Clinical significance of antinuclear antibody positivity in patients with severe coronavirus disease 2019

Background/Aims@#This study aimed to investigate the clinical characteristics and outcomes of fluorescent antinuclear antibody (FANA)-positive patients admitted for coronavirus disease 2019 (COVID‐19) and identify FANA as a prognostic factor of mortality. @*Methods@#This retrospective study was conducted at a university-affiliated hospital with 1,048 beds from September 2020 to March 2022. The participants were consecutive patients who required oxygenation through a high-flow nasal cannula, non-invasive or mechanical ventilation, or extracorporeal membrane oxygenation, and conducted the FANA test within 48 hours of admission. @*Results@#A total of 132 patients with severe COVID-19 were included in this study, of which 77 (58.3%) had FANA-positive findings (≥ 1:80). FANA-positive patients were older and had higher inflammatory markers and 28-day mortality than FANA- negative patients. In the multivariate Cox proportional hazard regression analysis, FANA-positive findings (hazard ratio [HR], 2.65; 95% confidence interval [CI], 1.04–6.74), age (per 1-year; HR, 1.05; 95% CI, 1.01–1.10), underlying pulmonary disease (HR, 3.16; 95% CI, 0.97–10.26), underlying hypertension (HR, 2.97; 95% CI, 1.28–6.87), and blood urea nitrogen > 20 mg/dL (HR, 3.72; 95% CI, 1.09–12.64) were independent predictors of 28-day mortality. Remdesivir (HR, 0.34; 95% CI, 0.15–0.74) was found to be an independent predictor that reduced mortality. @*Conclusions@#Our findings revealed an autoimmune phenomenon in patients with severe COVID-19, which provides an ancillary rationale for strategies to optimize immunosuppressive therapy. In particular, this study suggests the potential of FANA to predict the outcomes of COVID-19.

Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea

Purpose@#Although the taller-than-wide (TTW) sign has been regarded as one of the most specific ultrasound (US) features of thyroid malignancy, uncertainty still exists regarding the US probe’s orientation when evaluating it. This study investigated which US plane would be optimal to identify the TTW sign based on malignancy risk stratification using a registry-based imaging dataset. @*Methods@#A previous study by 17 academic radiologists retrospectively analyzed the US images of 5,601 thyroid nodules (≥1 cm, 1,089 malignant and 4,512 benign) collected in the webbased registry of Thyroid Imaging Network of Korea through the collaboration of 26 centers. The present study assessed the diagnostic performance of the TTW sign itself and fine needle aspiration (FNA) indications via a comparison of four international guidelines, depending on the orientation of the US probe (criterion 1, transverse plane; criterion 2, either transverse or longitudinal plane). @*Results@#Overall, the TTW sign was more frequent in malignant than in benign thyroid nodules (25.3% vs. 4.6%). However, the statistical differences between criteria 1 and 2 were negligible for sensitivity, specificity, and area under the curve (AUC) based on the size effect (all P0.05, respectively). @*Conclusion@#A longitudinal US probe orientation provided little additional diagnostic value over the transverse orientation in detecting the TTW sign of thyroid nodules.

Efficacy of 3D-Printed Titanium Mesh-Type Patient-Specific Implant for Cranioplasty / 대한신경손상학회지

Objective@#Autologous bone grafting for cranioplasty is associated with a high infection rate and bone absorption. Synthetic implant materials for cranioplasty have been developed. In this study, we evaluated the efficacy of titanium mesh-type patient-specific implants (PSIs) for patients with skull defects using the dice similarity coefficient (DSC), clinical outcomes, and artifacts caused by implants. @*Methods@#This retrospective study included 40 patients who underwent cranioplasty with a titanium mesh PSI at our institution. Based on preoperative and postoperative computed tomography scans, we calculated DSC and artifacts. @*Results@#The calculated DSC of 40 patients was 0.75, and the noise was 13.89% higher in the region of interest (ROI) near the implanted side (average, 7.64 hounsfield unit [HU]±2.62) than in the normal bone (average, 6.72 HU±2.35). However, the image signal-to-noise ratio did not significantly differ between the ROI near the implanted side (4.77±1.78) and normal bone (4.97±1.88). The patients showed no significant perioperative complications that required a secondary operation. @*Conclusion@#Titanium mesh-type PSIs for cranioplasty have excellent DSC values with lower artifacts and complication rates.

