No abstract available.
Myasthenia Gravis* ; Pregnancy*

BACKGROUND: Tracheal intubation commonly results in sympathetic stimulation manifested by increased heart rate and arterial blood pressure. This study was carried out to determine whether lightwand would result in less hemodynamic changes than direct laryngoscopy. METHODS: With informed consent, fourty healthy female patients scheduled of elective surgical procedures were randomly allocated into two groups; lightwand (LW) or direct laryngoscopy (DL) group. Mean arterial pressure (MAP) and heart rate (HR) were recorded upon arrival. Under a standardized anesthetic technique, the patients were intubated either with no. 3 curved blade direct laryngoscopy (DL group) or with lightwand (LW group). The MAP and HR were recorded before intubation and every 1 minutes following intubaion. Time to intubation (TTI) was also recorded. All patients were intubated by a same fourth grade resident. RESULTS: Fourty patients were studied. Every intubation was successed in first attempt. The TTI was significantly shorter in LW group. Even while there was no significant difference in HR changes, there was significant difference in the increase of MAP following intubation. The increase of MAP was significantly greater with DL than with LW. CONCLUSIONS: This study suggests that lightwand intubation requires shorter TTI and may give rise to less blood pressure change than direct laryngoscopy. So we found no difference in disadvantage and may offers advantage in terms of hemodynamic stability.
Arterial Pressure* ; Blood Pressure ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Informed Consent ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy* ; Surgical Procedures, Elective

The review of normal intravenous pyelography can give us important criteria of the diseases of the urinary system and the adjacent organs. Authors analyzed 200 cases of intravenous pyelography of normal Korean adults and measured the following points; the length of kidneys, the distance from midline to both poles, the slope degree of longitudinal axis, the ureteral length and width, the shortest distance from midline to abdominal ureters, the longest distance form midline to pelvic ureters, and configuration of urinary bladder. The results were obtained as follows; 1. The average length of kidneys in adult male was 12.53±0.78 cm on right, 12.83±0.82cm on left; in adult female, 12.08±0.72cm on right, 12.46±0.73cm on left. In the age distribution, the length gradually became shorter by getting old. In 20% of cases, right kidney was longer than left. 2. The average distance from both the renal poles to midline was longer in male compared to female. The distance from upper pole to the midline was longer in left side than right in male, but in the lower pole, there was no difference in both sexes. 3. The slope degree of the renal longitudinal axis was larger in male than in female, and lager in right kidney compared to left. 4. The length of ureter was longer on left, but there was no remarkable difference between both sexes. 5.The short set distance from midline to abdominal ureter, there was no remarkable difference between both sexes and also between right and left side. But concerning the longest distance from midline to pelvic ureter, it was longer in female; and especially in female, right side was shorter than left. 6. The longitudinal diameter of urinary bladder was longer in male, but horizontal diameter was longer in female.
Adult ; Age Distribution ; Female ; Humans ; Kidney ; Male ; Ureter ; Urinary Bladder ; Urinary Tract ; Urography

No abstract available.
Stomach Neoplasms*

No abstract available.
Cause of Death* ; Fever* ; Humans

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nasocomial pathogen. The active surveillance of MRSA is essential to limit its transmission. The BD GeneOhm MRSA real-time PCR assay (Becton Dickinson Diagnostics, San Diego, USA) has been recently developed and used for same-day MRSA detection directly from nasal swab specimens. The authors of the present study compared GeneOhm MRSA PCR with culture methods to evaluate its diagnostic performance for MRSA active surveillance. METHODS: The present study was conducted on patients admitted to the ICU for six months. A total of 371 nasal swab specimens were obtained from patients at admission day and at the seven-day follow-up. The swab was streaked onto culture media, and presumptive S. aureus colonies were confirmed as MRSA using the BD Phoenix automated microbiology system (Becton Dickinson Diagnostic Systems, Sparks, USA). In addition, GeneOhm MRSA PCR was performed. For discrepant results between Gene-Ohm MRSA PCR and culture, the enrichment broth culture method was performed. RESULTS: There were 34 samples with discrepant results between the GeneOhm MRSA PCR and culture. The overall agreement was 90.7%. For the detection of MRSA, the GeneOhm MRSA PCR was 96.8% sensitive and 86.3% specific, with positive and negative predictive values of 83.9% and 97.3%, respectively. CONCLUSION: Identification of MRSA-colonized patients was achieved in as little as two hours, and the high negative predictive value of GeneOhm MRSA PCR suggests that the assay is a rapid method for the identification of persons who are not colonized with MRSA. However, due to the low positive predictive value, GeneOhm MRSA PCR combined with enrichment culture in cases of positive GeneOhm MRSA PCR is potentially useful for active MRSA surveillance activities.
Colon ; Culture Media ; Follow-Up Studies ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction

