No abstract available.
Leiomyoma* ; Thrombocytosis*

Adenosis tumor is a ra re tumor of the breast and primarily consists of adenosis. Authors report a case of surgically proved adenosis tumor in a 31-year-old woman. Mammogram showed a Iobulated, well-circumscribed mass with several surrounding radiolucent halos. In the center of the mass several linear radiolucent densities were seen with the appearance of a conglomerated well-circumscribed mass such as fibroadenoma. These linear radiolucent densities were consistent with the fat between the fibrous sclerosis in pathologic specimen. Ultrasonogram showed a well-circumscribed mass with homogeneous low echogenicity, partial posterior enhancement, and bilateral acoustic shadowings.
Acoustics ; Adult ; Breast* ; Female ; Fibroadenoma ; Humans ; Sclerosis ; Shadowing (Histology) ; Ultrasonography

OBJECTIVE: The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. METHOD: From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC) At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders phi gelser) side effect scale were checked. RESULTS: After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from 168.9+/-89.4ng/ml to 183.0+/-102.0ng/ml after fluoxetine addition(p=0.011) but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from 114.3+/-70.2ng/ml to 168.0+/-86.2ng/ml after fluoxetine addition(p=0.011) In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from 283.1+/-125.3ng/ml to 350.9+/-78.4ng/ml after fluoxetine addition(p=0.016) After fluoxetine addition, no significant change was noted in the UKU side effect scale score. CONCLUSION: As consequence of comparson of plasma amitriptyline and nortriptyline level before and after fluoxetine addition mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.
Amitriptyline* ; Chungcheongnam-do ; Depression ; Fluoxetine* ; Humans ; Inpatients ; Nortriptyline ; Outpatients ; Plasma*

By means of hospital-based data over 8 years we sought to evaluate the clinical indications and incidence of emergency peripartum hysterectomy by demographic characteristic and reproduction history. From the obstetric record of all deliveries at Chung Goo Hospital between Jan. 1, 1990, and Nov. 31, 1997, we identified all women undergoing emergency cesarean hysterectomy, calculated incidence rates, conducted statistical tests of linear trends and heterogenety, and observed the clinical indicatons preceding the onset of this procedure. There were 16731 deliveries during this period, Cesarean hysterectomy was performed in 24 of 5993 cesarean sections(0.40%) and in 10 of 10738 vaginal deleveries(0.09%), so more frequently after cesarean section than vaginal delivery. The age of patients varied from 22 to 40 years old. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was uterine atony(52.94%) followed by placental disorders(41.18%), uterine myoma with pregnancy(2.9%) and uterine rupture (2.9%). All patients who had hysterectomy received transfusion from 1 pint to 57 pints. The postoperative complications were bladder injury, febrile morbidity, disseminated intravascular coaguolopathy and wound disruption. There were three maternal deaths, the cause was disseminated intravascular coaguolopathy and amniotic embolism. The data identifiy uterine atony as the primary cause for gravid hysterctomy. The data also illustrated how the incidence of emergency peripartum hysterectomy increases significantly with increasing parity, especially when influenced by a current placenta previa or a prior cesarean section. Maternal morbidity remained high.
Adult ; Cesarean Section ; Embolism ; Emergencies ; Female ; Humans ; Hysterectomy* ; Incidence ; Leiomyoma ; Maternal Death ; Parity ; Peripartum Period* ; Placenta Previa ; Postoperative Complications ; Pregnancy ; Reproduction ; Urinary Bladder ; Uterine Inertia ; Uterine Rupture ; Wounds and Injuries

No abstract available.
Apoptosis* ; Cell Line* ; Colon* ; Colonic Neoplasms* ; Etoposide*

PURPOSE: In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. METHODS: All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. RESULTS: Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001). CONCLUSION: The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.
Anti-Bacterial Agents ; Bacteremia ; Catheters ; Central Venous Catheters ; Child ; Fetal Blood ; Fever ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Neutropenia ; Pediatrics ; Transplants

