PURPOSE: Leptin, a product of the ob gene, is a 16-KDa protein that is mainly expressed in the adipose tissue and involved in the regulation of body weight. Elevated levels of serum leptin is noted in pregnant woman and the placenta is the site of nonadipose tissue production of leptin. In this study, we investigated the effect of serum leptin concentrations on fetal growth to estimate the effect of leptin on fetal growth. METHOD: Leptin concentrations were measured in venous and arterial cord blood and maternal serum at birth using a specific radioimmunoassay employing human recombinant leptin(Human Leptin RIA kit; Linco research, St. Louis, Mo). Thirty two full term pregnant women(n=32) had no medical complications and delivered the healthy babies(male=14, female=18). RESULTS: Serum leptin levels were 1.51 - 19,36 ng/ml(mean 7.16, SD 3.76) in arterial cord blood and 1.59 - 16.18(mean 7.47, SD 4.08) in venous cord blood and there was no difference between arterial and venous cord blood. Serum concentrations in arterial and venous cord blood were positively correlated with birth weight(r=0.7181, 0.6970; p<0.0001). There was no correlation in maternal BMI, maternal serum leptin and cord blood leptin concentrations. CONCLUSION: These findings suggest that cord blood leptin independently contributes to fetal body weight regardless of maternal serum leptin and body weight.
Adipose Tissue ; Birth Weight* ; Body Weight ; Female ; Fetal Blood* ; Fetal Development ; Fetal Weight ; Humans ; Hypertension, Pregnancy-Induced* ; Leptin* ; Parturition* ; Placenta ; Pregnancy* ; Pregnant Women ; Radioimmunoassay

Klippel-Trenaunay-Weber syndrome is a rare, sporadically occuring disorder characterized by hemihypertrophy (unilateral limb hypertrophy), varicose veins, hemangiomata and occasionally arteriovenous malformation. With the development of ultrasonography, this syndrome can be detected by antenatal sonography. We report a case of Klippel-Trenaunay-Weber syndrome that demonstrates huge mass with increased blood flow on left thigh detected by ultrasonography.
Arteriovenous Malformations ; Extremities ; Klippel-Trenaunay-Weber Syndrome* ; Thigh ; Ultrasonography* ; Varicose Veins

Large intestinal Lipohyperplasia (LPH) is a poorly recognized lesion characterized by adipose tissue infiltration in the submucosal layer of the colon. Most of all, LPH developed at Ileoceal valve, especially upper lip which was called by ileocecal valve syndrome. For endoscopists and radiologists, it has often remained difficult to make a distinction from malignant neoplasia. We report here the case of a mild obese, 51-year-old man who had polypoid lipohyperplasia of the colon associated with extreme hyperplasia of the appendix. His chief complaint was recurrent intermittent abdominal pain. The colonoscopic finding was a submucosal tumor-like polypoid mass originating from appendix with smooth surface, But ileocecal valve was intact. Abdominal CT finding was 2.5 cm sized round heterogeneous low density mass like lesion with intratumoral fatty density of cecal tip area with enhancement of peripheral portion. In barium enema study, after retrograde filling of contrast, smooth extrinsic indentation of cecal tip with partial filling of appendix was seen. Histological exemination revealed infiltration of mature adipose tissue in the submucosal layer. Because of recurrent abdominal pain, ileocecal resection was performed at operation. We discuss the case and review the literatures on this subject.
Abdominal Pain ; Adipose Tissue ; Appendix* ; Barium ; Colon ; Enema ; Humans ; Hyperplasia ; Ileocecal Valve ; Lip ; Middle Aged ; Tomography, X-Ray Computed

Renal angiomyolipomas are benign mixed mesenchymal tumors, which are composed of atypical blood vessel, smooth muscle and fat cells. A 34-year-old woman presented with a palpable right abdominal mass, accompanied with discomfort. A CT scan showed a large right perinephric mass, with heterogeneous density, surrounding the kidney, with enlargement of the regional lymph nodes. The presumptive diagnosis was one of a malignant tumor of the retroperitoneum, with lymph node metastasis or an angiomyolipoma, involving both the kidney and lymph nodes. A right radical nephrectomy, including the tumor, was performed. The final diagnosis was an angiomyolipoma arising from the kidney, with the dissected lymph nodes having the same pathology. There was no evidence of a tumor recurrence during the six month follow-up period. This was an unusual case of a multicentric angiomyolipoma.
Adipocytes ; Adult ; Angiomyolipoma* ; Blood Vessels ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Kidney ; Lymph Nodes* ; Muscle, Smooth ; Neoplasm Metastasis ; Nephrectomy ; Pathology ; Recurrence ; Tomography, X-Ray Computed

PURPOSE: This study was performed in order to compare unenhanced CT with diffusion-weighted, T2-weight-ed,and fast FLAIR MR imaging in the detection of hyperacute cerebral ischema induced in a dog and to deter-mine whichmodality first detected cerebral ischemia. MATERIALS AND METHODS: Experimental cerebral infarction was induced bythe occlusion of intracerebral arter-ies using embolic materials (polyvinyl-alcohol, 300 -6 00 micro) introducedthrough a microcatheter into the internal carotid artery of five dogs weighing 12 -20 kg. Serial CT and MR imageswere obtained at one hour intervals from one to five hours after occlusion, and were analyzed independently by tworadiologists. We assessed changes in attenuation, as seen on unenhanced CT and the signal intensity of the lesionon each MR image, and measured the contrast-to-noise ratio (CNR) of the lesions. RESULTS: Ischemic lesions weredetected on unenhanced CT 1 -3 hours after occlusion of cerebral arteries. In all dogs, the lesions were detectedearliest on diffusion-weighted images obtained at 1 hour. They were detect-ed on T2-weighted images at 3 -5 hoursand on fast FLAIR images of 2 -5 hours. The CNR of ischemic lesions increased gradually during the 5-hour period.It was highest on diffusion-weighted images, while on unen-hanced CT, T2-weighted, and fast FLAIR images it wassimilar. CONCLUSION: Hyperacute ischemic lesions were detected earliest on diffusion-weighted images, and earlieron unenhanced CT than on fast FLAIR or T2-weighted MR image.
Animals ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Arteries ; Cerebral Infarction* ; Dogs* ; Magnetic Resonance Imaging*