Factor Associated with Injury Related to Home Mechanical Ventilation in General Ward Patients: A Retrospective Study / 임상간호연구

Purpose@#This study aims to describe the characteristics of safety incidents and factors associated with injury for patients with Home Mechanical Ventilation (HMV) at the hospital. @*Methods@#This is a retrospective study. Data were collected from the work log of respiratory home care nurses and the patients’ electronic medical records were investigated. In order to compare group differences, independent t-test and x 2 test were used. Associated factors with injury development were identified by generalized mixed modeling analysis controlling for age and gender. @*Results@#A total of 304 patients on HMV were included in this study, among which 129 (42.4%) experienced 352 HMV-related incidents. Mean frequency of incidents for each patient was 5.11±3.98, ranged from 1 to 15 times.In 19.0% of the incidents, injury was developed. Types of incident and persons involved in the incidents were significantly associated with the patient's injury. In the case of the safety incidents, patient’s injury was significantly higher in accidents caused by respiratory circuit problems compared to those caused by problems with the ventilator operation by the medical staff (coefficient=1.25, p=.020). In addition, in the case of those involved in the safety incidents, patient’s injury was significantly higher in the accident caused by the patient family members or caregivers than that caused by the medical personnel (coefficient=1.25, p=.019). @*Conclusion@#In order to minimize injury caused by incidents in patients with HMV, hospitals need to provide systemic education to their medical staff and caregivers to enhance awareness of the importance of reporting and safety management.

Comparing the Procedural and Clinical Outcomes of Sapien XT and Sapien 3Valves in Transcatheter Aortic Valve Replacement in Korean Patients

Background and Objectives@#The Sapien 3 (S3) valve has not been compared to the Sapien XT (SXT) valve in Korea. We compared procedural and clinical outcomes between the 2 devices. @*Methods@#A total of 189 patients who underwent transcatheter aortic valve replacement (TAVR) with S3 (n=95) or SXT (n=94) valve was analyzed. The primary endpoint was cardiovascular mortality at 1 year. The median follow-up duration was 438 days. @*Results@#The Society of Thoracic Surgeons score was similar between the 2 groups. The device success rate (90.4% vs. 97.9%; p=0.028) was higher in the S3 than in the SXT. The S3 showed significantly fewer cases of moderate or severe paravalvular leakage (PVL) (16.7% vs.0.0%; p=0.001) than the SXT. However, effective orifice area (EOA) (2.07±0.61 vs. 1.70±0.49 cm2 ; p<0.001) was smaller in the S3. Multivariable Cox regression analysis showed the S3 was associated with significantly fewer cardiovascular mortality at 1 year compared to the SXT (5.4% vs. 1.1%; hazard ratio, 0.031; 95% confidence interval, 0.001–0.951; p=0.047). Periprocedural complication rates, composite of disabling stroke or all-cause mortality, allcause mortality, and disabling stroke at 1 year were similar between the 2 groups. @*Conclusions@#Cardiovascular mortality was lower in the S3 group than in the SXT group over 1 year of follow-up. The reduction in PVL was attributed to the higher device success rate of TAVR with the S3 valve. However, the benefit of S3 obtained at the expense of reduced EOA should be meticulously re-evaluated in larger studies during long-term follow-up.

