PURPOSE: To evaluete the sonographic features of ovarian mass torsion. MATERIALS AND METHODS: We evaluated the sonographic findings in 22 cases of torsioned cystic ovarian mass, benign teratoma(n=21), and normal ovary (n=l) confirmed surgically on pathologically. We classified the ovarian mass into two groups as sonographic ally cystic (n=15) or non-cystic mass(n=6). The patients were 17-72 years old(mean:36.9). We retrospectively reviewed US examination with respect to (1) free fluid in Douglas pouch, (2)pelvic mass & mass wall thickening, (3)dilated uterine tube, (4)prominent follicles, (5) engorged vessels, and (6)beak-like echo in torsion site. The combined conditions of torsion were uterine myoma(n=l) and intrauterine pregnancy(n=3). RESULTS: In sonogram, sonographic cystic mass (n=15) group showed (1)free fluid in Douglas pouch (9/15), (2)mass wall thickening(6/15), (3)dilated uterine tube(2/15), and sonographic non-cystic mass(n=6) group showed (1) free fluid in Douglas pouch (3/6). In sonogram, torsion of the normal ovary(n=1) showed (1) free fluid in Douglas pouch, and (2) prominent follicles. CONCLUSION: If sonogram of reproductive aged women with acute abdomen show free fluid in Douglas pouch and pelvic mass with wall thickening, ovarian mass torsion is suggested. But clinical features of acute abdomen and clinical diagnosis of torsion are more important than sonographic features.
Abdomen, Acute ; Diagnosis ; Douglas' Pouch ; Fallopian Tubes ; Female ; Humans ; Ovary ; Retrospective Studies ; Ultrasonography*

No abstract available.
Child* ; Humans ; Infant* ; Urinary Tract Infections* ; Urinary Tract*

Although the occurrence of fatal pulmonary embolism may be diminishing, it still accounts for a substantial proportion of postoperative deaths in the middle-aged and older persons, especially among those undergoing major orthopedic surgery, despite improvements in patient management. We experienced cardiac arrest during bipolar endoprosthesis. Cardiopulmonary resuscitation was started and the transesophageal echocardiogram showed right heart failure. We suspected acute pulmonary thromboembolism and decided to perform thromboembolectomy with cardiopulmonary bypass. A massive old blood clot and a 1.0 x 1.5 cm thrombus were removed from both pulmonary arteries. However, despite massive fluid therapy and the use of inotropic agent, the patient failed to recover successfully with postoperative management in the intensive care unit.
Cardiopulmonary Bypass* ; Cardiopulmonary Resuscitation ; Fluid Therapy ; Heart Arrest ; Heart Failure ; Hip* ; Humans ; Intensive Care Units ; Orthopedics ; Pulmonary Artery ; Pulmonary Embolism* ; Thrombosis

No abstract available.
Anisakiasis*

We report a case of a 66-year-old woman with progressing myelopathy. Her history revealed instrumented fusion from T10 to S1 for degenerative lumbar kyphosis and spinal stenosis. The plain radiographs showed narrowing of the intervertebral disc space with a gas shadow and sclerotic end-plate changes at T9-T10. Magnetic resonance imaging revealed a posterolateral mass compressing the spinal cord at the T9-T10 level. The patient was treated with a discectomy through the posterior approach combined with posterior instrumentation. The patient's symptoms and myelopathy resolved completely after the discectomy and instrumented fusion. The thoracic disc herniation might have been caused by the increased motion and stress concentration at the adjacent segment.
Aged ; Diskectomy ; Female ; Humans ; Intervertebral Disc ; Kyphosis ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord ; Spinal Cord Diseases ; Spinal Stenosis

BACKGROUND: Everolimus and cyclosporine (CsA) exhibit synergistic immunosuppressive activity when used in combination. We analyzed preliminary data about the use of everolimus with a CsA-sparing strategy in de novo renal transplant recipients. METHODS: A comparative, parallel, randomized, open-label, 1 year study has been performed in 117 patients from 5 transplant centers to compare the efficacy and tolerability of everolimus (EVE)+reduced-dose CsA or enteric-coated mycophenolate sodium (Myfortic)+standard-dose CsA in combination with basiliximab and steroids. It ended on August 24, 2011. Efficacy failure (biopsy-proven acute rejection, death, graft loss, or loss to follow-up), safety, and renal function were evaluated at 1, 3, 5, and 12 months post-transplantation. RESULTS: Efficacy failure was comparable between the two groups. Only one graft loss has been reported in the control group and no patient death reported in either group. There was no significant difference in the incidence of biopsy-proven acute rejection until 3 and 5 month post-transplantation (P>0.05). The mean e-GFR of the group of EVE+reduced-dose CsA was significantly higher than that of the control group at 3 (65.6+/-16.9 mL/mim/1.73 m2 vs. 56.7+/-14.4 mL/mim/1.73 m2; P=0.007) and 5 (68.6+/-18.8 mL/mim/1.73 m2 vs. 58.1+/-16.2 mL/mim/1.73 m2; P=0.009) months. There was no significant difference in the incidence of discontinuations and serious adverse events between the groups (P>0.05). CONCLUSIONS: The regimen of EVE+reduced-dose CsA seems to be tolerated well, with comparable efficacy failure and better renal function than enteric-coated mycophenolate sodium+standard-dose CsA.
Antibodies, Monoclonal ; Cyclosporine ; Everolimus ; Graft Rejection ; Humans ; Immunosuppression ; Incidence ; Kidney ; Kidney Transplantation ; Mycophenolic Acid ; Recombinant Fusion Proteins ; Rejection (Psychology) ; Sirolimus ; Sodium ; Steroids ; Transplants

