No abstract available.
Humans ; Mental Health* ; Paresis* ; Rehabilitation* ; Stroke*

We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 minutes, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography. Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.
Anaphylaxis ; Anti-Bacterial Agents ; Aorta, Thoracic ; Cardiopulmonary Resuscitation* ; Echocardiography ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Intensive Care Units ; Middle Aged ; Operating Rooms ; Renal Artery ; Ribs ; Stomach Neoplasms ; Survivors* ; Thorax ; Tomography, Spiral Computed

This study was done to compare the nutritional status of antioxidant vitamins between college women smokers and nonsmokers. Dietary intakes and serum levels of antioxidant vitamins were determined in 33 smokers and 42 nonsmokers residing in the Seoul area. Dietary intakes of vitamin A and C were determined by a quick and convenient dietary intake method. Serum vitamin C level was measured by 2,4-dinitrophenylhydrazine method and serum levels of vitamin A and E were measured by HPLC. The mean A intake of nonsmokers and smokers was 504.3 microgram R.E./day and 450. 4 microgram R.E./day and the mean vitamic C intake of nonsmokers and smokers was 51.6mg/day and 50.2mg/day, reapectively. There was no difference in the dietary intakes of antioxidant vitamins between smokers and nonsmokers. The serum vitamin A level, 0.71mg/1 in nonsmokers was not significantly different from that of 0.74mg/1 in smokers. However, the serum vitamin C level, 7.94mg/1 in smokers was 15% lower(p<0.05) than that of 9.30mg/1 in nonsmokers. The serum vitamin E level, 18.15mg/1 in smoders was also 34% lower(p<0.05) than that of 27.58mg/1 in nonsmokers. There was no significant correlation between dietary intakes and serum levels of vitamin A and C for both smokers and nonsmokers. These results suggest that cigarette smokers need more dietary intakes of vitamin C and E than do nonsmokers to reach the same serum level.
Ascorbic Acid ; Chromatography, High Pressure Liquid ; Female ; Humans ; Nutritional Status* ; Seoul ; Tobacco Products ; Vitamin A ; Vitamin E ; Vitamins*

PURPOSE: This study examined the relationship between the level of activity daily living and powerlessness of spinal cord injury patients'. METHOD: The subjects for the study consisted of 68 persons agreed above twenty below seventy had had spinal cord injury. The data were collected from November 1, 2003 to January 30, 2004. The instruments used for this study were ADL check List and Powerlessness Scale. The data were analysed by using SPSS computerlized program and included number, percentage, t-test and ANOVA, Pearson Correlation Coefficient. RESULTS: The mean of activity daily living was paraplegia 49.53+/-10.91 and tetraplegia 25.65+/-13.24. The mean of powerlessness was paraplegia 35.22+/-9.50 and tetraplegia 37.55+/-9.01. In the relationship between activity daily living and powerlessness were significant difference. CONCLUSION: in order to increase the level of activity daily living of rehabilization nurse should be helpful to provide them. Also, it could be identified that informational support was important, that is, the lesser the informational support, spinal cord injury patient don't feel the powerlessness.
Activities of Daily Living ; Humans ; Paraplegia ; Quadriplegia ; Spinal Cord Injuries* ; Spinal Cord*

Articular cartilage can be damaged by trauma or by progressive degradation caused by disease. Unfortunately, it has a extremely limited capacity for repair and regeneration. The use of joint prosthesis has revolutionized but remains limited in its use. To know the possibility of clinical application of clinical application of autogenous bone-articular graft in open complicated intraarticular fractures we studied the change of bone-articular cartilage defect in medial femoral condyle of rabbits and viability of autogenous bone-articular graft stored within abdominal wall of rabbits. The results were obtained as follows: 1. There was over 90% viability of subchondral bone after 10 days storage in the adbominal wall but the articular cartilage showed degenerative change about 40% after 5 days passed. 2. The bone-articular defect was replaced by undifferentiated mesenchymal tissue and fibrous tissue, postoperative 6 weeks later. 3. In implanted bone-articular cartilage graft at 3 days, the chondrocyte of basal cell layer in articular cartilage was relatively well preserved but in 7 days, transplanted articular cartilage graft showed almost necrotic chage. Most of subchondral bones were well healed with host bone without regard to duration of implantation.
Abdominal Wall ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Intra-Articular Fractures ; Joint Prosthesis ; Rabbits ; Regeneration ; Transplants

OBJECTIVE: The purpose of this present study was to compare mouse embryo development in 3 commercial media and hatching competence of mouse embryo with or without enzymatic treatment. METHODS: Collected 375 mouse embryos were divided into three groups, and then cultured in IVF-20 (G2), Medicult IVF (M3), P-1 (blastocyst M), respectively. Three day mouse morulae were cultured in G2 media treated with pronase. The results were analyzed using Chi-square test, and considered statistically significant when p<0.01. RESULTS: The developmental rate of 2 cell mouse embryo after 72 hours was highest in IVF-20 (G2) among conventional 3 media. The hatching rate of mouse morulae was low when clultured in G2 media without pronase during 48 hours. However, it was higher when cultured in media treated with l mg/ml, 2.5 mg/ml, 5 mg/ml pronase, respectively. CONCLUSIONS: Using good media and digestion of zona pellucida with enzymatic treatment improve development and hatching rate of embryo. Therefore, implantation and pregnancy rate could be improved.
Animals ; Digestion ; Embryonic Development ; Embryonic Structures* ; Female ; Mental Competency ; Mice* ; Morula ; Pregnancy ; Pregnancy Rate ; Pronase* ; Zona Pellucida

