OBJECTIVE: This study was designed to evaluate whether maternal serum human chorionic gonadotropin(hCG) level measured during second trimester could be used as a predictor of pregnancy-induced hypertension. METHODS: Between March 1996 and November l997, 505 pregnant women undergoing second trimester(14-22 weeks of amenorrhea) triple marker screening for neural tube defect and Down syndrome who delivered at our institution were reviewed. All samples were assayed in the same laboratory and medical records were reviewed about medical and obstetrical history. RESULTS: Maternal serum human chorionic gonadotropin level(multiples of the median, MoM) was significantly higher in the pregnancy-induced hypertension group than in the control group. With the use of 2. l multiples of the median as a cutoff value, the sensitivity of human chorionic gonadotropin as a screening marker for development of pregnancy-induced hypertension was 38.7%, the specificity was 95.9%, positive predictive value was 38.7% and negative predictive value was 95.9%. Conlusion: We suggest that second trimester maternal serum human chorionic gonadotropin levels can be used clinically as an early predictive marker for pregnancy-induced hypertension.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Humans ; Humans* ; Hypertension* ; Hypertension, Pregnancy-Induced ; Mass Screening ; Medical Records ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Sensitivity and Specificity

Urine discoloration occurs in the intensive care unit (ICU) due to many causes such as medications, metabolic disorders, and infections. Propofol is advocated as one of the first line sedatives in the ICU, but it is not well known to the intensivists that propofol can induce urine color change. We experienced two cases of green urine after propofol infusion. Propofol should be warranted as the cause of urine discoloration during ICU stay.
Hypnotics and Sedatives ; Intensive Care Units* ; Propofol*

No abstract available.
Peroxisomes

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*

The universal first step for the treatment of diabetes mellitus, hypertension, dyslipidemia or atherosclerotic disease is therapeutic lifestyle change (TLC). However, in most cases, long-term sincere maintenance of TLC is very difficult. The Look-AHEAD study was initiated based on the results of the Diabetes Prevention Program (DPP) trial that evaluated the effects of TLC on the prevention of diabetes. However, the look-AHEAD trial failed to demonstrate the benefit of intensive lifestyle intervention (ILI) for the prevention of CVD or CVD-associated mortality. Several explanations were suggested, including that the ILI group did not maintain effective weight loss, and that the intervention and control groups both received the same high-quality medical treatments. The participants of the look-AHEAD trial were very highly motivated, and the investigators of the trial systematically pursued their patients to achieve the desired end result, which is quite different from the usual clinical practice setting. Simple advisement for patients to perform diet restriction and moderate intensity regular physical exercise typically fails and is ineffective for the prevention of CVD in actual clinical practice. Concomitant sincere control of other risk factors is necessary for long-term CVD prevention. Further research on practical and effective methods for achievement of successful TLC is needed.
Cardiovascular Diseases* ; Diabetes Mellitus ; Diet ; Dyslipidemias ; Exercise ; Humans ; Hypertension ; Life Style* ; Mortality* ; Research Personnel ; Risk Factors ; Weight Loss

As the newly reconstructed nipple tends to be flattened, especially if submitted to pressure, prudent dressings using various protective devices as a physical support against pressure on a new nipple is important. We used a breathing bag connecting tube as a protective device in nipple reconstruction. A breathing bag connecting tube recycled was cut and trimmed at 1cm above the height of the reconstructed nipple. Before stitch out, the newly reconstructed nipple with a local flap was dressed and protected in this way for 10 days after surgery. After stitch out, patients learnt how to manage the new nipple at home. The sole means of nipple dressing was affixing the breathing bag connecting tube with adhesive tape. Two patients had worn the tube for two months with the best compliance. Owing to the soft composition of the tube material, it is possible for a surgeon to have an easy cutting and trimming of the tube at appropriate heights as well as for a patient to show better compliance yielding better results. The cost factor is another advantage.
Adhesives ; Bandages ; Compliance ; Fibrinogen ; Humans ; Nipples* ; Protective Devices ; Respiration*