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

Main objectives of this study were to produce the experimental postirradiation sialadenitis and to observe the effects of hyperbaric oxygen therapy after the production of postirradiation sialadenitis in the unilateral parotid gland of white rats. To produce the experimental postirradiation sialadenitis, author attempted the various methods of irradiation such as 1000rad weekly for 5 weeks, or single dosage of 2000rad, 3000rad, 5000rad, but those attempts were futile due to the high mortality of experimental animals(used 80rats for pilot study). Finally author had to design fractional irradiation, that is, 1000rad per 2 weeks, total 5000rad for 8 weeks in order to produce postirradiation sialadenitis. The occurrence of postirradiation sialadenitis was proved with serial salivary scan findings. Author used irradiation 1000rats, dividing into the control(50) and experimental group (50) and rendered the hyperbaric oxygen therapy(2 hours/daily at 2.4ATM) on the experimental group for 6 weeks. The effect of hyperbaric oxygen therapy was examined by salivary scan findings and microscopic examination. The obtained results of this study were as follows: 1. The differences of salivary gland function between irradiated parotid glands(right) and nonirradiated parotid glands(left) showed the most remarkable changes at 32 weeks after total 5000rad irradiation. 2. In microscopic examination at 32 weeks after total 5000rad irradiation, irradiated parotid glands(right) showed severe degenerative changes of acinar cells, separations of lobules due to edema, severe intralobular fibrosis and connective tissue fibrosis. 3. After hyperbaric oxygen therapy for 4 weeks, the effect of hyperbaric oxygen therapy showed no distinctive difference findings between the control and the experimental group with salivary scan findings(p>or=0.05), while the experimental group showed progressive intralobular edema, copillary proliferation, hyperemia in connective tissues and intralobular fibrosis in microscopic examination. 4. Tc99m uptake of the experimental group was raised after hyperbaric oxygen therapy for 6 weeks, and showed reduction of Tc99m uptake ratio between irradiated parotid gland and nonirradiated gland up to 8 to 10 weeks(p<0.05), while in the microscopic exemination the experimental group showed aggravated acinar cell degeneration, intercalated duct proliferation, connective tissues fibrosis. In this study, author speculated that though the hyperbaric oxygen therapy improved the capillary impairment, there was a tendency to increase the degenerative changes of parechyma of postirradiated parotid glands, thus the usage of the hyperbaric oxygen therapy should be considered carefully in the aspect of hazardous effect to the parotid parenchymal tissues.
Acinar Cells ; Animals ; Capillaries ; Connective Tissue ; Edema ; Fibrosis ; Hyperbaric Oxygenation* ; Hyperemia ; Mortality ; Osteoradionecrosis ; Oxygen ; Parotid Gland ; Rats* ; Salivary Glands ; Sialadenitis* ; Xerostomia

The study was performed retrospectively to compare the results of anterior chamber IOL(Intraocular Lens) implantation and posterior chamber IOL implantation by scleral fixation in cases of inadequate zonular or capsular support during the extracapsular cataract extraction. A total of 27 cases were reviewed of which 11 cases had anterior chamber IOL implantation and 16 cases had posterior chamber IOL implantation by scleral fixation. The follow-up period ranged from two to twenty-four months. Nine of eleven in anterior chamber IOL group and thirteen of sixteen in posterior chamber IOL group had the final corrected vision of 0.5 or better. Vision-threatening complications included two cases of cystoid macular edema in anterior chamber IOL group, whose visual acuity was 0.1 and 0.5, and three cases of vitreous hemorrhage in posterior chamber IOL group, which had little effect on visual outcome The final visual acuity didn't show statistically significant difference between the two groups.
Anterior Chamber* ; Cataract Extraction ; Follow-Up Studies ; Lenses, Intraocular* ; Macular Edema ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage