We report a case of prenatal diagnosis of fetal congenital goiter at 31weeks of gestation by ultrasonogram and fetal hypothyroidism confirmed at birth as thyroid function test by umbilical cord blood sampling. Maternal Graves' disease and the drugs used to treat hyperthyroidism in pregnant women can affect the fetus, causing hyperthyroidism or hypothyroidism and goiter. Fetal hypothyroidism may be caused by transplacental passage of either maternal thyrotropic-binding inhibitory immunoglobulin(TBII) antibodies or maternal treatment with propylthiouracil(PTU). Untreated fetal hypothyroidism may result in mental retardation, perceptual-motor, visual-spatial, and language developmental problems. In this article fetal thyroid function was not assessed by cordocentesis, but fetal congenital goiter was detected ultrasound. Ultrasound should be used to detect fetal goiter from 20 weeks onward. Fetal goiter should resolve when maternal PTU treatment is decreased. We have diagnosed fetal hypothyroidism in utero by ultrasonography. Significance of in utero management of fetal hypothyroidism is discussed.
Antibodies ; Congenital Hypothyroidism ; Cordocentesis ; Female ; Fetal Blood ; Fetus ; Goiter* ; Graves Disease ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Intellectual Disability ; Language Development ; Mothers* ; Parturition ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Thyroid Function Tests ; Thyroid Gland ; Ultrasonography

Methemoglobinemia can be caused by dapsone toxicity. We report a case dapsone induced methemoglobinemia unresponsive to methylene blue successfully treated by exchange transfusion. A 52-year-old male ingested a handful of dapsone. He presented with severe peripheral cyanosis in lips and fingertips and his methemoglobin level was found to be 21.9%. After admission, methylene blue (1%) at 1 mg/kg was injected each time peripheral cyanosis and rising serum methemoglobin occurred. Despite methylene blue therapy, the patient's methemoglobin level continued to fluctuate. Five days after the injections of methylene blue, many Heinz bodies were visualized in the peripheral blood, suggestive of hemolytic anemia occurrence. By hospital day 6, serum methemoglobine levels were elevated and not measurable (> 50%) and the patient was constantly in a semi-comatose mental state. An exchange transfusion carried out by utilizing 6 units of packed red blood cells and 4 units of fresh frozen plasma was performed. The patient's methemoglobin levels were subsequently kept up below 20% and his peripheral cyanosis receded. Physicians should recognize the important role of exchange transfusion in refractory dapsoneinduced methemoglobinemia.
Anemia, Hemolytic ; Cyanosis ; Dapsone ; Erythrocytes ; Hand ; Heinz Bodies ; Humans ; Lip ; Male ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Middle Aged ; Plasma

This study empirically examined the actual level of elementary school children's knowledge of nutrition and the extent of current nutrition education for the children through the use of textbooks. Two or three classes were sampled from each of six schools, respectively, in Gangneung; of the 562 questionnaires that were distributed, 537 were returned and used for analysis. Respondents were all sixth-graders, on average boys and girls were 153.02+/-8.19cm and 152.79+/-7.15cm in height and 45.27+/-10.32kg and 43.33+/-7.46kg in weight, respectively, which was consistent with others' research. Most children had two siblings and a working mother, considered that they were well off, and their mother prepared meals. Children regularly had breakfast and dinner, although more children had dinner than breakfast. As a whole, their knowledge of the main nutrients contained in foods was lower than their general knowledge of nutrition. There were significant differences in knowledge of the main nutrients contained in foods, with girls showing more knowledge than boys (p<0.01). Most of them learned about nutrition at school, followed by home. At school, Practical Technology classes taught them the most about nutrition. Although Physical Education classes were expected to teach about nutrition in a quantitative way, they accounted for just 4.7% of the overall knowledge. As for the children's understanding of nutrition education through use of a textbook at school, just 19% of the students gained a very good understanding. As for interest in nutrition education at school, 22.2% of the students had no interest, while girls were more likely to have their interest in nutrition education at school affected by knowledge of nutrition than boys. For both boys and girls, the most desired method of education was cooking practice. More research across subjects is necessary so that nutrition education concentrated on the curriculum for fifth-graders can be provided by stages from the lower grades. Since cooking practice or games were preferred, it is necessary to develop nutrition education methods to incite active interest rather than passive education.
Breakfast ; Child ; Cooking ; Curriculum ; Surveys and Questionnaires ; Eating* ; Education* ; Female ; Gangwon-do* ; Humans ; Meals ; Mothers ; Physical Education and Training ; Siblings

A modern development of ambulatory ECG monitoring gave great advances in the diagnosis and evaluation of various cardiac conditions. Fifteen cases of ischemic heart disease, 11 cases of nonischemic heart disease, 5 cases of noncardiac disease and 9 cases of normal healthy subjects were studied from January 1980 to July 1981 in national Medical Center, with the following results: 1) The heart rate was decreased during night time, with less decreasing tendency in patients with ischemic heart disease. 2) Among 30 cases, including 12 patients with ischemic heart disease, who didn't show arrhythmia on routine 12 lead ECG, 12 cases, including 6 patients with ischemic heart disease, showed arrhythmia on Holter monitoring. 3) Among 5 cases with ischemic heart disease who showed premature ventricular contraction on day time monitoring, 2 cases didn't show premature ventricular contraction on nigh time monitoring. 4) The S-T segment and T wave were changed during night time in 2 cases with ischemic heart disease and in 2 normal subjects. From these results, we could assert that Holter monioring or ambulatory ECG tracing would be a good method for diagnosis and evaluation of ischemic heart disease, and other cardiac conditions. Several another studies with this equipment have to be performed and would give more distinctive outcomes.
Arrhythmias, Cardiac ; Diagnosis ; Electrocardiography ; Electrocardiography, Ambulatory* ; Heart Diseases ; Heart Rate ; Humans ; Myocardial Ischemia ; Ventricular Premature Complexes

This study evaluated the effect of dagassing on the ceramic bond strength of two Ni-Cr alloys under varying holding time at the upper limit temperature and atmospheric conditions. Metal specimens were divided into 5 groups for each alloy according to degassing conditions prior to porcelain application : no degassing, degassing under vacuum without hold, degassing under vacuum with hold for 5min. and 10 min. respectively at the upper limit temperature and degassing in air. Total number of metal ceramic specimens was eighty and each group had eight specimens : The ceramic bond strength was measured by four-point flexural test using Instron and the fractured surface was examined under SEM. The results obtained were as follows. 1. Degassing in air improved the ceramic bond strength of Ni-Cr alloys. 2. in degassing under vacuum, hold at the upper limit temperature was advantageous to the ceramic bonding of Ni-Cr alloys. 3. After ceramic metal bond test, metal surfaces were partially covered with the thin porcelain layer, and the cohesive failures in porcelain were predominant in groups showing higher ceramic bond strength.
Alloys* ; Ceramics* ; Dental Porcelain ; Vacuum

PURPOSE: This study was conducted to evaluate the effect of IVIG infusion on renal function in VLBW infants. IVIG has been proved quite safe in neonates given prophylactic and therapeutic doses. But nephrotoxicity is not recognized as adverse in IVIG therapy, only several previous adult cases have been noted. METHODS: For a total of ten VLBW infants who had not been received any medication except parenteral nutrition, vitamin and Fe supplements was assigned for study. To observe changes in renal function after preventive dose of IVIG administration(500mg/kg, 1dose) serum BUN and creatinine, 2-microglobulin( 2-MG) and N-acetyl- -D-glucosaminidase(NAG) were obtained prior to study and 1, 3 and 7 days after infusion. RESULTS: 1) There were no elevation of serum BUN and creatinine after IVIG administration, 2) There was transient increase of urine NAG from 1.1+/-0.7 u/mg creatinine before infusion to 2.7+/-5.3 u/mg creatinine on the first day of infusion, which was not statistically significat, decreasing to pretreatment level on the 3rd and 7th days after infusion. 3) There was transient increase of urine 2-MG from 294.6+/-223.8 microgram/mg creatinine before infusion to 680.0+/-108.9 microgram/mg creatinine on the first day and 416.0+/-246.3 microgram/mg creatinine on 3rd day after infusion, which was not statistically significant. CONCLUSIONS: It was found that prophylactic dose of IVIG in VLBW infants does not cause clinically significant impairment of renal function. but mild increment of urine NAG and 2-MG may suggest the possibility of renal tubular damage. Based on these results, further evaluation of the effect of IVIG on renal function in VLBW infant is recommended.
Acetylglucosaminidase ; Adult ; Creatinine ; Humans ; Immunoglobulins, Intravenous ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Parenteral Nutrition ; Vitamins

Horse chestnut (Aesculus hippocastanum) is a common tree found on roads and parks. The shape of the fruit is very similar to that of the edible Korean chestnut (Castanea crenata); thus, people can eat it by mistake. However, reports of the side effects and toxicity from ingestion are very rare. A 46-year-old male who had no unusual findings in the past had eaten horse chestnut seed which he had mistaken to be Korean chestnut. He visited the emergency department (ED) with complaints of epigastric pain, nausea, and sweating. Blood tests showed a slight increase in the levels of liver enzymes, serum amylase, and pancreatic amylase. During the monitoring, he complained of palpitations, and electrocardiogram showed atrial fibrillation. On the following day after conservative treatment, blood testing and electrocardiogram showed normal findings. He was discharged from the ED as he did not complain of any further symptoms. When a patient who has eaten horse chestnut visits the ED, blood examination and electrocardiogram monitoring are needed, and conservative treatment is required.

Propafenone is a Class Ic antidysrhythmic agent, used in the management of atrial fibrillation. This is also a calcium channel and a weak beta blocker. The conventional therapy of hypotension induced by propafenone overdose includes fluid resuscitation followed by inotropic support. NaHCO3 is considered to be the treatment of choice. We report a case of successful insulin therapy for propafenone-induced hypotension unresponsive to NaHCO3. A 41-year-old woman with a prior medical history of atrial fibrillation presented to the ED after ingesting 4500 mg of propafenone, prescribed for her atrial fibrillation treatment. On initial examination, she was alert with O2 saturation of 96% and normal vital sign. Fifteen minutes later, her electrocardiogram revealed polymorphic ventricular tachycardia and then changed to ventricular fibrillation. When CPR was stopped, her BP was 70/40 mmHg, HR was 68 beats/min with wide QRS complex. Normal saline and inotropics were administered rapidly to improve hypotension. And we injected NaHCO3. Her blood pH was kept between 7.45 and 7.55. But, BP was not improved. Refractory to the conventional therapy for sodium channel blocker toxicity, we decided to try insulin treatment, considering properties of propafenonen having beta and calcium channel blocking effect. We administered short-acting insulin. Her blood glucose level was kept euglycemia by continuous 5% dextrose infusions and tried to keep serum potassium normal range. Thirty minutes after adminstering insulin, her SBP was checked at 100 mmHg. She was discharged 8 days post-ingestion without further complications. Insulin must be considered in severe hypotension induced by propafenone overdose unresponsive to other conventional therapy.
Adult ; Atrial Fibrillation ; Blood Glucose ; Calcium Channels ; Cardiopulmonary Resuscitation ; Electrocardiography ; Female ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Insulin ; Insulin, Short-Acting ; Potassium ; Propafenone ; Reference Values ; Resuscitation ; Shock ; Sodium ; Sodium Bicarbonate ; Sodium Channels ; Tachycardia, Ventricular ; Ventricular Fibrillation ; Vital Signs

Hemangiopericytoma is a rare vascular tumor arising from pericytes. The tumor usually develops in the skin or subcutaneous tissue, particularly in the extremities.4 pulmonary origin of hemangiopericytoma is known to be quite rare. It has the potential to become a highly malignant lesion, so wide excision is the treatment of choice. We present a case of primary malignant hemangiopericytoma of the lung and discuss the clinical symptoms, diagnosis, therapy and prognosis within the context of a brief review.
Diagnosis ; Hemangiopericytoma* ; Lung* ; Pericytes ; Prognosis ; Skin ; Subcutaneous Tissue

No abstract available.
Carcinoma, Transitional Cell*