No abstract available.
Cesarean Section* ; Female ; Pregnancy ; Pulmonary Embolism*

No abstract available.

No abstract available.
Condylomata Acuminata* ; Dermoscopy* ; Diagnosis, Differential* ; Lymphangioma* ; Vulva*

PURPOSE: To determine the best routes of administration of Tobramycin, the intracameral concentrations was assessed as time progressed after administering identical amounts and concentrations of tobramycin through various methods. METHODS: 40 eyes from 20 house rabbits were administered the same amount (200 micro liter) of 0.3% tobramycin. The first group was administered topically, and the second group was administered by subconjunctival injection. Contact lenses were soaked in tobramycin for 30 minutes and were covered over the corneas of the third group. While amniotic membranes were transplanted onto the corneas and tobramycin was topically administered in the fourth group. 100 micro liter of aqueous fluid was extracted 30 min, 1 hr, 2 hr and 3 hr after the administration and intracameral concentrations of tobramycin were measured using FPIA (fluorescence polarization immunoassay). RESULTS: After topical administration and subconjunctival injection, statistically significant decreases of average concentrations were observed after 2~3 hours. The group that was covered with flexible hydrophilic contact lenses showed high concentrations after 30 minutes, and a statistically significant increases of concentration was observed after 2 hours. The group that was topically administered with 0.3% tobramycin after amniotic transplantation on the cornea, showed a gradual increase of concentration as time progressed, and statistically significant increase of concentration was observed after 1~2 hours. CONCLUSIONS: Topical administrations with more frequent instillations increased intracameral concentrations, exceeding the MIC90 concentration of Staphylococcus aureus. while low concentration (0.3%) of subconjunctival injections did not significantly increases intracameral concentrations. Using flexible contact lenses, high concentrations were observed in the early stages, exceeding the MIC90 concentrations of Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa. Concentrations exceeded MIC90 concentration of Staphylococcus epidermidis 30 minutes after amniotic membranes transplantation, and continued to increases after 3 hours, Therefore, we can conclude that amniotic membrane can be used as a reservoir for transferring drugs.
Administration, Topical ; Amnion ; Aqueous Humor* ; Contact Lenses ; Contact Lenses, Hydrophilic ; Cornea ; Pseudomonas aeruginosa ; Rabbits ; Staphylococcus aureus ; Staphylococcus epidermidis ; Tobramycin*

No abstract available.
Dermoscopy ; Melanoma*

To substantiate the hypothesis that patients with antecedent angina(> or =24hr before myocardial infarcton) are more likely to have a significant residual stenosis than are those without antedecent angina, the coronary angiogram of 27 patients with successful coronary thrombolysis for acute myocardial infarction were reviewed. In comparison with the patients without antecedent angina the patient with antecedent angina had an increased mean stenosis (86.9% vs 69.3%) and had a more decreased ejection fraction(52.3% vs 65.6%). These findings suggest that angina pectoris before acute myocardial infarction would be regarded as one of high risk factors after acute myocardial infarction.
Angina Pectoris* ; Constriction, Pathologic* ; Humans ; Myocardial Infarction* ; Risk Factors

Although lumbosacral lipoma is reported to occur in 4-8 of 100,000 patients, and 66% of lipomyelomeningoceles in young patients are accompanied by hypertrophic filum terminale, it is very rare to find two isolated spinal lipomas simultaneously. A 3 month-old baby girl was admitted to the hospital for a protruding, non-tender, soft, subcutaneous 2.5 cm mass of the lumbosacral area that had been present since birth. Simple radiography showed a spinal posterior arch defect from L3 to L5, and magnetic resonance imaging (MRI) demonstrated two isolated spinal lipomas, a transitional type from L3 to L5, and a terminal type below S1 without dural defect. The cornus medullaris was severely tethered descending to the S1, but there was no cerebellar or brain stem herniation on the MRI. We suggest that the presence of a combined spinal lipoma should be a point for careful differentiation in an infant with spinal lipoma.
Treatment Outcome ; Spinal Cord Neoplasms/*diagnosis/*surgery ; Neural Tube Defects/*diagnosis/*surgery ; Lumbosacral Region/*surgery ; Lipoma/*diagnosis/*surgery ; Infant ; Humans ; Female

