No abstract available.

No Abstract Available.
X-Ray Film*

PURPOSE: High flow rate (FR) and pressure limit (PL) strategy with time-cycled pressure-limited (TCPL) ventilator is employed routinely in the neonates. Theoretical basis of this strategy is the two-compartment theory that the lung with acute respiratory failure consists of units with different compliance and resistance. But such constant pressure strategy has the risk of ventilator induced lung injury. We compared the ventilatory indices and clinical outcomes of two different strategies, high FR-constant pressure and low FR-constant FR in the ventilator care of the neonates with acute respiratory failure. METHODS: For the neonates born in our hospital and treated with mechanical ventilation from March to August in 1997, two different ventilator strategies were employed randomly with flow control ventilator. In the high-FR group, the FR was fixed at 10 L/ min and the PL was adjusted according to the arterial blood gas analysis (ABGA) results. In the low-FR group, the FR was adjusted to 10 mL/kg of tidal volume. Sixty neonates were enrolled, 32 in high-FR and 28 in low-FR group. Ventilatory indices and clinical outcomes were statistically cornpared in the two groups. RESULTS: Perinatal factors were not different in the two groups. Initial ventilator settings, ABGA results and ventilatory indices were not different. The tidal volume, fraction of inspired oxygen, peak inspired pressure and oxygenation index were higher and dynamic compliance was lower in the high-FR group compared to the low-FR group after 3 to 72 hours of ventilator care. In clinical outcomes, incidences of pulmonary interstitial emphysema, pneumothorax and chronic lung disease were significantly lower in the low-FR group. CONCLUSION: Low-FR with constant FR strategy resulted in better clinical outcomes in the ventilator care of neonates. We conclude that constant FR strategy prevents damage of the better compliant lung units and decreases the incidence of acute and chronic complications of ventilator care.
Blood Gas Analysis ; Compliance ; Emphysema ; Humans ; Incidence ; Infant, Newborn* ; Lung ; Lung Diseases ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency* ; Tidal Volume ; Ventilator-Induced Lung Injury ; Ventilators, Mechanical

No abstract available.
Child* ; Endoscopy* ; Humans

The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome; 14(25.9%) vs 7(9.72%), ventilatory support; 18(33.3%) vs 5(6.9%), neonatal seizure; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.
Apgar Score ; Bronchopulmonary Dysplasia ; Counseling ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Incidence ; Infant, Newborn ; Length of Stay ; Maternal Age ; Parity ; Parturition ; Pregnancy ; Pregnancy, Triplet ; Pregnancy, Twin* ; Reproductive Techniques, Assisted* ; Seizures ; Triplets*

A 32-year-old housewife who resides in Taegu was admitted in Yeungman University Hospital due to right upper quadrant abdminal pain of 2 mounths'duration. An abdomical CT and ultrasonography revealed a relatively well demarcated low density mass in the right lobe of liver. Right hepatic lobectomy was performed on the clinical impression of hepatoma. On the light microscopic study, the lobulated liver mass showed extensive central necrosis and fibrosis, with large numbers of pseudotubercles therein. The pseudotubercles have distorted helminthic eggs frequently. The submitted common bile duct lymph node also showed a few pseudotubercles. The eggs recovered from the tissue homogenate measured 140~152 micrometer by 75~85 micrometer in size and were unembryonated and light yellow to brown. The eggs were determined as those of Fasciola species. We reported the present case as 11th one of human fascioliasis in korea.
Humans

