No abstract available.
Amniotic Fluid* ; Female ; Fetal Proteins* ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

No abstract available.
Colonic Neoplasms* ; Rectum*

No abstract available.
46, XX Disorders of Sex Development* ; Female* ; Humans

No abstract available.
Edema*

It is currently necessary to manage chronic ischemic foot gangrene because the rate of hospitalization and operations is increasing as a result of diet change and the growth of an aging population. Chronic ischemic foot gangrene is caused by Buerger`s disease, atherosclerosis and particularly, diabetes. In this study, we used the Wagner ischemic index with Doppler flowmeter and Wagner classification on 62 patients over 8 years from 1991 to 1998 as an index for treatment and prognosis. We measured the systolic pressure to determine the ischemic index, and according to Wagner the blood flow was inadequate in cases of diabetic foot gangrene and nondiabetic foot gangrene when it was below 0.45 and 0.35, respectively. According to the observation of clinical symptoms, we divided the cases by Wagner classification. Based on the above data, we performed conservative treatment, skin graft, local flap, superficial sural arterial island flap and amputation. We then followed up the patients and observed the treatment results. We concluded that the Wagner ischemic index with Doppler flowmeter and Wagner classification was useful in determining, selecting, and predicting the rate of survival or death as a result of amputation and graft when a surgical operation is performed.
Aging ; Amputation ; Atherosclerosis ; Blood Pressure ; Classification* ; Diabetic Foot ; Diet ; Flowmeters* ; Foot Ulcer* ; Foot* ; Gangrene ; Hospitalization ; Humans ; Prognosis ; Skin ; Transplants

This study was aimed to assess the free calcium status with or without its direct measurement in patients on hemodialysis(HD: n=27) and malnourished ones from extrarenal diseases(MN: n=14). It was performed by the comparison of measured free calcium (Ca++m) levels by gas analyzer and calculated free calcium(Ca++c) levels based on those of total calcium (TCa), albumin, and pH with the modified algorithm invented by Moore(J Clin Invest. 49:318, 1970). Of 27 HD pts, 14(5296) had low[Ca++m] below 1.05mmol/L despite only 2(796) with low [TCa] below 2.05mmoV L, whereas 14 MN pts had similar numbers between low[Ca++m] and low[TCa]. Compared to MN pts, HD pts showed significantly lower mean levels(SE) of pH(7.37 0.01 vs. 7A4 0.01, p<0.01), higher[TCa](2.33 0.04 vs. 1.83 0.08mmol/L, p<0.01), and higher albumin (4.33 0.06 vs. 2.59 0.17mg/dL, p<0.01).However, [Ca++m] between 2 groups did not reveal any significant difference. Furtherrnore, in total 41 pts of 2 groups, no similarity was observed between the values of [Ca++ml and [Ca++c] but with their significant difference(p<0.05). Only[TCa] was significantly corre- lated with albumin level(r=0.73, p<0.01). Furthermore, multiple regression analysis between [Ca++m] and other factors including pH and albumin didn't show any correlation. In conclusion, this data suggests that relatively high prevalence of low values of physiologically important free ionized calcium in chronically ill pts, especially on maintenance HD, could be missed when predicted on total calcium level, and pH without its direct measurement.
Calcium* ; Chronic Disease* ; Humans ; Hydrogen-Ion Concentration* ; Prevalence

