An accurate and relatively simple method for estimating the amount of acute blood loss is essential in the hemorrhagic shock patients. Conventional physiologic parameters, blood pressure, pulse rate and CVP, could not serve for evaluation of the adequate oxygen transport in the tissue. Pulmonary artery catheter is a best tool for evaluating the cardiopulmonary function and the oxygen transport system, and mixed venous oxygen saturation(SvO2) monitoring have made a great advances for early detection of cardiovascular dysfunction and the changes in peripheral tissue oxygenation. But pulmonary artery catheterization is complicated procedure in emergency setting. Although the central venous oxygen saturation(ScvO2) cannot completely replace the SvO2 value, it has a close relation with SvO2 change in variable clinical situations. We testify the usefulness of ScvO2 monitoring in 24 patients of the hemorrhagic shock. Initial resuscitation was performed with ATLS standard and continuous ScvO2 was monitored. Systolic blood pressure and pulse rate were recorded for one hour from initial resuscitation in each 15 minutes. Nineteen patient was traumatic hemorrhagic shock and five was non traumatic. Twelve of 19 patients was blunt trauma, and remains were stab in injury mechanism. Mortality rate was 29.2%. Initial ScvO2 of nonsurvivor was 43.6%, and 51.3% in survivor groups(p>0.05). In the group of stab wound and non-traumatic hemorrhage, the ScvO2 was gradually increase by time. But ScvO2 in survivors of blunt trauma was increased first 30 minutes and decrease afterthen. Continuous monitoring of ScvO2 may by partly useful in resuscitation for hemorrhagic shock. It is more valuable in the blunt trauma than in the penetrating injury or non-traumatic hemorrhage.
Blood Pressure ; Catheterization, Swan-Ganz ; Catheters ; Emergencies ; Heart Rate ; Hemorrhage ; Humans ; Mortality ; Oxygen* ; Pulmonary Artery ; Resuscitation ; Shock, Hemorrhagic* ; Survivors ; Wounds, Stab

No abstract available.
Angiocardiography* ; Contrast Media* ; Electrolytes* ; Osmolar Concentration* ; Plasma* ; Renin*

The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

Allergic conjunctivitis is commonly encountered in the office parctice of ophthalmology. However, diagnosis is not easy because allergic conjunctivitis shows nonspecific ocular symptoms and signs. And for accurate diagnosis, conjunctival scraping for eosinophils, tear levels of specific IgE, skin testing to aeroallergens, and ocular challenge with allergens are available but these methods are much time and cost consuming. So we evaluate the usefulness of the detection of eosinophils by conjunctival impression cytology. Conjunctival impression cytology was done on 44 eyes of 44 patients who were diagnosed as allergic conjunctivitis. 7 eyes of 7 normal subjects and 14 eyes of 14 patients with epidemic keratoconjunctivits were used as control. Scoring system was defined according to the past history, symptom, sign, and slit lamp finding ranged from +1 to +5. Eyes of score +1 or +2 were defined as allergy suspect group, and eyes of score +3 to +5 defined as allergy group. The sensitivities of the impression dytology were 59% in allergy suspect group, 86% in definite allergy group and 72%in total, The specificity was 95%. According this study, we conclude that impression cytology is a simple, non-invasive and cheap method with high sensitivity and specificity for the diagnosis of allergic conjunctivitis.
Allergens ; Conjunctivitis, Allergic* ; Diagnosis ; Eosinophils* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Ophthalmology ; Sensitivity and Specificity ; Skin Tests