Factors Associated with Daily Completion Rates in a Smartphone-Based Ecological Momentary Assessment Study / 대한의료정보학회지

OBJECTIVES: Ecological momentary assessment (EMA) methods are known to have validity for capturing momentary changes in variables over time. However, data quality relies on the completion rates, which are influenced by both participants' characteristics and study designs. This study applied an EMA method using a mobile application to assess momentary moods and stress levels in patients with Moyamoya disease to examine variables associated with EMA completion rates. METHODS: Adults with Moyamoya disease were recruited from a tertiary hospital in Seoul. Patients with cognitive impairment were excluded. The EMA survey was loaded as a mobile application onto the participants' personal smartphones. Notifications were sent at semi-random intervals four times a day for seven consecutive days. Daily completion rates were calculated as the percentage of completed responses per day; overall completion rates were calculated as the proportion of completed responses per total of the 28 scheduled measures in the study and assessed through a descriptive analysis, t-test, ANOVA, and regression analysis, with mixed modeling to identify the point at which the daily completion rate significantly decreased. RESULTS: A total of 98 participants responded (mean age, 41.00 ± 10.30 years; 69.4% female; 75.5% married). The overall completion rate was 70.66%, with no gender or age differences found. The daily completion rate decreased significantly after day 5 (p = 0.029). CONCLUSIONS: Obtaining a good completion rate is essential for quality data in EMA methods. Strategic approaches to a study design should be established to encourage participants throughout a study to improve completion rates.

Ecological Momentary Assessment Using Smartphone-Based Mobile Application for Affect and Stress Assessment / 대한의료정보학회지

OBJECTIVES: This study aimed to describe the process of utilizing a mobile application for ecological momentary assessment (EMA) to collect data on stress and mood in daily life setting. METHODS: A mobile application for the Android operating system was developed and installed with a set of questions regarding momentary mood and stress into a smartphone of a participant. The application sets alarms at semi-random intervals in 60-minute blocks, four times a day for 7 days. After obtaining all momentary affect and stress, the questions to assess the usability of the mobile EMA application were also administered. RESULTS: The data were collected from 97 police officers working in Gyeonggi Province of South Korea. The mean completion rate was 60.0% ranging from 3.5% to 100%. The means of positive and negative affect were 18.34 of 28 and 19.09 of 63. The mean stress was 17.92 of 40. Participants responded that the mobile application correctly measured their affect (4.34 ± 0.83) and stress (4.48 ± 0.62) of 5-point Likert scale. CONCLUSIONS: Our study investigated the process of utilizing a mobile application to assess momentary affect and stress at repeated times. We found challenges regarding adherence to the research protocol, such as completion and delay of answering after alarm notification. Despite this inherent issue of adherence to the research protocol, the EMA still has advantages of reducing recall bias and assessing the actual moment of interest at multiple time points that improves ecological validity.

Does Diabetes Mellitus Influence Carpal Tunnel Syndrome?

BACKGROUND AND PURPOSE: Diabetes mellitus (DM) has been proposed as a risk factor for carpal tunnel syndrome (CTS), but this remains controversial. We investigated the association between DM and CTS using both ultrasonography (US) and nerve conduction study (NCS) data. METHODS: We analyzed a prospectively recruited database of neuromuscular US and medical records of subjects who had undergone NCSs and electromyography for symptoms suggestive of CTS. Subjects were assigned to the follow groups: Group I, CTS with DM; Group II, CTS without DM; Group III, no CTS with DM; and Group IV, no CTS without DM. US cross-sectional area (CSA) and NCS measurements at the median nerve (MN) were compared among groups. We used a general linear mixed model to adjust for statistically significant covariates. RESULTS: The 230 participants comprised 22, 83, 19, and 106 in Groups I–IV, respectively. In multivariate analyses, the MN action potential amplitude in females was the only variable that was significantly associated with DM (p<0.001). Groups with DM tended to have a longer latency, smaller amplitude, and lower conduction velocity in the NCSs compared to groups without DM. The measured US CSA values did not differ significantly among the groups. CONCLUSIONS: NCS measurements of the MN tended to differ between DM and non-DM patients regardless of the presence or absence of CTS. However, US did not reveal any statistically significant relationship between CTS and DM.

