Succinylcholine is commonly administered intravenously, however sometimes it can be administered intramuscularly or sublingually when an intravenous line is not available. We investigated the neuromuscular blocking effect of subcutaneous injection of succinylcholine. The 60 adult patients (ASA 1 or 2) were randomly divided into two groups. After intravenous administration of propofol 3 mg/kg, succinylcholine 1 mg/kg was administered intravenously in one group (IV group, n=10) and subcutaneously in another (SQ group, n=50). Neuromuscular transmission was monitered continuously by the train-of-four (TOF) from response stimulated the ulnar nerve with 2Hz at wrist and the evoked compound action potential of hypothenar muscles was measured with Relaxograph (Datex Co.). We determined the maximum depressed the twitch height (T(TXD)), onset time from injection of succinylcholine to T(MXD), recovery time from T(MXD) to the recovery of 75%, and duration of action from injection of succinylcholine to the recovery of 75%. In the results, T(MXD) of SQ group varied from O% to over 75% compared with 0% in IV group. The onset time of SQ group were more delayed between 7.78+/-2.80 to 13.08+/-3.51 minutes compared with 1.08+/-0.16 minutes in IV group. The recovery time of SQ group were faster between 15.67+/-10.40 to 2.59+/-1.75 minutes compared with 18.68+/-3.68 minutes in IV group. The duration of action of SQ group were not significantly different compared with IV group. And in the SQ group, the lesser depression of twitch height the slower onset time and the faster recovery time was revealed. Conclusively, the subcutaneous administration of succinylcholine 1 mg/kg resulted that the magnitudes of neuromuscular blockade was variable and incomplete, and onset time were slower but recovery were faster than intravenous injection.
Action Potentials ; Administration, Intravenous ; Adult ; Depression ; Humans ; Injections, Intravenous ; Injections, Subcutaneous ; Muscles ; Neuromuscular Blockade* ; Propofol ; Succinylcholine* ; Ulnar Nerve ; Wrist

OBJECTIVES: We investigated the parenting stress and depressive mood of mothers with developmentally-delayed children and the effects of participation in a mother-child development promotion program on same. METHODS: Subjects were the mothers of 20 developmentally-delayed children. The severity of the mothers' parenting stress was evaluated via the Korean version of the Parenting Stress Index, Short Form (K-PSI-SF) and the severity of their depressive symptoms were evalueted by the Korean version of the Beck Depression Inventory (K-BDI). RESULTS: The mean K-PSI-SF score and mean K-BDI score for these mothers were 93.35 (SD=10.47) and 23.25 (SD=10.42), respectively. These scores correspond to high parenting stress and moderate depression. The mothers who participated in a mother-child attachment- promotion program showed significant decreases in their K-PSI-SF and KBDI scores. CONCLUSION: Our data suggest that a mother-child attachment promotion program with emphasis on child development is effective in reducing parenting stress and depressive mood in mothers of developmentally-delayed children.
Child ; Child Development ; Depression ; Humans ; Mothers ; Parenting ; Parents

No abstract available.
Necrosis* ; Typhoid Fever*

No abstract available.
Fatty Liver* ; Ultrasonography*

PURPOSE: Hematuria is a frequently encountered clinical problem in kidney graft recipients. The causes are variable, may be benign or malignant, but imperative to affect long- term graft function and survival. We have evaluated renal recipients who had hematuria using a newly defined algorithm. METHODS: We evaluated 1060 renal transplant recipients from March 1, 1992 to February 28, 2000. In 93 recipients, hematuria was transitory and spontaneously resolved within 3 months. We tried to identify the cause of persistent hematuria in 126 recipients. Patients were evaluated with plain x-ray, sonography, cystoscopic examination and/or graft biopsy. RESULTS: The mean duration of hematuria onset after transplantation was 17.81+/-14.6 months (4-70 months). The causes of gross hematuria were urolithiasis (n= 15), benign bladder mucosal bleeding (n=3), bladder cancer (n=2) and kidney cancer from an original kidney (n=1). Graft kidney biopsies were performed in 96 patients and the results were as follows: chronic rejection in 18, IgA nephropathy in 16, cyclosporine toxicity in 8, acute rejection in 5, focal segmental glomerulosclerosis in 3, the other glomerulonephritis in 2, and tubular atrophy and interstitial fibrosis in 19 patients. Combined pathologic findings were detected in 15 patients. In 8 patients, no pathological diagnoses were made. We were unable to evaluate 9 patients due to patient's refusal. CONCLUSION: The causes of hematuria after kidney transplantation are variable from benign to malignant disease. If the cause of hematuria is uncertain on ultrasonographic examination, cystoscopic examination and/or graft biopsy should be performed for making a definite diagnosis.
Atrophy ; Biopsy ; Cyclosporine ; Diagnosis ; Disulfiram ; Fibrosis ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulosclerosis, Focal Segmental ; Hematuria* ; Hemorrhage ; Humans ; Kidney ; Kidney Neoplasms ; Kidney Transplantation ; Transplantation ; Transplants ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urolithiasis

