Idiopathic thrombocytopenic purpura is an uncommon illness but most common form of thrombocytopema in pregnancy. Corticosteroids, splenectomy, immunosuppressive drugs, and immunoglobulin therapy have been recommended for manaaement. The optimal method of delivery is controversial. We have experienced a case of idiopathic thrombocytopenic purpura diagnosed previously and managed with corticosteroid and vincrstine, which was followed by pregnancy, vaginal delivery and postpiirtum splenectomy.
Adrenal Cortex Hormones ; Immunization, Passive ; Pregnancy* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

We have recently experienced a clinically atypical case of malignant histiocytosis involving the spleen, ileum and bone marrow, in a 25-year-old Korean male. He was admitted to our hospital because of multiple purpuric lesions of skin which had been appearing since 2 years ago. Physical and laboratory examinations revealed marked splenomegaly with pancytopenia. With clinical impression of hypersplenism, splenectomy was performed. During the operation, the surgeons found a dark red mucosal lesion in the ileum incidentally, to resect the segment. Microscopic findings of the spleen and the ileal lesion showed extensive proliferation of atypical histiocytes, many of them phagocytosing numerous erythrocytes. Bone marrow biopsy was done for follow-up study, which showed increased cellularity with infiltration of atypical histiocytes.
Follow-Up Studies ; Biopsy

This study was conducted to examine and compare the characteristics in the cognitive functions of peritoneal dialysis, hemodialysis and normal kidney function groups as basic data for effectively educating dialysis patients. The data were collected from May 10 to October 30. 2000, collected from each of 20 patients with peritoneal dialysis, hemodialysis and normal Kidney function and who registered for the dialysis room at a general hospital affiliated to a university in Seoul and sampled by age and educational level through personal interviews with the researchers of this study. As a measuring tool, MMSE developed by Folstein et al.(1975) to measure cognitive function disorder was used, slightly revised for hemodialysis patients. Collected data were processed into frequency, percentage, mean, and standard deviation by the use of SAS. The results of this study are as follows: 1.With a maximum of 30 points for cognitive function, the mean of the peritoneal dialysis patients was 27.06+/-2.06, while that of the hemodialysis patients was 27.25+/-2.76; that of the normal Kidney function patients was 27.85+/-2.00, indicating no significant difference among those three groups. 2. As for the subjects who scored 23 points, the turning point of confirming the cognitive disorder, the percentage was 5% in the case of the peritoneal dialysis, 10% in the case of the hemodialysis and 5% in the case of the normal Kidney function group. 3.Differences between the peritoneal dialysis and hemodialysis patients by gender, occupation, spouse, diabetes, hypertension, the period of dialysis, number of hospitalizations, and the use of erythropoietin were not significant in the scoring of cognitive function. 4. There was no significant correlation between the level of Hb, Hct, albumin, aluminium, PTH, BUN, Cr, dialysis adequacy and the cognitive function. Considering such results, it is clear that there is no significant difference in the cognitive functions of the sampled subjects. Therefore, the nurse in the dialysis room should continually carry out assessment and intervention against elements degrading the effect of patients' education to improve self-care.
Dialysis ; Education ; Erythropoietin ; Hospitalization ; Hospitals, General ; Humans ; Hypertension ; Kidney* ; Occupations ; Peritoneal Dialysis* ; Renal Dialysis* ; Self Care ; Seoul ; Spouses

The term myxosarcoma is currently not used in standard classification for soft tissue tumors, but restricted to cardiac tumors. Primary cardiac myxosarcoma is a very rare disease and is difficult to differentiate from myxoma clinically and pathologically. We report a case of left atrial myxosarcoma with widespread systemic metastasis in a 21-yr-old male. The patient presented with sudden onset of intermittent dyspnea and orthopnea. Echocardiography showed a mobile, pedunculated tumor, 7.5x5x2 cm in size, at left atrium. Histologically, the excised tumor showed an amorphous finely fibrillar and mucinous stroma, in which irregular cords and clusters of lepidic cells and large stellate cells with plump vesicular nuclei resembled the usual type of cardiac myxoma were noted. And it showed focally cellular area with great nuclear pleomorphism and frequent mitoses. The patient received combination chemotherapy, peripheral blood stem cell collection transplantation and operations for systemic metastases in the brain, skeletal muscle and lung. He is alive at present 37 months after initial diagnosis and has no more new metastatic lesion.
Adult ; Case Report ; Heart Neoplasms/therapy ; Heart Neoplasms/pathology* ; Human ; Male ; Myxosarcoma/therapy ; Myxosarcoma/secondary* ; Myxosarcoma/pathology*