PURPOSE: To determine the effect of polyurethane with sustained release dexamethasone in delayed adjustable strabismus surgery in rabbits. METHODS: After recession of the superior rectus muscle(SRM), balanced salt solution or polyurethane film with/without sustained release dexamethasone was applied beneath and over the SRM in the control group(group C), polyurethane-steroid group(group P-S) and polyurethane group(group P), respectively. Delayed adjustment was performed once on each SRM at four and six weeks postoperatively by a masked observer. The possible length to adjust and the necessary force required for the adjustment, as well as the degree of any adhesions, were also evaluated. RESULTS: In the control group, adjustment was impossible in all of the eyes at four and six weeks postoperatively. In group P-S, adjustment was possible in 11 out of 11(11/11) eyes four weeks postoperatively and in 10/11 eyes six weeks postoperatively. In group P, adjustment was possible in 9/11 eyes four weeks postoperatively and in 10/12 eyes six weeks postoperatively. In addition, the degree of adhesion was significantly less in group P and in group P-S compared to the control group. The degree of adhesion between the SRM and the sclera was marginally better(p=0.051) in group P-S four weeks postoperatively than in group P. CONCLUSIONS: Use of polyurethane film could delay adjustment in most of the rabbit eyes for up to six weeks postoperatively. Sustained release dexamethasone is helpful for delaying adjustment in rabbit eyes until six week postoperatively without the need for frequent topical instillation of steroids.
Dexamethasone* ; Masks ; Polyurethanes* ; Rabbits ; Sclera ; Steroids ; Strabismus*

The present study examined cortical cerebral microinfarcts (CMIs) on a 3T magnetic resonance imaging and investigated the impact of CMIs on the comprehensive functional outcomes during the post-stroke rehabilitation period. Patients with acute phase of firstever ischemic stroke were retrospectively recruited (n = 62) and divided into 2 groups with and without CMIs. Clinical parameters including age, sex, stroke lesion laterality, location, the National Institutes of Health Stroke Scale score, as well as history of hypertension, dyslipidemia, diabetes mellitus, and smoking were obtained. Functional outcomes were assessed twice at baseline and one month later with the Korean version of the MiniMental State Examination, the Berg balance scale (BBS), and the functional independence measure. Partial correlation and multiple linear regression analyses were used to examine the relationship between the presence of CMIs and the change in functional outcomes. At least one CMI was reported in 27 patients, who were older (p = 0.043). The presence of CMIs was significantly associated with functional impairment in all 3 functional outcomes, after controlling for confounding factors (p < 0.05). CMIs might contribute to poor functional outcomes during the post-stroke rehabilitation period. These results suggest that CMIs should be considered when establishing rehabilitation treatment strategies or making a prognosis.

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

PURPOSE: The purpose of this study was to develop and evaluate breastfeeding effectiveness scale to measure effectiveness of breastfeeding for mothers in the early postpartum period. METHODS: A conceptual framework was constructed from properties of effective breastfeeding (Yang and Seo, 2011), and item construction was derived from literature review and analysis of the data along with interviews with breastfeeding mothers. Content validity was tested by experts. Each item was scored on a five-point Likert scale. The preliminary questionnaire was administered to 248 breastfeeding mothers. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's α. RESULTS: From the factor analysis, 20 items in seven factors were derived. The factors were identified as mother's satisfaction, suckling, assurance of milk quantity, infant's satisfaction, latching on, infant's feeding desire, and breastfeeding positioning. The seven factors explained 65.1% of total variance, Cronbach's α of the total items was .83 and the factors ranged from .44 to .75. CONCLUSION: Results of this study suggest that breastfeeding effectiveness scale is a reliable and valid instrument to measure breastfeeding effectiveness of mothers in the early postpartum period.
Breast Feeding* ; Humans ; Milk ; Mothers ; Postpartum Period ; Weights and Measures