PURPOSE: Perinatal asphyxia occurring in newborn is one of the major causes of acute mortality and chronic neurological disability in survivors. We have studied the relationship between early electroencephalography(EEG) findings and clinical course and neurologic outcome in severe asphyxiated neonates. METHODS: Between the period of July 1999 and June 2002, 25 neonates who were diagnosed with severe perinatal asphyxia(1-minute Apgar score of < or =3 and initial pH is less than 7.2) at NICU in Dongsan Medical Center were enrolled. An EEG was recorded and analyzed within three days of life and divided into two groups - group 1(normal or focal change on EEG) and group 2(generalized abnormal EEG). Between the two groups, clinical courses and neurologic outcomes were compared. RESULTS: Fifteen infants(60%) were group 1 and ten infants(40%) were group 2(polyspikes, burst- suppression, generalized low voltage). Associated maternal disease, days of hospitalization, need for ventilator support, delay of oral feeding and convulsion duration are significantly higher and longer in group 2. Also, poor neurologic outcome(expire, developmental delay) was significantly higher in group 2(60%) than group 1(13.3%). CONCLUSION: Thus, the early neonatal EEG in asphyxiated newborn can be a predictable diagnostic tool in assessment of neurologic outcome.
Apgar Score ; Asphyxia ; Electroencephalography ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mortality ; Seizures ; Survivors ; Ventilators, Mechanical

No abstract available.
Melanoma ; Nevus

No abstract available.
Osteoarthropathy, Primary Hypertrophic* ; Peptic Ulcer* ; Polyps* ; Stomach*

Renal vein thrombosis is a rare, renal disease in adults that is related to hypercoagulability. We experienced a case of renal vein thrombosis in a 30-years old woman who presented with fever, chills and left flank pain after delivery. She was treated with catheter-directed thrombolytic therapy and oral anticoagulants.
Adult ; Anticoagulants ; Chills ; Female ; Fever ; Flank Pain ; Humans ; Pregnancy ; Renal Veins* ; Thrombolytic Therapy ; Thrombophilia ; Thrombosis*

Purpose: The purpose of this study is to find out the meaning of self-care experiences of family members of mentally ill patients and describe its essential structure. Methods: The Giorgi's phenomenological research methodology was used. Six families participated in this study. In-depth individual interviews were used to collect data from October to December in 2021. Results: Five clusters of themes were identified. They were “Selfless life”, “Life on shaky grounds”, “Attempts to escape from the suffering”, “Moving forward on self-care path”, and “Happiness blooming in being together”. Conclusion The findings suggest that mental health care professionals should provide educational programs to enable families of patients with mental illness to recognize the necessity for self-care and discover ways to take care of themselves. In addition, it is necessary to develop policies to expand patient management services at mental health welfare centers so that families of patients with mental illness can secure time for self-care.

Purpose: As the daily life experiences of community-dwelling people with mental disabilities are closely correlated to mental health recovery, this study aimed to analyze their daily life experiences in depth to determine their significance. Method: Participants included eight community-dwelling people with mental disabilities. A total of 12 in-depth interviews were conducted once or twice per participant. The collected data were analyzed using the phenomenological analysis method described by Giorgi. Results The daily life experiences of community-dwelling people with mental disabilities were categorized into the following four components: “encountering shocking reality in the outside world”, “life tied down by the mental illness”, “happiness and gratefulness encountered in daily life”, and “wishing for a change and self-sustaining life”. Conclusion: This study found that the recovery and welfare of community-dwelling people with mental disabilities were promoted and that these patients made necessary efforts to become a member of the local community. These findings could be used as a reference for establishing social welfare policies which enable people with mental disabilities to participate as functioning members of the community that facilitate the prevention of relapse, to promote their integration into the community. Furthermore, the present results will contribute to the development of nursing intervention programs to promote recovery and prevent relapse, to ultimately establish a mental health management system.

