ABSTRACT
To determine blood alcohol concentration (BAC) by extrapolation, an understanding of basal pharmacokinetics is indispensable. Breath alcohol concentration (BrAC) has been used for the determination of body alcohol concentration replaced by BAC in Korea. Therefore, the determination of BAC/BrAC ratio is a key problem in alcohol pharmacokinetics. Among several factors, the ingested dose of alcohol and the allelic variation of mitochondrial aldehyde dehydrogenase 2 (ALDH2) are the most significant factors influencing the pharmacokinetic parameters, particularly in the absorption and elimination phases. This study shows a detailed pharmacokinetic analysis of BAC and BrAC associated with genetic polymorphism including ALDH2 in 42 healthy Korean men. The change in the alcohol dose ingested influenced the maximum concentration (C(max)), the time to reach C(max) (T(max)), the absorption rate constant (K(01)), the area under the concentration-time curve (AUC(last)), and the hourly elimination rate. The conversion of wild-type 487Glu (ALDH2*1) to 487Lys (ALDH2*2) in human ALDH2 resulted in changes in C(max) (ALDH2*1/*1, 0.03+/-0.01 g/dL [+/-standard deviation] vs. ALDH2*1/*2, 0.05+/-0.004 g/dL [P<0.01]), AUC(last) (ALDH2*1/*1, 4.48+/-2.19 g.min/dL vs. ALDH2*1/*2, 7.52+/-1.26 g.min/dL [P<0.05]), and the BAC elimination rate (ALDH2*1/*1, 0.05+/-0.02 g/L/hr vs. ALDH2*1/*2, 0.09+/-0.01 g/L/hr [P<0.05]). Moreover, the comparison of BAC and BrAC by Bland-Altman plot showed good agreement, suggesting that the measurement of BrAC can be a good alternative for the determination of BAC, particularly in the post-absorption phase. These results provide fundamental information about the pharmacokinetics of alcohol and the determination of BAC in forensics.
Subject(s)
Humans , Male , Absorption , Alcohols , Aldehyde Dehydrogenase , Forensic Sciences , Korea , Pharmacokinetics , Polymorphism, GeneticABSTRACT
BACKGROUND/AIMS: Intranasal mupirocin and chlorhexidine bathing are candidate strategies to prevent healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA). In Korea, intranasal mupirocin is not available, and mupirocin ointment, an over-the-counter drug, has been used indiscriminately. Furthermore, because it is covered by health insurance, mupirocin is easy to prescribe within hospitals. METHODS: We performed a mupirocin drug utilization review (DUR) within Hallym University Sacred Heart Hospital. Annual use of mupirocin was investigated between 2003 and 2013, and monthly consumption of mupirocin was assessed during the final 2-year period. The DUR focused on August 2012, the period of highest use of mupirocin. Also, we investigated trends in mupirocin resistance in MRSA between 2011 and 2013. RESULTS: Annual consumption of mupirocin increased from 3,529 tubes in 2003 to 6,475 tubes in 2013. During August 2012, 817 tubes were prescribed to 598 patients; of these, 84.9% were prescribed to outpatients, and 77.6% at the dermatology department. The most common indication was prevention of skin infections (84.9%), and the ointment was combined with systemic antibiotics in 62.9% of cases. The average duration of systemic antibiotic administration was about 7.8 days. The rate of low-level mupirocin resistance in MRSA increased from 8.0% to 22.0%, and that of high-level mupirocin resistance increased from about 4.0% to about 7.5%. CONCLUSIONS: Inappropriate use of mupirocin is prevalent. Considering the increase in resistance and the future application of intranasal mupirocin, prophylactic use of mupirocin in dermatology departments should be reconsidered.
