No abstract available.
Child* ; Humans

No abstract available.
Chlorambucil* ; Nephrotic Syndrome*

No abstract available.
Aneurysm*

We report a case of pneumonia in 36 year-old male patient who presented acute respiratory failure and associated radiologic findings of bilateral ground-glass opacity with focal cystic changes, showing rapidly aggravating course and was diagnosed as concomitant Pneumocystis carinii and Cytomegalovirus pneumonia accompanied by acquired immunodeficiency syndrome through antemortem open lung biopsy.
Acquired Immunodeficiency Syndrome ; Biopsy ; Cytomegalovirus ; Humans ; Lung ; Male ; Pneumocystis carinii ; Pneumonia ; Respiratory Insufficiency*

PURPOSE: To compare the prevalance and the amount of astigmatism between the epiblepharon patients who had been operated epiblepharon and normal school children. METHODS: The noncycloplegic refraction using autorefractor was performed in 120 epiblepharon patients from Jan. 1997 to June 2000. Astigmatism in excess of 0.5 D was studied. We compared the findings of epiblephron patients and 443 normal school children in Seoul. RESULTS: The prevalence of astigmatism was 72.9% in epiblephron group and 41.6% in normal children group, and the difference was statistically significant (P< 0.001). The amount of astigmatism was 1.52 D and 0.73 D in each group, and the difference was statistically significant (P< 0.001).The distribution of astigmatism showed 1.0 D or less in 22.5%, from above 1.0 D to 2.0 D or less in 26.3%, from above 2.0 D to 3.0 D or less in 10.8%, from above 3.0 D to 4.0 D or less in 9.6% and above 4.0 D in 3.8% in epiblepharon group and in normal children group 26.2%, 11.2%, 2.6%, 1.0%, and 0.7% respectively. The difference between both groups was statistically significant (P< 0.001). With-the-rule astigmaism was found in 77.9% and against-the-rule was 22.1% in epiblephron group and 72.8% and 27.2% respectively in normal children group. CONCLUSIONS: The prevalence and the amount of astigmatism were higher in epiblepharon group than in normal children group. It might be caused by the increase of orbicularis muscle tone and the effect of skin fold overriding lid margin in epiblepharon patients.
Astigmatism* ; Child* ; Humans ; Prevalence ; Seoul ; Skin

PURPOSE: To evaluate CT findings for the differential diagnosis of mechanical bowel obstruction and paralytic ileus. MATERIALS AND METHODS: Without information relating to clinical or operative findings, we retrospectively analyzed the CT scans of 24 patients with mechanical bowel obstruction and 19 patients with paralytic ileus. Final diagnosis was confirmed by operation (n=26), or by clinical symptoms, radiologic findings and follow-up study CT findings were obtained : 1) the diameter of the most dilated part of the small bowel, and the thickness and enhancing pattern of the dilated small bowel wall; 2) the diameter of the most dilated part of the descending colon and the ratio of the diameter of the small bowel to that of the descending colon; 3) the number of transitional zones, length and thickness. and 4) associated ascites and its location. RESULTS: The mean diameters of the most dilated part of the small bowel in mechanical bowel obstruction and paralytic ileus were 3.6cm and 2.9cm, respectively. The diameter of the small bowel in mechanical bowel obstruction was significantly greater than in paralytic ileus(p< .05). The mean thickness of dilated small bowel wall was 4.0mm in mechanical bowel obstruction and 2.4mm in paralytic ielus, and target-like enhancement was prominent in mechanical bowel obstruction (46%) (p< .05). he mean diameter of the most dilated part of the descending colon was not significantly different to that of the most dilated part of the small bowel, but the ratio of the diameter of the small bowel to that of the colon was 2.9 in mechanical bowel obstruction and 1.9 in paralytic ileus, respectively, which was statistically significant (p< .05). A transitional zone was seen in 23 cases (96%) of mechanical bowel obstruction and in nine (47%) of paralytic ileus. In mechanical bowel obstruction, mean transitional zone length was 2cm, shorter than that of paralytic ileus (3.4cm) (p< .05) The thickness of transitional zone and the presence of ascites and its locations were not significantly different between mechanical bowel obstrction and paralytic ileus. CONCLUSION: In the differential diagnosis of mechanical bowel obstruction and paralytic ileus, the following CT findings were considered useful : diameter of the most dilated part of the small bowel ; thickness and target-like enhancing pattern of dilated small bowel wall ; ratio of the diameter of the small bowel to that of the descending colon ; and the number of transitional zones, and their length.
Ascites ; Colon ; Colon, Descending ; Diagnosis ; Diagnosis, Differential* ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction* ; Retrospective Studies ; Tomography, X-Ray Computed

