No abstract available.
Animals ; Binding Sites* ; Carbon Monoxide* ; Carbon* ; Rats* ; Serotonin*

PURPOSE: Asphyxia is the most common cause of neurologic sequelae in perinatal period. We hoped to help other clinicians by investigating factors affecting neurologic outcome in asphyxiated term babas. METHODS: A clinical study of factors affecting neurologic outcome was made on 120 patients, who were asphyxiated term baby. They admitted to neonatal intensive care unit of Chungnam National University Hospital from January, 1995 to December, 1996. RESULTS: There was no significant correlation in neurologic outcome and gestational age, delivery type, sex, birth weight, one minute Apgar score. Five minute Apgar score had influence on neurologic outcome. Presence of acidemia had influence on neurologic outcome. Mental status and seizure influenced on neurologic outcome. Poor neurologic outcome was prone to come in the presence of prolonged duration of abnormal mental function or a repetitive seizure not controlled immediately. There was poor neurologic outcome in the patients who have abnormal findings on EEG, CT, and neurosonography. In addition, there was poor neurologic outcome in congenital heart disease patients. All of above had statistical significance. CONCLUSION: Now, we can obtain much benefit by monitoring clinical course such as five minute Apgar score, mental change, and seizure. And, we can obtain much benefit by monitoring acidemia and perform EEG, CT and neurosonography.
Apgar Score ; Asphyxia ; Birth Weight ; Chungcheongnam-do ; Electroencephalography ; Gestational Age ; Heart Defects, Congenital ; Hope ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Seizures

We have reserched the relationship of their clinical pictures and factors related to the risk of recurrence of 75 patients with simple or complex febrile convulsions, who were admitted to the Departmenrt of Pediatrics, Chungnam National University Hospital from January 1987 to July 199. The 75patient were followed up and consisted of the 55 patients with initial or non-recurrent febrile convulsions and the othere 20 patients with recurrent febrile convulsions. The results were of follows; 1) The age of first episodes was under the 6 years in 94.6% and the first episode under the 12 months was 14.6% in initial cases and 55% in recurrent cases. 2) There were family history of convulsive disorder in 40% of recurrent cases, compared to 10.9% of initial cases. 3) In gestational age, there was no significant difference between initial and recurrent cases. 4) In sex distribution, the boys (66.7%) outnumbered the girls(33.7%) and the ratios was 2:1. Among the recurrent cases of 20 patients, the boys(90%) were much more than the girls(10%). 5) The patients of low birth weight had more febrile convulsions than large birth weight in both initial and recurrent cases. 6) There was no significant difference between initial and recurrent cases in the causes of febrile convulsion. 7) In abnormal EEG findings, recurrent cases were 30% more than 7.3% of initial cases. 8) There was no significant difference of number of seizure during a day in both initial and recurrent cases 9) In episodes of duration over 15 minutes, recurrent cases were 40% more than 23.7% of initial cases. 10) The resident of urban was 78.6% and of rural was 21.4%. 11) The types of convulsion were generalized in 92% of total cases and focalized in 8%. In the focal types, recurrent cases (15%) were much more than initial cases (5.5%). 12) In occurrence of seizures in body temperature above 40 degrees C, it was 5.5% in initial cases, whereas it was 20% in recurrent cases. 13) 13) There was no significant difference between initial and recurrent cases on fever duration before seizure.
Birth Weight ; Body Temperature ; Chungcheongnam-do ; Electroencephalography ; Fever ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Pediatrics ; Recurrence* ; Seizures ; Seizures, Febrile* ; Sex Distribution

Malignant melanoma of the spinal cord is a rare tumor 3,8,9,12 The melanomas that originate in the meninges bear a general structural resemblance to those arising elsewhere, but it is questionable whether they ever metastasis outside the central nervous system7. If can be also argued that the primary central nervous system melanoma could actually be a metastasis from an occult primary site in the skin, esophagus, rectum or other sites6. We are reporting a case of malignant melanoma involving the cervical spinal meninges and hard palate.
Central Nervous System ; Esophagus ; Melanoma* ; Meninges ; Neoplasm Metastasis ; Palate, Hard ; Rectum ; Skin ; Spinal Cord*