PURPOSE: A new quantitative tumor marker, based on the combined measurement of urinary fragments of cytokeratins 8 and 18, namely the urinary bladder cancer antigen(UBC(TM)) test, has been proposed for the detection of bladder transitional cell carcinoma(TCC). We evaluated the diagnostic efficacy of UBC(TM) test in comparison with that of urinary cytology to establish UBC(TM) test for the diagnosis of TCC. MATERIALS AND METHODS: One-hundred ninety-six patients with hematuria were included in this study. Forty patients were diagnosed histologically as TCC by transurethral resection or radical cystectomy(group A), while the others had various benign urinary tract conditions(group B). RESULTS: UBC(TM) levels were significantly different between groups A (1851.39+/-4627microgram/l) and B (19.28+/-107.03microgram/l) (p<0.001). Sensitivity for diagnosis of TCC was 89.7%(36/40) in UBC(TM) test and 45%(18/40) in cytology(p<0.05). Specificity for diagnosis of TCC was 84.6%(132/156) in UBC(TM) test and 100%(156/156) in cytology. UBC(TM) test was significantly more sensitive than cytology in stage Ta(85.7% vs. 0%, p<0.05), T1 tumors(89.4% vs. 31.5%, p<0.05), and in Grades 1(83.3% vs. 25%, p<0.05) and 2(90.4% vs. 52.3%, p<0.05) tumors. UBC(TM) test was more sensitive in higher Grade(83.3% in Grade 1, 90.4% in Grade 2 and 100% in Grade 3). CONCLUSIONS: In comparison with urinary cytology, UBC(TM) test could be a valuable marker for diagnosis of TCC in patients with early stage and low grade TCC. Therefore, UBC(TM) test in association with cytology may be useful as a screening test for TCC of the bladder.
Carcinoma, Transitional Cell* ; Diagnosis ; Hematuria* ; Humans ; Keratins ; Mass Screening* ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Tract

OBJECTIVE: To evaluate the role of C-reactive protein and fetal fibronectin for patients with preterm labor and intact mxmbranes. STUDY DESIGN: The study group was comprised of sixty patients who presented to the Taegu Fatima Hospital between 24-36 gestational weeks who had a diagnosis of preterm labor. The study group underwent assay of C-reactive protein in the matemal serum, and fetal fibronectin from the external os and posterior fomix of the vagina by means of polyester fiber swabs. The study group was categorized to four groups according to the results of CRP and fetal fibronectin, that is 28 cases of CRP(-)/fetal fibronectin(-); group I, 12 cases of CRP(+)/fetal fibronectin (-); groupII, 9 cases of CRP(-)/fetal fibronectin(+); groupIII, 11 cases of CRP(+)/fetal fibronectin(+): grouplV, and the controls were 12 women without preterm labor. Outcome measures were occurrence of preterm delivery, the admission-to-delivery interval, matemal age and parity, fetal body weight, 1min/5min Apgar score, perinatal morbidity and mortality etc. Statistical analyses were performed by means of ANOVA test and Dunnett's t-test. RESULTS: The prevalence of study group were group I 46.7%, group II 20%, group III 15% and group IV 18.3%. There were no significant difference of matemal age, parity and gestational weeks at admission between study group and control group, but in all study group the admission to delivery interval was significantly shorter than that of control group. Analysis indicated also no significant difference of maternal hemoglobin between study group and conuol group but white blood cell count of group II and IV were significantly higher than that of control group. In perinatal outcomes, the mean birth weight and 1 minute Apgar score of study group except group I were significantly lower than those of control group but 5minutes Apgar score was lower only in group IV compared with control group. Perinatal morbidity and mortality of study group were higher than those of control group except group I. This study group was designed to compare the diagnostic performance of cervical fibronectin and of the serum CRP levels. The sensitivity and specificity of fetal fibronectin as a test to predict of preterm labor were 80% and 90%, which were slightly higher than those of CRP(70%, 78%). CONCLUSION: Both positive cervicovaginal fetal fibronectin and positive C-reactive protein in women with preterm uterine contraction can help identify the pregnancies at risk and to select proper management protocol.
Apgar Score ; Birth Weight ; C-Reactive Protein ; Daegu ; Diagnosis ; Female ; Fetal Weight ; Fibronectins ; Humans ; Leukocyte Count ; Membranes* ; Mortality ; Obstetric Labor, Premature* ; Outcome Assessment (Health Care) ; Parity ; Polyesters ; Pregnancy ; Prevalence ; Sensitivity and Specificity ; Uterine Contraction ; Vagina

The gastrointestinal lymphoma is a well known entity for bleeding or perforation during treatment, but spontaneous perforation is not common. We report the CT findings of an unusual case of small bowel lymphoma which presented with massive pneumoperitoneum following spontaneous perforation.
Hemorrhage ; Intestinal Neoplasms ; Lymphoma* ; Pneumoperitoneum*

No abstract available.