No abstract available.
Nephrotic Syndrome*

Purpose: : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods: : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane’s revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results: : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=–0.22, 95% CI : -0.51∼0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33∼1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

The author list should be corrected.

Total hip replacement arthroplasties(THRA) have been done in 19 patients(31 hips), who were diagnosed ad ankylosing spondylitis from January, 1984 till July, 1993 at Seoul National University Hospital. All patients were male; 12 patients were affected bilaterally. Modified New York criteria was used as diagnostic criteria. HLA B27 antigen was positive in 18 cases(95%). The thoracolumbar spine and sacroiliac joint were affected in all cases and cervical spine was affected in five patients, among them, fiberoptic laryngoscopic intubation was needed in four cases. The trastrochanteric approach was used in 19 cases, which have severe limitation of motion and deformity of the acetabulum. For the prevention of postoperative heterotopic ossification, low dose radiation therapies were done in 10 cases of the risk group. The average follow-up period was three year and eleven months(two year-seven year and 10 months). Harris hip score and radiographs were obtained at each follow-up. The mean preoperative Harris hip score was 50(19–90), and finally, the mean Harris hip score was 87(68–96). Loosening of endoprothesis was noted in 3 cases and heterotopic ossification in 5 hips. Ischial enthesopathy was observed in 13 cases. Among the hips which had heterotopic ossification, four were class Ι by Brooker's classification and only one was class Ⅲ. No nonunion was observed in the cases which had trochanteric osteotomy expect breakage of wire in 4 cases. In THRA of ankylosing spendylitis, we obtained good result clinically and radiologically. In severely affected cases, we had used transtrochanteric approach and obtained good result due to better operative field. The incidence of heterotopic ossification was not significant and the prophylactic low dose radiation therapy seems to be effective in risk group.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Hip ; HLA-B27 Antigen ; Humans ; Incidence ; Intubation ; Male ; Ossification, Heterotopic ; Osteotomy ; Rheumatic Diseases ; Sacroiliac Joint ; Seoul ; Spine ; Spondylitis, Ankylosing

No abstract available.
Porokeratosis

Glassy cell carcinoma is an unusual neoplasm of the uterine cervix with highly aggressive clinical behavior. On cervico-vaginal smear examination, the tumor has well confused of atypical repair cell of the endocervix. Recently, we have experienced two cases of glassy cell carcinoma of the uterine cervix, diagnosed on cervico-vaginal smears and confirmed on following histologic sections. The cervico-vaginal smears revealed abundant clusters with well defined boarders. The cell clusters were composed of large tumor cells. The tumor cells had distinct granular cytoplasm and eosinophilic macronucleoli. Characteristic cytologic features of this tumor were discussed in view of differential diagnosis.
Adenocarcinoma ; Breast ; Cervix Uteri ; Cytoplasm ; Diagnosis, Differential ; Eosinophils ; Female ; Hydronephrosis*

False aneurysm has been recognized for many years. Incomplete severance of an artery as the result of trauma is thought to be the precipitating factors in the formation of false aneurysm. False aneurysm of the peripheral artery is presented with pulsating mass and may show extrinsic indentations of the adjacent bone with or without neurovascular symptoms, mimicking a malignant tumor. But careful history taking can reveal a proceeding deep penetrating injury variable period prior to development of symptoms. We are reporting two cases of false aneurysm of the superior gluteal artery and superficial femoral artery in each after trauma.
Aneurysm, False ; Arteries ; Femoral Artery ; Precipitating Factors

Purpose: To investigate the relationship between retinal nerve fiber layer (RNFL) thickness and carotid artery stenosis (CAS). Methods: We retrospectively reviewed the medical records of 106 patients who underwent both optical coherence tomography to determine RNFL and carotid artery sonography within 1 year. The RNFL was divided into four quadrants, and each quadrant’s RNFL thickness and average thickness were compared with the artery endothelial thickness, the presence of plaque, and the degree of CAS. A multiple regression analysis was performed to assess the relationship between RNFL and CAS. Results: The presence of carotid artery plaque had a significant association with a decrease in the average RNFL thickness (p = 0.039). There was no statistically significant difference in age or risk factors associated with vascular disease, with the exception of carotid endothelial thickness and the total cholesterol level in the two groups, depending on the presence of total carotid plaque. RNFL thickness was confirmed to be related to age and total cholesterol levels using linear univariate regression analysis. In a multivariable linear regression analysis, with age and total cholesterol levels controlled, the presence of carotid artery plaque was significantly associated with a decrease in average RNFL thickness (p = 0.026). Conclusions Asymptomatic CAS may be associated with a decrease in average RNFL thickness. In patients with decreased RNFL thickness without any ophthalmic diseases, carotid artery examination should be considered.

