Cytogenetic Analysis of Amniotic Fluid, CVS, and Abortus in a University Hospital for Ten Years / 임상검사와정도관리

BACKGROUND: This study was conducted to analyze, compare, and assess the indications, incidences, and types of chromosomal abnormalities in the amniotic fluid, chorionic villus sampling (CVS), and abortus and to compare these with those previously reported. METHODS: The study subjects included 1,995 cases of amniocentesis and 169 cases of abortus, 20 cases of CVS, 21 cases of cord blood, and 2 cases of cardiac-puncture fluid in the last ten years (June 1999 to May 2009). RESULTS: Among the indications, the maternal serum and triple/quad markers testing positive emerged the highest (57.5%). Other factors those were found were an advanced maternal age (over35) (19.5%) and abnormal ultrasonography findings (8.2%). The frequency of chromosomal abnormality in the amniotic fluid was 4.5%, wherein the numerical abnormality was 3.1% and the structural abnormality was 1.4%. Among the numerical abnormalities, trisomy of chromosome 21 emerged the highest (1.4%). The frequency of the chromosomal abnormality of CVS and abortus was 39.1%, the numerical abnormality was 23.7%, and the order of frequency for trisomy was obtained chromosomes 16, 22, and 21. In the sex ratio of the normal chromosomes, it was 1.1%, but it resulted in 0.5% in CVS. CONCLUSIONS: The results of this chromosomal study on amniotic fluid, CVS, and abortus could serve as useful data regarding the prenatal genetic abnormalities of fetuses and for genetic consultation.

The Effects of the Combined Treatment of Medication and Parent Training in Children with Attention-Deficit/Hyperactivity Disorder(ADHD) / 신경정신의학

OBJECTIVE: We attempted to confirm the effects of the combined treatment of medication and parent training on the behavioral problems of referred ADHD children, the maternal behavior, and the parenting stress of their mothers. METHODS: Twenty-four children between the ages of 5 to 11 and their mothers were selected as subjects from Child Psychiatric Clinics of Hanyang University Hospital. Three groups were organized : combined treatment group of medication and parent training(N=6) ; wating list group(N=6) ; and medication only group(N=6). Methylphenidate(0.5-0.7 mg/kg/day) was prescribed for children. Mothers of the combined treatment group of medication and parent training and the wating list group attended the parent training once a week for nine weeks and a booster session 4 weeks later. Treatment outcomes were evaluated by comparing both treatment groups at pre- and post-treatment using the various rating scales. Especially the combined treatment group was followed up after 6 months to evaluate the stability of treatment effects. RESULTS: This study showed greater effectiveness of the combined treatment of medication and parent training relative to the medication only in decreasing the overall behavioral problems of ADHD children and the parenting stress of mothers as well as in increasing the desirable maternal behavior. In addition, these improvements were maintained at 6 month follow-up. CONCLUSION: The combined treatment of medication and parent training facilitated the behavioral improvement of referred ADHD children in several aspects.

The Effects of Oral Nicardipine on Cardiovascular Response to Tracheal Intubation / 대한마취과학회지

Induction of general anesthesia with direct laryngoscopy and tracheal intubation is routine procedure but causes varying degree of sympathetic stimulation such as increasing in blood pressure and heart rate. Many approaches have been tried to attenuate these hemodynamic responses. To evaluate the effects of nicardipine, a new calcium channel blocker, for prevent sympathetic stimulation induced by direct laryngoscopy and tracheal intubation, we administered nicardipine (40 mg P.O.) 60 minutes before laryngoscopy and endotracheal intubation. 60 patients, ASA physical status 1,2, scheduled operation, were selected randomly. We divided these patients into two groups. Group 1: control, valium 0.1-0.2 mg/kg P.O. (N=30), Group 2: valium 0.1-0.2 mg/kg with nicardipine 40 mg P.O. (N=30). We measured systolic blood pressure, diastolic blood pressure and heart rate before premedicstion, before induction and 1,3,5,10 minutes after intubation in both groups and compared with control group. The results were follows ; 1) Systolic blood pressure and diastolic pressure in nieardipine group were significantly decreased before induction after premedication. 2) After induction systolic blood pressure increased in both group (p<0.005) but increasing rate was significantly less than in nicardipine group (p<0.005). 3) After intubation diastolic pressure decreased significantly in nicardipine group (p<0.005). 4) The changes of heart rate were no difference in both groups.

The Effects of Oral Nicardipine on Cardiovascular Response to Tracheal Intubation / 대한마취과학회지

Induction of general anesthesia with direct laryngoscopy and tracheal intubation is routine procedure but causes varying degree of sympathetic stimulation such as increasing in blood pressure and heart rate. Many approaches have been tried to attenuate these hemodynamic responses. To evaluate the effects of nicardipine, a new calcium channel blocker, for prevent sympathetic stimulation induced by direct laryngoscopy and tracheal intubation, we administered nicardipine (40 mg P.O.) 60 minutes before laryngoscopy and endotracheal intubation. 60 patients, ASA physical status 1,2, scheduled operation, were selected randomly. We divided these patients into two groups. Group 1: control, valium 0.1-0.2 mg/kg P.O. (N=30), Group 2: valium 0.1-0.2 mg/kg with nicardipine 40 mg P.O. (N=30). We measured systolic blood pressure, diastolic blood pressure and heart rate before premedicstion, before induction and 1,3,5,10 minutes after intubation in both groups and compared with control group. The results were follows ; 1) Systolic blood pressure and diastolic pressure in nieardipine group were significantly decreased before induction after premedication. 2) After induction systolic blood pressure increased in both group (p<0.005) but increasing rate was significantly less than in nicardipine group (p<0.005). 3) After intubation diastolic pressure decreased significantly in nicardipine group (p<0.005). 4) The changes of heart rate were no difference in both groups.

The Relationship between End Tidal and Arterial Carbon Dioxide Tension during Endobronchial Anesthesia / 대한마취과학회지

The purpose of this study is to evaulate the relationship between end-tidal PCO2(PetCO2) and arterial PCO2(PaCO2) by placing patients from the supine to the lateraI decubitus position and by the changes from two lung ventilation(TLV) to one lung ventilation(OLV) during noncardiac thoracic surgery in 20 patients. All patients had been intubated with double-lumen endobronchial tubes and respirations were controlled with a rate of 14- l7 breaths per minute and tidal volume of 8 ml/kg by an anesthetic ventilator. End tidal PCO2 and arterial PCO2 were measured at three different measurement points(supine plus TLV, lateral decubitus plus TLV, and lateral decubitus plus OLV). End tidal PCO was obtained by mainstream infrared analysis, and arterial blood samples for arterial PCO2 were taken from the radial artery simultaneously. The results were as follows: l) The mean difference between arterial and end tidal carbon dioxide tension(Pa-etCO2) was 7.5+/-2.9mmHg at the supine position, TLV(r=0.76, P<0.01). 2) The mean Pa-etCO2 was 6.2+/-3.1 mmHg at the lateral decubitus position, TLV(r =0.68, P < O.ol ). 3) The mean Pa-etCO2 was 7.1+/-2.5 mmHg at the lateral decubitus position, OLV(r=0.85, P< 0.01). 4) The changes in Pa-etCO2 were very slight during thoracotomy and endobronchial anesthesia, these were of negligible clinical importance. We conclude that measurement of PetCO2 is reliable as a guideline of ventilation during endobronchial anesthesia.