Respiratory distress syndrome of preterm infants remains a significant cause of morbidyty and mortality. Early, just after birth, prediction and recognition of RDS is so important. The precision and reliability of the stable microbubble test (SMR)and shake test as a predictor of respiratory distress syndrome were studied. A 110-neonate who was born at Chungnam National University Hospital between November 1991 to September 1992was selected randomely and studied. The results were as follows; 1) Among the 110 neonates, 13 cases were noticed as RDS. 2) Among the 13 infants with RDS, SMR results were zero and very weak in 11 cases, weak in 2 cases. Of the 97 infants with Non-RDS, 9 cases were weak, 88cases were medium and strong, positive predictive value and negative predictive value was 100%, 98% respectively. 3) Of the 13 infants with RDS, Shake test result were negative in 8 cases, 1+in 1 case, 2+in 1 case and 4+in 3 case. Of the 97 infants with Non-RDS, 3 cases were negative, 9 cases were 1+, 9cases were 2+ and 63 cases were 4+, positive predictive value and negative predictive value was 72.7%, 9 However, frequent relapses and severe side effects caused by such therapy necessitate development of a more specific and effective therapeutic regimen.Recently, a T cell derived cytokine, interleukin 4 (IL-4)is being recognized as a major cytokine up-regulating IgE production and response, while interferon- (IFN- )counteracts IL-4 actions to down-regulate the IL-4 induced IgE response. Hence, the present study is aimed to investigate the role of IL-4 in MCNS. Using freshly isol 4.9% respectively. We conclude that the rapidity, simplicity and reliability of the stable microbubble test is more useful as a bedside procedure in identifying of predicting the infants who are likely to develop RDS than shake test.
Chungcheongnam-do ; Humans ; Immunoglobulin E ; Infant ; Infant, Newborn ; Infant, Premature ; Interleukin-4 ; Microbubbles* ; Mortality ; Parturition ; Recurrence

Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.
Anti-Bacterial Agents ; Child ; Esophageal Stenosis ; Esophagus ; Granuloma ; Granulomatous Disease, Chronic* ; Humans ; Recurrence ; Steroids

No abstract available.

No abstract available.
Hemangioma, Cavernous*

Traditional technique for the treatment of osmidrosis had a few problems, such as difficulty in exposing axilla because of the scar that is left after the operation, and sometimes brought misunderstanding of breast augmentation. I have designed a new operation method by improving the existing suction cannula in order to reduce the recurrence rate, by raising the apocrine gland removal to the incision technique level while maintaining the existing suction technique merits. The new method is based on negative pressure of suction, but has a scraping function added for removing the subdermal gland appropriately. It is named Scrape & Inhalation Technique(SIT). This was enforced to 104 patients from January, 2004 to December, 2004. The follow-up on the operation results were examined for at least 3 months and 19 months maximum. Recurrence and sequela were checked by direct counseling, telephone, e-mail, and cell phone messages after the operation. Among the subjects, 5 patients showed recurrence and received operation again. The others were totally satisfied with results. One patient had skin necrosis, but its diameter was not over 2cm and was completely treated by dressing having small scar. Inconvenience such as the epidermis sloughing was found in many patients, but it was treated well without any scars by simple dressing. Sequela such as permanent motor abnormality or dysaesthesia was not found at all.
Apocrine Glands ; Axilla ; Bandages ; Breast ; Catheters ; Cellular Phone ; Cicatrix ; Counseling ; Electronic Mail ; Epidermis ; Follow-Up Studies ; Humans ; Inhalation* ; Lipectomy ; Necrosis ; Recurrence ; Skin ; Suction ; Telephone

Lesions of the skull vault are often incidentally encountered during in plain radiography, CT, and MR imaging of the brain and benign lesions are more common than primary malignancies. The usefulness of plain skull films is limited, but when combined with CT or MRI, there is a high probability of accurate diagnosis. The aim of this essay is to describe a wide range of cranial lesions and to illustrate their distinguishing features.
Brain ; Diagnosis ; Magnetic Resonance Imaging ; Radiography ; Skull*

Impetigo herpetiformis is a rare pustular eruption that may be seen in late pregnancy. It is associated with severe maternal and fetal complications in case of misdiagnosis and delayed treatment. The patient was a 25-years-old multigravida with psoriasis in her past history. At 20weeks gestation, she had been developed erythematous scaly annular patchs with papules and pustules on inner thigh. At 37weeks' gestation, the patient was suffered from a severely pruritic pustular rash with fever and leukocytosis. The skin of the affected areas was biopsied and showed intraepidermal pustular abscess with a neutrophilic infiltrate. Treatment commenced with intravenous fluids, antibiotics, systemic prednisone, steroid creams, and phototherapy(UVB) under the careful fetal well being monitoring. Cesarean section was done due to fetal distress, and a normal healthy male infant was delivered, following which the patient's condition improved rapidly.
Abscess ; Anti-Bacterial Agents ; Cesarean Section ; Diagnostic Errors ; Exanthema ; Female ; Fetal Distress ; Fever ; Humans ; Impetigo* ; Infant ; Leukocytosis ; Male ; Neutrophils ; Prednisone ; Pregnancy* ; Psoriasis ; Skin ; Thigh

