PURPOSE: Prolonged fetal hypoxia stimulates erythropoiesis in fetal life and induces increased nucleated erythrocytes(NRBC) counts at the early newborn period. To evaluate the relationship between prolonged fetal hypoxia and neonatal intraventricular hemorrhage (IVH), and the prediction of neonatal IVH by neonatal NRBC. METHODS: We compared the daily courses of the absolute NRBC count in preterm new- boms at 34 weeks' gestation or earlier with(n=17) and without(n=20) IVH for 7 days of life. RESULTS: Absolute NRBC counts at birth were higher in neonates with IVH than in control neonates(2,499/mm3+/-3,748 and 412/mm3+/-272, respectively, P=0.0022). The cut-off value of 1,000/mm3 for absolute NRBC counts at birth showed the best parameter estimate of the predictive model for IVH at early newborn period with 100% of positive predictive value and 74.1% of negative predictive value. CONCLUSION: Prolonged fetal hypoxia inducing fetal erythropoiesis near labor is closely related to IVH at early newborn period. Thabsolute NRBC counts at birth is the very important predictable marker for the condition.
Erythroblasts* ; Erythropoiesis ; Fetal Hypoxia ; Hemorrhage* ; Humans ; Infant, Newborn* ; Parturition ; Pregnancy

BACKGROUND: Generally, for patients with cancer, chronic disease, burn injury or pediatric patients to whom oral medication is difficult or whose vessels are fragile, it is difficult to inject analgesics parenterally. To know the effect of subcutaneous infusion which would be directly used by patients themselves or their care givers, we compared subcutaneous patient-controlled analgesia (SQ PCA) with intravenous patient-controlled analgesia (IV PCA) morphine for acute postoperative pain. METHODS: We undertook a study to prospective, randomized, controlled patients (n = 30) undergoing elective total hysterectomy to compare SQ PCA with IV PCA morphine for postoperative pain control. We prepared a 5 mg/ml solution of morphine for the SQ PCA group (n = 15) and a 1 mg/ml solution of morphine for the IV PCA group (n = 15). The regimen of morphine was a basal rate 20 microgram/kg/h, 1 mg bolus, 10 min lockout interval, 1 hour limit of 8 mg. We evaluated the VAS score at rest and at coughing after postoperative 6, 12, 18, 24, 30, 36, 42 and 48 hours, 6 hourly doses of morphine, total requirement of infused morphine for 48 hours and delivery to demand ratio. Side effects and satisfactory score were checked too. RESULTS: The Visual analogue scale (VAS) pain score at rest and with coughing, the 6 hourly doses of morphine, the total requirement of infused morphine for 48 hours, the delivery to demand ratio, side effects and the satisfactory score were not significantly different in the two groups (P<0.05). CONCLUSION: Thus SQ PCA morphine represents a clinically acceptable alternative to IV PCA in the treatment of postoperative pain control.
Analgesia, Patient-Controlled* ; Analgesics ; Burns ; Caregivers ; Chronic Disease ; Cough ; Humans ; Hysterectomy ; Infusions, Subcutaneous ; Morphine* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Prospective Studies

BACKGROUND: To evaluate the safety and the efficacy of amlodipine, a dihydropyridine calcium antagonist, monotherapy in the treatment of moderate essential hypertension. METHOD: Amlodipine 5mg once a day was administered as a starting dose in 30 patients with essential hypertension in the morning and a one step upward titration was performed (amlodipine 10 mg once a day) was done at the end of 4weeks treatment. Final evaluation was done at 12weeks with laboratory test and echocardiogram. RESULT: Within 4weeks treatment with dose of 5mg amlodipine once a day, the systolic blood pressure (SBP) was decreased(184.5+/-23.3/150.5+/-16.0mmHg,p<0.000), and the diastolic blood pressure(DBP) was also decreased significantly (109.9+/-04.6/92.3+/-11.5mmHg, P<0.001). After 12 weeks of treatment with a mean dosage of 6.6mg once a day, SBP and DBP was maintained comparing with basal level (147.0+/-15.8/88.1+/-0.9mmHg, respectively). The efficacy of amlodipine treatment was noted an excellent in 16 patients(53.3%), good in 4 patient(13.3%), fair in 4 patients(13.3%), and failed in 2 patients(6.7%). There was no significant change in heart rate before and after amlodipine treatment. (80.0+/-2.3/80.9+/-10.4 beats/minute n.s). Amlodipine had not significant effects on laboratory findings such as serum creatinine, BUN, ALT/AST, hemoglobin, leukocyte count,platelet and lipid profiles. There was facial flushing 2 patients, but no need to discontinue administration of amlodipine and all patients completed for 12weeks therapy. CONCLUSION: It is concluded that amlodipine is an effective antihypertensive agent, as monotherapy once a day in patients with moderate essential hypertension.
Amlodipine ; Blood Pressure ; Calcium ; Creatinine ; Flushing ; Heart Rate ; Humans ; Hypertension* ; Leukocytes

