BACKGROUND: Computerized topography(CT) is the method of choice for establishing patients with abdominal and/or pelvic trauma. However, the sensitivity of CT far detecting bladder rupture has been questioned. We investigated the roles of CT as the initial evaluation of abdominal and pelvic trauma in diagnosis of bladder rupture. METHODS: We reviewed the medical records and radiographs of 53 patients with bladder rupture for last 5 year. And among them, all radiographs of 30 patients who underwent both CT and retrograde cystography were evaluated independently by two urologists who had no knowledge of the patients' final diagnosis. RESULTS: Among 30 patients, all of patients were correctly diagnosed by retrograde cystography, but the CT diagnosis was correct in only 23 patients(76.7%), who were 17 patients(85.0%) with intraperitoneal rupture and 6 patients(60%) with extraperitoneal rupture. And of the 7 patients who were negative by the CT, all showed the sign of inadequate bladder distension. CONCLUSION: We suggest that CT, if properly performed with adequate bladder filling, is as sensitive for detection of bladder injuries as conventional cystography. Especially, in trauma patients with hematuria and suspected other organ injury, CT-cystography with retrograde filing may be as accurate as conventional cystography and obviate the need for an additional plain film cystography,
Diagnosis* ; Hematuria ; Humans ; Medical Records ; Rupture ; Urinary Bladder*

STATEMENT OF PROBLEM: Proper proximal contact is important for maintaining and stabilizing the dental arch. However, the proximal contact strength (PCS) is not a constant value and can be affected by a variety of factors. PURPOSE: This study examined the influences of postural changes on the posterior PCS. MATERIAL AND METHODS: Twelve adults with a normal occlusion and had not undergone prosthetic treatment or proximal restoration were participated in this study. A metal strip was inserted into the proximal surface and removed at a constant velocity. The contact strength was measured in every contact point between canine to second molar in both arches. The PCSs were obtained initially in the upright position, secondly in the supine position and finally in the upright position again. All measurements were repeated after a 2 hour period. Statistical analysis was carried out using the Friedman test (P < .05). RESULTS: Generally, a decrease in PCS occurred when the posture was changed from the initial upright to supine position, while it increased when the posture was changed from the supine to upright position. A significant change was observed in all areas except for between the canine-first premolar in the maxilla and between the first molarsecond molar in the mandible areas. CONCLUSION: The posterior PCS, which dentists generally believe to be a static feature of occlusion, is affected significantly by posture.
Adult ; Bicuspid ; Dental Arch ; Dentists ; Humans ; Mandible ; Maxilla ; Molar ; Posture ; Supine Position

BACKGROUND: Recently, it has been established that plateletpheresis needs more efficiency and shorter processing time. Fenwall laboratories developed a new collection chamber for CS-3000 Plus, PLT-30TM collection chamber, which can reduce the processing time with efficient collection. We evaluated the PLT-30TM collection chamber by comparing it with A-35 collection chamber that has been used as a standard collection chamber of CS-3000 Plus us. METHODS: Thirty platelet collection procedures were performed using the CS 3000 Plus with A-35 collection chamber and PLT-30TM collection chamber. The changes of the hematologic parameters between pre- and post-donation in donors and the total platelets yields and the contaminated WBCs in the plateletpheresis products were evaluated. In processing, the yield predictor calibration was adjusted to 1.00 and 1.13 in A-35 and PLT-30TM respectively. Yield predictors of pheresis were the same as 3.5x1011 in both and end point volumes were calculated from the CS-3000 Plus. Processing volume and processing times were compared between A-35 and PLT-30TM groups. RESULTS: With PLT-30TM collection chamber, 3.38+/-0.72x1011/L platelets were harvested, whereas 3.20+/- 0.73x1011/L were collected with A-35 collection chamber, which was not significantly different. But processing time with the PLT-30TM collection chamber was more reduced than that with the A-35 collection chamber by about 20 minutes (PLT-30TM : 88.6+/-8.4 min, A-35 : 106.7+/-11.7min). Collection efficiency of PLT-30TM chamber was 50.7+/-12.5% and that of A-35 chamber was 44.4 + 8.8%. The leukocyte contamination of the platelet concentrates were not statistically different(PLT-30TM: 0.0-3.6x106, A-35 : 0.1-4.1x106). CONCLUSIONS: PLT-30TM collection chamber has the advantages of shortening the donation time and decreasing the processing volume with better collection efficiency and flexibility of platelet concentrate volume.
Blood Component Removal ; Blood Platelets ; Calibration ; Humans ; Leukocytes ; Plateletpheresis ; Pliability ; Tissue Donors

