No abstract available.
Pulmonary Embolism* ; Pulmonary Infarction*

No abstract available.
Animals ; Mice*

PURPOSE: Acute urinary retention is one of the most severe complications in patients with benign prostatic hyperplasia (BPH). We investigated the efficacy of age, International Prostatic Symptom Score (I-PSS), quality of life (QOL) score and various parameters obtained by transrectal ultrasonography (TRUS) as predictors of acute urinary retention. MATERIALS AND METHODS: Of 153 patients with BPH, who underwent transurethral resection of the prostate, 72 were treated due to acute urinary retention (retention group) and 81 due to lower urinary tract symptoms (symptomatic group). TRUS was used to calculate the total prostate (TP) and transitional zone (TZ) volumes, the transitional zone index (TZ index=TZ volume/TP volume) and the elongation ratio (ER=the ratio of the maximal anteroposterior to transverse diameter of the prostate). To compare the usefulness of various parameters between the retention and symptomatic groups, the area under the receiver-operating characteristic (ROC) curve was calculated for each parameter. RESULTS: There were significant differences in the TP and TZ volumes, the TZ index and the elongation ratio between both groups, but no significant differences in age, I-PSS or QOL score. In the retention group, the most effective cutoff values were 40cc, 20cc, 0.55 and 0.75 for the TP volume, the TZ volume, the TZ index and the elongation ratio, respectively. The area under the ROC curves were 0.894, 0871, 0843 and 0771 for the TZ index, the elongation ratio, the TZ volume and the TP volume, respectively. CONCLUSIONS: The TP and TZ volumes, the TZ index, and the elongation ratio are useful predictors of acute urinary retention in patients with BPH. The TZ index is the most useful predictor, and may be a useful parameter in selecting the treatment for BPH.
Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; ROC Curve ; Ultrasonography ; Urinary Retention*

Gynecomastia is a proliferation of the glandular component of the male breast. Gynecomastia is the most common variant condition of the male breast and results from the effect of an altered estrogen-androgen balance on breast tissue or from the increased sensitivity of breast tissue to a normal estrogen level. We experienced a case of macrogynecomastia in a 16-year-old boy who had a normal male phenotype and was treated by reduction mammoplasty with breast tissue removal, which was effective and produced good cosmetic and psychologic results.
Adolescent ; Breast ; Estrogens ; Female ; Gynecomastia ; Humans ; Male ; Mammaplasty* ; Phenotype

Ventilator-induced lung injury (VILI) is the additional inflammatory damage caused by mechanical ventilation, especially in acute respiratory distress syndrome (ARDS). VILI can induce a systematic inflammatory response, resulting in multiple organ dysfunction syndrome, which is the major cause of death in ARDS patients. The two main mechanisms of VILI are physical stretch injury caused by a high tidal volume and shearing force caused by the reopening and collapse of alveoli in atelectatic lung. Protective ventilation strategies to prevent VILI include low tidal volume ventilation, high positive end-expiratory pressure, prone position ventilation, the alveolar recruitment maneuver, and extracorporeal membrane oxygenation. The clinical support is strongest for low tidal volume ventilation, which should be used in all cases of ARDS. However, its effectiveness might be limited because of the severe spatial heterogeneity of the lung involvement, which cannot completely prevent regional alveolar distension. Although there is insufficient clinical evidence supporting the other strategies, and they are controversial, various strategies other than low tidal volume ventilation should be considered in selected clinical conditions in which they might be effective.
Cause of Death ; Extracorporeal Membrane Oxygenation ; Humans ; Lung ; Multiple Organ Failure ; Population Characteristics ; Positive-Pressure Respiration ; Prone Position ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Tidal Volume ; Ventilation ; Ventilator-Induced Lung Injury*

PURPOSE: To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate, glucocorticoids, and antibiotics, on the timing of the first stool in preterm infants. METHODS: Medical records of all preterm infants admitted to the neonatal ward at Kangnam Sacred Heart Hospital between March 1998 and August 1998 were reviewed. We studied the time of the first stool in 55 infants. RESULTS: The median age of the infant at the time of first stool was 18 hours, and 90% of the infants passed stool by 50 hours. Both the gestational age and the illness severity, as measured by the score for neonatal acute physiology(SNAP), correlated significantly with the timing of the first stool(r=0.47 and P<0.001 for SNAP; r=0.29 and P<0.05 for gestational age). An analysis of covariance showed that the relationship between SNAP and the timing of the first stool was significant even after adjustment for gestational age(P<0.01), but the relationship between the gestational age and the timing of the first stool was not significant after adjustment for SNAP (P=0.14). Antenatal exposure to magnesium sulfate for tocolysis, glucocorticoids for enhancing fetal lung maturity, and antibiotics, had no effect on the timing of the first stool. CONCLUSION: Delayed passage of first stool is a function of illness severity, not of gestational immaturity. Antenatal exposure to magnisium sulfate, dexamethasone, and antibiotics, does not affect the timing of first stool in premature infants.
Anti-Bacterial Agents ; Dexamethasone ; Gestational Age ; Glucocorticoids ; Heart ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Magnesium Sulfate ; Medical Records ; Tocolysis

