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

BACKGROUND: The changes of serum TNF-alpha, sTNFR, sIL-2R and sICAM-1 levels have been recently reported in some cancer patients but the clinical significance of these cytokines is not clearly established. To define the changes and clinical significance of these cytokines in patients with hepatocellular carcinoma (HCC), serum levels of TNF- alpha, sTNFR, sIL-2R and sICAM-1 were measured. METHODS: The serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM-1 were measured before and after transarterial chemoembolization (TACE) by enzyme immunoassay in 20 patients with HCC and 10 adult healthy subjects as controls. These patients were divided into two groups, no response (NR, 14 cases) and partial response (PR, 6 cases) on the basis of changes of tumor size, new growth foci on the ultrasonographic or CT findings, and serum levels of alpha-fetoprotein. RESULTS: Serum levels of TNF-alpha, sTNFR, sIft-2R and sICAM-1 were significantly higher in all patients with HCC than in those of adult healthy controls (p<0.01). Serum levels of TNF-alpha after TACE tended in to be higher in comparison with those before TACE in the NR group (p<0.1), but those were not significantly different between before and after TACE in the PR group. Serum levels of sTNFR, sIL-2R and sICAM-1 were not significantly different between after and before TACE in both groups. CONCLUSIONS: These results suggest that serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM:-1 in patients with HCC before therapy are significantly increased, compared with those of the control group, and the measurement of serum TNF-alpha levels may become useful in the diagnosis and monitoring of hepatocellular carcinoma in the future.
Adult ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cytokines ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Tumor Necrosis Factor-alpha*

BACKGROUND: The changes of serum TNF-alpha, sTNFR, sIL-2R and sICAM-1 levels have been recently reported in some cancer patients but the clinical significance of these cytokines is not clearly established. To define the changes and clinical significance of these cytokines in patients with hepatocellular carcinoma (HCC), serum levels of TNF- alpha, sTNFR, sIL-2R and sICAM-1 were measured. METHODS: The serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM-1 were measured before and after transarterial chemoembolization (TACE) by enzyme immunoassay in 20 patients with HCC and 10 adult healthy subjects as controls. These patients were divided into two groups, no response (NR, 14 cases) and partial response (PR, 6 cases) on the basis of changes of tumor size, new growth foci on the ultrasonographic or CT findings, and serum levels of alpha-fetoprotein. RESULTS: Serum levels of TNF-alpha, sTNFR, sIft-2R and sICAM-1 were significantly higher in all patients with HCC than in those of adult healthy controls (p<0.01). Serum levels of TNF-alpha after TACE tended in to be higher in comparison with those before TACE in the NR group (p<0.1), but those were not significantly different between before and after TACE in the PR group. Serum levels of sTNFR, sIL-2R and sICAM-1 were not significantly different between after and before TACE in both groups. CONCLUSIONS: These results suggest that serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM:-1 in patients with HCC before therapy are significantly increased, compared with those of the control group, and the measurement of serum TNF-alpha levels may become useful in the diagnosis and monitoring of hepatocellular carcinoma in the future.
Adult ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cytokines ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Tumor Necrosis Factor-alpha*

Paraffinoma is a well known complication of previous paraffin injection into the subcutaneous layer that presents as various conditions including firm mass formation, edema, induration, ulceration, and skin necrosis. Paraffinoma can mimic neoplasm on physical examination and imaging studies and may complicate ultrasonographic diagnoses due to typical posterior shadowing and high echogenicity. When paraffinomas involve around the thyroid gland, the diagnosis of thyroid tumors is very difficult. We present a case of thyroid cancer, the evaluation of which was complicated by the presence of cervical paraffinoma.
Edema ; Hydrazines ; Necrosis ; Paraffin ; Physical Examination ; Shadowing (Histology) ; Skin ; Thyroid Gland ; Thyroid Neoplasms ; Ulcer

Idiopathic neuralgic amyotrophy (INA) is known as Parsonage-Turner syndrome or idiopathic brachial plexitis and is characterized by sudden onset of severe limb pain, followed by weakness and atrophy of limb. There is no specific tests for the diagnosis of INA. The diagnosis of INA is mainly dependent on the clinical history and electrodiagnostic study. It is often confused with more common disorders such as acute cervical radiculopathy, rotator cuff tear, or acute calcific tendinitis. A few recent reports have revealed that magnetic resonance image (MRI) of brachial plexus and shoulder can be helpful in the diagnosis of INA. We report two cases of classic INA in which MRI enhanced specificity and confidence in the diagnosis. MRI of the brachial plexus and corresponding limb as well as cervical spine should be included in patients clinically suspected of INA.
Atrophy ; Brachial Plexus ; Brachial Plexus Neuritis* ; Diagnosis ; Extremities ; Humans ; Magnetic Resonance Imaging ; Radiculopathy ; Rotator Cuff ; Sensitivity and Specificity ; Shoulder ; Spine ; Tendinopathy

