No abstract available.
Septo-Optic Dysplasia*

PURPOSE: To establish the accuracy of the newly released biometer Ocuscan RxP(R) (Alcon, USA) by comparison with the established Ultrasonic Biometer Model 820(R) (Allergan Humphrey, USA), and to compare the accuracy of contact and immersion biometries. METHODS: This is a prospective study involving 27 patients (40 eyes) who were scheduled for cataract surgery and had axial lengths measured with an Ocuscan RxP(R) biometer using both contact (Method 1) and immersion (Method 2) techniques. As a reference, a contact type Ultrasonic biometer 820(R) (Method 3) was also used. IOL(Intraocular Lens) power for the cataract surgery was calculated using this result. An axial length which would have caused no post-operative refractive error was reversely calculated from the difference of target diopter and post-operative refractive error. This length was compared with the axial lengths obtained via Methods 1, 2 and 3. RESULTS: The means and standard deviations for the measurement sets were compared. Methods 1 and 2 showed no significant difference (23.22+/-0.68, 23.24+/-0.69 mm, p=0.55). The axial length measured by Method 3 was 23.32+/-0.67 mm. The difference between the target refraction and post-operative refractive error was 0.29+/-0.60D. The axial length was reversely calculated from the difference (23.07+/-0.84 mm). The differences between the reversely calculated axial lengths and those of Methods 1, 2 and 3 were 0.15+/-0.31, 0.17+/-0.31 and 0.24+/-0.28 mm, respectively. CONCLUSIONS: Biometric results from Methods 1 and 2 caused less refractive error than did Method 3. The contact and immersion methods are both accurate for IOL power calculation if performed by a well-skilled examiner.
Biometry ; Cataract ; Cimetidine ; Humans ; Immersion ; Prospective Studies ; Refractive Errors ; Ultrasonics

OBJECTIVE: This study evaluated the possible role of 2 additional tumor markers to CA125 in discriminating between benign and malignant ovarian tumors. METHODS: Serum samples from 1,346 patients were obtained on seven days before operation. All patients underwent surgery for ovarian tumors. Serum levels of 3 tumor markers were compared to histology. Concentrations of tumor markers (CA125, CA72-4, CA19-9) were detected by enzyme immuno- or immunoradiometric assays. Normal range of these markers was defined as CA125 Humans ; Immunoradiometric Assay ; Reference Values ; Sensitivity and Specificity ; Biomarkers, Tumor*

BACKGROUND: Hepatitis B virus (HBV)-associated glomerulonephritis (HBGN) occurs with high prevalence in Asia, and accounts for over 30% of secondary glomerulonephritis in Korea. However, the association between HLA and HBGN has been hardly reported upon in the literature. METHODS: A total of 50 Korean patients with HBGN, 100 HBsAg (-) healthy controls and 89 HBsAg (+) controls (subjects with chronic HBV infection, HBsAg positive at least for 6 months) were included. HLA-DR typing was done using a reverse sequence specific oligonucleotide typing kit and HLA-DRB1 genotyping was done for HLA-DR2 positive samples by PCR-single strand conformational polymorphism method. RESULTS: In the HBGN patients, HLA-DR2 was highly significantly increased compared with HBsAg (-) controls (p=0.0002, corrected p=0.002, OR=4.0) and also compared with HBsAg (+) controls (p= 0.0005, corrected p=0.006, OR=3.7). Different HLA- DR2 alleles were strongly associated with different pathologic subtypes of HBGN: DRB1*1502 was associated with membranoproliferative glomerulonephritis (MPGN) (p=0.0003, corrected p=0.004, OR=14.5), and DRB1*1501 with membranous nephropathy (MN) (p= 0.05, OR=3.8). These associations were also found to be significant compared with HBsAg (+) controls (HBV-MPGN, p=0.002; HBV-MN, p=0.04). DR13 was found to have some protective effect in HBV infection (p=0.01, OR=0.3) and DR11 was found to be weakly associated with HBV infection (p=0.01, OR= 4.6), however these HLA alleles were not associated with disease susceptibility to HBGN. CONCLUSION: These results suggest that HLA- DR2 or a closely associated genetic factor is associated with disease susceptibility to HBGN, and different HLA-DR2 subtypes are associated with different pathologic subtypes of HBGN in Koreans.
Alleles ; Asia ; Disease Susceptibility ; Fibrinogen ; Glomerulonephritis* ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; HLA-DR Antigens* ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Korea ; Prevalence