PURPOSE: To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate, glucocorticoids, and antibiotics, on the timing of the first stool in preterm infants. METHODS: Medical records of all preterm infants admitted to the neonatal ward at Kangnam Sacred Heart Hospital between March 1998 and August 1998 were reviewed. We studied the time of the first stool in 55 infants. RESULTS: The median age of the infant at the time of first stool was 18 hours, and 90% of the infants passed stool by 50 hours. Both the gestational age and the illness severity, as measured by the score for neonatal acute physiology(SNAP), correlated significantly with the timing of the first stool(r=0.47 and P<0.001 for SNAP; r=0.29 and P<0.05 for gestational age). An analysis of covariance showed that the relationship between SNAP and the timing of the first stool was significant even after adjustment for gestational age(P<0.01), but the relationship between the gestational age and the timing of the first stool was not significant after adjustment for SNAP (P=0.14). Antenatal exposure to magnesium sulfate for tocolysis, glucocorticoids for enhancing fetal lung maturity, and antibiotics, had no effect on the timing of the first stool. CONCLUSION: Delayed passage of first stool is a function of illness severity, not of gestational immaturity. Antenatal exposure to magnisium sulfate, dexamethasone, and antibiotics, does not affect the timing of first stool in premature infants.
Anti-Bacterial Agents ; Dexamethasone ; Gestational Age ; Glucocorticoids ; Heart ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Magnesium Sulfate ; Medical Records ; Tocolysis

BACKGROUND: Transglutaminase-2 (TG-2) has been reported to play an important role in the process of fibrosis. However, TG-2 studies on fibroproliferation of acute lung injury (ALI) are absent. The purpose of this study was to investigate the role of TG-2 in the fibroproliferation of lipopolysaccharide (LPS)-induced ALI. METHODS: The male C57BL/6 mice of 5 weeks age were divided into 3 groups; control group (n=30) in which 50 microL of saline was given intratracheally (IT), LPS group (n=30) in which LPS 0.5 mg/kg/50 microL of saline was given IT, and LPS+Cyst group treated with intraperitoneal 200 mg/kg of cystamine, competitive inhibitor of TG-2, after induction of ALI by LPS. TG-2 activity and nuclear factor (NF)-kappaB were measured in lung tissue homogenate. Tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, IL-6, myeloperoxidase (MPO), and transforming growth factor (TGF)-beta1 were measured using bronchoalveolar lavage fluids. Histopathologic ALI score and Mallory's phosphotunistic acid hematoxylin (PTAH) for collagen and fibronectin deposition were performed. RESULTS: The TG-2 activities in the LPS group were significantly higher than the control and LPS+Cyst groups (p<0.05). The TNF-alpha and IL-1beta concentrations and NF-kappaB activity were lower in the LPS+Cyst group than the LPS group (p<0.05). The LPS+Cyst group showed lower MPO, ALI score, TGF-beta1 concentration, and Mallory's PTAH stain than the LPS group, but the differences were not significant (p>0.05). CONCLUSION: Inhibition of TG-2 activity in the LPS-induced ALI prevented early inflammatory parameters, but had limited effects on late ALI and fibroproliferative parameters.
Acute Lung Injury ; Animals ; Bronchoalveolar Lavage Fluid ; Collagen ; Cystamine ; Fibronectins ; Fibrosis ; Hematoxylin ; Humans ; Inflammation ; Interleukin-6 ; Interleukins ; Lipopolysaccharides ; Lung ; Male ; Mice ; NF-kappa B ; Peroxidase ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Tumor Necrosis Factor-alpha

No abstract available.
Humans ; *Positive-Pressure Respiration ; *Respiratory Insufficiency

Acute respiratory distress syndrome (ARDS) is a common disorder associated with significant mortality and morbidity. The American-European Consensus Conference (AECC) definition of ARDS, established in 1994, has advanced the knowledge of ARDS by allowing the acquisition of clinical and epidemiological data, which in turn have led to improvements in care for patients with ARDS. However, after 18 years of applied research, a number of issues regarding various criteria of AECC definition have emerged. For these reason, and because all disease definitions should be reviewed periodically, the European Society of Intensive Care Medicine convened an international expert panel to revise the ARDS definition from September 30 to October 2, 2011, Berlin, Germany, with endorsement from American Thoracic Society and the Society of Critical Care Medicine. This consensus discussion, following empirical evaluation and consensus revision, addressed some of the limitations of the AECC definition by incorporating current data, physiologic concepts, and clinical trials to develop a new definition of ARDS (Berlin definition). The Berlin definition should facilitate case recognition and better match treatment options to severity in both the research trials and clinical practice.
Acute Lung Injury ; Berlin ; Consensus ; Critical Care ; Germany ; Humans ; Critical Care ; Respiratory Distress Syndrome, Adult