No abstract available.
Dexamethasone* ; Psychotic Disorders*

No abstract available.
Colon* ; Dilatation* ; Humans ; Infant, Newborn*

No abstract available.
Female ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Renal Dialysis*

BACKGROUND/AIMS: Liver biopsy has been used to evaluate the degree of hepatic fibrosis in patients with chronic liver diseases. It is important to assess liver fibrosis when following the course of chronic liver diseases. Histopathological examination of percutaneous biopsy specimens is invasive and is also of questionable value because of the heterogenous distribution of pathological changes in the liver. Therefore, non-nvasive methods to determine the progress of liver fibrosis are needed. Serum hyaluronic acid and type IV collagen are known to be related to hepatic fibrosis. This study was performed to evaluate the clinical usefulness of serum hyaluronic acid and type IV collagen measurement as a differential point in patients with chronic liver diseases and early cirrhosis. METHODS: This study included 109 patients with chronic liver diseases caused by various etiologies. Liver biopsy and histopathological classification were done in all patients. Serum hyaluronic acid and type IV collagen were measured by one-tep sandwich binding protein assay and one-tep sandwich enzyme immunoassay. RESULTS: The concentrations of hyaluronic acid and type IV collagen in the early cirrhosis group (208.5+/-186.4 ng/mL, 242.1+/-162.8 ng/mL) were significantly higher (p<0.01) than those in the normal and fatty liver group (26.3+/-21.7 ng/mL, 79.2+/-28.8 ng/mL), mild chronic hepatitis group (22.8+/-15.4 ng/mL, 125.5+/-79.7 ng/mL), moderate to severe hepatitis group (66.3+/-60.5 ng/mL, 148.5+/-78.7 ng/mL). At the cutoff value of 100 ng/mL for hyaluronic acid and 200 ng/mL for type IV collagen, the sensitivities were 66.7% and 55.6%, and specifities were 82.9% and 89%, and diagnostic efficiencies were 78.9% and 80.7% respectively for discriminating patients with cirrhosis (4 points) from the mild to severe fibrosis (0~3 points). CONCLUSIONS: The serum levels of hyaluronic acid and type IV collagen may be sensitive markers of fibrotic process in chronic liver diseases and useful biochemical markers in differentiation of the patients with early cirrhosis from those with chronic liver diseases.
Biomarkers ; Biopsy ; Carrier Proteins ; Classification ; Collagen Type IV* ; Fatty Liver ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Hyaluronic Acid* ; Immunoenzyme Techniques ; Liver Cirrhosis* ; Liver Diseases ; Liver*

OBJECTIVE: This study investigates the morbidity of adnexal surgery through minilapatotomy by comparing with adnexal surgery through laparotomy. METHODS: From January 2000 to December 2001, 84 patients with adnexal diseases were managed through minilaparotomy and 80 patients treated with adnexal surgery through laparotomy. RESULTS: Fifty-three (69.0%) of the adnexal diseases were ectopic pregnancies. Fifty-seven patients (67.9%) were treated with salpingectomy. Other patients were treated with the following operations: salpingotomy (3 cases, 3.6%); salpingostomy (3 cases, 3.6%); fimbrioplasty (2 case, 2.4%); ovarian cyst enucleation (4 cases, 4.8%); ovarian resection (6 cases, 7.1%); parovarian cystectomy (5 cases, 6.0%); salpingooophorectomy (4 case, 4.8%). The average operation time for minilaparotomy was 30.5 +/- 9.2 minutes. The average bowel function recovery time for minilaparotomy was 28.2 +/- 15.6 hours (p<0.05). The average postoperative pain control was 29 cases (34.5%) lower than that of controls (p<0.05). The average postoperative hospital stay for minilaparotomy was 3.4 +/- 1.0 days (p<0.05). The procedure morbidity was lower than that of controls. CONCLUSION: It is suggested that minilaparotomy is a quick, convenient method to decrease patient morbidity and postoperative stay and that it could be considered an alternative to laparotomy for the treatment of adnexal diseases.
Adnexal Diseases ; Cystectomy ; Female ; Humans ; Laparotomy* ; Length of Stay ; Ovarian Cysts ; Pain, Postoperative ; Pregnancy ; Pregnancy, Ectopic ; Recovery of Function ; Salpingectomy ; Salpingostomy