OBJECTIVE: To evaluate the correlation of HPV infection and E6 oncoprotein expression with carcinogenesis and prognostic role of cervical carcinoma METHODS: Paraffin embedded tissues were obtained from 35 invasive cervical carcinoma, 15 carcinoma in situ, 12 dysplasia of cervix and 20 patients with benign uterine disease as control. HPV type was determined by polymerase chain reaction using type specific primers. E6 oncoprotein expression was analyzed by immunohistochemical staining using C1P5 mouse monoclonal antibody. RESULTS: 1. The positivity of HPV type 16 PCR in invasive cervical carcinoma was 77.1% and it was significantly higher than carcinoma in situ(53.3%), cervical dysplasia(25%), and control (10%). But the positivity of HPV type 18 was not correlated between above groups. 2. The positivity of HPV type 16/18 in cervical carcinoma was not correlated to patient's age. 3. The positivity of HPV in cervical carcinoma was correlated to clinical stage of cervical carcinoma but the positivity of HPV in cervical dysplasia was not correlated to the degree of dysplasia. 4. The positivity of E6 oncoprotein expression was 77.1% in invasive cervical carcinoma, 66.7% in carcinoma in situ and 20% in control group. E6 oncoprotein was not decteted among the cases which negative was for HPV 16/18. The E6 oncoprotein expression in 35 cases of invasive cervical carcinoma was negative in 8, weakly positive in 7, positive in 12, and strong positive in 8 ases. But in 20 cases of normal control group, there was no case of strong positive or posirive E6 oncoprotein expression. 5. The E6 oncoprotein expression was significantly correlated to the clinical stage and lymph node metastasis. The incidence of lymph node metastasis increased and the stage became higher as the E6 oncoprotein expression increased. CONCLUSION: These results suggest that HPV is one of the most important factors in the carcinogenesis of cervical carcinoma and the E6 oncoprotein expression may be associated with biological aggressiveness of cervical carcinoma.
Animals ; Carcinogenesis ; Carcinoma in Situ ; Cervix Uteri ; Female ; Humans* ; Incidence ; Lymph Nodes ; Mice ; Neoplasm Metastasis ; Paraffin ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms* ; Uterine Diseases

The authors reviewed 1134 pediatric patients in the ebergency room in this hospital during 5 years period from Jan. 1979. to Dec. 1979. The results were obtained as follows: 1) Among the patients visiting the emergency room, the patients under 15 years of age were 6.1%(1134) of total emergency patients(18447). 2) The male to female ratio was 1.5:1. 3) The highest age group was in the 3-5 years, and the patients in this age group were occupied 23.8%. The age distribution showed that 57.7% was under the 5 years of age. 4) Seasonal distribution of patients showed high incidence in summer(June, July, and Aug.). 5) The most popular time of visiting the emergency room was between 8:00 P.M. to 12:00 P.M. at which time about 32.8% of patients were seen. 6) Distribution of cases as follows: Respiratory disease 35.7%, accident 177% and gastrointestinal disease 14.8%, in turn, kusted reseoectuvely in decresing order of frequency. URI was the most frequency, 25.1% of the total cases, The next diseases were diarrhea(9.5%), Bronchitis(6.6%) and febrile convulsion(6.3%) in turn decreasing order. 7) The most frequent case in various age groups was Respiratory disease. 8) Admission rate of total pediatric patients visiting ER was 7.4% by recommendation. Rate against recommendation of admission was 3.2% of total pediatric patients visiting ER. 9) We think the number of pediatric emergent patient is increasing due to understanding of community inhabitant.
Age Distribution ; Emergencies* ; Emergency Service, Hospital* ; Female ; Gastrointestinal Diseases ; Humans ; Incidence ; Male ; Seasons ; Statistics as Topic*

