No abstract available.
Anemia, Aplastic* ; Pregnancy*

Diffuse telangiectatic type of pulmonary arteriovenous malformation (AVM) is an uncommon disease entity in which numerous small arteriovenous connections occur throughout the lungs. It has rarely been confirmed by pulmonary angiography. We report a case of diffuse telangiectatic pulmonary AVM occurring in a patient with dyspnea and confirmed by CT using the slab maximum intensity projection (MIP) technique and conventional direct pulmonary angiography.
Angiography ; Arteriovenous Malformations* ; Dyspnea ; Humans ; Lung ; Tomography, X-Ray Computed*

OBJECT: The nonstress test(NST) and complete biophysical profile(BPP) were compared with the rapid biophysical profile(BPP) in order to evaluate the efficacy of the rapid BPP, namely, the combination of amniotic fluid index(AFI) and sound-provoked fetal movement(SPFM) detected by ultrasound, in predicting intrapartum fetal distress in high-risk pregnancies. STUDY DESIGN: From JAN 9th 2000, through JAN 5th 2001, the prospective study of diagnostic tests was conducted on a total of 91 high-risk singleton pregnancies, undergoing antepartum assessment both the standard NST and the new rapid BPP(including other indices of complete BPP). The diagnostic indices of the NST, rapid BPP and complete BPP were calculated in term of predicting intrapartum fetal distress. RESULT: The sensitivity, specificity, negative predictive value, and positive predictive value of NST were 50.00, 94.81, 96.05, and 42.86% respectively, and those of rapid BPP were 75.00, 98.53, 98.53, and 75.00%, and those of complete BPP were 83.33, 98.72, 98.72, and 83.33%, as well. In addition, the efficiency of NST, rapid BPP, and complete BPP were 91.57%, 97.22% and 97.62% respectively. CONCLUSIONS: The rapid BPP is an effective and reliable predictor of intrapartum fetal distress with high-risk pregnancies. Moreover, it may be inexpensive and less time-consuming method.
Amniotic Fluid ; Diagnostic Tests, Routine ; Female ; Fetal Distress ; Pregnancy ; Pregnancy, High-Risk ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography

Myelodysplastic syndrome (MDS) is a relatively uncommon hematological disorder, charactedzed by cytopenia in the peripheral blood and normo-or hypercellularity in the bone marrow with morphological dysplastic change. Ineffective hematopoiesis leads to hematological failures in this syndrome. MDS is largeIy affected in older individuaIs with a median age of 60-75. It's association with pregnancy is even rarer. Although the exact incidence of MDS in pregancy is unknown, it is likely to be less than 1 per 100,000 pregnancies annually. Recently, we experienced a case of MDS presented initially during pregnancy in a 34-year-old primipara and managed with intensive hematologic support. Uerine rupture occurred in pregnancy complicated with MDS at 34 gestation weeks and a healthy infant was successfully delivered by Cesarean section. We report this case with a brief review of the literature.
Adult ; Bone Marrow ; Cesarean Section ; Female ; Hematopoiesis ; Humans ; Incidence ; Infant ; Myelodysplastic Syndromes* ; Pregnancy* ; Rupture ; Uterine Rupture*

Myelodysplastic syndrome (MDS) is a relatively uncommon hematological disorder, charactedzed by cytopenia in the peripheral blood and normo-or hypercellularity in the bone marrow with morphological dysplastic change. Ineffective hematopoiesis leads to hematological failures in this syndrome. MDS is largeIy affected in older individuaIs with a median age of 60-75. It's association with pregnancy is even rarer. Although the exact incidence of MDS in pregancy is unknown, it is likely to be less than 1 per 100,000 pregnancies annually. Recently, we experienced a case of MDS presented initially during pregnancy in a 34-year-old primipara and managed with intensive hematologic support. Uerine rupture occurred in pregnancy complicated with MDS at 34 gestation weeks and a healthy infant was successfully delivered by Cesarean section. We report this case with a brief review of the literature.
Adult ; Bone Marrow ; Cesarean Section ; Female ; Hematopoiesis ; Humans ; Incidence ; Infant ; Myelodysplastic Syndromes* ; Pregnancy* ; Rupture ; Uterine Rupture*

