No abstract available.
Rupture* ; Spleen*

Polyethylene glycol (PEG)-3350 is the most frequently used lavage solution for bowel cleansing prior to colonoscopy or elective surgery because its large molecular weight means that it is poorly absorbed. However, if it leaks into the peritoneal cavity, complications may arise. Few published studies have assessed the absorption, distribution, metabolism and excretion of PEG. Moreover, no published clinical data regarding complications due to the intra-peritoneal leakage of PEG-3350 could be found. We report on an elderly patient who developed the poisoning caused by leaking of PEG-3350 during bowel preparation. It resulted in severe metabolic acidosis, hypernatremia, hyperosmolality and a high anion gap, but it was effectively treated with early continuous renal replacement therapy after surgery.
Absorption ; Acid-Base Equilibrium ; Acidosis ; Aged* ; Colonoscopy ; Humans ; Hypernatremia ; Metabolism ; Molecular Weight ; Peritoneal Cavity ; Poisoning* ; Polyethylene Glycols* ; Renal Replacement Therapy ; Therapeutic Irrigation

The frequent occurrence of hematuria in children necessitates diagnostic evaluation. Hematuria may occur with either renal or lower urinary tract disease. Clarification of the etiology of hematuria, whether microscopic or gross, is facilited by localizing the site of bleeding to the kidney (glomerular) or the lower urinary tract (non-glomerular). The mean cellular volume (MCV) of urinary red blood cells (RBCs) of pediatric patients with glomerular (group I; n=77) and non-glomerular (group II; n=34) hematuria was determined using Coulter Counter Model S plus IV. We found that re blood cells of glomerular origin had a smaller volume than non-glomerular cells(73.79 9.75 m3 vs 83.55 3.77 m3, p<0.001). If an urinary MCV equal to 80.56 m3 was taken as the cut-off value between glomerular and non-glomerular hematuria, a correct assessment of the site of bleeding was made in 89 (80%) of the 111 patients studied (sensitivity 76%, specificity 88%). The ratio of the urinary erythrocyte MCV to that in blood(Umcv/Bmcv) was compared with the diagnosis. If an Umcv/Bmcv ratio equal to 0.95 was taken as the cut-off value between glomerular and non-glomerular hematuria, a correct assessment of the site of bleeding was made in 93 (83%) of the 111 patients studied (sensitivity 79.6%, specificity 94%). Coulter counter analysis of urine provides a simple noninvasive and objective aid to the diagnosis of hematurai. This test, when used early in the management of pediatric patients with hematuria, may help to avoid invasive investigations.
Blood Cells ; Child ; Diagnosis ; Erythrocytes* ; Hematuria* ; Hemorrhage ; Humans ; Kidney ; Sensitivity and Specificity ; Urinary Tract ; Urologic Diseases

No abstract available.
Arthritis* ; Osteoarthritis* ; Transforming Growth Factor beta* ; Transforming Growth Factors*

BACKGROUND: Clinical and experimental studies have suggested that brain death may cause hemodynamic, electrocardiographic, functional or histopathologic changes of the heart. METHODS: Brain death was induced by increasing intracranial pressure(ICP) abruptly by intermittent bolus injection of saline(model ) or gradually by continuous infusion of saline(model ) to the epidural catheter in 5 mongrel dogs, respectively. Hemodynamic and biochemical changes during the process of brain death and histopathologic changes of the myocardium were analyzed and compared in two brain death models, and the association of apoptosis was also evaluated. RESULTS: 1) Two predominant subsets of acute contraction band lesion were produced in both brain death models : paradiscal and holocystic contraction band lesions. Both contraction band lesions were more prevalent in brain death model . 2) The frequency of both contraction band lesions was lowest in the epicardial layer and highest in the endocardial layer in both models, but no correlation was observed between the degree of contraction band lesions and ICP, LV maximum +dp/dt or catecholamine levels. There was no statistical difference between any of the LV circumferential blocks and either type of contraction band lesion, and transaxial distribution was not also different in both models. 3) There was no remarkable histopathologic changes in the analysis of major epicardial coronary arteries. Apoptotic cells were suggested in the scattered myocytes in the light microscopy and apoptosis was detected by in situ nick end labeling method. Electron microscopy revealed a condensation of nuclear chromatin and convolution of nuclear membrane in those myocytes. CONCLUSIONS: Myocardial changes due to brain were observed frequently, and few apoptotic cells were found in the brain death heart. Studies on the treatment strategy to minimize damages of myocardial structure and function caused by brain death should be followed in the near future.
Animals ; Apoptosis ; Brain Death* ; Brain* ; Catheters ; Chromatin ; Coronary Vessels ; Dogs ; Electrocardiography ; Heart ; Hemodynamics ; In Situ Nick-End Labeling ; Microscopy ; Microscopy, Electron ; Muscle Cells ; Myocardium* ; Nuclear Envelope