PURPOSE: To report the results according to anterior elevation changes following corneal crosslinking (CXL) treatment for keratoconus. METHODS: The present retrospective study included 14 patients (15 eyes) with progressive keratoconus who underwent CXL with a follow-up of 12 months. Patients were classified into 2 groups according to pre and postoperative anterior elevation difference maps. On the preoperative anterior elevation map, distances from maximum anterior elevation to pupil center were compared between the 2 groups. The outcome of best correct visual acuity (BCVA), maximum keratometry and parameters of corneal topography were compared between the 2 groups before CXL as well as 6 and 12 months after CXL. RESULTS: The anterior elevation changes were classified as group 1 (-7.88 +/- 10.53 micrometer) or group 2 (8.71 +/- 5.99 micrometer) (p = 0.001). The preoperative corneal topography of eyes observed in group 1 (0.19 +/- 0.13 mm) had shorter mean distances from maximum anterior elevation to pupil center than eyes in group 2 (0.47 +/- 0.23 mm) (p = 0.018). BCVA (log MAR) improved from 0.68 +/- 0.78 to 0.57 +/- 0.81 (p = 0.115) 12 months after CXL in group 1 and decreased from 0.51 +/- 0.34 to 0.56 +/- 0.38 (p = 0.109) 12 months after CXL in group 2. The maximum keratometry decreased from 63.01 +/- 19.07D to 58.95 +/- 16.32D (p = 0.017) in group 1 and increased from 60.70 +/- 9.46D to 61.29 +/- 7.51D (p = 0.674) in group 2. CONCLUSIONS: Clinical and optical effects improved postoperatively in group 1, and were stabilized in group 2. The preoperative distance from maximum anterior elevation to pupil center and the anterior elevation changes after CXL were factors in predicting the CXL outcome.
Corneal Topography ; Eye ; Follow-Up Studies ; Glycolates ; Humans ; Keratoconus ; Pupil ; Retrospective Studies ; Visual Acuity

The rapid technological progress in the fields of computer and engineering has accelerated the medical society to introduce a new advanced paradigm in handling medical information. This paper describes a fully integrated Computer Aided Diagnosis, Speech Recognition/PACS system running on a single platform. We feel that the combination of Computer Aided Diagnosis, Speech Recognition and PACS in a fully integrated single platform has created a tremendous synergy, with process improvements that maximize the advantage s of three systems. The Computer Aided Diagnosis and the Speech Recognition included marked improvement in experiments turnaround time and cost saving for departments because of decreased transcription costs. Proposed system should help others complete the task of digitalizing a hospital information system and may be adaptable to other systems as well.
Cost Savings ; Diagnosis* ; Hospital Information Systems ; Nonoxynol ; Running ; Societies, Medical

No abstract available.
Staphylococcus aureus* ; Staphylococcus*

OBJECTIVE: To systematic analyze the change of indications, age distribution of the patients and chromosomal results according to patient's age and indications in midtrimester genetic amniocentesis METHODS: This study reviewed 2,000 genetic amniocentesis cases from 1984 to 1997 which were done at Severance Hospital, after prenatal genetic counseling for the mothers who have high risk for carrying chromosomally abnormal babies. We analized the change of the indication, age distribution and chromosomal results according to maternal age and indications of amniocentesis RESULTS: 1. The incidence of amniocentesis had been in gradual increase since the 1980's, and from the mid 1990's it showed an abrupt increment. 2. Of the 2,000 amniocentesis cases, 31.8% was maternal age 35 to 39 which was most common age group and followed by age 30 to 34 was 28.4% and age 25 to 29 was 27.4. 3. The indications for amniocentesis were advanced maternal age(39.6%), abnormal maternal serum markers(27.8%) and abnormal ultrasonographic findings which implies chromosomal abnormality(6.4%). Recently maternal serum markers and ultrasonography play an important role as an indicator for the amniocentesis. 4. From the 2000cases, 1,950 cases showed normal diploidy and 50 cases abnormal karyotype which consisted 2.5%. In autosomal disorders ll Down syndrome, 7 Edward syndrome, 1 Patau syndrome, 15 Translocation, 3 Mosaicism were diagnosed. In sex chromosomal disorders 3 Klinefelter syndmme, 2 Turner syndrome and other 8 chromosomal abnormalities were diagnosed. No statistic significance was found among different age groups. Those who had abnormal ultrasonographic findings implying chromosomal abnormality were found to have correlation with chromosomal abnormality than other indications CONCLUSION: Midtrimester genetic amniocentesis is an important diagnostic tool in prenatal diagnosis, of which the annual incidence has been recently increased abruptly. Not only maternal age, but the maternal serum markers and ultrasonograms should be considered in prenatal counseling, The genetic amniocentesis should be well informed to the general population.
Abnormal Karyotype ; Age Distribution ; Amniocentesis* ; Biomarkers ; Chromosome Aberrations ; Chromosome Disorders ; Counseling ; Diagnosis* ; Diploidy ; Down Syndrome ; Female ; Genetic Counseling ; Humans ; Incidence ; Maternal Age ; Mosaicism ; Mothers ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Turner Syndrome ; Ultrasonography