This report is concerned with our clinical experience of 40 cases of anesthesia for open heart surgery at the Department of Anesthesiology, Seoul Adventist hospital during the period between July, 1988 and May, 1990. The results were as follows: 1) Among the 40 cases, 16 cases were congenital heart disease and 24 cases were acguired heart disease. 13 cases were male and 27 were female, Age was varied from 4 years to 71 years and mean was 33.2 years. 2) Morphine and glycopyrrolate were used as premedicants. 3) Thiopental, morphine and fentanly were used as induction agents, were injected singly or in combination. 4) Morphine, fentanyl and N2O were used as anesthetic agents in conjunction with halothane or enflurane. 5) Succinylcholine, vecuronium and pancuronium were used for intubation and maintenance of muscle relaxation. 6) The duration of eardiopulmonary bypass, aortic cross clamp, surgery and anesthesia in acquired heart disease were longer than in congenital heart disease, 7) Overall the mortality rate was 5% and the cause of death were air embolism and respiratory failue.
Anesthesia* ; Anesthesiology ; Anesthetics ; Cause of Death ; Embolism, Air ; Enflurane ; Female ; Fentanyl ; Glycopyrrolate ; Halothane ; Heart Defects, Congenital ; Heart Diseases ; Heart* ; Humans ; Intubation ; Male ; Morphine ; Mortality ; Muscle Relaxation ; Pancuronium ; Seoul ; Succinylcholine ; Thiopental ; Thoracic Surgery* ; Vecuronium Bromide

PURPOSE: The purpose of this study was to analyze the patterns of intervertebral disc enhancement seen in tuberculous and pyogenic spondylitis, and to evaluate their utility in differentiating between the two groups. MATERIALS AND METHODS: Magnetic resonance images obtained in 31 consecutive infectious spondylitis patients (43 discs) in whom intervention occurred due to infected vertebral bodies, were retrospectively analysed. Nineteen of the patients had tuberculosis and 12 were infected by pyogenic organisms. After analysis, the patterns of disc enhancement revealed by contrast-enhanced T1-weighted axial and sagittal MR imaging were classified as of four types: Type I, non-enhancing; Type II, enhancement of the peripheral margin of the disc; Type III, enhancement of the peripheral margin and central area adjacent to the cortical vertebral endplate; Type IV, general enhancement and/or destruction of the disc. RESULTS: There were 19 cases of tuberculous spondylitis involving 28 intervertebral discs, and the enhancement patterns observed were as follows: Type I: n=4, 14%, Type II: n=17, 61%, Type III: n=1, 4%, Type IV: n=6, 21%. Twelve cases of pyogenic spondylitis involved 15 intervertebral discs; the enhancement patterns observed in these cases were as follows: Type I: n=1, 7%, Type II: n=2, 13%, Type III: n=10, 67%, Type IV: n=2, 13%. CONCLUSION: Careful analysis of the patterns of disc enhancement occurring in infectious spondylitis can be useful for differentiating between the tuberculous and pyogenic varieties of this condition.
Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylitis* ; Tuberculosis

In order to investigate the role of adenovirus in diarrheal children, we evaluated 907 children with diarrhea and 193 children without diarrhea for a 22-month. Stools were tested for group A rotavirus antigen and for adenovirus types 40/41 (Ad 40/41) by using ELISA, cell technique and indirect immunofluorescent method. Adenovirus was detected in 10.1% of the diarrheal children and 3.1% of the non-diarrheal children. Ad40/41 was detected in 4.85% of the diarrheal children. Other nonenteric adenovirus was detected in 5.29% of the diarrheal children. In addition, 24% of the adenovirusinfected children excreted rotavirus simultaneously. Rotavirus was found in 57.1% of the diarrheal patients. Among the diarrheal children. 88% of those with adenovirus were younger than 24 months. Although peaks of adenovirus infection were detected in July and Autumn in the study, there is no apparent seasonal trend with adenovirus. The average duration of admission caused by adenoviral infection was 4.9 days and 88% of the cases accompanied by fever. Stool occult blood test revealed positive reaction in 66.3% of the cases and serum aminotransferase activities transiently elevated in 5.4% of the cases. Diarrhea with more than 10 stools per day, vomiting, or fever in adenovirusinfected children were similar with ratavirus, where as the first two manifestions were associated with confection of rotavirus and adenovirus. Nine out of 92 cases(9.8%) of the gastroenteritis caused by adenovirus revealed intussusception. We conclude that Ad40/41 is an important cause of diarrhea among infants and children, and non-enteric adenovirus is considered to be a cause of diarrhea, but their role in diarrheal children should be further studied.
Adenoviridae Infections ; Adenoviridae* ; Candy ; Child* ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Fever ; Gastroenteritis ; Humans ; Infant ; Intussusception ; Occult Blood ; Rotavirus ; Seasons ; Vomiting

