No abstract available.
Muscle, Skeletal* ; Prednisolone*

BACKGROUND: Noninvasive estimation of pulmonary artery pressure is an important component of echocardiographic studies. A number of methods are available for estimation of pulmenary pressure, each with varying degrees of reported accuracy. To assess accuracy and difficulties, noninvasive pulmonary artery pressure estimates were performed in infants and children with congenital heart diseases. METHODS: Noninvasive estimates from 8 methods were compared with catheterization measurements. Systolic pressure was estimated by the Burstin method and from perak tricuspid regurgitation velocity, and also from systolic pressure gradients through the VSD(ventricular septal defect) and PDA(patent ductus arteriosus). Mean pressure was estimated by acceleration time divided by ejection time measured from Koppler spectrum obtained at the right ventricular out flow tract. Diastolic pressure was estimated from pulmonary regurgitation velocity spentrum at end-diastolic, and also from diastolic pressure gradient through the patent ductus arteriosus. RESULTS: IN systolic pressure, Burstin and tricuspid regurgitation velocities estimates correlated significantly(r=0.92, 0.90 respectively), whereas VSD and PDA estimates correlated less well with catheterization estimates(r=0.83, 0.65 respectively). The mean pressure, measured from RVOT(right ventricular outflow tract) Doppler spectrum corresponded well with catheterization pressure(r=0.89), whereas those obtained from the main pulmonary artery correlated less well(r=0.74). The diastolic pressure estimates from pulmonary regurgitation velocity spectrum, revealed good correlation(r=0.79), but those from diastolic Doppler spectrum at PDA correlated less well with catheterization estimates(r=0.63). CONCLUSION: All of eight Doppler echocardiographic methods seemed to be easily performable for estimation of pulmonary artery pressure. But, the degree of accuracy was variable. Because a pressure estimante from only a single method may be in error, care should be taken in combining use of other(one or two) methods.
Acceleration ; Blood Pressure ; Catheterization ; Catheters ; Child ; Ductus Arteriosus, Patent ; Echocardiography* ; Echocardiography, Doppler ; Heart Diseases ; Humans ; Infant ; Pulmonary Artery* ; Pulmonary Valve Insufficiency ; Tricuspid Valve Insufficiency

Cytomegalovirus (CMV) is a major cause of morbidity and mortality in immunocompromised patients. CMV can cause pneumonia, retinitis, gastrointestinal ulcers, and widely disseminated disease, but cutaneous CMV is rare. We report two cases of cutaneous CMV infection presenting as perianal ulcers. A 54 year-old male who had liver transplantation and a 72-year-old male, who was treated with chemotherapy for angioimmunoblastic T-cell lymphoma, presented with perianal ulcers and had systemic symptoms of CMV infection with CMV antigenemia. They had multiple ulcerations with erythematous bases on the perianal area, and histopathologic examinations showed large atypical cytomegalic cells in the dermis, and immunohistochemical stains, with the anti-CMV antibody showed positive reactions.
Aged ; Coloring Agents ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Dermis ; Drug Therapy ; Humans ; Immunocompromised Host* ; Liver Transplantation ; Lymphoma, T-Cell ; Male ; Mortality ; Pneumonia ; Retinitis ; Ulcer

BACKGROUND: This study was aimed to assess the level of knowledge on the disinfection among nurses in the hospital. METHODS: Data was collected from the nurses who participated in an educational meeting of Korean Association of Infection Control Nurses for two days from July 7 to 8 in 2000. Seventy nurses (58.3%), among 120 participants. were answered to the 32 item questionnaire which was developed to test the level of knowledge in different types of disinfection. The correct answers for each item were computed and the rate of the total correct answer was dichotomized and compared at the level of 60% correct answer to identify the respondent's characteristics which affect the knowledge on the disinfection. RESULTS: The percent of the correct answer was 60.0% in total. 63.4% for the disinfectants general; 59.4% for the disinfection of skin: 57.6% for the disinfection of devices: 63.9% for the disinfection of endoscopies, and 55.1% for the disinfection of environments. The percent of correct answer was significantly higher among the nurses who participated in the educational programs on the disinfection previously (p=0.006), as well as the nurses who are at the infection control office or at the quality improvement department compared to other areas in the hospital (p=0.001). CONCLUSIONS: This study indicates that the level of knowledge about the disinfection was low with only 63% of the correct rate in total. We perceive that more educational programs and manuals on the use of disinfectants in a hospital setting is urgently required.
Disinfectants ; Disinfection* ; Infection Control ; Quality Improvement ; Surveys and Questionnaires ; Skin

OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

BACKGROUND: Pain is one of the most common presenting complaints in the emergency department(ED) and adequate analgesia for painful conditions is an important goal of emergency medical practice. This study was designed to investigate on the actual condition regarding the use of analgesic injections for traumatized patients in the field of ED and to reconsider the concern and methods of pain management in the future. METHOD: We carried out a prospective, noninterventional observational clinical study of adult patients presenting with acute trauma in the ED. Using a numeric rating scale ranging from 0 to 10, patients quantified their pain intensity on arriving at the ED and on one hour after analgesic administrations in the cases of analgesic use or after initial Assessment in the cases of no analgesic use. They also were interviewed about the level of their satisfaction to pain relief before leaving the ED. RESULTS: Seventy eight percent of all patient received analgesic injections(nonsteroidal antiinflammatory drugs; 62%, opioids; 16%) and the remaining 22 patients(22%) were treated without analgesics. At the time of secondary assessment to pain, initial pain score in the cases of analgesic administration decreased. Patients who are beyond fair in the level of satisfaction were recorded for only 18% of all patient even though 78% of patients received analgesic injections. CONCLUSION: Our data illustrate that the patient of trauma commonly receive analgesic injections in the ED but their levels of satisfaction are under fair. This finding suggests that the concern and methods of pain management have to be reconsidered through the understanding of analgesic pharmacology and pattern of pain relief by analgesics.
Adult ; Analgesia ; Analgesics ; Analgesics, Opioid ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Pain Management* ; Pharmacology ; Prospective Studies

