No abstract available.
Humans*

Percutaneous biliary dilation was done in 3 patients with benign strictures. The first case was 50-year-oldmale who had multiple intrahepatic stones with biliary stricture. The second 46-year-old female and the third25-year-old male suffered from recurrent cholangitis with benign stricture of anastomotic site aftercholedochojejunostomy. In the first case, a 6mm diameter Grunzig dilatation balloon catheter was introducedthrough the T-tube tract. In the second case, the stricture was dilated with two balloons of 5mm and 8 mm in eachdiameter sequentially thorugh the U-loop tract formed by surgically made jejunostomy and percutaneous transhepaticpuncture. In the third case, the dilatation catheter was introduced through the percutaneous transhepatic tract.Dilatation was made with a pressure of 5 to 10 atmospheres for 1 to 3 minutes duration for 3 times. In all 3cases, the structures were successfully dilated and in second and third cases internal stent was left across thelesion for prevention of restenosis.
Atmosphere ; Catheters ; Cholangitis ; Constriction, Pathologic ; Dilatation ; Female ; Humans ; Jejunostomy ; Male ; Middle Aged ; Stents

BACKGROUND: Leptin, produced in the adipose tissue, is involved in the regulation of body weight. The release of the leptin is increased in obese adults even in children. This study investigated whether the serum leptin in cord blood was related to babys birth weight and metabolic parameters. METHODS: 71 pairs of singleton pregnancy babies and their mother were studied. Babies are classified in LGA (large for gestational age), AGA (appropriate for gestational age), SGA (small for gestational age) three groups. After delivery, cord blood and maternal venous blood samples were drawn. We measured the plasma leptin, insulin-like growth factor (IGF)-1, insulin and proinsulin in cord and maternal serum. RESULTS: The concentration of leptin from cord blood was increased in LGA babies and decreased in SGA babies compued with the level in AGA babies. There was positive correlatian (r=0.55, p<0.01) between the plasma leptin level in cord and birth weight. There were positive correlatian between both the plasma proinsulin (r=0.37, p<0.01) and IGF-1 (r=0.32, p<0.01) and birth weight, too. But there was no difference between female and male baby's cord blood leptin level. In multiple regression analysis, cord blood leptin level was found independent factor related to birth weight ( p=0.001) CONCLUDION : The plasma leptin, proinsulin and IGF-1 is correlates to the birth weight. These data provide evidence that leptin and proinsulin are highly related to the nutritional status already during the fetal periods, and effect on the intrauterine fetal growth.
Adipose Tissue ; Adult ; Birth Weight* ; Body Weight ; Child ; Female ; Fetal Blood* ; Fetal Development ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Mothers ; Nutritional Status ; Parturition* ; Plasma ; Pregnancy ; Proinsulin

No abstract available.
Granuloma* ; Leprosy, Lepromatous*

Isoimmune hemolytic disease of the newborn due to anti-E is a disease characterized by the progressive neonatal hyperbilimbinemia and anemia which is caused by the IgG antibody transmitted from the mother to the ferns. Authors have experienced two cases of isoimmune hemolytic disease due to anti-E, who presented with jaundice on the first and the second day of life, respectively. The ABO and Rh blood types of their mother and father were B, CcDee and O, ccDEE, respectively. Both babies showed positive direct Coombs test and the mother showed strong positive indirect Coombs test. Antibody identification tests were made only in the first case and the mother, both of which revealed anti-E antibody. The first case was treated with phototherapy for 3 days and two blood transfusions. The second case was treated with phototherapy for 6 days and two exchange transfusions.
Anemia ; Blood Transfusion ; Coombs Test ; Fathers ; Ferns ; Humans ; Immunoglobulin G ; Infant, Newborn ; Jaundice ; Mothers ; Phototherapy ; Siblings*

BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

OBJECTIVE: In a pregnant rabbit model using hysteroscopy-guided inoculation of E. coli, we investigated pregnancy outcome according to elapsing time with immediate antibiotic treatment after E. coli inoculation, and in turn determined which of the maintenance of pregnancy with antibiotic and tocolytic administration or prompt delivery in the management of preterm labor complicated with intrauterine infection offered the improvement of pregnancy outcome. METHODS: Timed-pregnant rabbits underwent hysteroscopy at 20-21 days of gestation(70%). Animals were inoculated with either E. coli(0.2 ml containing 10' cfu/ml) or saline, and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) in divided doses every 8 hours beginning 30 minutes after microbial inoculation until euthanasia with one of the following; 3 days(n 10), 5 days(n 8), or 7 days(n-8) after hysteroscopy. In the first study, which performed in animals with inoculation of E. coli, pregnancy outcome including fetal survival rate and results of microbial studies and placental pathology were compared among three groups. In second study, which performed in animals with inoculation with saline, pregnancy outcome were compared among three groups for the purpose of elucidating effects of antibiotic administration during inoculation-to-euthanasia interval on pregnancy outcome. RESULTS: Of rabbits inoculated with E. coli and receiving antibiotics immediately, the rate of fetal survival and positive intrauterine cultures in total and live fetuses decreased significantly, and the rate of placental inflammation in total and live fetuses increased significantly with time from intracervical inoculation with E. coli to euthanasia(p<0.05, respectively). Of rabbits inoculated with saline and receiving antibiotics immediately, the rates of fetal survival, positive intrauterine cultures in total and live fetuses, and placental inflammation in total and live fetuses have no difference with time from intracervical inoculation with saline to euthanasia. CONCLUSION: Fetal complications including fetal death could be induced in utero if persistent subclinical intrauterine infection was present in spite of earlier antibiotics administration initiated after inoculation of E, coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitor the presence of persistent intrauterine infection, and if it is persistent, prompt delivery may be better than maintenance of pregnancy with antibiotic and tocolytic administration for the improvement of pregnancy outcome.
Animals ; Anti-Bacterial Agents* ; Euthanasia ; Female ; Fetal Death ; Fetus ; Hysteroscopy ; Inflammation ; Obstetric Labor, Premature ; Pathology ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rabbits ; Survival Rate

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Extensive laceration of the lung itself has relatively little attention as a threat to life compared with other intrathoracic organ injuries. The incidence of pulmonary laceration extensive enough to require thoracotomy is rare, but is higher than expected. The diagnosis of extensive pulmonary laceration may be difficult, but this injury should be suspected with attention and early thoracotomy can be carried out in indicated cases. Recently, thoracoscopy has assumed a major role in the management of a variety of surgical diseases of the chest. We experienced a case of extensive pulmonary laceration caused by nonpenetrating trauma, which underwent lobectomy by thoracoscopic surgery. A 21-year-old man who was injured in a motocycle accident was brought to Emergency Room from the scene by an ambulance, and complained of chest pain and dyspnea. A chest roentgenogram showed a hemothorax and fractures of the posterior ends of the right seventh, eighth, and ninth ribs. A chest tube was inserted. Thirteen hundred ml of blood was drained through the chest tube during the next one hour. Emergency right mini-thoracotomy revealed extensive laceration of the lower lobe extending to the pulmonary hilum. The lower lobe was the most badly torn. A lower lobectomy was done by video-assisted thoracic surgery (VATS). He complained less postoperative pain and the postoperative course was uneventful.
Ambulances ; Chest Pain ; Chest Tubes ; Diagnosis ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Hemothorax ; Humans ; Incidence ; Lacerations* ; Lung ; Pain, Postoperative ; Ribs ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy ; Thorax ; Young Adult

The major purpose for the use of autotransfusion is to prevent the transmission of blood borne infectious agents, such as human immunodeficiency virus and non-A & non-B hepatitis virus. To evaluate the efficacy and quality of autolgous shed blood for autotransfusion, eighty patients who had total knee arthroplasty from Dec. 1992 to Mar. 1994, were included in one of two groups: Group I, who received the autotransfusion, or Group II, who did not. Each group included 20 patients of unilateral TKR and 20 patients of bilateral TKR. The Orth-evac system(Deknatel, USA) was used to salvage drained blood in the first six hours after the operation. All of the patients were evaluated for the postoperative blood loss, transfusion requirements, hemoglobin, hematocrit, platelet count, blood pressure and body temperatures. l. In bilateral TKR, the reinfusion of shed blood reduced the requirements for homologous blood by 41.4%(1.2 pints in group I versus 2.9 pints in group II). In unilateral TKR, it was decreased to 36.4%(0.4 pint in group I vs 1.1 pint in group II). 2. In bilateral TKR, the requirements for homologous transfusion was decreased from 95% of patients in control group to 55% in group I .In unilateral TKR, it was decreased from 60% to 20%. 3. There were four patients who had high fever above 39℃ after autotransfusion. 4. At the immediate postoperative period there were two patients who had hypovolemic shock in group I patients who had bilateral TKR. 5. There was no clotting abnormality, no transfusion reaction and no thromboembolic disease in group I patients. In conclusion, the reinfusion of autologous shed blood after TKR is an acceptable alternative to the homologous transfusion without untoward effect.
Arthroplasty, Replacement, Knee ; Blood Transfusion, Autologous ; Body Temperature ; Fever ; Hematocrit ; Hepatitis Viruses ; HIV ; Humans ; Knee ; Platelet Count ; Postoperative Hemorrhage ; Postoperative Period ; Shock ; Transfusion Reaction