No abstract available.
Bowen's Disease* ; Porokeratosis*

The purpose of this study was to evaluate the effect of postural change on hemodynamics under halothane-N2O-O2 anesthesia. The authors measured heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (PVP), and cardiac index (C1) on supine position (baseline), and after a postural change to the lithotomy, head up tilt (5, 10, 15 degress) and head down tilt (5, 10, 15 degrees) positions in 10 healthy subjects. The results were as follows: 1) After a postural change to the lithotomy position, all hemodynamic variables revealed no changes. 2) After a change to the head up position, MAP, CVP, PAP, PCWP, and CI decreased significantly, while HR remained unchanged. 3) After a change to the head down position, CVP, PAP, PCWP, and CI increased and HR decreased significantly, while MAP remained unchanged. From the above results, it might be concluded that a down ward tilt of 10 degrees is most the appropriate position to restore hemodynamics in the presence of cardiovascular instability.
Anesthesia ; Arterial Pressure ; Central Venous Pressure ; Head ; Head-Down Tilt ; Heart Rate ; Hemodynamics* ; Pulmonary Artery ; Supine Position

In this study, trends in the sales of antimicrobials for use in livestock facilities and fisheries from 2003 to 2012 were investigated with regard to antimicrobial group, antimicrobial usage, and animal species. The overall amount of antimicrobials sold each year from 2003 to 2007 was 1,500 tons, after which they decreased, with the lowest sales being 936 tons in 2012. The total volume of antimicrobials used for feed additives decreased markedly by 94% from 2003 to 2012, which was mainly attributed to banning of feed additives. However, antimicrobial consumption through self prescription by farmers for disease prevention and treatment increased by 25% from 2003 to 2012. The largest volume of antimicrobials sold was for use in pigs (48~57%), followed by poultry (18~24%), fisheries (11~25%), and cattle (5~8%). Tetracycline was the highest selling antimicrobial, followed by penicillins and sulfonamides, although the overall sale of all three antimicrobials gradually decreased over the study period. This study demonstrated that the total consumption of antimicrobials has gradually decreased since 2008. Nevertheless, usage by nonprofessionals increased, which can ultimately cause emergence and spread of antimicrobial resistance. Thus, early establishment of veterinary prescription guidelines for prudent use of antimicrobials is urgently needed in Korea.
Animals ; Cattle ; Commerce* ; Fisheries* ; Korea ; Livestock* ; Penicillins ; Poultry ; Prescriptions ; Sulfonamides ; Swine ; Tetracycline

BACKGROUND: It is critical to differentiate heparin-induced thrombocytopenia (HIT) from disseminated intravascular coagulation (DIC) in heparinized intensive care unit (ICU) patients with thrombocytopenia because the therapeutic approach differs based on the cause. We investigated the usefulness of PF4/heparin antibody tests in these patients. METHODS: A total of 127 heparinized ICU patients whose platelet counts were <150x10(9)/L or reduced by >50% after 5-10 days of heparin therapy were enrolled. PF4/heparin antibodies were measured using 2 immunoassays. We assessed the probability of HIT by using Warkentin's 4T's scoring system for antibody positive patients and compared routinely performed coagulation test results between patients with and without antibodies to evaluate the ability of these tests to discriminate between HIT and DIC. RESULTS: Positive results were obtained for 14 (11.0%) and 11 (8.7%) patients in the 2 assays. The analysis performed using the 4T's scoring system revealed that 11 of 20 (15.7%) patients with antibodies in at least 1 assay had intermediate or greater probability of HIT. Patients without antibodies had significantly higher levels of D-dimer than those with antibodies. However, there were no intergroup differences in platelet counts, PT, aPTT, fibrinogen, DIC score, and rate of overt DIC. CONCLUSION: Seropositivity for PF4/heparin antibody was 8.7-11.0% in the patients with thrombocytopenia, and more than a half of them had an increased probability of HIT. Among the routine coagulation tests, only D-dimer was informative for differentiating HIT from DIC. PF4/heparin antibody test is useful to ensure appropriate treatment for thrombocytopenic heparinized ICU patients.
Antibodies ; Dacarbazine ; Dietary Sucrose ; Disseminated Intravascular Coagulation ; Fibrin Fibrinogen Degradation Products ; Fibrinogen ; Heparin ; Humans ; Immunoassay ; Critical Care ; Intensive Care Units ; Platelet Count ; Platelet Factor 4 ; Thrombocytopenia