Balanced approach can help initial outcomes: analysis of initial 50 cases of a new liver transplantation program in East Asia

PURPOSE: To evaluate patient triage pattern and outcomes according to types of liver transplantation as part of a new liver transplant program developed in an East Asian country with a limited number of deceased donors. METHODS: Medical records of initial 50 liver transplantations were reviewed retrospectively. RESULTS: Twenty-nine patients underwent deceased donor liver transplantation (DDLT) and 21 patients underwent living donor liver transplantation (LDLT). Mean model for end-stage liver disease scores of recipients of DDLT and LDLT were 24.9 +/- 11.6 and 13.1 +/- 5.4, respectively (P < 0.0001). Twenty-eight patients had HCCs and 17 of them (60.7%) underwent LDLT, which was 80.9% of LDLTs. There were 2 cases of perioperative mortality; each was from DDLT and LDLT, respectively. Median follow-up was 18 months. Overall patient and graft survival rates at 6 months, 1 and 2 years were 95.7%, 93.4%, and 89.8%, respectively. There was no significant difference in survival between DDLT and LDLT. Overall recurrence-free survival rates of hepatocellular carcinoma (HCC) patients at 6 month, 1, and 2 years were 96.3%, 96.3%, and 90.3%, respectively. There was no significant difference in recurrence-free survival between DDLT and LDLT. CONCLUSION: As a new liver transplant program with limited resource and waiting list, patients with critical condition could undergo DDLT whereas relatively stable patients with HCCs were mostly directed to LDLT. We recommend a balanced approach between DDLT and LDLT for initiating liver transplant programs.

Simplified Method to Measure the Peripapillary Choroidal Thickness Using Three-dimensional Optical Coherence Tomography

PURPOSE: To evaluate a simplified method to measure peripapillary choroidal thickness using commercially available, three-dimensional optical coherence tomography (3D-OCT). METHODS: 3D-OCT images of normal eyes were consecutively obtained from the 3D-OCT database of Korea University Medical Center On the peripapillary images for retinal nerve fiber layer (RNFL) analysis, choroidal thickness was measured by adjusting the segmentation line for the retinal pigment epithelium to the chorioscleral junction using the modification tool built into the 3D-OCT image viewer program. Variations of choroidal thickness at 12 sectors of the peripapillary area were evaluated. RESULTS: We were able to measure the peripapillary choroidal thickness in 40 eyes of our 40 participants, who had a mean age of 41.2 years (range, 15 to 84 years). Choroidal thickness measurements had strong inter-observer correlation at each sector (r = 0.901 to 0.991, p < 0.001). The mean choroidal thickness was 191 +/- 62 microm. Choroidal thickness was greatest at the temporal quadrant (mean +/- SD, 210 +/- 78 microm), followed by the superior (202 +/- 66 microm), nasal (187 +/- 64 microm), and inferior quadrants (152 +/- 59 microm). CONCLUSIONS: The measurement of choroidal thickness on peripapillary circle scan images for RNFL analysis using the 3D-OCT viewing program was highly reliable and efficient.

Rapid Isolation of Adipose Tissue-Derived Stem Cells by the Storage of Lipoaspirates

