No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Humans ; Living Donors*

No abstract available.
Humans ; Living Donors*

PURPOSE: Tethered cord syndrome(TCS) is defined as low position of the conus medullaris by the abnormally fixed spinal cord with progressive neurologic deficit MATERIALS AND METHODS: To evaluate the findings of TCS at MRI and its diagnostic value, we performed a retrospective analysis of MRI of 30 patients with emphasis on clinical manifestation, level of conus medullaris, cause of tethering, and associated findings. RESULTS: Clinical presentation included back mass(26 cases), neurogenic bladder(5 cases), urinary incontinence(5 cases), progressive constipation(2 cases), skin dimpling(1 case), gait disturbance(1 case) and club foot (1 case). Neurologic deficit was developed in 11 cases(40% and mean age of these patients at the time of diagnosis was 8.6 years. The most common cause of tethering was lipoma(63%). The tips of conus medullaris were below the level of the second lumbar spine in all patients. The causes of tethering were lipomatous component(spinal lipoma and lipomyelomenigocele) in 67% myelomeningocele in 20%, presacral mass in 7%, thickened filum terminale in 3% and postoperative change in 3%. Associated anomalies included syringomyelia(20%) and hydrocephalus was associated in 3 out of 5 patients who underwent brain MRI. CONCLUSION: MRI clearly delineated the location of conus, tethering of the filum terminale with their causes and associated abnormalities. MRI examination is a very useful diagnostic tool for the early evaluation of TCS and the postoperative follow up.
Brain ; Cauda Equina ; Conus Snail ; Diagnosis ; Follow-Up Studies ; Foot ; Gait ; Humans ; Hydrocephalus ; Lipoma ; Magnetic Resonance Imaging ; Meningomyelocele ; Neural Tube Defects* ; Neurologic Manifestations ; Retrospective Studies ; Skin ; Spinal Cord ; Spine

Nutcracker syndrome consists in the compression of the left renal vein by an aortomesenteric clamp. This results in left renal venous hypertension leading to the development of collateral veins with intrarenal and perirenal varicosities which can cause hematuria. The main presenting symptom is hematuria with or without left flank pain. It responds successfully to surgical treatment. We report a case of anesthesia for a nutcracker syndrome patient.
Anesthesia ; Flank Pain ; Hematuria ; Humans ; Hypertension ; Renal Veins ; Veins

Objective: Imaging modalities such as intravascular ultrasonography or computed tomography or angiography have shown limitations in assessing coronary calcification. In this study, we investigated whether quantitative indices of optical coherence tomography (OCT) in calcified lesions are correlated with the late outcome of a coronary stent. Methods: We consecutively enrolled patients who had more than grade 2 coronary calcification on fluoroscopy. OCT was performed at baseline, immediately after stenting, and at 9 months after stenting. We analyzed qualitative and quantitative characteristics of plaque, calcification, and stent-related indices. Results: All images of 3-time points were available in a total of 10 patients. Calcified lesions were frequently associated with thin cap fibroatheroma (100%), plaque erosion (20%), or rupture (20%) before the procedure. Thrombus was found in 100% of cases in the OCT immediately after stenting. Maximal calcium area before stenting was strongly correlated with late luminal loss assessed by 9-month follow-up OCT (r= 0.766, P= 0.01). Conclusion Preprocedural OCT assessment on calcified coronary lesion may predict high-risk procedure and late stent outcome. Further studies are warranted to confirm these findings.