BACKGROUND: Somatosensory evoked potential (SSEP) has been used to help minimize neurologic morbidity during spinal surgery. But, SSEP is affected by various factors, namely technical errors, anesthetics and physiologic aspects (systemic blood pressure, temperature, blood gas tensions). We experienced 40 cases of spinal surgery done with total intravenous anesthesia under SSEP monitoring. We reviewed these cases with the availability of total intravenous anesthesia during SSEP monitoring. METHODS: Forty patients, ASA class I-II, free of neurologic disease and scheduled for elective spinal surgery were randomly selected for the study. All of the operations were performed under general anesthesia employing the method of total intravenous anesthesia with propofol and fentanyl, and monitored by SSEP. We recorded latency and amplitude of SSEP in the pre-induction, post-induction, during-instrument insertion and post-distraction periods. RESULTS: There were no statistical differences in latencies among pre-induction, post-induction, screw insertion and post-distraction period. The amplitude of the post-induction period was statistically higher than pre-induction period (p<0.05), but there were no differences in other periods. None of cases showed abnormal findings (i.e., delay of latency over 10% or decrease of amplitude over 50%). CONCLUSIONS: SSEP monitoring may be helpful in identifying potentially neurologically threatening surgical maneuvers during spinal surgery. To achieve better outcomes, we should consider the effects of various factors on SSEP. Total intravenous anesthesia may be useful method, which has lifter influence on SSEP monitoring.
Anesthesia, General ; Anesthesia, Intravenous* ; Anesthetics ; Blood Pressure ; Evoked Potentials* ; Evoked Potentials, Somatosensory ; Fentanyl ; Humans ; Propofol

BACKGROUND: Many methods are available for the monitoring of spinal cord injury during an operation. During anesthesia, somatosensily evoked potentials (SSEP) may undergo substantial changes in the latencies and amplitudes which may be interpreted as pathological. It is essential for the anesthesiologist to know the potential interactions between anesthetic drugs and neurophysiologic responses during operation. The depressant effect of inhalation agents on the central nervous system exceeds commonly used intravenous anesthetics. Therefore, intravenous anesthesia is preferred to inhalation agents. This study was designed to compare the effects of intravenous anesthetics (propofol and fentanyl) and inhalational anesthetics (enflurane and nitrous oxide) used in the operation room. METHODS: According to the inclusion criteria of ASA I-II, 40 patients who were free of neurologic disease with electric abdominal operations were randomly selected. The baseline of the SSEPs were recorded with stimulation of the posterior tibial nerve at the ankle. After obtaining the baseline (preinduction) of the SSEPs, intravenous anesthetics (propofol 10 mg/kg/h, fentanyl 1 2 microgram/kg) and inhalational anesthetics (end tidal enflurane concentration 1.0 vol %, 50% nitrous oxide in oxygen) were administered. 30 minutes after induction (steady state), additional SSEPs were recorded. Mean arterial pressure, heart rate, temperature and arterial blood carbon dioxide tension were monitored. RESULTS: There were no significant differences in the baseline of SSEPs between the intravenous anesthetics group and the inhalational anesthetics group. There were no significant differences in latencies and amplitudes between the preanesthesia state and the postanesthetia state in the intravenous anesthetics group. But the inhalational anesthetics group revealed prolonged latencies in the postanestesia state as compared with their preanesthesia state. CONCLUSIONS: The above findings suggest that the use of intravenous anesthetics can be beneficial to intraoperative SSEP monitoring for possible damage to the central nervous system during operations.
Anesthesia ; Anesthesia, Intravenous ; Anesthetics* ; Anesthetics, Intravenous ; Ankle ; Arterial Pressure ; Carbon Dioxide ; Central Nervous System ; Enflurane ; Evoked Potentials* ; Fentanyl ; Heart Rate ; Humans ; Inhalation ; Nitrous Oxide ; Spinal Cord Injuries ; Tibial Nerve

Dumping syndrome is a known complication of gastric surgery in adults, but a very rare disease in the pediatric population. We report on a case of dumping syndrome in a 19-month-old child, who underwent gastrojejunal feeding tube insertion for the treatment and prevention of gastroesophageal reflux and frequent aspiration pneumonia. At 17 months of age, 2 months after the beginning of gastrojejunal tube feeding, postprandial diaphoresis, palpitation, lethargy, bloating, and diarrhea occurred, and a single episode of convulsion with hypoglycemia were noted. Early and late dumping syndrome was confirmed by an abnormal oral glucose tolerance test with early onset hyperglycemia followed by delayed onset hypoglycemia. Diet therapy including uncooked corn starch then improved the postprandial diaphoresis, abnormal glucose levels, and her nutritional status. We conclude that dumping syndrome may be considered as a complication of gastrojejunal tube feeding in a child.
Adult ; Child* ; Diarrhea ; Diet Therapy ; Dumping Syndrome* ; Enteral Nutrition* ; Gastroesophageal Reflux ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Hypoglycemia ; Infant ; Lethargy ; Nutritional Status ; Pneumonia, Aspiration ; Rare Diseases ; Seizures ; Starch ; Zea mays

No abstract available.
Diabetes Mellitus, Type 2* ; Humans