PURPOSE: This study examined a rapid isolation method decreasing the time and cost of the clinical application of adipose tissue-derived stem cells (ASCs). MATERIALS AND METHODS: Aliquots (10 g) of the lipoaspirates were stored at 4degrees C without supplying oxygen or nutrients. At the indicated time points, the yield of mononuclear cells was evaluated and the stem cell population was counted by colony forming unit-fibroblast assays. Cell surface markers, stem cell-related transcription factors, and differentiation potentials of ASCs were analyzed. RESULTS: When the lipoaspirates were stored at 4degrees C, the total yield of mononuclear cells decreased, but the stem cell population was enriched. These ASCs expressed CD44, CD73, CD90, CD105, and HLA-ABC but not CD14, CD31, CD34, CD45, CD117, CD133, and HLA-DR. The number of ASCs increased 1x1014 fold for 120 days. ASCs differentiated into osteoblasts, adipocytes, muscle cells, or neuronal cells. CONCLUSION: ASCs isolated from lipoaspirates and stored for 24 hours at 4degrees C have similar properties to ASCs isolated from fresh lipoaspirates. Our results suggest that ASCs can be isolated with high frequency by optimal storage at 4degrees C for 24 hours, and those ASCs are highly proliferative and multipotent, similar to ASCs isolated from fresh lipoaspirates. These ASCs can be useful for clinical application because they are time- and cost-efficient, and these cells maintain their stemness for a long time, like ASCs isolated from fresh lipoaspirates.

The effect of weather and air pollution on the prevalence of headaches

Background: Some epidemiological studies have indicated that weather and air pollution can cause adverse health conditions and that these effects can exhibit regional variation. The prevalence of headache is so high and it is a common cause of morbidity. Therefore, this study evaluated whether weather and air pollution were associated with the prevalence of headaches. Methods: A symmetric bidirectional case-crossover design was applied, using conditional logistic regression models to determine the association between headaches and weather and air pollution. From January 2006 to August 2007, a total of 245 patients with headaches were recruited. Headache subtypes were classifi ed as migraine, tension-type headaches, and others. Meteorological data (average temperature and relative humidity) and values related to air pollutants (CO, NO2 , O3 , SO2 , and particulate matter with an aerodynamic diameter of less than 10 μm) were obtained. Results: Higher average temperatures were associated with the total number of headaches (hazard ratio 1.124-1.130; P<0.001). With regard to headache subtype, O3 seems to provoke headaches, especially those related to tension and those listed as other headache varieties. Conversely, other pollutants, especially CO and SO2 , showed the opposite association. Conclusions: These fi ndings indicated that temperature and some air pollutants are able to affect headaches, suggesting that weather and air pollution levels seem to have an effect on the risk of headache.

Organic and inorganic matter increase related to eutrophication in Gamak Bay, South Korea.

Water quality, the carbon isotope ratio of suspended particulate organic matter (POM), and limiting nutrients were investigated at seven surface and bottom seawater stations in Gamak Bay, South Korea, to evaluate the effectiveness of counter-measures to organic matter increase. The increase in surface water COD in Gamak Bay appear to be the result of phytoplankton growth, which is consistently limited by nitrogen (N) or phosphorous (P), but not by silicon (Si). High chlorophyll a concentrations seem to be caused by freshwater inputs of N and P associated with wastewater in the northern and northeastern portions of the Bay, and by the inflow of NH4-N and P associated with the digestion of organic matter from the bottom layer in western areas. To regulate the increase of organic matter in Gamak Bay, controlling phytoplankton growth, particularly by regulating the input of N or P, may be more important than controlling the input of terrestrial organic matter.

Difference in Viability of CD34+Cells in Cryopreserved Cord Blood According to Evaluation Methods / 대한혈액학회지

BACKGROUND: On performing umbilical cord blood (UCB) transplantation, faster engraftment may lead better clinical outcome. Because transplanted viable cell count in UCB is related to the engraftment, accurate evaluation of viability of CD34+cells in cryopreserved UCB has clinical implication. We examined the difference in viability of cells in cryopreserved UCB according to the duration of cryopreservation and different methods. METHODS: A total of 60 UCB samples which were cryopreserved for 1 to 4 years were used in this study. Viability of cryopreserved cells were examined with trypan blue exclusion assay, DNA contents analysis, caspase-3 activation test, intracellular esterase activity and Annexin-V/PI staining. RESULTS: After thawing the cryopreserved UCB, 89% of the total MNCs and 84% of CD34+cells were viable as identified by trypan blue exclusion assay. In the CD34+cell population, the cell death rate was found to be 47% by Annexin-V/PI staining and less than 5% by DNA contents analysis. However, cspase-3 activity failed to document apoptosis. The intracellular esterase activity test also showed a cell death rate of about 10~20% at 2, 4, and 6 hours after thawing. CONCLUSION: Viable cells in UCB should be measured by several compensatory techniques rather than a single method. Discordance among Annexin-V/PI staining versus trypan blue exclusion, DNA contents analysis, and the caspase-3 activation test or intracellular esterase activity should be clarified in order to apply these techniques for actual cord blood transplantation.