BACKGROUND: Video assisted thoracic sympathectomy or sympathicotomy is a safe and effective therapy for the treatment of palmar hyperhidrosis with immediate symptomatic imporvement. However the degree of satisfaction may diminish with time due to cmpensatory sweating or excessive hand dryness. Therefore by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathectomy or sympathicotomy at various levels we aim to determine the optimal level of sympathetic nerve block which will result in minimal side effects and maximal benefit. MATERIAL AND METHOD: Among 194 patients having undergone video assisted thoracic sympathectomy or sympathicotomy between January 1996 and June 1999, 137 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into three groups. Group I(n=61) ; patients having undergone T2,3,4 sympathectomy group II(35) ; patients having undergone T2 sympathicotomy and group III(41) ; patients having undergone limited T2 sympathicotomy which consist of block of interganglionic neuronal fiber on the third rib. The parameters studied comprised of pre- and post-operative palmar temperature change treatment satisfaction the degree of compensatory sweating or discomfort from palmar dryness postoperative complication and changes in plantar sweating. RESULT: There was no difference in age and sex among the groups and the mean postoperative elevation in palmar temperature was 21.59degrees C without any differences among the groups. Patients expressing satisfaction were 65.6%, 62.9% and 90.24% in groups I, II and III, respectively(p<0.05) Moderate to severe compensatory sweating was present in 65.6% 51.4%, and 24.39%, in group I, II, and III, respectively (p<0.05) Slight but comfortable amount of palmar humidness was expressed in decreasing order group III(41.6%) group I(24.6%) and group II(5.7%) (p<0.05) Ineffectiveness or recurrence was present in 5patients in group I(8.2%) 1 patient in group II(2.9%) and none in group III. With regards to plantar sweating decrease in sweating was expressed in 43 patients(31.4%) while similar degree of sweating in 61 patients(44.5%) and increase in sweating in another 33 patinets(24.1%). CONCLUSION: Limited T2 sympathicotomy resection of the lower interganglionic neuronal fiber of the second sympathetic ganglion on the third rib showed immediate effect in palmar hyperhidrosis and caused lesser compensatory sweating and hand dryness.
Autonomic Nerve Block ; Ganglia, Sympathetic ; Hand ; Humans ; Hyperhidrosis* ; Interviews as Topic ; Neurons ; Postoperative Complications ; Surveys and Questionnaires ; Recurrence ; Ribs ; Sweat ; Sweating ; Sympathectomy

BACKGROUND: The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. METHODS: We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center from April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. RESULTS: Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). CONCLUSION: At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intubation ; Intubation, Intratracheal* ; Paralysis ; Retrospective Studies ; Succinylcholine ; Tertiary Care Centers* ; Tertiary Healthcare* ; Tracheostomy

BACKGROUND:Rotational atherectomy has been developed for several years. It is a useful tool in complex coronary lesion morphologies such as diffuse, calcific, ostial and angulated lesion. We report initial experience of the rotational atherectomy in complex coronary artery morphology. METHODS: We included 64 patients who was treated with rotational atherectomy since July 1997 to February 1999. Mean age was 56+/-9 years with 47 male patients. Clinical diagnosis was 12 acute myocardial infarction, 49 unstable angina, and 3 stable angina. Rotational atherectomy was done by transfemoral or transradial approach with adjunctive ballooning and/or stenting in all patients. RESULTS: Ninty-one percent of the treated lesions showed complex lesion morphologies (B2/C lesion) with 43 left anterior descending artery and 19 right coronary artery. Rotational atherectomy was done in 37 de novo lesion (58%) and 27 (42%) restenosis patients. Transradial approach was done in 33 patients (52%). Mean maximal burr size was 1.68 mm and mean burr to reference artery ratio was 0.63. Rotastenting were done in 58% of the patients with higher post-procedure minimal lumen diameter, % diameter stenosis and net gain than rotablator with adjunctive balloon angioplasty. Overall procedural success was 94% (62/64). Complications were one non-Q infarction, one coronary artery perforation, two slow flow, and one guidewire fracture. None of the patients showed inhospital mortality or 30 day cardiac event (death, emergency CABG, Q-infarction, or re-intervention). CONCLUSION: Rotational atherectomy is a useful technique with high success rate without showing major cardiac events during inhospital period and within 30 days.
Angina, Stable ; Angina, Unstable ; Angioplasty, Balloon ; Arteries ; Atherectomy ; Atherectomy, Coronary* ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Emergencies ; Hospital Mortality ; Humans ; Infarction ; Male ; Myocardial Infarction ; Stents