RESUMO
Lumbar epidural block is one of effective methods for treating low back pain with or without radiculopathy. However, neurologic complications can occur after epidural block due to several causes such as direct nerve injury or epidural hematoma. It is important to determine whether the neurologic complication is related to the procedure or is due to the underlying neurologic disease. We report two cases of patients who complained of weakness in their lower extremities after receiving a lumbar epidural block; they were ultimately diagnosed with amyotrophic lateral sclerosis.
Assuntos
Humanos , Esclerose Lateral Amiotrófica , Hematoma , Dor Lombar , Extremidade Inferior , RadiculopatiaRESUMO
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Magnesium has been reported to be effective in reducing the incidence or prophylaxis of AF. Magnesium is also an essential constituent of many enzyme systems and plays a physiological role in coagulation regulation. The aim of the present study was to examine the effects of magnesium, whether magnesium infusion might decrease the incidence of AF and induce hypocoagulable state in patients with AF, who were undergoing mitral valve annuloplasty. METHODS: This prospective laboratory study was performed using blood from patients with AF undergoing mitral valve annuloplasty. The radial artery was punctured with a 20 gauge catheter and used for monitoring continuous arterial pressure and blood sampling. After anesthesia induction, 4 g of magnesium was mixed with 100 ml normal saline and infused for 5 minutes. Magnesium, calcium, activated clotting time (ACT) and thromboelastographic parameters were checked before and 60 minutes after the magnesium infusion. The electrocardiography changes after magnesium infusion were also checked before commencing cardiopulmonary bypass. RESULTS: After magnesium infusion, the serum level of magnesium increased significantly but serum calcium did not change significantly. ACT did not change significantly before or after magnesium infusion. The thromboelastographic parameters showed no significant changes before or after magnesium infusion. None of the patients converted to sinus rhythm from AF after the magnesium infusion. CONCLUSIONS: A magnesium infusion did not influence the course of AF and coagulation in patients during prebypass period with AF undergoing mitral valve annuloplasty.
Assuntos
Humanos , Anestesia , Arritmias Cardíacas , Pressão Arterial , Fibrilação Atrial , Cálcio , Ponte Cardiopulmonar , Catéteres , Eletrocardiografia , Incidência , Magnésio , Valva Mitral , Anuloplastia da Valva Mitral , Estudos Prospectivos , Artéria Radial , TromboelastografiaRESUMO
Hereditary stomatocytosis is a rare congenital hemolytic anemia, named after mouth shaped or stomatocytic erythrocyte morphology. In this report, we present a case of a hereditary stomatocytosis in a 1 month old boy. During the initial identification process, we overlooked the morphology of the RBC in peripheral blood smear and tentatively diagnosed it to be a hereditary spherocytosis case. In order to study further, we isolated RBC membranes from the patient, separated membrane proteins by SDS polyacrylamide gel electrophoresis, and found that a protein band, band 7, was missing in the patient. We suggest that erythrocyte morphology as well as erythrocyte membrane protein analysis is an important criterion in the diagnosis of hereditary hemolytic anemia.
