The authors regret that two co-authors were missing in the article.

BACKGROUND: Sepsis is a clinical syndrome characterized by a systemic inflammatory and hemodynamic response to severe bacterial infections that involve various mediators. Endothelin (ET)-1, a potent vasocon strictor is associated with multiple organ failure, and interleukin (IL)-8, a proinflammtory cytokine, plays a major role in neurophil activation. Both have been reported to be useful parameters in the clinical assessment of sepsis. The levels of ET-1 and IL-8 in the blood were measured in patients with sepsis, and the correlation of both parameters and their relationship with the clinical data was assessed. METHODS: 19 sepsis patients and 17 controls were studied. Blood samples of the sepsis patients were drawn in day 1, 3, 7, and 14. the APACHE III scores were calculated in concurrent days. The ET-1 and IL-8 levels were measured using immunoassay methods. RESULTS: The ET-1 levels of patients with sepsis were significantly higher than in the controls. In patients with sepsis, non-survivors had higher ET-1 levels than survivors on day 1 and 7, and patients with shock also had higher ET-1 levels than normotensive patients on admission. The ET-1 levels were significantly correlated wit the creatinine levels in day 1, 7, and 14. The IL-8 levels showed a significant correlation with the ET-1 levels on day 14. CONCLUSION: ET-1 was found to be closely related with the clinical outcome, shock, and renal failure, and showed a correlation with IL-8. these mediators can be considered not only to play pathophysiologic roles but also as useful parameters in the clinical assessment of sepsis.
APACHE ; Bacterial Infections ; Creatinine ; Endothelin-1* ; Endothelins ; Hemodynamics ; Humans ; Immunoassay ; Interleukin-8* ; Interleukins ; Multiple Organ Failure ; Naphazoline ; Renal Insufficiency ; Sepsis* ; Shock ; Survivors

Endoscopic retrograde cholangiopancreatography(ERCP) and its therapeutic developments have become popular in the managemtnt of patients with biliary and pancreatic disease. But certain to anatomical arrangements such as Billroth II partial gastrectomy may cause technical difficulty In the patients with a previous Billroth-II resection, it may be difficult to enter the afferent loop Selectively; and to reach and identify the papilla. Cannulation and sphincterotomy are more difficult because of the direction of approach. Endoscopic retrograde cholangiopancreatography(ERCP) and/or endoscopic sphineterotomy (EST) was perfomed on 12 patients, who had received Billroth II gastrectomy. We could achieve successful cholangiogram in 9 patients(75%) out of 12 patients, And EST was done successfully in 5 patients(83%) out of 6 patients.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Gastrectomy ; Gastroenterostomy ; Humans ; Pancreatic Diseases ; Sphincterotomy, Endoscopic*

No abstract available.
Follow-Up Studies* ; Pneumonectomy*

In order to find out the distribution of fibronectin and fibrinogen in placenta among pregnancy induced hypertensive (PIH) patients, 6 normotensive pregnancies and 17 PIH patients were chosen. The placentas were obtained right after delivery and soaked in the 10% formalin solution. The score was measured in terms of the positiveness of the stain in immunohistochemical stain by using I antibody with the rabbit antihuman fibronectin and the rabbit anti-human fibrinogen. Comparison between two groups are as following: 1.The placenta of PIH patients showed significantly reduced positiveness of fibronectin in their fetal villous vessels and villous stroma. 2. In the PIH patients, the positiveness was reduced in the group giving the birth to intrauterine fetal growth retardation compared to giving birth to normal baby. 3. In both normotensive and PIH patients, the villous basement membrane did not show the staining response to fibronectin, while showing heavy staining response to fibrinogen. 4. The positiveness of fibrinogen in fetal vessels, villous basement membrane, intervillous space and stroma were almost same in both normotensive and PIH patients. From above results, we can conclude that there is abnormality in the distribution of fibronectin especially in the fetal vessels and the villous stroma of placenta among PIH patients. The cause of this result needs further study.
Basement Membrane ; Fetal Growth Retardation ; Fibrinogen* ; Fibronectins* ; Formaldehyde ; Humans ; Parturition ; Placenta* ; Pre-Eclampsia ; Pregnancy*