BACKGROUND:We experienced unintentional hyperventilation during mechanical ventilation in infants under general anesthesia. It is very difficult to decide upon respiratory rate or tidal volume for adequate ventilation without respiratory gas monitoring. During pulmonary ventilation using a Mapleson D circuit, the utilization of high fresh gas flow dilutes the expired gas and causes an underestimation of end-tidal CO2. We undertook to find a proper respiratory rate (RR) with a fixed tidal volume during controlled ventilation in infant general anesthesia. METHODS: We studied 50 infants weighing below 10 kg during general anesthesia. An uncuffed endotracheal tube was selected 3.5 or 4.0 mm (inner diameter). After intubation with midazolam, thiopental sodium and vecuronium, controlled ventilation was applied: total fresh gas flow 3 L/minute, peak inspiratory pressure 15-20 cmH2O, and RR 19 or 20/minute. Arterial blood gas analysis was done 20 minutes later. We calculated the RR for a PaCO2 of 36 mmHg according to the equation: RR (applied) = estimated RR x estimated PaCO2/ideal PaCO2. In addition, linear regression was performed to analyze the relation between age and RR. RESULTS: The estimated regression equation for RR using Pearson's correlation coefficient was as follows: RR = 22.835 - 0.415 x age (months). CONCLUSIONS: The equation (RR = 22.835 - 0.415 x age [months]) could be used as an index for safe ventilatory management without severe hyper- or hypo-carbia in infants during general anesthesia.
Anesthesia, General* ; Blood Gas Analysis ; Humans ; Hyperventilation ; Infant* ; Intubation ; Linear Models ; Midazolam ; Pulmonary Ventilation ; Respiration, Artificial ; Respiratory Rate* ; Thiopental ; Tidal Volume ; Vecuronium Bromide ; Ventilation*

OBJECTIVES: The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. METHODS: Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. RESULTS: The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities( 50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). CONCLUSIONS: These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.
Adolescent ; Alcohol Drinking ; Counseling ; Drinking ; Humans ; Korea ; Male ; Prevalence ; Questionnaires ; Weights and Measures

From February 1996 to May 1997, 18 patients underwent mitral valve repair for mitral regurgitation. There were 9 male and 9 female patients aged from 19 to 68 years (mean, 53). Thirteen patients were in New York Heart Association (NYHA) class III and IV. The cause of mitral regurgitation was degenerative in 12 patients, rheumatic in 5 patients and infective in 1 patient. Fifteen patients were in Carpentier's functional classification II, 2 patients in Carpentier's class III and 1 patient in Carpentier's class I. Surgical procedures included prosthetic ring annuloplasty (16 cases), rectangular resection of posterior leaflet (15 cases), chordal shortening (5 cases), triangular resection of anterior leaflet (2 cases), commissurotomy (2 cases), partial transposition of posterior leaflet (1 case). These procedures were combined in most patients. There was no operative death. These patients have been followed from 1 to 15 months, mean of 6.7 months. There was one late death resulted from low cardiac output following mitral valve replacement. The function of the repaired valve in other 17 patients has remained satisfactory during the observed interval. We consider that mitral valve repair is highly satisfactory in patients with mitral regurgitation.
Cardiac Output, Low ; Classification ; Female ; Heart ; Humans ; Male ; Mitral Valve Insufficiency* ; Mitral Valve*

Pregnancy induced hypertension is multifaceted syndrome with variable involvement of several key organ systems, so sensitive and specific laboratory tests for predicting severity and prognosis. and early diagnosis of this disease are required. Because heme catabolism results in equimolar production of carboxyhemoglobin, iron and bilirubin, a concomittant rise of these parameters would provide confirmation of increased heme catabolism. Microangiopathic hemolytic anemia may occurs in severe preeclampsia, but it is not known whether increased red cell turnover - occurs with mild preeclampsia as complication. The purpose of this study was to confirm that increased heme catabolism also occurs in patients with mild preeclampsia. The analysis of data was done on 23 cases with mild preeclampsia and 35 normal pregnant women, who were admitted to Yeungnam University Hospital from October 1992 to March 1993. The results were as follows. 1. The mean antepartum serum iron concentration was significantly higher in the group with mild preeclampsia (86.5+/-6.1 microg/dl) than in the controls (53.2+/-5.3 microg/dl). 2. The mean antepartum and postpartum carboxyhemoglobin concentrations were significantly higher in the group with mild preeclampsia (antepartum : 2.55+/-0.42 mg/dl, postpartum 1.21+/-0.4 mg/dl) than the controls (antepartum : 0.61+/-0.2 mg/dl, postpartum 0.53+/-0.2 mg/dl) 3. During postpartum, carboxyhemoglobin concentration in preeclampsia reduced significantly from antepartum level, but there was no difference between antepartum and postpartum carboxyhemoglobin concentrations among controls. 4. Bilirubin concentrations were similiar in both groups
Anemia, Hemolytic ; Bilirubin ; Carboxyhemoglobin* ; Early Diagnosis ; Female ; Heme ; Humans ; Hypertension, Pregnancy-Induced ; Iron* ; Metabolism ; Postpartum Period ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Prognosis