BACKGROUND: Since hydroxyethyl starch has colloidal properties closely approximating those of human albumin, it is considered to be a good plasma volume expander. Pentastarch is a hydroxyethyl starch similar to hetastarch, but with lower average molecular weight and molar substitution ratio. These characteristics result in enhanced enzymatic hydrolysis, faster renal elimination and less effect on coagulation. This study was designed to evaluate the safety and clinical efficacy of 10% pentastarch in priming fluid for cardiopulmonary bypass compared with that of 5% albumin. METHODS: Thirty- two adult patients undergoing elective cardiac surgery were randomized into two groups. Sixteen patients received 500 ml of 10% pentastarch and sixteen patients received 100 ml of 20% albumin in a bloodless priming solution for cardiopulmonary bypass. The fluid balance, coagulopathy and organ functions(cardiac, pulmonary and renal) were evaluated at several time intervals. RESULTS: There were no differences between the two groups in operation and bypass time, chest tube drainage and blood usage. The measured prothrombin time, partial thromboplastin time and platelet count of pentastarch group were not significantly different from those of the albumin group at each time interval(p<0.05). We did not find any differences of statistical significance in hemodynamic data, serum osmolarity, pulmonary shunt and BUN between the two groups(p<0.05). CONCLUSIONS: Our study suggests that 10% pentastarch can be used safely and effectively as cardiopulmonary bypass prime in cardiac surgery.
Adult ; Cardiopulmonary Bypass* ; Chest Tubes ; Colloids ; Drainage ; Heart ; Hemodynamics ; Humans ; Hydrolysis ; Hydroxyethyl Starch Derivatives* ; Molar ; Molecular Weight ; Osmolar Concentration ; Partial Thromboplastin Time ; Plasma Volume ; Platelet Count ; Prothrombin Time ; Starch ; Thoracic Surgery ; Water-Electrolyte Balance

No abstract available.
Hypoglycemia*

BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin

BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*

No abstract available.
Dystonia Musculorum Deformans* ; Dystonia*

In this study, among intermittent exotropia cases, 38 cases indicating sensory anomaly of diplopia and 27 cases indicating sensory anomaly of suppression, and tried to compare the results of operation. Cases of diplopia ranged from 3 years of age to 21 years of age averaging 4.5 years of age, and the follow up period after operation ranged from 2 months to 18 months averaging 6.5 months. The success rate of operation in cases of diplopia was 92%(35/38), and that in cases of suppression was 74%(20/27). Consequently, among intermittent exotropia patiens indicating sensory anomaly the case of diplopia can be said to be higher in the success rate of operation than that of suppression.
Diplopia ; Exotropia* ; Follow-Up Studies

Infection with cytomegalovirus(CMV) during adult life was first recognized in debilitated patients with compromised immune mechanisms, renal transplant recipients, and patients undergoing extracorporeal perfusion or transfusions. CMV infection is very rare in inmunologically normal adult. Recently CMV infection has been reported previously healthy adult, usually wth a predilection for involvement of lung, liver, spleen, hematopoietic system, or heart but central nervous system involvement is apparently rare. This report describes a previously healthy woman who had encephalitis and documented CMV infection by serologic test for CMV. So we report a case with brief review of literature.
Adult* ; Central Nervous System ; Encephalitis* ; Female ; Heart ; Hematopoietic System ; Humans ; Liver ; Lung ; Perfusion ; Serologic Tests ; Spleen ; Transplantation

BACKGROUND: The HBV-PCR assay seems to be potentially valuable diagnostic tool for the evaluation of variable serologic status. However, the selection of the primer for HBV-PCR test may be very important because they can influence the HBV-PCR positivity. METHODS: We compared the results of primer HBV1/2 including famous 1896 and 1899 mutation sites with those of primer PHBV1/2 at precore/core region. HBV-PCR was tested in 87 HBsAg-positive patients using two sets of primers. The results were evaluated according to the primers and also compared the results with the clinical diagnosis and the alanine aminotransferase (ALT) level. RESULTS: The positive rate of PHBV primer was higher than HBV primer including mutation sites (nucleotide 1896 and 1899) in HBeAg-negative patients. According to the clinical diagnosis, the sensitivity of PHBV primer was higher than that of HBV primer in chronic hepatitis patients. There was no significant correlation between ALT level and HBV-PCR results. CONCLUSIONS: It is important that the selection of primer in HBV-PCR is important, because the primer including mutation sites may result in false negative results. PHBV primer used in this study could be useful for the detection of HBV-DNA by HBV-PCR.
Alanine Transaminase ; Diagnosis ; Hepatitis, Chronic ; Humans ; Polymerase Chain Reaction*

PURPOSE: High frequency oscillatory ventilation (HFOV) is used to support infants with severe respiratory failure unresponsive to conventional ventilation (CV). We reviewed chest radiographs before and after HFOV with clinical correlation in infants with respiratory distress syndrome (RDS). METHODS: Eighteen very low birth weight infants with RDS who had HFOV were included in this study. All patients were diagnosed as having RDS clinically and radiologically. Mean gestational age of infants was 27 weeks (range : 24-31 weeks). The mean duration of HFOV was 3 days (range : 14 hours-9 days). The chest radiographs of these infants within 3 hours before and after application of HFOV were retrospectively reviewed. Radiological findings based on aeration and parenchymal densities were classified into improved, no change, and progressed. Medical records were reviewed for FiO2 levels, clinical outcomes, complications, and causes of death. RESULTS: In 15 of 18 infants, aeration and parenchymal densities were improved and FiO2 levels were also improved after HFOV. Four of these 15 infants who showed improvement of radiological findings developed pneumothorax, sepsis, pulmonary or intestinal bleeding, and subsequently died. In remaining 3 infants in whom chest radiographs after HFOV showed no interval change or progression, oxygenation was also worsened and all died. CONCLUSION: Chest radiographs of HFOV-treated, very low birth weight infants showed improvement of aeration and parenchymal densities in most cases. Clinical outcome was good in infants who showed improvement on chest radiographs compared to those of progression group as far as there was no associated complication. Knowledge of radiological changes after HFOV will help in interpretation of chest radiographs in those HFOV-treated infants.
Cause of Death ; Gestational Age ; Hemorrhage ; Humans ; Infant* ; Infant, Very Low Birth Weight* ; Medical Records ; Oxygen ; Pneumothorax ; Radiography, Thoracic ; Respiratory Insufficiency ; Retrospective Studies ; Sepsis ; Ventilation*

Glassy cell carcinoma is an unusual neoplasm of the uterine cervix with highly aggressive clinical behavior. On cervico-vaginal smear examination, the tumor has well confused of atypical repair cell of the endocervix. Recently, we have experienced two cases of glassy cell carcinoma of the uterine cervix, diagnosed on cervico-vaginal smears and confirmed on following histologic sections. The cervico-vaginal smears revealed abundant clusters with well defined boarders. The cell clusters were composed of large tumor cells. The tumor cells had distinct granular cytoplasm and eosinophilic macronucleoli. Characteristic cytologic features of this tumor were discussed in view of differential diagnosis.
Adenocarcinoma ; Breast ; Cervix Uteri ; Cytoplasm ; Diagnosis, Differential ; Eosinophils ; Female ; Hydronephrosis*