Respiratory distress syndrome (RDS) in the newborn infants remains a major cause of mortality and morbidity in the newborn period despite much improvements in neonatal intensive care and artificial ventilatory techniques. Gastric fluid was obtained from 151 patients within 6 hours after delivery. The sensitivity, specificity, and predictive value of the simple shake test (133 cases) and stable microbubble rating (SMR) test (151 cases) were assessed in the diagnosis of RDS, as well as the relation between both tests and RDS. We carried out both tests of on gastric aspirates all newborn who admitted to NICU of Presbyterian Medical Center from June 1991 to August 1992. The results were summarized as follows: 1) Among the total 151 cases, RDS were found in 41 cases(27.2%). 2) RDS occurence rate of the simple shake test was 11/11 in 0 group, 17/26 in +1 group, 8/28 in +2 group, 2/41 in +3 group, and 2/27 in +4 group. RDS occurence rate was high the 0 and +1 group. 3) RDS occurence rate of the SMR test was 4/4 in very weak group, 32/36 in weak group, 1/33 in medium group, and 4/78 in strong group. RDS occurence rate was high in the very weak and weak group. 4) Among the positive group of the SMR test 95 cases, positive group of the shake test were found in 87 cases. Among negative group of the SMR test 38 cases, negative of the shake test were found in 29 cases (correlation coefficient=0.763). 5) Sensitivity of the shake test and SMR test were 70%, 87.8% respectively. Specificity of the shake test and SMR test were 93.3%, 96.4% respectively. Positive predictability were 75.7%, 90% respectively and negative predictability were 87.5%, 95.5% respectively. The shake test, as Well as SMR test, has significant value to diagnosis of the RDS. We predict RDS occurence rate of the SMR test was significantly higher than shake test.
Diagnosis ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Microbubbles* ; Mortality ; Protestantism ; Respiratory Distress Syndrome, Newborn* ; Sensitivity and Specificity

A variety of disease states are marked by prolonged and profound eosinophilia associated with localized or widespread eosinophilic infiltrates. Cardiac involvement maybe a major cause of morbidity and mortality of this disease. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocardilic myocarditis by endomyocardial biopsy.
Biopsy ; Eosinophilia ; Eosinophils* ; Mortality ; Myocarditis*

Formaldehyde is a colorless irritating gas of pungent odor, which is used as a disinfectant, antiseptic, deodorant, tissue fixative and embalming fluid, It is used in the formation of resins, alcohols and acids, and in permanent press processes in the textile industry. If formaldehyde is swallowed, severe abdominal pain and vomiting is immediately noted. Corrosive gastritis can follow with diffuse ulceration, fibrosis and contracture of the stomach, resembling linitis plastica, which may be severe enough to require gastrectomy. We report a case of cicatricial contracted stomach due to the ingestion of formalin.
Abdominal Pain ; Alcohols ; Contracture ; Deodorants ; Eating* ; Embalming ; Fibrosis ; Formaldehyde* ; Gastrectomy ; Gastritis ; Linitis Plastica ; Odors ; Stomach* ; Textile Industry ; Ulcer ; Vomiting

Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.
Adenocarcinoma* ; Carcinosarcoma* ; Humans ; Middle Aged ; Sarcoma ; Stomach*

Esophageal perforation is a rare disease, which require emergent diagnosis and therapeutic procedure. In this paper, we present one case of esophageal perforation by traction of toothbrush which was swallowed during pharyngeal irritation. After the toothbrush was inserted to stomach by gastroscope, gastrostomy was performed for removal of toothbrush and the esophageal perforation was repaired by operation.
Diagnosis ; Esophageal Perforation* ; Gastroscopes ; Gastrostomy ; Rare Diseases ; Stomach ; Traction