Assuntos
Humanos , Recém-Nascido , Masculino , Anemia Hemolítica Congênita , Diagnóstico , Eletroforese em Gel de Poliacrilamida , Membrana Eritrocítica , Eritrócitos , Proteínas de Membrana , Membranas , BocaRESUMO
PURPOSE: There are many methods for the evaluation of the renal function. The proximal tubule of the nephrons have a role of reabsorption of the materials such as water, electrolytes, glucose, amino acids, and small molecular weight protein through the glomerular filtration. Therefore if abnormality is in the proximal tubule, these materials can be changed both in serum & urine. It is very useful to know the normal value of the materials for the age related concentration in serum & urine. METHODS: A study of age related serum & urine calcium, phosphorus, uric acid concentration & Ca/Cr ratio, Cua/Ccr ratio & TRP(tubular reabsorption of phophorus) levels was carried on 178 prematures, neonates, infants & children who were admitted to hallym university hospital from Jul. 1994 through Jan. 1995. RESULTS: The results obtained were as follows, 1)The mean serum calcium levels were the premature 9.8+/-1.3mg/dl, neonate 9.1+/- 1.3mg/dl, 2-12mo 9.8+/-1.2mg/dl, 13-24mo 9.8+/-0.9mg/dl, 25mo-5yr 9.1+/-1.4mg/dl, and 6-15yr 9.2+/-0.8mg/dl. 2)The mean urine calcium levels were the premature 1.0+/-0.8mg/dl, neonate 1.0+/-0.8mg/dl, 2-12mo 2.7+/-1.7mg/dl, 13-24mo 3.0+/-2.2mg/dl, 25mo-5yr 4.1+/-1.9mg/dl, and 6-15yr 4.5+/-2.9mg/dl. 3)The mean serum phosphorus levels were the premature 6.7+/-1.6mg/dl, neonate 6.0 +/-1.3mg/dl, 2-12mo 5.5+/-0.7mg/dl, 13-24mo 5.0+/-0.7mg/dl, 25mo-5yr 4.5+/-0.8mg/dl, and 6-15yr 4.5+/-0.6mg/dl. 4)The mean urine calcium levels were the premature 9.1+/-6.4mg/dl, neonate 10.5+/-7.9mg/dl, 2-12mo 25.9+/-11.2mg/dl, 13-24mo 26.1+/-12.6mg/dl, 25mo-5yr 24.4+/-13.7mg/dl, and 6-15yr 20.3+/-10.7mg/dl. 5)The mean serum uric acid levels were the premature 6.0+/-3.1 mg/dl, neonate 4.7+/-1.4mg/dl, 2-12mo 4.6+/-1.6mg/dl, 13-24mo 4.7+/-1.9mg/dl, 25mo-5yr 4.5+/-1.2mg/dl, and 6-15yr 4.2+/-1.6mg/dl. 6)The mean urine uric acid levels were the premature 27.2+/-18.1mg/dl, neonate 24.3+/-12.8mg/dl, 2-12mo 27.1+/-15.8mg/dl, 13-24mo 27.5+/-14.5mg/dl, 25mo-5yr 28.8+/-14.1 mg/dl, and 6-15yr 26.1+/-9.2mg/dl. 7)The mean levels of the 24hours urine Ca/Cr ratio were the premature 0.1+/-0.08, neonate 0.12+/-0.1, 2-12mo 0.2+/-0.1, 13-24mo 0.2+/-0.1, 25mo-5yr 0.2+/-0.1, and 6-15yr 0.14+/-0.07. 8)The mean levels of the Cua/Ccr(Fractional urate excretion) ratio were premature 83.2+/-115.3%, neonate 19.3+/-41.5%, 2-12mo 19.8+/-9.4%, 13-24mo 19.3+/-13.4%, 25mo-5yr 15.7+/-5.5%, and 6-15yr 16.1+/-4.9%. 9)The mean level of the TRP ratio were premature 88.3+/-8.2%, neonate 111.7+/-129.4%, 2-12mo 84.5+/-8.9%, 13-24mo 85.0+/-9.9%, 25mo-5yrs 86.9+/-7.5, 6-15yrs 89.1+/-6.4%. CONCLUSIONS: This study was performed to understand the develpoment renal function.
Assuntos
Criança , Humanos , Lactente , Recém-Nascido , Aminoácidos , Cálcio , Eletrólitos , Filtração , Glucose , Peso Molecular , Néfrons , Fósforo , Valores de Referência , Ácido ÚricoRESUMO
Urinary tract anomaly is the most common anomaly in childhood. We reviewed medical records of 45 patients who were confirmed urinary tract anomalies on radiologic studies as Chuncheon Sacred Hospital, from Dec. 1984 to Sep. 1992. We analyzed incidence and clinical characteristics of urinary tract anomalies. The results obtained were as follows: 1) The age distribution were: 1)7 cases (37.8%) under 3 years, 6 cases (13.3%) from 4 to 6 years, 10 cases (22.2%) from 7 to 9 years, 9 cases (20.0%) from 10 to 12 years and 3 cases (6.7%) from 13 to 15 years. 2) Main symptoms were fever, dysuria and hematuria. 3) 26 cases (59.8%) were combined with urinary tract infection, and main causative organism were E. coli and Staphylococcus. 4) The most common anomalies were hydronephrosis, duplication of urinary tract and renal agenesis in order of sequence. 5) 34 cases (75.6%) were simple anomaly and 11 cases (24.4%) were complex anomalies. 6) Operative correction was needed on 20 cases.