No abstract available.
Pierre Robin Syndrome*

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome including insulin resistance, hypertension, dyslipidemia, central obesity, type 2 diabetes, and cardiovascular disease. In NAFLD, insulin resistance plays an important role in the progression of liver damage. In this study, we evaluated insulin resistance, plasma adiponectin, hepatic steatosis, and their association in adults with normal liver transaminase concentrations. METHODS: We analyzed 111 subjects, aged over 20 years old, who visited the Health Management Center at Chung-Ang University Hospital between May 2006 and August 2006. They had neither history nor clinical evidence of diabetes, cardiovascular or liver disease. They were divided into three groups by the degree of hepatic steatosis based on ultrasound findings. Anthropometric parameters were measured and blood samples were drawn after eight hours of fasting. RESULTS: Hepatic steatosis had a positive correlation with body mass index, waist circumference, blood pressure, triglycerides, HOMA-IR, and QUICKI. Moreover, it had a negative correlation with high-density lipoprotein cholesterol and adiponectin. Triglycerides, Adiponectin, and QUICKI were independent variables in predicting the degree of hepatic steatosis. CONCLUSION: This finding suggests that triglycerides and plasma adiponectin are independent predictors of hepatic steatosis in adults with normal liver transaminase concentrations.
Adiponectin ; Adult ; Aged ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Dyslipidemias ; Fatty Liver ; Humans ; Hypertension ; Insulin Resistance ; Lipoproteins ; Liver ; Liver Diseases ; Obesity, Abdominal ; Plasma ; Triglycerides ; Waist Circumference

PURPOSE: This exploratory study aims to identify various factors influencing the rehabilitation nursing competencies (RNC) of nurses in various types of health institutes. METHODS: The researcher developed a questionnaire consisting of 45 items based on the ARN rehabilitation nursing competency model. Subjects were 434 nurses working at general hospitals, long-term care facilities, or community health centers. RESULTS: Nurses' RNC were significantly higher among those who have higher levels of education, receive continuing education in rehabilitation nursing, and practice more frequently in rehabilitation nursing. Age and duration of nursing career were significant only for interprofessional care domain. General hospital nurses scored highest in every domain while nurses working at long-term care facilities scored lowest in every domain. Multiple regression analysis showed that practicing daily or more than twice per week in rehabilitation nursing, achieving master's degree or higher, and working at long-term care facilities were statistically significant factors with RNC. These factors explained 31.1% of the total variability in RNC in this sample. CONCLUSION: Currently, there is no official certification program for rehabilitation nurse practitioners in South Korea. The results of this study would be useful in developing RNC training programs for Korean nurses, and provide strong evidence for necessity of certified rehabilitation nurse specialists.
Academies and Institutes ; Certification ; Community Health Centers ; Education ; Education, Continuing ; Hospitals, General ; Humans ; Korea ; Long-Term Care ; Nurse Practitioners ; Nursing ; Rehabilitation Nursing* ; Rehabilitation* ; Specialization

A fourteen-year female Jindo dog showing signs of hemoperitoneum was diagnosed with hemangiosarcoma through abdominal radiography and histopathological examination. In the abdominal radiographs, a circular mass was observed on the posterior of the spleen. When the splenic mass was removed via laparotomy, it was spherical, poorly circumscribed, and showed signs of necrosis, with white spots present on the outer side of the mass. Microscopically, the mass showed that hemorrhage was widespread and extensive infiltration of neoplastic cells was found throughout. There was hypercellularity, including occasional pleomorphic cells and mitotic figures. Inflammation at the edge of the mass, along with necrosis, was also found. In this report, we describe the gross and histopathological findings of a case of canine hemangiosarcoma.
Animals ; Dental Caries ; Dogs ; Female ; Hemangiosarcoma ; Hemoperitoneum ; Hemorrhage ; Humans ; Inflammation ; Laparotomy ; Necrosis ; Radiography, Abdominal ; Spleen

PURPOSE: To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction inrabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CTscanning. MATERIALS AND METHODS: In 28 rabbits weighing 2.5-4kg, the segmental renal artery was occluded throughthe left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography andspiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of thesegmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, wasevaluated by two radiologists. RESULTS: In all cases, as seen on power Doppler ultrasonography, infaretedareas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. Thelocation of the lesion closely corresponded to the location seen during CT scanning. After renal arterialocclusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% ofrabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Dopplerultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterialocclusion. CONCLUSION: Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congestedcapsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition,as seen on power Doppler ultrasonography.
Animals ; Arteries ; Diagnosis ; Estrogens, Conjugated (USP) ; Infarction ; Kidney ; Perfusion ; Rabbits ; Renal Artery* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Ultrasonography* ; Ultrasonography, Doppler