PURPOSE: The aim of this study was to identify the predictive factors in the early laboratory findings for cardiac sequelae in Kawasaki disease(KD). METHODES: A retrospective review of the records was conducted of all children with KD who were admitted to the Ulsan Dongkang General Hospital, Masan Samsung Hospital, and Gyeongsang National University Hospital between January 1995 and December 1999. We analyzed and compared the early laboratory findings between the patients with and without coronary artery dilatation. RESULTS: A total of 981 patients were divided into two groups : 826 patients(84.3%) with normal coronary artery and 155 patients(15.7%) with coronary artery dilatation. Age and sex were not significantly different between the two groups. The mean serum C-reactive protein(CRP) in the coronary artery dilatation group and in the normal coronary artery group were 5.0 mg/dl(+/-5.3) and 4.1 mg/dl(+/-5.0), respectively, with a significant difference(P<0.05), whereas the other early laboratory findings had no difference between the groups. CONCLUSION: This study shows that the early serum CRP was higher in patients with KD who had coronary artery dilatation than in those with normal coronary artery. There may be a strong possibility of cardiac sequelae at a high level of serum CRP. However, the cut-off value of serum CRP could not be determined for the prediction of cardiac sequelae in patients with KD.
Child ; Coronary Vessels ; Dilatation ; Hospitals, General ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies ; Staphylococcal Protein A* ; Ulsan

BACKGROUND: Aspiration of gastric contents is an ever -present risk in the use of general anesthesia, particularly in emergency and obstetric situations, and morbidity and mortality associated with this complication increases with the volume and acidity of the aspirate. Since direct inhibition of acid secretion may be a preferable method, we studied the effectiveness of ranitidine in increasing gastric pH. METHODS: Sixty patients scheduled for elective cesarean section under general anesthesia before midday were randomly divided into three groups. The control group (n=20) did not received preanesthetic ranitidine. Group I (n=20) received a slow intravenous injection of 50 mg ranitidine, one hour before surgery. Group II (n=20) received 150 mg ranitidine orally, both the night before surgery and the morning of surgery. RESULTS: Compared with the control group, the mean gastric pH increased significantly in group I and II (P<0.05). There was no significant difference of gastric pH between group I and II. CONCLUSIONS: The results of this study indicate that ranitidine is a useful agent in increasing the gastric pH in women undergoing elective cesarean section. Ranitidine administered intravenously and orally were equally effective means in increasing the gastric pH.
Anesthesia, General ; Cesarean Section* ; Emergencies ; Female ; Gastric Acid* ; Humans ; Hydrogen-Ion Concentration ; Injections, Intravenous ; Mortality ; Pregnancy ; Ranitidine*

BACKGROUND: Minimum alveolar concentration (MAC) is decreased during pregnancy, but there are no data regarding the requirements for intravenous agents. Recently only one study showed that the requirement for thiopental in pregnant women of 7-13 weeks' gestation was less than the requirement obtained in nonpregnant women. Thus we wanted to determine whether pregnant patients needed less propofol for hypnosis and anesthesia than nonpregnant patients. METHODS: One hundred nonpregnant women having gynecologic surgery and 100 pregnant women of 5-13 weeks' gestation undergoing elective abortions were recruited. They were randomly allocated 10 groups according to the doses of propofol and each group had 10 patients. During a period of 30 seconds, one of the doses of propofol 1.0, 1.25, 1.5, 1.75, 2.0, 2.25, 2.5, 2.75, 3.0 or 3.25 mg/kg was administered. Two minutes later, patients were asked to open their eyes as a test for hypnosis. Patients who did not open their eyes were given a 10 seconds, 50-Hz, 80-mA transcutaneous tetanic electrical stimulus to the ulnar nerve as a test for anesthesia. Estimates of ED50 and ED95 for hypnosis and anesthesia were obtained by logistic regression. RESULTS: In the pregnant women, the median effective doses (ED50) (95% confidence interval) for hypnosis and anesthesia were 1.25 (1.13-1.35) mg/kg and 2.71 (2.49-3.04) mg/kg, the ED95 (95% CI) were 1.51 (1.16-1.87) mg/kg and 3.04 (2.80-3.58) mg/kg respectively. Whereas in the nonpregnant women, the ED50 for hypnosis and anesthesia were 1.27 (1.39-1.90) mg/kg and 4.12 (3.50-6.01) mg/kg, the ED95 were 1.53 (1.41-1.93) mg/kg and 4.35 (3.66-7.26) mg/kg respectively. CONCLUSIONS: In early pregnant women, the doses of propofol for hypnosis and anesthesia were 1.6% and 34.2% less compared with those in nonpregnant women.
Anesthesia ; Female ; Gynecologic Surgical Procedures ; Humans ; Hypnosis ; Logistic Models ; Pregnancy* ; Pregnant Women ; Propofol* ; Thiopental ; Ulnar Nerve

