• Journal of Yeungnam Medical Science
• /
• 제34권1호
• /
• pp.37-42
• /
• 2017

Background: A motor blockade of lower limbs interferes with early ambulation and limits the usefulness of patient-controlled epidural analgesia (PCEA). The concentration of local anesthetic solution is a major determinant for motor block with PCEA. We compared the effects of epidural infusion of 0.075% ropivacaine with 0.15% epidural ropivacaine on postoperative analgesia, motor block of lower limbs, and other side effects. Methods: A total of 70 patients undergoing laparoscopic gynecologic surgery received epidural infusions (group R1, 0.15% ropivacaine with fentanyl; group R2, 0.075% ropivacaine with fentanyl). Pain score, motor block, and side effects (hypotension, nausea, vomiting, pruritus, urinary retention, dizziness, and numbness) were measured. Results: There were no significant differences in the demographic profiles between the groups. Pain scores of the group R1 and the group R2 were not significantly different. Motor block was more frequent in the group R1 (0.15% ropivacaine with fentanyl) than in the group R2 (0.075% ropivacaine with fentanyl). Conclusion: Lower concentration of ropivacaine (0.075%), when compared with higher concentration of ropivacaine (0.15%), seemed to provide similar analgesia with less motor blockade of the lower limbs for the purpose of PCEA.

• The Korean Journal of Physiology
• /
• 제24권1호
• /
• pp.131-144
• /
• 1990

It is well known that the atrial natriuretic peptide (ANP) has a prepro-hormone of 151 amino-acids which loses their hydrophobic signal peptide to form 126 amino acid prohormone. The whole prohormone is released and then cleaved by proteases into more than one circulating forms. Recently, Winters et al. (1988a, b) reported that high concentrations of N-terminal fragments of prepro-ANP $(26{\sim}55),\;(56{\sim}92)\;and\;(104{\sim}123)$ were detected in human plasma. However, their physiological roles have not been established. The present study was conducted to determine whether the N-terminal fragments of pro-ANP have any effect on the renal function and to compare the effect with those of G-terminal fragments of pro-ANP The results indicate that intrarenal arterial infusions of prepro-ANP $(26{\sim}41),\;(26{\sim}55),\;(56{\sim}92)\;and\;(104{\sim}123)$ induced no significant changes in renal function. Whereas ${\alpha}-human$ ANP $(prepro-ANP,\;124{\sim}151)$ and pro-ANP caused a significant increase in urine volume, renal plasma flow, glomerular filtration rate, urinary excretions of sodium, chloride and potassium, and fractional excretion of sodium. These results suggest that the N-terminal fragments of pro-ANP are ineffective, while the C-terminal fragments retain the natriuretic and diuretic activities.

• 한국임상수의학회지
• /
• 제25권4호
• /
• pp.231-235
• /
• 2008

Various kinds of antibiotic intramammary infusions are used for treatment of bovine mastitis. As antibiotic-resistant bacteria are increased, the therapeutic rate for bovine mastitis is decreased. The goal of this research is to detect significant synergic effects of combination of antibiotics with sulbactam, $\beta$-lactamase inhibitor, on methicilin-resistant Staphylococcus aureus (MRSA). We used 5 strains of MRSA isolated from bovine mastitis with clinical and subclinical signs. All of the bacteria isolated had resistance to oxacillin and showed multi-resistant patterns in the antimicrobial susceptibility tests. Minimal bactericidal concentrations of ampicillin, amoxicillin, cephalexin, ampicillin/sulbactam(2:1), amoxicillin/sulbactam (2:1), and cephalexin/sulbactam (1:1) were measured according to broth microdilution method suggested by National Committee for Clinical Laboratory Standards (NCCLS, M31-A2) to compare the synergic effects of sulbactam combination with each antibiotic alone. Ampicillin and amoxicillin showed synergic antibacterial activity to 4 and 3 respectively in 5 strains of MRSA in combination with sulbactam. This study demonstrates that ampicillin/sulbactam and amoxicillin/sulbactam can be therapeutic choices for mastitis associated with MRSA.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제20권2호
• /
• pp.134-137
• /
• 2017

Gastric hemangioma in the neonatal period is a very rare cause of upper gastrointestinal bleeding. We present a case of hemangioma limited to the gastric cavity in a 10-day-old infant. A huge, erythematous mass with bleeding was observed on the lesser curvature side of the upper part of the stomach. Surgical resection was ruled out because the location of the lesion was too close to the gastroesophageal junction. Medical treatment with intravenous $H_2$ blockers, octreotide, packed red blood cell infusions, local epinephrine injection at the lesion site, application of hemoclip, and gel-form embolization of the left gastric artery did not significantly alter the transfusion requirement. Hemostasis was achieved with endoscopic argon plasma coagulation (APC). After two sessions of APC, complete removal of the lesion was achieved. APC was a simple, safe and effective tool for hemostasis and the ablation of gastric hemangioma without significant complications.

