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

No abstract available.

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

No abstract available.
Dermoscopy ; Melanoma*

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*

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

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

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: The intimal thickening of coronary artery was understood as an early process in the beginning of atherosclerosis. However, the implication of intimal thickening as a morphologic change of coronary artery disease, on the coronary vascular hemodynamics has not been explored. METHODS: To evaluate the effect of intimal thickening on the coronary vascular hemodynamics, we studied the extent of intimal thickening on intravascular ultrasound(IVUS) and the coronary vascular flow and resistance by using Doppler wire in left anterior descending coronary arteries after successful intervention in 40 patients(29 males, mean age 55+/-9 years) with coronary artery disease. Mean intimal index and mean lumen cross sectional area were determined by IVUS and coronary flow average peak velocity was obtained by using Doppler wire before and after intracoronary adenosine in distal artery to the stenosis. Coronary flow velocity reserve(CFR), volumetric coronary blood flow(CBF) and coronary vascular resistance index(CVRI) were calculated. Hyperemic pressure-to-flow ratio(hyperemic mean aortic pressure/hyperemic volumetric coronary blood flow), ie, an index of minimal coronary vascular resistance(mCVR), was further derived. RESULTS: Intimal index(mean 20.0+/-8.3%) was significantly correlated with CVRI(mean 0.33+/-0.14, r=.37, p=.02) and mCVR(mean 0.81+/-0.40mmHg/ml/min, r=.36, p=.02). However, there was no correlation with CBF and CFR. CONCLUSION: The CVRI and mCVR(hyperemic pressure to flow ratio), the indices coronary microvascular resistance, were significantly related to the degree of intimal thickness of coronary artery. The extent of intimal thickness of coronary artery on IVUS study may be related to microvascular integrity.
Adenosine ; Arteries ; Atherosclerosis ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Hemodynamics ; Humans ; Male ; Vascular Resistance*

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