OBJECTIVES: The objective of this study is to analyze 1,068 cases of prenatal genetic amniocentesis and to compare the results with reported studies. METHOD: We analyzed 1,068 cases of midtrimester prenatal genetic amniocenteses from September 1994 to February 1999, and investigated the fetal chromosomal abnormality, obstetric outcomes and complications by the indications of genetic amniocentesis and prophylactic antibiotic use at the Department of Obstetrics and Gynecology, Ajou University School of Medicine. RESULTS: Abnormal maternal serum markers were the most common indication of amniocentesis (57.7%) and the most common age distribution was 25-29 years (39.2%). One case of early amniocentesis (14 gestational weeks) was performed. The overall incidence of chromosomal aberration was 5.2% (56/1,068), of which there were 28 cases (50.0%; 28/56) of numerical aberrations and 28 cases (50.0%; 28/56) of structural aberrations. There were 50 cases (4.7%) of autosomal chromosomal aberrations and 6 cases (0.6%) of sex chromosomal aberrations. The pregnancy outcome was full-term delivery in 86.5%, preterm delivery in 7.6%, termination of pregnancy in 4.0%. There were no cases of serious complications including fetal death except for a case of self-limited amniotic fluid leakage(high leakage) in which the pregnancy was maintained. There were no significant differences between prophylactic antibiotics user group and non-user group in obstetric complications and outcomes. CONCLUSION: We could confirm that the trend in the indication of genetic amniocentesis had changed from advanced maternal age(35 year-old) toward abnormal maternal serum marker(triple test), and we recognized the importance of genetic amniocentesis according to the various antenatal screening tests of maternal serum marker, antenatal ultrasound, past history of fetal anomaly or family history of fetal chromosomal anomaly in the younger age groups(< 35 year-old) that are involved in more than half of the chromosomal anomaly. Further study will be needed to elucidate the efficacy of using prophylactic antibiotics in amniocentesis.
Age Distribution ; Amniocentesis* ; Amniotic Fluid ; Anti-Bacterial Agents ; Biomarkers ; Chromosome Aberrations ; Female ; Fetal Death ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Ultrasonography

Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Diabetes, Gestational ; Female ; Fetus* ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin*

No abstract available.
Jeollabuk-do* ; Pregnancy* ; Toxoplasma*

Purpose: The aim of this study was to determine whether the stone mineral content (SMC) and stone mineral density (SMD), as measured by dual energy X-ray absorptiometry, can predict the stone fragility in extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: In the experimental study, the stone size, weight, SMC and SMD of 111 urinary calculi, obtained by open surgery, were measured. The SMC and SMD were measured using dual energy X-ray absorptiometry, which is the gold standard for measuring the bone mineral content and density. The number of shock waves necessary for full fragmentation was accepted as a measure of the stone fragility in ESWL (EDAP-sonolith Praktis). In the clinical study, the stone size, SMC and SMD were measured in a total of 48 patients with a solitary renal stone of less than 3cm. Prior to ESWL all patients underwent dual energy X-ray absorptiometry to calculate the SMC and SMD. The correlations between the number of total shock waves and the stone size, SMC and SMD were analyzed. Results: In the experimental study, the stone size, stone weight, SMC and SMD values correlated with total shock waves, with a correlation coefficients (R) of 0.79, 0.95, 0.99 and 0.86, respectively (n=111). In the clinical study, the mean stone size, mean MC and MD values differed significantly between the clinically successful and failed ESWL (n=36 and n=12), respectively (p=0.0002, p=0.004, p=0.004). On a simple regression analysis, the SMC (R2=0.74), SMD (R2=0.56) and stone size (R2=0.51) were significant factors in predicting the number of shock waves. Using the receiver operating characteristic curves for comparing the stone size, SMC and SMD in relation to the number of shock waves, the areas under the respective curves were 0.79, 0.84 and 0.81 with cut-off values of 1.8, 1.4 and 1.8. Conclusions: The stone size, SMC and SMD measured by dual energy x-ray absorptiometry may provide a prediction of the outcome of patients prior to ESWL treatment. Patients with high SMC (greater than 1.4gm) could be recommended for percutaneous nephrolithotripsy or another treatment modality, thus, avoiding the unnecessary cost of prior ESWL.
Absorptiometry, Photon* ; Bone Density ; Humans ; Lithotripsy* ; ROC Curve ; Shock* ; Urinary Calculi

No abstract available.
Leptospira interrogans* ; Leptospira*

The aim of this study was to evaluate the risk factors of recurrences after their first febrile convulsions in infants and young children. Dlinical studies were made on 187 cases of febrile convulsions who were admitted to the Department of pediatrics of wallace Memorial Baptist Hospital from March, 1990 to December, 1992. 1) 63 cases of 187 cases had recurrences after their febrile convulsions. Thus, the recurrence rate was 33.7%. 2) The male to female ratio was 2.1:1. And there were no significant differences in recurrence rates between sexes. 3) The recurrence rate was significantly higher in those whose initial febrile convulsions were developed before first 18 months of life than those whose initial convulsions were after 18 months of age (49.5% vs. 12.5%). 4) The time interval from initial attack to recurrence was within 12 months in 80% of cases. 5) Our study revealed that the seizure characteristics of the initial febrile convulsion are not important as predictive factors about the probability of recurrences. 6) Among the total 187 cases, family history were present in 52 cases (27.8%). And there were significantly higher recurrence rates if their families show the same history of febrile convulsion (63.5% vs. 22.2%). 7) The risk of recurrence was much higher in patients whose first febrile history of febrile convulsion at the same time.
Child ; Female ; Humans ; Infant ; Male ; Pediatrics ; Protestantism ; Recurrence ; Risk Factors ; Seizures ; Seizures, Febrile*

No abstract available.
Priapism*