No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal*

BACKGROUND: This study was undertaken to test the validity of M-mode and a new cross sectional cehocardiographic quantification of pericardial effusion. METHODS: This study was performed in 12 patients with large pericardial effusion of whom hed M-mode and 2-D echocardiography just before therpeutic drainage of the effusion. The volume of Pericardial fluid removed by pericardiocentesis was compared with te echo-free space estimated by M-mode echocardiography and the volume estimated by new 2-D echocardiographic method. The pericardial sac volume and the cardiac volume were calculated by applying the formula for the volume of a prolate ellipse. RESULTS: 1) There was a good correlation between 2-D echocardiographic estimate and the actual volume removed by pericardiocentesis(r=0.72, p<0.05). 2) The correlation between the echo-free space estimated by M-mode echocardiography at the level of mitral valve and the actual volume was also good(r=0.81,p<0.001). CONCLUSION: The M-mode and 2-D echocardiographic method is successful in helping to estimate large pericardial effusion.
Cardiac Volume ; Drainage ; Echocardiography* ; Humans ; Mitral Valve ; Pericardial Effusion* ; Pericardiocentesis ; Phosmet

Hematuria is a important clinical sign that is a consequence of significant fenal. urologic or sytemic disease. Recently the morphology of the red cell in hematuria has been used to indicate a renal or non-renal source and also the measurement of red cell volume by red cell analyzer has been used to distinguish glomerular from non-glomerular hematuria. In this study. the MCV(mean corpsular red cell voume). RDW(red cell distribution width) and HDW (hemoglobin distribution width) were measured using H-1 system in57 children with hematuria to assess the diagnostic usefulness of the urinary red cell analyzer in the differentation of glomerular and non-glomerular hematuria. The patients were divided into two groups as glomerular diseases(40cases)and non-glomerular diseases(17 cases)and the location of the bleeding was confirmed by renal biopsy, radiology and the clinical findings. The results were as follows. 1) The urinary red cell MCV waslower in patients with glomerular diseases than that in patients with non-glomerular diseases (79.89 +/- 12.0fl vs. 90.93 +/- 9.71fl vs. 90.93+/-9.71 fL; p<0.01) 2) The urinary RDW and HDW were significantly higher in glomerular diseases than those in non-glomerular diseases (RDW; 19.86 +/- 11.28% vs 11.34+/-5.88%, HDW; 3.37+/-2.07 gm vs. 1.86+/-1.43gm). 3) The urinary red cell MCV was correlated well with the RDW and HDW while there was no correlation between the urinary red cell MCV and the urinary SG or pH. 4) The sensitivity, specificity and positive predictability of the urinsary MCV were 37.8%, 94.1% and 93.7% and those of RDW were 62.5%, 82.3% and 89.2% 5) The sensitivity, specificity and positive predictability of the urinary HDW were 42.5%, 88.2% and 89.4% We concluded from above date that the measurment of the urinary MCV, RDW and HDW would be useful as a primary non-invasive screening test in differentation of glomerular and non-glomerular hematuria in children.
Biopsy ; Cell Size* ; Child* ; Diagnosis* ; Hematuria* ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Mass Screening ; Sensitivity and Specificity

OBJECTIVE: The aim of our study was to make a practical comparative evaluation of the first and second trimesters in order to determine the period during which a higher yield of fetal nucleated red blood cells (FNRBCs) can be obtained. METHODS: NRBCs were isolated from maternal blood during the first and second trimesters of pregnancy using double Percoll gradients with different osmolarities. Magnetic activated cell sorting was performed with Kleihauer-Betke stain. We isolated fetal NRBCs from 10 mL of samples of maternal blood and determined fetal sex and fetal aneuploidy by fluorescence in situ hybridization (FISH). RESULTS: The average number of NRBCs was 9.85 in samples obtained during the first trimester and 14.88 in samples obtained during the second trimester (P=0.07). The average number of NRBCs with Y chromosome signals was 5.73 in the first trimester and 8.22 in second trimester (P=0.56). However, the percentage of NRBCs with Y chromosome signals in the first trimester (70.6%) was significantly higher than in the second trimester (59.8%) (P=0.049). We diagnosed the blood samples from 7 pregnant women having fetal aneuploidy using this method and the number of NRBCs was 18.4. CONCLUSION: The method using Percoll osmolarity and a double density gradient system may be a very useful method for separation of NRBCs in the first trimester of pregnancy and also in the second trimester.
Aneuploidy ; Centrifugation, Density Gradient ; Erythrocytes ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Magnetics ; Magnets ; Osmolar Concentration ; Povidone ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnant Women ; Prenatal Diagnosis ; Silicon Dioxide ; Y Chromosome

