We have experienced a case of 13 ring chromosome in a 40-month-old girl who demonstrated psychomotor retardation with delayed speech, growth retardation, hearing loss(left), microcephaly, trigonocephaly with flat occiput, hypertelorism, epicanthal folds, microophthalmia, broad prominamt nasal bridge, high arched palate, micrognathia, large auricles and other anomalies. Cytogenetic studies of peripheral blood lymphocytes with differential staining of chromosomes revealed 46, XX, r13. Her parents' karyotypes were normal. We reported the case with the review of the associated literatures.
Child, Preschool ; Craniosynostoses ; Cytogenetics ; Female ; Hearing ; Humans ; Hypertelorism ; Karyotype ; Lymphocytes ; Microcephaly ; Palate ; Ring Chromosomes*

PURPOSE: The purpose of this study was to describe the clinical characteristics of neonatal urinary tract infection (UTI) caused by Klebsiella pneumoniae and non- Klebsiella pneumoniae UTI. METHODS: We compared clinical characteristics of 84 neonatal patients with UTI caused by Klebsiella pneumoniae who were hospitalized at the Department of Pediatricsat Han Dong University, Sunlin Hospital during the period between May, 1994 and August, 1998. The cases were divided into two groups depending upon causative organisms' Klebsiella pneumoniae UTI vs non-Klebsiella pneumoniae UTI, and the clinical characteristics of these groups were compared. RESULTS: Escherichia coli was the most common bacterial pathogen causing neonatal UTI, followed by Klebsiella pneumoniae. There was no significant difference in the sex distribution of Klebsiella pneumoniae UTI, but non-Klebsiella pneumoniae UTI showed male predominence. There were no significant differences in the incidences of hematologic, urologic, radiologic findings and perinatal complications in between these 2 groups. CONCLUSION: Klebsiella pneumoniae is the second most common pathogen causing neonatal UTI. There were no specific differences in the laboratory, symptomatologic, and radiologic findings in these two groups.
Escherichia coli ; Humans ; Incidence ; Klebsiella pneumoniae* ; Klebsiella* ; Male ; Pneumonia ; Sex Distribution ; Urinary Tract Infections* ; Urinary Tract*

In systemic rheumatic disease, marker antibodies such as anti-Sm, anti Scl-70 and anti Jo-1 are helpful in the diagnosis of disease, but in rheumatoid arthritis, the diagnosis is difficult due to the low sensitivity and specificity of the rheumatoid factor(RF). So, a new maker antibody with high sensitivity and specificity was needed. Recently, the antiperi- nuclear factor(APF) has gained particular attention. The results of the APF and RF test in 165 patients with rheumatoid arthritis, 77 patients with osteoarthritis, and 109 normal healthy persons, which were taken between January, 1994 through December 1994 were as follows; 1. The sensitivity, specificity, and predictive value of positivity of the RF test in patients with rheumatoid arthritis were 58.2%, 93.5%, and 95.0%, and that of the APF test were 72.1%, 94.6% and 92.2%, respectively. 2. The sensitivity, specificity and predictive value of positivity when combining the APF with the RF were 83.0%, 85.7%, and 92.6%, respectively. 3. The disease status of the patients correlated with intensity of the APF test, that is, the more severe the disease status, the higher intensity. In conclusion, the APF was useful in the diagnosis of rheumatoid arthritis, and may be used as an indicator of disease status. When combining test the APF with RF, the incidence of sero-negative rheumatoid arthritis decreased.
Antibodies ; Arthritis, Rheumatoid ; Diagnosis ; Humans ; Incidence ; Osteoarthritis ; Rheumatic Diseases ; Sensitivity and Specificity

