No abstract available.
Alcoholism* ; Primary Health Care*

No abstract available.
Humans

No abstract available.
Spinal Muscular Atrophies of Childhood*

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a syndrome with complex genetics and diverse manifestations. Diffuse alveolar hemorrhage is caused by alveolar microcirculation injury associated with lung illness or systemic disorders. To date, the relationship between diffuse alveolar hemorrhage and MELAS has not been reported. We report a MELAS patient who presented complications with diffuse alveolar hemorrhage.

PURPOSE: Cross-modality coregistration of positron emission tomography (PET) and magnetic resonance imaging (MR) could enhance the clinical information. In this study we propose a refined technique to improve the robustness of registration, and to implement more realistic visualization of the coregistered images. MATERIALS AND METHODS: Using the sinogram of PET emission scan, we extracted the robust head boundary and used boundary-enhanced PET to coregister PET with MR. The pixels having 10% of maximum pixel value were considered as the boundary of sinogram. Boundary pixel values were exchanged with maximum value of sinogram. One hundred eighty boundary points were extracted at intervals of about 2 degree using simple threshold method from each slice of MR images. Best affined transformation between the two point sets was performed using least square fitting which should minimize the sum of Euclidean distance between the point sets. We reduced calculation time using pre-defined distance map. Finally we developed an automatic coregistration program using this boundary detection and surface matching technique. We designed a new weighted normalization technique to display the coregistered PET and MR images simultaneously. RESULTS: Using our newly developed method, robust extraction of head boundary was possible and spatial regishation was successfully performed. Mean displacement error was less than 2.0mm. In visualization of coregistered images using weighted normalization method, structures shown in MR image could be realistically represented. CONCLUSION: Our refined technique could practically enhance the performance of automated three dimensional coregistration.
Brain* ; Head ; Magnetic Resonance Imaging ; Positron-Emission Tomography

OBJECTIVE: The aim of this study was to expect the possibility of developing fetal thrombocytopenia by observation of the clinical features of pregnant women with ITP and their neonates, and to know the effect of steroid and IVIG therapy. METHODS: The patient group was 21 cases of pregnancies with ITP diagnosed by Bone marrow biopsy or suspective to have ITP due to thrombocytopenia (150 K/micro L) not complicated by sepsis, preeclampsia or massive bleeding resulting DIC, who were admitted and delivered at Dongsan Medical Center, Keimyung University from Jul. 1998 to Jun. 2002. The study was performed retrospectively. We defined severe thrombocytopenia as less than 70 K/micro L and treated them with Prednisolone or IVIG during pregnancy and Platelet concentrate in some perinatal condition. On admission, we performed a history taking about splenectomy etc., antiplatelet antibody test and serial follow up of CBC, coagulation test during perinatal period. We used Fisher's exact test to detect statistical significance between clinical features of pregnancy women with ITP and severe neonatal thrombocytopenia and concluded to be significant if p-value was less than 0.05. RESULTS: The delivery mode of pregnancies with ITP was Cesarean section for 9 cases and vaginal delivery for 12 cases. The decision was purely dependant on obstetric indication. Because there was no significant bleeding during prenatal period even among the women with severe thrombocytopenia, they were treated with steroid in 8 cases followed by IVIG in 1 case, only IVIG in 1 case under no transfusion of Platelet concentrate. Platelet count was not normalized completely but increased over 100% in 7 cases and there was no response in only 1 case. Soon after delivery, neonatal thrombocytopenia was seen in 2 cases (9.5%). There was no ecchimosis or intracranial hemorrhage in spite of vaginal delivery in both cases. CONCLUSION: There were no prospective factors to predict the relationship between the clinical features of pregnant women with ITP and fetal thrombocytopenia. Most of the cases in which steroid therapy was done did not show neonatal thrombocytopenia but there was no statistical significance. There needs to be further study with much more cases.
Biopsy ; Blood Platelets ; Bone Marrow ; Cesarean Section ; Dacarbazine ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Immunoglobulins, Intravenous ; Infant, Newborn ; Intracranial Hemorrhages ; Platelet Count ; Pre-Eclampsia ; Prednisolone ; Pregnancy* ; Pregnant Women ; Purpura, Thrombocytopenic, Idiopathic* ; Retrospective Studies ; Sepsis ; Splenectomy ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune*

No abstract available.
Hepatolenticular Degeneration*

The pseudoaneurysms are resulted from complication of vascular catheterization, trauma, etc. and recently, the reports on pseudoaneurysms have been increasing. Successful treatment of pseudoaneurysms have been described usingdirect compression guided by color doppler ultrasound, instead of invasive surgical treatment. Authors experienced three cases of pseudoaneurysm ; two resulted from post-catheterization and one from trauma. We successfully treated two post-catheterization cases using C-clamp compression under the color doppler US-guidance. The traumatic case was treated by embolization instead of US-guided compression. We suggest that the compression of pseudoaneurysm using C-clamp under the US-guidance is more useful than hand or probe compression method.
Aneurysm, False* ; Arteries* ; Hand ; Ultrasonography ; Vascular Access Devices

Ventriculoperitoneal shunt (VP shunt) for hydrocephalus is thought to inhibit the closure of processus vaginalis by increasing intraabdominal pressure, thus it promotes the inguinal hernia. We reviewed the incidence and characteristics of the inguinal hernia in VP shunted patients, and tried to estimate the patency rate of processus vaginalis in early childhood. A reprospective review of patients undergone insertion of VP shunt between January 1980 and May 1998 at Seoul National University Children Hospital was done. 262 patients were included in this study. Among them, 28 patients developed inguinal hernia (10.7%). Six patients developed inguinal hernia before the insertion of VP shunt. According to the age of VP shunt, the inguinal hernia developed in 16.2% (12/74) of patients who had undergone VP shunt before 6 months old, 12.4% (11/89) between 6 months and 2 years old and 5.1% (5/99) after 2 years old. Among 22 patients excluding 6 patients who developed hernia before VP shunt, the incidence of inguinal hernia after VP shunt was 8.6% (22/256) with male predominance (M:F=18:4). 8 patients developed inguinal hernia bilaterally (36.4%). It is suggested that at least 14% of processus vaginalis is patent until 2 years old.
Child ; Child, Preschool ; Hernia ; Hernia, Inguinal* ; Humans ; Hydrocephalus ; Incidence ; Infant ; Male ; Seoul ; Ventriculoperitoneal Shunt*

No abstract available.
Carcinoma, Renal Cell* ; Nephrons*