Effect of Foot Reflexomassage on Constipation-affected College Women / 여성건강간호학회지

PURPOSE: This study was to determine the effects of foot reflexomassage on constipated college women for the treatment of constipation. METHOD: The researcher sampled nursing students attending a college of nursing science in Gyeonggi-Do, and checked if they were affected by constipation in reference to the Rome II criteria & CAS. They were randomly divided into an experimental group(15 subjects) and a control group(15 subjects). Foot reflexomassage was applied to the experimental group 10 times in 2 weeks : each time lasted 40 minutes. The frequency of defecation and severity of constipation by CAS were measured. The collected data was analyzed using the SPSS 11.5 program. RESULT: The CAS score of the experimental group was significantly lower after foot reflexomassage than those of the control group (p=.000). CONCLUSION: Foot reflexomassage can be considered an effective alternative treatment for constipated young women.

Evaluation of the Abbott Cell-Dyn Sapphire Hematology Analyzer / 대한진단검사의학회지

BACKGROUND: The performance of Cell-Dyn Sapphire (Abbott Diagnostic, USA) was compared to the Bayer Advia 2120 (Bayer Diagnostics, USA), Sysmex XE-2100 (Sysmex Corporation, Japan), and reference microscopy. METHODS: Three hundred samples for routine CBC and WBC differentials were randomly chosen for a comparison analysis. The Cell-Dyn Sapphire system was evaluated according to the linearity, imprecision, inter-instrument correlations, and white blood cell differential. RESULTS: The CBC parameters (WBC, RBC, hemoglobin and platelet) showed a significant linearity with correlation coefficients greater than 0.99 (P<0.0001). Coefficients of variation (CV) for withinrun and differential count of WBC were less than 5% except for Total CV for monocytes, eosinophils, and basophils and within-run CV for low valued eosinophils. The correlation coefficients with manual count were lower in monocytes, eosinophils, and basophils than in neutrophils and lymphocytes. The correlation with other hematology anlayzers was significant exclusive of basophils. CONCLUSIONS: These results demonstrate that the Cell-Dyn Sapphire has a good linearity, an acceptable reproducibility, a minimal carryover, and a comparable performance with the sysmex XE-2100 and Advia 2120.

Anger and Health Status in Late School-Age Children / 간호학회지

PURPOSE: This cross-sectional study was designed to identify anger-expression types in late school-age children and investigate the relation between the identified anger-expression types and their health status. METHOD: One thousand twenty seven children in elementary school fifth and sixth grades were recruited from November to December, 2004. Data was analyzed using descriptive statistics, cluster analysis, 2-test, ANOVA, Duncan's multiple comparison test, and Wilcoxon rank sum test. RESULTS: Three anger-expression types in late school-age children were found; Anger-out/in, Anger-control, and Low anger-expression types. Children frequently using the anger-out/in type among the three types and with a higher state anger reported higher psychosomatic symptoms and depression. Children from a divorced or separated family reported higher state anger. CONCLUSION: This study suggests that a specific anger management program needs to be developed for late school-age children with high state anger and frequently using the anger out/in expression type. For understanding the anger level and the anger expression types of Korean school-age children, further research needs to be done with large samples using a randomized sampling method.

