Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossae. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present a case of fetal bilateral renal agenesis diagnosed by ultrasonography after amnioinfusion at 19 weeks gestation.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Ultrasonography, Prenatal* ; Urinary Bladder

The occurrence of Non-Hodgkin's lymphoma (NHL) during pregnancy is very rare and this malignancy is most commonly associated with aggressive histology and dissemination. Treatment in pregnant women with low-grade lymphoma may be delayed until after delivery but women with an aggressive lymphoma must have a immediate initiation of standard chemotherapy whether to have a therapeutic abortion or not. A-32-year-old woman with NHL stage IIb complicating pregnancy is presented. The diagnosis was made aggressive lymphoma. The baby weighting 1,830 gm was delivered by normal spontaneous vaginal delivery. Following delivery, the patient received combination chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone regimen but magnetic resonance imaging undertaken during follow-up showed leptomeningeal involvement, indicating poor prognosis. She wanted discharge ten months later from disseminated disease. We experienced a case of rapid growing Non-Hodgkin's lymphoma developed on anterior mediastineum that diagnosed during pregnancy and treated following delivery. We report this case with a brief review of literature.
Abortion, Therapeutic ; Cyclophosphamide ; Diagnosis ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Magnetic Resonance Imaging ; Prednisone ; Pregnancy* ; Pregnant Women ; Prognosis ; Vincristine

PURPOSE: To evaluate the signal characteristics of intracranial hemorrhage, as seen on fluid attenuatedinversion recovery(FLAIR) MR imaging according to various stages, and to compare FLAIR imaging with spin-echo T1-and T2-weighted MR imaging. MATERIALS AND METHODS: We retrospectively evaluated fast FLAIR images along withspin-echo T1- and T2-weighted MR images of 32 lesions in 26 patients (12 males and 14 females, aged 3-84 yrs) withintracranial hemorrhagic lesions. For imaging, a 1.5T unit was used, and the nature of the lesions was found to beas follows : intracranial hemorrhage(n=15) ; tumor(n=9) ; infarction (n=4) ; arteriovenous malformation (n=3) ;and arachnoid cyst with hemorrhage(n=1). On the basis of spin-echo MR imaging, lesions were classified as acute,early subacute, late subacute, early chronic, or late chronic stage. The signal characteristics of intracranialhemorrhage were analysed in accordance with each staging, as seen on MR FLAIR imaging, and compared to the stagingseen on spin-echo T1- and T2-weighted MR imaging. RESULTS: For the 32 hemorrhagic lesions, staging was found to beas follows : acute(n=4) ; early subacute(n=8) ; late subacute(n=11) ; early chronic(n=5) and late chronic(n=1). Inthe remaining three patients with arteriovenous malformation, the stage of the hemorrhage was found to be mixedsubacute and chronic. The signal intensity of hemorrhage, as seen on FLAIR imaging during the acute andearly-subacute stage, was low, and during the late subacute stage it was high ; for T2WI, the findings weresimilar. FLAIR imaging, however, showed that hemorrhage intensity during the early chronic stage was low, and thatof the late chronic stage was very low ; these findings were similar to those of T1WI. CONCLUSION: The signalintensity of intracranial hemorrhage, as seen on FLAIR imaging, was not characteristic ; it was similar to that ofT2WI during the acute and subacute stages, and similar to that of T1WI during the chronic stage. When usedtogether with spin-echo T1- and T2-weighted MR imaging, however, FLAIR imaging may be useful for theclassification of chronic intracranial hemorrhage as either early or late stage.
Arachnoid ; Arteriovenous Malformations ; Female ; Hemorrhage ; Humans ; Infarction ; Intracranial Hemorrhages* ; Magnetic Resonance Imaging ; Male ; Retrospective Studies

