The occurrence of carcinoma in a congenital uterine anomaly is uncommon. Indeed, malignancy of the uterine fundus with congenital uterine anomaly is quite rare, with fewer than 50 cases reported in the world liturature. Many patients go through life without the knowledge of their presence, and they are discovered at autopsy. Early diagnosis and proper management is necessary to decrease the high mortality. We present a case of endometrial carcinoma in a single horn of a bicornuate uterus.
Animals ; Autopsy ; Early Diagnosis ; Endometrial Neoplasms* ; Female ; Horns* ; Humans ; Mortality ; Uterus*

PURPOSE: This study was conducted to get baseline data to establish a guideline for the infant nutrition by observing the feeding practice and nutritional intake during infancy and evaluationg the nutritional status of iron and lipids at 12-month-old infants. METHODS: This survery was cnducted from July to November, 1992. Subjects were healthy infants who were brought to Yeungnam University Hospital for vaccination. We followed up feeding methods for 6 months in 120 infants, and laboratory tests which include hemoglobin, fematocrit, MCHC, ferritin, total cholesterol, HDL-cholesterol, triglyceride and urea nitrogen/creatinine ratio were done in 36 infants at 12 months of age. RESULTS: Male to female sex ratio was 1.6:1 in total 120 study infants. Among 36 infants who took laboratory tests, five infants were breast-fed, 25 were formula-fed, and 6 were mexed-fed. Percentage of the formula-fed infants increased as their monthly age increases. Although 54.2% of the studied infants were started weaning diet at four months of age, 10.8% of infants were not given any weaning diet until 6 month of age. Breastfed infnats had lower hemoglobin(10.6+/-1.8g/dl), hematocrit(32.6+/-3.6%), serum ferritin(13.6+/-13.1ng/ml)(p<0.05), and 15.6% of them had anemia and 16.7% of them had iron deficiency. Serum lipids levels except total cholesterol in breaset-fed female infants were comparable between groups. CONCLUSIONS: We confirm that the incidence of iron deficiency anemia was increased in breast fed infants and there was no difference in lipids levels according to different feeding methods. Adequate iron supplementation through weaning diets is one of the most important problems in breast milk feeding
Anemia ; Anemia, Iron-Deficiency ; Breast ; Cholesterol ; Diet ; Feeding Methods ; Female ; Ferritins ; Humans ; Incidence ; Infant* ; Iron* ; Male ; Milk, Human ; Nutritional Status* ; Sex Ratio ; Triglycerides ; Urea ; Vaccination ; Weaning

BACKGROUND: Epidural narcotics are now widely used for postoperative pain relief, but their side effects are problematic. Thus, this study was undertaken to evaluate the analgesic effects and to minimize the side effects of the combination of epidural morphine and ketamine versus epidural morphine alone in pateints with postoperative pain. METHODS: The value of using a combined infusion of morphine with a variable dose of ketamine for postoperative analgesia following subtotal gastrectomy was assessed in a double-blind randomised study of 30 patients. Three groups of 10 patients received an infusion of morphine at 2 mg/day, either alone, or combined with ketamine at a rate of 0.4 or 0.6 mg/kg/day. RESULTS: Postoperative anlagesia, sedation, and side effects were not statistically significantly different between groups I and II. Postoperative sedation, and side effects were not statistically significantly different between groups I and III. VAS of group III at 1-2 h was lower than in group I. CONCLUSION: The addition of ketamine to a continuous infusion of morphine dose not significantly improve postoperative analgesia. In addition, increasing the dose of ketamine does not significantly improve postoperative analgesia, Nor does it increase sedation, or side effects.
Analgesia ; Gastrectomy* ; Humans ; Ketamine ; Morphine* ; Narcotics ; Pain, Postoperative*

