No abstract available.
Brain Edema* ; Brain* ; Microvessels* ; Vascular Endothelial Growth Factor A*

No abstract available.
Brain Edema* ; Brain* ; Meningioma* ; Vascular Endothelial Growth Factor A*

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*

PURPOSE: To evaluate the specific findings of angiography for various causes of gastrointestinal bleeding. MATERIALS AND METHODS: We retrospectively analyzed 35 patients of gastrointestinal bleeding detected by angiography, between April 1987 and July 1993. There were 28 men and 7 women, 19 to 83 years old (mean, 47 years). Of these 35 cases of gastrointestinal bleedings, there were 12 gastric bleedings, 4 duodenal bleedings, 9 small intestinal bleeings, 6 ileocecal bleedings, and 4 large intestinal bleedings. RESULTS: Of 35 cases, we could diagnose the specific cause of bleeing in 13 patients (37%) by angiography. Of these 13 cases, there were 4 cases of gastric ulcers showing contrast pooling in ulcer crater, 5 cases of vascular malformations showing anomalous vascular mass with early dilated venous drainage, 2 cases of direct invasion of hepatocellular carcinoma showing invasion of hypervascular mass into small bowel, one case of pseudoaneurysm at gastroduodenal artery in a patient of acute pancreatitis, and one case of small intestinal lymphoma showing contrast pooling in a irregular dilated small intestinal lumen. CONCLUSION: in gastrointestinal bleeding, angiography is useful not only in detecting the bleeding site, but also for evaluating the specific causes such as gastric ulcers or vascular malformations.
Aged, 80 and over ; Aneurysm, False ; Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis* ; Drainage ; Female ; Hemorrhage* ; Humans ; Lymphoma ; Male ; Pancreatitis ; Retrospective Studies ; Stomach Ulcer ; Ulcer ; Vascular Malformations

BACKGROUND: Mixed venous oxygen saturation (SO2) monitoring turned out to be invaluable in following up systemic cardiovascular status. But balloon-tipped flow-directed thermodilution catheter (Swan-Ganz catheter) insertion carries additional inherent risks other than those of central venous catheterization, and it costs much more expense than simple venous catheter. There has been a lot of papers which argue that central venous catheterization may substitute for the Swan-Ganz catheterization. In addition, it may be very difficult or impossible to insert the Swan-Ganz catheter in pediatric patients. This study was performed to determine whether Swan-Ganz catheterization might be replaced by the central venous catheterization in regards to SO2. METHODS: In 17 pediatric open heart surgery (OHS) patients, from the central venous catheter, the tip of which had been located in the center of right atrium (RA) and pulmonary artery, blood samples were drawn for gas analysis simultaneously, which was done immediately after emergence from cardiopulmonary bypass. RESULTS: There were no significant differences between RA blood and mixed venous blood gas analyses except oxygen saturation. The oxygen saturations of both were linearly correlated with each other. The relation was SO2=17 0.8 SRAO2 (R=0.77, p<0.05) CONCLUSIONS: It may be concluded that RA blood may be used for blood gas analysis in place of mixed venous blood immediately after pediatric open heart surgery.
Blood Gas Analysis ; Cardiopulmonary Bypass* ; Catheterization, Central Venous ; Catheterization, Swan-Ganz ; Catheters ; Central Venous Catheters ; Heart Atria ; Heart* ; Humans ; Oxygen* ; Pulmonary Artery ; Thermodilution ; Thoracic Surgery*