OBJECTIVES: For estimating the antenatal fetal wellbeing to develop new analysis method of fetal heart rate(FHR) with electronic Fetal Heart Rate Monitoring(eFHRM) and computer. METHODS: Heart rate signal is received from distressed fetus using eFHRM. It is necessary to carry out low pass filtering as a preprocess for the nonlinear method. Nonlinear parameters are calculated and classified to investigate the relations between these parameters and values of umbilical cord blood gas. RESULTS: By dividing values of the umbilical cord blood gas into 5 fetuses of acidemic group and 17 fetuses of non-acidemic group after 22 neonates who presented fetal distress were born, the following results as compared with nonlinear chaotic analysis result were obtained. 1. Delay time through AMI for acidemic group was 16.80+/-3.11, and was higher than 15.41+/-2.27 for non-acidemic group, and is not significant in statistics. 2. Embedding Dimension calculated with FNN method was 5.60+/-2.07 for acidemic group, and 4.71+/-1.26 for non-acidemic group, and it was not significant statistically. 3. Correlation dimension for acidemic group was 1.41+/-0.20, and was higher than 1.10+/-0.38 for non-acidemic group, and is not significant in statistics. 4. Mean crossing value by isoangular return map was 28.80+/-11.34 for acidemic group, and 16.65+/-7.00 for non-acidemic group, and it was significant statistically(P=0.008). 5. In comparison of information entropy in 1-D ED, acidemic group was 6.32+/-0.38 and non-acidemic group was 6.20+/-0.28 and it was not significant statistically. Also, in comparison of value in 2-D ED, acidemic group was 10.20+/-0.34. It was higher than non-acidemic group of 9.51+/-0.43 significantly in statistics(P=0.004). But, in comparison of value in 2-D EP, acidemic group was 8.78+/-0.86 and non-acidemic group is of 9.22+/-0.74 and it wasn't significant statistically. And, 2-D ED(DI) value was 10.64+/-0.14 for acidemic group and 10.51+/-0.18 for non-acidemic group, and it wasn't significant statistically. CONCLUSIONS: By the above result, nonliner dynamics and chaotic analysis of heart rate data with computer can serve as a new diagnosis method which may estimate the fetal wellbeing with real time. Through further studies for establishment of diagnosis standard and computer programming, real time diagnosis method shall be applied to clinical practice.
Diagnosis ; Entropy ; Female ; Fetal Blood ; Fetal Distress* ; Fetal Heart* ; Fetus ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Infant, Newborn ; Nonlinear Dynamics* ; Pregnancy

PURPOSE: This study was performed to examine the effects of image filter on observer performance by counting the number of holes at each wedge step on a radiographic image. MATERIALS AND METHODS: An aluminum step wedge with 11 steps ranged in thickness from 1.5 mm to 16.5 mm in 1.5 mm increments was fabricated for this study. Each step had 10 notched holes with 1.0 mm diameter on the bottom of the step wedge which were ranged in depths from 0.1 mm to 1.0 mm in 0.1 mm increments. Digital radiographic raw images of the aluminum step wedge were acquired by using CCD intraoral sensor. The images were processed using several types of noise reduction filters and kernel sizes. Three observers counted the number of holes which could be discriminated on each step. The data were analyzed by ANOVA. RESULTS: The number of holes at each step was decreased as the thickness of step was increased. The number of holes at each step on the raw images was significantly higher than that on the processed images. The number of holes was different according to the types and kernel sizes of the image filters. CONCLUSION: The types and kernel sizes of image filters on observer performance were important, therefore, they should be standardized for commercial digital imaging systems.
Aluminum ; Noise ; Radiographic Image Enhancement ; Radiography, Dental ; Task Performance and Analysis

