PURPOSE: To compare the success rate of recanalization in three types of the proximal fallopian tube obstruction. MATERIALS AND METHODS: Transcervical fallopian tube catheterization (TFTC) was performed in 141 infertile patients with 239 fallopian tube obstruction. Three-coaxial catheter and 0.018 inch guide wire(Terumo, Tokyo, Japan) were employed for the recanalization. The obstructed proximal fallopian tubes were divided into three groups according to the appearance of the distal end of obstructed fallopian tubes : smooth tapering, concave, or convex. RESULTS: Recanalization was successful in 151 of 239 tubes(63.2%) ; success rates were 82.7%(62/75) in the smooth tapering group, 80.2%(69/86) in the concave, and 25.6%(20/78) in the convex. In theproximal portion, success rates were 80.3%(53/66) in the smooth tapering group, 82.6%(38/46) in the concave, and 48.5%(16/33) in the convex. Eighty-nine patients were successfully recanalized. Sixty-four of 89 patients were followed-up for more than one year and 29 patients(45%) became pregnant. Complications occurred in 37 tubes, tube perforation in 32, re-obstruction in five, and ectopic pregnancy in one. CONCLUSION: The success rate of recanalization of an obstructed proximal fallopian tube was higher in smooth tapering and concave types than inthe convex type.
Catheterization ; Catheters ; Fallopian Tubes ; Female ; Humans ; Pregnancy ; Pregnancy, Ectopic

PURPOSE: Large rearrangements in the dystrophin gene is detected in about 65-70% of patients by multiplex PCR or Southern blot, although detection of point mutations and microlesions is currently in progress. The purpose of this study is to carry out mutation analysis of the dystrophin gene by application of PCR-related molecular diagnostic methods in Duchenne muscular dystrophy (DMD). METHODS: Five patients diagnosed as a DMD by muscle biopsy, and their first-degree relatives and mothers were enrolled in this study. The genomic DNA was extracted from the peripheral blood lymphocyte. We used a total of 28 pairs of primers including Beggs' and Chamberlain's primers. The multiplex PCR was performed in 4 groups; 5'Rxn2, 3'Rxn2, Rxn2, and CRxn2. For exon duplication analysis, multiplex PCR and gel densitometry were carried out by comparing the band intensities among individual bands. For groups with no detectable deletion, single strand conformation polymorphism (SSCP) analysis and direct DNA sequencing method were performed with individual PCR of candidate exons. RESULTS: About 12-20microg of genomic DNA was extracted from 1mL of blood, and the size of DNA was over 50kb. Up to 9 PCR products were made from multiplex PCR using the genomic DNA. Among 5 families with DMD, No. 6 had about 240kb DNA deletion from exon 45 and 47-53, and No. 11 had about 130kb deletion from exon 47-49 and 53. No. 1 showed duplication of exon 43 when the multiplex PCR products were analyzed by a densitometer. When the deletion/duplication negative No. 3 was analyzed by SSCP method, exon 43 and 49 showed abnormal band patterns. The abnormal band pattern of exon 43 was caused by deletion mutation of A residue, which resulted in pretermination of dystrophin synthesis, meanwhile exon 49 showed transversion mutation of C G at intron 49. CONCLUSION: Based on the results of this study, the methods of multiplex PCR, SSCP and direct DNA sequencing of PCR products made it possible to analyze several types of mutation of DMD.
Biopsy ; Blotting, Southern ; Densitometry ; DNA ; Dystrophin* ; Exons ; Humans ; Introns ; Lymphocytes ; Mothers ; Multiplex Polymerase Chain Reaction ; Muscular Dystrophy, Duchenne* ; Pathology, Molecular ; Point Mutation ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Sequence Deletion

