PURPOSE: Asphyxia is the most common cause of neurologic sequelae in perinatal period. We hoped to help other clinicians by investigating factors affecting neurologic outcome in asphyxiated term babas. METHODS: A clinical study of factors affecting neurologic outcome was made on 120 patients, who were asphyxiated term baby. They admitted to neonatal intensive care unit of Chungnam National University Hospital from January, 1995 to December, 1996. RESULTS: There was no significant correlation in neurologic outcome and gestational age, delivery type, sex, birth weight, one minute Apgar score. Five minute Apgar score had influence on neurologic outcome. Presence of acidemia had influence on neurologic outcome. Mental status and seizure influenced on neurologic outcome. Poor neurologic outcome was prone to come in the presence of prolonged duration of abnormal mental function or a repetitive seizure not controlled immediately. There was poor neurologic outcome in the patients who have abnormal findings on EEG, CT, and neurosonography. In addition, there was poor neurologic outcome in congenital heart disease patients. All of above had statistical significance. CONCLUSION: Now, we can obtain much benefit by monitoring clinical course such as five minute Apgar score, mental change, and seizure. And, we can obtain much benefit by monitoring acidemia and perform EEG, CT and neurosonography.
Apgar Score ; Asphyxia ; Birth Weight ; Chungcheongnam-do ; Electroencephalography ; Gestational Age ; Heart Defects, Congenital ; Hope ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Seizures

The management of skin and soft tissue defects on the buttock, perineum and lower abdomen has been improved through the development of myocutaneous flap. However, sacrifice of the deep muscles causes some problems such as intraoperative bleeding and functional disabilities of donor sites. And we can not also control the volume of the flap for the skin reliability of myocutaneous flaps. To overcome these disadvantages, we tried perforator-based myocutaneous island flaps for the reconstruction of the sacral, ischial sores or deep wounds of the perineum and lower abdomen. During the dissection of the flap, we could control the volume and shape of the flap exactly depending on the perforators. Clinically, total of 14 cases were treated with 10 parasacral perforator-based myocutaneous island flaps and 4 perforator-based extended myocutaneous island flaps. Parasacral flap is based on the parasacral perforators along the lateral sacral border and, the degree of containing muscles can be easily decided according to the depth of wound. In the cases of the extended myocutaneous flaps, we could design the perforator-based skin flap on the tip of myocutaneous island flap and appropriate volume of skin falp was obtained with the wide arc of rotation. Finally, the donor defect could be closed primarily and there was no significant sequela. There perforator-based myocutaneous island flaps require no significant sacrifice of the muscles and can be easily dissected and applied with the appropriate volumes for the reconstruction of the defect on the buttocks, perineum and lower abdomen.
Abdomen ; Buttocks ; Hemorrhage ; Humans ; Muscles ; Myocutaneous Flap ; Perineum ; Skin ; Surgical Flaps ; Tissue Donors ; Wounds and Injuries*

The reconstruction of pressure sore is often complicated problem due to underlying disease and general condition of the patients. Sometimes, it is too radical to use the muscle or musculocutaneous flap for the patients who has severe systemic disease and can not withstand the lengthy operation or the patients who already recovered from paraplegic condition and has no risk recurrence. To get over these problems, we recently have used the parasacral perforator-based island skin flaps for the sacral pressure sores. This flap is based on the axial pattern perforators originating from the internal pudendal artery and lateral sacarl artery. We performed this operation for 11 sacral sores with reasonable results. There was no significant complication, and duration of operation was relatively short and blood loss was a little. We concluded that this flap was useful for the patient with sacral pressure sore who could be categorized nontraumatic nonparaplegic group(NTNP group) or nontraumatic paraplegic group(NTP group). But this island flap has drawback, which is elimination of sensory nerve within the flap.
Arteries ; Humans ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Skin*

BACKGROUND: Nitric Oxide (NO) has been discovered to be an important endothelium-derived relaxing factor. The exogenous inhaled NO may diffuse from the alveoli to pulmonary vascular smooth muscle and produce pulmonary vasodilation, but any NO that diffuses into blood will be inactivated before it can produce systemic effects. To examine the effects of NO on pulmonary and systemic hemodynamics, NO was inhaled by experimental dogs in an attempt to reduce the increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by hypoxia in dogs. METHODS: Eight mongrel dogs were studied while inhaling 1)50% O2 (baseline), 2)12% O2 in N2 (hypoxia), 3)followed by the same hypoxic gas mixture of O2 and N2 containing 20, 40 and 80 ppm of NO, respectively. RESULTS: Breathing at FIO2 0.12 nearly doubled the pulmonary vascular resistance from 173 56dyn sec cm-5 to 407 139dyn sec cm-5 and significantly increased the mean pulmonary artery pressure from 16 3mmHg to 22 4mmHg. After adding 20~80 ppm NO to the inspired gas while maintaining the FIO2 at 0.12, the mean pulmonary artery pressure decreased (p<0.05) to the level when breathing oxygen at FIO2 0.5 while the PaO2 and PaCO2 were unchanged. The pulmonary vascular resistance decreased significantly and the right ventricular stroke work index returned to a level similar to breathing at FIO2 0.5 by addition of NO into the breathing circuit. Pulmonary hypertension resumed within 3~5 minutes of ceasing NO inhalation. In none of our studies did inhaling NO produce systemic hypotension and elevate methemoglobin levels. CONCLUSIONS: Inhalation of 20~80 ppm NO selectively induced pulmonary vasodilation and reversed hypoxic pulmonary vasoconstriction without causing systemic vasodilation and bronchodilation. Methemoglobin and NO2 were within normal limit during the study.
Animals ; Anoxia ; Dogs ; Endothelium-Dependent Relaxing Factors ; Hemodynamics* ; Hypertension, Pulmonary ; Hypotension ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Oxygen ; Pulmonary Artery ; Respiration ; Stroke ; Vascular Resistance ; Vasoconstriction* ; Vasodilation