PURPOSE: The purpose is to evaluate the CT or MRI findings to help in the differentiation between benign and malignant meningiomas. MATERIAL AND METHODS: The CT and MRI findings of 8 patients with surgically proven malignant meningioma were reviewed. Four cases of 8 malignant meningiomas and 18 cases of 27 benign lesions were studied with a 1.5T or 0.5T MRI. Radiologic analysis was focused on the heterogeneity of tumor, grade of peritumoral edema, presence of cystic degeneration and calcification, tumoral enhancement pattern, dural enhancement, and tumoral border. RESULT: Histologic types of malignant meningioma were meningotheliomatous (n=4), papillary(n=1), fibroblastic(n=l), angioblastic(n=l), and sarcomatous(n=l). Tumoral Heterogeneity was seen in 8 of 8 malignant lesions(100%) and 8 of 27 benign ones(30%). (p<0.01) Marked peritumoral edema was seen in 8 of 8 malignant lesions(100%) and 2 of 27 benign ones. (7.3%)(p<0.01) Most of malignant lesions(6 of 8 cases, 75%) showed ill defined border. Calcification was not present in malignant lesions in contrast with benign ones (14 of 27 cases, 52%). (p<0.05) No statistical significance was noted in cystic degeneration, dural tail like enhancement or tumoral enhancement pattern between malignant and benign meningiomas. MRI signal intensity of malignant meningiomas was homogeneously or heterogeneously hypointense on T1WI, heterogeneously isointense or hypointense on T2WI and heterogeneous or mixed on Gd-DTPA enhancement study. CONCLUSION: The CT or MRI findings such as heterogeneity, ill defined tumoral border, marked peritumoral edema, and absence of calcification may suggest the possibility of malignancy in meningioma.
Edema ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging* ; Meningioma* ; Population Characteristics

No abstract available.
Endocardial Cushion Defects* ; Endocardial Cushions* ; Ultrasonics*

The scabies mite is an ectoparasite, which is able to infest humans. The incidence of scabies decreased during the past 20 years in Korea. However, the incidence is likely to increase again, and may be delayed or missed diagnosis recently. Its clinical presentation is typical, although in a host with compromised immune system, like the mentally retarded and elderly patients, the clinical presentation may be altered. Because a delay in diagnosis may induce rapid spread of the scabies mite, immediate diagnosis and treatment are necessary. We report two cases of scabies in elderly patients from different nursing homes. These patients were transferred to our center for treatment of pneumonia and chronic renal disease. They revealed pruritus and skin rashes after the treatment of further underlying diseases. We consulted to a dermatologist because of worsening symptoms, despite an application of medication with antihistamine and topical steroid, scabies was diagnosed. The symptom improved with topical 1% gamma-benzene hexachloride, an effective scabies drug. We suggest that geriatrists should suspect scabies who presents with pruritus that is persistent or resistant to conventional treatment, especially patients transferred from nursing homes.
Aged ; Chronic Disease ; Exanthema ; Humans ; Immune System ; Immunocompromised Host ; Incidence ; Korea ; Lindane ; Mentally Disabled Persons ; Mites ; Nursing Homes ; Pneumonia ; Pruritus ; Renal Insufficiency, Chronic ; Scabies