Subject(s)
Humans , Administration, Cutaneous , Anti-Bacterial Agents/administration & dosage , Drug Prescriptions , Drug Resistance, Multiple, Bacterial , Drug Utilization Review , Hospitals, University , Inappropriate Prescribing/trends , Methicillin-Resistant Staphylococcus aureus/drug effects , Microbial Sensitivity Tests , Mupirocin/administration & dosage , Ointments , Practice Patterns, Physicians'/trends , Predictive Value of Tests , Republic of Korea , Retrospective Studies , Staphylococcal Skin Infections/diagnosis , Time FactorsABSTRACT
OBJECTIVE: The purpose of this study was to determine the independent factors that predict neonatal birthweight and find the relationship between maternal weight gain and neonatal birthweight in women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). METHODS: Forty-six women with GDM and one hundred fifty women with NGT were included in the study. All subjects had singleton pregnancies and no medical diseases that may affect the fetal growth and were certain of gestational age by early ultrasonography. Maternal weight at each prenatal visit was recorded and neonatal anthropometic measurement was done within 2 days of birth. RESULTS: The average rate of weight gain (kg/week) in NGT was lowest during the first trimester (0.09 +/-0.10), peaked during the second trimester (0.52+/-0.14), and slowed after 34 gestational weeks (0.46+/-0.26). In women with GDM, the average rate of weight gain was also lowest during the first trimester (0.18+/-0.23), but it was twofold higher compared with women with NGT. There was a significant decrease of the rate of weight gain after 28 gestational weeks in women with GDM. Total weight gain during pregnancy was 3.4 kg less in women with GDM. Neonatal birthweight was correlated with maternal weight gain and the rate of weight gain during 14-27 and 28-33 weeks in NGT. However, birthweight was correlated with maternal weight gain and the rate of weight gain during the first trimester and 14-27 weeks in GDM. CONCLUSION: This result suggests that the women with GDM who have greater weight gain during the first and the second trimester have a increased risk of excessive fetal growth. Thus strict glycemic control during pregnancy is needed especially in these women.
Subject(s)
Female , Humans , Pregnancy , Diabetes, Gestational , Fetal Development , Gestational Age , Glucose , Parturition , Pregnancy Outcome , Pregnancy Trimester, First , Pregnancy Trimester, Second , Ultrasonography , Weight GainABSTRACT
No abstract available.
ABSTRACT
PURPOSE: The aim of this study is to investigate the effects of high humidification of nearly 100% on insensible water loss and total fluid requirement in very low birth weight infants during their first week of life. METHODS: We retrospectively compared twenty-five infants (GA 28.1+/-1.7 wk, and BW 970+/-186 g) who were cared for in a double walled incubator with high humidification with 24 infants (GA 27.6+/-2.2 wk, and BW 972+/-186 g) who were in a double walled incubator without raised humidity during the first week of their life. We analyzed the changes in body weight, total fluid intake, insensible water loss, urine output, input of sodium and potassium, serum levels of sodium and potassium, and the incidence of complications during the hospitalization in the high humidified group and the control group. RESULTS: High humidification during the first week of life in very low birth weight infants reduced insensible water loss and total fluid requirement. However the imbalance of serum electrolyte or oliguria did not increase. The high humidification group (n=25) acquired more physiologic weight loss during the first two weeks of life than the control group (n=24) but gained more weight than the control group (n=24) on the third month of life. Infants nursed with high humidification showed an increased tendency toward spontaneous closure of the patent ductus arteriosus and a decreased tendency toward surgical ligation of the patent ductus arteriosus and intraventricular hemorrhage without the evidence of an increase in infection. No significant differences were noted in the incidence of patent ductus arteriosus, bronchopulmonary dysplasia and retinopathy of prematurity. CONCLUSION: The high humidification of nearly 100% and fluid restriction therapy during the first week of life were effective in the fluid and electrolyte management of very low birth weight infants.
