PURPOSE: The aim of this study is to evaluate the incidence of hyperkalemia and the contributing factors of nonoliguric hyperkalemia in low birth weight infants within 48 hours after birth. METHODS: The incidence of nonoliguric hyperkalemia and difference of clinical features between hyperkalemia (>6.7 mEq/L) and normokalemia (< or =6.7 mEq/L) groups were determined by reviewing medical records of 196 low birth weight infants who were born in Hanyang university hospital between Oct. 2001. and Jul. 2004. We analized the serum level of sodium, potassium, fluid intake, urine output, pH of blood gas and others. RESULTS: Among 196 infants, 17 infants was hyperkalemia developed in 48 hours after birth. In that cases, 10 infants were showed EKG abnormalities, such as ventricular tachycardia. In all cases, birth weight, gestational age, Apgar score, usage of surfactant, urine output, BUN and creatinine were significant. In A group gestational age, urine output, BUN, creatinin were significant, in B group BUN, creatinine were significant, in C group BUN were significant between hyperkalemia and normokalemia. Six infants with hyperkalemia died as a result of hyperkalemia induced cardiac arrhythmia. CONCLUSION: Hyperkalemia frequently occurred extremely premature infants. But hyperkalemia also be developed in low birth weight infants who were not suffered from asphyxia or tissue damage. Serum potassium level should be monitored to avoid life threatening cardiac arrhythmia in low birth weight infant.
Apgar Score ; Arrhythmias, Cardiac ; Asphyxia ; Birth Weight ; Creatinine ; Electrocardiography ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Hyperkalemia* ; Incidence ; Infant* ; Infant, Extremely Premature ; Infant, Low Birth Weight* ; Infant, Newborn ; Medical Records ; Parturition ; Potassium ; Sodium ; Tachycardia, Ventricular

Metaphyseal chondrodysplasia (MCD) is a relatively rare hereditary disease of the skeletal system, in which disproportionate dwarfism sparing the trunk is noted. Among the four subtypes of MCD, the Schmid type is relatively common and shows minimal clinical abnormalities. We report a boy, diagnosed to have MCD, Schmid type, and who was followed-up for 17 years until skeletal maturity, during this period he underwent proximal femoral valgus osteotomies as well as tibial deformity correction with lengthening and femoral lengthening procedures.
Congenital Abnormalities ; Dwarfism ; Follow-Up Studies* ; Genetic Diseases, Inborn ; Humans ; Male ; Osteotomy

Elastic Tissue ; Humans ; Hyperplasia ; Joints ; Mandibular Condyle ; Osteoarthritis ; Rabbits

No abstract available.
Acetylcholine/physiology ; Adult ; Cold Temperature/adverse effects ; Exercise ; Hot Temperature/adverse effects ; Humans ; Male ; Urticaria/diagnosis/*etiology/physiopathology

We report a healthy patient with postpartum headache and neck stiffness which were diagnosed as symptoms of pseudoaneurysm of vertebral artery. She had received a Cesarean section under the spinal anesthesia, and complaint of headache and neck stiffness. Epidural blood patches were done twice, but symptoms persisted. Eight days later, she experienced sensory disturbance and emergent laminectomy was done. When persistent postpartum headache occurs after epidural blood patch, more precise differential diagnosis should be made and considering other possible pathologies.
Anesthesia, Spinal ; Aneurysm, False ; Blood Patch, Epidural* ; Cesarean Section ; Diagnosis, Differential ; Female ; Headache ; Hematoma, Subdural, Spinal* ; Humans ; Laminectomy ; Neck ; Pathology ; Post-Dural Puncture Headache ; Postpartum Period* ; Pregnancy ; Vertebral Artery

