No abstract available.
Child* ; Humans ; Proteinuria*

The frequent occurrence of hematuria in children necessitates diagnostic evaluation. Hematuria may occur with either renal or lower urinary tract disease. Clarification of the etiology of hematuria, whether microscopic or gross, is facilited by localizing the site of bleeding to the kidney (glomerular) or the lower urinary tract (non-glomerular). The mean cellular volume (MCV) of urinary red blood cells (RBCs) of pediatric patients with glomerular (group I; n=77) and non-glomerular (group II; n=34) hematuria was determined using Coulter Counter Model S plus IV. We found that re blood cells of glomerular origin had a smaller volume than non-glomerular cells(73.79 9.75 m3 vs 83.55 3.77 m3, p<0.001). If an urinary MCV equal to 80.56 m3 was taken as the cut-off value between glomerular and non-glomerular hematuria, a correct assessment of the site of bleeding was made in 89 (80%) of the 111 patients studied (sensitivity 76%, specificity 88%). The ratio of the urinary erythrocyte MCV to that in blood(Umcv/Bmcv) was compared with the diagnosis. If an Umcv/Bmcv ratio equal to 0.95 was taken as the cut-off value between glomerular and non-glomerular hematuria, a correct assessment of the site of bleeding was made in 93 (83%) of the 111 patients studied (sensitivity 79.6%, specificity 94%). Coulter counter analysis of urine provides a simple noninvasive and objective aid to the diagnosis of hematurai. This test, when used early in the management of pediatric patients with hematuria, may help to avoid invasive investigations.
Blood Cells ; Child ; Diagnosis ; Erythrocytes* ; Hematuria* ; Hemorrhage ; Humans ; Kidney ; Sensitivity and Specificity ; Urinary Tract ; Urologic Diseases

This study is a retrospective clinical analysis of two hundred forty-four consecutive cases of acute subdural hematoma which were confirmed by operation during the last five years at the Department of Neurosurgery of the Dong-guk University Hospital. The authors have attempted, through this analysis to identify the factors affecting the outcome of acute subdural hematoma. A favorable outcome occurred in 40%, and an unfavorable outcome in 21% of patients at the time of discharge while a death ocurred in 39% of the cases. We have concluded that initial GCS, pupillary status, systolic arterial blood pressure, FDP vaules, presence or absence of skull fracture. IICP findings on brain CT, hematoma amount, and associated intracranial lesions are all prognostic factors, although the timing of operation did not reflect a significant difference in the outcome, however the sooner the intracranial hematoma lesion is evacuated, the better the outcome will be.
Arterial Pressure ; Brain ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Neurosurgery ; Retrospective Studies ; Skull Fractures

As the development of CT scan enabled rapid and precise diagnoses of epidural hematoma, recent efforts have been sought to reduce its mortality rate. This study is a retrospective clinical analysis of one hundred eighty-one consecutive cases of epidural hematoma treated at the Department of Neurosurgery in Dong-guk University Hospital between Jan. 1991 and Dec. 1994. The rate of unsatisfactory outcome is 10.5%, While the mortality rate is 4.9%. Delayed epidural hematoma was founded tobe 12%. The authors have attempted to identify the factors influencing the prognosis of epidural hematoma. Based on the results of the above study we concluded that age, initial Glasgow coma scale, pupillary reflex and its size, IICP findings on brain CT, hematoma amount, associated intracranial lesions, rate of development of symptoms and timing of operation after injury are all relevant prognostic factors.
Brain ; Diagnosis ; Glasgow Coma Scale ; Hematoma* ; Mortality ; Neurosurgery ; Prognosis ; Reflex, Pupillary ; Retrospective Studies ; Tomography, X-Ray Computed

Posttraumatic cerebral infarction is a recognized complication of craniocerebral trauma, but, its frequency, cause, and influence on mortality are not well defined. During a two year period, 706 patients with head trauma were examined in our hospital with cranial CT studies. The CT findings which strongly suggested the herniation were seen in 46 patients. The posttraumatic cerebral infarction was diagnosed retrospectively in 18 of these patients. Detailed information, including CT findings were recorded from 1 to 10 days after admission. Posttraumatic cerebral infarctions were seen in the vascular territories of the middle cerebral artery(PCA) in 9 patients, posterior cerebral artery(PCA) in 4 patients, anterior cerebral artery(ACA) in 3 patients, and multiple in 2 patients. Outcomes of these 18 patients were severely disabled in 8 patients, moderate disabled in 6 patients, and death in 3 patients. Only one remaining patient was demonstrated a good recovery. These results suggest that cerebral infarction with severe head trauma might be associated with significantly bad influence on outcome of these patients when compared with those without cerebral infarction.
Cerebral Infarction ; Craniocerebral Trauma ; Humans ; Mortality ; Retrospective Studies