STUDY DESIGN: Case study of two cases. OBJECTIVES: The aim of our study is to describe atypical patterns of tuberculous spondylitis. SUMMARY OF LITERATURE REVIEW: Few reports of tuberculous spondylitis have discussed atypical cases, which resulted in a poor prognosis due to the delay in early diagnosis and proper treatment. MATERIALS AND METHODS: A 74-year-old female underwent an incision and drainage, and posterior decompression and fusion (PDF) due to tuberculous epidural abscess after vertebroplasty of a compression fracture at T12. A 52-year-old female underwent interbody fusion and posterior lateral fusion (PLF) because of aggravation of an abscess and neurologic symptoms following non-invasive intervention to treat atypical tuberculous spondylitis. RESULTS: Clinical symptoms and serological tests of the patients were improved at postoperative 6 months. CONCLUSIONS: When a patient presents with focal bony or soft tissue abnormality on an image study, the possibility of non-typical tuberculous spondylitis has to be considered when infective spondylitis or a tumor is detected. Moreover, an invasive diagnosis tool such as biopsy will be needed for proper management.
Abscess ; Aged ; Biopsy ; Decompression ; Diagnosis ; Drainage ; Early Diagnosis ; Epidural Abscess ; Female ; Fractures, Compression ; Humans ; Middle Aged ; Neurologic Manifestations ; Prognosis ; Serologic Tests ; Spondylitis* ; Vertebroplasty

The reliability of emergency ultrasonographic(US) detection of hemoperitoneum and solid organ injury in blunt abdominal trauma was evaluated retrospectively. From October 1,1995 to August 31,1996,90 patients were included in the study. Ultra- sonographic findings showed a sensitivity, specificity, and accuracy of 97.6%, 97.9%, and 98.1%, respectively, in detecting intraabdominal fluid collection. We believe that US in an emergency center is a quick, safe screening method in the evaluation of blunt abdominal trauma. In our department, US has replaced diagnostic peritonaeal lavage(DPL) and computed tomography(CT) as the screening study of first choice.
Emergencies* ; Hemoperitoneum* ; Humans ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

The effects of NMDA-receptor antagonist (MK-801) were assessed for the oxygen free radical mediated brain (hippocampus) injury with eighty rats which were exposed to carbon monoxide (CO) followed by hyperbaric oxygen (HBO) treatment. Superoxide dismutase (SOD) and malondialdehyde (MDA) were used as parameters of the oxygen free radical reaction. Experimental groups consisted of (1) control group (=breathing with air), (2) CO group (=exposed to CO after air breath), (3) CO-air group(exposed to CO after air breath followed by air breath), and (4) CO-HBO group (=exposed to CO after air breath followed by 3 ATA HBO). Each group was divided two subgroup according to the pretreatment (normal saline or MK-801). CO, CO-air and HBO groups increased in SOD activity as compared with control group. And CO-air and HBO groups increased in MDA as compared with control and CO group. Pretreatment of MK-801 decreased SOD activities significantly (p-value<.05) , but MDA amount not significantly (p-value=.107). These results suggest a useful protective effect of NMDA-receptor antagonist (MK-801) in CO induced hippocampal injury mediated by oxygen free radicals.
Animals ; Brain Injuries* ; Brain* ; Carbon Monoxide ; Dizocilpine Maleate ; Free Radicals ; Malondialdehyde ; Oxygen* ; Rats* ; Superoxide Dismutase

Although acute acalculous cholecystitis (AAC) accounts for less than 10% of acute cholecystitis in the adult population, gangrene and perforation are much more frequent compared to the usual cases of acute cholecystitis (calculus cholecystitis). However, spontaneous biliary-enteric fistula is well recognized in AAC, 90% of which are cholecystoduodenal fistula (CDF) though it is an uncommon disorder. The majority of the CDF are caused by cholelithiasis. As patients are usually associated with complicated clinical illness, the diagnosis is often difficult to make and required surgery is often delayed. We have studied a rare complication of acute acalculous cholecystitis which was presented as intermittent upper gastrointestinal bleeding. Ulceration of the superficial branch of the cystic artery has been observed due to acalculous cholecystitis associated with a cholecystoduodenal fistula. We have performed a transfixing ligation of the bleeding vessel, cholecystectomy and simple closure of the CDF. We have finally made a diagnosis of early gallbladder cancer through a frozen section. There was no serious complication after the operation and the patient has achieved an uneventful recovery.
Acute Disease ; Cholecystectomy ; Cholecystitis/*diagnosis ; Duodenal Diseases/*complications ; Gallbladder Neoplasms/diagnosis ; Gastrointestinal Hemorrhage/*etiology ; Human ; Intestinal Fistula/*complications ; Male ; Middle Aged