BACKGROUND: Hypotension associated with epidural anesthesia for cesarean section is common and serious, despite the use of uterine displacement and volume preload. This study evaluated the role of crystalloid volume preload for prevention of hypotension during epidural anesthesia. METHODS: Forty parturients undergoing elective cesarean section were allocated randomly to receive either no preload (Group II, n=20) or preload with Ringer's lactate solution 1000 ml over 10-15 minutes (Group I, n=20) before epidural anesthesia. Hypotension was defined as a decrease of systolic blood pressure to less than 90 mmHg and to less than 80% of baseline value. Systolic blood pressure and heart rate were measured 2 minutes interval during first 20 minutes after epidural injection. Apgar score, umbilical venous, arterial and maternal arterial blood gas analysis were done. RESULTS: Significant hypotension occured in seven of the twenty parturients in no preload group (Group II) and seven of twenty parturients in Ringer's lactate preload group (Group I). There were no statistical differences in systolic blood pressure, heart rate, amount of used ephedrine, Apgar score, umbilical venous, arterial and maternal arterial blood gas analysis. CONCLUSIONS: Ringer's lactate preload (1000 ml) before epidural anesthesia in the supine tilted parturients did not decrease the incidence or severity of hypotension.
Anesthesia, Epidural* ; Anesthesia, Obstetrical ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Ephedrine ; Female ; Heart Rate ; Hypotension* ; Incidence ; Injections, Epidural ; Lactic Acid* ; Pregnancy

No abstract available.
Glomerular Filtration Rate*

BACKGROUND: Postoperative nausea and vomiting (PONV) are common problems in patients undergoing outpatient laparoscopy and hysteroscopy. Associated complications range in severity from mild discomfort to hospital admission for dehydration or pulmonary aspiration. This study was designed to assess the efficacy of 2 antiemetics (metoclopramide and ondansetron) with propofol as the induction agent for prophylaxis of postoperative emesis in women undergoing general anesthesia for gynecologic endoscopic surgery. METHODS: One hundred and twenty six healthy women undergoing laparoscopic and hysteroscopic surgery with general anesthesia were randomized to receive intravenous bolus of saline 2 ml, metoclopramide 10 mg, ondansetron 4 mg prior to induction of anesthesia. Anesthesia was induced with propofol 2~2.5 mg/kg, vecuronium 0.1 mg/kg and maintained with O2, N2O, enflurane, fentanyl 1~2 microgram/kg. The incidence of nausea and vomiting was assessed at recovery room and all patients were contacted 24 hours after discharge. RESULTS: The incidence of PONV showed 11.9% in control group, 11.9% in metoclopramide group and 9.5% in ondansetron group in recovery room. The incidence of PONV showed 14.3% in control group, 14.3% in metoclopramide group and 7.1% in ondansetron group in 24 hours postoperatively. There were no significant differences among the groups. CONCLUSIONS: When propofol was administered by intravenous induction agent, no antiemetic in this study was more efficacious than propofol alone in reducing PONV for women undergoing outpatient laparoscopic and hysteroscopic surgery.
Anesthesia ; Anesthesia, General ; Antiemetics ; Dehydration ; Enflurane ; Female ; Fentanyl ; Humans ; Hysteroscopy ; Incidence ; Laparoscopy* ; Metoclopramide* ; Nausea ; Ondansetron* ; Outpatients ; Postoperative Nausea and Vomiting* ; Propofol* ; Recovery Room ; Vecuronium Bromide ; Vomiting