PURPOSE: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. RESULTS: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). CONCLUSION: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
Biopsy ; Carcinosarcoma ; Follow-Up Studies ; Humans ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors

BACKGROUND: Correction of a bulbous tip is a difficult procedure in Asians, because their lower lateral cartilage is relatively small and structurally weak to support the thick skin soft tissue envelope (SSTE). Therefore, lower lateral cartilage manipulation alone yields inadequate bulbous tip correction. In this study, authors aim to provide a new bulbous tip definition reflecting nasal tip SSTE and categorization with a suitable surgical procedure. METHODS: One hundred sixty-three patients with tip rhinoplasty between January 2009 and December 2012 were studied who had a tip lobular width greater than 60% of the alar base width. Depending on cartilage size and characteristics of the nasal tip superficial musculoaponeurotic system (SMAS) with SSTE thickness, the following classifications were made: Group I: thin SSTE with a large lower lateral cartilage, Group II: thick SSTE with a small lower lateral cartilage, Group IIa: thick SSTE with loose SMAS, and Group IIb: thick SSTE with dense SMAS. We evaluated the degree of surgical improvement by comparing pre- and postoperative photographs. RESULTS: After comparing pre- and postoperative photos, we observed improvements in tip bulbosity by 11.7% in Group I (n=41), 11.9% in Group IIa (n=64), and 7.1% in Group IIb (n=58). CONCLUSIONS: In Asians, nasal tip bulbosity is often due to excess SSTE. Therefore, a bulbous tip should be defined and evaluated based on its underlying SSTE. Adequate soft tissue resection in addition to lower lateral cartilage support and manipulation are warranted to achieve a refined tip.
Asian Continental Ancestry Group* ; Cartilage ; Classification ; Humans ; Rhinoplasty* ; Skin*

PURPOSE: To compare postoperative clinical outcomes, optical quality, and patient satisfaction between two types of diffractive multifocal intraocular lens (IOL, Acri Lisa 366D and Acrysof ReSTOR +3.00 D). METHODS: In a total of 68 eyes, one of two diffractive multifocal IOL (Acri Lisa 366D and Acrysof ReSTOR +3.00 D) was implanted after cataract extraction. Visual acuity was measured postoperatively at one week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function were determined via questionnaire at postoperative 1 month. RESULTS: Intermediate visual acuity of Acri Lisa 366D and Acrysof ReSTOR at 6 months were 0.31 +/- 0.14, and 0.24 +/- 0.11 (log MAR), respectively. At 6 months, near and distant visual acuity results showed no significant differences between the two groups. The photopic contrast sensitivity of Acri Lisa 366D at 6 cycles/degree was 55.36 +/- 7.40 and showed significant differences with Acrysof ReSTOR (47.25 +/- 9.67). The mesopic contrast sensitivity values of Acri Lisa 366D and Acrysof ReSTOR were 40.26 +/- 11.38 and 28.97 +/- 10.45, respectively, and the spherical aberration values were 0.037 +/- 0.039 microm and 0.105 +/- 0.066 microm. The spherical aberration of Acri Lisa 366D was significantly lower than that of Acrysof ReSTOR. Total and high order aberration, coma, and trefoil show no significant differences between the two groups. CONCLUSIONS: The Acri Lisa 366D multifocal IOL showed better contrast sensitivity and spherical aberration compared to Acrysof ReSTOR multifocal IOL, which had an effective intermediate visual acuity.
Cataract Extraction ; Coma ; Contrast Sensitivity ; Lenses, Intraocular* ; Lotus ; Patient Satisfaction ; Visual Acuity

OBJECTIVES: To study the distributions of pH and gas values in umbilical arterial(UA) blood of normal newborns following uncomplicated pregnancies and vaginal births. Methods: In 457 consecutive normal term infants who were born between March 1995 and June 1998, we examined the UA pH and blood gas values obtained immediately following delivery. Maternal inclusion criteria were defined as an uncomplicated singleton pregnancy and a normal full term spontaneous vaginal delivery. And also neonatal inclusion criteria were defined as a normal intrauterine growth appropriate for gestational age without any malformations and Apgar score of 7 or more at both one and five minutes after birth. Umbilical artery blood samples were collected at each birth and were evaluated for pH, carbon dioxide pressure (PaCO2), oxygen pressure (PaO2) and actual bicarbonate. RESULTS: Histogram of UA pH value resemble normal distribution curve. The lowest UA pH was 7.04 and the 10th percentile value was 7.23. The median UA pH was 7.31 and 5% was below 7.20. The lowest UA PaO2 was 4.6mmHg and the 10th percentile value was 11.5mmHg. The highest UA PaCO2 was 67.2mmHg and the 90th percentile value was 56.5mmHg. The lowest bicarbonate value was 13.2mmol/L and the 10th percentile value was 18.4mmol/L. CONCLUSION: The distributions of the UA pH and gas values of the collective of normal newborns were illustrated. None of the UA pH was below 7.0.
Apgar Score ; Blood Gas Analysis* ; Carbon Dioxide ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Oxygen ; Parturition ; Pregnancy ; Umbilical Arteries*