No abstract available.
Pregnancy*

No abstract available.
Ciprofloxacin* ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus*

OBJECTIVES AND METHODS: To directly examine the function of the endothelial cell(EC) and smooth muscle cell in umbilical arteries acquired from preeclampsia patients between June 1998 to November 1999, using a conventional tension measurement and bioassay experiment. RESULTS: Relaxation responses to EC-dependent relaxing agents including bradykinin and A23187 in human umbilical artery rings were significantly decreased in preeclampsia(p<0.01). Relaxation responses to EC-independent agents(SNP and SNAP) were also inhibited in umbilical artery rings acquired from preeclampsia patients(p<0.01). To test the change of endothelial cell function in preeclampsia without involvement of smooth muscle dysfunction, we used human umbilical artery and rabbit femoral artery as a donor and detector, respectively, in bioassay experiment. Relaxation responses to EC-dependent agents(A23187 and bradykinin) showed similar results to conventional tension measurement (p<0.01). Relaxation responses to 8-bromo-cGMP in human umbilical artery rings were also significantly decreased in preeclampsia(p<0.01). CONCLUSIONS: It can be concluded that increased vascular resistance in preeclampsia is not only due to the disturbance of endothelial function, but also to smooth muscle dysfunction.
Biological Assay ; Bradykinin ; Calcimycin ; Endothelial Cells ; Femoral Artery ; Humans ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Pre-Eclampsia* ; Relaxation* ; Tissue Donors ; Umbilical Arteries* ; Vascular Resistance

External stereotaxic irradiation of intracranial lesions has recently gained its interest in the fields of not only radiation oncology but also neurosurgery. Its main goal is to deliver large doses to a relatively small target volume. Authors present methods of the stereotaxic radiosurgical irradiation using 6MV linear accelerator (Nelac-6) and isodose distribution by therapeutic computer (Therac 2000). We attempt to demonstrate the dose distribution on verification films.
Neurosurgery ; Particle Accelerators ; Radiation Oncology ; Radiotherapy*

BACKGROUND: To ensure patient safety and improvements in the quality of hospital care, rapid response teams (RRTs) have been implemented in many countries, including Korea. The goal of an RRT is early identification and response to clinical deterioration in patients. However, there are differences in RRT systems among hospitals and limited data are available. METHODS: In Seoul St. Mary's Hospital, the St. Mary's Advanced Life Support Team was implemented in June 2013. We retrospectively reviewed the RRT activation records of 287 cases from June 2013 to December 2016. RESULTS: The median response time and median modified early warning score were 8.6 minutes (interquartile range, 5.6 to 11.6 minutes) and 5.0 points (interquartile range, 4.0 to 7.0 points), respectively. Residents (35.8%) and nurses (59.1%) were the main activators of the RRT. Interestingly, postoperative patients account for a large percentage of the RRT activation cases (69.3%). The survival rate was 83.6% and survival was mainly associated with malignancy, Acute Physiology and Chronic Health Evaluation-II score, and the time from admission to RRT activation. RRT activation with screening showed a better outcome compared to activation via a phone call in terms of the intensive care unit admission rate and length of hospital stay after RRT activation. CONCLUSIONS: Malignancy was the most important factor related to survival. In addition, RRT activation with patient screening showed a better outcome compared to activation via a phone call. Further studies are needed to determine the effective screening criteria and improve the quality of the RRT system.
Epidemiology* ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Mass Screening ; Patient Safety ; Physiology ; Reaction Time ; Retrospective Studies ; Seoul ; Survival Rate