A Study on the Effect of the Hand Acupuncture on IBS-affected College Women's Bowel Symptoms and Psychologic Health / 성인간호학회지

PURPOSE: to determine the effects of hand acupuncture on IBS-affected college women's bowel symptoms and psychologic health by applying the therapy to them. METHOD: The researcher sampled the nursing student attending a college of nursing science in Seoul and checked if they were affected by IBS in reference to the Rome II Criteria. Students were classified into a experimental group(21 subjects) and a control group(19 subjects). Hand acupuncture was applied to the experimental group 8 rounds for 4 weeks; each round lasted 30 minutes. Data were collected for 8 weeks from October 11 to December 1, 2004. The collected data were analyzed using the SPSS 12.0 program. RESULT: After the therapy, frequency(p=.005), distress(p=.001) and disability (p=.000) associated IBS bowel symptom and anxiety were significantly lowered in the experimental group(p=.026). CONCLUSIONS: It was confirmed through this study that the hand acupuncture would be effective in relieving IBS bowel symptoms and anxiety.

Effects of Insulin-like Growth Factor-I and 1,25-(OH)2 Vitamin D3 Concentration on Intrauterine Growth of Newborns from Mothers with Preeclampsia / 소아과

PURPOSE: This study was undertaken to observe the blood levels of IGF-I and 1,25-(OH)2 Vit. D3 in maternal and neonatal compartments and the effects of IGF-I concentration on intrauterine fetal growth and 1,25-(OH)2 Vit. D3 metabolism in the presence of preeclampsia. METHODS: Thirty-four full-term pregnant women with preeclampsia and their newborns(preeclampsia group) and 10 normotensive full-term pregnant women and their newborns(normotensive group) were observed. IGF-I and 1,25-(OH)2 Vit. D3 concentrations in maternal and umbilical cord blood were analysed. RESULTS: Maternal and umbilical cord blood levels of IGF-I and 1,25-(OH)2 Vit. D3 were significantly lower in the preeclampsia group than in the normotensive group. In the preeclampsia group, maternal and cord blood levels of IGF-I of small-for-gestational age newborns were significantly lower than those of appropriate-for-gestational age newborns. The birth weight and length of newborns correlated with IGF-I concentrations of maternal and umbilical cord blood in small-for-gestational age newborns of preeclampsia group. The correlation between IGF-I and 1,25-(OH)2 Vit. D3 was significant in the umbilical cord blood of preeclampsia group, but only in appropriate-for-gestational age newborns. CONCLUSION: It is suggested that the lower level of IGF-I is the primary factor of intrauterine growth retardation in preeclampsia, and the effect of IGF-I on the metabolism of 1,25-(OH)2 Vit. D3 is different according to the presence of preeclampsia and intrauterine fetal growth retardation.

Characterization of the Pulmonary Circulation According to Hemodynamic Changes by Computed Tomography

Increased or decreased pulmonary blood flow (PBF) and an increased pulmonary vascular resistance (PVR), represent common and important change in pulmonary hemodynamics. In this study, we constructed 3 hemodynamic models in 5 dogs, that is, an increased and a decreased PBF model, and an increased PVR model. A CT perfusion scan was performed in each hemodynamic model. Perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT), and maximal slope (MS) were calculated automatically by specialized software and analyzed for changes according to hemodynamic status. In terms of the normal state, blood flow was affected by gravity and dependent area showed higher BF and BV and lower MS and MTT than the non-dependent area. The decreased PBF model showed a significant increase in BF and MS (p=0.046, 0.005) but no significant change in BV (p > 0.05), and a slight elongation of MTT (p > 0.05) versus the normal state. The increased PBF model showed a slightly increased BV and a slightly decreased MTT (p > 0.05). The increased PVR model showed significant reduction in BF, BV, and MS (p 0.05). However, it was noticeable that the distribution of MTT with respect to gravity in the normal lung was completely reversed in the increased PVR model. In conclusion, based on our understanding of perfusion characteristic in normal state, abnormal regional hemodynamic changes in the lung can be detected and evaluated. Predicting changes in pulmonary vascular resistance should be possible by a thorough analysis of CT perfusion parameters.