No abstract available.
Blood Pressure* ; Humans ; Infant, Newborn*

Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition

The value of the bone scan in pyogenic bone and joint infections is demonstrated in patients who had signs and symptoms suggestive of bone or joint infection. Nineteen patients were evaluated with 99m Tc-methylene diphosphonate bone scan and roentgenogram. The diagnosis of acute osteomyelitis was made in eight patients, chronic osteomyelitis in six patients, septic arthritis in three patients and two patients had soft tissue infection only. Seven of the eight patients with acute osteomyelitis had focal increase of radiopharmaceutical uptake in the bone well before the bony change appeared on roentgenogram. Five of six chronic osteomyelitis patients had not only bony change on roentgenogram but also increased radiopharmaceutical uptake of bone. But the remaining one had only the former, and the lesion was interpreted as inactive. In two of three septic arthritis patients, the lesion was in S-I joint and both of them had no abnormality on roentgenogram but had increased uptake of radiopharmaceutical agent in the joint. Two patients with soft tissue infection had no abnormal radiological bony change and no increase of the radiopharmarceutical uptake in bone on bone scan. From the above data, we concluded that bone scan is recommended in the evaluation of the patients with signs and symptoms suggestive of bone or joint infection for the earlier diagnosis and differential diagnosis in acute case and for the determination of the activity and location of the lesion in chronic case.
Arthritis, Infectious ; Diagnosis ; Diagnosis, Differential ; Humans ; Joints ; Osteomyelitis ; Soft Tissue Infections

PURPOSE: The aim of this pilot study was to determine the relationship between the beta-fibrinogen G/A-455 single nucleotide polymorphism and the risk of ischemic stroke in Korea because there are racial differences in polymorphisms and Koreans have never been studied before. METHODS: From March to September 2003, we compared 80(male : female=1.2 : 0.8) patients who were diagnosed with ischemic stroke at Kyung Hee university hospital emergency center had been to 150 control subjects. The genotypes of the beta-fibrinogen G/A-455 polymorphism were confirmed by using the polymerase chain reaction (PCR) followed by HaeIII restriction enzyme digestion. RESULTS: The results showed that the patient group had a much higher rate of heterozygotism (GA or AG). A statistical analysis of the genotype frequency showed chi2 to be 6.24, indicating a significant difference between the patient and the control groups (p=0.044). For the allele frequency, the odds ratio was 1.88(95% CI 1.16-3.04), indicating a significant difference between the two groups, and also allele frequency in ischemic stroke patient with or without hyperfibrinogenemia, male sex and smoking history showed odds ratio to be 2.38(95% CI 1.26~4.49), 1.78(95% CI 1.01~3.14)and 1.94(95% CI 1.12~3.35) indicating significant difference. CONCLUSION: The high rate of polymorphisms of the AA genotype of beta-fibrinogen G/A-455 in ischemic stroke patients in our study leads us to the belief of the possibility that beta-fibrinogen G/A-455 polymorphisms in males with a smoking history and hyperfibrinogenemia, if found in advance, could lead to an improved prognosis and reduced clinical expenses by allowing early diagnosis and preventive management.
Digestion ; Early Diagnosis ; Emergencies ; Gene Frequency ; Genetics ; Genotype ; Humans ; Korea ; Male ; Odds Ratio ; Pilot Projects* ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prognosis ; Smoke ; Smoking ; Stroke*

OBJECTIVE: To compare sexual function before and 12 months after between sacrocolpopexy and sacrocervicopexy. METHODS: This retrospective study examined a cohort of 55 sexually active women who underwent either supracervical hysterectomy with sacrocervicopexy (n=28) or total abdominal hysterectomy with sacrocolpopexy (n=27) for stage II to IV pelvic organ prolapse. Pelvic floor support was measured with Pelvic Organ Prolapse-Quantification examination. Pelvic floor function was measured with the Pelvic Floor Distress Inventory-Short Form 20 and sexual function was measured with Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-Short Form 12 (PISQ-12). RESULTS: Baseline pelvic floor symptoms, demographics and PISQ-12 questionnaire scores were similar between the two groups. Overall improvements in sexual function were seen based on PISQ-12 scores in both groups, but were not statistically significant. No differences were seen in PISQ-12 scores regardless of sparing the cervix or surgical route. Responses to the PISQ-12 question of avoiding sexual intercourse because of vaginal bulging showed significant improvement in both group. No recurrences of prolapse occurred. CONCLUSION: In women with pelvic organ prolapse, sexual function after either sacrocolpopexy or sacrocervicopexy was not different. Sexual dysfunction in terms of avoidance of sexual activity because of vaginal bulging was greatly improved in both groups with statistical significance.
Cervix Uteri ; Cohort Studies ; Coitus ; Demography ; Female ; Humans ; Hysterectomy ; Pelvic Floor ; Pelvic Organ Prolapse ; Prolapse ; Recurrence ; Retrospective Studies ; Sexual Behavior