BACKGROUND: Definite criteria for determining severity of organophosphate poisoning have not been made. Discovery of the third neuromuscular syndrome, the intermediate syndrome, have made it more complicating then ever. Objectives of this study is to determine early prognostic factors of outcome and development of a new treatment algorithm. METHOD: 74 patients admitted to Severance hospital with acute organophosphate poisoning during 5 years were included. We made a protocol concerning the initial consciousness level, QTc interval, PVC, serum cholinesterase, the intermediate syndrome, total hospital, ICU day, length of ventilator support, disposition and have done a study retrospectively. Multiple regression and Chi-square was used as statistical analysis. Significant statistical P-value was 0.05. RESULTS: The total hospital days were prolonged as serum cholinesterase levels were lower, the age was older and mental status graver.(p<.05) The length of ventilatory support was prolonged when patient's serum cholinesterase level was very low, they were unconscious and serum cholinesterase level not recovered to 500 IU/ml within initial 3 days. The intermediate syndrome was significantly related to the prolonged cholinesterase inhibition. CONCLUSION: As an early prognostic factor for the length of ventilatory support in organophosphate poisoning, 1) level of concsiousness and 2) serum cholinesterase level at admission, 3) recovery to more than 500 IU/ml within initial 3 days are useful. Especially when the serum cholinesterase level is not recovered to more than 500 IU/ml within initial 3 days, it is essential to observe closely for the possibility of an intermediate syndrome.
Cholinesterases ; Consciousness ; Humans ; Organophosphate Poisoning* ; Retrospective Studies ; Ventilators, Mechanical

Perillae Herba has been traditionally used for the sedation in the oriental countries. Therefore, this study was conducted to determine whether Perillae Herba ethanol extract (PHEE) enhances pentobarbital-induced sleeping behaviors in animals. In addition, the possible mechanisms are demonstrated. PHEE (12.5, 25 and 50 mg/kg. p.o.) reduced the locomotor activity in mice. PHEE reduced sleep latency and augmented the total sleep time in pentobarbital (42 mg/kg, i.p.)-induced sleep in mice. Furthermore, the number of sleeping mice treated with sub-hypnotic pentobarbital (28 mg/kg, i.p.) increased. PHEE (50 mg/kg. p.o.) decreased the sleep/wake cycles and wakefulness, and increased total sleeping time and NREM sleep in electroencephalogram (EEG) of rats. In addition, PHEE (0.1, 1.0 and 10 µg/ml) increased the intracellular Cl⁻ level through the GABA receptors in the hypothalamus of rats. Moreover, the protein of glutamate decarboxylase (GAD) was overexpressed by PFEE. It was found that PHEE enhanced pentobarbital-induced sleeping behaviors through GABA(A)-ergic transmissions.
Animals ; Electroencephalography ; Ethanol* ; Eye Movements* ; gamma-Aminobutyric Acid ; Glutamate Decarboxylase ; Hypothalamus ; Mice ; Motor Activity ; Pentobarbital ; Perilla* ; Rats ; Receptors, GABA ; Wakefulness

PURPOSE: The purpose of this study was to identify the factors influencing parenting stress in primiparas. METHOD: The participants in this study were 198 primiparas of infants aged 1-6 months who visited well baby clinics in 5 hospitals. The data were collected from April 15 to June 15, 2003. RESULTS: The mean score for parenting stress was 2.4 of a possible 5 and thus considered average. The score for parenting stress was significantly correlated with the level of maternal perception of the infant and the level of social support. The score for parenting stress was significantly different according to the education level of the primiparas and prenatal management. For the primiparas, social support(20%) and maternal perception of the infant(9%) were significant predictors explaining parenting stress. CONCLUSIONS: Nursing interventions to improve maternal perception of the infant and increase social support should be provided for primiparas in order to reduce parenting stress.
Education ; Humans ; Infant ; Nursing ; Parenting* ; Parents* ; Child Health

Multiple aspergillus spondylitis (AS) is a life threatening infection that occurs more commonly in immunocompromised patients, and is commonly treated with antifungal agents. However, there is relatively little information available on the treatment of multiple AS. The authors encountered a 46-year-old man suffering from low back and neck pain with radiculomyelopathy after a liver transplant. The patient had concomitant multiple AS in the cervico-thoraco-lumbar spine and right hip joint, as confirmed by radiologic imaging studies. The pathological examination of a biopsy specimen revealed fungal hyphae at the cervical and lumbar spine. Anterior decompression and interbody fusion were performed for the cervical and lumbar lesions, which showed instability and related neurological symptoms. Additional antifungal therapy was also performed. The patient was treated successfully with remission of his symptoms.
Antifungal Agents ; Aspergillus ; Biopsy ; Decompression ; Hip ; Hip Joint ; Humans ; Hyphae ; Immunocompromised Host ; Liver ; Middle Aged ; Neck Pain ; Spine ; Spondylitis ; Stress, Psychological ; Transplants