No Abstract available.
Cross Infection* ; Korea*

PURPOSE: An experimental study was carried out to evaluate the morphological changes in the blood brain barrier and neighbouring brain tissue caused by Gd-DTPA in uremia-induced rabbits. MATERIALS AND METHODS: Bilateral renal arteries and veins of ten rabbits were ligated. Gd-DTPA(0.2 mmol/kg) was intravenously injectedinto seven rabbits immediately after ligation. After MRI, they were sacrificed 2 or 3 days after ligation in orderto observe light and electron microscopic changes in the blood brain barrier and brain tissue. RESULTS: MRIfindings were normal, except for enhancement of the superior and inferior sagittal sinuses on T1 weighted imagesin uremia-induced rabbits injected with Gd-DTPA. On light microscopic examination, these rabbits showed perivascular edema and glial fibrillary acidic protein expression ; electron microscopic examination showed separation of tight junctions of endothelial cells, duplication/rarefaction of basal lamina, increased lysosomes of neurons with neuronal death, demyelination of myelin, and extravasation of red blood cells. Uremia-induced rabbits injected with Gd-DTPA showed more severe changes than those without Gd-DTPA injection. CONCLUSION: Injuries to the blood brain barrier and neighbouring brain tissue were aggravated by Gd-DTPA administration inuremia-induced rabbits. These findings appear to be associated with the neurotoxicity of Gd-DTPA.
Animals ; Basement Membrane ; Blood-Brain Barrier* ; Brain Injuries ; Brain* ; Demyelinating Diseases ; Edema ; Endothelial Cells ; Erythrocytes ; Gadolinium DTPA* ; Glial Fibrillary Acidic Protein ; Ligation ; Magnetic Resonance Imaging ; Myelin Sheath ; Neurons ; Rabbits* ; Renal Artery ; Tight Junctions ; Veins

The cardiac function of the patients with chronic renal failure, who have had routine hemodialysis for long period is influenced by many factors including hypertension, anemia, artherosclerosis, interdialytic fluid collection and acidosis. Also the fluid shifts that occur during dialysis can alter left ventricular loading conditions. Hemodialysis may also influence left ventricular contractility by virture of its ability to correct electrolyte imbalances, BUN, hematocrit and concentration of inotrophics. Ten patients with chronic renal failure, who have hemodialysis during more than 6 months were studied for the effect of hemodialysis on left ventricular function through echocardiography. 1) Body weight and systolic blood pressure were decreased(P<0.05) and diastolic blood pressure mean arterial blood pressure and heart rate did not increased significantly. 2) Serum calcium increased and BUN and serum potassium decreased significantly(P<0.05). 3) The prolonged preejection period, decreased left ventricular ejection time, stroke volume, endsystolic wall stress and increased rate corrected velocity of circumferential fiber shortening, shortening fraction had statistical significance. In conclusion, hemodialysis can improve cardiac function as decreased preload and increased left ventricular contractility from the patients with chronic renal failure.
Acidosis ; Anemia ; Arterial Pressure ; Blood Pressure ; Body Weight ; Calcium ; Dialysis ; Echocardiography ; Fluid Shifts ; Heart Rate ; Hematocrit ; Humans ; Hypertension ; Kidney Failure, Chronic* ; Potassium ; Renal Dialysis* ; Stroke Volume ; Ventricular Function, Left*

The study was undertaken to evaluate the effect of major blood components on the CT number. The CT numbers according to the various levels of hematocrit, total protein and cholesterol were checked and analysed by the dilution of pack cell, plasma and 184 complete blood cell count samples under same scanning conditions. In case of normal protein and cholesterol level(33 samples), the CT number was increased about 5.5 hounsfield unit according to 10% increase of hematocrit level: and In case of normal hematocrit and cholesterol level(39 samles), the CT number was increased about 3.5 hounsfield unit according to 1gm% increase of protein level. CT number changes were not predictable according to the changes of cholesterol level(34 samples). From these results, we concluded that major blood components should be considered in the CT number analysis of tissue.
Blood Cell Count ; Cholesterol ; Hematocrit ; Plasma Cells

