BACKGROUND: The value of serum lipid in children after recovery of Kawasaki disease may be important bacause of the predilection of this disease for the coronary artery. METHODS: To determine the alterations in serum total cholesterol(TC) and high density lipoprotein(HDL)-cholesterol levels in Kawasaki disease(KD), we measured serum HDL-cholesterol and TC in 35 patients(mean age 36.8+/-22.0 months, range 6 to 93 months) with Kawasaki disease(KD) during 10 days or less after the onset(group A) and 2 months later after recovery. TC and HDL-cholesterol were also measured in an acute febrile respiratory illness group(group B) and a nonfebrile respiratory illness group(group C) to compare with those of KD. RESULTS: HDL-cholesterol levels in group A were depressed(29.6+/-11.0mg/dl) compared with group B and C(47.3+/-13.3mg/dl and 45.1+/-12.4mg.dl, respectively, p<0.01). TC levels in group A(145.1+/-33.1mg/dl) were not significantly different from those of group B(146.8+/-33.4mg/dl) and C(157.1+/-29.6mg/dl). Also the level of serum HDL-cholesterol in the acute phase of KD was significantly lower when compared with that after recovery(30.2+/-13.2mg/dl vs 50.0+/-10.2mg/dl, p<0.05). In KD patients, TC levels were not significantly different between the acute & recovery phase(145.0+/-26.6mg/dl, 153.4+/-32.6mg/dl). Echo-cardiography confirmed coronary artery aneurysms in 11 patients(31.4%) and otherwise, normal findings(n=24) in the KD group. There were no significant difference in TC level(140.7+/-27.6mg/dl vs. 146.9+/-35.4mg/dl, p=NS) and HDL cholesterol level(30.1+/-12.5mg/dl vs. 29.2+/-10.7mg/dl, p=NS) between patients with and without coronary aneurysms. CONCLUSIONS: HDL-cholesterol levels were significantly depressed only in the acute phase of KD but TC levels did not change significantly. Both levels were not related to coronary artery aneurysm.
Aneurysm ; Child ; Cholesterol, HDL ; Coronary Aneurysm ; Coronary Vessels ; Humans ; Mucocutaneous Lymph Node Syndrome*

No abstract available.
Cardiomyopathies* ; Congenital Hypothyroidism* ; Echocardiography*

The 6 patients with neglected rupture of the Achilles tendon were treated by end to end anastomosis using the V-Y tendinous flap originated by Abraham in 1975. A tendinous flap was developed over the tendon by making an inverted V incision, which was then repaired in a Y fashion. The postoperative results were satisfactory with no functional disability of the ankle and with recovery of muscle strength for periods of 8 months to 15 months, but slight limited dorsiflexion of the ankle in two cases were noticed. The advantages of this method are: 1. Optimum functional recovery. 2. Recovery of muscle strength and tendon contour. 3. Prevention of late stretching or possible rupture of the healed tendon at the rupture site.
Achilles Tendon ; Ankle ; Humans ; Methods ; Muscle Strength ; Rupture ; Tendons

BACKGROUND: Urinary tract infections (UTIs) are the most frequent nosocomial infections and are frequently associated with indwelling urinary catheters. It is known that adherence to standard infection control measures for urinary catheters can reduce UTIs in hospitals. This study was performed to evaluate the effect of education in reducing catheter-related UTIs (CR-UTIs) in intensive care units (ICUs) of a university hospital. METHODS: CR-UTIs were prospectively monitored for all patients with indwelling urinary catheters in ICUs from July 2006 through December 2007. Recommendations based on previously known guidelines for catheter insertion, catheter management, and specimen collection to prevent CR-UTIs were formulated and educated in March 2007. Knowledge and adherence level were evaluated before and after educating healthcare workers about the recommendations using questionnaire. Changes in knowledge and adherence level before and after education were compared by Chi-square test. Changes in the rate of CR-UTIs and urinary catheter utilization ratios were also analyzed by Fisher's exact test. RESULTS: After education, knowledge level of and adherence level to most of the recommendations were improved significantly. The rate of CR-UTIs significantly decreased by 48% from 7.43/1,000 catheter-days before intervention to 3.87/1,000 catheter-days after intervention (P=0.02). CONCLUSION: Surveillance for nosocomial infections and education for standard infection control measures are very important in preventing CR-UTIs in ICUs.
Catheters ; Cross Infection ; Delivery of Health Care ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Prospective Studies ; Specimen Handling ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Surveys and Questionnaires