PURPOSE: The aim of our study was to determine the incidence of bronchopulmonary dysplasia (BPD) using the newly proposed definition for BPD and investigate the relationship between the severity of BPD by new definition and clinical severity of illness and radiographic change. METHODS: We selected very low birth weight infants <1,500 g with gestational age <32 weeks born in the Bun-Dang Seoul National University Hospital from June 2003 to May 2005. The datas were categorized in four weight groups, <751, 751 to 1,000, 1,001 to 1,250 and 1,251 to 1,500 g and the incidence of BPD was computed in survivors based on the oxygen need at postnatal 28 days and 36 weeks postmenstrual age (PMA). Further, BPD-associated comorbidities and radiographic changes at 36 weeks PMA were compared among the groups defined by the new severity of BPD criteria. RESULTS: Among VLBW <1,500 g, the incidence of BPD at 28 days and 36 weeks PMA were 67 and 39%, respectively. Using the newly defined criteria, the incidence of mild, moderate and severe BPD were 29, 33 and 6%, respectively. Associated comorbidities correlated significantly with severity of BPD. Significantly longer hospital stay, longer duration of mechanical ventilation, higher score of radiography at 36 weeks PMA was observed with increasing severity of BPD. CONCLUSIONS: The severity of BPD by new definition significantly related to clinical severity and radiographic changes. Whether it will have a role in predicting long-term pulmonologic and neurologic outcome remains to be determined.
Bronchopulmonary Dysplasia* ; Comorbidity ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Length of Stay ; Oxygen ; Radiography ; Respiration, Artificial ; Seoul ; Survivors

BACKGROUND: Cardiovascular disease is the leading cause of mortality in type 2 diabetes. PWV correlates well with arterial distensibility and stiffness and a useful approach for evaluating the severity of systemic atherosclerosis in adults, and, in particular, the measurement of brachial-ankle PWV (baPWV) has been commonly reported as a simple, noninvasive and practicable method. baPWV was mainly affected by age, SBP and sex. And also, baPWV was affected by many different factors such as body weight, BMI, waist to hip ratio, HbA1c, microalbuminuria, triglyceride, gammaGTP, duration of DM. We evaluated determinants of 1-year changes of baPWV in patients with type 2 DM. METHODS: The study group comprised 189 diabetic patients who measured ankle brachial pressure index (ABI), baPWV at base line and 1-year later. The anthropometric parameters, blood pressure, pulse pressure, fasting plasma glucose (FBS), fasting insulin, A1c, lipid profile, hsCRP, microalbuminuria, AST/ALT, gammaGTP were also checked concurrently. We also analyzed correlation between change of baPWV and subject's medications. We retrospectively analyzed the relationship between the 1-year changes of baPWV and the other factors. All analyses were performed with the SPSS Version 14.0 and P values < 0.05 were considered significant. RESULTS: baPWV change was affected by systolic blood pressure change, diastolic blood pressure change, pulse pressure change, body weight, BMI, triglyceride change, insulin treatment and total cholesterol. Multiple regression analysis of the relationship between change of baPWV and other associated variables shows that the 1-year change of baPWV was significantly associated with the changes of blood pressure and insulin treatment in patients with type 2 DM. CONCLUSION: 1-year change of baPWV was significantly associated with the changes of blood pressure in patients with type 2 DM.
Adult ; Animals ; Ankle ; Atherosclerosis ; Blood Pressure ; Body Weight ; Body Weight Changes ; Cardiovascular Diseases ; Cholesterol ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Humans ; Insulin ; Plasma ; Pulse Wave Analysis ; Retrospective Studies ; Waist-Hip Ratio