Twenty-our cases of pituitary adenoma, 13 males and 11 females with the age ranging from 11 to 65 years, received radiation therapy(RT) on the pituitary area with 6MV linear accelerator during past 25 months at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic Medical College. Of 24 case of RT, 20 were postoperative and 4 primary. To evaluate the effect of RT, we analyzed the alteration of the endocrinologic tests, neurologic abnormalities, major clinical symptoms, endocrinologic changes and improvement in visual problems after RT. The results were as follows ; 1. Major clinical symptoms were headache, visual defects, diabetes insipidus, hypogonadisms and general weakness in decreasing order of frequency. 2. All but the one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with an invasive tumor mass around supra and para-ellar area. 3. Endocrinological classifications of the patient were 11 prolactinoma, 4 growth hormonesecreting tumors, 3 ACTH-ecreting tumors consisting of one Cushing's disease and two Nelson's syndrome, and 6 nonfunctioning tumors. 4. Eleven of 14 patients, visual problems were improved after treatment but remaining 3 were unchanged. 5. Seven of 11 prolactinomas returned to normal hormonal level after postoperative and primary RT and 3 patients are being treated with bromocriptine (BMCP) but on lost case. 6. Two of 4 growth hormone-ecreting tumor returned to normal level after RT but the remaining 2 are being treated with BMCP, as well.
Bromocriptine ; Classification ; Diabetes Insipidus ; Female ; Growth Hormone* ; Headache ; Humans ; Male ; Particle Accelerators ; Pituitary Neoplasms* ; Plasma* ; Prolactinoma ; Sella Turcica

Acute mercury inhalation poisoning is a rare cause of acute lung injury. It is usually fatal because of progressive pulmonary failure. We experienced a patient with acute respiratory distress syndrome (ARDS) after illicit use of mercury vapor for hemorrhoid treatment; he developed acute chemical pneumonitis following exposure to mercury vapor. Prompt treatment with corticosteroids and penicillamine for acute chemical pneumonitis was instituted; radiologic pulmonary infiltrates disappeared within a week, but late phase neurologic sequelae and pulmonary interstitial fibrosis progressed.
Adrenal Cortex Hormones/administration & dosage ; Aged ; Antidotes/administration & dosage ; Disease-Free Survival ; Human ; Inhalation Exposure/adverse effects* ; Male ; Mercury Poisoning/diagnosis ; Mercury Poisoning/complications* ; Penicillamine/administration & dosage ; Respiratory Distress Syndrome, Adult/drug therapy ; Respiratory Distress Syndrome, Adult/chemically induced* ; Substances:Penicillamine ; Substances: Antidotes ; Substances: Adrenal Cortex Hormones

INTRODUCTION: The traditional cytogenetic analysis requires relatively long cell culture time, intensive labour and trained personnel. But, in clinical situations, rapid diagnosis of genetic disease is very important for urgent decision for future management. So we need more rapid and precise diagnostic tools for clinical genetic counselling. The fluorescence in situ hybridization (FISH) has been studied for detecting chromosomal aneuploidies because this method can get rapid and precise results of cytogenetic studies. OBJECTIVE: To evaluate the clinical utility of fluorescence in situ hybridization technique as a diagnostic tool of chromosomal anomaly. METHODS: Peripheral blood or gonadal tissue were obtained from the patients (n=63) clinically suspicious of genetic disease. Chorionic villi (n=6), amniotic fluid (n=9), and fetal cord blood (n=2) were obtained from 15 pregnancies undergoing fetal karyotyping at 9 to 30 weeks of gestation for prenatal genetic counselling. Karyotyping was performed by both traditional cytogenetics and FISH, using commercially available kits. After the procedures, the results of FISH were compared with the results of traditional cytogenetic studies. RESULTS: In a blind series of 17 samples all, including trisomy 21 (1 case), trisomy 18 (1 case), monosomyX (1 case), 47,XYY (1 case), and 47,XXY (1 case), were correctly identified. FISH results were correspondent with conventional karyotyping results in 7 patients with intersex except one case of suspicious of mosaicism. In nine children of Turner syndrome, the results of two methods were correspondent too. There was a fluorescent signal defect in band 15 q11-q13 in one of chromosome 15 in 18 children of 29 patients, clinically suspicious of Prader-Willi syndrome, with FISH method and only four patients were diagnosed as Prader-Willi syndrome with G-banding microscope. It was impossible to identify the defect in chromosome 15 q11-q13 in 10 (34%) children by both methods. Two children of 11 patients, clinically suspicious of Angelman syndrome, were diagnosed as Angelman syndrome with both method respectively. And four children were diagnosed as Angelman syndrome only with FISH method. In 5 cases, we cannot detect the defect in chromosome 15 q11-q13 with both methods. In four cases of Williams syndrome, the results of both methods were as follows; 1 case (25%): diagnosed as Williams syndrome by both methods; 2 cases (50%): diagnosed
Amniotic Fluid ; Aneuploidy ; Angelman Syndrome ; Cell Culture Techniques ; Child ; Chorionic Villi ; Chromosomes, Human, Pair 15 ; Cytogenetic Analysis ; Cytogenetics ; Diagnosis* ; Down Syndrome ; Female ; Fetal Blood ; Fluorescence* ; Gonads ; Humans ; In Situ Hybridization* ; Karyotyping ; Mosaicism ; Prader-Willi Syndrome ; Pregnancy ; Trisomy ; Turner Syndrome ; Williams Syndrome