Subject(s)
Humans , Infant , Infant, Newborn , Body Weight , Bronchopulmonary Dysplasia , Ductus Arteriosus, Patent , Hemorrhage , Hospitalization , Humidity , Incidence , Incubators , Infant, Very Low Birth Weight , Ligation , Oliguria , Potassium , Retinopathy of Prematurity , Retrospective Studies , Sodium , Water Loss, Insensible , Weight LossABSTRACT
PURPOSE: To find the anthropometric characteristics of newborn in women with gestational diabetes mellitus(GDM), and the relationship between the birth weight and anthropometric measurements of newborn, maternal body habitus and glycemic control in GDM group. METHODS: Maternal weight, height, and obstetric history of 82 women with GDM and 93 women with normal glucose tolerance were recorded at the time of screening test and delivery. Within 2 days after birth, the birth weight and anthropometric measurements were obtained, and maternal glycohemoglobin concentrations were measured and umbilical cord blood samples for C-peptide were collected in GDM group at delivery. RESULTS: There were no differences in the birth weight and frequency of LGA newborn between GDM and control group, although the primary C-section of GDM group was significantly higher compared with the control group. The abdominal circumference(AC) and triceps, subscapular, and thigh skinfold thickness(SFT) of newborn in GDM group were significantly increased compared with the control group. Maternal glycohemoglobin concentration was correlated with birth weight, but not with AC and three SFTs in GDM group. Umbilical cord blood C-peptide level had a correlation with birth weight and three SFTs in GDM group. Newborn's AC had a correlation with maternal weight and weight gain in GDM group, but not in control group. CONCLUSION: Although the birth weight and frequency of LGA did not differ, AC and triceps, subscapular, and thigh SFT were increased in GDM group. These increases of anthropometric measurements were observed in AGA newborn, and were greater in LGA newborn.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , C-Peptide , Diabetes, Gestational , Fetal Blood , Glucose , Hyperinsulinism , Mass Screening , Parturition , Thigh , Weight GainABSTRACT
Infantile onset diabetes mellitus(especially, neonatal diabetes) is rare disorder and may be transient or permanent. Most patients are full-term but small-for-date infants and typical symptoms occur within the first 4-6 weeks of life, requiring insulin therapy. Neonatal diabetes differs from type 1 diabetes in many aspects and seems to form a distinct entity of inborn pancreatic malfunction. The transient cases often develop type 2 diabetes mellitus later in life. In recent reports, transient neonatal diabetes is associated with paternal uniparental isodisomy and unbalanced duplication of chromosome 6q22-23. In our study, clinical course of case 1 was compatible with transient neonatal diabetes, but chromosomal abnormalities such as above was not shown in DNA analysis. In case 2 and 3, we could not decide exactly on genetic basis.
Subject(s)
Humans , Infant , Chromosome Aberrations , Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , DNA , Genomic Imprinting , Insulin , Uniparental DisomyABSTRACT
PURPOSE: This study was performed to examine the impact of gestational diabetes mellitus (GDM) on perinatal outcomes, especially macrosomia and metabolic complications in Korean women. Subjects and METHODS: We studied perinatal outcomes of 65 women with GDM who delivered a singleton infant and were not complicated by medical disease that might effect the fetal growth, 65 women with normal glucose tolerance were selected to match subject with GDM matched to age, height, and prepregnancy weight. RESULTS: 1) Mean birth weight in infants of mothers with GDM was significantly heavier than that in infants of control mothers, even though the delivery was almost one week earlier (3524 vs. 3364gm). 2) Although length and head circumference of infants were not different between 2 groups, chest circumference and Ponderal index were significantly higher in infants of mothers with GDM. 3) The frequencies of LGA infants and macrosomia were higher in GDM group, but frequency of prematurity was not different between 2 groups. 4) The proportion of disproportionate growth among macrosomic infants was significantly higher in GDM group. 5) In infants of mothers with GDM, the frequencies of LGA infants were not significantly different between 2 groups which were separated according to the fasting glucose level measured at the time of diagnosis. 6) In infants of mothers with GDM, the frequencies of hypoglycemia, polycythemia, hypocalcemia and hyperbilirubinemia were 21.5%, 18.5%, 3.1% and 33.8% respectively. When infants of mothers with GDM were divided to 2 groups (LGA, AGA), the frequencies of polycythemia and hyperbilirubinemia in LGA infants were higher than those in AGA infants (30.8 vs. 10.3% and 50.5 vs. 23.1%, respectively). 6) There was a significant positive correlation between Ponderal index and chest circumference/head circumference ratio (r=0.37, p<0.01). CONCLUSIONS: Inspite of tight metabolic control of mothers with GDM, perinatal complications, such as macrosomia, hypoglycemia, hyperbilirubinemia were frequent in infants of mothers with GDM. In case of infants of mothers with GDM, perinatal complication should be treated earlier or prevented by careful physical examination and intensive management.
