Autosomal dominant polycystic kidney disease (ADPKD) is a hereditary disorder characterized by renal cyst formation, hypertension, and end-stage renal disease. For many years, ADPKD was considered an adult disease. In fact, it may occur at any time in life including in utero. We experienced a case of ADPKD at 34 weeks of gestation. On ultrasound, both kidnies were enlarged and echogenic. Amniotic fluid index was normal. We discovered a family history of paternal origin. Sonographic findings of bilaterally enlarged and echogenic kidnies without oligohydroamniosis may suggest ADPKD. Renal ultrasound examination of parents is useful in the diagnosis of ADPKD.
Adult ; Amniotic Fluid ; Diagnosis* ; Female ; Humans ; Hypertension ; Kidney Failure, Chronic ; Parents ; Polycystic Kidney, Autosomal Dominant* ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography

The purpose of this study is to investigate the effects of doxapram on the rates of spontaneous and neostigmine-induced recovery from neuromuscular block with vecuronium and atracurium. Following intravenous injection of either vecuronium (40 patients) or atracurium (40 patients), recovery index (RI) was measured without administering either doxapram or neostigmine (Group 1), or after administration of a combination of neostigmine 40 ug/kg and doxapram 1 mg/kg (Group 2), neostigmine 40 ug/kg (Group 3) or doxapram 1 mg/kg (Group 4) when twitch tension returned to 25% block of train of four response, each of the four group had 10 patients. The results were such that RI was significantly prolonged after vecuronium in the presence of doxapram compared with Group 1 (13.5 min vs 8.2 min). There was no significant difference in the RI after atracurium in the presence of doxapram compared with Group 1 (7.0 min vs 7.1 min). There was rapid recovery which was significant when neostigmine was administered with or without doxapram (2.4 min vs 2.3 min respectively after vecuronium; 2.3 min vs 2.4 min respectively after atracurium). The authors conclude that administration of doxapram in situation where neuromuscular block with vecuronium is not adequately antagonized does not contribute to rapid recovery from neuromuscular block.
Atracurium* ; Doxapram* ; Humans ; Injections, Intravenous ; Neostigmine ; Neuromuscular Blockade ; Vecuronium Bromide*

No abstract available.
Nipples* ; Poroma*

Pulmonary artery rupture with a flow-directed balloon tipped pulmonary artery catheter (Swan-Ganz catheter)is a rare complication with high mortality. This report concerns a case of this complication with hemothorax leading to fatal exsanguination. Emphasis is placed on the safety guidelines to prevent this. Also, possible causes and managements are presented. A high index of suspicion is necessary whenever a patient with the catheter has hemoptysis or unexplained hemodynamic or respiratory changes.
Arteries* ; Catheters* ; Exsanguination ; Hemodynamics ; Hemoptysis ; Hemothorax ; Humans ; Mortality ; Pulmonary Artery ; Rupture*

Pulmonary artery rupture with a flow-directed balloon tipped pulmonary artery catheter (Swan-Ganz catheter)is a rare complication with high mortality. This report concerns a case of this complication with hemothorax leading to fatal exsanguination. Emphasis is placed on the safety guidelines to prevent this. Also, possible causes and managements are presented. A high index of suspicion is necessary whenever a patient with the catheter has hemoptysis or unexplained hemodynamic or respiratory changes.
Arteries* ; Catheters* ; Exsanguination ; Hemodynamics ; Hemoptysis ; Hemothorax ; Humans ; Mortality ; Pulmonary Artery ; Rupture*

PURPOSE: The purpose of the study was to identify the level of resilience, autonomous motivation, depression and self-care and their correlates in elders with hypertension. METHODS: The participants were 200 elders with hypertension living in J, I, and K city. Data were collected through face-to-face interviews using the Resilience Scale, Treatment Self Regulation Questionnaire, Short Form Geriatric Depression Scale, and Hypertension Self-care Scale. RESULTS: Total scores for resilience, autonomous motivation, depression, and self-care were 109.65± 20.78, 38.18±5.99, 8.33±2.61, and 52.06±6.94, respectively. Autonomous motivation, income, acceptance of self and life, resilience, experience of hypertension education, and gender were verified as factors influencing self-care. These factors accounted for 51.6% of self-care. CONCLUSION: Understanding these factors is essential for developing effective interventions to improve self-care in elders with hypertension.
Depression ; Education ; Hypertension* ; Motivation ; Self Care* ; Self-Control

