No abstract available.
Blood Glucose* ; Glucose* ; Humans ; Infant, Newborn*

PURPOSE: To evaluate the specif!c radiologic findings of the dysgenesis of corpus callosum(CCD) on CT and/or MR images. MATERIALS AND METHODS: The authors reviewed retrospectively CT and/or MR images of 10 patients with CCD. After classifying CCD into partial and total type according to the degree of its development, we investigated structural abnormalities on CT and/or MR images resulting from or related to CCD and then associated anomaly. RESULTS: The most common findings of CCD on axial planes of CT and/or MR images were dilatation of posterior part of the lateral ventricles(8/10) and feature of the bodies of the both lateral ventricles(8/10) in parallel. Sagittal and coronal planes of MR demonstrated exact extent of dysgenesis of the corpus callosum(5/5) and radiating pattern of gyri in medial surface of cerebral hemisphere extending to the 3rd ventricle without interruption by cingulate sulcus(4/5). CONCLUSION:MR image of mid-sagittal plane appeared most useful in diagnosis of CCD because of its direct depiction of the whole length of corpus callosum. In most cases, however, CCD can be easily diagnosed with CT scan by characteristic findings of dilatation of the posterior part of lateral ventricles and paralleling of the lateral ventricles.
Cerebrum ; Corpus Callosum ; Diagnosis ; Dilatation ; Humans ; Lateral Ventricles ; Retrospective Studies ; Tomography, X-Ray Computed

Purpose: Recently, microRNA (miRNA) has been evaluated to provide a new diagnostic and therapeutic modality hepatocellular carcinoma (HCC) and other tumors. They are small non-coding RNA molecules that function as transcriptional and post-transcriptional regulators of gene expression by silencing target genes. The aim of this study was to evaluate the clinical significance of microRNA-18a, 221 (miR-18a, miR-221) expression in HCC formalin-fixed paraffin-embedded (FFPE) tissue. Methods: miR-18a and miR-221 expressions were assessed by reverse transcription and real-time quantitative reverse transcription polymerase chain reaction in 50 pairs of FFPE HCC and the adjacent noncancerous liver tissues. And we evaluated the expression level in HCC tissues as compared with their adjacent noncancerous counterparts. And the relationship between miR-18a, miR-221 level and clinicopathological data and survival rates were analyzed. Results: miR-221 and miR-18a were overexpressed in HCC tissue as compared with their adjacent noncancerous liver tissue (P<0.001). miR221 expression was found to be correlated with larger tumor size (P=0.048). miR-18a expression was correlated with modified Union for International Cancer Control stage (P=0.05). The overall survival (P=0.02) of HCC patients with high miR-221 expression was significantly poorer compared to those patients with low expression. Multivariate analyses demonstrated that miR-221 may be a poor prognostic factor of HCC patients. Conclusion High expression of miR-221 in FFPE tissues could provide significance for prognosis of HCC patients. Although, miR-18a expression was significantly upregulated in HCC tissues, they are not correlated with prognosis. Further large prospective studies are needed to determine their clinical significance.

PURPOSE: Adrenal tumor is relatively rare disease. But according to the development of diagnostic tools, their incidence is rising. Therefore, new concept of surgical treatment for adrenal tumor should be established. METHODS: We analysed medical records for 41 cases of adrenal tumor patients who was performed adrenalectomy at Samsung Medical Center from Sep. 1994 to Apr. 1997. RESULTS: 39 cases were adenoma and 2 were adenocarcinoma. 24 cases were functioning tumors. Of these, 4 were Cushing's syndrome, 12 were pheochromocytoma and 8 were primary aldosteronism. Mean age for the patients was 45.6 years old. Among various diagnostic tools, abdominal CT scan was particularly helpful for diagnosis and localization. 2 cases of pheochromocytoma were MEN II. So, when we treat pheochromocytoma, a possibility of MEN II should be considered. CONCLUSION: 2 cases of 12 pheochromocytoma were proven to MEN II. So, when we treat pheochromocytoma, a possibility of MEN II should be considered. Considering improvement of surgical technique, such as laparoscopic adrenalectomy, we could consider more aggressive treatment for adrenal tumors.
Adenocarcinoma ; Adenoma ; Adrenalectomy ; Cushing Syndrome ; Diagnosis ; Humans ; Hyperaldosteronism ; Incidence ; Medical Records ; Multiple Endocrine Neoplasia Type 2a ; Pheochromocytoma ; Rare Diseases ; Tomography, X-Ray Computed