BACKGROUND: Angiotensin converting enzyme(ACE) inhibition as a means of controlling blood pressure began in the 1970s. This increasing knowledge of ACE inhibitors has resulted in their being used with confidence in a antihyertensive therapy, combining high efficacy with very low levels of side effects. METHOD: In this study, the antihyertensive effect of ramipril was assessed in 28 patients(9 males and 19 females with mean age of 52 years)with mild-to-moderate hypertension. After a placebo run-in phase, patients received ramipril as monotherapy in a dose 2.5 to 5 mg daily for 6 weeks. RESULTS: 1) At the end of 6 weeks, ramipril induced clinically significant reduction in supine(30.1mmHg in systole, 17mmHg in diastole) and sitting(33.4mmHg in systole, 18.5mmHg in diatole)blood pressure. 2) The heart rate was similar after 6 weeks. 3) The most frequent side effect was dry cough in 6 patients(5.6%) followed by dizziness. CONCLUSION: This study indicate that ramipril is effective in the treatment of mild to moderate essential hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Blood Pressure ; Cough ; Dizziness ; Female ; Heart Rate ; Humans ; Hypertension* ; Male ; Ramipril* ; Systole

Presentation of antigen in a suitable form to lymphocytes is prerequsite for the initiation of primary immune response. Dendritic cells (DC) provide an effective pathway for presenting antigens to lymphocytes in situ. The aim of this study was to establish a dendritic cell-line from human tonsils and to investigate the changes in surface phenotype during culture. Immunohistochemical studies using various surface markers indicated that cultured DC were follicular dendritic cells (FDC) from human tonsils. Cultured DC showed typical dendritic morphology at early stage of culture. Their shape changed into fibroblast-like cells over culture time. Surface phenotype study suggested that cultured DC were distinct from human fibroblast. Antigenic pattern of FDC was changed during culture; I-ILA-DR antigens decreased and HJ2 antigens increased with aging of culture. Functional characteristics of human tosillar FDC will be investigated in the future.
Aging ; Dendritic Cells ; Dendritic Cells, Follicular* ; Fibroblasts ; Humans ; Lymphocytes ; Palatine Tonsil ; Phenotype

BACKGROUND/AIMS: Obesity is associated with gastroesophageal reflux disease (GERD). Leptin is a hormone which controls appetite and energy homeostasis. Alterations of its level in humans have been linked with obesity and related carcinogenesis. We postulated that the leptin level in plasma or tissues might be different according to the phenotype of GERD. We evaluated this hormone in patients with non-erosive reflux disease (NERD) and reflux esophagitis (RE) with demographic characteristics to confirm the postulation. METHODS: The patients with typical GERD symptoms such as acid regurgitation and heartburn were prospectively enrolled and evaluated. The demographic data included body mass index, waist circumference, smoking, and the consumption of coffee. Rapid urease test was done to evaluate the status of Helicobacter pylori infection. We measured plasma leptin level along with the tissue level, which was obtained from the fundus of stomach. RESULTS: A total of 44 patients were evaluated (RE 20 cases, NERD 24 cases). No demographic data was different between the two groups, except waist circumference (mean 88.6 cm in RE, 80.9 cm in NERD, p=0.006), smoking (45% in RE, 12.5% in NERD, p=0.021) and coffee consumption (85% in RE, 50% in NERD, p=0.025). The level of plasma leptin was not different between the two groups. The level of tissue leptin was also not different between the two groups with an increasing tendency in RE (mean 32.5 ng/mL vs. 28.0 ng/mL in NERD). CONCLUSIONS: We could not find any association between plasma and tissue leptin levels and the phenotype of GERD. However, increasing tendency in RE could afford to further studies in near future.
Adult ; Aged ; Body Mass Index ; Coffee ; Female ; Gastroesophageal Reflux/*complications ; Helicobacter Infections/complications ; Helicobacter pylori ; Humans ; Leptin/analysis/*blood ; Male ; Middle Aged ; Obesity/complications ; Phenotype ; Smoking ; Waist Circumference