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

PURPOSE:To evaluate the role of unenhanced CT in diagnosing the acute appendicitis. METHOD AND MATERIALS: We retrospectively analyzed conventional contrast-enhanced abdominal CT scans of 197 normal patients and barium enemas of 26 out of the 197 patients. Additional unenhanced CT scans of right lower abdomen were performed on 30 patients who were suspected of having acute appendicitis;barium enema was performed in 26 patients. RESULTS: in the analysis of the conventional CT scans, we could detect 132(67%) normal appendicies. On barium enema of 26 out of 197 patients, abruptly narrowed appendix was visualized in 5 cases and luminal irregularity in 4 cases but all 26 cases showed normal appendix on CT. In the 30 cases of unenhanced CT, all appendicies were visualized. Among 12 Cases which were proved as acute appendicitis, barium enenma was done in 10 case;abruptly narrowed appendix was shown in 3 and luminal irregularity in 1. Among 18 cases which were diagnosed as normal appendix, nonvisualization of appendix' was in 1 case, abruptly narrowed lumen in 3, and luminal irregularity in 9. CONCLUSION:Unenhanced CT in the area of the cecum may be an effective and safe diagnostic tool for acute appendicitis.
Abdomen ; Appendicitis* ; Appendix ; Barium* ; Cecum ; Enema* ; Humans ; Phenobarbital ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: It is not easy to determine the cause of pulmonary consolidative lesion. Even without any definite mass, malignancy cannot be ruled out. And sometimes, it is difficult to differentiate tuberculosis from pneumonia. To differentiate malignant consolidative lesion from benign one, we studied patterns of air bronchogram, mucoid impaction, and computed tomographic anglogram etc. MATERIALS AND METHODS: Fifty seven cases of pulmonary consolidative lesions(23 cases of malignancy,34 cases of benign lesion) were retrospectively reviewed by three radiologists. RESULTS: Among the 28 cases which showed a little air bronchogram(less than 1/3 of the whole lesion in volumetric measure with the eye) 19 cases were malignancy and nine cases were benign lesions. All of the 12 cases which showed profound air bronchogram over 2/3 of the whole lesion were benign lesions. Bronchiectasis was detected in 31 cases(four of malignancy and 27 of benign lesions). Among the 20 cases which didn't show the mucoid impaction five cases were malignancy and 15 cases were benign lesions. Out of eight cases with mucoid impaction filling the long segments(branching tree shape), seven cases were malignancy and one case was benign lesion. So called CT anglogram was detected in nine cases of malignancy and two cases of benign lesions. All of nine cases of malignancy showed CT anglogram which was like arborizing tree. CONCLUSION: Scanty air bronchogram, profound arborizing mucoid impaction and/or CT angoigram within consolidative lesion could suggest malignancy.
Bronchiectasis ; Pneumonia ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed* ; Tuberculosis

No abstract available.
Diabetic Ketoacidosis* ; Drug Therapy* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Remission Induction*

OBJECTIVE: Self-expanding stents are increasingly used for the treatment of complex intracranial aneurysms. The purpose of this study was to evaluate the usefulness and safety of a self-expanding nitinol stent (Enterprise) in the treatment of wide-necked intracranial aneurysms. METHODS: This was a retrospective study of 39 patients with 40 wide-necked intracranial aneurysms who were enrolled in a single-center registry of patients treated with the Enterprise between June 2009 and December 2011. Thirty patients were asymptomatic, four had cerebrovascular accident sequelae, and five had suffered subarachnoid hemorrhage. One aneurysm had reopened after prior coil embolization, while 39 had not been treated. Clinical charts, procedural data, and angiographic results, including both immediate post-procedural angiograms and follow-up imaging, were reviewed. RESULTS: The mean neck size of the aneurysms was 5.58 mm (range 3-15.1 mm). Embolization was successful in all patients. There were five procedure-related events. There were no fatalities, but one procedure-related morbidity was noted. The immediate angiographic results included eight complete occlusions (20%), six remnant necks (15%), and 26 remnant sacs (65%). At angiographic follow-up (mean: 11.3 months), out of 18 of the aneurysms treated with stent-assisted coiling, there were 13 (72.2%) complete occlusions, four (22.2%) remnant necks, and one recanalization (5.6%). CONCLUSION: Stent-assisted coiling using the Enterprise is effective for the treatment of wide-necked intracranial aneurysms. Further angiographic and clinical follow-up investigation will be needed for evaluation of the long-term outcomes.
Aneurysm* ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Neck ; Retrospective Studies ; Stents* ; Stroke ; Subarachnoid Hemorrhage

PURPOSE: Atopy is a state of allergic response, mediated by IgE, to common environmental allergens. In recent decades, there has been an increase in prevalence of atopic disorders in children in developed countries. The factor associated with the rise of atopy incidence may be declining exposure to some infection opportunities. The aim of this study is to determine if the immune response to Mycobacterium tuberculosis can suppress atopy by investigating the association between tuberculin responses and serum IgE. METHODS: We divided the patients into two groups according to tuberculin skin test. Group A showed positive response (induration diameter > or =10mm), while Group B showed negative response (induration diameter< l0mm). A comparison was made between the two groups in terms of age, sex, serum total IgE and allergen-specific IgE. RESULTS: Twenty-one patients comprised Group A and 72 comprised Group B. The mean serum total IgE concentration and the number of patients showing positive MAST in Group B was significantly higher than that of Group A (P<0.05). CONCLUSION: In our study, there was an inverse association between delayed hypersensitivity to Mycobacterium tuberculosis and atopy.
Allergens ; Child ; Developed Countries ; Humans ; Hypersensitivity, Delayed ; Immunoglobulin E* ; Incidence ; Mycobacterium tuberculosis ; Prevalence ; Skin Tests ; Tuberculin*

Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

No abstract available.
Adenosarcoma* ; Endometrium* ; Female

No abstract available.
Adenosarcoma* ; Endometrium* ; Female

BACKGROUND: Norwegian scabies is a highly infectious disease characterized by crust formation, different from ordinary scabies, and is caused by Sarcoptes scabiei. After the patient in our case was diagnosed with Norwegian scabies, active measures were taken to prevent its transmission within the hospital. Methods: A 66-year-old female patient was admitted to the general ward of a university hospital on January 23rd, 2008 and 6 days later, she was found to have been infected with Norwegian scabies all over the body. For epidemiological investigation, those who had been in contact with the patient were identified and interviewed. The patient was advised to follow the contact precaution, and linen the patient used was cleaned thoroughly. The surrounding environment was decontaminated by applying surface disinfectant. Preventive cream against the Norwegian scabies was distributed to staff members and patients who had been exposed to the patient, and appointed a dermatologist to educate them on how to use of medicine, what the mechanism of the disease is, what cautions must be taken, and how to write an ex post facto report. RESULTS: After the confirmation of the 1st case, no additional cases have been reported in the hospital during the ensuing 2 months. Therefore, prompt prevention and infection control activities against Norwegian scabies can be thought to have been successful. CONCLUSION: Whena patient with an uncertain skin disease is admitted, pertinent measures must be taken from the moment the patient is admitted and contact precaution should be applied both to the patients and the staff members. When a scabies patient is detected in an institution, the medical staff must enforce as much active preventive measures as possible, and by doing so, there will be a better chance to prevent the outbreak of scabies in the hospital.
Aged ; Bedding and Linens ; Communicable Diseases ; Cross Infection ; Female ; Humans ; Infection Control ; Medical Staff ; Patients' Rooms ; Sarcoptes scabiei ; Scabies ; Skin Diseases