No abstract available.
Diabetes Insipidus, Nephrogenic*

PURPOSE: This study attempted to analyze problems of informed consent in the clinical setting and appraise ethical aspects inherent in such issues in order to boost awareness of informed consent and its implementation among healthcare professionals. METHODS: Study methods included identifying ethical meanings of informed consent in the clinical setting based on the principal ethics, and exploring the process of informed consent utilizing communicative ethics and feminine care ethics RESULTS: The ethical basis of informed consent encompasses not only respect for autonomy but also prohibiting malice, practicing beneficience, and establishing justice. These principles, however, are limited in illustrating the ethical aspects of communicative ethics and care ethics that are entailed in informed consent within clinical settings. The ethical meaning of informed consent involves a communicative and caring process between healthcare professionals, patients, and family built on mutual respect. CONCLUSION: Healthcare professionals must fully understand the ethical meanings of informed consent and in turn respect and protect the clients' right to know and making decisions. Nurses especially, must take on the role of mediator and advocate throughout the process of obtaining informed consent, and practice ethical caring by facilitating communication grounded in mutual understanding among the physician, patient, and family members.
Delivery of Health Care ; Ethics ; Humans ; Informed Consent* ; Social Justice

A 3 year and 3 months old boy with recurrent infections since his age of 5 months was presented with clinical data and autopsy findings. He was the 4th product of healthy parents. His elder brother died of recurrent perianal abscess and sepsis at his age of 3 years. His 2nd elder sister died on the 14th day of life probably from the complication of BCG vaccination. Beginnig with perianal abscesses at his age of 5 months, he has been continuously suffering from recurrent infections such as arthritis, ostomyelitis, pneumonia, epididymitis, subcutaneous abscesses and perianal abscesses. In spite of meticulous supportive and aggressive antibiotic therapy persistent positive cultures for staph. Aureus, klebsiella, E. Coli, Enterococcus and coliform bacilli from different sited were noted. Erythrocyte sedimentation rate of 25 to 40 were constant. White cell count varied frem 15500 to 33400 with polymorphonucleocytes predominance. NBT test showed persistent low scoring of 2% throught the course. He finally died of pneumonia and empyema. At postmortem examination, multiple abscesses and grnulomas of right lung and multipe granulomas in the liver, spleen, lymph node, bone, marrow, adrenal gland, kidney and intestinal wass were noted. At microscopic examination histiocytic granulomas with lipid containing histiocyte infiltrations were noted in every organs described including brain.
Abscess ; Adrenal Glands ; Arthritis ; Autopsy ; Blood Sedimentation ; Bone Marrow ; Brain ; Cell Count ; Empyema ; Enterobacteriaceae ; Enterococcus ; Epididymitis ; Granuloma ; Granulomatous Disease, Chronic* ; Histiocytes ; Humans ; Infant ; Kidney ; Klebsiella ; Liver ; Lung ; Lymph Nodes ; Male ; Mycobacterium bovis ; Parents ; Pneumonia ; Sepsis ; Siblings ; Spleen ; Vaccination

The most important factor in clinical development of respiratory care has been the clinical availabiTity of blood gas and pH measurement and it is important to get the accurate values of those. There can be an error to get the value of PCO2, PO2 and pH by dilutional effect of liquid-Naheparin that is usally used as an anticoagulant. We compared values of 20 arterial blood gases sampled with 1 cc plastic syringe utilizing liquid-Na-heparin with those ones sampled with 1 cc arterial blood gas kits which were pre-filled with dry-Lithium-heparin. The results were as follows; 1) There are no difference in values of PO2 and pH between two groups. 2) The value of PCO2 sampled with 1 cc plastic syringe utilizing liquid-Na-heparin is 1.62 torr less than the value of that with 1 cc arterial blood gas kits which were pre-filled with dry-Lithium-heparin (p<0.05).
Blood Gas Analysis* ; Gases ; Hydrogen-Ion Concentration ; Plastics ; Syringes*