PURPOSE: It is widely known that allergic diseases progress through an allergic march. However, there have not been any recent reports in Korea on how the diseases progress. METHODS: Parents who visited one of the Pediatric Allergy Clinics of four university hospitals in Seoul with a child under the age of 6 years during the period from May 1-30, 2006 were asked to complete a questionnaire. RESULTS: A total of 229 parents answered the questionnaire about their children, of which 122 were male and 107 were female. The most common allergic disease before 2 years of age was atopic dermatitis (79%). Meanwhile, in 2- to 4-year age group, allergic rhinitis (38%) and asthma (37%) were predominant. The most common allergic disease in the 4- to 6-year age group was asthma (72%), followed by allergic rhinitis (64%). Seventy-three percent of the children had a family history of allergic disease, most often in the fathers (39%). Among patients with allergic rhinitis, 50% had experienced asthma in their earlier days and 30% had experienced atopic dermatitis. In addition, 57% of the children with asthma had suffered from atopic dermatitis. Parents believed that asthma was the most serious allergic disease. CONCLUSION: In the present study, allergic disease showed a tendency to march from atopic dermatitis to asthma and then to allergic rhinitis. Early diagnosis and treatment of atopic dermatitis is, therefore, considered important for prevention of the allergic march.
Asthma ; Child ; Dermatitis, Atopic ; Early Diagnosis ; Fathers ; Female ; Hospitals, University ; Humans ; Hypersensitivity ; Korea ; Male ; Parents ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial

PURPOSE: Our examination was designed to determine the diagnostic properties of the cutoff point for the prediction of bacteremia in febrile children less than 3 years of age. Cutoff point is the value that simultaneously maximizes both sensitivity and specificity. METHODS: We conducted a retrospective study of febrile children, less than 3 years of age, who clinically have no identifiable source of fever. Peripheral blood leukocyte count(WBC), absolute neutrophil count(ANC), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were measured at the same time. All patients received blood culture, urine culture and/or CSF culture. Bacterial infection was defined as single pathogen isolated from the CSF or blood or a urinary tract infection (UTI). Patients were dichotomized into two groups: those with bacterial infection and no bacterial infection. We analyzed the characteristics of the children in the two groups. RESULTS: Seventy-one patients(44 males; 27 females) were enrolled in the study. Twenty patients (28%) had a serious bacterial infection(twelve urinary tract infection, five bacteremia, three meningitis) and fifty-one(72%) had no serious bacterial infection. WBC, ESR and CRP were significantly different between the two groups(P<0.05). The cutoff point of WBC, ESR and CRP were 20,000/mm3, 30 mm/hr and 3.0 mg/dL, respectively. The sensitivity and specificity of each cutoff point were WBC(75%, 75%), ESR(79%, 68%) and CRP(83%, 77%), respectively. CONCLUSION: These data show the ability of predictors to identify febrile children less than 3 years of age with bacterial infection. Febrile children who reach the cutoff point must be treated intensively and those who do not reach the cutoff point can be carefully managed without administering antimicrobial agents.
Anti-Infective Agents ; Bacteremia ; Bacterial Infections* ; Blood Sedimentation ; Child* ; Fever ; Humans ; Leukocytes ; Male ; Neutrophils ; Retrospective Studies ; Sensitivity and Specificity ; Urinary Tract Infections

Specific apolipoprotein (apo) E genotype has been suggested as a risk factor for atherosclerosis in the general population. Lipid metabolism is known to be modulated by apo E genotype. In this study, we measured apo E genotype, lipoprotein (a)[Lp (a)], apo A phenotype and other lipoproteins in 50 CAPD patients, and evaluated the association of lipid parameters with atherosclerotic cardiovascular disease. Dipyridamole thallium scan with SPECT and ankle- arm blood pressure index (AABI) were performed in all the subjects. The patients who had positive finding in at least one of the two test were considered to have atherosclerotic cardiovascular disease [CVD (+)]. Fifteen patients had evidence of cardiovascular disease. Serum Lp (a) concentration (median; interquartile range) of CVD (+) patients (n=15, 62.0 mg/dl; 29.5-82.3) was not different from that of CVD (-) patients (n=35, 65.1mg/dl; 34.3-89.9). The frequency distribution of apo (a) phenotype of CVD (+) patients did not differ from that of CVD (-) patients. In addition, there were no differences of other lipoproteins levels and lipid profiles between two group. However, significant difference in the frequency distribution of apo E genotype (E2; 6.7 vs 20%, E3; 40 vs 68.6%, E4; 53.3 vs between CVD (+) and CVD (-) patients. After stratifying the subjects according to the apo E genotype, we observed no difference of lipid profiles, apolipoproteins and Lp (a) concentration in E2, E3, E4. Multivariate regression analysis of risk factors for CVD revealed age and the presence of apo E4 phenotype as independent risk factors of atherosclerotic cardiovascular disease. In conclusion, Apo E4 genotype could be an independent risk factor of atherosclerotic cardiovascular disease in CAPD patients.
Apolipoprotein E4 ; Apolipoproteins E ; Apolipoproteins* ; Arm ; Atherosclerosis ; Blood Pressure ; Cardiovascular Diseases* ; Dipyridamole ; Genotype ; Humans ; Lipid Metabolism ; Lipoproteins ; Peritoneal Dialysis, Continuous Ambulatory* ; Phenotype ; Risk Factors ; Thallium ; Tomography, Emission-Computed, Single-Photon