Objective: Imaging modalities such as intravascular ultrasonography or computed tomography or angiography have shown limitations in assessing coronary calcification. In this study, we investigated whether quantitative indices of optical coherence tomography (OCT) in calcified lesions are correlated with the late outcome of a coronary stent. Methods: We consecutively enrolled patients who had more than grade 2 coronary calcification on fluoroscopy. OCT was performed at baseline, immediately after stenting, and at 9 months after stenting. We analyzed qualitative and quantitative characteristics of plaque, calcification, and stent-related indices. Results: All images of 3-time points were available in a total of 10 patients. Calcified lesions were frequently associated with thin cap fibroatheroma (100%), plaque erosion (20%), or rupture (20%) before the procedure. Thrombus was found in 100% of cases in the OCT immediately after stenting. Maximal calcium area before stenting was strongly correlated with late luminal loss assessed by 9-month follow-up OCT (r= 0.766, P= 0.01). Conclusion Preprocedural OCT assessment on calcified coronary lesion may predict high-risk procedure and late stent outcome. Further studies are warranted to confirm these findings.

Localized nodular myositis is an uncommon benign inflammatory myopathy of unkonwn cause affecting skeletal muscle and, presenting as a localized painful swelling within the soft tissue of an extremity. Histological examination reveals lymphocytic infiltration, scattered muscle fiber necrosis and regeneration, and interstitial fibrosis. MRI finding is an enhancement with increased signal intensity around the lesion. We report two cases of localized nodular myositis presenting as pseudothrobothrombophlebitis. We believe this is the first case report of localized nodular myositis in Korea.
Extremities ; Fibrosis ; Korea ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Myositis* ; Necrosis ; Regeneration

BACKGROUND: Recent evidence indicates that neurokinins released from cutaneous C-fibers can function as inflammatory mediators by activating cells of the immune system such as lymphocytes, monocytes and mast cells. Substance P (SP) induces normal human keratinocytes (KCs) to produce the cytokines, such as interleukin-1 alpha and the interleukin-1 receptor antagonist. KCs also have SP specific receptors, neurokinin-1. SP binds its specific receptors and mediates its biological effect to various cells in the skin. OBJECTIVE: To demonstrate that SP may induce transforming growth factor-alpha and interleukin-6 production from cultured KC. METHODS: Normal human neonatal foreskins were obtained from circumcision and the epidermal KCs were cultured in Medium 154 without serum. TGF-alpha and IL-6 mRNA expression on SP stimulated KCs were analyzed by the northern blot method with the poly-A+ RNA preparations. The amount of secreted TGF-alpha protein from cell free supernatants was measured by the enzyme-linked immunosorbent assay method. In addition the KC proliferation effect of SP was examined by the measurement of DNA synthesis using the [(3)H]thymidine incorporation assay. RESULTS: The addition of SP to cultured KCs resulted in an increase in KC TGF-alpha mRNA expression but SP had no effect on KC IL-6 mRNA. KC TGF-alpha mRNA were increased at one hour after SP stimulation, and it slightly decreased at 3 hours but remained at an increased level compared to the control. Twenty four hours after 100 and 1000nM SP stimulation, the TGF-alpha protein level was increased in the supernatant. This result is consistent with that of northern blot analysis. Among SP fragments, S(7-11)P was active, but SP(1-7) had no effect. The [(3)H]thymidine assay showed that KC proliferation was inhibited only at 1,000 nM SP. CONCLUSION: SP induces TGF-alpha mRNA expression and increases the protein level in cultured KCs, but reduces the KC DNA synthesis. These results suggest that SP may play some roles in the pathogenesis of skin diseases showing KC proliferation such as psoriasis.
Blotting, Northern ; Circumcision, Male ; Cytokines ; DNA ; Enzyme-Linked Immunosorbent Assay ; Female ; Foreskin ; Humans* ; Immune System ; Interleukin-1 ; Interleukin-1alpha ; Interleukin-6 ; Keratinocytes* ; Lymphocytes ; Male ; Mast Cells ; Monocytes ; Psoriasis ; Receptors, Neurokinin-1 ; RNA ; RNA, Messenger ; Skin ; Skin Diseases ; Substance P* ; Transforming Growth Factor alpha

BACKGROUND: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates. METHODS: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. RESULTS: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital, 101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). CONCLUSION: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.
Death Certificates* ; Education ; Emergencies ; Mortality ; Retrospective Studies ; Seoul