PURPOSE: This study was performed to evaluate clinical manifestations and findings of ultrasonogram of neonatal septic arthritis and osteomyelitis. We tried to determine the value of ultrasonogram as a tool for early diagnosis of septic arthritis and osteomyelitis. METHODS: We reviewed the records of 17 patients, who were diagnosed septic arthritis and/or osteomyelitis in Departments of Pediatrics and Orthopedic Surgery, Han dong University Sunlin Hospital in Pohang between Jan. 1994 and Sep. 1998. Radiologic findings were reviewed retrospectively according to the duration of symptoms at the onset. We compared the sensitivity of ultrasonogram with other radiologic tools done within 7 days of illness. RESULTS: We compared sensitivity of each imaging study done within 7 days of illness. 20%(3/5) had abnormality in plain radiographs, 78.6%(11/14) in ultrasonogram, 28.6%(2/7) in bone scan, and 100,0%(3/3) in MRI. Deep soft-tissue swelling around the bone was the earliest sign of acute osteomyelitis in ultrasonogram. Concurrently early septic arthritis showed deep soft tissue swelling around the joint and increased synovial effusion in ultrasonogram. CONCLUSION: Ultrasonogram is not so expensive, non-invasive, not harmful to patients, and there is no need to sedate patients for examination. Comparing with other imaging studies, the sensitivity of ultrasonogram is relatively high. Ultrasonogram is a useful diagnostic tool of septic arthritis and osteomyelitis in newbom infants.
Arthritis, Infectious* ; Early Diagnosis ; Gyeongsangbuk-do ; Humans ; Infant ; Joints ; Magnetic Resonance Imaging ; Orthopedics ; Osteomyelitis* ; Pediatrics ; Retrospective Studies ; Ultrasonography

No abstract available.
Osteoarthropathy, Primary Hypertrophic*

No abstract available.
Respiratory Distress Syndrome, Newborn*

PURPOSE: The aim of our study was to determine the incidence of bronchopulmonary dysplasia (BPD) using the newly proposed definition for BPD and investigate the relationship between the severity of BPD by new definition and clinical severity of illness and radiographic change. METHODS: We selected very low birth weight infants <1,500 g with gestational age <32 weeks born in the Bun-Dang Seoul National University Hospital from June 2003 to May 2005. The datas were categorized in four weight groups, <751, 751 to 1,000, 1,001 to 1,250 and 1,251 to 1,500 g and the incidence of BPD was computed in survivors based on the oxygen need at postnatal 28 days and 36 weeks postmenstrual age (PMA). Further, BPD-associated comorbidities and radiographic changes at 36 weeks PMA were compared among the groups defined by the new severity of BPD criteria. RESULTS: Among VLBW <1,500 g, the incidence of BPD at 28 days and 36 weeks PMA were 67 and 39%, respectively. Using the newly defined criteria, the incidence of mild, moderate and severe BPD were 29, 33 and 6%, respectively. Associated comorbidities correlated significantly with severity of BPD. Significantly longer hospital stay, longer duration of mechanical ventilation, higher score of radiography at 36 weeks PMA was observed with increasing severity of BPD. CONCLUSIONS: The severity of BPD by new definition significantly related to clinical severity and radiographic changes. Whether it will have a role in predicting long-term pulmonologic and neurologic outcome remains to be determined.
Bronchopulmonary Dysplasia* ; Comorbidity ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Length of Stay ; Oxygen ; Radiography ; Respiration, Artificial ; Seoul ; Survivors

Retrograde transpapillary cholangioscopy can be safely performed by use of a mother-baby-scope system after endoscopic sphincterotomy. Improved endoscopes are now available and may lead to a better acceptance of this technique. Cholangioscopy is complementary to cholangiography for differential diagnosis of various types of bile duct lesions. From march 1992 to September 1994, we performed 15 cases of peroral cholangioscopy for evaluation of bile duct lesions. Indications of peroral cholangioscopy were 6 cases of benign biliary diseases and 9 cases of malignant biliary diseases. In benign diseases, two cases of extrahepatic bile duct stones, 1 case of intrahepatic duct stone with stricture, 2 cases of benign elevated lesions of bile duct and 1 case of occluded expandable metallic stent were involved. In malignant diseases, 7 cases of primary bile duct cancer, 2 cases of hepatocellular carcinoma with bile duct invasion were involved. By use of peroral cholangioscopy with biopsy, differential diagnosis of bile duct lesion was possible. As a complication, severe abdominal pain and hypotension was developed in one case during the procedure and in another case, cholangitis was developed after the procedure. In conclusion, peroral cholangioscopy is a safe and useful procedure in various types of biliary diseases especially in the differential diagnosis of malignancy.
Abdominal Pain ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Constriction, Pathologic ; Diagnosis, Differential ; Endoscopes ; Hypotension ; Sphincterotomy, Endoscopic ; Stents