No Abstract Available.
Female ; Hormone Replacement Therapy* ; Humans ; Life Style* ; Osteoporosis*

BACKGROUND: In a noisy hospital setting, it is not easy to induce hypnosis or sedation calmly. Although the noise stress has been neglected, it seems to disturb a patient's sleep or induction of sedation. Therefore, we tried to evaluate the effects of loud operating room (OR) background noise on bispectral index (BIS) during monitored anesthesia care (MAC) by using an audiometer and BIS monitor. METHODS: Thirty adult patients (ASA class I) were scheduled two times for nasal or dental procedures at an interval of two or three days. In a randomized, cross-over study design, we prospectively compared the BIS values according to the loudness of OR noise in two different depths of sedation during MAC. Propofol target controlled infusion (TCI) was started at a propofol target concentration (CT) 2.0 microgram/ml using a DiprifusorTM with flash mode until a BIS 80 and/or a modified Observer's Assessment of Alertness/Sedation (mOAAS) score of 4 (group 1), and BIS 75 and/or mOAAS score 3 (group 2) was obtained. We evaluated the effect site concentrations and the elapsed time and checked the BIS at 50, 80, 110, and 120 dB of sound pressure level (SPL) in both groups. RESULTS: The BIS at 80, 110 and 120 dB of SPL in group 1 was significantly increased compared to those at 50 dB (P < 0.05). Similarly, the BIS at 110 and 120 dB of SPL in group 1 was significantly increased compared to those at 80 dB (P < 0.05). The patients in their twenties were most susceptible to loud OR noise during sedation. CONCLUSIONS: The loud OR background noise might be possible to interfere with induction of sedation to a degree, which was more noticeable on light to moderate sedation than for deep sedation.
Adult ; Anesthesia* ; Conscious Sedation ; Cross-Over Studies ; Deep Sedation ; Humans ; Hypnosis ; Noise* ; Operating Rooms* ; Propofol ; Prospective Studies

BACKGROUND: Physical activity and calcium nutriture with reproductive endocrine status are primary controller of bone remodelling activity. There are differences in impact of exercise on early menopausal bone ; late menopausal bone. There are possibility of different effect of calcium intake on bone mass among different life stage. The aim of this study was to elucidate whether the relation between lifestyle and bone mineral density varied with life stages. METHODS: We examined bone mineral density and took questionnaires related to lifestyle of 1,698 women aged 49~54 years old who lived in ulsan from July 1999 to Dec. 1999. We selected 731 healthy subjects without medical conditions or lifestyle factors known to affect bone metabolism. RESULTS: In 6~10 years postmenopausal women, those with calcium intake of more than 600 or 800mg /day showed significantly greater BMD. In postmenopausal women , those daily consumption of milk showed greater BMD. But it is not significantly. In premenopausal women with regular menstruation, those who took regular exercise showed significantly greater BMD than those who did not. Working hours is not related with BMD. CONCLUSIONS: Our study showed that the relation between calcium intake or physical activity and BMD differed with life stages. It was suggested that life stages should be taken into consideration to perform lifestyle modifications for the prevention and management of osteoporosis.
Bone Density* ; Calcium* ; Female ; Humans ; Life Style ; Menopause ; Menstruation ; Metabolism ; Milk ; Motor Activity* ; Osteoporosis ; Ulsan ; Surveys and Questionnaires