Total knee arthroplasty has become a common procedure for treatment of severe osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. In the past, failure of total knee arthroplasty was commonly attributable to aseptic loosening, often associated with component malalignment, soft tissue imbalance. With improved surgical instrumentation and soft tissue balancing techiniques, failure secondary to mechanical loosening has been minimal. But surgeons are still dissatisfied with implant malalignment. Correct tibiofemoral alignment seems to be particularly important since it is generally agreed that axial deviation and imprecise implantation may lead to loosening of the implant component. Navigation systems and robotic techniques could potentially solve problems of imprecision in traditional total knee arthroplasty. It is expected that the success rate and longevity of total knee arthroplasty will be improved during the twenty first century.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Knee* ; Longevity ; Osteoarthritis ; Surgical Instruments

No abstract available.
Diagnosis* ; DNA*

BACKGROUND: During cesarean delivery, hypotension is a frequently occurring adverse effect following spinal anesthesia. Our hypothesis was that hypotension could be avoided or delayed with a lateral decubitus position for 10 minutes after intrathecal injection, by reducing the detrimental effects of the aortocaval compression. METHODS: Spinal anesthesia was performed in the lateral decubitus position with 8 mg of 0.5% hyperbaric bupivacaine and 15 µg of fentanyl. Forty-one patients undergoing elective cesarean delivery were randomly assigned to one of two groups. In the experimental group, patients were maintained in the lateral position for 10 minutes following intrathecal injection (group Decubitus). In the control group, patients were repositioned to supine immediately after the injection (group Supine). Incidence of hypotension, the required dose of ephedrine, and characteristics of the sensory blockade, were subsequently investigated. RESULTS: The incidence of hypotension, the incidence of nausea, and total amount of ephedrine, were not statistically different between the two groups. In group Decubitus, the onset of hypotension was delayed significantly (5.6 ± 1.7 min vs. 13.8 ± 1.7 min, P < 0.001), and the maximal blockade level was more cephalad (T3 [T1–T4] vs. T4 [T3–T5], P < 0.001) when compared to that of group Supine. Apgar scores were comparable in both groups. CONCLUSIONS: Maintaining the lateral position for 10 min following intrathecal injection during cesarean delivery did not influence the incidence of maternal hypotension. However, it caused delayed onset of hypotension and higher cephalad spread of sensory block.
Anesthesia, Spinal* ; Bupivacaine ; Ephedrine ; Fentanyl ; Humans ; Hypotension* ; Incidence ; Injections, Spinal ; Nausea

A 59-year-old man with thymic carcinoma underwent Tc-99m MIBI myocardial SPECT, and Tc-99m MIBI uptake in the mass was unexpectedly found in a planar image. SPECT images of the thorax showed an increased uptake area with central photon deficiency (a ring-like appearance), which reflected central tumor irreversible ischemia or progressing necrosis with peripheral viable tumor tissue.
Humans ; Ischemia ; Middle Aged ; Necrosis ; Thorax ; Thymoma* ; Tomography, Emission-Computed, Single-Photon

STUDY DESIGN: This is a retrospective study on the factors affecting the surgical results for cervical spondylotic myelopathy. OBJECTIVES: We wanted to analyze the clinical and radiologic factors affecting the results of treatment for cervical spondylotic myelopathy patients who underwent anterior decompression with fusion or open door laminoplasty. SUMMARY OF THE LITERATURE REVIEW: Many authors have reported on the prognostic factors affecting the results of surgical treatment for cervical spondylotic myelopathy; some of the reported factors do affect the results, but there is a wide range of opinion about them. MATERIALS AND METHODS: We reviewed 38 patients who underwent anterior decompression with fusion or open door laminoplasty for cervical spondylotic myelopathy between March 1999 and Dec. 2003. We analyzed the factors, including age, the duration of symptoms, the symptomatic classification, the preoperative and postoperative JOA scores, the compression ratio of the spinal cord and the surgical method. RESULT: The mean JOA score increased from 10.3+/-3.4 preoperatively to 14.9+/-4.6 postoperatively with a recovery rate of 69.0% +/- 21.24%. The preoperative JOA score and the compression ratio of the spinal cord on MRI correlated positively with the recovery rate. The patients' age showed negative correlation with the recovery rate. There is no difference between the two surgical methods for the recovery rate. CONCLUSION: The preoperative JOA score, the patients' age and the spinal cord compression ratio on MRI are the prognostic factors affecting the surgical results, but there are no difference between the two surgical method.
Classification ; Decompression ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Diseases*