PURPOSE: To determine the value of magnetic resonance imaging(MR) and magnetic resonance angiography(MRA) inassessing collateral vessels of moyamoya disease. MATERIALS AND METHODS: Twenty-four patients with moyamoyadisease who underwent MR, 3D TOF MRA, and conventional angiography participated in this study. Two radiologistsworking independently and with no knowledge of the angiographic findings, interpreted the MR and MRA images. Todetermine the presence of parenchymal and leptomeningeal collaterals(48 hemispheres) and transdural collaterals(38hemispheres in 19 patients were depicted by angiography of the external carotid), the findings were compared withthose of angiography. RESULTS: Parenchymal, leptomeningeal, and transdural collaterals were depicted byconventional angiography in 34(71%), 32(67%), and 11(29%) hemispheres respectively. The sensitivity andspecificity of MR/MRA for collateral vessels were 79.1/ 88.1% for parenchymal collaterals, 72.1/ 88.1% forleptomeningeal collaterals, and 0.1/18.1% for transdural collaterals, respectively. Respective sensitivity andspecificity of MR/MRA were 88.94/94.1% for leptomeningeal collaterals, and 18.93/55.1% for transdural collaterals,when the prominent posterior cerebral and external carotid artery were regarded as secondary signs ofleptomeningeal and transdural collateral vessels. CONCLUSION: In moyamoya disease, MR and MRA are useful imagingmodalities for the assessment of collateral vessels. The prominent posterior cerebral artery and external carotidartery can be useful secondary signs of leptomeningeal and transdural collateral vessels.
Angiography* ; Carotid Artery, External ; Cerebral Angiography ; Humans ; Moyamoya Disease* ; Posterior Cerebral Artery

PURPOSE: The purpose of this study was to assess the usefulness of CT angiography(CTA) in patients withintracerebral hematoma. MATERIALS AND METHODS: Eighteen patients with spontaneous intracerebral hematoma underwentCTA ; 20-30 seconds after the onset of an injection of contrast media(100mL, with the use of a power injector, ata rate of 3 mL/sec), Scanning(30-second continuous exposure and 60-90mm length) was performed with a table speedof 2-3 mm/sec and section thickness of 2mm. The starting point selected was the floor of the sella turcica. Theresulting data were reformatted by maximum intensity projection(MIP) after reconstruction at 1-mm intervals, andCTA findings were compared with those of conventional angiography(n=17), surgery(n=6), and postcontrast CT(n=10). RESULTS: The diagnostic findings of CTA included five arteriovenous malformations, two aneurysms, one venousangioma, and one venous sinus occlusion, while the remaining nine patients had no vascular lesion. In all cases,CTA findings correlated well with those of conventional angiography and surgery ; in four cases, they weresuperior to those of postcontrast CT. In one cases of arteriovenous malformation, however, the feeding artery anddraining vein were not definite on CTA, and in one case of sinus occlusion, the full length of the superiorsagittal sinus could not be delineated. CONCLUSION: In patients with spontaneous intracerebral hematoma, CTA is avaluable screening method.
Aneurysm ; Angiography* ; Arteries ; Arteriovenous Malformations ; Hematoma* ; Humans ; Mass Screening ; Sella Turcica ; Veins

PURPOSE: The purpose of this study was to assess the relative diagnostic capability of magnetic resonance angiography(MRA) and CT angiography(CTA) in the evaluation of intracranial aneurysm. MATERIALS AND METHODS: MRA and CTA were performed in 14 intracranial aneurysms (Including four which were ruptured) confirmed in the II patients involved by conventional angiography(CA). The size(in largest dimension) of the aneurysms ranged between 3 mm and 20 mm and the mean was 10.5 mm. For MRA, the 3D TOF method, with magnetization transfer suppression, wasused at 1.5T. For CTA, twenty seconds after beginning the injection of contrast media(100mL with use of a power injector at the rate of 3 mL/sec), CT scanning(30-second exposure and 60-mm length) was performed with a table speed of 2 mm/sec and a section thickness of 2mm. The resulting data were reformatted by MIP. MRA and CTA were compared with regard to the detection of aneurysms and their neck, size, shape, direction, intensity and relationship to adjacent bony structures or vessels. RESULTS: All aneurysms were clearly visualized with CTA. Inone case with a 3-mm aneurysm, however, this was not defined on MRA. Of the 13 aneurysms demonstrated by both MRA and CTA, eight were seen equally well with both modalities. CTA was considered to be superior to MRA in fivecases, either because calcification in the aneurysm wall was seen only on CTA(n = 3) or because the relationship with adjacent bony structures were seen better with CTA(n = 2). With CTA, the intensities of the aneurysm were homogeneous in all cases ; with MRA, however, the intensities of three large aneurysms were different. CONCLUSION: MRA and CTA may be useful in the evaluation of intracranial aneurysm, CTA has specific advantages over MRA inthe evaluation of large aneurysms, calcification of aneurysm wall and relationship with adjacent bony structure.
Aneurysm ; Angiography* ; Cerebral Angiography ; Intracranial Aneurysm* ; Magnetic Resonance Angiography* ; Neck