We report a case of cold hemagglutinin disease associated with Mycoplasma pneumoniae infection treated with cord blood transfusion. Cold hemagglutinin disease is a hemolytic anemia most commonly associated with cold-reactive autoantibody with anti-I specificity. On the basis of the fact that the level of I antigen on cord red blood cells is extremely low, a six year old male patient was transfused with 60 mL of ABO blood type-matched, cord blood. No complication from the transfusion was observed. Due to the deficiency in cord blood supply, filtered irradiated RBC 100 mL was transfused three times thereafter. The hemoglobin level began to increase from the fifth hospital day. The patient was discharged without additional transfusion on the eleventh hospital day. No remarkable complications were noted at the time of discharge.
Anemia, Hemolytic ; Erythrocytes ; Fetal Blood* ; Hemagglutinins* ; Humans ; Male ; Mycoplasma pneumoniae* ; Pneumonia, Mycoplasma* ; Sensitivity and Specificity

PURPOSE: The etiology of hemolytic anemia can be classified as either cellular or extracellular defects of red blood cells. The aim of this study was to investigate the clinical and laboratory findings of hemolytic anemia concerning its etiological classification. METHODS: Clinical and laboratory findings of the patients with hemolytic anemia treated from January 1987 to May 2002 at Severance Hospital were analyzed retrospectively. They were divided into two groups based on the types of red cell defects(group I : erythrocytic defect, group II : extraerythro cytic defect). RESULTS: Twenty one cases were included in group I, thirty four cases in group II, and three cases were unclassified. In group I, nineteen cases(90.5%) were diagnosed as hereditary spherocytosis and were proved to have red cell membrane disorders while two cases(9.5%) were shown to have red cell enzyme deficiencies. In group II, thirteen cases(38.2%) were noted as autoimmune hemolytic anemia, eleven cases(32.4%) as traumatic or microangiopathic hemolytic anemia, four cases(11.8%) as drug induced hemolytic anemia, two cases(5.9%) were related with systemic lupus erythematosus and one case(2.9%) with malignancy. Hemoglobin at the time of diagnosis(7.5 g/dL vs. 6.2 g/dL, P< 0.05) and the incidence of splenomegaly(85.7% vs. 18.2%, P<0.05) were higher in group I though blood urea nitrogen(9.0/0.4 mg/dL vs. 27.8/1.6 mg/dL, P<0.05) was higher in group II. CONCLUSION: Comparing the clinical features of pediatric hemolytic anemia, we concluded as following: In cases associated with extraerythrocytic defect, blood tests revealed significant initial lower hematocrit with higher level of BUN and Cr while cases with erythrocytic defect, splenomegaly were more common noted.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Cell Membrane ; Classification* ; Erythrocytes ; Hematocrit ; Hematologic Tests ; Humans ; Incidence ; Lupus Erythematosus, Systemic ; Retrospective Studies ; Splenomegaly ; Urea

Intubation granuloma is a delayed complication of endotracheal intubation in adults.The most frequent complaint of the patient with laryngeal granuloma is hoarseness and the most common location of the granuloma is the vocal process of arytenoid cartilage.We report a female patient with incidentally detected granuloma during endotracheal intubation who had no preoperative vocal symptoms.
Female ; Granuloma ; Granuloma, Laryngeal ; Hoarseness ; Humans ; Intubation ; Intubation, Intratracheal

Pulmonary venous stenosis may be congenital or acquired. Regardless of its origin, the prognosis for patients affected with PVS remains poor. There have been many attempts to palliate PVS with little success. This report describes two patients with PVS which became evident after repair of total anomalous pulmonary venous connection. Intravascular stents were successfully implanted, but progressive restenoses in the stents occurred and eventually both of the patients died. The pertinent literature is reviewed.
Constriction, Pathologic* ; Humans ; Prognosis ; Pulmonary Veins ; Stents*

Microscopic Polyangiitis(MPA) belongs to a spectrum of systemic vasculits, and particularly antineutrophil cytoplasmic autoantibodies(ANCA)-associated small-vessel vasculitis which is characterized by involvement of the lung and kidney. The diagnosis of MPA is often difficult to make, and delayed because of the variability of the clinical presentation. Renal biopsies have a very important diagnostic and prognostic value in MPA. We experienced a case of microscopic polyangiits which was confirmed by renal biopsy and positive serum perinuclear ANCA, associated with alveolar hemorrhage and gastrointestinal bleeding. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor and Ca channel blocker were used when proteinuria and hypertention developed. On admission, the patient's lab findings showed BUN 117 mg/dL, Cr 2.3 mg/dL, while on the 60th hospital day BUN/Cr values fell to 20.8 mg/dL / 1.6 mg/dL and though proteinuria persisted, the patient's condition was tolerable and is currently under observation on an out-patient basis. The last lab values were BUN 26 mg/dL / Cr 1.6 mg/dL.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Cyclophosphamide ; Cytoplasm ; Diagnosis ; Glomerulonephritis* ; Hemorrhage* ; Humans ; Kidney ; Lung ; Methylprednisolone ; Microscopic Polyangiitis* ; Outpatients ; Plasmapheresis ; Proteinuria ; Systemic Vasculitis ; Vasculitis