• Journal of Chest Surgery
• /
• 제48권4호
• /
• pp.281-284
• /
• 2015

We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.

• 기본간호학회지
• /
• 제20권4호
• /
• pp.372-380
• /
• 2013

Purpose: This study was done to investigate nurses' perceived importance of, and performance of intravenous fluid therapy. Methods: Data were collected from a convenience sample of 234 nurses (return rate: 93%) working in 3 small-medium general hospitals. Results: The score for perceived importance of intravenous fluid therapy ($3.65{\pm}0.37$) was higher than that of performance ($3.45{\pm}0.39$). There were positive correlations between perceived importance and performance (r=.576, p<.001). There were 180 (80.8%) errors in intravenous fluid therapy. Perceived importance and performance scores were higher in nurses who had not experienced medication errors in intravenous fluid therapy. Conclusion: The results indicate a need to develop appropriate strategies to improve perceived importance and performance and enhance safety management during intravenous fluid therapy for nurses in small-medium general hospitals.

• Journal of Korean Neurosurgical Society
• /
• 제47권6호
• /
• pp.420-423
• /
• 2010

Objective : Peripheral nerve injury often leads to neuropathic pain, which is characterized by burning pain, allodynia, and hyperalgesia. The role of the sympathetic nervous system in neuropathic pain is a complex and controversial issue. It is generally accepted that the alpha adrenoreceptor (AR) in sympathetic nerve system plays a significant role in the maintenance of pain. Among alpha adrenoreceptor, alpha-1 receptors play a major role in the sympathetic mediated pain. The primary goal of this study is to test the hypothesis that sympathetically maintained pain involves peripheral alpha-2 receptors in human. Methods : The study was a randomized, prospective, double-blinded, crossover study involving twenty patients. The treatments were : Yohimbine (30 mg mixed in 500 mL normal saline), and Phentolamine (1 mg/kg in 500 mL normal saline) in 500 mL normal saline at 70 mL/hr initially then titrated. The patients underwent infusions on three different appointments, at least one month apart. Thus, all patients received all 2 treatments. Pain measurement was by visual analogue scale, neuropathic pain questionnaire, and McGill pain questionnaire. Results : There were significant decreases in the visual analogue scale, neuropathic score, McGill pain score of yohimnine, and phentolamine. Conclusion : We conclude that alpha-2 adrenoreceptor, along with alpha-2 adrenoreceptor, may be play role in sympathetically maintained pain in human.

• Pediatric Infection and Vaccine
• /
• 제2권2호
• /
• pp.194-199
• /
• 1995

Most boys afflicted with panhypogammaglobulinemia, also known as X-linked agammaglobulinemia, remain healthy during the first 6 to 12 months of life because of protection by maternally transmitted IgG antibodies. Thereafter, they repeatedly acquire infections with high-grade pathogens, such as pneumococci, streptococci, and hemophilus unless given antibiotics or immunoglobulin replacement therapy. We experienced a case of panhypogammaglobulinemia in a 4 years old boy. He had been suffered from recurrent upper respiratory tract infection, otitis media and pneumonia since late infancy. He was admitted due to right pleural effusion with pneumonia, and streptococcus pneumoniae was isolated from pleural fluid and blood cultures. His immune status revealed panhypogammaglobulinemia and deficiency in mature B lymphocyte. He was treated with appropriate antibiotics therapy, but showed poor responses. He was transferred to department of thoracic surgery, and received minithoracotomy (decortication) operation. He was successfully treated with operation, antibiotics, and IV gammaglobulin infusions. Now he is being followed with periodic IV gammaglobulin replacement therapy.

• Childhood Kidney Diseases
• /
• 제22권2호
• /
• pp.81-85
• /
• 2018

Amyloidosis is a rare disease that results from the deposition of extracellular protein in various body tissues, causing progressive organ dysfunction. Secondary renal amyloidosis is a rare but serious complication of chronic inflammatory bowel disease, particularly in patients with Crohn's disease or ulcerative colitis. We report a case of secondary renal amyloidosis in a pediatric patient who reported a 16-year history of "very early onset inflammatory bowel disease". Intensive treatment including repeated infliximab infusions improved clinical parameters of inflammatory bowel disease, although renal dysfunction showed progression. Amyloidosis should be considered in patients with IBD, particularly if they suffered disease progression.

• 대한유전성대사질환학회지
• /
• 제5권1호
• /
• pp.18-22
• /
• 2005

저자들은 Pompe 병으로 진단된 3세 남아에 recombinant human GAA 정주를 통한 효소 보충 치료를 시행하여 운동 능력과 심기능이 호전되며 간비대도 호전된 1례를 경험하였기에 보고하는 바이다.