No abstract available.
Intestinal Obstruction*

Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

In the figure 3, designation of severity of bronchopulmonary dysplasia (BPD) was misprinted. Open bars (white) represent severe BPD, not mild BPD. Closed bars (Black) represent mild BPD, not severe BPD. Gray bars in the middle represent moderate BPD without change.

BACKGROUND: A fully automated enzyme-immunoassay (EIA) analyzer, Enzymun System, ES-300 (Boehringer Mannheim, Germany) uses streptavidin technology and performs single test or panels of up to 12 tests per run. We evaluated the results of ES-300 for anti-HCV by comparing the results with microplate-EIA, radioimmunoassay (RIA), and confirmatory test. METHODS: Total 79 sera (51 positive, 24 negative, 4 indeterminate results confirmed by Lucky HCD Confirm) were analysed. ES-300 with Enzymun-Test(R) Anti-HCV (Boehringer Mannheim, Germany) and microplate-EIA (Green Cross Center Innotest HCV 3.0(R)) were used. Fifty one sera were examined additionally by 2nd-generation RIA method, NANBDINE 125C(General Biologicals Corp., R.O.C.). And all results were compared to the results of Lucky HCD Confirm. RESULTS: The overall concordance rate of ES-300 and Innotest(R) was 72/79 (91.1%). The results of Lucky HCD Confirm on seven discrepant samples were five negative and two indeterminate. The results of ES-300 and NANBDINE 125C showed concordance rate of 90.2%. The sensitivity and specificity of ES-300 with regard to Lucky HCD Confirm were 94.5%, and 87.5%, respectively, and that of Innotest(R) were 98.2% and 66.7%, respectively. Clear distinction of positive and negative results by signal/cut off ratio was available in both EIAs. The positive predictive values of ES-300 and Innotest(R) were 94.5%, and 87.1%, respectively. CONCLUSIONS: ES-300 showed relatively good results in sensitivity and positive predictive value with regard to confirmatory test. In EIA-positive persons, however, follow-up study would be necessary for reliable evaluation of HCV infection.
Humans ; Radioimmunoassay ; Sensitivity and Specificity ; Streptavidin

BACKGROUND: The aim of this study was to evaluate the sensitivity of a clinicians' self-report method for the detection of nosocomial infections (NIs) in comparison with a total surveillance method in a neonatal intensive care unit (NICU). METHODS: Two surveillance methods were concurrently performed in the NICU of a university hospital during 5 months in 2003. Clinicians' self-report surveillance (CSRS) was based on the retrospective verification of monthly reports of positive bacteriologic results by NICU clinicians. Total surveillance (TS) was done prospectively by an infection control nurse based on chart review and laboratory data. RESULTS: One hundred fifty nine patients accounting to 2759 patient-days were included in the study. Twenty-seven NIs among 26 patients were identified by TS. The sensitivity of CSRS compared to TS was 14.8% (4 of 27 NIs). The specificity was 98.5% (131 of 133 non-NIs). Kappa measures of agreement were -0.309. CONCLUSIONS: Our results confirm that the retrospective review of charts and laboratory data by clinicians lacks sensitivity and agreement for the surveillance of nosocomial infections.
Cross Infection* ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care, Neonatal* ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Sepsis* ; Yersinia*

We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

Beta-lapachone (beta-Lap; 3,4-dihydro-2, 2-dimethyl-2H-naphthol[1, 2-b]pyran-5,6-dione) is a novel anti-cancer drug under phase I/II clinical trials. beta-Lap has been demonstrated to cause apoptotic and necrotic death in a variety of human cancer cells in vitro and in vivo. The mechanisms underlying the beta-Lap toxicity against cancer cells has been controversial. The most recent view is that beta-Lap, which is a quinone compound, undergoes two-electron reduction to hydroquinone form utilizing NAD(P)H or NADH as electron source. This two-electron reduction of beta-Lap is mediated by NAD(P)H:quinone oxidoreductase (NQO1), which is known to mediate the reduction of many quinone compounds. The hydroquinone forms of beta-Lap then spontaneously oxidizes back to the original oxidized beta-Lap, creating futile cycling between the oxidized and reduced forms of beta-Lap. It is proposed that the futile recycling between oxidized and reduced forms of beta-Lap leads to two distinct cell death pathways. First one is that the two-electron reduced beta-Lap is converted first to one-electron reduced beta-Lap, i.e., semiquinone beta-Lap (SQ).- causing production of reactive oxygen species (ROS), which then causes apoptotic cell death. The second mechanism is that severe depletion of NAD(P)H and NADH as a result of futile cycling between the quinone and hydroquinone forms of beta-Lap causes severe disturbance in cellular metabolism leading to apoptosis and necrosis. The relative importance of the aforementioned two mechanisms, i.e., generation of ROS or depletion of NAD(P)H/NADH, may vary depending on cell type and environment. Importantly, the NQO1 level in cancer cells has been found to be higher than that in normal cells indicating that beta-Lap may be preferentially toxic to cancer cells relative to non-cancer cells. The cellular level of NQO1 has been found to be significantly increased by divergent physical and chemical stresses including ionizing radiation. Recent reports clearly demonstrated that beta-Lap and ionizing radiation kill cancer cells in a synergistic manner. Indications are that irradiation of cancer cells causes long-lasting elevation of NQO1, thereby sensitizing the cells to beta-Lap. In addition, beta-Lap has been shown to inhibit the repair of sublethal radiation damage. Treating experimental tumors growing in the legs of mice with irradiation and intraperitoneal injection of beta-Lap suppressed the growth of the tumors in a manner more than additive. Collectively, beta-Lap is a potentially useful anti-cancer drug, particularly in combination with radiotherapy.
Animals ; Apoptosis ; Benzoquinones ; Cell Death ; Electrons ; Humans ; Hydroquinones ; Injections, Intraperitoneal ; Leg ; Mice ; NAD ; Naphthoquinones ; Necrosis ; Radiation Tolerance ; Radiation, Ionizing ; Reactive Oxygen Species ; Recycling ; Substrate Cycling

