PURPOSE: Neonatal surgical conditions affecting the gastrointestinal tract are varied, can affect any part of the intestinal tract, and frequently require urgent surgical intervention. Unfortunately, nonspecific and overlapping symptomatology exists among the conditions affecting the intra-aMominal intestinal tract and requires of the evaluating physician a thorough understanding of their pathophysiology. So we studied signs and symptoms, frequency and incidence, ages at diagnosis, and diagnostic method of the neonatal gastrointestinal obstructions. METHOD: We reviewed retrospectively the charts of patients, who had been diagnosed as gastrointestinal obstruction during the neonatal period, and had been admitted to Gyeongsang National University Hospital from Feb. 1988 to Feb. 1997. RESULT: Total 77 cases were enrolled in this study. There were 59 rnales (76.796) and female 18 cases (23.4%). The male to female ratio was 3.28: 1. Twenty-two cases of imperforate anus (28.6%), 18 cases of hypertrophic pyloric stenosis (23.4%), 15 cases of congenital megacolon (19.5%) were observed. Other diseases causing the neonatal gastrointastinal obstruction were annulus pancreas (7.8%), jejunal atresia (6.5%), duodenal atresia (1.3%), duodenal web (2.6%), ileal atresia (2.6%), midgut volvulus (2.6%), intussusception (1.3%), and trachoesophageal fistula (2.6%). The rnost common symptom was vomiting with 32 cases (41.6%), followed by abdominal distension with 31 cases (40.3%), absence of anus with 17 cases (22.1%), and delayed meconium passage with 9 cases (11.7%). Associated other anomalies were observed in 18 cases (23%). Imperforate anus was seen with the highest rate of associated anomalies. The most common associated anomaly was the cardiac anomaly. Colon study (26%), physical examination (24.7%), abdominal sonography (15.6%), upper GI series (11.7%), and simple abdomen (9.1%) were diagnostic in the neonatal gastrointestinal obstructions. Seventeen cases (22%) were died before or after the surgical intervention. CONCLUSION: Neonatal gastrointestinal obstructions were associated with the high mortality rate. Abdominal distension and vomiting were the specific symptoms of neonatal gastrointe- stinal obstructions. Extensive search for the associated anomalies are reqiured because of its high frequency in the patients of the neonatal gastrointestinal obstructions. Thorough physical examination, colon study, abdominal sonography, upper GI series, and simple abdomen were essential in the diagnosis of the neonatal intestinal obstructions.
Abdomen ; Anal Canal ; Anus, Imperforate ; Colon ; Diagnosis ; Female ; Fistula ; Gastrointestinal Tract ; Hirschsprung Disease ; Humans ; Incidence ; Infant, Newborn ; Intestinal Atresia ; Intestinal Obstruction ; Intestinal Volvulus ; Intussusception ; Male ; Meconium ; Mortality ; Pancreas ; Physical Examination ; Pyloric Stenosis, Hypertrophic ; Retrospective Studies ; Vomiting

PURPOSE: To evaluate the usefulness in diagnosing the gallbladder perforation MATERIALS AND METHODS: CT scans of surgically proved 11 cases of gallbladder perforation were retrospectively reviewed. CT findings analyzed were iuminal diameter of GB, GB wall thickness and configuration, presence or absence of fluid collection in the pericholecystic or intraperitoneal space, and observation of pericholecystic anatomic structures. All patients underwent cholecystectomy, and surgical findings were also compared. RESULTS: The GB was distended in 6 cases(55% with a range of 4.0-7.5cm, mean :5.2cm). GB wall was thickened in most cases(9/11,82%) with homogeneous(n=7) or inhomogeneous(n=2) enhancement. At the sites of perforation, focal defect or contour bulging was seen in the GB wall in 3 cases. in 2 cases with gangrene, GB wall showed loss of normal contour with mottled contrast enhancement. Pericholecystic or intraperitoneal fluid co11ection was noted in 9 cases(82%), especially in the region of perforation. In all cases, there was evidence of diffuse infiltration in the pericholecystic space, omenturn or mesentery. Other findings included cholecy-stoenteric fistula in 1 case, and intrahepatic or intraperitoneal abscess formation in 2 cases. CONCLUSION: CT is useful in correct diagnosis of gallbladder perforation.
Abscess ; Cholecystectomy ; Diagnosis ; Fistula ; Gallbladder* ; Gangrene ; Humans ; Mesentery ; Retrospective Studies ; Tomography, X-Ray Computed

Peutz-Jeghers syndrome(PJS) is a relatively rare autosomal-dominant disease characterized by the occurrence of extensive mucocutaneous hyperpigmentation and gastrointestinal polyps. PJS patients are considered to have a high prevalence of intussusception due to polyps. We report the radiological findings in two cases of intussusception due to polyps in patients with PJS, and review the literature.
Humans ; Hyperpigmentation ; Intussusception* ; Peutz-Jeghers Syndrome* ; Polyps ; Prevalence