Purpose: The prevalence of Group B Streptococcus (GBS) colonization in pregnant Korean women is increasing; however, nationwide studies are lacking. Therefore, we aimed to analyze regional colonization rates and antimicrobial susceptibility for GBS in pregnant Korean women through a nationwide survey. Materials and Methods: From January 2018 to December 2020, data from the Seoul Clinical Laboratories on vaginal swab cultures were retrospectively analyzed to detect maternal GBS carriers. Each swab specimen was inoculated onto a 5% blood agar plate and incubated at 35°C–37°C in a 5% CO 2 incubator for 24 h. GBS isolates were identified using a Microflex MALDI Biotyper. Antimicrobial susceptibility tests were performed using the Vitek 2 automated system. Results: The overall nationwide GBS colonization rate in pregnant Korean women was found to be 10.6% (3578/33721). The maternal GBS colonization rates ranged from 10.5%–10.8% over the 3-year study period. The GBS colonization rates by province, in descending order, were as follows: Jeolla-do, 13.2%; Gangwon-do, 12.0%; Chungcheong-do, 11.8%; Gyeonggi-do, 11.3%; Seoul, 10.2%; and Gyeongsang-do, 9.6%. During the study period, the resistance rates against chloramphenicol, levofloxacin, clindamycin, erythromycin, and tetracycline were 2.6%–2.7%, 18.2%–19.6%, 33.4%–35.7%, 35.6%–36.8%, and 50.5%–53.3%, respectively. Conclusion In pregnant Korean women, GBS colonization rates were in the range of 9.6%–13.2%, with Gyeongsang-do being the lowest and Jeolla-do the highest. The resistance rate against clindamycin was high (33.4%–35.7%). GBS colonization rates during pregnancy should be studied nationwide according to the Centers for Disease Control and Prevention-recommended guidelines with periodic antimicrobial resistance monitoring.

In 2016, external quality assessment trials for urinalysis and faecal occult blood (FOB) were performed with 1,487 participants in Korea. Urine chemistry and FOB tests were performed three and two times, respectively, whereas urine sediment was evaluated once using photography. Urine chemistry tests consisted of pH, protein, glucose, ketone, bilirubin, blood, urobilinogen, and nitrite levels; leukocyte count; specific gravity. The results of the urine chemistry and specific gravity tests showed accuracy rates of >95%. The accuracy rate of urine sediments was low, especially that for transitional epithelial cells and atypical crystals. In the FOB quality test, all reagents showed accuracy rates of >90%, which suggested the improvement of false-positive reaction. In the FOB quantitative test, discrepant results depending on the instrument used was observed. To compensate for the result differences caused by the stool samples, the results should be reported using another unit (µg/g of stool).
Bilirubin ; Chemistry ; Epithelial Cells ; Glucose ; Hydrogen-Ion Concentration ; Indicators and Reagents ; Korea* ; Leukocyte Count ; Occult Blood* ; Photography ; Specific Gravity ; Urinalysis* ; Urobilinogen

BACKGROUND: The UF-100 flow cytometer (Sysmex Co., Japan) and the Iris iQ200 (Iris Diagnostics, USA) are widely used for routine urinalysis in Korea. We compared the diagnostic accuracy of these two automated systems based on the microscopic finding, and evaluated the clinical performance of the automated systems. METHODS: A total of 323 fresh urine samples were selected and analyzed by conventional microscopy and the automation systems, the UF-100 and the iQ200. Quantification for RBCs, WBCs, and bacteria were also evaluated using both automated systems. RESULTS: For 158 of urine sample classified as normal urines, the agreement rate for the UF-100 and the iQ200 was 84.8% (N=134) and 89.9% (N=142), respectively. For 165 of urine samples classified as abnormal urines, the agreement rate for the UF-100 and the iQ200 was 90.9% (N=150) and 81.8% (N=135), respectively. The UF-100 showed a good linearity in the quantitative measurements of RBCs and WBCs. For both systems, false-negative value for WBCs and bacteria were about 30% in abnormal urines. Both systems showed inaccurate results for pathologic casts and bacteria. CONCLUSIONS: We compared the microscopic finding and the primary results of automated systems without user reclassification, and the agreement rate was about 85%. The agreement rate will be improved by deliberating "Review" comments of the instruments.
Automation ; Bacteria ; Iris ; Korea ; Microscopy ; Urinalysis

