Journal of Korean medical science
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J. Korean Med. Sci. · Oct 2003
Postoperative outcome in formerly premature infants undergoing herniorrhaphy: comparison of spinal and general anesthesia.
To compare the postoperative outcome according to the type of anesthesia, formerly prematured and high-risk infants who had received and weaned ventilator care preoperatively and had undergone inguinal herniorrhaphy were enrolled in this study. Immediate pre- and post-operative respiratory data which contained the lowest respiratory rates, SpO2, heart rates and the incidence of hypoxemia and bradycardia were collected with the incidence of ventilator care, application of continuous positive airway pressure (CPAP), application of oxygen, hospital stay, and respiratory mortality by chart review, retrospectively. ⋯ One infant in the GA group died because of acute respiratory failure caused by respiratory syncythial virus pneumonia. We concluded that spinal anesthesia reduces postoperative oxygen desaturation and respiratory morbidity in formerly prematured and high-risk infants who underwent inguinal herniorrhaphy.
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J. Korean Med. Sci. · Oct 2003
Case ReportsEmphysematous prostatic abscess due to Klebsiella pneumoniae: report of a case and review of the literature.
Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. ⋯ Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.
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J. Korean Med. Sci. · Oct 2003
The clinical significance of antibody screening test including Dia+ panel cell in Asian-Mongoloid populations.
The Di(a) antigen is well known as one of the antigens with low incidence among Caucasians; however, it has been discovered with a relatively higher incidence among Mongoloid populations. Thus, it has been speculated that the incidence of unexpected antibody against the Di(a) antigen might be relatively higher among these populations. Hemolytic transfusion reactions (HTRs) and hemolytic disease of the newborns (HDNs) caused by anti-Di(a) have been reported sporadically. ⋯ The authors conducted a series of antibody screening tests on 11,219 Korean individuals for 25 months, by using three kinds of screening cells including Di(a) cell. Anti-Di(a) was detected in 8 patients, seven of whom had a history of transfusions or were multigravida. The incidence of anti-Di(a) measured in this study was higher than expected, ranked third among unexpected antibodies identified during the period of the study, so it is strongly recommended that the Di(a+) panel cell must be incorporated into antibody screening test for safer transfusion in Asian-Mongoloid populations.
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J. Korean Med. Sci. · Oct 2003
Multiplex PCR for the detection of genes encoding aminoglycoside modifying enzymes and methicillin resistance among Staphylococcus species.
We developed multiplex polymerase chain reaction (PCR) to detect aac(6 ')/aph(2 "), aph(3 ')-IIIa, and ant(4 ')-Ia, the genes encoding the most clinically relevant amino-glycoside modifying enzymes (AME), and simultaneously, the methicillin resistant gene, mecA, in Staphylococcus species. Clinical isolates of 45 S. aureus and 47 coagulase negative staphylococci (CNS) from tertiary university hospitals were tested by conventional susceptibility testing, using the agar dilution method and by multiplex PCR. Of a total of 92 isolates, 61 isolates were found to be methicillin-resistant. ⋯ The concordance between methicillin-resistance and the presence of mecA gene was 98% in S. aureus and 81% in CNS. The concordance between gentamicin resistance and the presence of aac(6 ')/aph(2 ") gene was 100% in S. aureus and 85% in CNS. The multiplex PCR method that we developed appears to be both a more rapid and reliable than conventional method.
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J. Korean Med. Sci. · Jun 2003
A practical protocol for titrating "optimal" PEEP in acute lung injury: recruitment maneuver and PEEP decrement.
This study was conducted to evaluate the effectiveness and safety of a practical protocol for titrating positive end-expiratory pressure (PEEP) involving recruitment maneuver (RM) and decremental PEEP. Seventeen consecutive patients with acute lung injury who underwent PEEP titration were included in the analysis. After baseline ventilation, RM (continuous positive airway pressure, 35 cm H2O for 45 sec) was performed and PEEP was increased to 20 cmH2O or the highest PEEP guaranteeing the minimal tidal volume of 5 mL/kg. ⋯ Three patients experienced transient hypotension and one patient experienced atrial premature contractions. No patient had gross barotrauma. PEEP titration protocol involving RM and PEEP decrement was effective in improving oxygenation and was generally well-tolerated.