PURPOSE: Exaggerated pro-inflammatory reactions during the acute phase of Kawasaki disease (KD) suggest the role of immune dysregulation in the pathogenesis of KD. We investigated the profiles of T regulatory cells and their correlation with the clinical course of KD. METHODS: Peripheral blood mononuclear cells were collected from 17 KD patients during acute febrile and subacute afebrile phases. T cells expressing CD4, CD25, and Foxp3 were analyzed using flow cytometry, and the results were correlated with the clinical course of KD. RESULTS: The percentage of circulating CD4+CD25highFoxp3+ T cells among CD4+ T cells was significantly higher during the subacute afebrile phase than during the acute febrile phase (1.10%+/-1.22% vs. 0.55%+/-0.53%, P=0.049). Although levels of CD4+CD25lowFoxp3+ T cells and CD4+CD25-Foxp3+ T cells were only slightly altered, the percentage of CD4+CD25+Foxp3- T cells among CD4+ T cells was significantly lower during the subacute afebrile phase than during the acute febrile phase (2.96%+/-1.95% vs. 5.64%+/-5.69%, P=0.036). Consequently, the ratio of CD25highFoxp3+ T cells to CD25+Foxp3- T cells was higher during the subacute afebrile phase than during the acute febrile phase (0.45%+/-0.57% vs. 0.13%+/-0.13%, P=0.038). CONCLUSION: Decreased CD4+CD25highFoxp3+ T cells and/or an imbalanced ratio of CD4+CD25highFoxp3+ T cells to CD4+CD25+Foxp3- T cells might play a role in KD development. Considering that all KD patients were treated with intravenous immunoglobulin (IVIG), recovery of CD4+CD25highFoxp3+ T cells during the subacute afebrile phase could be a mechanism of IVIG.
Flow Cytometry ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome ; T-Lymphocytes

Benign metastasizing leiomyoma is usually detected years after hysterectomy or myomectomy and characterized by well-circumscribed, singular or, often, multiple nodules. The patient was a 33-year-old woman who presented with cough. She underwent a myomectomy for a large uterine leiomyoma 9 years ago. And now she has recurrent uterine myoma. Multiple nodular lesions in both whole lung fields were incidentally found on a routine chest radiograph. Video-assisted thoracoscopy (VATs) was performed. The resected small nodular lesions composed of extremely well- defferentiated smooth muscle cells with collagen. On immunohistochemical stain, they are positive for smooth muscle markers (desmin and actin). There is no definite evidence of malignancy. Therefore, these multiple nodules are considered as benign metastasizing leiomyoma from a uterine leiomyoma. We report this case with review of literatures.
Adult ; Collagen ; Cough ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Lung Neoplasms ; Lung* ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Radiography, Thoracic ; Thoracoscopy

A rare gastric mucosal lesion characterized by Russell body-containing plasma cell infiltration is termed as Russell body gastritis. This lesion is highly suggested to be correlated with Helicobacter pylori-induced chronic gastritis, and often misdiagnosed as mucosa-associated lymphoid tissue lymphoma, signet ring cell carcinoma, plasmacytoma, or xanthoma. However, Russell body gastritis is easily discriminated by its polyclonal immunoreaction to immunoglobulin light chains contrary to monoclonal immunoreaction of neoplastic disease. We report here a case of Russell body gastritis associated with H. pylori infection, which disappeared after H. pylori eradication.
Carcinoma, Signet Ring Cell ; Gastritis* ; Helicobacter pylori* ; Helicobacter* ; Immunoglobulin Light Chains ; Lymphoma, B-Cell, Marginal Zone ; Plasma Cells ; Plasmacytoma ; Stomach ; Xanthomatosis

Open heart surgery under cardiopulmonary bypass (CPB) in patients with liver cirrhosis is prone to the development of various complications associated with high mortality rates. According to recent studies, patients with advanced cirrhosis (Child-Pugh class B or C cirrhosis) have a significantly higher mortality rate (50-100%) after open heart surgery under CPB. We report the anesthetic management of cardiac surgery using CPB of 61-year-old man with aortic valve regurgitation, tricuspid regurgitation and ventricular septal defect (VSD) who had complicated by liver cirrhosis of Child-Pugh class B. The patient underwent successfully aortic valve replacement, tricuspid valvuloplasty and VSD closure. The use of tranexamic acid and transfusion of fresh whole blood appears to produce beneficial effects for outcome.
Aortic Valve ; Cardiopulmonary Bypass ; Fibrosis ; Heart Septal Defects, Ventricular ; Humans ; Liver ; Liver Cirrhosis ; Middle Aged ; Thoracic Surgery ; Tranexamic Acid ; Tricuspid Valve Insufficiency

Heat-moisture exchanger (HME) is an inexpensive and effective device used to prevent respiratory complications that can be caused by endotracheal tube insertion during general anesthesia. But, HME can increase airway resistance and be occluded by the patient's secretions. Whether a HME could be occluded by clear fluids such as condensate in the airway circuit is not certain yet. In vitro, a case of HME occlusion by normal saline was reported. We report a case of HME obstruction by distilled water came from the heated wire circuit which was unintentionally connected to the HME.
Airway Resistance ; Anesthesia, General ; Hot Temperature ; Porphyrins ; Water