BACKGROUND: Malignant follicular lesion is not differentiated from benign lesions cytologically. The objective of this study was to assess the rate and the risk of malignancy in thyroid nodules which were cytologically diagnosed as follicular neoplasm by fine-needle aspiration (FNA) cytology. METHODS: All the patients who had undergone surgery with cytological diagnosis of follicular neoplasm from January 1996 through December 2001 in Asan Medical Center were studied retrospectively. Patients' and nodule characteristics were analyzed for factors associated with the presence of cancer. Two hundred and fifteen patients (196 females, 19 males) were included and their mean age was 39.4 years (range: 12~76). RESULTS: About half of the patients (102 out of 215, 47.4%) had malignancy with 29 papillary carcinomas, 57 follicular carcinomas, 15 H rthle cell carcinomas and 1 medullary carcinoma. Previously suggested factors associated with risk for malignancy, such as male gender, large tumor size (> 4 cm) or age of patients (> 45 years), were not associated with increased risk. Diagnosis of H rthle cell neoplasia on FNA was also not associated with increased risk. Only the extremes in age of the patients (below 20 or above 60 years) were associated with increased risk for malignancy. CONCLUSION: In our findings, prevalence of carcinoma in thyroid nodule patients with cytological diagnosis of follicular neoplasm was much higher than those reported. Clinical characteristics, such as male gender, age and nodule size, are not useful predictors for the presence of malignancy. Thyroid nodules with cytological diagnosis of follicular neoplasm warrant immediate surgery.
Adenocarcinoma, Follicular/pathology ; Adenoma, Oxyphilic/pathology ; Adolescent ; Adult ; Age Factors ; Aged ; Biopsy, Needle ; Carcinoma, Medullary/pathology ; Carcinoma, Papillary, Follicular/pathology ; Child ; Female ; Human ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms/*pathology ; Thyroid Nodule/*pathology ; Thyroidectomy ; Thyroiditis, Autoimmune/pathology

BACKGROUND: The associations between preterm labor or premature rupture of membrane (PROM) and urogenital infections of pregnant women are reported. Ureaplasma urealyticum and Mycoplasma hominis are well known as important pathogens of urogenital infections in pregnant women. In routine clinical laboratory, conventional culture for these microorganisms has not been made generally because of the requirements for strict growth condition. MYCOFAST(R) Evolution 2 is an easy and rapid liquid microculture method using metabolism of these microorganisms. Author investigated the relationship between U. urealyticum or M. hominis infections and preterm labor or PROM by MYCOFAST Evolution 2 and PCR. Also it was reviewed that the possibility of substitution of MYCOFAST Evolution 2 for conventional culture method by comparing with PCR methods. METHODS: This study was done on 91 pregnant women. They were composed of two groups; group I(n=48) had full-term delivery and group II(n=43) had preterm labor or PROM before the 37th week.Two cervical swabs were made each time. One was used for MYCOFAST(R) Evolution 2 and the other for PCR. RESULTS: The positivity of U. urealyticum was 39.6% in group Iand 58.1% in group IIby MYCOFAST Evolution 2 and 39.6% and 58.1% by PCR method, respectively. The positivity of M. hominis was 4.2% in group Iand 11.6% in group IIby MYCOFAST Evolution 2 and 4.2% and 7.0% by PCR method, respectively. The positivity of U. urealyticum and M. hominis in group IIwas higher than that in group Ibut was not significant statistically. The concordance rates between two methods were 86.8% for U. urealyticum and 97.8% for M. hominis. It showed good correlation between two methods (U. urealyticum, r=0.736; M. hominis, r=0.835). CONCLUSIONS: The infections of U. urealyticum and M. hominis were related to preterm labor or PROM. Considering vertical transmission to fetus or neonates resulting in perinatal morbidity or mortality, the detection of these microorganisms is important. MYCOFAST(R) Evolution 2 was an easy, rapid and reliable method substituting conventional culture method.
Female ; Fetus ; Humans ; Infant, Newborn ; Membranes ; Metabolism ; Mortality ; Mycoplasma hominis* ; Mycoplasma* ; Obstetric Labor, Premature ; Polymerase Chain Reaction* ; Pregnancy ; Pregnant Women* ; Rupture ; Ureaplasma urealyticum* ; Ureaplasma*