The authors experienced a case of myoglobinuria accompanied by generalized myalgia and mild fever that developed 3 hours 30 minutes after general anesthesia. Tracheal intubation was done smoothly 5 minutes after injection of thiopental sodium(275 mg) and pancuronium bromide(6 mg), and anesthesia was maintained with ethrane/N2O/O2(1.5-2%/21/21/min). There was no specific event except tachycardia and fluctuation of blood pressure throughout operation. In this case, we assume that the myoglobinuria is a presentation of the sign of an abortive type of malignant hyperthermia. However, it was not confirmed. We had good patient outeome with the supportive measures of hydration and diuresis. The patient was discharged twenty three days after operation without any complication.
Anesthesia ; Anesthesia, General* ; Blood Pressure ; Diuresis ; Fever ; Humans ; Intubation ; Malignant Hyperthermia ; Myalgia ; Myoglobinuria* ; Pancuronium ; Tachycardia ; Thiopental

A 36-year-old woman (para 1-0-2-1) was transferred to Korea University Hospital at 38 weeks gestation for dyspnea and chest pain. On admission, her blood pressure ranged from 130/ 70 to 230/130 mmHg, the heart rate was 144 beats/min and respiratory rate was 36/min. The ECG pattern, serum creatinine phosphokinase and lactic dehydrogenase levels were consistent with acute myocardial infarction. The baby was delivered by cesarean section under general anesthesia with nitroglycerin and propranolol support, After delivery, the patient was diagnosed as having pheochromocytoma by hormone study, abdominal magnetic resonance imaging, and computerized tomography scan. Removal of tumor was suceessfully done under combined general and epidural anesthesia after preoperative preparation with phenoxybenzamine and propranolol for two weeks. Postanesthetic recovery was uneventful.
Adult ; Anesthesia, Epidural ; Anesthesia, General ; Blood Pressure ; Cesarean Section ; Chest Pain ; Creatinine ; Dyspnea ; Electrocardiography ; Female ; Heart Rate ; Humans ; Korea ; Magnetic Resonance Imaging ; Myocardial Infarction* ; Nitroglycerin ; Oxidoreductases ; Phenoxybenzamine ; Pheochromocytoma* ; Pregnancy ; Pregnant Women* ; Propranolol ; Respiratory Rate

Familial adenomatous polyposis (FAP) is an autosomal dominant disease characterized by formation of multiple colorectal adenomas with nearly 100 percent potential for malignant transformation. FAP is a rare condition with an incidence of 1 in 10,000 live births. Germline mutations in the adenomatous polyposis coli gene (APC) located on chromosome 5q21 have been founded in many patients with FAP. Patients with FAP can have extracolonic manifestations of their disease. These include tumors of the upper gastrointestinal tract (hamartomatous polyps, adenomas, carcinomas), small intestine adenomas or cacinoma, bile duct adenomas, papillary thyroid carcinoma, osteomas of the mandible, skull, and long bones, a variety of soft tissue lesions, including fibromas, lipomas, and desmoid tumors, congenital hypertrophy of the retinal pigment epithelium (CHRPE) and hepatoblastoma. Hepatocellular carcinoma combined with FAP is a very rare condition. Just 8 cases of Hepatocellular carcinoma with a history of FAP have been reported in the literature. We now present a report of a case of Hepatocellular carcinoma with FAP (Gardner's syndrome) in a 19 year-old girl.
Adenoma ; Adenoma, Bile Duct ; Adenomatous Polyposis Coli* ; Carcinoma, Hepatocellular* ; Female ; Fibroma ; Fibromatosis, Aggressive ; Germ-Line Mutation ; Hepatoblastoma ; Humans ; Hypertrophy ; Incidence ; Intestine, Small ; Lipoma ; Live Birth ; Mandible ; Osteoma ; Polyps ; Retinal Pigment Epithelium ; Skull ; Thyroid Neoplasms ; Upper Gastrointestinal Tract ; Young Adult

Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
Adrenal Insufficiency/diagnosis/etiology ; Adult ; Brain/diagnostic imaging ; Depression/etiology ; Female ; Hepatolenticular Degeneration/*complications ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/diagnosis/etiology ; Liver Cirrhosis/complications/diagnostic imaging ; Magnetic Resonance Imaging ; Steroids/therapeutic use ; Thyrotropin-Releasing Hormone/therapeutic use