BACKGROUND: Acute idiopathic thrombocytopenic purpura(ITP) in children has a low morbidity and mortality, and most of cases are self limited illness. But some of them are not responsive to treatment and finally progress to chronic disease. The purpose of this study is to evaluate the factors which influence the outcome in childhood idiopathic thrombocytopenic purpura. METHOD: From January 1990 to December 1995, patients with ITP who were admitted to the Pediatric department of Pusan National University Hospital were divided into acute and chronic form depending on whether the platelet count had returned to normal(150 x 10(9)/1) by six months after diagnosis. Between two groups, the clinical and laboratory characteristics, response to treatment were compared. RESULT: 1) Out of 55 patients with ITP, 36 cases(65.5%) were acute and 19 cases(34.5%) were chronic ITP. 2) Sex, previous viral infection history, clinical manifestations were not significantly different between two groups, but the chronic ITP was rare in less than 1 year of age. 3) The duration of symptoms over >2 weeks at presentation was strongly predictive of chronic ITP. 4) Most of chronic disease (87.5%) showed platelet counts below 150 x 10(9)/1 at 28 days after diagnosis as compared with acute disease(25.0%). 5) Among 19 cases of chronic disease, 6 cases responded completely to treatment, but 11 cases(57.9%) did not respond to any treatments, 2 cases improved spontaneously. CONCLUSION: A history of symptoms over 2 weeks at presentation and platelet counts below 150 x 10(9)/1 at 28 days after diagnosis were strong predictors of chronic ITP in children.
Busan ; Child ; Chronic Disease ; Diagnosis ; Humans ; Mortality ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

The influence of age and menopausal status at diagnosis on the prognosis of patients with primary breast cancer remains controversial. Some studies have found that younger patients have worse clinical outcomes than older patients, others have reported that younger patients have a more favorable outcome, and others have found no relation with age. We analyzed the effects of menopausal status in the survival of patients with operable breast cancer and estimated the correlations between the menopausal status and other established prognostic factors. We reviewed the records of the patients who had been operated on at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University during the past 10 years (1985~1996). The results were as follows: 1) The peak age group was the fifth decade (27%), and all of patients, except one, were females. 2) The most common symptom was a palpable breast mass with or without pain (88%). 3) Most patients (72.8%) visited within 6 months of the first appearance of a symptom, and the most frequent tumor size was 2~5 cm in diameter (58.9%). 4) Most of the primary tumors were located in the upper outer quadrant (61%); tumors located in the lower outer quadrant were rare (3%). 5) The most common TNM stage group was stage II (54.1%), and there was no difference of distribution between the premenopause and the postmenopause groups. 6) The common pathologic cancer types were infiltrating ductal cancer (73.8%), medullary cancer (9.3%), mucinous cancer (8.3%). 7) Axillary lymph-node metastasis was present in 58 cases (62.4%). 8) The overall five-year survival rate for all patients was 43.9%. 9) The five-year survival rates of the 38 premenopausal patients and the 38 postmenopausal patients were 42.4% and 35.8%, respectively, but there was no statically significant difference between the two groups. 10) Menopausal status did not significantly correlated with tumor size, tumor location, lymph-node metastasis or TNM stage. In conclusion, the menopausal status may be not correlated with the prognosis in breast cancer However, the effect of menopausal status on the prognosis of patients with breast cancer needs to be investigated for a large papulation of breast cancer patients.
Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Heart ; Humans ; Mucins ; Neoplasm Metastasis ; Postmenopause ; Premenopause ; Prognosis ; Survival Rate

BACKGROUND: To evaluate the safety and the efficacy of amlodipine, a dihydropyridine calcium antagonist, monotherapy in the treatment of moderate essential hypertension. METHOD: Amlodipine 5mg once a day was administered as a starting dose in 30 patients with essential hypertension in the morning and a one step upward titration was performed (amlodipine 10 mg once a day) was done at the end of 4weeks treatment. Final evaluation was done at 12weeks with laboratory test and echocardiogram. RESULT: Within 4weeks treatment with dose of 5mg amlodipine once a day, the systolic blood pressure (SBP) was decreased(184.5+/-23.3/150.5+/-16.0mmHg,p<0.000), and the diastolic blood pressure(DBP) was also decreased significantly (109.9+/-04.6/92.3+/-11.5mmHg, P<0.001). After 12 weeks of treatment with a mean dosage of 6.6mg once a day, SBP and DBP was maintained comparing with basal level (147.0+/-15.8/88.1+/-0.9mmHg, respectively). The efficacy of amlodipine treatment was noted an excellent in 16 patients(53.3%), good in 4 patient(13.3%), fair in 4 patients(13.3%), and failed in 2 patients(6.7%). There was no significant change in heart rate before and after amlodipine treatment. (80.0+/-2.3/80.9+/-10.4 beats/minute n.s). Amlodipine had not significant effects on laboratory findings such as serum creatinine, BUN, ALT/AST, hemoglobin, leukocyte count,platelet and lipid profiles. There was facial flushing 2 patients, but no need to discontinue administration of amlodipine and all patients completed for 12weeks therapy. CONCLUSION: It is concluded that amlodipine is an effective antihypertensive agent, as monotherapy once a day in patients with moderate essential hypertension.
Amlodipine ; Blood Pressure ; Calcium ; Creatinine ; Flushing ; Heart Rate ; Humans ; Hypertension* ; Leukocytes