Urinary tract calculi are among the earliest documented afflictions of man but much remains to be learned about the causes and prevention of this common disease. We estimated the serum concentration and urinary excretion of calcium in 65 stone-formers, comparing to those 21 controls. Additionally, serum parathyroid hormone level in 38 stone-formers was estimated. The results were as follows: 1. Serum calcium levels of stone formers were significantly higher than those of controls in total, male and female. 2. Urinary calcium levels of stone formers were significantly higher than those of controls in total, male and female. 3. Hypercalcemia was significantly more frequent for stone-formers in total and male, but not in female. 4. Hypercalcemia was significantly more frequent for stone-formers in total, but not in male and female. 5. The incidence of stone-formers, in whom normocalcemia and normocalciuria, was significantly less than that of controls. 6. Serum parathyroid hormone levels of stone formers were significantly higher than those of control in total and female, but not in male. 7. The elevated serum parathyroid hormone was more frequent in stone formers, but not significant statistically. These results suggest the possibility that metabolic disorder of calcium may play some roles in the genesis of urinary stone.
Calcium* ; Calculi ; Female ; Humans ; Hypercalcemia ; Incidence ; Male ; Parathyroid Hormone* ; Urinary Calculi* ; Urinary Tract

BACKGROUND: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. METHODS: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. RESULTS: At the final follow-up, the mean Korean Showlder Society score and Constant scores were 88.96 +/- 12.1 and 86.6 +/- 11.9, respectively, in group A and 86.21 +/- 11.8 and 85.3 +/- 11.7, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was 1.6degrees in group A and 4.8degrees in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). CONCLUSIONS: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
Aged* ; Decision Making ; Follow-Up Studies ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder Fractures* ; Sutures*

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was performed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.
Actinomycosis ; Adult ; Bacteria ; Biopsy, Fine-Needle ; Breast ; Carcinoma, Hepatocellular ; Diverticulum* ; Drainage ; Fibroadenoma ; Flank Pain ; Gallbladder ; Humans ; Infarction ; Liver ; Monocytes ; Neutrophils ; Penicillins ; Physical Examination ; Vesico-Ureteral Reflux* ; Weight Loss

Colitis cystica profunda is a benign disorder in which a mucous cyst is located in the submucosal layer of, primarily, the pelvic colon and rectum. Radiologic reports of the condition are rare. We report the radiological findings of a case of colitis cystica profunda arising from the proximal ascending colon near the ileocecal valve, and causing intussusception. We also review the literature.
Colitis* ; Colon ; Colon, Ascending ; Ileocecal Valve ; Intussusception* ; Rectum

Endometrial carcinoma usually occurs in postmenopausal women ; less than 5% occurs in women under the age of40. Up to one quarter of endometrial carcinoma patients below this age have PCO(polycystic ovary disease, Stein-Leventhal syndrome). The increased incidence of endometrial carcinoma in patients with PCO is related to chronic estrogenic stimulation. We report MR imaging in one case of endometrial carcinoma occuring in a 23 yearold woman with PCO and had complained of hypermenorrhea for about three years. On T2-weighted MR image the endometrial cavity was seen to be distended with protruded endometrial masses of intermediate signal intensity, and the junctional zone was disrupted beneath the masses. Both ovaries were best seen on T2-weighted MR imagingand showed multiple small peripheral cysts and low signal-intensity central stroma.
Endometrial Neoplasms* ; Estrogens ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Menorrhagia ; Ovary*

The authors report a case of giant-cell tumor of the right middle cranial fossa floor a 43-year-old man. His presentation, characteristic magnetic resonance image findings, treatment, and 2-year follow-up result are described. The patient about this rare neoplasm of the skull base are also reviewed.
Adult ; Cranial Fossa, Middle* ; Follow-Up Studies ; Humans ; Skull Base

No abstract available.
Onychomycosis