The role of amino acids in culture media for IVF-ET was examined in a total of 76 cycles. Patients received clomiphene citrate (CC) followed by hMG or GnRH-a combined with gonadotropins (FSH/hMG) for controlled ovarian hyperstimulation. Severe male (<4 x10(6) motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. No significant differences were found in age, duration of infertility, follicle size, the level of E2 on the day of hCG injection, the mean number of oocytes retrieved, total motile sperm count, fertilization rate and the mean number of embryos transferred between bHTF (without amino acids) and mHTF (with amino acids) groups. However, total ampules of gonadotropins were higher (p<0.01) in mHTF group than bHTF group. Significantly (p<0.05) more clinical pregnancies were recorded in mHTF group (13/30) compared with bHTF group (9/46). The multiple pregnancy rates were 11.1% in bHTF group and 77% in mHTF group. There were one ectopic pregnancy in mHTF group and one heterotopic pregnancy in bHTF group. Abortion rates were 22.2% in bHTF group and 7.7% in mHTF, respectively The ongoing pregnancy or livebirth .ate was significantly (p<0.05) higher in mHTF group (12/30) than bHTF group (7/46). These results suggest that the addition of amino acids in culture media is essential for culture of zygotes in vitro and adjustment of energy substrates in phosphate-free culture media appears to be beneficial for human IVF-ET procedure.
Abortion, Induced ; Age Factors ; Amino Acids* ; Clomiphene ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gestational Sac ; Gonadotropins ; Humans* ; Infertility ; Male ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Multiple ; Sperm Count ; Ultrasonography ; Zygote

BACKGROUND: Recovery from anesthesia, postoperative pain, nausea and vomiting are very important after pediatric tonsillectomy surgery. We compared the effects of supplemented opioids (remifentanil, meperidine) combined with sevoflurane on the recovery and side effects. METHODS: Patients were randomized to receive meperidine (group M, n = 41) or remifentanil (group R, n = 43). Group R received a bolus dose of normal saline, and group M 1 mg/kg of meperidine. A continuous infusion of normal saline was followed in the group M, and remifentanil 0.25micro/kg/min in the group R. In all patients, signs of inadequate anesthesia were treated with an increase of sevoflurane concentration. Intraoperative hemodynamics, recovery profiles, and side effects were assessed. RESULTS: Supplemented remifentanil resulted in significantly lower systolic blood pressure and heart rate during operation (P < 0.05). The emergence from anesthesia was not different between groups. Although the patients in the group R had early recovery characteristics at recovery room, time to discharge at recovery room was longer in the group R than in the group M (P < 0.05). The incidence of retching and vomiting was not different between groups. Supplemented meperidine resulted in less analgesic requirements than the other group (P < 0.05). CONCLUSIONS: Supplemented remifentanil was associated with hemodynamic stability, however it provided later discharge time at recovery room. Postoperative analgesic requirements were reduced by the supplemented meperidine without increasing postoperative nausea, vomiting.
Analgesics, Opioid ; Anesthesia* ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Meperidine ; Nausea ; Pain, Postoperative ; Pediatrics* ; Postoperative Nausea and Vomiting ; Recovery Room ; Tonsillectomy* ; Vomiting

Occurrence of dynamic left ventricular outflow tract (LVOT) obstruction is not infrequent in critically ill patients, and it is associated with potential danger. Here, we report a case of transient heart failure with hemodynamic deterioration paradoxically induced by extreme dehydration. This article describes clinical features of the patient and echocardiographic findings of dynamic LVOT obstruction and significant mitral regurgitation caused by systolic anterior motion of the mitral valve in a volume-depleted heart.
Cardiac Volume ; Dehydration/*complications ; Echocardiography/methods ; Female ; Heart Failure/*etiology/therapy ; Humans ; Middle Aged ; Mitral Valve Insufficiency/complications/*etiology ; Pulmonary Edema/etiology ; Ventricular Outflow Obstruction/*complications/etiology

BACKGROUND: Since the 1960 s rabbit antihuman globulin reagent has been used widely. Recently most conjugate of enzyme immunoassay is produced from goat, and precise purification method is developed. Therefore we evaluated the commercial value of the goat antihuman globulin as a blood bank test reagent. METHODS: The human IgG was purified by protein-A gel, and injected into goat. The goat antihuman globulin was coupled by CNBr activated sepharose 4B-gel and purified by 0.2M glycine elution buffer. For verification of this reagent, commercial reagents(Ortho rabbit reagent & DiaMed Gel test) were used. RESULTS: The minimal concentration for detecting antibody of goat reagent was 9 ng/mL. The results of direct antiglobulin tests, with 400 samples collected from donated blood in CPDA-1, were all negative(false positive rate: 0%). With 613 samples collected from inpatients of Severance Hospital, the results were positive in 35 patients(positive rate:5.7%), and those results were in complete agreement with commercial reagent(concordance rate: Goat vs. Ortho :99.8%, Goat vs. DiaMed :98.4%). And with 30 samples of artificially prepared complement-coated RBC, the results were all negative. Indirect antiglobulin test showed higher agglutination score than commercial reagents. CONCLUSIONS: Goat reagent showed high sensitivity and specificity in comparison with rabbit reagent. Because false positive reaction was not observed in negative control samples, the heterophil agglutinin reaction, which was the major problem when the reagent was initially developed, might be excluded. In conclusion, goat reagent seems to be more economical than rabbit reagent because the former can be obtained in a large quantity and of high potency.
Agglutination ; Blood Banks ; Coombs Test ; False Positive Reactions ; Glycine ; Goats* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G ; Indicators and Reagents ; Inpatients ; Sensitivity and Specificity ; Sepharose

Placenta increta is a life threatening complication of pregnancy, causing severe post-curettage bleeding. It is usually presented in the postpartum period with hemorrhage during difficult placental removal. It is especially rare in the 1st and 2nd trimesters, which is not easy to find and diagnose. We have confirmed a case of placenta increta after emergency hysterectomy due to severe vaginal bleeding following the dilatation and curettage during the 1st trimester of her pregnancy. So we report it with a brief case history and review of the concerned literatures.
Dilatation and Curettage ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Placenta Accreta* ; Placenta* ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, First* ; Uterine Hemorrhage