In evaluating the early state of shock patients and their response to treatment, generally vital signs or additional hemodynamic values were used. Vital signs are easily obtained and repetitious values or continous monitoring is possible, whereas it cannot evaluate the patient's status properly nor is it a good prognostic factor. Meanwhile, additional hemodynamic values are obtained from pulmonary artery catheterization. But this procedure is difficult to proceed in the emergency room. Since central venous oxygen saturation has the advantage of being easily obtained and acts as a good prognostic factor for shock patients, we intended to prove its efficacy. From 1997 May to October, 50 patients admitted to Yonsei University Young Dong Severance Hospital in shock state, with systolic blood pressure below 90mmHg, were evaluated. Central venous catheter was inserted to obtain central venous oxygen saturation, serum lactate, base excess value, and its' initial value compared with the prognosis. The central venous oxygen saturation and base excess were low, while serum lactate value was high in the nonsurvival group. And in ROC(relative operating characteristic) curve, the AUC(area under curve) of central venous oxygen saturation was larger than the others. In comparing the MOF(multi-organ failure) group with the non-MOF group, the MOF group had a lower central venous oxygen saturation and base excess, and a higher serum lactate level, whereas in ROC curve, the AUC of base excess was larger than the others. Therefore, in estimating the prognosis of shock patients, the early central venous oxygen saturation proved to be a good prognostic factor.
Area Under Curve ; Blood Pressure ; Catheterization, Swan-Ganz ; Central Venous Catheters ; Emergency Service, Hospital ; Hemodynamics ; Humans ; Lactic Acid ; Oxygen* ; Prognosis ; ROC Curve ; Shock* ; Vital Signs

Acute scrotum is defined as an acute painful swelling of the scrotum or its content. There are many conditions it may cause acute scrotum, but since a delay in the diagnosis and treatment may led to necrosis and its loss, the possibility of torsion of the spermatic cord should be ruled out in the first place. In a retrospective study of 32 childhood patients with acute scrotum presenting to Chungbuk National University Hospital from March 1992 to March 1995, we evaluated general aspects of acute scrotum including the result of follow up. The incidence of acute epididymitis, testicular torsion, mumps orchitis, and torsion of a testicular appendage were 66%, 19%, 9% and 6%, respectively. Of the eight scrotal explorations performed, 6 had testicular torsion, and 2 had torsion of appendages. With the exception of cases of far advanced necrotic testes, both color Doppler ultrasound and radioisotope imaging were highly specific diagnostic modalities. But, because of the potentially devastating outcome of a false-negative result of imaging studies, we continue to believe that physical exam is the best guide regarding the necessity of surgical exploration and all patients with unequivocal examinations are best served by prompt surgical therapy.
Acute Pain ; Child* ; Chungcheongbuk-do ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mumps ; Necrosis ; Orchitis ; Retrospective Studies ; Scrotum* ; Spermatic Cord ; Spermatic Cord Torsion ; Testis ; Ultrasonography ; Ultrasonography, Doppler, Color*

BACKGROUND AND OBJECTIVE: AT-1 cells have been derived from the left atrial tissue in which the ANF promoter targeted SV40 large T antigen expression. When cultured, clusters of spontaneously contracting cells were observed after 4-5 days and contiguous sheets of synchronously beating cardiomyocytes were formed after 10 days. In this study, expression of several cell cycle regulatory genes were monitored through Northern blot analyses in AT-1 cells during beating and after formation of beating sheets (BS). MATERIALS AND METHOD: AT-1 RNAs were obtained in 3 days after plating, during beating and after formation of BS, and used for Northern blot analyses. RESULTS: alpha-Cardiac myosin heavy chain expression was prominent in beating cells, as would be expected for this contractile protein isoform but ANF was decreased after beating. Gax was not expressed in cultured AT-1 cells but in AT-1 tumor and murine heart. p53 and p21 were decreased after beating which indicate transcription level of p53 and p21 correlated well in AT-1 cells. In contrast, pRB and p107 were increased after beating but p68 (2.4 kb) which arose by alternative splicing of p107 and lacks the pocket domain B was decreased in beating cells. pTCS2, murine tuberous sclerosis gene, represented similar levels during beating but a little was decreased after formation of BS. mRAD50, the murine homologue of yeast DNA recombinational repair gene RAD50, was increased in beating cells, a similar pattern to p107 and pRB. But the p50 arose by alternative splicing of mRAD50 and has 3' half of mRAD50 had unexpectedly appeared and maintained after beating. CONCLUSION: The expression of cell cycle regulatory genes after beating and formation of BS in AT-1 cells showed gene-specific pattern and the p50 which has homology to the mRAD50 may participate in differentiation of cardiomyocytes.
Alternative Splicing ; Antigens, Viral, Tumor ; Atrial Natriuretic Factor ; Blotting, Northern ; Cell Cycle* ; Genes, Regulator* ; Heart ; Myocytes, Cardiac* ; Myosin Heavy Chains ; Recombinational DNA Repair ; RNA ; Tuberous Sclerosis ; Yeasts

