No abstract available.
Prenatal Diagnosis*

Neuropathic joint, which was originally described by Charcot in 1868, has been reported by many authors since that time. Charcot's joint is a feature of various conditions, such as syringmyelia, diabetes mellitus, congenital indifference to pain and leprosy, but it is mostly depended upon tertiary syphilis. In the past few decades. the occurance of this arthropathy however, seemed to decrease with the discovery of antibiotics and efficient control of syphilis in many countries. But syphilis has become popularized in recent years because of the rapid development of transportation and an offence against public deoency throughout the world. Authors experienced 3 cases of Charcots joint in Our Lady of Mercy Hospital, Catholic Medical College, two of them were tabetic, one diabetic in origin, which affected four knee joints, two ankle joints and one tarsometatarsal joint. The patients were treated conservatively without surgical intervention on the affected joints. One was lost for foIlow up after being discharged from the hospital against medical advice and the res two cases have been on follow up. This paper is auned to illustrate the importance of clinical aspects of neuropathic joints which seemed to be in the tendency of increase in recent years. in spite of development of efficient managements of the causative diseases.
Ankle Joint ; Anti-Bacterial Agents ; Arthropathy, Neurogenic ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Leprosy ; Pain Insensitivity, Congenital ; Syphilis ; Transportation

BACKGROUND: Total intravenous anesthesia (TIVA) is by definition a technique involving the induction and maintenance of the anesthetic state with intravenous drugs alone. In particular, propofol and opioid and muscle relaxants allow enhanced control of the state of anesthesia for the entire duration of the surgical procedure. We evaluated the clinical usefulness of TIVA with fixed fentanyl concentration 3 ng/ml using isoconcentration nomogram and titrated propofol for coronary artery bypass graft. METHODS: Anesthesia was induced using 1% propofol mixed with lidocaine 0.5 mg/kg and ephedrine 10 mg (150 ml/hr) until loss of consciousness in 19 patients undergoing coronary artery bypass graft. Infusion rate of propofol was adjusted in response to blood pressure and pulse rate. To achieve constant fentanyl concentration, infusion rate of fentanyl was changed timely according to isoconcentration nomogram. Infusion of propofol and fentanyl was discontinued 15 and 30 min before predictable end of surgery, respectively. Intraoperative hemodynamics, recovery profile and postoperative analgesic requirements were checked. RESULTS: Overall intraoperative hemodynamics including cardiac index and PCWP showed no significant changes compared with preinduction control value except during CPB period. Average flow rate of propofol and fentanyl was 3.4 0.2 mg/kg/hr and 2.8 0.4 g/kg/hr, respectively. Spontaneous eye opening time was 96.4 min after discontinuation of fentanyl. More than 80% (16/19) of patients did not require any analgesic during first postoperative 24hrs for pain relief. CONCLUSIONS: TIVA with propofol and fentanyl (3 ng/ml) could be a suitable and safe anesthetic technique for coronary artery bypass graft.
Anesthesia ; Anesthesia, Intravenous* ; Blood Pressure ; Coronary Artery Bypass* ; Coronary Vessels* ; Ephedrine ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Lidocaine ; Nomograms ; Propofol ; Transplants ; Unconsciousness

No abstract available.
Trophoblastic Neoplasms* ; Trophoblasts*

OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Androstenedione ; Biological Availability ; Carrier Proteins* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hyperandrogenism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Luteinizing Hormone ; Ovary* ; Ovulation ; Prolactin ; Somatomedins* ; Testosterone ; Thyrotropin ; Volunteers

In some clinical situations such as cerebrovascular accident, pelvic bone fracture or any bed ridden states patients do not have self control of their bowel movement. Nursing care around the perianal area is not an easy job. There is no devices which substitude the work because of the chracteristics of the anatomy of the anorectum and the fecal matter made of solid and gel state component. AIM: to evaluate the possibility of passive evacuation of the fecal matter from the rectum with a newly developed silicon device. MATERIAL AND METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured external balloon surrounding the internal balloon, a connecting tube disposed under the both internal and external balloons and supply tube containing a pair of air passages and an enema fluid passages. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 20~25 kg of body weight was used for the acute experiment. Three types (1.5, 2.0, 2.5 cm in luminal diameter of the solid portion) of NCD were applied in 3 consecutive every other days. For softening of the stool, normally harder than that of human, Psyllium dextrose 30 gm was added to the daily food. Average 750 cc of tepid water was administered through the device for bowel irrigation. Anesthesia was not used in each procedures. The amount evacuated fecal matter and remained solid stool in rectum were checked. To evaluate the rectal mucosal injury anoscopic examinations were performed. RESULTS: Stool evacuation was closely correlated with the intemal diameter of the device and stool component. The device with 2.5 cm in luminal diameter passed fecal matter well enough in 5 of 6 dogs however, smaller devices did not. Accidental prolapse of NCD were noted in 4 of 6 cases with 2.5 cm sized and all of 1.5 and 2.0 sized devices eventually until last push. CONCLUSION: The NCD with 2.5 cm of internal diameter could be used in selected clinical situations.
Anal Canal ; Anesthesia ; Animals ; Body Weight ; Colostomy* ; Dogs* ; Enema ; Glucose ; Human Body ; Humans ; Nursing Care ; Pelvic Bones ; Phenobarbital ; Prolapse ; Psyllium ; Rectum ; Silicones ; Stroke ; Water

