No abstract available.
Skin*

Dieulafoys lesion consists of abnormally large gastric submucosal artery which ruptures into the stomach causing massive or recurrent intragikstric bleeding. The lesion is very small and easily overlooked even at laparatomy and aan only be correctly diagnosed by endoscopy or arteriography if the patient is actively bleeding. Three patients who were admitted with bleeding of upper gastrointestinal tract and eventually diagnosed as having Dieulafoys lesions were analysed. All were men with age range of 44 to 55 years. All patient were asymptomatic before presenting with hematemesis. Two of the three patients had had history of upper Gl bleeding. One patient used analgesics daily for ureteral colic and two patient drank alcohol excessively. Gastroscopy was performed during the bleeding episode in all three patients. Dieulafoy's lesion was seen in all three cases and in the second case, there was concomittent diffuse petechia in the whole stomach. The lesion was situated on the posterior wall of upper body in one, on anterior wall of upper body in another, lesser curvature side of gastric fundus in the other case. All three patient underwent laparotomy for persistent bleeding and the lesion was suture ligated only in two patients while in one patient vagotomy and pyloroplasty was added. Resection biopsy was performed in two cases and both revealed only normal gastric mucosa. All patients discharged after complete recover.
Analgesics ; Angiography ; Arteries ; Biopsy ; Endoscopy ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Renal Colic ; Rupture ; Stomach ; Sutures ; Upper Gastrointestinal Tract ; Vagotomy

No abstract available.
Humans ; Infant, Newborn*

Intraventricular hemorrhage (IVH) is common in the premature infants and occurs mainly in subependymal germinal matrix. In contrast, IVH in the term infants is rare and different in pathogenesis and bleeding sites from those of the premature infants. Most studies of IVH in term infants have been studied by computerized tomography and postmortem examination. Brain ultrasonography which has become a frequently used diagnostic tool of IVH in the premature infants is reported to be also effective in diagnosis in the term infants. The study population comprised 11 term neonates admitted to the Neonatal Intensive Care Unit of Seoul National University Children's Hospital between July 1989 and June 1991, in whom IVH was diagnosed by ultrasonography. We analysed severity of birth asphyxia. ultrasonographic findings and clinical manifestations to investigate severity, timing, risk factors, and pathogenesis of IVH in the term neonates. 1) Apgar scores were available in 7 cases with severe asphyxia (Apgar at 1 min: less than 3), 1 cases with mild asphyxia (Apgar at 1 min: between 5~7), and 2 cases without asphyxia. 2) Clinically, 4 cases had fetal distress, and 3 cases had meconium aspiration pneumonia. 3) Bleeding sites by ultrasonography were subependymal germinal matrix in all 11 cases. IVH of choroid plexus was combined in 2 cases. Severity of IVH were grade I in 9 cases, grade II in 2 cases by Papile's classification. 4) There were no correlations between the grade of IVH and severity of perinatal asphyxia. In conclusion, ultrasonography is very useful in diagnosis and follow-up of IVH in term neonates. Subependymal germinal matrix could be common site of IVH in term neonates because germinal matrix still remains in term neonates despite of its regression. Also this can explain why IVH in our cases is not severe.
Asphyxia ; Autopsy ; Brain ; Choroid Plexus ; Classification ; Diagnosis ; Fetal Distress ; Follow-Up Studies ; Hemorrhage* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Parturition ; Pneumonia ; Risk Factors ; Seoul ; Ultrasonography

The causes of hypocalcemia in patients suffering from severe infection including sepsis are largely uncertain. So we measured serum albumin, total protein, cholesterol, PTH, and calcitonin of the infection-associated hypocalcemic children and compared with those of normocalcemic children suffering from tsutsugamushi disease. All had normal renal functions and had been admitted to the department of pediatrics of Gyeongsang National University Hospital. Hypocalcemic patients were hypoalbuminemic. Serum total calcium was inappropriately more decreased compared to the decreased amount of serum albumin in the hypocalcemic group. We also observed more frequent incidence of hypocholesterolemia (<100mg/dL) in this group. And serum PTH was appropriately elevated in the hypocalcemic patients. Serum calcitonin was elevated in both groups, but 6 times higher in the hypocalcemic group than in the normocalcemic one. Serum total calcium was positively correlated with serum albumin and negatively correlated with serum PTH and calcitonin.
Calcitonin ; Calcium ; Child ; Cholesterol ; Humans ; Hypoalbuminemia ; Hypocalcemia* ; Incidence ; Pediatrics ; Scrub Typhus ; Sepsis ; Serum Albumin

No abstract available.
Adult* ; Humans ; Molecular Epidemiology* ; Oxalobacter formigenes* ; Seoul*

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

No abstract available.
Diagnosis* ; Hemoglobinuria*

To assess the effectiveness of Magnetic Resonance Imaging (MRI) with endorectal surface coil in the ataging of carcinoma of the uterine cervix with emphasis on parametrial involvement. Thirty women with clinically and radiographically proven carcinoma of the uterine cervix were initially included for this study, but thirteen patients were excluded since the stages of tumors wore beyond stage IIa. CT and MR findings of the remaining seventeen patients were performed at Cheil General Hospital and compared a1ong with clinical findings with the special emphasis on the parametrial involvement by the tumor. Staging was assessed by CT and MRI, and the results were compared with the pathologic staging. Radiea1 abdominal hysterectomy with the pelvic and paraaortic lymphnode dissection was done to all sewenteen patients. The staging made primarily by CT and MRI was either stsge 1 or Ila, but MR images with endorectal surface coil was superior to CT in the visualization of depth of tumor infiltration, especially parametrial involvement. The determination of the depth of the tumor made by MR images showed statistically significant correlation with histologic evaluation(R =0.768, p<0.01). The accuracy rate for the evaluation of the parametrial invo1vement was 82.3% far CT and 94.1% for MRI with endorectal surface coil. The overall accuracy rate for tumor staging was 70.5% for clinical, 58.8% for CT and 82.3% for MR evaluation. The accurecy rate in evaluation of the pelvic and paraaortic lymphnode was 88.2% for CT, but the evaluation done by MRl was not adequate due to small FOV(field of view). In assessment of The steging of careinoma of the uterine cervlx, MR images with endorectal surface coil was superior to CT, especially in the evaluation of the parametrial involvement.
Cervix Uteri* ; Female ; Hospitals, General ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Neoplasm Staging