Hearing loss is a very common health problem throughout the world, although the number of hearing impaired individuals varies greatly in the countries. It is generally accepted that hearing impairment inevitably leads to a breakdown in communication and physical and mental health problems consequently. Nevertheless, few community based studies have been undertaken to examine both the mental and more general physical state of the hearing impaired patients. This study was conducted to evaluate the anxiety and depression in hearing impaired patients. Self-administered questionnaires including sociodemographic data were given to 336 subjects over the age of 18 years who visited the Health Management Center, Uijongbu St. Mary's Hospital for the routine health check up from January 1996 to April 1996 and three hundred seventeen samples (male: 197, female: 120) were selected. For the assessment of anxiety and depression we used Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) devised by Zung. And hearing impairment was evaluated using a Beltone Model 110 Audiometer. The results were statistically analyzed by ANOVA test and x(2) test. The results obtained were as follow: 1. The mean anxiety scores counted by SAS of 0-15dB HL (hearing loss) group (classified by the average loss in the better ear at 500, 1,000, 2,000Hz frequencies), 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 33.1+/-6.6 32.2+/-5.9, 41. +/-8.4, 42.8+/-6.0 respectively. And the mean depression Scores counted by SDS of 0-15dB HL group, 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 37.4+/-7.7, 37.2+/-7.2, 46.2+/-8.4, 48.6+/-8.6, respectively. The more than 30dB HL group showed significant high scores in SAS and SDS than the less than 30dB HL group (p<0.001). 2. The frequency of clinically significant anxiety disorder (SAS > or = 50) was 3.4% in less than 30dB HL group and 11. 1% in more than 30dB HL group. The difference between two groups was statistically significant (p<0.05). 3. The frequency of clinically significant depression disorder (SDS > or = 50) was 5.1% in less than 30dB HL group and 39.5% in more than 30dB HL group. The difference between two groups was statistically significant (p<0.05). 4. When several important interaction variables related to anxiety: and depression (such as age, sex, marital status, education level, economic status, occupation, religion) were stratified and we compared the groups between the more than 30dB HL and less than 30dB HL, most factors about anxiety and depression showed the significant differences in two groups. 5. Multiple logistic regression analysis revealed that hearing loss(p<0.05) predicted anxiety disorder (SAS> or = 50) and hearing loss(p<0.01), age(p<0.05) predicted depression disorder (SDS> or = 50). In conclusion, there was significant difference in anxiety and depression scores, between more than 30dB HL(in the better hearing ear) group and less than 30dB HL group. This study suggested that anxiety and depression should be considered as adverse effects of hearing impairment.
Anxiety Disorders ; Anxiety* ; Depression* ; Ear ; Education ; Female ; Hearing Loss* ; Hearing* ; Humans ; Logistic Models ; Marital Status ; Mental Health ; Occupations ; Questionnaires

Purpura is discoloration of the skin and mucous membranes due to extravasation of red blood cells and may be due to a variety of factors, but it is sometimes difficult to identify the exact cause. Some forms of purpura can frighten the patient and puzzle the physician. Mask phenomenon is an unusual purpura of the relatively loose tissues of the face and neck occuring after prolonged coughing, vigorous vomiting, valsalva's maneuver, parturition, or any other exertion that raises intrathoracic or abdominal pressure. This occurs with acute onset and fades within twenty-four to seventy-two hours spontaneously. A work-up for a coagulation or platelet defect is usually not required. We herein describe five cases of mask phenomenon(unusual facial purpura).
Blood Platelets ; Cough ; Erythrocytes ; Humans ; Masks* ; Mucous Membrane ; Neck ; Parturition ; Purpura* ; Skin ; Valsalva Maneuver ; Vomiting