No abstract available.
Fibronectins* ; Granulation Tissue* ; Wound Healing* ; Wounds and Injuries*

We report a case of the accidental intravenous administration of a large dose of magnesium sulfate during cesarean section. A 41-year-old woman, at 33 weeks gestation, with pregnancy-aggravated hypertension, headache and generalized edema presented in acute labor and showed fetal bradycardia on a nonstress test. Laboratory tests demonstrated an increased level of magnesium (5.4 mg/dl). A cesarean section was performed under general anesthesia with O2-N2O-enflurane and vecuronium. After delivery 2,000 mg of magnesium sulfate was mixed with the lactated Ringer's solution 1,000 ml and 550 ml administered to the patient. After noticing the accidental infusion of the magnesium sulfate, we replaced the lactated Ringer's solution with normal saline 1,000 ml and performed arterial blood gas analysis, checked serum electrolyte, including Mg2+ and Ca2+, and had monitored depth of muscle relaxation and vital signs. The level of magnesium had increased to 8.9 mg/dl after the accidental magnesium infusion. For about one and half hours after emergence from general anesthesia, she complained of dyspnea and paraparesis of extremities. To treat the hypermagnesemia, 3% calcium gluconate 1,000 mg and furocemide were given intravenously to antagonize magnesium and to increase the urine output. The depth of neuromuscular block was frequently monitored using a nerve stimulator. After conservative treatment, she recovered from the effect of the hypermagnesemia and was discharged on the fifth postoperative day. Anesthesiologists must to keep in mind the preoperative patients' pathophysiologic conditions, check co-administered drugs and the contents of intravenously connected solutions.
Administration, Intravenous* ; Adult ; Anesthesia, General ; Blood Gas Analysis ; Bradycardia ; Calcium Gluconate ; Cesarean Section* ; Dyspnea ; Edema ; Extremities ; Female ; Headache ; Humans ; Hypertension ; Magnesium Sulfate* ; Magnesium* ; Muscle Relaxation ; Neuromuscular Blockade ; Paraparesis ; Pre-Eclampsia ; Pregnancy ; Vecuronium Bromide ; Vital Signs

PURPOSE: To measure the muscle length of the gastrocnemius and soleus during gait in CP patients with an equinus deformity before and after surgery. MATERIALS AND METHODS: Twelve CP patients with an equinus deformity (17 limbs) were examined by gait analysis preoperatively and postoperatively. The patient group was further classified into the TAL and Strayer group according to the surgical technique. The mean age and mean follow-up periods were 14.3 years (5-25 years) and 15.3 months (12.5-18.5 months), respectively. The muscle length of the Gastrocnemius and Soleus was measured during gait using the SIMM program linked to a gait analysis system. RESULTS: The ankle ROM, knee ROM, maximal muscle length and peak-to-peak excursion during gait improved after surgery. There was a significant difference between the preoperative and postoperative measurements (p<0.05), but no difference between the postoperative and control groups (p>0.05). The muscle length of the soleus was elongated during gait after the Strayer procedure. CONCLUSION: Patients with an equinus deformity had a contracted triceps muscle, which was elongated after surgery. These changes were quantified by a comparison of the preoperative and postoperative measurements.
Animals ; Ankle ; Cerebral Palsy ; Contracts ; Equinus Deformity ; Follow-Up Studies ; Gait ; Humans ; Knee ; Muscle, Skeletal ; Muscles

BACKGROUND/AIMS: The QuantiFERON-TB Gold (QFT-G) and QuantiFERON-TB Gold in tube (QFT-IT) assays have been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. The clinical usefulness of these assays for the detection of active extrapulmonary (EP) TB has not been fully defined. The aim of this study was to compare the diagnostic value of these two interferon-gamma assays for EP-TB. METHODS: From June 2007 to August 2010, we evaluated the usefulness of QFT-G (n = 56) and QFT-IT (n = 48) in patients (n = 104) with suspected EP-TB. The diagnostic sensitivity, specificity, postive predictive value (PPV), and negative predictive value (NPV) of QFT-G and QFT-IT, and the cut-off value of QFT-IT were analyzed. RESULTS: EP-TB was diagnosed in 55 (53%) patients. The overall sensitivity, specificity, PPV, and NPV of the QFT-IT assay were 96%, 42%, 62%, and 91%, respectively, and those of the QFT-G test were 81%, 52%, 68%, and 68%, respectively. In subgroup analyses according to infection site, the sensitivity and NPV of QFT-IT were higher than those of QFT-G. Analysis confirmed that the manufacturer's recommended test cut-off value fell within our cut-off value range (0.30-0.45 IU/mL; 95.8% sensitivity, 41.7% specificity). CONCLUSIONS: The QFT-IT assay showed superior sensitivity and NPV, and equivalent specificity, as comparison with the QFT-G test for the detection of Mycobacterium tuberculosis infection. The logistic benefits of the QFT-IT test format should facilitate the diagnosis of EP-TB.
Humans ; Interferon-gamma ; Lymphadenitis ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Spondylitis ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND AND OBJECTIVES: It has been known that various vasoactive agents are involved in the regulation of cardiac function through the modification of the K+ channel activities, including the ATP-sensitive K+ channel (KATP). We examined the effects of several vasoactive agents on the cardiac KATP currents in isolated cardiac myocytes. MATERIALS AND METHODS: Ventricular myocytes were isolated from the hearts of ICR mice by enzymatic digestion. The channel currents were recorded by the excised inside-out and cell-attached patch clamp configurations. RESULTS: In the excised inside-out patches, bradykinin (BRK; 1-10 micrometer) and prostaglandin I2 (PGI; 10-50 micrometer) did not affect the channel activities, whereas the vasodilators increased the attenuated channel activities in the presence of 100 micrometer ATP. BRK and PGI in parallel shifted the dose-response curves of ATP (1-1,000 micrometer), and this inhibited the KATP currents to the right. Endothelin (ET-1; 0.1-1 nM) and leukotriene D4 (LTD; 3-10 micrometer) decreased the channel activities immediately after making the inside-out patches. However, the vasoconstrictors did not affect the attenuated channel activities by ATP. In the cell-attached patches, both BRK and PGI increased the channel activities and these effects were markedly attenuated by glibenclamide (50 micrometer). ET-1 and LTD did not affect the baseline channel activities in the cell-attached patches, but they markedly attenuated the dinitrophenol-induced activities. CONCLUSION: It was inferred that certain vasoactive substances are involved in the regulation of cardiac KATP channel activities, and that bradykinin and PGI2 enhance the channel activities, and ET-1 and LTD4 inhibit the channel activities.
Adenosine Triphosphate ; Animals ; Bradykinin ; Digestion ; Endothelins ; Epoprostenol ; Glyburide ; Heart ; Leukotriene D4 ; Mice ; Mice, Inbred ICR ; Muscle Cells ; Myocytes, Cardiac ; Potassium Channels* ; Potassium* ; Vasoconstrictor Agents ; Vasodilator Agents

OBJECTIVES: The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. METHODS: Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. RESULTS: Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. CONCLUSION: The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.
Anxiety ; Attention Deficit and Disruptive Behavior Disorders ; Checklist ; Child Behavior ; Child* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Nocturnal Enuresis* ; Parents ; Psychopathology ; Social Problems