Of 375 newborn infants in Korea General Hospital in the period of 6 months from March 1 to August 30, 1976. 304 newborn infants were available for the study of serum bilirubin level at the third day of the birth. The followings are results analyzed: 1) The mean value of serum bilirubin level estimated is 10.6mg%. The incidence of neonatal jaundice is estimated as 95.4 percent. 2) The premature infants reveal a marked elevation of serum bilirubin level. Conditions with increased level of serum bilirubin in variable degree include vacuum suction and/or forcep delivery, high or low hematocrit value, low Apgar scores, artificial resuscitation, cephalhematoma and spontaneous premature rupture of the membrance. 3) No relationship in serum bilirubin levels between differences in sex, body weight, number of pregnacies and ABO blood groups of mother and infant is present in this study.
Bilirubin ; Blood Group Antigens ; Body Weight ; Hematocrit ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Jaundice, Neonatal* ; Korea ; Mothers ; Parturition ; Resuscitation ; Rupture ; Suction ; Surgical Instruments ; Vacuum

Total 11 cases of tricuspid atresia were diagnosed radiographically at Seoul National University Hospital in recent two years since 1979. Some characteristic radiological findings were analyzed in chest P-A view and cineangiographies of right atrium and left ventricle. The results are as follows; 1. Among the 11 cases, 4 cases were male and 7 cases were female. Age distribution was from 2 months to 19 years and mean age was 3 1/2 years. 2. Anatomaic types of those cases according to Keith's classification were as follows; type Ia in 2 cases, type Ib in7 cases, type Ic 1 case and type IIb in 1 case. 3. The cineangiographic features of tricuspid atresia are sequential filling of contrast media in the order of right atrium, left atrium, and left ventricle, and triangular filling defect at the base of the heart in all cases, and right atrial dimple in two cases. 4. It is essential for the diagnosis of tricuspid atresia to undertake cineangiographies of right atrium and left ventricle, and the interrelationship of great arteries.
Age Distribution ; Arteries ; Cineangiography ; Classification ; Contrast Media ; Diagnosis ; Female ; Heart ; Heart Atria ; Heart Ventricles ; Humans ; Male ; Seoul ; Thorax ; Tricuspid Atresia

Dyschromatosis universalis hereditaria is a rare pigmentary disorder initially described in the Japanese literature. The pattern of inheritance is believed to be autosomal dominant, but many sporadic cases have been reported. We encountered a family in which dyschromatosis universalis hereditaria occurred in seventeen members of three generations. In the two members whom we observed, typical skin lesions were distributed all over the body except palrns and soles. By pedigree analysis, we found an autosomal dominant pattern of inheritance. The differential diagnosis of the other reticulate pigmentary disorders is discussed with a review of dyschromatosis reported in the Korean literature.
Asian Continental Ancestry Group ; Diagnosis, Differential ; Family Characteristics ; Humans ; Pedigree ; Skin ; Wills

BACKGROUND: Nonobstertic surgery during pregnancy needs special considerations by the surgeon in relation to the maternal and the fetal outcomes. Although there are many studies about appendicitis in pregnant women, nonobstetric surgery, in general, during pregnancy has not been sufficiently analyzed. In this clinical study, we reviewed the incidences of nonobstetric surgical diseases during pregnancy and observed the maternal and the fetal outcomes of surgery, including the effects of anesthesia and antibiotics. METHODS: We retrospectively analyzed 80 patients who were pregnant at the time of operation and who had undergone operations during an 11-year period from March 1986 to April 1997 at Shinchon- and Inchon-Severance Hospital. The distributions of age, disease, and delivery history were analyzed, and the diagnostic characteristics, and the fetal and the maternal outcomes were observed with respect to anesthesia and antibiotic usage. RESULTS: The average age of the patients was 32, and 53% of the patients were over 30. The numbers of patients in the first, the second, and the third trimester were 24 (30%), 36 (45%) and 20 (25%), respectively. The most frequent surgical disease was appendicitis with 52 patients (65%). The average duration of hospitalization was 14.4 days. Twenty-two patients (27.5%) had postoperative preterm labor and were successfully managed with tocolytic agents except for one preterm delivery. The total number of preterm deliveries was 10 (12.5%), and still birth occurred in 3 cases (3.8%). The cases of still birth involved severe original diseases, such as rectal carcinomas, pancreatic carcinomas, and sepsis. Among the antibiotics that were used during surgical care, monotherapy with ampicillin was the most frequently used mode. The incidence frequencies of delivery complications according to the used antibiotics were not significantly different from each other. General endotracheal anesthesia was used in 40 cases, spinal and epidural anesthesia was inducted in 25 and 13 cases, respectively. The incidences of fetal complications according to the methods of was administering anesthesia were not significantly different. CONCLUSIONS: The maternal and the fetal risks of nonobstetric surgery during pregnancy depend on the risk of the original surgical disease of the patient. Modes of anesthesia or antibiotic usage do not increase the incidences of obstetric complications.
Ampicillin ; Anesthesia ; Anesthesia, Epidural ; Anti-Bacterial Agents ; Appendicitis ; Female ; Hospitalization ; Humans ; Incidence ; Obstetric Labor, Premature ; Parturition ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Sepsis ; Tocolytic Agents