Subject(s)
Female , Humans , Infant , Pregnancy , Birth Weight , Diabetes, Gestational , Diagnosis , Fasting , Fetal Development , Glucose , Head , Hyperbilirubinemia , Hypocalcemia , Hypoglycemia , Mothers , Physical Examination , Polycythemia , ThoraxABSTRACT
PURPOSE: We tried to find the relationships between the fetal beta-cell function and neonatal birth weight, anthropometric measures, and maternal characteristics, and to observe role of insulin as fetal growth factor in offsprings of mothers who have normal glucose metabolism. METHODS: We measured umbilical cord blood insulin and C-peptide concentrations in 236 neonates delivered at Cheil General Hospital from Jan. 1 to Jan. 31 1994. Their mothers had normal glucose metabolism during pregnancy. The birth weight and other anthropometric measures were performed within 24 hours after birth by same pediatrician. RESULTS: 1) The mean gestational age was 39.5+/--0.1 wk and mean birth weight was 3.3+/--0.2 Kg. According to birth weight percentile, the numbers of small for gestational age(SGA), adequete for gesational(AGA), and large for gestational age(LGA) infans were 3(1.3%), 178(75.4%), and 55(23.3%), respectively. There were no differences in gestational age, birth weight, length, head circumference, chest circumference, Ponderal index, and symmerty index between male and female infants. 2) The maternal weight gain during pregnancy was related to neonatal birth weight, length, and head circumference, but not to Ponderal index and symmetry index. 3) The mean cord blood insulin and C-peptide concentrations were 5.1+/--0.1uU/ml and 1.3+/--0.1 ng/ml. There was a significant positive correlation between insulin and C-peptide concentrations. 4) There were no significant differences in cord blood insulin and C-peptide concentrations among the SGA, AGA, and LGA group. 5) The cord blood insulin and C-peptide concentrations had weak positive correlations with neonatal birth weight, obesity, and gestational age, but nor with maternal weight gain during pregnancy. CONCLUSIONS: Although insulin has a significant role in fetal growth in diabetic pregnancy or intrauterine growth retardation(IUGR), our results suggest that it does not have a significant effect on fetal growth in offsprings of mothers who have normal glucose metabolism.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Birth Weight , C-Peptide , Fetal Blood , Fetal Development , Gestational Age , Glucose , Head , Hospitals, General , Insulin , Metabolism , Mothers , Obesity , Parturition , Thorax , Umbilical Cord , Weight GainABSTRACT
Total 8,341 pregnant women who visited Obstetric Clinic Cheil General Hospital from Jaunary 1991 to July 1992 were screened for HBsAg. Sixty five women with positive HBsAg who delivered healthy babies during that period and their infants are included in the study. HBsAg, Anti-HBs, Anti-HBc, HBeAg and Anti-HBe were tested by radioimmunoassay and hepatitis B virus DNA were studied by polymerase chain reaction technique in both mothers' and babies serum. The results were as follow: 1) Among 8,341 pregnant women who were screened for HBsAg 374 were asymptomatic carriers(4.5%). 2) The newborn babies born to 65 mothers who were positive HBsAg showed HBsAg in 4.6%, HBeAg 75.0%, anti-HBc 98.4% and hepatitis B virus DNA in 26.2%. 3) It showed discordance of HBeAg/anti-HBe, with hepatitis B virus DNA in newborn infants. 4) Follow up study at 8~20 months showed HBeAg and hepatitis B virus DNA in 2 infants out of 20.