BACKGROUND: Adrenal tumor is relatively rare disease. But according to the development of diagnostic tools, their incidence is rising. Therefore, new concept of surgical treatment for adrenal tumor should be established. METHODS: We analysed medical records for 41 cases of adrenal tumor patients who was performed adrenalectomy at Samsung Medical Center from Sep. 1994 to Apr. 1997. RESULTS: 39 cases were adenoma and 2 were adenocarcinoma. 24 cases were functioning tumors. Of these, 4 were Cushing's syndrome, 12 were pheochromocytoma and 8 were primary aldosteronism. Mean age for the patients was 45.6 years old. Among various diagnostic tools, abdominal CT scan was particularly helpful for diagnosis and localization. 2 cases of pheochromocytoma were MEN II. So, when we treat pheochromocytoma, a possibility of MEN II should be considered. CONCLUSION: 2 cases of 12 pheochromocytoma were proven to MEN II. So, when we treat pheochromocytoma, a possibility of MEN II should be considered. Considering improvement of surgical technique, such as laparoscopic adrenalectomy, we could consider more aggressive treatment for adrenal tumors.
Adenocarcinoma ; Adenoma ; Adrenalectomy ; Cushing Syndrome ; Diagnosis ; Humans ; Hyperaldosteronism ; Incidence ; Medical Records ; Multiple Endocrine Neoplasia Type 2a ; Pheochromocytoma ; Rare Diseases ; Tomography, X-Ray Computed

PURPOSE: We observed excessive renal excretion of salt and water, without underlying renal diseases or definite causes, accompanied with severe hypotension in critically ill patients. This study investigates the clinical courses and characteristics of these patients. METHODS: We retrospectively analyzed 13 patients with polyuria of unknown origin, which persited equal to or longer than 3 days, among hypotensive patients, who were admitted to intensive care unit. RESULTS: The causes of hypotension included sepsis in 11 patients and adrenal insufficiceny in one patient. The cause of hyptension was unknown in one patient. Vassopressors were used in all patients, and hypotension persisted for 13.2+/-8.6 days. Polyuria persisted for 10.6+/-8.2 days, and the duration of polyuria was strongly correlated with that of hypotension (R=0.919, p<0.001). Low dose steroid was used in 8 patients for the treatment of hypotension, and hypotension improved in 3 patients within 2 days after steroid administration. Four patients died during the hosptialization, and the duration of hypotension in non-survivors was greater than that in survivors (21.2+/-9.7 days and 9.6+/-5.2 days respectively, p=0.020). CONCLUSION: In critically ill patients with severe hypotension, we observed 13 cases of inappropriate natriuresis and polyuria. These results suggest that the persistence of poyluria and hypotension might affect the prognosis of these patients, and adrenal insufficicieny might be associated with this appearance in some patients. Further studies are needed to establish causes and treatments for this appearance.
Adrenal Insufficiency ; Critical Illness ; Humans ; Hypotension ; Intensive Care Units ; Natriuresis ; Polyuria ; Prognosis ; Retrospective Studies ; Sepsis ; Survivors

Acrodermatitis enteropathica due to zinc deficiency is characterized by periorificial dermatitis, alopecia, and intractable diarrhea. Here we report a case of transient acrodermatitis enteropathica in a 2-month-old preterm infant, whose skin is erythematous, scaly, eczematous, with an eruption starting from the periorificial area. While her serum zinc level was normal at 118.2 ug/dL, the serum alkaline phosphatase level was low at 48 IU/L and the serum alkaline phosphatase level get increased concordant with clinical improvement after zinc supplementation. Hence, this case shows that the diagnosis of zinc deficiency can be aided with a low level of serum alkaline phoaphatase although serum zinc level is normal.
Acrodermatitis ; Alkaline Phosphatase ; Alopecia ; Dermatitis ; Diarrhea ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Skin ; Zinc