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*

PURPOSE: To determine the usefulness of fluid attenuated inversion recovery(FLAIR) imaging for the in detection of high signal intensity of hippocampus or amygdala in mesial temporal sclerosis (MTS), compared with that of turbo spin-echo T2-weighted imaging. MATERIALS AND METHODS: Two neuroradiologists independently analyzed randomly mixed MR images of 20 lesions of 17 patients in whom MTS had been diagnosed, and ten normal controls. All subjects underwent both who performed both FLAIR and turbo spin-echo T2-weighted imaging, in a blind fashion. In order to determine hippocampal morphology, oblique coronal images perpendicular to the long axis of the hippocampus were obtained. The detection rate of high signal intensity in hippocampus or amygdala, the radiologists 'preferred imaging sequence, and intersubject consistency of detection were evaluated. Signal intensity in hippocampus or amygdala was considered high if substantially higher than signal intensity in the cortex of adjacent temporo-parietal lobe. RESULTS: In all normal controls, FLAIR and spin-echo T2-weighted images showed normal signal intensity in hippocampus or amygdala. In MTS, the mean detection rate of high signal intensity in hippocampus or amyg-dala, as seen on FLAIR images was 93%, compared with 43% on spin-echo T2-weighted images. In all cases in which signal intensity on FLAIR images was normal, signal intensity on spin-echo T2-weighted images was also normal. The radiologists preferred the contrast properties of FLAIR to those of spin-echo T2-weighted images. CONCLUSION: In the diagnosis of MTS using MRI, FLAIR images are more useful for the detection of high signal intensity of hippocampus or amygdala than are spin-echo T2-weighted images. In the diagnosis of MTS, FLAIR imaging is therefore a suitable alternative to spin-echo T2-weighted imaging.
Amygdala ; Axis, Cervical Vertebra ; Diagnosis ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Sclerosis

OBJECTIVE: In accordance with the increasing number of elderly people in our society, the incidence of pedicle screw fixation which is a technically demanding procedure and requires a lengthy operation time has increased in the patients with lumbars instability over 60 years old. To ascertain the outcome and efficacy of the pedicle screw fixation in patients over 60 years old, we analyzed the surgical results including complications. PATIENTS AND METHOD: From May, 1994 to September, 1997, we assessed 30 patients over 60 years of age and 159 patients under the age of 60 with lumbar spinal instability who underwent surgery of pedicle screw fixation and compared with the results of surgery between two groups. RESULTS: For the elderly, the average operation time was 244 minutes and the transfusion amount was 3.3 pints. For younger patient the average operation time was 246 minutes and the transfusion amount was 3.2 pints. Four surgical complications occurred; two patients with voiding difficulty, one patient with heart problem, and a patient with DIC(Disseminated Intravascular Coagulation). However, all complications were controlled without further problems. The success rate in the elderly was 60%, which was lower than the success rate of 76% among younger patients. CONCLUSION: Considering the condition of the diseases in the elderly and the fact that the operations were performed without any major problems, these results are acceptable. Based on our analysis, it is our view that advanced age per se should not be regarded as a contraindication for pedicle screw fixation.
Aged ; Follow-Up Studies* ; Heart ; Humans ; Incidence ; Middle Aged*

No abstract available.
Humans

7 Korean dogs were anesthetized with oxygen and isoflurane in different concentrations (1 vo1.%, 2 vo1.%, 3 vo1.%). Cardiovascular effects of isoflurane in different concentrations were investigated. The results were as follow: 1) Heart rate was decreased significantly (p<0.05) following increase of isoflurane concentrations. 2) Mean arterial blood pressure was decreased significantly (p<0.05) following increase of isoflur- ane concentrations. 3) Cardiac index was decreased significantly (p<0.05) following increase of isoflurane concentra- tions. 4) Left ventricular stroke work index was decreased significantly (p<0.05) following increase of isoflurane concentrations. 5) Pumonary artery pressure and pumonary artery wedge pressure were decreased significantly (p<0.05) following increase of isoflurane, but there were no significant changes in central venous pressure, systemic vascular resistance and pulmonary vascular resistance.
Animals ; Arterial Pressure ; Arteries ; Central Venous Pressure ; Dogs* ; Heart Rate ; Isoflurane* ; Oxygen ; Pulmonary Wedge Pressure ; Stroke ; Vascular Resistance