Subject(s)
Female , Humans , Infant , Infant, Newborn , DNA , Follow-Up Studies , Hepatitis B e Antigens , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis B , Hepatitis , Hospitals, General , Mothers , Polymerase Chain Reaction , Pregnant Women , RadioimmunoassayABSTRACT
To identify the neonates at the risk of having meconium aspiration syndrome, the perinatal characteristics and finding of fetal heart rate monitorings in 366 neonates who had meconium-stained amniotic fluid were retrospectively reviewed. The results were as follows; 1) Overall incidence of MAS was 0.7%. 2) Mortality rate of MAS was 5.8%. 3) The mean Apgar scores at 1-and 5-minute were significantly different in the two groups with and without meconium aspiration sydrome (MAS)(p<0.001). 4) PROM, postterm delivery and IUGR were the major obstetric risk factors associated with MAS. 5) Although severe variable decelaeration and decreased variability on FHR monitoring were present more often in the group with MAS, it showed no statistically significant difference between the two groups. 6) The presence of above findings on monitoring and thick meconium in amniotic fluid should alert clinicians to the possibility of a fetus that requires intervention.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Amniotic Fluid , Fetal Growth Retardation , Fetal Heart , Fetus , Heart Rate, Fetal , Incidence , Meconium Aspiration Syndrome , Meconium , Mortality , Retrospective Studies , Risk FactorsABSTRACT
No abstract available.
Subject(s)
Humans , Infant, Newborn , Blood Glucose , Glucose , Insulin , TocolysisABSTRACT
Doppler echocardiography was performed to evaluate the tricuspid regurgitation in 786 infants and children with heart disease. 3 Doppler methods were used. : The duration of systolic turbulence of tricuspid regurgitation in thr right atrium was evaluated by continuous wave Doppler method, the distance of systolic turbulence within right atrium from the tricuspid plane, by pulsed Doppler method and the retrograde systolic hepatic vein regurgitation, by color Doppler method. The following results were obtained. 1) Incidence of pan systolic tricuspid regurgitation in each disease were as follows. 68% of ECD, 66% of Ebstein's anomaly, 54% of pulmonary atresia, 50% of arrhythmia, 45% of ASD, 38% of TAPVR, 15% of VSD, 26% of TOF, 12% of PDA, 13% of normal children. 2) In about 90% of children with tricuspid regurgitation, hepatic vein regurgitation was detected by color Doppler echocardiography.
Subject(s)
Child , Humans , Infant , Arrhythmias, Cardiac , Ebstein Anomaly , Echocardiography, Doppler , Echocardiography, Doppler, Color , Heart Atria , Heart Diseases , Heart , Hepatic Veins , Incidence , Pulmonary Atresia , Scimitar Syndrome , Tricuspid Valve InsufficiencyABSTRACT
We evaluated the accuracy of a noninvasive method for estimating right ventricular systolic pressures in patients with atrial septal defect and tricuspid regurgitation defected by two-dimensional and Doppler ultrasound. Of 54 patients with atrial septal defect, 24(44%) had jets of tricuspid regurgitation. By use of the maximum velocity(V) of the regurgitatant jet recorded by continuous wave Doppler ultrasound and the Bernoulli equation, we predicted right ventricular systolic pressure(RVP) calculated by the equation of RVP=4V2+10 proposed by Tei et al.The values correlated well with catheterization values(r=0.851, standerd error of estimate=4mmHg). In addition the relation between the Lt to Rt shunt amount and the severity of tricuspid regurgitation was assessed. The severity of tricuspid regurgitation graded on a four-pointscali by pulsed Doppler and two-dimensional echocardiography correlated with Qp/Qs ratio calculated by the Fick's method(p<0.05).