We present a case of systemic lupus erythematosus(SLE) asseci ted with vitiligo in a 57 year-old male patient. Physical examination revealed two distinct skin lesions those of itiligo showed as centrally located depigmented patches surrounded by erythernatous patch on the right cheek, scalp and left dorsurn of hand and those of SLE showed as erythematous papules and patchs with partial adherent scales on the face, scalp, neck, both extensor surface of arm, and left dorsun of hand. Their coexistence lends credence to the contention that altered autoimrnunity may play a role in the pathogenesis of each of these diseases. In Western countries and Japen, patients with lupus erythema osis have been observed to develop vitiligo or depigmented spots on the skin, while in Korea, its has not been previously observed.
Arm ; Cheek ; Erythema ; Hand ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Male ; Middle Aged ; Neck ; Physical Examination ; Scalp ; Skin ; Vitiligo* ; Weights and Measures

BACKGROUND: We performed electrical cardioversion for the patients with chormic nonvalvular atrial fibrillation under the transesophageal echocardiographic guidance after anticoagulation to evaluate the safety of this procedure and the effects of electrical cardioversion on the atrial function. METHODS: After anticoagulation therapy with coumadine for three weeks, we tried chemical cardioversion with amiodarone first. Failed cases were included in this study. Pre-cardioversion transesophageal echocardiographic parameters were measured after exclusion of thrombi. After sedation with intravenous midazolam, direct-current cardioversion was done with the transesophageal echocardiographic probe in situ. Immediately after sinus conversion, we measured echocardiographic parameters again. Spontaneous echo contrast(SEC), left atrial appendage flow velocity, pulmonary vein flow velocity and time-velocity-integral(TVI), transmitral flow velocity, TVI and deceleration time were measured. All patients were anticoagulated for at least 4 weeks after cardiovesion. RESULTS: The total number of patients was forty one(24 males, 17 females) with the mean age of 58 years(range : 39-70). Mean duration of atrial fibrillation was 65 months(range : 1-360). Hypertension(12), dilated cardiomyopathy(10), cerebrovascular accidents(6), ischemic heart disease(2) and chronic lung disease(1) were associated. There were no complications. SEC increased or newly appeared in 18(43.9%) patients after sinus conversion. The left atrial appendage emptying velocity decreased(32.8+/-17.4 vs. 22.1+/-11.4cm/sec, p=0.020) and systolic TVI of both upper pulmonic vein increased significantly after sinus conversion. In two cases, early systolic forward flow(S1) of pulmonic vein appeared after sinus conversion. Transmitral E velocity decreased(86.9+/-28.8 vs. 76.3+/-30.6cm/sec, p=0.006) and the deceleration time increased(164+/-49 vs. 206+/-53msec, p=0.000) after sinus conversion. Transmitral A velocity was still low(34.9+/-19.5cm/sec) and E/A ratio was high(2.6+/-1.4) immediately after sinus conversion. CONCLUSION: After appropriate anticoagulation therapy and exclusion of left atrium and left atrial appindage thrombi with TEE we could perform electrical cardioversion safety without complications. The changes in transesophageal echocardiographic parameters after sinus conversion revealed the appearance of atrial mechanical activity in concordance with electrical activity. But these findings suggested atrial stunning or electromechanical dissociation which necessitates extended anticoagulation therapy until the full recovery of atrial mechanical function.
Amiodarone ; Atrial Appendage ; Atrial Fibrillation* ; Atrial Function ; Deceleration ; Echocardiography* ; Echocardiography, Transesophageal ; Electric Countershock* ; Heart ; Heart Atria ; Humans ; Lung ; Male ; Midazolam ; Pulmonary Veins ; Veins ; Warfarin

No abstract available.
Cervix Uteri* ; Female