This is a case report of the congenital ileal atresia with disuse microcolon. The patient was a 3 day-old male newborn infant who was admitted in department of pediatrics Soon Chun Hyang Hospital with complaints of persistant vomitings, no meconium passage, and jaundice from a few hours after birth. The diagnosis was established by characteristic clinical features and barium enuma and finally confirmed by operationl. The operative findings showed that entire colon showed very narrow lumen and was associated with malrotation of the cecum, volvulus of midgut, multiple bands formation, and atresia of ileum with marked dilated proximal small bowel. It is considered that this microcolon was originated from non-use of the colon due to atreisa of the ileum. Resection of the obstructed ileum with multiple bandlysis and finally ileo-ileal end to end anastomosis were done. Microscopic findings showed that sections of cord like mass revealed marked narrowing of mucosal lumen with collections of mucus and necrotic cell debris and lack of mucosa. He was discharged 50 days after operation with favorable condition and normal finding of follow-up barium enema. A brief review of related literature was also presented.
Barium ; Cecum ; Colon ; Diagnosis ; Enema ; Follow-Up Studies ; Humans ; Ileum ; Infant, Newborn ; Intestinal Volvulus ; Jaundice ; Male ; Meconium ; Mucous Membrane ; Mucus ; Parturition ; Pediatrics

OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.
Adolescent Psychiatry ; Adolescent ; Anxiety ; Child ; Depression ; Epidemiologic Studies ; Fibrinogen ; Humans ; Korea ; Prothrombin ; Psychometrics ; Suicidal Ideation ; Thromboplastin ; Weights and Measures

INTRODUTION: The gamma-aminobutyric acid type A (GABAA) receptor is an important pharmacological target of alcohol. The phamacological characteristics of the receptor are largely determined by its subunit composition. Compared with all other alpha subtypes, the alpha6- containing receptors are more sensitive to GABA and less sensitive to benzodiazepines. The purpose of this study was to address a role for GABAAalpha6 receptor subunit gene in the development of alcohol dependence. The differential manifestation of alcohol withdrawal symptoms related to GABAAalpha6 polymorphism in patients treating with benzodiazepines was also examined. METHODS: Eighty-seven inpatients with alcohol dependence, and sixty healthy controls were evaluated using CIWA-Ar scale. Each patient was genotyped for GABAAalpha6 subunit. Association between GABAAalpha6 polymorphism and severity of withdrawal symptom were determined. RESULTS: No significant difference was found in GABAAalpha6 receptor genetic type and allelic distribution between the alcohol dependent and control subject. Tremor was more severe in CC than TT type. TT type had higher degree of anxiety, agitation and headache than CC type. The GABAAalpha6 C allele increased the average score of tremor significantly, and T allele increased that of agitation. CONCLUSION: The results suggested that GABAAalpha6 genetic polymorphism was not associated with alcohol dependence and with severity of alcohol withdrawal symptoms. But in benzodiazepine treated patients, GABAAalpha6 polymorphism and allelic type show the difference in severity of each withdrawal symptom. These differences of severity are partly responsible for the unique pharmacological properties associated with the GABAAalpha6 subunit.
Alcoholism ; Alleles ; Anxiety ; Benzodiazepines ; Dihydroergotamine ; gamma-Aminobutyric Acid ; Headache ; Humans ; Inpatients ; Polymorphism, Genetic ; Receptors, GABA ; Substance Withdrawal Syndrome* ; Tremor

Adenoid cystic carcinoma is an uncommon adenocarcinoma type which affects mainly the salivary gland and respiratory system. In the female reproductive tract it occurs more commonly in Bartholin's gland and than in uterine cervix. Almost patients are postmenopausal women. The main presenting complaint is vaginal spotting having an abnormal pap smear. It has been diagnostically confused with adenoid basal carcinoma which has a somewhat different clinical course and pathology. The treatment should be individualized to the patients by local recurrence or distant metastasis. It shows relatively unfavorable survival. Recently we experienced a case of adenoid cystic carcinoma arising in the cervix after menopause, so we report this case with a brief review of literature.
Adenocarcinoma ; Adenoids* ; Carcinoma, Adenoid Cystic* ; Cervix Uteri* ; Female ; Humans ; Menopause ; Metrorrhagia ; Neoplasm Metastasis ; Pathology ; Recurrence ; Respiratory System ; Salivary Glands

PURPOSE: The purpose of this study was to identify the effects of Yakson therapy as a pain management tool on the physiologic and behavioral reponses of infants with a painful heelstick procedure. METHOD: Infants were randomly assigned to a group that underwent a series of Yakson therapy and a control that received nothingbefore a heelstick. Heart rate, oxygen saturation, and NIPS were compared between the experimental (n=16) and control (n=16) infants during an undisturbed baseline and after a standard heelstick procedure. Yakson therapy consisted of laying a hand on the back, and caressing the abdomen by hand for 5 minutes. RESULT: The pain scores of the Yakson group were lower than the control group. Foroxygen saturation, there were statistically significant differences between groups. For heart rate, there were no statistically significant differences between groups. CONCLUSION: This data suggests that Yakson therapy had a pain relief effect in behavior responses and SaO2. Accordingly, Yakson therapy should be used as a nursing intervention for simple pain management for a heel prick.
Blood Specimen Collection ; Female ; Heart Rate ; Heel ; Humans ; Infant, Newborn ; Male ; *Neonatal Nursing ; Oximetry ; Pain/nursing/*therapy ; Pain Measurement ; Punctures/adverse effects ; Therapeutic Touch/*methods/nursing

OBJECTIVE: The purpose of this study was to evaluate whether the C677T Methylene-TetraHydroFolate Reductase (MTHFR) polymorphism affects the total maternal serum homocysteine and folate concentration in preeclamptic pregnant women. METHODS: Patients admitted to the hospital for the delivery during 2000-2002. 126 controls without the pregnancy complications and 34 patients with severe preeclampsia were enrolled. The serum homocysteine analysis was conducted using the high performance liquid chromatography methods. The serum folate and vitamin B12 concentration were determined using a radioimmunoassay kit. The C677T MTHFR gene mutation was examined by the polymerase chain reaction of the genomic DNA fragments. RESULTS: The total maternal serum homocysteine concentration and the serum vitamin B12 concentration were not significantly different between controls and the preeclampsia patients (p=0.44 for homocysteine, p=0.06 for vitamin B12). However, the maternal serum folate concentration was significantly higher in the preeclampsia patients than in controls (27.00 +/- 9.54 nmol/L versus 18.03 +/- 12.97 nmol/L, respectively, p=0.01). The total maternal serum homocysteine concentration, the serum folate concentration, and serum vitamin B12 in the C677T MTHFR CC type and TT type were not significantly different (p=0.21 for homocysteine, p=0.22 for folate, p=0.14 for vitamin B12). CONCLUSION: The C677T MTHFR mutation does not significantly affect the maternal homocysteine and folate concentration in both the controls without pregnancy complication and the preeclampsia patients.
Chromatography, Liquid ; DNA ; Female ; Folic Acid* ; Homocysteine* ; Humans ; Oxidoreductases* ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnancy Complications ; Pregnant Women* ; Radioimmunoassay ; Vitamin B 12 ; Vitamins

OBJECTIVE: To determine whether meconium staining can be the indicator of intrauterine hypoxia by comparing umbilical venous erythropoietin (EPO) concentration and the number of nucleated erythrocytes (NRBC), as a marker of intrauterine hypoxia, between non meconium-stained neonates and meconium-stained neonates of term pregnancy. And to determine correlation between the number of NRBC, EPO levels and interleukin-6 (IL-6), as another mediator of intrauterine hypoxia. METHODS: In 240 neonates with gestational age ranged from 37 to 41 weeks, including 231 cases of nonmeconium-stained neonates and 9 cases of meconium-stained neonates, we performed the measurement of EPO levels by RIA, the number of NRBC per 100 white blood cells (WBC) by blood smear and IL-6 by ELISA in umbilical venous blood at delivery. Statistical analysis was performed by chi-square test, Wilcoxon rank sum test, linear regression analysis using SPSS 11.0 version statistical package. RESULTS: Amniotic fluids of meconium-stained neonates had significantly greater EPO concentrations compared with that of nonmeconium-stained controls (41.3+/-13.0 vs 26.5+/-18.9 mIU/mL, p=0.001). But there were no statistical difference in the number of NRBC, IL-6 levels and hematocrit of umbilical venous blood. The EPO levels in umbilical venous blood was correlated with the number of nucleated erythrocytes (r2=7.7%, p<0.001), and IL-6 in umbilical venous blood was correlated with the number of NRBC. (r2=11.5%, p<0.001). CONCLUSION: These results suggest that meconium-stained amniotic fluid can be associated with fetal hypoxia. And the production of fetal NRBC is thought to be stimulated by EPO and IL-6, but it requires further study of other (yet to be determined) hypoxia-derived mediators.
Amniotic Fluid ; Anoxia ; Enzyme-Linked Immunosorbent Assay ; Erythroblasts ; Erythropoietin* ; Female ; Fetal Hypoxia ; Gestational Age ; Hematocrit ; Humans ; Infant, Newborn* ; Interleukin-6 ; Leukocytes ; Linear Models ; Meconium* ; Pregnancy*