No abstract available.
Chlorambucil* ; Nephrotic Syndrome*

The recovery process of brain damage caused by an acute severe cerebral hypoxia has been reported in various literatures. And the possibility of complete recovery of such case was said to be good in younger age group than in adult's group. We experienced a case of cardiac arrest of a 12 year old girl during halothane anesthesia induction and the cardiac and pulmonary resuscitation was succeeded promptly. But the hypotensive period persted for few minutes before the diagnosis was made. The condition of the patient after the resuscitation was good except that her unconsciousness state persisted unusually. The proposed appendectomy performed uneventfully and the anesthesia recovery of the patient was carefully observed in our I.C.U. The uncoscious state lasted for 2 days with agitated movements of legs, EEG showed abnormal, irregular patterns but showed no signs of damage of gobus pallidum and putamen. During the first month, the order of recovery of cerebral function was comatous state, swallowing, eating, and urination. The cerebellar dysunction was prominent. Then recovery of amnesia and defection followed. Speech and gate started to regain in the 26 and 36 post-operative day respectively. Writing function started recover quickly with the recovery of speech function, which occurred in 4 to 6 post-operative months. Recovery of intelligence was slowest and gradually reached to the intelligent level of 11 year old child in one year. It was found the primitive function recovered first and the highly cultivated function recovered last.
Amnesia ; Anesthesia* ; Appendectomy ; Brain* ; Child ; Deglutition ; Diagnosis ; Dihydroergotamine ; Eating ; Electroencephalography ; Female ; Halothane ; Heart Arrest* ; Humans ; Hypoxia, Brain ; Intelligence ; Leg ; Putamen ; Resuscitation ; Unconsciousness ; Urination ; Writing

No abstract available.
Anemia, Iron-Deficiency* ; Humans ; Infant* ; Iron*

Since Dongboo City Hospital cares patients with medicaid and poor socio-economic status in large percentage, we analized all the newborns delivered at the hospital from 1984 to 1992 by their birth weights, gender, gestational age and their Medical Care System. We found our babies?mean birth weight was lower than National standard mean birth weight of 1975 and 1985 (published by KPA) and also lower than other reported studies. But the fact than mean birth weight has been increasing since 1990 is encouraging.
Birth Weight* ; Gestational Age ; Hospitals, Urban* ; Humans ; Infant, Newborn ; Medicaid ; Parturition*

The isolation of fetal cells from maternal circulation has the potential to allow relativelyself prenatal diagosis for all pregnant women. The present technology, however, has notreached the accuracy required for clinical diagnosis because of maternal cell contaminationSo we published a new method for enrichment of nRBC in a fetal cell isolation(1996).In this study, attempted to FISH analysis of nRBC which was isolated by our ownmethods. We evaluated the efficiency of FISH.As the results, we have successfully used FISH on enriched nRBC.We were able to identified 2 abnormal fetus which were confirmed by conventionalcytogenentic study as Down syndrome(Fig.1) and Klinefeltre syndrome(Fig.2). And thesensitivity and specificity for FISH was 86%(49/57) and 92.3%(36/39), respectively.According to our results, fetal cell analysis by FISH can be reliable used for prenatalaneuploidy diagnosis. However, the problems of enrichment of the fetal cell and FISH probeor condition should be over come before analyze.
Aneuploidy ; Diagnosis ; Erythroblasts* ; Female ; Fetus ; Fluorescence* ; Humans ; Pregnant Women ; Sensitivity and Specificity

This is a report of anesthesia for five cases of renal transplantation which was performed between February 1969 and August 1969 at St. Mary's Hospital, Catholic Medical College, Seoul, Korea. General of renal insufficiency of the operated cases were described. Operative technique were unilateral nephrectomy for three cases and bilateral nechprectomy with splenectomy for 2 cases ; Anesthesia was induced with epontol (propanidid) 250mgs i.v. and 4% halothane-oxygen and maintained with 1% halotbane-oxygen which was supplemented by nitrous oxide occasionally. 6% dextrose and lactated-Ringer's solution were infused. For transfusion, whole blood was given to replace the operative blood loss. Dextran was also used to maintain adequate blood volume. Shortly before anastomosis of renal and femoral vessels, patients were haparinized. Fluids and electrolytes balance were studied pre-and post-operatively. Preoperatively, uremia and hyperpotassemia was corrected by several hemodyalysis. Urinary output after surgery showed a marked degree of diuresis up to 1800 ml/hr until second post-operative day. The special concern of anesthesia for kidney transplantation were: 1. Patients were suffering from severe uremia and metabolic disterbances. 2. Acidosis and hyperpotassemia should be corrected before surgery by hemo-or peritoneal dialysis. 3. Immunosuppressive agents made the patient less resistant to infection. 4. Anemia and hydrops was difficult to be corrected before surgery. 5. Muscle relaxants of choice were depolarizing agents, because of impaired renal excretion.
Acidosis ; Anemia ; Anesthesia* ; Blood Volume ; Dextrans ; Diuresis ; Edema ; Electrolytes ; Glucose ; Humans ; Hyperkalemia ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Korea ; Nephrectomy ; Nitrous Oxide ; Peritoneal Dialysis ; Propanidid ; Renal Insufficiency ; Seoul ; Splenectomy ; Uremia