The congenital cystic adenomatoid malformation (CCMA) of the lung is a rare variant of congenital cystic lung disease consisted of one or usually multiple interconnecting cysts in the pulmonary parenchyma lined by cuboidal and columnar epithelium. This diease present clinically in three ways: 1) stillborn or perinatal death, 2)progress respiratory distress in the newborn, and 3)acute and chronic pulmonary infections in the older infant and child. The onset of symptoms, which are cyanosis, tachypnea, and other forms of respiratory distress, usually occurs at or shortly after birth, This manifestations are related to compression of the remained normal ung by expansion of the cysts. We have experienced a case of congenital cystic adenomatoid malformation of the lung in a 1-day-old male infant who had tachypnea. A right upper lobectomy was done with satisfactory postoperative courses clinically and radiologically at 8 months of age. A brief review of the related literature is presented.
Child ; Cyanosis ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Epithelium ; Humans ; Infant ; Infant, Newborn ; Lung Diseases ; Lung* ; Male ; Parturition ; Tachypnea

Bile* ; Choledochal Cyst* ; Humans ; Infant* ; Peritonitis*

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Cardiovascular Diseases* ; Child* ; Cineangiography* ; Heart Defects, Congenital ; Humans

No abstract available.
Female ; Fibronectins* ; Hypertension, Pregnancy-Induced* ; Plasma* ; Pregnancy*

BACKGROUND: There are two methods to understand a periodic signal. One is describing it in the time domain, and the other is in the frequency domain. Various methods have been described for analysis of Doppler signals in terms of velocities and they need to be further characterized. Frequency domain analysis involves conventional Fourier transformation and analysis by modeling. In 1980's, Skidmore et al. applied Laplace transformation analysis to the femoral and ankle Doppler waveforms and described the waveforms in terms of damping, stiffness and distal impedance. However, few subsequent studies have been reported by other authors. Further, an appealing feature of frequency function analysis is that it can be used for modeling of the resistive and/or storage property of the circuit. PURPOSE: The purpose of study is to analyze the Doppler waveforms of lower extremity in frequency domain and compare the results with the currently known parameters of pusatility in the time domain. METHODS: This study includes 119 Doppler waveforms from 7 non-symptomatic limbs and from 18 limbs with symptoms of chronic low extremity ischemia. Each five representative beats of Doppler waveforms were curve-fitted by third-order AR (auto-regressive) model and z-transformed resulting in three representative roots in the z-plane. Maximum velocity (Max), minimum velocity (Min), maximum excursion of the waveform (Max-Min; MaxE), mean velocity (Avg), pulsatility index (PI) and resistive index (RI) were calculated and compared with the values of the roots. RESULTS: Mostly, the poles of the transfer function were two imaginary and one real poles. Severely diseased waveforms had all three poles in real axis or the imaginary poles approached toward the real axis. The average value of the three poles (Rmean) was 0.5096 ( 0.0967 S.D.) (range: 0.2193~0.7197). The real value of the first pole (R1real) was 0.8957 ( 0.067 S.D.) (range: 0.5964~0.97). The absolute value of imaginary value of the first pole (R1imag) was 0.0998 ( 0.0713 S.D.) (range: 0~0.2336). Significant correlation was observed between 1) Rmean and MaxE (r=0.769), Max (r=0.7498), Avg (r=0.3106), RI (r=0.4378), 2) R1real and MaxE (r=0.5382), Max (r=0.4732), RI (r=0.3629), and 3) R1imag and MaxE (r=0.4785), Max (r=0.3333), Min (r= 0.3703), RI (r=0.5611). CONCLUSIONS: The position of roots of third-order transfer function of Doppler waveforms seems to correlate with the known parameters of velocity. In addition to these parameters of velocity, transfer function analysis appears to be a useful tool to evaluate the Doppler waveforms. Further studies are needed in relation to clinical manifestation.
Ankle ; Axis, Cervical Vertebra ; Electric Impedance ; Extremities ; Fourier Analysis ; Ischemia ; Lower Extremity*