BACKGROUND: White coat effect (WCE) and white coat hypertension (WCH) are relatively prevalent in clinical situation (20 - 57% of WCH in the hypertensive population). The aim of this study was to analyze the determinant factors of WCE. METHODS: A prospective study was carried out in outpatient clinic in a consecutive hypertensives without receiving pharmacologic treatment. Twenty-four hour ambulatory blood pressure monitoring (ABPM) was performed following more than two resting blood pressure (BP) determinations carried out with the interval of 1 - 2 weeks by mercury sphygmomanometer. WCE was calculated for systolic and diastolic BP as the difference between a clinic BP (CBP) and an average daytime ambulatory BP (ABP). WCH was defined as;BP in the clinic > or = 140/90 mmHg with a mean daytime BP by ABPM < or =137/< or =89 mmHg. RESULTS: 1) Two hundred thirty-five patients (mean age 49.7 years, females 74%) were studied. Thirty-seven percent in male and forty-six percent in female patients fulfilled WCH criteria. 2) CBP was significantly correlated to daytime ABP (systolic BP;r=.47, p<.001 and diastolic BP;r=.65, p<.001). 3) The magnitude of WCE was greater in the group of WCH (28.9+14.6/19.3+6.9 mmHg) than ambulatory hypertensives (15.1+15.7/13.0+8.2 mmHg) (p<.001). 4) The magnitude of WCE is significantly correlated with female (r2=.12, p<.001) and the stage of CBP according to JNC-V (r2=.23, p<.001) in systolic BP, the stage (r2=.08, p<.001) in diastolic BP, and the stage (r2=.09, p<.001) and weight (r2=.15, p<.01) in mean BP. CONCLUSIONS: The magnitude of WCE in essential hypertension diagnosed at the clinic is significantly correlated with female, the magnitude of clinic BP, and weight.
Ambulatory Care Facilities ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension* ; Male ; Prospective Studies ; Sphygmomanometers ; White Coat Hypertension

BACKGROUND: Noninvasive estimation of pulmonary artery pressure is an important component of echocardiographic studies. A number of methods are available for estimation of pulmenary pressure, each with varying degrees of reported accuracy. To assess accuracy and difficulties, noninvasive pulmonary artery pressure estimates were performed in infants and children with congenital heart diseases. METHODS: Noninvasive estimates from 8 methods were compared with catheterization measurements. Systolic pressure was estimated by the Burstin method and from perak tricuspid regurgitation velocity, and also from systolic pressure gradients through the VSD(ventricular septal defect) and PDA(patent ductus arteriosus). Mean pressure was estimated by acceleration time divided by ejection time measured from Koppler spectrum obtained at the right ventricular out flow tract. Diastolic pressure was estimated from pulmonary regurgitation velocity spentrum at end-diastolic, and also from diastolic pressure gradient through the patent ductus arteriosus. RESULTS: IN systolic pressure, Burstin and tricuspid regurgitation velocities estimates correlated significantly(r=0.92, 0.90 respectively), whereas VSD and PDA estimates correlated less well with catheterization estimates(r=0.83, 0.65 respectively). The mean pressure, measured from RVOT(right ventricular outflow tract) Doppler spectrum corresponded well with catheterization pressure(r=0.89), whereas those obtained from the main pulmonary artery correlated less well(r=0.74). The diastolic pressure estimates from pulmonary regurgitation velocity spectrum, revealed good correlation(r=0.79), but those from diastolic Doppler spectrum at PDA correlated less well with catheterization estimates(r=0.63). CONCLUSION: All of eight Doppler echocardiographic methods seemed to be easily performable for estimation of pulmonary artery pressure. But, the degree of accuracy was variable. Because a pressure estimante from only a single method may be in error, care should be taken in combining use of other(one or two) methods.
Acceleration ; Blood Pressure ; Catheterization ; Catheters ; Child ; Ductus Arteriosus, Patent ; Echocardiography* ; Echocardiography, Doppler ; Heart Diseases ; Humans ; Infant ; Pulmonary Artery* ; Pulmonary Valve Insufficiency ; Tricuspid Valve Insufficiency

No abstract available.
Aneurysm* ; Hydrocephalus*

A 58-year-old female with an episode of gross hematuria two months before and fever and chill for the past three days presented oliguric acute renal failure. She has taken NSAID intermittently for 18 years due to rheumatoid arthritis, and herb medicine for one week two months ago when gross hematuria developed. Physical examination revealed mild tenderness on costovertebral angles. Her blood pressure was 170/100 mmHg, the urinalysis showed >300 mg protein with many RBCs and 10-20 WBCs and the serum creatinine was 5.8 mg/dl. A renal biopsy performed on the 4th hospital day showed that it was overwhelmed by severe tubular lesions which reveal intratubular obstruction by massive erythrocyte casts and tubular necrosis. The glomeruli showed focal minimal crescents with many red blood cells entrapped in the crescents and in the capillaries. Immune deposits were not present. A renal failure resolved spontaneously and the patient was discharged three weeks later with creatinine of 2.4 mg/dl. In this patient, acute renal failure was considered to be due to a tubular lesion related to the glomerular bleeding from focal glomerulonephritis revealing minimal crescents.
Acute Kidney Injury* ; Arthritis, Rheumatoid ; Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Erythrocytes ; Female ; Fever ; Glomerulonephritis* ; Hematuria* ; Hemorrhage ; Humans ; Middle Aged ; Necrosis ; Physical Examination ; Renal Insufficiency ; Urinalysis