OBJECTIVE: Amniocentesis for the diagnosis of prenatal genetic abnormalities is now the standard care for women who are at special risk. because the application of population-based maternal serum screening to prenatal diagnosis is now widespread, we can estimate the trend change of amniocentesis indications. METHODS: Four hundred twenty eight women who were attending the antenaltal clinic of Hanyang University Hospital had a amniocentesis between January 1992 and June 1997. The result were analyzed in reference to indication of amniocentesis, gestational age, pregnancy outcome and karyotype. RESULT: The major indications were abnormal maternal serum marker(53.3%), advanced maternal age(23.8%), previous fetal chromosomal anomaly(7.9%) and the most common age distribution at amniocentesis was 25-29 years(37.9%). The pregnancy outcome was full-term delivery(84.2%), preterm delivery(13.7%), spontaneous abortion(1.4%) and termination of pregnancy(0.7%). Among the 33 cases(7.7%) of abnormal karyotype, structural aberration was 21 cases(4.9%) and numerical aberration was 12 cases(2.8%). Among the numerical aberration, six cases of trisomy 21, five cases of Klinefelter syndrome, and one case of Turner syndrome were found. Among the structural aberration, insertion was most common(nine cases), and seven cases of inversion, four cases of translocation and one case of deletion were found. CONCLUSION: This is a report of genetic amniocentesis, with analysis of the indication, gestational age, karyotype results and complication.
Abnormal Karyotype ; Age Distribution ; Amniocentesis* ; Diagnosis ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotype ; Klinefelter Syndrome ; Mass Screening ; Pregnancy ; Pregnancy Outcome ; Prenatal Diagnosis* ; Turner Syndrome

OBJECTIVE: Amniocentesis for the diagnosis of prenatal genetic abnormalities is now the standard care for women who are at special risk. because the application of population-based maternal serum screening to prenatal diagnosis is now widespread, we can estimate the trend change of amniocentesis indications. METHODS: Four hundred twenty eight women who were attending the antenaltal clinic of Hanyang University Hospital had a amniocentesis between January 1992 and June 1997. The result were analyzed in reference to indication of amniocentesis, gestational age, pregnancy outcome and karyotype. RESULT: The major indications were abnormal maternal serum marker(53.3%), advanced maternal age(23.8%), previous fetal chromosomal anomaly(7.9%) and the most common age distribution at amniocentesis was 25-29 years(37.9%). The pregnancy outcome was full-term delivery(84.2%), preterm delivery(13.7%), spontaneous abortion(1.4%) and termination of pregnancy(0.7%). Among the 33 cases(7.7%) of abnormal karyotype, structural aberration was 21 cases(4.9%) and numerical aberration was 12 cases(2.8%). Among the numerical aberration, six cases of trisomy 21, five cases of Klinefelter syndrome, and one case of Turner syndrome were found. Among the structural aberration, insertion was most common(nine cases), and seven cases of inversion, four cases of translocation and one case of deletion were found. CONCLUSION: This is a report of genetic amniocentesis, with analysis of the indication, gestational age, karyotype results and complication.
Abnormal Karyotype ; Age Distribution ; Amniocentesis* ; Diagnosis ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotype ; Klinefelter Syndrome ; Mass Screening ; Pregnancy ; Pregnancy Outcome ; Prenatal Diagnosis* ; Turner Syndrome

PURPOSE: Molecular magnetic resonance(MR) imaging technique using the superparamagnetic iron oxide nanocrystals(SPIO) are developed for the monitoring the stem cells noninvasively. This study was performed to monitor the transplanted SPIO labelled human mesenchymal stem cells(hMSCs) with the molecular MR imaging and histologically in the rat bladder. MATERIALS AND METHODS: SPIO(Feridex; AMI, Cambridge, MA, USA) were labelled to hMSCs using GenePORTER. The labeling viability, efficiency of the SPIO labelled hMSCs were examined with tripan blue, prussian blue staining. SPIO labelled hMSCs are transplanted to the bladder in rats and MR images of them were examined using 1.5 T MR. Histologic examination of the SPIO labelled hMSCs transplanted bladder was performed with H&E and prussian blue staining. RESULTS: The viability, efficiency of the SPIO labelled hMSCs were good. MR signal intensity at the areas of the SPIO labelled hMSCs in the bladder decreased after transplantation of 1x10(6) SPIO labelled hMSCs and were confined locally. Intracellular SPIO were confirmed in the hMSCs transplanted bladder up to 5 weeks. CONCLUSION: The SPIO labelled hMSCs in the bladder can be monitored using the molecular MR imaging and SPIO labelled hMSCs were found in the transplanted bladder.
Animals ; Humans* ; Iron* ; Magnetic Resonance Imaging ; Mesenchymal Stromal Cells* ; Rats* ; Stem Cells ; Urinary Bladder*