PURPOSE: The purpose of this study is to evaluate the outcome of laparoscopic (LA) vs. open appendectomy (OA) in children under 12 years old with perforated appendicitis. METHODS: We reviewed the medical files of 156 children who underwent LA (n=96), OA (n=59), and conversion (CO) (n=1), and compared duration of operation, length of hospital stay, incidence of wound infection, mechanical ileus, intra-abdominal abscess (IAA), and re-admission. RESULTS: Compared to OA, LA resulted in longer duration of operation (58.32+/-17.105 min vs. 44.27+/-18.735 min; p=0.001), but fewer wound infections (2.1% vs. 10.2%; p=0.054), and fewer cases of mechanical ileus (0% vs. 5.1%; p=0.053). No differences in the length of hospital stay (5.85+/-1.824 days vs. 6.10+/-3.027 days; p=0.526), IAA (2.1% vs. 1.7%; p=1.000), or re-admissions (2.1% vs. 5.1%; p=0.369) were observed. CONCLUSION: We report that although LA showed an association with longer duration of operation compared to OA, it is superior to OA with regard to incidence of wound infection and mechanical ileus.
Abdominal Abscess ; Appendectomy ; Appendicitis ; Child ; Humans ; Ileus ; Incidence ; Length of Stay ; Wound Infection

BACKGROUND: It is known that propofol protects myocardium against a global ischemia-reperfusion injury in the isolated rat heart model. The aim of this study was to investigate whether propofol, at a clinically relevant concentration infused during the peri-ischemic period, also provides a protective effect against a regional myocardial ischemia-reperfusion injury in vivo. METHODS: Rats were subjected to 25 minutes of coronary artery occlusion followed by 24 hours of reperfusion. Propofol or intralipid was administrated during 35 minutes starting 5 minutes before the onset of ischemia until 5 minutes after the onset of reperfusion. A micromanometer catheter was advanced into the left ventricle and the hemodynamic function was evaluated. The infarct size was determined by triphenyltetrazolium staining after 24 hours of reperfusion. RESULTS: Propofol administration during the peri-ischemic period demonstrated protective effects on hemodynamic function and infarct size reduction. In the control group, the peak rate of the ventricular pressure increase (+dP/dt(max))(P = 0.0001) and the peak rate of the intraventricular pressure decline (-dP/dt(max))(P = 0.0001) were significantly decreased compared to the sham group. In the propofol group, the +dP/dt(max) (P = 0.003) and -dP/dt(max) (P = 0.002) were significantly improved compared to the control group. The infarct size was 47.6% of the area at risks in the control group, and was reduced markedly by administration of propofol during the peri-ischemic period to 26.2% in the propofol group (P = 0.004). CONCLUSIONS: Propofol, at a clinically relevant concentration infused during the peri-ischemic period, have protective effect after regional myocardial ischemia-reperfusion injury in an in vivo rat heart model.
Animals ; Catheters ; Coronary Vessels ; Emulsions ; Heart ; Heart Ventricles ; Hemodynamics ; Ischemia ; Myocardium ; Phospholipids ; Propofol ; Rats ; Reperfusion ; Reperfusion Injury ; Salicylamides ; Soybean Oil ; Tetrazolium Salts ; Ventricular Pressure