The individual onset of action of pancuronium and vecuronium has been examined with a priming dose of same or the other agent or two times priming. Measurement of changes in the Tl% of TOF ratio of the adductor pollicis muscle were performed by Accelograph (Biometer). Sixty adult patients were administered Vecuronium(V) 0.015mg/kg (group 1), V 0.005mg/kg 3 minutes after 0.01mg/ kg(group 2), Pancuronium(P) 0. 015 mg/kg(group 3,4) as a priming agents. After 5 minutes, the intubating dose of V 0.085mg/kg (group 1,2,3), P 0.085 mg/kg (group 4) were administered with the induction agent, thiopental sodium 5 mg/kg. All sixty patients underwent orotracheal intubation at 60 seconds after the injection of intubating dose. Intubation condition, reduction of Tl% at 60 seconds, the onset time of maximal blockade (Tl 0%) were evaluated. There was no difficulty in intubation. Fifty-two (86%) patients were distributed in exellent and satisfactory grade of largest in group 2. While group 3 showed more rapid than group 4, group 2 showed the most rapid onset time significantly. These results indicate that the twicely divided dose of vecuronium for priming agent may be adequate and vecuronium after priming with pancuronium is more rapid than priming with same agent.
Adult ; Humans ; Intubation ; Intubation, Intratracheal* ; Pancuronium* ; Thiopental ; Vecuronium Bromide*

Epidural clonidine is reported to produce analgesia in humans. To investigate the analgesic effect and prolongation of epidural and spinal anesthesia, we mixed 0.2mg epinephrine, 150 mcg clonidine, or 1 cc normal saline with 0.5% bupivacaine and compared the hemodynamie and analgesic effects of each drug. Heart rate and blood pressure were checked before, during and after anesthesia. Sensory level was checked by pin-prick method. The results were as follows; 1) The analgesia onset time and the time to highest level of sensory loss was most rapid in the epinephrine group. 2) The two segment regression time was significantly prolonged in the epinephrine group. 3) The analgesia duration was significantly prolonged in the clonidine and epinephrine group. 4) Although the heart rate gradually decreased over 60 min. After injection of each drug, there was no significant change between the groups. 5) Blood pressure decreased over 20-30 min. After injection of each drug, but there was no significant change between the groups.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal ; Blood Pressure ; Bupivacaine* ; Clonidine* ; Epinephrine* ; Heart Rate ; Humans

Forty patients with preeclampsia, undergoing general anesthesia for Cesarean section were studied. They were allocated randomly to receive either propofol 2.5 mg/kg and laryngeal mask insertion or thiopental sodium 4 mg/kg and endotracheal intubation for induction of anesthesia. All patients receiving thiopental sodium and tracheal intubation showed potentially dangerous reflex cardiovascular instability. There was a average 48.7 mmHg increase in systolic blood pressure after intubation. The patients receiving propofol and laryngeal mask insertion showed only 10.7 mmHg increase in systolic blood pressure. It is concluded that thiopental sodium induction and traeheal intubation of patients with preecalmpsia produces an increase in blood pressure which can lead to a risk of significant complication. Thus propofol induction and laryngeal mask seems to be a suitable anesthetic method in preeclampsia.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Cesarean Section* ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks* ; Pre-Eclampsia* ; Pregnancy ; Propofol* ; Reflex ; Thiopental

No abstract available.
Acetazolamide* ; Aneurysm* ; Brain* ; Humans ; Perfusion* ; Subarachnoid Hemorrhage* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Pneumonia*

To investigate cellular proliferation pattern of pterygial tissue, eleven paraffin sections through two normal conjunctiva, six primary and three recurrent pterygia were studied immunohistochemically by finding epithelial cells and subepithelial fibroblasts staining patterns as defined by monoclonal antibody for proliferating cell nuclear antigen(PCNA). The results showed similar epithelial cellular proliferation patterns in normal conjunctiva, primary and recurrent pterygia. But scattered patches of fibroblasts in subepithelial connective tissue staining positive with PCNA were found only in recurrent pterygium. Our results suggest that primary pterygium is not a disorder of excess cellular proliferation, but a proliferation of fibroblasts in subepithelial connective tissue have a role in pathogenesis of recurrent pterygium.
Cell Proliferation ; Conjunctiva ; Connective Tissue ; Epithelial Cells ; Epithelium ; Fibroblasts ; Paraffin ; Proliferating Cell Nuclear Antigen ; Pterygium*