A 41-year-old man sought evaluation at the emergency department for pain in the anterior chest that had been ongoing for approximately 35 hours. The electrocardiogram showed marked ST segment elevation in the precordial leads. Cardiac biomarker levels were elevated. He subsequently underwent coronary angioplasty and stenting of the left anterior descending artery using two sirolimus-eluting stents. The following day, the patient complained of severe pain in his chest and shoulders. Computed tomography (CT) of the chest showed small gas bubbles around the aortic wall and mild pericardial thickening with subtle air densities, suggesting acute mediastinitis. With an impression of postcardiac injury syndrome and acute mediastinitis, he was treated with intravenous antibiotics and oral ibuprofen. Two days later, the patient had subjective improvement and the friction rub was no longer heard.
Adult ; Angioplasty ; Anti-Bacterial Agents ; Arteries ; Electrocardiography ; Emergencies ; Friction ; Humans ; Ibuprofen ; Mediastinitis ; Myocardial Infarction ; Shoulder ; Stents ; Thorax

OBJECTIVE: To compare observer performance using liquid-crystal display (LCD) and cathode-ray tube (CRT) monitors in the interpretation of soft-copy chest radiographs for the detection of small solitary pulmonary nodules. MATERIALS AND METHODS: By reviewing our Medical Center's radiologic information system, the eight radiologists participating in this study (three board-certified and five resident) retrospectively collected 40 chest radiographs showing a solitary noncalcified pulmonary nodule approximately 1 cm in diameter, and 40 normal chest radiographs. All were obtained using a storage-phosphor system, and CT scans of the same patients served as the gold standard for the presence of a pulmonary nodule. Digital images were displayed on both high-resolution LCD and CRT monitors. The readers were requested to rank each image using a five point scale (1 = definitely negative, 3 = equivocal or indeterminate, 5 = definitely positive), and the data were interpreted using receiver operating characteristic (ROC) analysis. RESULTS: The mean area under the ROC curve was 0.8901+/-0.0259 for the LCD session, and 0.8716+/-0.0266 for the CRT session (p > 0.05). The reading time for the LCD session was not significantly different from that for the CRT session (37.12 and 41.46 minutes, respectively; p = 0.889). CONCLUSION: For detecting small solitary pulmonary nodules, an LCD monitor and a CRT monitor are comparable.

Despite advanced effective prophylaxes, pulmonary complications still occur in a high proportion of all hematopoietic stem cell recipients, accounting for considerable morbidity and mortality. The aim of our study was to describe the causes, incidences and mortality rates secondary to pulmonary complications and risk factors of such complications following hematopoietic stem cell transplantation (HSCT). We reviewed the medical records of 287 patients who underwent either autologous or allogeneic HSCT for hematologic disorders from February 1996 to October 2003 at Samsung Medical Center (134 autografts, 153 allografts). The timing of pulmonary complications was divided into pre-engraftment, early and late period. The spectrum of pulmonary complications included infectious and non-infectious conditions. 73 of the 287 patients (25.4%) developed pulmonary complications. Among these patients, 40 (54.8%) and 29 (39.7%) had infectious and non-infectious conditions, respectively. The overall mortality rate from pulmonary complications was 28.8%. Allogeneic transplant, grade II-IV acute graft-versus-host disease (GVHD) and extensive chronic GVHD were the risk factors with statistical significance for pulmonary complications after HSCT. The mortality rates from pulmonary complications following HSCT were high, especially those of viral and fungal pneumonia, diffuse alveolar hemorrhage and idiopathic pneumonia syndrome.
Transplantation, Homologous ; Transplantation, Autologous ; Transplantation Conditioning ; Middle Aged ; Male ; Lung Diseases/*etiology ; Lung/microbiology ; Humans ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Graft vs Host Disease ; Female ; Bacterial Infections/etiology ; Aged ; Adult ; Adolescent