evidence, and consider advances in laboratory diagnostics and research. The principal recommendations of the 2023 Korean STI guidelines in terms of viral infection follow: 1) If genital herpes recurs more than 4–6 times annually, suppressive therapy with acyclovir 400 mg orally 2 times/day or famciclovir 250 mg orally 2 times/day or valacyclovir 500 mg orally once a day (for patients with <10 episodes/year) or valacyclovir 1 g orally once daily (for patients with ≥10 episodes/year) is recommended to prevent recurrence; 2) molecular human papillomavirus (HPV) testing is not recommended as a routine test for STI status, nor for determination of HPV vaccination status; and 3) patients should inform their current sexual partners about anogenital warts because the types of HPV that cause such warts can be passed to partners. These guidelines will be updated every 5 years and will be revised when new knowledge on STIs becomes available and there is a reasonable need to improve the guidelines. Physicians and other healthcare providers can use the guidelines to assist in the prevention and treatment of STIs.

Infantile onset diabetes mellitus(especially, neonatal diabetes) is rare disorder and may be transient or permanent. Most patients are full-term but small-for-date infants and typical symptoms occur within the first 4-6 weeks of life, requiring insulin therapy. Neonatal diabetes differs from type 1 diabetes in many aspects and seems to form a distinct entity of inborn pancreatic malfunction. The transient cases often develop type 2 diabetes mellitus later in life. In recent reports, transient neonatal diabetes is associated with paternal uniparental isodisomy and unbalanced duplication of chromosome 6q22-23. In our study, clinical course of case 1 was compatible with transient neonatal diabetes, but chromosomal abnormalities such as above was not shown in DNA analysis. In case 2 and 3, we could not decide exactly on genetic basis.
Chromosome Aberrations ; Diabetes Mellitus, Type 1* ; Diabetes Mellitus, Type 2 ; DNA ; Genomic Imprinting* ; Humans ; Infant ; Insulin ; Uniparental Disomy

Left ventricular hypertrophy(LVH) is one of common cardiovascular complications in hypertensive patients and it is well known that hypertensive cardiac disease accompained by LVH is still common cause of congestive heart failure in spite of treatment of hypertension. The authors assessed the prevalence of anatomical and functional abnormalities of left ventricle by EKG, chest X-ray and echocardiography in 45 essential hypertensive patients and also in 20 normal controls. Average values of left ventricular posterior wall thickness(LVPWd), interventricular septal thickness(IVSd), left ventricular mass(LVM), and left ventricular mass index(LVM/BSA) by echocardiography in hypertensive groups with LVH by EKG or chest X-ray were significantly higher than those of hypertensive groups without LVH by EKG or chest X-ray(P<0.005). Among 27 hypertensive patients with LVH by EKG and chest X-ray increased LVPWd was found in 24 patients(18%) and increased LVH in 26 patients(19%). Increased LVPWd and LVM were found in 3 patients(23%) among 13 hypertensives without LVH by EKG and chest X-ray. Hypertensive patients with increased LVH showed LVH by EKG and chest X-ray more frequently than those with increased LVPWd. Also, hypertensive patients without increased LVM showed MVH by EKG and chest X-ray less frequently than those without increased LVPWd. Therefore, echocardiography appears to be superior to routine chest X-ray and EKG for defecting LVH in hypertensive patients, especially without LVH by these tests. In conclusion, even though estimation of LVM by echocardiography seems to be a better method than single measurement of LVPWd, it seems thant estimation of LVM together with LVPWd will be more valuable in diagnosis of LVH in hypertensive patients.
Diagnosis ; Echocardiography* ; Electrocardiography ; Heart Diseases ; Heart Failure ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular* ; Prevalence ; Thorax

No abstract available.
Muscles ; Orbit ; Orbital Myositis