In this paper, we present some results from an experimental web-based Problem-Based Learning(PBL) course, which was offered to 64 medical students in the first grade at Konkuk university for 7 weeks. For the course, we developed a web-based PBL module, which is composed of three sections. The first section includes the 8 stages of problem probing and solving in patient's care. In every stage, the students can browse all the data for the problem solving. The second section contains some problems for evaluating the academic achievement of the students who successfully passed in the first section. In the third section, some questionnaires are presented to survey the students response. The followings are the results. 1. Average score of the first section was 64.1+/-13.2. Most students participated in the course with integrity, and especially seven students(11%) were remarkable in their clinical reasoning. 2.The student's computer skill did not largely affect their academic achievements. However, it is desirable for the students to learn basic computer usage in advance. 3.A few students attended to the discussion through bulletin board facilities. Considering the importance of discussion in PBL, we need to devise a new way of attracting students in the discussion. 4. The survey showed that sixty five percent of the students thought that the lecture was effective and ninety one percent of them that it would be better if it is offered as a regular course during summer or winter vacations. Seventy five percent of students became to realize the importance of basic sciences such as biochemistry and physiology after this course. 5. There were many students who complained about the malfunctioning of the system. The system should be modified to be more reliable and robust. In conclusion, the web-based PBL course provided an effective way of learning in medical education. It also turned out to be used as an alternative of traditional PBL and especially useful for self study.
Biochemistry ; Education, Medical ; Humans ; Learning ; Physiology ; Problem Solving ; Problem-Based Learning* ; Students, Medical ; Surveys and Questionnaires

BACKGROUND: The presence of late potentials on the signal-averaged electrocardiography (SAECG) is predictive of ventricular tachycardia and sudden cardiac death. We investigated the acute effect of HD on the SAECG in patients with end-stage renal disease (ESRD). METHODS: Twenty HD patients with normal sinus rhythm on a routine ECG were enrolled. SAECGs were recorded immediately before, within 30 minute after, and then 24 hour after the completion of HD. Serum electrolyte, BUN, calcium, echocardiogram and body weight were examined before and after the HD. RESULTS: Positive late potentials on SAECG were detected in 8 patients (40%) before HD, 12 patients (60%) at 30 minute after HD, and 5 patients (25%) at 24 hour after HD. There was a significant change in QRSd (QRS duration) after HD: (110.3+-9.7 msec before HD; 112.3+-9.3 msec at 30 minute after HD; 109.5+-8.6 msec at 24 hour after HD) (p<0.05). The reduction of serum potassium was greater in positive late potential (n=12) than in negative late potential group after HD (n=8) (p<0.05). A significant negative correlation was seen between the changes of dialysis-induced serum total CO2 and QRSd changes (r=-0.534, p<0.05). CONCLUSION: SAECG parameters tended to be aggravated after HD in patient with ESRD. Prolongation of QRSd after HD could be explained by the changes of potassium and bicarbonate.
Body Weight ; Calcium ; Death, Sudden, Cardiac ; Electrocardiography* ; Humans ; Kidney Failure, Chronic* ; Potassium ; Renal Dialysis* ; Tachycardia, Ventricular

We experienced a case of chronic fibrosing pancreatitis in an 18/12-year-old girl, which was idiopathic because there were no familial back ground, no cystic fibrosis of pancrease, no ductal anomalies and obstruction. The patient presented intermittent colicky abdominal pain and progressive obstructive jaundice, but T-tube drainage and removal of the lymph nodes around the common bile duct relieved her symptoms and disease process. This seems to be the first case reported in a Korean child. Idiopathic fibrosing pancreatitis should be considered in the differential diagnosis of abdominal pain with obstructive jaundice in children.
Abdominal Pain/complications ; Female ; Fibrosis ; Humans ; Infant ; Jaundice, Chronic Idiopathic/complications ; Pancreatitis/complications/*pathology

BACKGROUND/AIMS: This study assessed the antibiotic resistance organisms isolated from the blood and bile of acute cholangitis and evaluated risk factors associated with them and their impact on clinical outcomes. METHODS: The identities and antibiotic resistance profiles of bacteria isolated from 433 cases of acute cholangitis from 346 patients were analyzed. Risk factors and the outcomes of patients infected with them were assessed. RESULTS: Microorganisms were isolated from 266 of 419 blood cultures and 256 of 260 bile cultures. Isolates from bile and blood were identical in 71% of the cases. A total of 20 extended spectrum-beta-lactamase (ESBL)-producers and 4 carbapenemase-producing organisms were isolated from blood, and 34 ESBL-producers and 13 carbapenemase-producers were isolated from bile. Sixty-four (14.8%) cases were infected with any one of these bacteria isolated from blood or bile. Risk factors associated with them in blood were nosocomial infection and prior biliary intervention. In bile, indwelling biliary device was a risk factor associated with them. Antibiotic-resistant bacteria were associated with mortality, independent of other prognostic factors. CONCLUSIONS: ESBL or carbapenemase-producing bacteria were frequently isolated in acute cholangitis patients especially with prior biliary intervention and nosocomial infection. Isolation of antibiotic-resistant bacteria was an independent risk factor of mortality.
Bacteria ; Bacterial Proteins ; beta-Lactamases ; Bile ; Cholangitis ; Cross Infection ; Drug Resistance, Microbial ; Humans ; Risk Factors