OBJECTIVES: To determine changes in the incidence and pattern of eclampsia in Il Sin Christian Hospital over a 46-year period. METHODS: Information was collected from medical records of the 1910 eclamptic patients among 233,613 deliveries in Il Sin Christian Hospital from Jan. 1 1953 to Dec. 31 1998. Incidence, presentation, and management of eclampsia were reviewed retrospectively, and maternal mortality rate and perinatal mortality rate were calculated. Statistical analysis was done by Chi-squared and Fisher's exact test through two by two tables looking at relative changes between each study period. RESULTS: The overall incidence of eclampsia was 81.8 per 10,000 deliveries. The incidence of eclampsia had increased from 137.3/10,000 in 1953-1962 to 278.4/10,000 in 1963-1972, but the rate had reduced to 6.5/10,000 in 1993-1998. There was a statistically significant fall in the rate of eclampsia every decade between 1973 and 1992, but there has been steady decrease in the last study period. Convulsion occurred antepartum in 54% of patients, intrapartum in 29% and postpartum in 17%. With the reduction in the proportion of antepartum eclampsia, there has been a relative increase in that of intrapartum and postpartum eclampsia. Maternal death occurred in 59 cases among eclampsia, and maternal mortality rate was 3.1%. Maternal mortality rate had significantly decresed from 11.1% in 1953-1962 to 3.8% in 1963-1972, and there has been no maternal death from eclampsia since 1986. Postpartum eclampsia had increased death risk compared with antepartum or intrapartum eclampsia. There were 280 cases of perinatal death and overall perinatal mortality rate was 144.1 per 1000 deliveries. There was a significant decrease in the rate from 243.2/1000 in 1953-1962 to 141.5/1000 in 1963-1972, but the rate has risen steadily since 1983. CONCLUSIONS: With the improvement in antenatal care and management of eclampsia, the incidence of eclampsia and its associated maternal mortality has decreased over the last 46 years. But eclampsia still remains a significant complication of pregnancy with high maternal and perinatal mortality.
Eclampsia* ; Female ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Medical Records ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Seizures

BACKGROUND: There are several ways to treat for recurrent pericardial effussion and cardiac tamponade due to malignancy. They are repeated pericardiocentesis, pericardial instillation of sclerosing and chemotherapeutic agents, surgical creation of a pericardial window and transthoracic pericardiectomy. Surgical techniques are usually effective but bear a significant morbidity and mortality especially in chronic debilitating cancer patients. So percutaneous balloon pericardial window as an alternative to surgery in these patients. METHODS: After pericardiocentesis was performed, a 0.035 inch J-tip guidewire was advanced into the pericardial space. And a pigtail catheter was advanced over the wire. A moderate amount of pericardial fluid were removed. A nd then the pigtail catheter was withdrawn and 8F sheath was inserted. A20mm diameter, 4cm long(Single balloon method) or two 10mm diameter, 4cm long balloon dilating catheter(Double balloon medium) was advanced over the wire to straddle the parietal pericardial border though the sheath. Several inflations of the balloon with a solution containing 50% radiographic contrast medium were performed until disappearance of the balloon waist. After balloon dilation, contrast medium from the pericardial space to subcutaneous tisse suggesting successful PBPWF. Single ballon method was employed in 4 patients and Dould balloon method in 2 patients. RESULT: We performed percutaneous balloon pericardial window formation in 6 patiemts with malignant pericardial effusion. We did percutaneous balloon pericardial window formation successfully in 5 patients and failed due to adhesion of parietal pericardium in 1 patient. One patient developed recurrent pericardial effusion with tamponade at a mean follow-up of 11.49.6 months(1.5-26 months). Conclusion: These results suggest that PBPWF is an alternative method less invasive than subxiphoid surgical windowing, espesially in critically ill patients with recurrent malignant pericardial effussion. It carries less risks and has more constant effect than repeated pericardiocentesis.
Cardiac Tamponade ; Catheters ; Critical Illness ; Follow-Up Studies ; Humans ; Mortality ; Pericardial Effusion* ; Pericardiectomy ; Pericardiocentesis ; Pericardium ; Rabeprazole