Intercellular Adhesion Molecule-1(ICAM-1) plays an important role in a variety of inflammatory and immune-mediated mechanisms, including lymphocyte recruitment and targeting, antigen presentation and recognition, and lymphocyte cytotoxicity.In order to study the changes of soluble ICAM-1 and relationship to the immune mechanism of Graves' disease, we performed the measurement of a soluble form of ICAM-1 in sera from patients with Graves' disease before and after treatment with antithyroid drugs using a highly sensitive ELISA method.Our results were as followed.1) The serum levels of soluble ICAM-1 in patients with Graves' disease before treatment were significantly elevated than normal controls(p<0.001).2) The serum levels of soluble ICAM-1 in patients with Graves' disease after treatment significantly decreased after treatment(p<0.001) but not as low as normal controls. 3) The serum levels of soluble ICAM-1 molecule in patients with ophthalmopathy were not elevated compared to patients with no ophthalmopathy(p>0.2).4) The serum levels of soluble ICAM-1 showed no significant correlation with serum titers of anti-thyroperoxidase antibody and anti-thyroglobulin antibody, serum T_3, T_4, TSH and goiter size in patients with Graves' disease.In conclusion, the soluble ICAM-1 levels reflect the activity of autoimmune reaction and might be used as a index of efficacy of antithyroid drug treatment of Graves' disease.
Antigen Presentation ; Antithyroid Agents ; Enzyme-Linked Immunosorbent Assay ; Goiter ; Graves Disease ; Humans ; Intercellular Adhesion Molecule-1 ; Lymphocytes

Background: TSH binding inhibiting imunoglobulins(TBII) are autoimmune antibody causing autoimmune thyroid diseases such as Graves disease or Hashimoto's thyroiditis, while intercellular adhesion molecule-1(ICAM-1) is known as a substance expressed at the site of autoimmune reaction in relation with lymphocyte infiltration. The serum TBII activity is used as an index of the disease course and prognosis of Graves disease treated with antithyroid drugs, propylthiouracil or methimazole. The aim of this study is to understand the change of serum ICAM-1 level according to the change of the degree of autoimmunity and clinical course of Graves disease. Methods: In order to study the change of soluble ICAM-1 and relationship to the immune mechanism of Graves' disease, we measured serum levels of TBII and ICAM-1 in patients(n 35) with Graves disease before and after treatment with antithyroid drugs and in relapsed patients using a highly sensitive ELISA method. Results: The serum levels of TBII and ICAM-1 were markedly elevated in patients with Graves disease before treatment than normal controls and there were good correlation between TBII and ICAM-1 level. In patients with normalized TBII levels after 22 months antithyroid drug treatment, the ICAM-1 levels became normal but in the patients with high serum TBII level showed high serum level of ICAM-1 even with clinical remission with same treatment. The serum levels of TBII and ICAM-1 in relapsed patients were elevated as those of patients before treatment. Conclusion: With the above results, we can conclude that not only the TBII level but seru ICAM-1 level also reflect the degree of autoimmune activity of Graves disease and may be used as an index of the disease course and prognosis of Graves disease treated with antithyroid drugs.
Antithyroid Agents ; Autoimmunity ; Enzyme-Linked Immunosorbent Assay ; Graves Disease ; Humans ; Intercellular Adhesion Molecule-1 ; Lymphocytes ; Methimazole ; Methods ; Prognosis ; Propylthiouracil ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