Anomalies of cell migration are due to various kinds of damage(vascular, infectious, teratogenic etc.) which interfere with neuronal migration between the 8th and 24th week of gestation. Periventricular heterotopias are nodular masses which protrude into the ventricular lumen. There is a high frequency of convulsive disorders. A 38-year-old woman presented to a intermittent headache, seizure-like activity and post-ictal subjective weakness on the left side. The computerized tomography findings and physical and neurologic examinations with an EEG revealed no specific abnormal findings. The MRI showed tumor-like nodular mass lesions at right periventricular area. The histological study of stereotactic excised biopsy demonstrated a composition of neuron and glia. After operation, headaches were slightly reduced and there was no reattack of seizure activity. Authors reports one case of periventricular heterotopia with a review of the literature.
Adult ; Biopsy ; Cell Movement ; Electroencephalography ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Neuroglia ; Neurologic Examination ; Neurons ; Periventricular Nodular Heterotopia* ; Pregnancy ; Seizures

Despite advancement in diagnosis and progress in the management of intracranial pressure, infection remains a common complication following severe head injury. This following study attempts to better define the cell mediated immunity that decreased immediately following severe head injury. Twenty-five patients admitted with severe head injury(mean Glasgow Coma Scale, 5.32) were studied at the emergency rooms. The control group consisted of 25 mildly head-injured patients requiring hospital observation. Phenotyping of peripheral blood lymphocytes(PBL), determined by flow cytometry using monoclonal antibodies to lymphocytes subpopulation and HLA-DR receptors, was performed immediately following head injury. When severely head-injured patients were compared with controls, it was observed that the total T-cell counts(p<0.01) were markedly decreased, whereas the NK cell counts(p<0.01) were found to be increased. Infection rate of the study group was 44% and the majority of infections occur within the first 10 days after sever head injury. The results of this study suggests that severely head-injured patients had a decreased T-cell population and subpopulation in lines with higher infection rate.
Antibodies, Monoclonal ; Craniocerebral Trauma ; Diagnosis ; Emergency Service, Hospital ; Flow Cytometry* ; Glasgow Coma Scale ; Head* ; HLA-DR Antigens ; Humans ; Immunity, Cellular ; Intracranial Pressure ; Killer Cells, Natural ; Lymphocytes* ; T-Lymphocytes

An ectopic pregnancy in the abdominal organs is very rare. Primary intestinal pregnancy is considered the rarest form of extrauterine pregnancy, and only a few well-documented cases have been reported. Herein, a case of an abdominal pregnancy in a 25-year-old woman, with massive lower gastrointestinal bleeding, is reported. The source of bleeding could not be identified, despite gastroscopy, ultrasonography and angiography investigations. A diagnostic laparotomy disclosed an abdominal pregnancy, causing an erosion of the jejunal wall at the site of the pregnancy, with massive lower gastrointestinal bleeding. An abdominal pregnancy is seldom included in the differential diagnosis of lower gastrointestinal bleeding. The possibility of intestinal erosion in an abdominal pregnancy should be borne in mind in cases of lower gastrointestinal bleeding.
Adult ; Angiography ; Diagnosis, Differential ; Female ; Gastroscopy ; Hemorrhage* ; Humans ; Laparotomy ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Ultrasonography

Hemangiopericytoma of the kidney is rare. It seems to be slowly progressive and grows locally with 5cm consistency and well encapsulation, and may infiltrate surrounding tissue but the incidence and degree of its malignancy appears to be low. Herein we report a case of malignant renal hemangiopericytoma associated with asymptomatic hypoglycemia and presenting radiologically as a hypovascular mass which was developed from the left kidney in 32 years old sea man who was treated with radical nephrectomy and chemotherapy.
Adult ; Drug Therapy ; Hemangiopericytoma* ; Humans ; Hypoglycemia ; Incidence ; Kidney ; Nephrectomy

Hennekam syndrome is a rare autosomal recessive disorder resulting from malformation of the lymphatic system. The characteristic signs of Hennekam syndrome are lymphangiectasia, lymph edema, facial anomalies, and mental retardation. This is a case in which a patient presented with left-arm lymphedema, facial-feature anomalies, and multiple organ lymphangiectasia consistent with symptoms of Hennekam syndrome. There is no curative therapy at this time, but rehabilitative treatments including complete decongestive therapy for edema control appeared to be beneficial.
Edema ; Humans ; Intellectual Disability ; Lymphatic System ; Lymphedema