Spontaneous intracranial hemorrhage (ICH) occurs rarely during general anesthesia. We report a case of metastatic brain tumor producing an ICH during general anesthesia. A 47-year-old man was scheduled for the wedge resection of left lower lobe of lung under general anesthesia. He did not show any abnormal neurological sign and coagulation abnormality on arrival in the operating room. But he had a history of right hemiplegia 9 months ago which resolved completely. He was anesthetized for about 2 hours. Until 1 hour after the end of anesthesia and operation he did not regain his consciousness, but responded well to external stimuli. He was expected to be better, but his mentality became worse. Immediate computerized tomogram of brain revealed a left ICH. An emergency craniectomy was performed to remove the hematoma. Pathological investigations demonstrated a metastatic brain tumor from liver cell carcinoma. We presume that this intratumoral bleeding was produced by high intracranial blood pressure relating to general anesthesia or obstruction of jugular venous drainage by abnormal positioning of head.
Anesthesia ; Anesthesia, General* ; Blood Pressure ; Brain Neoplasms* ; Brain* ; Carcinoma, Hepatocellular ; Consciousness ; Drainage ; Emergencies ; Head ; Hematoma ; Hemiplegia ; Hemorrhage ; Humans ; Intracranial Hemorrhages* ; Lung ; Middle Aged ; Operating Rooms

BACKGROUND: Shivering, which occurs in the postanesthetic period, annoys many patients, so we examined the correlation of postanesthetic shivering (PAS) and warming intravenous fluids, the level of sensory blockade, and skin temperature during spinal anesthesia. METHODS: 65 patients undergoing an operation on a lower extremity were randomly allocated to 2 groups. The patients in group 1 and 2 received 500 ml of the unwarmed (ambient temperature) and warmed fluids prior to spinal anesthesia, respectively. All patients were anesthetized with 0.5% bupivacaine in 8% glucose. We measured the decrements of mean blood pressure (MBP) and heart rate, the highest sensory block level, and the increment of skin temperature 30 min after anesthesia, and the operating room temperature. After the operation we also evaluated the PAS by using the 10-mm visual anlalogue scale. RESULTS: The decrement of MBP was higher in group 2 than in group 1 (13 mmHg vs 5 mmHg, P<0.05). The highest sensory block level was higher in group 2 than in group 1 (T6.4 vs T7.6, P<0.05). However, there was no significant difference in heart rate decrement, skin temperature increment, ambient temperature, and PAS between groups. The more the MBP decrement, the less the PAS in all patients (r = 0.326, P = 0.008) and in group 1 (r = 0.480, P = 0.005), but there was no correlation between PAS and MBP decrement in group 2. The more the ambient temperature, the less the PAS in all patients (r = 0.334, P = 0.007), in group 1 (r = 0.386, P = 0.027), and in group 2 (r = 0.394, P = 0.026). The heart rate decrement, skin temperature increment, and sensory blockade level did not correlate with PAS. CONCLUSIONS: PAS lowers as MBP decreases and operating room temperature increases during spinal anesthesia, but warming intravenous fluids, sensory block level, and skin temperature change doesn't affect PAS.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine ; Glucose ; Heart Rate ; Humans ; Lower Extremity ; Operating Rooms ; Shivering* ; Skin Temperature* ; Skin*