Yonsei medical journal
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Yonsei medical journal · Apr 2004
Discharge decision-making by intensivists on readmission to the intensive care unit.
Patients readmitted to the intensive care unit (ICU) have a significantly higher mortality rate. The role of intensivists in judging when to discharge patients from the ICU is very important. We undertook this study to evaluate the effect of the intensivists' discharge decision-making on readmission to ICU. ⋯ Respiratory failure was the major cause of readmission. In the non-survivors out of the readmitted patients, the Acute Physiology and Chronic Health Evaluation (APACHE) scores on the initial discharge and readmission, the multiple organ dysfunction syndrome (MODS) scores on the initial admission, discharge and readmission were higher than the corresponding indices in the survivors. We conclude that the readmission rate was lower when intensivists participated in the discharge decision-making, and that APACHE and MODS scores on the first discharge and readmission were significant prognostic factors in respect of the readmitted patients.
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Yonsei medical journal · Apr 2004
Case ReportsFirst Turkish patient with floating harbor syndrome with additional findings: cryptorchidim and microcephaly.
We report the first Turkish patient with Floating Harbor Syndrome (FHS). The 12-year old male patient exhibited classical dysmorphic features of FHS, mental retardation, celiac disease and additional undescribed findings: microcephaly and cryptorchidism.
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Yonsei medical journal · Apr 2004
Case ReportsIsolated extramedullary relapse of acute myelogenous leukemia as a uterine granulocytic sarcoma in an allogeneic hematopoietic stem cell transplantation recipient.
We report an unusual case of acute myelogenous leukemia in a patient who showed an extramedullary relapse in her uterus, without bone marrow recurrence, two years after an allogeneic bone marrow transplant. She complained of irregular vaginal spotting, and magnetic resonance imaging demonstrated a uterine mass. A biopsy revealed a massive infiltration of immature myeloid cells. ⋯ After receiving chemotherapy, her uterine mass had completely resolved. She has remained in complete remission for more than 6 months. This case suggests that physicians should be aware of the possibility of a uterine relapse in female bone marrow transplant recipients with acute myelogenous leukemia.
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Yonsei medical journal · Apr 2004
Expression of down stream molecules of RET (p-ERK, p-p38 MAPK, p-JNK and p-AKT) in papillary thyroid carcinomas.
To evaluate the roles of 4 putative downstream molecules (ERK, p38 MAPK, JNK and AKT) of the RET signal pathway in the tumorigenesis of papillary carcinomas, the expression patterns of RET and phosphorylated forms of ERK, p38 MAPK, JNK and AKT were evaluated in 115 cases of papillary thyroid carcinomas by 3 mm-core tissue microarray based immunohistochemical staining. The prevalence of RET protein expression was 62.6%. No distinct expression of p-ERK and p-p38 MAPK was demonstrated in tumor cells of papillary carcinomas. ⋯ There was no difference in the p-JNK expression between RET protein-positive and RET protein-negative papillary carcinomas (p > 0.05). Unequivocal nuclear staining for p-AKT was demonstrated only in 10 cases of papillary carcinomas, and all of them showed focal staining. Our results showing constitutive expression of p-JNK in most cases of surgically excised papillary thyroid carcinomas irrespective of RET protein expression status suggest that JNK activation may play a role in the tumorigenesis or survival of sporadic papillary thyroid carcinoma.
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Yonsei medical journal · Apr 2004
Comparative StudyComparison of perioperative complications between reconstructive pelvic surgery and general gynecologic surgery.
The purpose of this study was to compare the perioperative complication rates of reconstructive pelvic surgery and general gynecologic surgery, and to identify the predictive risk factors for perioperative complications in reconstructive pelvic surgery. The medical records of 148 reconstructive pelvic surgery patients and 146 general gynecologic surgery patients were reviewed, and the types of complications, along with their rates and predictive risk factors were examined. The statistical analysis included descriptive statistics and logistic regression. ⋯ Intraoperative blood loss (p= 0.006) and the duration of surgery (p=0.014) were independent risk factors for perioperative complications in the reconstructive pelvic surgery group. The perioperative complication rates for the patients undergoing reconstructive pelvic surgery were not higher than those of the patients undergoing general gynecologic surgery, even though more procedures were performed and a longer duration of surgery was needed in the former cases. Since the duration of surgery and the amount of blood loss are the major factors affecting the complication rate, decreasing these two factors would be the key to improving the outcomes of patients undergoing reconstructive pelvic surgery