Colposcopic examination and biopsy were performed on 197 patients with abnormal cervical cytology. The patients subsequently underwent electrocoagulation, LLETZ, conization and hysterectomy depending on their diagnosis from January, 1989 to December, 1994. The comparison between the diagnosis of cytology and that of colposcopic biopsy showed fair agreement with only 35% of cases(K=20%). The abnormal lesion was underestimated by cytology in 49.7% of cases. Thirty three cases(16.8%) were threated by LLETZ. Histological comparison between the colposcopic biopsies and LLETZ samples showed fair agreement with 39% of cases (K=25%). 5 cases(15%) of the colposcopic biopsy have been underestimated when compared to the LLETZ histology. Sixty two cases were done conization after colposcopic biopsy. Histological comparison between the colposcopic biopsies and conization samples showed fair agreement with 59% of cases(K=38%). The colposcopic biopsies were underestimated in 24.2% of cases compared to the cone biopsy specimen. The correct diagnosis rates of colposcopic biopsy of dysplasia, carcinoma in situ, and microinvasive carcinoma were 70%, 82%, and 20% respectively. (continue)
Biopsy ; Carcinoma in Situ ; Conization ; Diagnosis ; Electrocoagulation ; Humans ; Hysterectomy

No abstract available.
Female ; Fetal Heart* ; Heart Rate, Fetal* ; Meconium* ; Pregnancy

Postischemic functional impairment of the kidney is a severe problem following living or cadeveric renal transplantation. It is well established that a substantial component of postischemic injury is caused by oxygen free radicals generated from xanthine oxidase at ischemia/reperfusion (VR) through lipid peroxidation. Glutathione is well known as a radical scavenger of oxygen free radicals. Malonyldialdehyde (MDA) is a stable end product of lipid peroxidation. The present study was undertaken to investigate whether the measurement of levels of xanthine oxidase activity, glutathione, and MDA in renal tissue could be used as indicators of renal function following I/R injury 50 male Sprague-Dawley were divided into 3 groups; control group (N=10), allopurinol-pretreatment group (Group A, N=20) and no-pretreatment group (Group B, N=20) for in-vitro and in-vivo study. Animals in in-vitro study underwent bilateral renal ischemia for 60 min after pretreatment with allopurinol in group A and saline in group B, and left nephrectomy was then performed for study of ischemic injury. After 30 min of right renal reperfusion, right nephrectomy was then performed for VR injury study. Xanthine oxidase activity, glutathione, and MDA were measured in nephrectomized kidney tissues. In-vivo renal function studies were performed in both group A and B with measurement of creatinine clearance (Ccr) at 7th day of experiments after renal ischemia for 60 min. The xanthine oxidase activity decreased significantly in group A, but increased significantly in group B. The type conversion ratio increased significantly in group B. Glutathione levels decreased significantly in group B compared to group A. MDA levels increased significantly in group B compared to group A. Ccr decreased significantly in group B compared to group A. Thus, it is suggested that the measurement of levels of xanthine oxidase activity, glutathione, and MDA in renal tissue following ischemia/reperfusion injury could be used as indicators of renal function.
Allopurinol ; Animals ; Creatinine ; Free Radicals ; Glutathione ; Humans ; Ischemia ; Kidney ; Kidney Transplantation ; Lipid Peroxidation ; Male ; Malondialdehyde ; Nephrectomy ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Xanthine Oxidase

PURPOSE: The aim of this study was to determine the impact of nursing organizational culture types on innovative behavior and job embeddedness among clinical nurse. METHODS: For this study a descriptive correlational study design was used. Participants were 293 nurses who had more than one year work experience. They were recruited from two university hospitals, one in Seoul and one in Gyeonggi province in 2016. Collected data were analyzed using SPSS/WIN 21.0 statistics program. RESULTS: Hierarchy-oriented culture was the highest type of organizational culture perception and innovation-oriented culture, the lowest. Multiple linear regression analyses showed that, when age and total clinical experience were adjusted for, innovation-oriented culture perception was the most significant factor influencing innovative behavior, followed by task-oriented culture and relation-oriented culture in that order (R²=.33, F=24.50, p<.001). Relation-oriented culture perception was the factor most influencing job embeddedness, followed by task-oriented culture and innovation-oriented culture in that order (R²=.48, F=55.98, p<.001). CONCLUSION: More systematic and sustained organizational efforts are required to improve the hierarchy-oriented culture highly perceived by nurses and to emphasize innovation-oriented, relation-oriented and task-oriented organizational culture to increase innovative behavior and job embeddedness among clinical nurses.
Gyeonggi-do ; Hospitals, University ; Job Satisfaction ; Linear Models ; Nursing* ; Organizational Culture* ; Seoul