BACKGROUND: We compared the LightCycler MRSA advanced test (Roche Diagnostics, Germany) with enrichment culture methods to evaluate the relative diagnostic performance of the LightCycler MRSA advanced test for active surveillance in a high-prevalence setting. METHODS: A total of 342 nasal swab specimens were obtained from patients in the intensive care unit at admission and on the seventh day for follow-up. The results of LightCycler MRSA advanced test were compared to those of the enrichment culture. For discrepant results, mecA gene PCR was performed. RESULTS: For the detection of methicillin-resistant Staphylococcus aureus (MRSA), the LightCycler MRSA advanced test showed 98.5% sensitivity and 78.6% specificity and had positive and negative predictive values of 75.0% and 98.8%, respectively. A total of 46 samples had discrepant results between the LightCycler MRSA advanced test and enrichment culture. Of the 44 specimens that were positive in the LightCycler MRSA advanced test but negative by enrichment culture, mecA genes were detected in 37 specimens. In addition, of the original 44 cases, 21 patients had a history of MRSA colonization or infection within the last month; of those 21 specimens, 20 were positive for mecA gene as shown by PCR. Seven mecA-negative discrepant specimens comprised 3 methicillin-sensitive S. aureus-culture positive and only 2 patients had MRSA infections. CONCLUSIONS: Despite its low specificity and positive predictive value, the LightCycler MRSA advanced test could serve as a rapid test for patients colonized with MRSA.

PURPOSE: To evaluate the diagnostic value of magnetic resonance(MR) imaging in the differentiation of benign and malignant soft tissue masses. MATERIALS AND METHODS: MR examination of 47 patients with pathologically proven soft tissue masses were reviewed. This series included 19 malignant and 28 benign masses of upper and lower extremities, body, and neck. Lesions were evaluated for their margin, signal intensity and homogeneity, pattern and degree of enhancement, involvement of the adjacent tissue, and degree of surrounding edema. RESULTS: Sixteen of benign lesions(57.1%) had well-defined and smooth margin. The tumor margin was irregular in nine lesions(47.4%), however, smooth margin was noted in five cases(26.3%) of malignant lesions. On T2-weighted images, signal inhomogeneity was noted in 84% of malignant lesions and 32% of benign lesions. On Gd-DTPA enhancement study, all malignant lesions(n=18) showed enhancement and 89% showed heterogeneously enhancing pattern. Neurovascular involvement was observed more often in malignancy(n=7) compared to benign lesion(n=1). Direct invasion of the adjacent bone was noted only in malignant lesions(n=3). Surrounding edema was revealed in two benign and 11 malignant lesions. CONCLUSION: MR imaging appears useful for differentiating malignant and benign lesions by identifying tumor margin, signal homogeneity of tumor, pattern and degree of enhancement, involvement of adjacent tissue, and surrounding edema. The nature of the lesion can be determined in the majority of cases although no unique criterion to differentiate benignancy and malignancy is identified.
Edema ; Gadolinium DTPA ; Humans ; Lower Extremity ; Magnetic Resonance Imaging* ; Neck

No abstract available.
Uterus*

Insulinoma is rare functioning islet cell tumor of pancreas and its main feature is frequent attacks of hypoglycemia. Because of frequent seizure, the disease is occasionally mistook as epilepy. We experienced a case of insulinoma with dilantin toxicity in a 45 year old patient who had been treated with dilantin for 7 years. Selective splenic arteriogram showed 0.8cm mass in the tail of pancreas which was proven insulin secreting tumor on histiopathological examination. After operation no more seizure attack was detected and her blood sugar level was well maintained within normal range. This case might provide an insight that the possibility of insulinoma should be considered in patient with episodic neurobehavioral dysfunction such as epilepsy.
Adenoma, Islet Cell ; Blood Glucose ; Epilepsy ; Humans ; Hypoglycemia ; Insulin ; Insulinoma ; Pancreas ; Phenytoin ; Reference Values ; Seizures ; Tail