PURPOSE: To evaluate the usefulness of functional MR imaging(fMRI) for language mapping and determination of language lateralization. MATERIALS AND METHODS: Functional maps of the language area were obtained during word generation tasks and decision task in ten volunteers(7 right handed, 3 left-handed). MR examination were performed at 1.5T scanner with EPI BOLD technique. Each task consisted of three resting periods and two activation periods with each period of 30 seconds. Total acquisition time was 162sec. SPM program was used for the postprocessing of images. Statistical comparisons were performed by using t-statistics on a pixel-by-pixel basis after global normalization by ANCOVA. Activation areas were topographically analyzed(p<0.001) and activated pixels in each hemisphere were compared quantitatively by lateralization index. RESULTS: Significant activation signals were demonstrated in 9 of 10 volunteers. Activation signals were found in the premotor and motor cortices, the inferior frontal, inferior parietal, and mid-temporal lobes during stimulation tasks. In the right handed seven volunteers, activation of language areas was lateralized to the left side. Verb generation task produced stronger activation in the language areas and higher value of lateralization index than noun generation task or decision task. CONCLUSION: fMRI could be a useful non-invasive method for language mapping and determination of language dominance.
Brain ; Hand ; Magnetic Resonance Imaging* ; Rabeprazole ; Volunteers

BACKGROUND: The neuromuscular blocking effects of a nondepolarizing neuromuscular blocker (NDNM) during a nitroglycerin (NTG) infusion were significantly potentiated and prolonged. NTG reduced the requirement of a NDNM in surgical patients. We investigated the influence of a NTG single bolus injection on a mivacurium nuromuscular blockade. METHODS: We studied 36 adult surgical patients, ASA physical status I or II, between 15 and 53 years old. Neuromuscular monitoring was measured by TOF-GUARD (Biometer Co., Denmark). Anesthesia was induced by thiopental sodium 3-5 mg/kg and fentanyl 3 microgram/kg, and maintained with 3 L/min N2O, 2 L/min O2 and 1 vol.% isoflurane. Patients were randomly assigned to 3 groups: 1) Control group (mivacurium 0.16 mg/kg), 2) N100 group (mivacurium 0.16 mg/kg, NTG 100 microgram), 3) N200 group (mivacurium 0.16 mg/kg, NTG 200 microgram). We measured the train-of-four (TOF) response from the beginning of recovery to the complete regaining of muscle twitch. RESULTS: NTG produced a prolongation of the neuromuscular blocking effect by mivacurium. T1 (contro group: 12.1 +/- 0.5, N100 group: 15.8 +/- 0.4 and N200 group: 11.6 +/- 0.4 min), T25 (16.4 +/- 0.4, 20.5 +/- 0.5 and 14.9 +/- 1.0 min), T75 (22.5 +/- 0.9, 29.4 +/- 0.7 and 20.1 +/- 1.0 min), T95 (27.3 +/- 0.6, 39.6 +/- 0.7 and 24.6 +/- 1.5 min) and the recovery index (6.1 +/- 0.6, 9.0 +/- 0.4 and 5.3 +/- 0.7 min) were significantly prolonged in the N100 and N200 groups (P < 0.05). CONCLUSION: These results suggest that a NTG bolus injection prolonged the neuromuscular blocking effect of mivacurium, dose relatively.
Adult ; Anesthesia ; Fentanyl ; Humans ; Isoflurane ; Middle Aged ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Nitroglycerin* ; Thiopental

Ketoconazole is one of the broad-spectrum oral antimycotic agents recently developed from imidazole derivatives. Authors performed multicenter trials to evaluate the therapeutic effect of ketoconazole in superficial fungal diseases. One hundred and eighty-four patients with superficial fungaI diseases were included in this study during 7 months from April to October, 1983 Patiets were treated with oral administration of 200 mg of ketoconazole(Nizoral) once a day for 4 weeks.-countinue-
Administration, Oral ; Humans ; Ketoconazole*

Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.
Humans ; Percutaneous Coronary Intervention* ; Thrombosis