To evaluate the incidence and clinico-pathologic correlation of benign epithelial changes of endometrium, we tried to classify the changes into squamous cell change, ciliary change, eosinophilic cell change, papillary surface epithelial change, and mucinous cell change by the criteria of Hendrickson. Based on the 450 hysterectomy specimens obtained from Jan. 1994 to Dec. 1994 in PMC, the incidence of the cell changes was as follows: squamous cell change: 1.1%, eosinophilic cell change: 6.8%, mucinous cell change: 6.6%, ciliary change: 10.4%, papillary surface epithelial change: 16.4%. Squamous cell change was noted in severe endometritis or endometrial hyperplasia and papillary surface epithelial proliferation was mainly associated with plasma cell infiltration in adenomyosis or leiomyoma. Eosinophilic change and ciliary change were sometimes concomitantly found in dilated glands of the basal layer or in the invaded glands of adenomyosis. The results of this study suggested a correlation of benign epithelial changes with endometritis, adenomyosis, leiomyoma and dysfunctional uterine bleeding.
Incidence

Angiomyofibroblastoma of the vulva is a rare mesenchymal tumor. It has been diagnostically confused with aggressive angiomyxoma which has a somewhat different clinical course and therapy. Herein we report a case of angiomyofibroblastoma of the vulva in a 46-year-old female. Microscopically, there were alternating hypercellular and hypocelluar edematous zones in which abundant capillary blood vessels were irregularly distributed. Spindle, plump spindle, and oval stromal cells were concentrated around the blood vessels, or loosely dispersed in the hypocellular area. Immunohistochemically, the stromal cells were positive for desmin, vimentin, muscle-specific actin and weakly positive for S-100 protein. Ultrastructural studies showed well developed rough endoplasmic reticulum, abundant intermediate filaments, and pinocytic vesicles in the stromal cells.
Female ; Humans

The purpose of this study is to evaulate the relationship between end-tidal PCO2(PetCO2) and arterial PCO2(PaCO2) by placing patients from the supine to the lateraI decubitus position and by the changes from two lung ventilation(TLV) to one lung ventilation(OLV) during noncardiac thoracic surgery in 20 patients. All patients had been intubated with double-lumen endobronchial tubes and respirations were controlled with a rate of 14- l7 breaths per minute and tidal volume of 8 ml/kg by an anesthetic ventilator. End tidal PCO2 and arterial PCO2 were measured at three different measurement points(supine plus TLV, lateral decubitus plus TLV, and lateral decubitus plus OLV). End tidal PCO was obtained by mainstream infrared analysis, and arterial blood samples for arterial PCO2 were taken from the radial artery simultaneously. The results were as follows: l) The mean difference between arterial and end tidal carbon dioxide tension(Pa-etCO2) was 7.5+/-2.9mmHg at the supine position, TLV(r=0.76, P<0.01). 2) The mean Pa-etCO2 was 6.2+/-3.1 mmHg at the lateral decubitus position, TLV(r =0.68, P < O.ol ). 3) The mean Pa-etCO2 was 7.1+/-2.5 mmHg at the lateral decubitus position, OLV(r=0.85, P< 0.01). 4) The changes in Pa-etCO2 were very slight during thoracotomy and endobronchial anesthesia, these were of negligible clinical importance. We conclude that measurement of PetCO2 is reliable as a guideline of ventilation during endobronchial anesthesia.
Anesthesia* ; Carbon Dioxide* ; Carbon* ; Humans ; Lung ; Radial Artery ; Supine Position ; Thoracic Surgery ; Thoracotomy ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*