We report the case of a recurrent carotid cavernous fistula (CCF) originating from a giant cerebral aneurysm (GCA) after placement of a covered stent. A 47-year-old woman presented with sudden onset of severe headache, and left-sided exophthalmos and ptosis. Cerebral angiography revealed a CCF caused by rupture of a GCA in the cavernous segment of the left internal carotid artery. Two covered stents were placed at the neck of the aneurysm. The neurological symptoms improved at first, but were aggravated in the 6 months following the treatment. Contrast agent endoleak was seen in the distal area of the stent. Even though additional treatments were attempted via an endovascular approach, the CCF could not be cured. However, after trapping the aneurysm using coils and performing superficial temporal artery-middle cerebral artery bypass, the neurological symptoms improved. In cases of recurrent CCF originating from a GCA after placement of a covered stent, it is possible to treat the CCF by endovascular trapping and surgical bypass.
Aneurysm ; Carotid Artery, Internal ; Carotid-Cavernous Sinus Fistula ; Cerebral Angiography ; Cerebral Arteries ; Endoleak ; Exophthalmos ; Female ; Fistula* ; Headache ; Humans ; Intracranial Aneurysm* ; Middle Aged ; Neck ; Rupture ; Stents*

BACKGROUND: Coughing during emergence from general anesthesia is a common clinical problem and results in a number of undesirable side effects. Remifentanil stimulate micron-opioid peptide receptor known to be related to antitussive effect. The goal of this study was to evaluate the effect of remifentanil on coughing after general anesthesia with desflurane. METHODS: Fifty one ASA physical status I and II patients undergoing elective oral and maxillofacial surgery were randomly assigned to receive either remifentanil with 1 ng/ml effect site concentration or normal saline until extubation. The number and intensity of coughs were monitored during emergence and the recovery time was recorded. RESULTS: The incidence and number of coughing during emergence was significant less frequent in the remifentanil group (P < 0.05). The intensity of coughing was significant milder in the remifentanil group (P < 0.05). There was no significant difference between two groups in the recovery time. CONCLUSIONS: Continuous remifentanil infusion with 1 ng/ml effect site concentration during emergence from general anesthesia with desflurane decrease the incidence of coughing without delaying the recovery time.
Anesthesia, General ; Cough ; Humans ; Incidence ; Isoflurane ; Piperidines ; Receptors, Peptide ; Surgery, Oral

PURPOSE: Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries in the world today. However, there is no consensus regarding whether LC can be performed in patients with acute cholecystitis while on antithrombotic therapy. The objective of our study was to describe postoperative outcomes of patients who underwent emergent LC without interruption to antithrombotic therapy. METHODS: We performed a retrospective review of patients who underwent LC for acute cholecystitis while on antithrombotic therapy from 2010 to 2015 at Soonchunhyang Universtiy Cheonan Hospital. Patients were divided into 2 groups as underwent emergent LC and elective LC. RESULTS: A total of 67 patients (emergent group, 22; elective group, 45) were included in the analysis. Elective group had significantly longer duration between the admission and operation (8 [7–10] days vs. 2 [1–3] days, P < 0.001) and longer duration of antithrombotic drugs discontinuation (7 days vs. 1 [0–3] days, P < 0.001). Emergent group had significantly more postoperative anemia (6 patients vs. 0 patient, P = 0.001) and 3 of 6 patients received packed RBC transfusion in postoperative period. However, there was no significant difference in length of postoperative stays, length of intensive care unit stays and mortality rates. CONCLUSION: Emergent LC without interruption to antithrombotic therapy was relatively safe and useful. A well-designed multicenter study is needed to confirm the safety and efficacy of LC without suspension of antithrombotic therapy and to provide a simple guideline.
Anemia ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Chungcheongnam-do ; Consensus ; Humans ; Intensive Care Units ; Mortality ; Postoperative Period ; Retrospective Studies