To investigate whether anti-Candida proteinase antibody could be a diagnostic marker, we examined seroreactivity to proteinase in sera from 90 healthy controls and 8 of C. albicans culture-positive patients. Previously we purified proteinases of C. albicans, C. tropicalis, and C. parapsilosis using a series of chromatographic steps consisting of DEAE- Sepharose, Sephacryl S-200, and size-exclusion HPLC. ELISA and Western blot technique were adopted to examine seroreactivity of C. albicans proteinase with sera. On ELISA, the seroreactivities of healthy controls and C. albicans-cultured patients were 0.601 +- 0.014 (mean+SEM), and 0.695 +- 0.079, respectively (P=0.084, t-test). In C. albicans-cultured patients, the positive rate was 62.5% (5/8) and the positive rate of healthy controls was 39% (35/90). On Western blot analysis, C. albicans proteinase molecule was blotted by all sera tested. But the intensity of blotted band was different with the same dilution of sera; the intensity of C. albicans proteinase molecule band blotted by 2 sera of 3 healthy control's sera was distinctively lower than that by C. albicans-cultured patients sera. However, all sera including C. albicans-cultured patient's sera did not blot the proteinase secreted by C. tropicalis and C. parapsilosis. It is necessary to collect sequential sera of patients with candidiasis and to establish a cut-off value for ELISA or serum dilution for Western blot analysis that will give reliable test sensitivity and specificity.
Blotting, Western ; Candida albicans* ; Candida* ; Candidiasis ; Chromatography, High Pressure Liquid ; Enzyme-Linked Immunosorbent Assay ; Humans ; Peptide Hydrolases ; Sensitivity and Specificity ; Sepharose

No abstract available.
Methods ; Prostate ; Urinary Bladder

No abstract available.
Chordoma*

OBJECTIVE: The variable operative methods are underwent as a treatment of tuberculous spondylitis. We propose hemilaminectomy and debridement as a one of operative method at a certain circumstance. METHODS: From July 1998 to June 2002, 13 consecutive patients with spinal tuberculosis were treated surgically in our institution. Among them, the authors analysed 7 patients in whom posterior approach were performed. The lumbar spine was involved in 6 patients, the thoracic in 1. The hemilaminectomy with debridement was done in all cases. The changes in the Kyphotic angle and the height of involved vertebras retrospectively measured from lateral spinal radiographs obtained preoperatively and postoperatively. Mean follow up periods were 16 months. RESULTS: Clinical symptoms and signs were improved in all cases. One patient (14%) was needed anterior fusion because of aggravation of lesion. Another one needed reoperation because of relapse of epidural abscess. The arithmethical average of kyphotic angle was worsened about 2 degrees and that of height loss was lesser than 5% postoperatively. CONCLUSION: The hemilaminectomy with debridement for spinal spondylitis can be a first therapeutic modality in a mild neurologic deficit and minor lesions with extended epidural abscess and granulation tissue to the adjacent vertebras in radiologic finding. Especially if epidural abscess and granulation tissue involve the multiple vertebras, we recommend this operative method.
Debridement ; Epidural Abscess ; Follow-Up Studies ; Granulation Tissue ; Humans ; Neurologic Manifestations ; Recurrence ; Reoperation ; Retrospective Studies ; Spine ; Spondylitis ; Tuberculosis, Spinal*

OBJECTIVE: Atypical teratoid/rhabdoid tumor(AT/RT) is a new entity among malignant pediatric brain tumors, and shows variable histopathologic features. The authors investigate the clinicopathologic and cytogenetic features of the tumor. METHODS: Five cases were included in this study ; three of them were primarily diagnosed, and two cases were reclassified from primitive neuroectodermal tumor/medulloblastoma to AT/RT. Mean age of patients at diagnosis was 5.6 years. The tumors were located in infratentorial or supratentorial areas. Maximum survival period was 13 months. RESULTS: Histopathologically, the tumors were mainly composed of modified rhabdoid cells and undifferentiated small cells, and mixed with epithelial, mesenchymal components, and other features mimicking glioma and chordoma. The histopathologic features were supported by polyphenotypic immunoreactivity, including epithelial membrane antigen, cytokeratin, vimentin, smooth muscle actin, and glial fibrillary acidic protein. Cytogenetic studies for karyotype analysis and fluorescent in situ hybridization revealed monosomy of chromosome 22 in two cases out of three cases of the tumor. CONCLUSION: Atypical teratoid/rhabdoid tumor may be an unique clinicopathologic entity, and histopathologic diagnosis should be made carefully by differentiating other polymorphous tumors of the brain.
Actins ; Brain ; Brain Neoplasms ; Central Nervous System* ; Chordoma ; Chromosomes, Human, Pair 22 ; Cytogenetics ; Diagnosis ; Glial Fibrillary Acidic Protein ; Glioma ; Humans ; In Situ Hybridization, Fluorescence ; Karyotype ; Keratins ; Monosomy ; Mucin-1 ; Muscle, Smooth ; Neural Plate ; Vimentin