BACKGROUND: Percutaneous Mitral Valvuloplasty (PMV) is the first-line treatment modality in selected patients with symptomatic mitral stenosis and more recently available Inoue single-balloon catheter technique produces good results with low incidence of complications. The purpose of this study was to evaluate the immediate and over 6 months follow-up results after successful PMV with an Inoue balloon and to identify the predictive factors for the results. METHODS: From May 1995 to Feburary 1997, a PMV with an Inoue balloon was tech-nically successful in 114 (95%) of the 119 patients treated at the Sejong General Hostpital. In this study, a series of echocardiographic follow-up were performed in 54 patients with rheumatic mitral stenosis, at least 6 months after their successful PMV. In PMV, the inflation was conducted in steps, starting with a recommended maximum size of balloon by the Inoue criteria. After each inflation, the mitral valve opening and competence were evaluated by Transesophageal echocardiography (TEE) and continuing increase balloon size. RESULTS: Echocardiographic follow-up assessment was performed in 54 patients serially in a interval of 3 months or 6 months. Their mean age was 46+/-11 years (24 to 66 years) and the mean total echocardiographic score was 7.1+/-1.6. A optimal result was obtained in 95% of the cases (51/54). The post-PMV mitral valve area increased to 1.95+/-0.37 cm 2 and 1.79+/-0.28 cm 2 by 2-D and Doppler method, the average transmitral mean diastolic pressure gradient decreased to 5.16+/-2.8 mmHg and LA pressure was decreased to 11.28+/-8.2 mmHg. The newly developed and aggravated mitral regurgitation was observed in 17 patients (31.5%). The restenosis was noted in 2 cases (3.7%) after 1 year follow-up. The pre-procedural echocardiographic score for leaflet mobility, thickening and calcification was more higher in patients with restenosis. There was significant tendency of decrement in the mitral valve area in patients with a echocardiographic score=8 compared with those< or =8 over 6 months after the PMV. CONCLUSION: PMV with the Inoue balloon under TEE guide as a combined treatment modality of patient with symptomatic mitral stenosis is relatively safe and achieves good immediate and midterm follow-up results. The echocardiographic score is considered as useful predictor of midterm results and restenosis after PMV with Inoue balloon.
Blood Pressure ; Catheters ; Echocardiography ; Echocardiography, Transesophageal ; Follow-Up Studies* ; Humans ; Incidence ; Inflation, Economic ; Mental Competency ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis

No abstract available.
Embryonic Structures* ; Female ; Fertilization in Vitro* ; Pregnancy ; Pregnancy, Tubal*

The authors had studied 55 cases with clinical seizure who were regularly treated with appropriate anticonvulsants over 6 months. In their distribution of age, teens are most freguent and their twenties followed. Males are more affected than female in the ratio of 3 to 2. Seizure may occur at any age; but our study shows that it is commoner in the first to third decades of life, about 72% of all cases, commonest in teens. The figures for 55 cases collected by us are : generalized type, 78% ; partial type, 22% ; 60% of all cases 33 are ldiopathic group, who had no demonstrable underlying neurologic abnormality. The major part of all idiopathic cases had their attacks of seizure before 30 years of age and; those of symptomatic cases are rather late over age of 30, and their figures are; cerebrovascular disorder, 6 cases; brain tumor, 5 cases; cerebral cysticercosis, 4 cases. 51 cases of all patients had evident abnormalities on their EEG. According to both their type of seizure and EEG findings, their drug was determined and, if need be, second drug was added. Freguently used drugs were dilantin, phenobarbital & Valproic acid etc. Mean therapeutic serum levels of anticonvulsants are: dilantin, 8.3 mg/L phenobarbital, 12.4 mg/L; which levels are less than those in U. S. A. In our study, the reponse to anticonvulsants were mostly good in about 2 years.
Adolescent ; Anticonvulsants ; Brain Neoplasms ; Cerebrovascular Disorders ; Cysticercosis ; Electroencephalography ; Female ; Humans ; Male ; Phenobarbital ; Phenytoin ; Seizures* ; Valproic Acid

No abstract available.
Animals ; Binding Sites* ; Carbon Monoxide* ; Carbon* ; Rats* ; Serotonin*

No abstract available.
Meningioma* ; Neoplasm Metastasis*

No abstract available.
DNA, Viral* ; Hep G2 Cells* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Spices*