PURPOSE: Monitoring the biological changes in transplanted stem cells is important. Molecular magnetic resonance (MR) imaging using superparamagnetic iron oxide nanocrystals(SPIO) has been developed for noninvasive monitoring of stem cells. This study was performed to investigate whether the biological status of transplanted human mesenchymal stem cells(hMSCs) in the rabbit penis can be monitored noninvasively using molecular MR imaging. MATERIALS AND METHODS: SPIO(Feridex; AMI, Cambridge, MA, USA) were transferred into hMSCs using GenePORTER. The labeling efficiency, viability, and differentiation of the SPIO-containing hMSCs were examined with Trypan blue, Von Kossa, alkaline phosphatase, toluidine, blueoil red O, and Prussian blue staining. SPIO-labeled hMSCs were transplanted into the rabbit penis, and MR images of them were examined in vitro or in vivo using 1.5 T MR. Histologic examination was performed. RESULTS: The viability and efficiency of the SPIO-transferred hMSCs were good. Osteogenic, chondrogenic and adipogenic differentiation from SPIO-containing hMSCs were found. A decrease in MR signal intensity in the SPIO-containing hMSCs was found in vitro. MR signal intensity in the areas of the SPIO-transferred hMSEc in the rabbit penis decreased and were confined locally. Intracellular SPIO were confirmed in the hMSCs transferred into penis. CONCLUSIONS: SPIO-labeled hMSCs in the rabbit penis can be evaluated noninvasively using molecular MR imaging.
Alkaline Phosphatase ; Humans* ; Iron ; Magnetic Resonance Imaging* ; Male ; Mesenchymal Stromal Cells* ; Penis ; Stem Cells ; Trypan Blue ; Urinary Bladder*

PURPOSE: Monitoring the biological changes in transplanted stem cells is important. Molecular magnetic resonance (MR) imaging using superparamagnetic iron oxide nanocrystals(SPIO) has been developed for noninvasive monitoring of stem cells. This study was performed to investigate whether the biological status of transplanted human mesenchymal stem cells(hMSCs) in the rabbit penis can be monitored noninvasively using molecular MR imaging. MATERIALS AND METHODS: SPIO(Feridex; AMI, Cambridge, MA, USA) were transferred into hMSCs using GenePORTER. The labeling efficiency, viability, and differentiation of the SPIO-containing hMSCs were examined with Trypan blue, Von Kossa, alkaline phosphatase, toluidine, blueoil red O, and Prussian blue staining. SPIO-labeled hMSCs were transplanted into the rabbit penis, and MR images of them were examined in vitro or in vivo using 1.5 T MR. Histologic examination was performed. RESULTS: The viability and efficiency of the SPIO-transferred hMSCs were good. Osteogenic, chondrogenic and adipogenic differentiation from SPIO-containing hMSCs were found. A decrease in MR signal intensity in the SPIO-containing hMSCs was found in vitro. MR signal intensity in the areas of the SPIO-transferred hMSEc in the rabbit penis decreased and were confined locally. Intracellular SPIO were confirmed in the hMSCs transferred into penis. CONCLUSIONS: SPIO-labeled hMSCs in the rabbit penis can be evaluated noninvasively using molecular MR imaging.
Alkaline Phosphatase ; Humans* ; Iron ; Magnetic Resonance Imaging* ; Male ; Mesenchymal Stromal Cells* ; Penis ; Stem Cells ; Trypan Blue ; Urinary Bladder*

PURPOSE: Integration of the functional information of myocardial perfusion SPECT (MPS) and the morphoanatomical information of coronary CT angiography (CTA) may provide useful additional diagnostic information of the spatial relationship between perfusion defects and coronary stenosis. We studied to know the added value of three dimensional cardiac SPECT/CTA fusion imaging (fusion image) by comparing between fusion image and MPS. MATERIALS AND METHODS: Forty-eight patients (M:F=26:22, Age: 63.3+/-10.4 years) with a reversible perfusion defect on MPS (adenosine stress/rest SPECT with Tc-99m sestamibi or tetrofosmin) and CTA were included. Fusion images were molded and compared with the findings from the MPS. Invasive coronary angiography served as a reference standard for fusion image and MPS. RESULTS: Total 144 coronary arteries in 48 patients were analyzed; Fusion image yielded the sensitivity, specificity, negative and positive predictive value for the detection of hemodynamically significant stenosis per coronary artery 82.5%, 79.3%, 76.7% and 84.6%, respectively. Respective values for the MPS were 68.8%, 70.7%, 62.1% and 76.4%. And fusion image also could detect more multi-vessel disease. CONCLUSION: Fused three dimensional volume-rendered SPECT/CTA imaging provides intuitive convincing information about hemodynamic relevant lesion and could improved diagnostic accuracy.
Angiography ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Fungi ; Hemodynamics ; Humans ; Perfusion ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon