PURPOSE: Intraventricular hemorrhage(IVH) is a major risk factor for neurodevelop- mental handicap in very low birth weight infant. So we carried out to determine the efficacy of indomethacin in reducing the incidence of intraventricular heorrhage in very low birth weight infant. METHODS: A prospective, random trial was carried out to determine the efficacy of indomethacin in preventing intraventricular hemorrhage. A total of 46 infants of less than 1500g birth weight admitted to NICU of IL Sin Christian Hospital from August 1995 to June 1997 were analyzed. Randomly, 23 infants were given indomethacin and 23 infants were not given as control group. Serial cranial ultrasound examination was performed. RESULTS: There were no differences in the birth weight, gestational age, sex, Apgar score, blood pressure, intake and output within the first 3 days between the indornethacin and control groups. Of 23 infants given indomethacin, four had germinal matrix or intraventricular hemorrhage, in comparison with 10 of 23 control infants(P=0.045). CONCLUSION: Prophylactic indomethacin lowers the incidence of IVH in very low birth weight infants.
Apgar Score ; Birth Weight ; Blood Pressure ; Gestational Age ; Hemorrhage* ; Humans ; Incidence ; Indomethacin* ; Infant ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors ; Ultrasonography

Proper education about dermatology in medical college would have physicians appropriately diagnose and treat common dermatoses without referring patients to dermatologists. However, physicians who are not dermatologists have difficulty in diagnosing and treating common dermatoses. We have made up a questionnaire about treatment and a slide test for clinical diagnosis of common dermatoses in order to evaluate the knowledge of physicians about common dermatoses, which reflects indirectly the current status of medical education of dermatology in Korea and can be used as a basic data for modifying directions for education in medical college. Total 654 physicians answered the questionnaire, including 125 just graduated general physicians, 111 general physicians who had just finished internship and 418 medical specialists. 11 data from dermatologists were analyzed as a control for evaluation. The result showed that 84%(545) of them have difficulty in diagnosing dermatologic diseases. The probable causes answered by them are lack of easy illustrative textbook for general physician(48%), inadequate education of dermatology in their medical colleges(27%) and so on. In the field of therapy in the questionnaire, only 53% of them had proper knowledge about indication of topical steroids, 56% about acne therapy, 22% about treatment of tinea pedis, 35% about scabies and 41% about urticaria. The average score was 53%. The score of family medicine group and urologist group was 69% and 66% each, which were significantly higher than that of other major groups except 98% of dermatologist group. In the slide test for clinical diagnosis, the average score was 71%. The score of family medicine group which had received postgraduate education on dermatology in their resident training was 84%, also significantly higher than that of other major groups except 100% of dermatologist group. The percentage of correct responders about tinea faciei is only 13%, tinea versicolor 42%, tinea cruris 49%, impetigo 53%, pityriasis rosea 60%, atopic dermatitis 67%, psoriasis 72% and fixed drug eruption 74%, etc. The average score was 71%. In conclusion, this study showed that physicians who are not dermatologists have difficulty in diagnosing and treating even common dermatoses. We think it is important to put stress on the common dermatoses in the field of dermatologic education in medical college. Moreover we could find the importance and need of postgraduate education on dermatology in the resident training of primary care physicians such as not only family medicine doctors but also internists and pediatricians.
Acne Vulgaris ; Dermatitis, Atopic ; Dermatology ; Diagnosis ; Drug Eruptions ; Education ; Education, Medical ; Humans ; Impetigo ; Internship and Residency ; Korea ; Physicians, Primary Care ; Pityriasis Rosea ; Psoriasis ; Scabies ; Skin Diseases* ; Specialization ; Steroids ; Tinea ; Tinea Pedis ; Tinea Versicolor ; Urticaria ; Surveys and Questionnaires

No abstract available.
Hernia*

OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

It has been known that childhood bipolar disorder is rare, especially combined with attention deficit hyperactivity disorder (ADHD). But, recent studies reported that childhood bipolar is more common than our guess. Many symptoms of childhood mania overlapped with ADHD, so it is difficult to differentiate from ADHD. It also often reported that psychostimulants, medication for ADHD, induce manic symptoms. Clinically, childhood mania has several characteristics. It is frequently chronic, mixed type, rapid cycling and often refractory to treatment. So it is important to diagnose, differentiate, treat childhood bipolar disorder and ADHD, but there is no report about comorbidity, treatment, clinical characteristics about that. We report a patient combined ADHD, mental retardation and childhood bipolar disorder.
Attention Deficit Disorder with Hyperactivity* ; Bipolar Disorder* ; Child* ; Comorbidity ; Humans ; Intellectual Disability*

Four cases medical accidents related to the iatrogenic injury of neck vessels are reported. The first case was a 54-year-old woman. Under the diagnosis of the herniated cervical disc, the operation was performed. After five hours from starting the operation, respiratory difficulty, facial cyanosis and syncope were found, suddenly. The autopsy finding were large hematoma at the posterior portion of neck organ and perforation of right carotid artery. The second case was a 61-year-old woman. Under the diagnosis of the aneurysm of the anterior communicating artery, the coiling and embolization were performed. After one hour from removal of catheter of right carotid artery, respiratory difficulty, facial cyanosis and syncope associated with right neck hematoma were found, suddenly. Eventually, she died after 41 days due to hypoxic brain injury. The third case was a 55-year-old woman. Under the diagnosis of the thyroid cancer, total thyroidectomy was performed. After three hours from operation, respiratory difficulty, facial cyanosis and syncope associated with severe neck hematoma were found, suddenly. Eventually, she died after 25 days due to hypoxic brain injury. The last case was a 34-year-old man. He visited the hospital due to stab wound of left neck. The irrigation and simple suture were performed at the first visit. After he went home, respiratory difficulty and syncope were found, suddenly. He returned the hospital and cardiopulmonary resuscitation was performed. However, he died. The autopsy finding were large hematoma around the neck organ and stab wound of left carotid artery.
Adult ; Aneurysm ; Arteries ; Autopsy* ; Brain Injuries ; Cardiopulmonary Resuscitation ; Carotid Arteries ; Catheters ; Cyanosis ; Diagnosis ; Female ; Hematoma ; Humans ; Middle Aged ; Neck* ; Sutures ; Syncope ; Thyroid Neoplasms ; Thyroidectomy ; Wounds, Stab

A schwannoma is a benign neurogenic tumor derived from Schwann cells. A rare case of a large painful schwannoma in the foot with metatarsal deformity was presented. Due to suspicion of malignancy, amputation had been recommended previously. We report on a rare case of a large forefoot schwannoma causing pain and paresthesia of the forefoot.
Amputation ; Foot ; Foot Deformities ; Neurilemmoma* ; Paresthesia ; Schwann Cells

We reports a woman's death caused by massive intraabdominal hemorrhage, who was in chronic alcoholic state with advanced liver cirrhosis and found dead in her room. No macroscopic source for the bleeding was found in her intraabdomen and there was no circumstances of traumatic forces to the individual's body around the death. The presenting unsuspected death could be consistent with the forensic pathological cases described as sudden, unexpected death due to massive nontraumatic intraabdominal hemorrhage in association with liver cirrhosis by DiMaio in 1987.
Alcoholics ; Hemorrhage* ; Humans ; Liver Cirrhosis* ; Liver*

AHCC (Active Hexose Correlated Compounds), which was at first extracted from cultured broth of Basidiomycotina, is known to be one of the Biological Response Modifiers (BRM). We examined the protective effects of AHCC on carbon tetrachloride (CCl4) and thioacetamide (TAA)-induced liver injury in mice. The AHCC pretreatment prevented the suppression of several physiological and biochemical parameters in the mice injected with CCl4 or TAA for 5 days. The liver weights and serum ALT and AST levels were increased by CCl4 or TAA, the degree of which was significantly reduced with the AHCC pretreatment. The AHCC pretreatment induced increasing activity of GST (glutathione s-transferase) and showed an increasing tendency of P450 and EROD (ethoxyresorufin o-dealkylation). The AHCC pretreatment also showed negative effects against the suppression of drug metabolizing enzymes, such as P450, EROD, and GST induced by CCl4 or TAA. AHCC pretreatment showed protective effects with significant inhibition of fatty change, inflammation, and necrosis in CCl4 and TAA intoxicated mice liver. The present study suggests that the protective effect of AHCC pretreatment might be related to the protection of liver from the drug induced liver injury in mice model.
Animals ; Carbon Tetrachloride ; Cytochrome P-450 CYP1A1 ; Drug-Induced Liver Injury* ; Immunologic Factors ; Inflammation ; Liver ; Mice* ; Necrosis ; Thioacetamide ; Weights and Measures

Neuronal migrational disorders of the brain represent abnormalities in the formation of the neocortex caused by faulty migration of the subependymal neuroblasts. The neuroblasts normally migrate between the sixth and 15th gestational week and in doing so form the six-layered neocortex. When the migration does not occur in a normal fashion the resultant brain anomalies include lissencephaly, pachygyria, schizencephaly, hemimegalencephaly, heterotopia, and polymicrogyria. Neuronal heterotopia is a collection of nerve cells in abnormal locations as a result of arrest of their radial migration, improper formation, or destruction of the radial glial fiber. We reported a case of neuronal heterotopia with brief review of related literatures.
Agenesis of Corpus Callosum ; Brain ; Lissencephaly ; Malformations of Cortical Development ; Neocortex ; Neuronal Migration Disorders ; Neurons*