BACKGROUND: This study was performed to analyze the appropriateness and the efficacy of fresh frozen plasma (FFP) transfusions for the treatment of coagulopathy. METHODS: Three hundred and eleven patients with FFP transfusion histories were evaluated on the state of coagulopathy and the reasons for transfusion. The reasons were classified according to the recommendations by the British Committee for Standards in Haematology (BCSH) for evaluation of transfusion appropriateness. The efficacy of transfusions was evaluated in 144 patients with coagulopathy by means of delta PT (%) and delta aPTT (sec). Corrected delta PT (c delta PT) and corrected delta aPTT (c delta aPTT) were defined as delta PT and delta aPTT divided by the transfusion amount, and these were compared among the disease groups. RESULTS: Forty-two patients (30.5%) were definitely indicated, and 53 patients (17.0%) were conditionally indicated. One hundred and eighty-four patients (59.2%) were transfused with no justification for the transfusions. Of the improved cases, 27.8% of the patients scored at more than 10% in the PT (%) category. In 28.1% of the patients, there were more than 10 sec in aPTT (sec). There was a significant correlation between the volume of the transfusion (mL/kg) and the delta PT and delta aPTT (r=0.2932, P=0.0004; r=0.2379, P=0.0047; respectively). The c delta PT had an inverse correlation to the elapsed time from transfusion to the coagulation assay (r=-0.1815, P=0.0301). The c delta PT and the c delta aPTT were significantly lower in patients with liver disease than those with DIC (P=0.0009, P=0.0084; respectively). CONCLUSIONS: We found that FFP was transfused more inappropriately than should have been. The transfusion volume was the most significant factor for the efficacy of FFP transfusions. FFP transfusions were less efficient in the patients with liver disease.
Blood Transfusion ; Dacarbazine ; Humans ; Liver Diseases ; Plasma*

OBJECTIVE: To investigate the effects of mirror therapy using a tablet PC for post-stroke central facial paresis. METHODS: A prospective, randomized controlled study was performed. Twenty-one post-stroke patients were enrolled. All patients performed 15 minutes of orofacial exercise twice daily for 14 days. The mirror group (n=10) underwent mirror therapy using a tablet PC while exercising, whereas the control group (n=11) did not. All patients were evaluated using the Regional House–Brackmann Grading Scale (R-HBGS), and the length between the corner of the mouth and the ipsilateral earlobe during rest and smiling before and after therapy were measured bilaterally. We calculated facial movement by subtracting the smile length from resting length. Differences and ratios between bilateral sides of facial movement were evaluated as the final outcome measure. RESULTS: Baseline characteristics were similar for the two groups. There were no differences in the scores for the basal Modified Barthel Index, the Korean version of Mini-Mental State Examination, National Institutes of Health Stroke Scale, R-HBGS, and bilateral differences and ratios of facial movements. The R-HBGS as well as the bilateral differences and ratios of facial movement showed significant improvement after therapy in both groups. The degree of improvement of facial movement was significantly larger in the mirror group than in the control group. CONCLUSION: Mirror therapy using a tablet PC might be an effective tool for treating central facial paresis after stroke.
Facial Paralysis* ; Humans ; Mouth ; National Institutes of Health (U.S.) ; Outcome Assessment (Health Care) ; Prospective Studies ; Smiling ; Stroke*

The authors found that the fourth author's affiliation had been inadvertently omitted.