Interstitial pneumonia is a heterogenous group of inflammatory and fibrosing lesions that manifest themselves as infiltrative lung disease. Of these, nonspecific interstitial pneumonia is characterized as a variable degree of interstitial inflammation with or without fibrosis and is distinguished from usual interstitial pneumonia and desquamative interstitial pneumonia, histologically. The influx of inflammatory cells and the responses of immune effector cells injury to the alveolar wall and these initial injuries results in alveolitis and fibrosis. Consequently, the gas exchange throughout the alveolar wall is impaired and the patients suffer from lung diseases of a restrictive pattern. The chief complaints represented are dyspnea and dry cough. We experienced a case of nonspecific interstitial pneumonia in a 10-year old girl. The patient had been healthy and had not been exposed to organic dusts or other toxic materials. The pathology of lung biopsy tissue showed that the alveoli were thickened by a mixture of chronic inflammatory cells and collagen type fibrosis. High resolution computed tomography(HRCT) found the patchy areas of ground-glass opacity with patchy consolidation and irregular reticular opacity, and diffuse distribution without zonal predominance. The forced vital capicity(FVC) was 31%, forced expiratory volume in one second (FEV1) 29% and FEV1/FVC 90%, so a restrictive pulmonary insufficiency was found.
Biopsy ; Child* ; Collagen ; Cough ; Dust ; Dyspnea ; Female ; Fibrosis ; Fluconazole ; Forced Expiratory Volume ; Humans ; Idiopathic Pulmonary Fibrosis ; Inflammation ; Lung ; Lung Diseases ; Lung Diseases, Interstitial* ; Pathology

PURPOSE: This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. METHODS: A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. RESULTS: The male to female ratio was 1:0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. CONCLUSION: The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.
Brain Neoplasms* ; Brain Stem ; Brain* ; Cerebrum ; Child ; Diagnosis ; Female ; Fourth Ventricle ; Headache ; Humans ; Infratentorial Neoplasms ; Lateral Ventricles ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Parents ; Pineal Gland ; Retrospective Studies ; Seizures ; Supratentorial Neoplasms ; Temporal Lobe

Immotile cilia syndrome is an inherited disorder characterized by specific ultrastructural defects of cilia and associated impairment of ciliary motion and mucociliary clearance. Disorders of ciliary structure or function result in chronic sinopulmonary diseases manifested as chronic sinusitis, bronchitis, otitis media, nasal polyposis, and ultimately bronchiectasis. In addition, situs inversus, dextrocardia, and infertility can be associated with dysfunctional ciliary activity. We experienced a case of immotile cilia syndrome presenting with recurrent bronchitis, pneumonia, chronic sinusitis, otitis media, and bronchiectasis. She was diagnosed by lack of dynein inner arm on electron microscopy. Treatment included chest percussion, bronchodilators, antibiotics, and surgical intervention. She has been followed up at regular intervals. We report this case with related literatures.
Anti-Bacterial Agents ; Arm* ; Bronchiectasis ; Bronchitis ; Bronchodilator Agents ; Cilia ; Ciliary Motility Disorders* ; Dextrocardia ; Dyneins* ; Infertility ; Microscopy, Electron* ; Mucociliary Clearance ; Otitis Media ; Percussion ; Pneumonia ; Sinusitis ; Situs Inversus ; Thorax

PURPOSE: A study was done to assess the incidence, clinical characteristics of urinary tract anomalies for decreasing urinary tract morbidity. METHODS: We review 98 cases of anomaly of urinary tract who were admitted Kyung Hee University Hospital between 1986 and 1995. We analyzed incidence and associated anomalies, associated diseases and treatment modalities. RESULTS: 1) It was composed of 45 cases (45%) of renal anomalies, 37 cases (37.7%) of ureteral anomalies, 7 cases (7.1%) of urethral anomalies, 3 cases Prune-belly syndrome, 3 cases of urachal remnants, 2 cases of bladder exstrophy, 1 cases of VATER syndrome. 2) Anomalies of the kidney were composed of 14 cases of renal agenesis, 11 cases of multicystic dysplastic kidney, 10 cases of hydronephrosis 3 cases of hypoplasia, 3 cases of polycystic kidney, 2 cases of ectopia, 1 case of malrotation and 1 case of horseshoe kidney, 20 cases (44.4%) were diagnosed before 1 month of life. 20 cases were male and 25 casses were female. Bilateral involvement were in 7 cases and 38 cases of unilateral involvement were composed of 23 cases of right side and 15 cases of left side. Operative treatment were performed in 15 cases (30%) of renal anomalies. The common chief complaint of renal anomalies were abnormal finding on urinalysis (24.4%), abnormal finding on fetal ultrasonogram (20%), gastrointestinal tract symptom (15.6%), and fever (9%). 3) Anomalies of the ureter were composed of 26 cases of ureteral duplication, 9 cases of UPJ obstruction, 2 cases of megaureter. Ureteric duplications included 8 cases of male and 18 cases of female and 19 cases were unilateral and 7 cases were bilateral. 19 cases were diagnosed before 5 years old. 19 cases (73.1%) had symptoms associated with urinary tract infection. 11 cases had abnormal finding of ipsilateral kidney on DMSA scan or IVP. Associated abnormalities were hydronephrosis, ureterocele and VUR. UPJ obstruction were mostly diagnosed before 1 month of life, 6 cases were male and 3 cases were female. 2 cases were bilateral and 3 cases were right side involvement and 4 cases were left side. CONCLUSIONS: It seems to be reasonable that we should recommend the patients with the symptoms of urinary tract diseases to do evaluate the possibility of congenital urinary tract anomalies.
Bladder Exstrophy ; Child* ; Child, Preschool ; Female ; Fever ; Gastrointestinal Tract ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Male ; Multicystic Dysplastic Kidney ; Polycystic Kidney Diseases ; Prune Belly Syndrome ; Succimer ; Ultrasonography ; Ureter ; Ureterocele ; Urinalysis ; Urinary Tract Infections ; Urinary Tract* ; Urologic Diseases

Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.
Antitussive Agents ; Asthma ; Bronchitis, Chronic ; Bronchodilator Agents ; Child ; Cough* ; Diagnosis ; Gastroesophageal Reflux ; Humans ; Interview, Psychological ; Male

No abstract available.
Liver Cirrhosis* ; Liver* ; Polycythemia Vera* ; Polycythemia*

Subglottic hemangioma is a rare condition which has the potential to cause life-threatening complications during the pediatric period. The most common presenting symptom is inspiratory and expiratory stridor, which is often exacerbated by crying and upper respiratory tract infection. The natural history of subglottic hemangioma is characterized by progressive airway obstruction during the proliferative phase for the first year, but after 1 year of age, the symptoms resolve spontaneously as the lesion regresses. We report a 50-day-old infant with subglottic hemangioma who suffered from episodes of cyanosis and persistent stridor with viral pneumonia. In addition, she had cutaneous hemangioma on her right cheek. The hemangioma was successfully controlled with just systemic steroids, because the lesion occupied 40% of total subglottic space. We concluded that if an infant with cutaneous hemangioma displays biphasic then stridor subglottic hemangioma should be included in differential diagnosis.
Airway Obstruction ; Cheek ; Crying ; Cyanosis ; Diagnosis, Differential ; Hemangioma* ; Humans ; Infant* ; Natural History ; Pneumonia, Viral ; Respiratory Sounds ; Respiratory Tract Infections ; Steroids

PURPOSE: Obesity and iron deficiency are common nutritional problems. Obese children are known to have iron deficiencies, but one presented opposite opinion in Korea. This study investigated the prevalence of obesity and iron deficiency in Incheon and the relationship between iron deficiency and obesity. METHODS: Physical measurement and hematologic examinations were done a 764 healthy female students aged 14 to 15 years in May, 2005. Overweight was defined as a body mass index > or = 85th percentile. Iron deficiency was defined as serum ferritin <10 ng/mL. Iron deficiency anemia (IDA) was defined as serum Hb <12 g/dL and serum ferritin <10 ng/mL and/or transferrin saturation <16%. RESULTS: 1) The prevalence of overweight was 24.4 percent (n=186), and that of obesity 16.5 percent (n=126). Ferritin and transferrin saturation was the lowest in the normal weight group. 2) The prevalence of iron deficiency and IDA was 18.7 percent (n=102) and 5.3 percent (n=41), respectively. 3) Iron deficiency was more common in the normal weight group compared with the overweight and underweight groups. Also, the non-obese had more iron deficiency and IDA than the obese. CONCLUSION: The prevalence of obesity in middle school girls could be higher in Incheon than in other regions, but there might be no difference in iron deficiency. However, iron deficiency was more prevalent in the normal weight group than in overweight group. The overweight group ate more food and gained more iron, so seemed to be less prevalent in iron deficiency than the normal weight group.
Adolescent ; Anemia, Iron-Deficiency ; Body Mass Index* ; Child ; Female* ; Ferritins ; Humans ; Incheon ; Iron* ; Korea ; Obesity ; Overweight ; Prevalence ; Thinness ; Transferrin