43 cases of neonatal hepatitis were clinicallt evaluated, who were admitted to the pediatric department of Severance hospital furing period from April, 1956 to Februart, 1976. The following results were obtained. There was little difference in sex incidence, and most of them were admitted at the age of 1 month to 3 months after birth. Clinical symptoms and signs on admission were jaundice(95%), hepatomegaly(95%), splenom-egaly(41%), fever(41%), and cough(20%). Clay-colored stool was found in 34 cases(79%), and jaundice was found within 6 weeks after birth in most patients. In laboratory studies, total bilirubin, SGOT, SGPT, and Al. phosphatase were all elevated, and return to normal level at 5 weeks after admission. For the precise diagnosis, needle biopsy of the liver was done in 18 cases, among which 14cases showed multinucleated giant cells in specimen, but in 4 cases, giant cells were not observed, and only intrabepatic cholestasis was seen. As complication, bronchopneumonia(9 cases), sepsis(6 cases), rickets(3 cases), and bleeding(4 cases) developed, but which did not influence the prognosis. Most patients were recovered completely, but 6 patients died during admission and 7 patients were discharged in a hopeless condition.
Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Biopsy, Needle ; Cholestasis ; Diagnosis ; Giant Cells ; Hepatitis* ; Humans ; Incidence ; Jaundice ; Liver ; Parturition ; Prognosis

Renal calcifications are a recognized complication of furosemide therapy in premature infants. Particularly in infants with chronic lung disease, the use of this potent diuretic is associated with hypercalciuria, which may predispose the infant to medullary nephrocalcinosis and renal calculi, We experienced two cases of nephrocalcinosis in very low birth weight infants. One had bronchopulmonary dysplasia, pneumonia, patent ductus arteriosus, ventricular septal defect and congestive heart failure and the other had systemic cytomegalovirus infection with cytomegalovirus pneumonitis and ricket of prematurity. Both patients received a large amount of furosemide. We presented these cases with brief review of literatures.
Bronchopulmonary Dysplasia ; Cytomegalovirus ; Cytomegalovirus Infections ; Ductus Arteriosus, Patent ; Furosemide ; Heart Failure ; Heart Septal Defects, Ventricular ; Humans ; Hypercalciuria ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Kidney Calculi ; Lung Diseases ; Nephrocalcinosis* ; Pneumonia

No abstract available.
Afibrinogenemia*

PURPOSE: We sought to determine the impact of the factors that affect the mortality of critically ill patients with sepsis or septic shock. METHODS: We performed a retrospective cohort study of adult patients admitted with sepsis or septic shock from April 1, 2006, to December 31, 2007, at a single, urban academic emergency department (ED). The primary outcome was patients' death. Predictor variables were the EDLOS, the time from registration to order for antibiotics administration, number of hospital days, initial systolic blood pressure, systolic blood pressure after hydration, heart rate, respiration rate, body temperature, serum white blood cell count, and serum lactic acid level. Cox's proportional hazard model was used to elucidate the relationship of predictor variables to patients' death. Data were analyzed with SPSS version 12.0. RESULTS: The overall mortality rate was 56.2%. Average length of stay was 204.5+/-90.6 minutes in the survival group and 166.6+/-81.8 minutes in the death group (p=0.041). The mortality was not shown to be significantly different between patients spending less than 4 hours and patients spending over 4 hours. The relative risk (RR) for patients' death was significantly higher in patients with hypotension persisting despite adequate fluid resuscitation. CONCLUSION: EDLOS did not affect mortality for the patients admitted with sepsis or septic shock. The patients' prognoses were mainly related to the systolic blood pressure after hydration.
Adult ; Anti-Bacterial Agents ; Blood Pressure ; Body Temperature ; Cohort Studies ; Critical Illness ; Emergencies ; Heart Rate ; Humans ; Hypotension ; Lactic Acid ; Length of Stay ; Leukocyte Count ; Prognosis ; Proportional Hazards Models ; Respiratory Rate ; Retrospective Studies ; Sepsis ; Shock, Septic

PURPOSE: The aim of this study was to evaluate the beta-fibrinogen gene -455 G/A and 448 G/A polymorphisms and to determine the relationship of these single nucleotide polymorphisms with plasma fibrinogen concentration and with the development of ischemic stroke in Korea. METHODS: 123 patients who were diagnosed with ischemic stroke at Kyung Hee University Hospital from March 2003 to February 2004 were compared to 230 control subjects. The genotypes of the beta-fibrinogen gene -455 G/A and 448 G/A polymorphisms were confirmed by polymerase chain reaction (PCR), and the allele frequencies of the patient group were compared to those of the control group. The associations of the single nucleotide polymorphisms with development of ischemic stroke and risk factors of ischemic stroke were assessed. RESULTS: The patient group had more heterozygotes (G/A or A/G) in the beta-fibrinogen gene than did the control group, and statistical analysis of the genotype frequencies indicated a significant difference between the patient group and the control group (p<0.05). The odds ratios of the allele frequencies were 1.53(95% CI; 1.03-2.29) for the -455 G/A polymorphism and 1.85(95% CI; 1.25-2.74) for the 448 G/A polymorphism, indicating a statistically significant difference between the patient and control groups. In ischemic stroke patients, the allele frequencies for smoking history and hyperfibrinogenemia yielded odds ratios of 1.96(95% CI; 1.17-3.27) and 2.40(95% CI; 1.31-4.40), respectively, for the -455 G/A polymorphism and 1.96(95% CI; 1.19-3.22) and 2.42(95% CI; 1.34-4.39) for the 448 G/A polymorphism. CONCLUSION: The -455 G/A and 448 G/A single nucleotide polymorphisms of the beta-fibrinogen gene appear to be associated with plasma fibrinogen concentration and the development of ischemic stroke in Korea.
Fibrinogen* ; Gene Frequency ; Genetics ; Genotype ; Heterozygote ; Humans ; Korea ; Odds Ratio ; Plasma* ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Risk Factors ; Smoke ; Smoking ; Stroke*