BACKGROUND: Listeria monocytogenes is a foodborne oppotunistic pathogen causing meningoencephalitis and bacteremia in certain groups such as neonates, pregnant women, the elderly, or immunosuppressed patients. We investigated the predisposing conditions, and laboratory and clinical features for listeriosis of non-pregnant adult patients in tertiary care hospitals. METHODS: Sixteen patients diagnosed at AMC from 1997 to April 2002 were newly analyzed. In addition, 20 cases published in domestic literatures from 1973 to 1997 were retrospectively reviewed for their medical records or literatures to evaluate demographic, clinical, and laboratory data. RESULTS: While AMC cases comprised 14 bacteremia, 2 meningitis, and 1 peritonitis, literature cases comprised 17 meningitis, 2 bacteremia, and 1 endocarditis. All but one endocarditis patients were in immunocompromised states such as malignancy (19 patients), diabetes (7), transplantation (5), SLE, asthma with steroid therapy (4), elderly alcoholics (1), and elderly tuberculosis (1). Ten of 36 cases developed fever 5 days after admission. All but two strains were susceptible to penicillin or ampicillin, and 28 of 29 treated cases received beta-lactam agents. Fifteen patients (41.6%), including 11 patients with malignancy, expired. Blood cultures were positive in all 19 meningitis cases, but direct smears of CSF for bacteria were positive in only 20%. CONCLUSION: L. monocytogenes frequently caused life-threatening sepsis or meningitis in immunocompromised patients at a tertiary care hospitaL. For early diagnosis of L. monocytogenesis infection, microbiology laboratories are advised to improve the sensitivity of CSF smear.
Adult* ; Aged ; Alcoholics ; Ampicillin ; Asthma ; Bacteremia ; Bacteria ; Early Diagnosis ; Endocarditis ; Female ; Fever ; Humans ; Immunocompromised Host ; Infant, Newborn ; Korea* ; Listeria monocytogenes* ; Listeria* ; Listeriosis ; Medical Records ; Meningitis ; Meningoencephalitis ; Penicillins ; Peritonitis ; Pregnant Women ; Retrospective Studies ; Sepsis ; Tertiary Healthcare ; Tuberculosis

BACKGROUND: Listeria monocytogenes is a foodborne oppotunistic pathogen causing meningoencephalitis and bacteremia in certain groups such as neonates, pregnant women, the elderly, or immunosuppressed patients. We investigated the predisposing conditions, and laboratory and clinical features for listeriosis of non-pregnant adult patients in tertiary care hospitals. METHODS: Sixteen patients diagnosed at AMC from 1997 to April 2002 were newly analyzed. In addition, 20 cases published in domestic literatures from 1973 to 1997 were retrospectively reviewed for their medical records or literatures to evaluate demographic, clinical, and laboratory data. RESULTS: While AMC cases comprised 14 bacteremia, 2 meningitis, and 1 peritonitis, literature cases comprised 17 meningitis, 2 bacteremia, and 1 endocarditis. All but one endocarditis patients were in immunocompromised states such as malignancy (19 patients), diabetes (7), transplantation (5), SLE, asthma with steroid therapy (4), elderly alcoholics (1), and elderly tuberculosis (1). Ten of 36 cases developed fever 5 days after admission. All but two strains were susceptible to penicillin or ampicillin, and 28 of 29 treated cases received beta-lactam agents. Fifteen patients (41.6%), including 11 patients with malignancy, expired. Blood cultures were positive in all 19 meningitis cases, but direct smears of CSF for bacteria were positive in only 20%. CONCLUSION: L. monocytogenes frequently caused life-threatening sepsis or meningitis in immunocompromised patients at a tertiary care hospitaL. For early diagnosis of L. monocytogenesis infection, microbiology laboratories are advised to improve the sensitivity of CSF smear.
Adult* ; Aged ; Alcoholics ; Ampicillin ; Asthma ; Bacteremia ; Bacteria ; Early Diagnosis ; Endocarditis ; Female ; Fever ; Humans ; Immunocompromised Host ; Infant, Newborn ; Korea* ; Listeria monocytogenes* ; Listeria* ; Listeriosis ; Medical Records ; Meningitis ; Meningoencephalitis ; Penicillins ; Peritonitis ; Pregnant Women ; Retrospective Studies ; Sepsis ; Tertiary Healthcare ; Tuberculosis

Congenital hypopituitarism is a possible cause of neonatal cholestasis, but the mechanism is still unknown. The pathogenesis of cholestasis may be due to hormone deficiency, which has effects on the physiological maturation of bile acid synthesis and transport. We experienced a case presenting with cholestasis and recurrent hypoglycemia associated with congenital hypopituitarism. Cholestasis resolved with thyroxine and hydrocortisone replacement therapy
Bile ; Cholestasis* ; Hydrocortisone ; Hypoglycemia ; Hypopituitarism* ; Thyroxine