Hypernatremia developing in nonhospitalized adults is predominantly a disease of the elderly and mentally handicapped patients, possibly revealing inadequate nursing care of these patients. It has long been claimed that the duration of hypernatremia and its rate of correction are correlated with improvement in patients' neurologic status. Since there are only a handful of cases with serum sodium levels greater than 200 mEq/L until recently, it is not clear at what rate plasma sodium concentration can be safely normalized in severe hypernatremic patients. We report a case of severe hypernatremia with survival. This patient underwent rapid correction of serum sodium concentration during the management of this metabolic derangement using isotonic solution.
Journal Article ; Female ; Human ; Hypernatremia/therapy* ; Hypernatremia/physiopathology ; Hypernatremia/blood ; Middle Age ; Sodium/blood* ; Treatment Outcome

BACKGROUND: Neurofibromatosis type 1 (NF1) is one of the most common inherited disorders and is characterized by abnormalities in multiple tissues derived from the neural crest. OBJECTIVES: We analyzed the presence of mutations of NF1 gene in unrelated 56 Korean NF-1 patients. METHODS: Mutations were detected by polymerase chain reaction, single strand conformational polymorphism analysis and direct DNA sequencing. RESULTS: We found five different kinds of mutations in the NF1 gene from 5 out of 56 unrelated Korean NF1 patients. Sequence analysis revealed a nucleotide substitution at codon 1276 of exon 22 (CGA to TGA, R1276X), 4 by insertion at codon 1270 of exon 22 (3809 ins TGGA), a base pair deletion at codon 1398 of exon 24 (4192 del G), 4 by deletion at codon 1638 of exon 28 (4914 del CTCT), and a base pair substitution at codon 1947 of exon 31 (CGA to TGA, R1947X). All of these mutations resulted in premature termination of the mutant alleles. CONCLUSION: Results showed that common consequences of NF1 mutations are introduction of a premature stop codon, and these mutant genes may encode truncated forms of neurofibromin.
Alleles ; Base Pairing ; Codon ; Codon, Nonsense ; Exons ; Genes, Neurofibromatosis 1* ; Humans ; Neural Crest ; Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibromin 1 ; Polymerase Chain Reaction ; Sequence Analysis ; Sequence Analysis, DNA

No abstract available.
Humans ; Lymphocytes*

Partial or complete loss of innervation of skeletal muscle leads to muscle weakness and atrophic changes, resulting in decreased muscle volume with fatty replacement. Rarely, enlargement of the affected muscle may occur, related to two processes: true hypertrophy and pseudohypertrophy. We report CT and MR findings of the pseudohypertrophy of calf muscles, especially the soleus and gastrocnemius muscles, in a patient with diabetic neuropathy that showed increased muscle volume with diffuse fatty replacement and the presence of scanty muscle fibers.
Diabetic Neuropathies* ; Humans ; Hypertrophy ; Muscle Weakness ; Muscle, Skeletal ; Muscles*

No abstract available.
Respiratory Distress Syndrome, Newborn*

No abstract available.
Humans ; Ranitidine* ; T-Lymphocyte Subsets* ; T-Lymphocytes*

PURPOSE: To assess the postoperative CT findings of aortic aneurysms or dissections treared by resection- and-graft replacement or continuous-suture graft-inclusion technique MATERIALS AND METHODS: We reviewed postoperative follow-up CT findings of 14 patients, 19 cases. There were 8 patients(10 cases) of aortic aneurysm and 6 patients(9 cases) of aortic dissecton which involved the thoracic aorta in 9 patients(13 cases) and abdominal aorta in 5 patients(6 cases). The interval of follow-up after operation was from 9 days to 2 year 9 months. On CT scans, we analyzed the appearance of graft materials, differences of CT findings between two surgical techniques, and normal or abnormal postoperative CT findings. RESULTS: Most of grafts appeared as hyperdense ring on precontrast scan, and all of them were not seperated from aortic lumen on postcontrast scan. On CT findings of patients who were operated by continuous-suture graft-inclusion technique, perigraft thrombus was concentrically located with sharp demarcation by native aortic wall and its density was homogeneous, but in cases of those operated by resection-and-graft replacement, perigraft hematoma was eccentrically located with indistinct margin and its density was heterogeneous and native aortic wall could not be delineated. In patients without complication, perigraft thrombus or hematoma(15 cases), perigraft calcification(11 cases), residual intimal flap(6 cases), graft deformity(4 cases), perigraft air(2 cases) and reconstructed vessels(1 case) were noted. And in one patient with complication, perigraft flow was noted with more increased perigraft hemaroma. CONCLUSION: Precise knowledge of the differences of CT findings between two surgical techniques and nor- mal postoperative CT findings is crucial to evaluate the postoperative CT findings in aortic aneurysm and dissection.
Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm* ; Follow-Up Studies ; Hematoma ; Humans ; Thrombosis ; Tomography, X-Ray Computed ; Transplants