BACKGROUND: The risk for cardiovascular morbidity and mortality is higher in hemodialysis (HD) patients than in general population. Early diagnosis, treatment and prevention of cardiovascular disease (CVD) are the best way to reduce the most important cause of death. However, cardiac geometric and/or functional alterations including left ventricular hypertrophy, atherosclerosis and/or systolic and diastolic dysfunction are not easily known to nephrologist in the sense that diagnostic procedure is limited because cardiac angiography and echocardiography are frequently needed. METHODS: To evaluate the cardiac alteration by non-invasive tools, we measured pre- and post-HD B-type natriuretic peptide levels and performed impedance cardiography (ICG) in 40 HD patients and 10 healthy adults as control. RESULTS: Pre- and post-HD BNP level, cardiac index (CI), cardiac output (CO), stroke volume (SV), systemic vascular resistance index (SVRI), systemic vascular resistance (SVR), acceleration index (ACI), velocity index (VI) and thoracic fluid content (TFC) in patients were significantly higher than those in normal control group (p<0.05). Pre-HD BNP level, stroke index (SI), SV and TFC were significantly different after HD (p<0.05). There were significant differences in pre-HD BNP level, SI, SV and VI between diabetes and non-diabetes groups (p<0.05). Pre-HD BNP level correlated significantly with post- HD BNP level, systolic blood pressure, diastolic blood pressure, CO, SVRI, SVR and TFC (p<0.05). In multiple linear regression analysis, SVR and TFC were positively associated with pre-HD BNP level (R2=0.289). The area under the ROC curve for cardiac alterations was 0.749 for pre-HD BNP level. A cut-point of 560 pg/mL for pre-HD BNP level was 80% sensitive and 72% specific in determining cardiac alterations. CONCLUSION: Even though cardiac alterations of patients were heterogeneous in our study, plasma BNP level and some parameters (SVR, TFC) of ICG seem to be available to nephrologist for detecting and monitoring cardiac conditions in HD patients.
Acceleration ; Adult ; Angiography ; Atherosclerosis ; Blood Pressure ; Cardiac Output ; Cardiography, Impedance* ; Cardiovascular Diseases ; Cause of Death ; Early Diagnosis ; Echocardiography ; Electric Impedance* ; Humans ; Hypertrophy, Left Ventricular ; Linear Models ; Mortality ; Natriuretic Peptide, Brain* ; Plasma ; Renal Dialysis* ; ROC Curve ; Stroke ; Stroke Volume ; Vascular Resistance

PURPOSE: To review the simple radiographic and sonographic findings in infants with neonatal sepsis. MATERIALS AND METHODS: We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm: term=23:13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. RESULTS: Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18 (50%), 9 (25%), and 1 (3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients (17%) radiologic examinations revealed no abnormality. CONCLUSION: In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment.
Brain ; Enterocolitis, Necrotizing ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Intestinal Pseudo-Obstruction ; Osteomyelitis ; Pulmonary Atelectasis ; Pulmonary Edema ; Retrospective Studies ; Sepsis* ; Thorax ; Ultrasonography

BACKGROUND: In survivors of acute myocardial infarction(ANI), reduced heart rate variability(HRV) has been demonstrated to be an independent predictor of sudden cardiac death and mortality. The heart rate variability can be examined and analyzed non-invasively and quantitated with 24-hour ambulatory ECG monitoring. In general, the patency of infarct-related artery appears to be one of the most important prognostic factor after AMI. Therefor, the correlation between infarct artery patency and HRV was examined in survivors of AMI. METHODS: The 24-Hour ambulatory electrocardiogram was performed in 23 patients with AMI and 20 normal controls, and analyzed for frequency & time domain HRV. HRV was recorded dwithin 7 days after AMI, and coronary angiogram was performed at 7th day after AMI. The AMI patients were divided into two groups, depending upon patency of infarct-related artery and correlated to clinical manifestations. Thirteen patients had patent vessel(Group 1) and ten patients had non-patent vessel(Group 2). Parameters of frequency domain HRV include LF, HF & LF/HF ratio and time domain HRV include SDNN, SDANN, SD, rMSSD and pNN50. RESULTS: All parameters of HRV was depressed in patients of AMI than in normal control(p<0.05). The mean left ventricular ejection fraction(LVEF) was 54.1+/-10.6% in group 1 and 42.6+/-12.2% in group 2(p<0.05). The mean values of LF, SDNN, SDANN, and SD in group 1 and group 2 were 5.09+/-0.83msec2/Hz & 4.09+/-0.53msec2/Hz, 84.5+/-24.2msec & 59.0+/-11.8msec, 73.2+/-22.8msec & 50.5+/-12.6msec, and 37.8+/-13.1msec & 27.2+/-4.4msec(p<0.05), respectively. There was no difference between two groups in HF,rMSSD and pNN50. The location of infarction and thrombolytic therapy itself did not influence of HRV. The mean values of HF, SDANN, rMSSD and pNN50 in patients with LVEF<40% were reduced significantly than in patients with LVEF> or =40%. There was a significant correlation between LVEF and LF, between LVEF and HF and between LVEF and LF/HF ratio(r:0.55, p<0.05;r:0.67, p<0.05;r:-0.56, p<0.05). CONCLUSION: HRV was depressed due to reduced vagal activity in patients with AMI. The values of LF, SDNN, SDANN, and SD in group of patent infarct-related artery were reduced significantly than in non-patent group.
Arteries* ; Death, Sudden, Cardiac ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Infarction ; Mortality ; Myocardial Infarction* ; Survivors ; Thrombolytic Therapy