Four cases of atypical chronic myeloid leukemia (aCML), which were compatible with the FAB guideline for the classification of chronic myeloid leukemia (CML), are presented. All 4 patients showed the onset in old age, leukocytosis with an increase in the number of immature granulo-cytes, monocytosis, a low basophil count, and a dysgranulopoiesis in the peripheral blood, a nega-tivity of the bcr-abl gene rearrangement, and a hypercellular marrow with marked granulocytic hyperplasia and dyshemopoietic features. Two patients died within 3 months and the other 2 are currently under observation after a partial response to hydroxyurea. aCML is known to have a poor therapeutic response and outcome without a blastic crisis. A greater deal of concern regarding aCML is required for an accurate diagnosis and classification.
Basophils ; Bone Marrow ; Classification ; Diagnosis ; Gene Rearrangement ; Humans ; Hydroxyurea ; Hyperplasia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytosis

Prenatal Ultrasonographic findings of meconium peritonitis show calcificalion, and abdominal echogenic masses such as pseudocyst. Also, we can find availability of 3 dimensional ultrasonography above these descriptions. We present a case of meconium peritonitis in uterus which was diagnosed by means of prenatal 2D & 3D ultrasonography with brief review of literatures.
Meconium* ; Peritonitis ; Ultrasonography ; Uterus

OBJECTIVES: To evaluate pregnancy outcomes after placental needle penetration during midtrimester diagnostic amniocentesis. METHODS: We collected 726 singleton pregnancy cases from 1054 pregnancies of midtrime-ster diagnostic amniocentesis, and analysed pregnancy outcomes after the procedure based on medical records. To compare the outcomes, we divided 726 cases into two groups; placental penetration group by aspiration needle(170 cases) and non-penetration group(556 cases). RESULTS: There were no statistically significant differences between two groups about maternal age and gestational age at the time of procedure, and the distribution of amniocentesis indication. In comparison of complications between two groups after procedure, a. There was no statistically significant difference in amniotic fluid leakage: in penetration group, 1 case (0.58%) and in non-penetration group, 5 cases(0.89%) were observed. b. There was no statistically significant difference in vaginal bleeding: in penetration group, 2 cases (1.18%) and in non-penetration group, 3 cases(0.54%) were observed. c. There was no statistically significant difference in developing abruptio placentae: in penetration group, no case developed and in non-penetration group, one case(0.18%) was observed. d. As for fetal loss, there was no statistically significant difference : in penetration group, 4 cases (2.35%) and in non-penetration group, 10 cases(1.80%) were occurred. e. As for birth weight, there was no statistically significant difference : in penetration group, 3.26+/-0.8 kg and in non-penetration group, 3.21+/-0.9 kg were measured. CONCLUSION: Our study shows that placental penetration by aspiration needle during diagnostic mid-trimester amniocentesis does not increase the risk of post-procedure complication.
Abruptio Placentae ; Amniocentesis* ; Amniotic Fluid ; Birth Weight ; Female ; Gestational Age ; Humans ; Maternal Age ; Medical Records ; Needles* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Uterine Hemorrhage

BACKGROUND/AIMS: Dyslipidemia and obesity are risk factors for the development of acute myocardial infarction (AMI) that affect the clinical outcomes in patients. METHODS: We analyzed 2,751 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) (mean age, 63.7 +/- 12.1 years). The patients were divided into four groups based on serum triglyceride levels and central obesity [Group Ia: triglycerides < 200 mg/dL and (-) central obesity; Group Ib: triglyceride < 200 mg/dL and (+) central obesity; Group IIa: triglyceride > or = 200 mg/dL and (-) central obesity; Group IIb: triglyceride > or = 200 mg/dL and (+) central obesity]. In-hospital outcome was defined as in-hospital mortality and complications. One-year clinical outcome was compared and defined as the composite of 1-year major adverse cardiac events (MACE), including death, recurrent MI, and target vessel revascularization. RESULTS: Total MACE developed in 502 patients (18.2%), while 303 patients (11.0%) died prior to the 1-year follow-up visit. In-hospital complications and in-hospital mortality were not different among the four groups. One-year clinical outcomes based on triglyceride levels (Group I vs. Group II) were not different. In addition, there were no differences in clinical outcomes in patients with a triglyceride level < 200 mg/dL, regardless of central obesity. One-year MACE rates were not significantly different among the four groups. CONCLUSIONS: There was no significant difference in the 1-year MACE rate based on the triglyceride level and presence of central obesity in patients with AMI who underwent PCI.
Dyslipidemias ; Follow-Up Studies ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Obesity ; Obesity, Abdominal* ; Percutaneous Coronary Intervention* ; Risk Factors ; Triglycerides*