Objective: Hypertensive disease during pregnancy increases the risk of maternal morbidity and mortality and leads to the development of multi-organ dysfunction, including kidney dysfunction. Complicated pregnancies require careful postpartum management to prevent sequelae. It is believed that kidney injury can consistently occur even after delivery; therefore, defining the chronicity and endpoint is essential for establishing diagnostic criteria. However, data on the prevalence of persistent renal complications following hypertensive disease during pregnancy are limited. In this study, we evaluated the risk of developing renal disorders in patients with a history of hypertensive disease during pregnancy. Methods: Participants who gave birth between 2009 and 2010 were followed up for 8 years after delivery. The risk of renal disorder development after delivery was determined according to a history of hypertensive disease during pregnancy. Different factors that could affect the course of pregnancy, including age, primiparity, multiple pregnancy, preexisting hypertension, pregestational diabetes, hypertensive disease during pregnancy, gestational diabetes, postpartum hemorrhage, and cesarean section, were adjusted for using the Cox hazard model. Results: Women with hypertension during pregnancy had a higher risk of developing renal disorders after delivery (0.23% vs. 1.38%; P<0.0001). This increased risk remained significant even after adjusting for covariates (adjusted hazard ratio, 3.861; 95% confidence interval [CI], 3.400-4.385] and 4.209 [95% CI, 3.643-4.864]; respectively). Conclusion Hypertension during pregnancy can contribute to the development of renal disorders, even after delivery.

Neurosurgical intervention in the syndrome is discussed in the light of two recently treated cases, one of which was admitted due to acute hydrocephalic attack, the other was confirmed by the typical computed tomographic findings as well as the classic triad of adenoma sebaceum, mental retardation and epilepsy. There cases had no family historty and were probably the result of new mutations and variable penetrance. Transcallosal microsurgical excision of tumor was accomplished in both cases and subependymal giant cell astrocytoma was confirmed. The hydrocephalus resolved but subduroperitoneal shunt was required in one case.
Astrocytoma* ; Epilepsy ; Humans ; Hydrocephalus ; Intellectual Disability ; Penetrance ; Tuberous Sclerosis*

Purpose: The purpose of this study is to share our outcomes and experiences on allogeneic hematopoietic stem cell transplantation (HSCT) in elderly patients aged 60 years and older with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) in South Korea, and to compare them with other studies. Materials and Methods: We analyzed the clinical outcomes of 116 patients with AML or MDS aged 60 years and older who underwent allogeneic HSCT. We also analyzed which pretreatment factors affect the overall survival (OS) after allogeneic HSCT. Results: Neutrophil and platelet engraftment were achieved at median day +11 [interquartile range (IQR) 10–15] and +14 (IQR 11–19), respectively. A complete donor chimerism was confirmed in 65 (56.0%) patients at 3 weeks and in 63 (54.3%) patients at 3 months after HSCT. The estimated incidence of grade II–IV acute graft-versus-host disease (GVHD) at day 100 was 13.7%. The estimated incidence of chronic GVHD at 2 years was 38.8%. Within a median follow-up of 14 months after HSCT, OS was 64% at 1 year and 55% at 2 years, and non-relapse mortality (NRM) was 20% at 1 year and 28% at 2 years. Multivariate analysis revealed that male sex and Hematopoietic Cell Transplantation-Specific Comorbidity Index ≥3 were associated with poor OS. Conclusion This study showed that allogeneic HSCT in elderly adults aged 60 and older can be performed with successful engraftment and acceptable NRM and OS are expected given the generally known survival of patients with higher risk MDS and poor risk AML.

Congenital sinus of Valsalva (SOV) aneurysm is a rare cardiac abnormality. Rarely the aneurysm enlarges without rupture, cause symptoms of the mass effect by compressing the adjacent structures, obstruction of the right ventricular outflow with tricuspid regurgitation, infectious endocarditis, thrombus formation and myocardial ischemia/infarction. And SOV aneurysm can also be a source of embolism. We observed a patient with cerebral infarction in whom a huge SOV aneurysm, was diagnosed as the presumed source of cerebral embolism and the cause of hypoplastic tricuspid valve.
Aneurysm* ; Cerebral Infarction ; Embolism ; Endocarditis ; Humans ; Intracranial Embolism* ; Rupture ; Sinus of Valsalva* ; Thrombosis ; Tricuspid Valve Insufficiency ; Tricuspid Valve*