We have cloned a cDNA encoding a cysteine proteinase of the Acanthamoeba healyi OC-3A strain isolated from the brain of a granulomatous amoebic encephalitis patient. A DNA probe for an A. healyi cDNA library screening was amplified by PCR using degenerate oligonucleotide primers designed on the basis of conserved amino acids franking the active sites of cysteine and asparagine residues that are conserved in the eukaryotic cysteine proteinases. Cysteine proteinase gene of A. healyi (AhCP1) was composed of 330 amino acids with signal sequence, a proposed pro-domain and a predicted active site made up of the catalytic residues, Cys(25), His(159), and Asn(175). Deduced amino acid sequence analysis indicated that AhCP1 belongs to ERFNIN subfamily of C1 peptidases. By Northern blot analysis, no direct correlation was observed between AhCP1 mRNA expression and virulence of Acanthamoeba, but the gene was expressed at higher level in amoebae isolated from soil than those from clinical samples. These findings raise the possibility that Ahcp1 protein may play a role in protein metabolism and digestion of phagocytosed bacteria or host tissue debris rather than in invasion of amoebae into host tissue.
Acanthamoeba/*enzymology/genetics/pathogenicity ; Amebiasis/parasitology ; Amino Acid Sequence ; Animals ; Base Sequence ; Cathepsins/*genetics ; DNA, Protozoan/chemistry/genetics/*isolation & purification ; Encephalitis/parasitology ; Gene Expression ; Genes, Protozoan ; Humans ; Molecular Sequence Data ; Polymerase Chain Reaction ; Protozoan Proteins/chemistry/genetics/physiology ; Sequence Alignment ; Virulence

No abstract available.
Cause of Death* ; Kidney Transplantation* ; Kidney*

BACKGROUND: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigated the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. METHOD: 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. RESULT: Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure(PImax) was also significantly lower in the depleted group(p<0.05). CONCLUSION: We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.
Body Weight ; Electric Impedance ; Forced Expiratory Volume ; Humans ; Korea ; Mortality ; Nutritional Status* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Residual Volume ; Total Lung Capacity ; Vital Capacity ; Weight Loss

PURPOSE: The contribution of perforating vein incompetence to the hemodynamic derangement in the chronic venous disease (CVD) remains a topic of debate. This study was designed to define the characteristics of IPV according to CEAP classification with development of CVD. METHOD: From March 1999, to August 2001, 145 patients were treated for CVD in our hospital. Of these, 15 patients with CEAP class 4, 5, 6 (Group I) and 130 patients with class 2 (Group II). Medial side of calf was assessed in the sitting position for looking IPVs by duplex scan. The number, location, and diameter at the fascia level of IPVs were determined. The characteristics of IPVs between two group were compared. Airplethysmogram (APG) was checked pre and postoperatively in 18 patients with class 2 without any procedure to IPVs. RESULT: 17 IPVs were found in 11/15 (73%) patients in group I, and 36 IPVs were found in 29/145 (20%) in group II. The mean number of IPVs in each limb of group I and II was 1.54, 1.09 (P>0.05) and the mean diameter was 0.52 cm, 0.38 cm (P=0.001). The 96% (51/56) of IPVs were found in lower half of the calf. All hemodynamic parameter of APG was improved statistically significantly after operation without ligation of IPVs in class 2 patients. CONCLUSION: With advancing of CVD (class 4, 5, 6), IPVs was found more and larger. This suggest significant hemodynamic role of IPVs in progression of CVD. So careful attention should be payed to IPVs in treatment of CVD. But it was doubted benefit of direct treatment of IPVs in class 2.
Classification* ; Extremities ; Fascia ; Hemodynamics ; Humans ; Ligation ; Veins*

PURPOSE: To evaluate the efficacy, safety, predictability and subjective symptoms of the implantable contact lens to treat moderate to high myopia. METHODS: A Staar Collamer posterior chamber phakic IOL was implanted in 83 eyes of 44 patients with spherical equivalent -10.10D (-3.87~-19.37D). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, adverse events, subjective quality of vision and satisfaction were evaluated. Mean follow-up was 4.9 months (3~9 months). RESULTS: All patients had a UCVA of 0.7 or better, and 61.4% had UCVA of 1.0 or better. Gains of 2 or more lines of BCVA occurred in 15 eyes (18.1%). Mean spherical equivalent refraction at postoperative 3 months was -0.37D (+0.25~-1.75D) and remained stable. There was no change in cylinder diopters. 81.9% of eyes were within +/-0.5D, and 97.6% were within +/-1.0D of predicted refraction. Glare and halo was observed in 5 eyes (6%) after laser iridotomy, lens flipping in 1 eye (1.2%), corneal edema in 2eyes (2.4%), drug induced ocular hypertension in 4eyes (4.8%). There was no case of cataract, glaucoma, retinal detachment, and lens dislocation. There was significant decrease of pupil diameter at postoperative 1 month and decreased pupil diameter was maintained until the last examination. Generally patient satisfaction was very good. But, some patients reported poor in the category of glare and halo. CONCLUSIONS: ICL implantation had good visual, refractive results, and stability. Long term follow-up is required to confirm the significant complications that do not occur in most patients over time.
Cataract ; Corneal Edema ; Follow-Up Studies ; Glare ; Glaucoma ; Humans ; Lens Subluxation ; Lenses, Intraocular* ; Myopia* ; Ocular Hypertension ; Patient Satisfaction ; Pupil ; Retinal Detachment ; Visual Acuity