BACKGROUND: This study was designed to compare the effects of remifentanil, alfentanil, and fentanyl on the hemodynamic changes, sedation, and analgesia when administered with small doses of midazolam in patients undergoing a retrobulbar block for cataract surgery. METHODS: Sixty patients scheduled for cataract surgery were divided into 4 groups (n = 15 for each group). Firstly, group C received 5 ml of a normal saline solution, 3 min before a retrobulbar block. Next, group R received remifentanil 0.3g/kg. Furthermore, group A received a 4.5g/kg dose of alfentanil, 90 s before a retrobulbar block, and group F received fentanyl 0.6g/kg, 210 s before a retrobulbar block. All solutions were mixed with normal saline to a 5 ml volume. In group R, A, and F, midazolam (0.5 mg for patients over the age of 65 years; 1.0 mg in patients under the age of 65 years) was injected 3 min before the retrobulbar block. RESULTS: The systolic blood pressure in patients significantly increased at 1 or 2 minutes after a retrobulbar block in group C and at 1 minute in group F. For group R, the systolic blood pressure decreased significantly at 3, 4, 5, and 10 minutes, and at 2, 3, 4, 5, and 10 minute in group A. The mean OAA/S scale during a retrobulbar block significantly declined in groups R and A. The VAS score for pain was significantly lower in groups R and A, whereas the VAS anxiety index was significantly lower in groups R, A, F compared to group C (P 0.05). CONCLUSIONS: We found that the combination of remifentanil or alfentanil with midazolam showed better hemodynamic stability, sedative, and analgesic effects compared to fentanyl with midazolam in the retrobulbar block for cataract surgery.
Alfentanil* ; Analgesia* ; Anxiety ; Blood Pressure ; Cataract* ; Fentanyl* ; Hemodynamics* ; Humans ; Midazolam ; Sodium Chloride

Seventy four patients with pituitary adenoma received radiation therapy(RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, kangnam St. mary's hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five (88%) patients were treated postoperatively and 9(12%) primary RT. To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin(PRL), growth hormone(GH), adrenocortiotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone(FSH) and thyroid stimulating hormone(TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turica with invasive tumor mass around supra-and/or parasella area. The patients were classified as 23(29%) prolactinomas and 20 (26%) growth hormone (GH) secreting tumors, and 6(8%) ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine(37%) had nonfunctioning tumor and four (5%) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15(65%) of 23 PRL and 3(15%) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively, Fifteen(20%) patients were lost to follow up atter RT.
Adrenocorticotropic Hormone ; Bromocriptine ; Female ; Growth Hormone ; Humans ; Hypothyroidism ; Lost to Follow-Up ; Male ; Particle Accelerators ; Pituitary Neoplasms* ; Prolactinoma ; Thyroid Gland