Distal renal tubular acidosis (RTA) is well-recognized complication of immunologically mediated condition such as Sj ogren's syndrome, SLE, idiopathic hypergammaglobulinemia, autoimmune liver disease, autoimmune thyroid disease, multiple myeloma, and renal tranplant rejection. Tubulointerstitial involvement frequently occurrs in SLE. A sepctrum of abnormalities including impaired uriary concentration or acidification, increased fractional excretion of low molecular weight protein, hyporeinaemic hypoaldosteroniam and impaired tubular potassium excretion can occur in SLE. But complete distal RTA associated wih SLE is rare. We report a 13 year-old female with SLE and distal RTA which was diagnosed by NaHCO3 loading test. She had nephrotic syndrome, hypokalemia, hyperchloremic metabolic acidosis with alkali urine. She had fatiquebility, general weakness, intermittent fever and chest pain for at least 12months. And then, the butterfly-shaped malar rash was developed, so pediatrician suspected SLE and she was refer to us. At hospitalization. She had malar rash, percardial effusion, persistent proteinuria greater than 3+, hemolytic anemia, lymphopenia, leukopenia, positive LE cell, Anti-DNA Ab and posotive ANA. So her clinical data are satisfied ARA criteria for SLE. Her renal biopsy showed diffuse proliferative SLE nephpritis and marked focal tubular atrophy with localized heavy mononuclear cell infiltration and fibrosis. We performed NaHCO3 loading test to confirm distal RTA. During the test, we detected the inability to achieve a high urinary PCO2. This result is the most sensitive index of impaired distal acidification, so we can diagnose distal RTA. She had a good response to the therapy with prednisolone NaHCO3 and oral KCL supplement.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

Distal renal tubular acidosis (RTA) is well-recognized complication of immunologically mediated condition such as Sj ogren's syndrome, SLE, idiopathic hypergammaglobulinemia, autoimmune liver disease, autoimmune thyroid disease, multiple myeloma, and renal tranplant rejection. Tubulointerstitial involvement frequently occurrs in SLE. A sepctrum of abnormalities including impaired uriary concentration or acidification, increased fractional excretion of low molecular weight protein, hyporeinaemic hypoaldosteroniam and impaired tubular potassium excretion can occur in SLE. But complete distal RTA associated wih SLE is rare. We report a 13 year-old female with SLE and distal RTA which was diagnosed by NaHCO3 loading test. She had nephrotic syndrome, hypokalemia, hyperchloremic metabolic acidosis with alkali urine. She had fatiquebility, general weakness, intermittent fever and chest pain for at least 12months. And then, the butterfly-shaped malar rash was developed, so pediatrician suspected SLE and she was refer to us. At hospitalization. She had malar rash, percardial effusion, persistent proteinuria greater than 3+, hemolytic anemia, lymphopenia, leukopenia, positive LE cell, Anti-DNA Ab and posotive ANA. So her clinical data are satisfied ARA criteria for SLE. Her renal biopsy showed diffuse proliferative SLE nephpritis and marked focal tubular atrophy with localized heavy mononuclear cell infiltration and fibrosis. We performed NaHCO3 loading test to confirm distal RTA. During the test, we detected the inability to achieve a high urinary PCO2. This result is the most sensitive index of impaired distal acidification, so we can diagnose distal RTA. She had a good response to the therapy with prednisolone NaHCO3 and oral KCL supplement.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

Autoimmune hepatitis is an inflammatory liver disease characterized histologically by a dense mononuclaear cell infiltration of the portal tract, serologically by the presence of non-organ and liver specific autoantibodies and increased concentrations of IgG in the absence of a known etiology. Two types of autoimmune hepatitis are classified in the peripheral blood of antinuclear antibody and/or in antismooth muscle antibody (ANA/ASMA) or liver-kidney microsomal type 1 antibody (LKM-1). Type I (ANA/ASMA positive) and type II (LKM-1 positive) autoimmune hepatitis in children have clinical, biochemical, and histologic differences. We have experienced a case of type I autoimmune hepatitis in a 9-year-old girl. She had shown highly elevated IgG, high serum transaminase and marked hepatosplenomegaly. And so serologically ANA and ASMA were positive, histological findings of the liver biopsy were compatible with chronic active hepatitis. She was medicated with prednisone, but symptoms did not improved. Now she is receving conservative regimens.
Antibodies, Antinuclear ; Autoantibodies ; Biopsy ; Child* ; Female ; Hepatitis, Autoimmune* ; Hepatitis, Chronic ; Humans ; Immunoglobulin G ; Liver ; Liver Diseases ; Prednisone

Autoimmune hepatitis is an inflammatory liver disease characterized histologically by a dense mononuclaear cell infiltration of the portal tract, serologically by the presence of non-organ and liver specific autoantibodies and increased concentrations of IgG in the absence of a known etiology. Two types of autoimmune hepatitis are classified in the peripheral blood of antinuclear antibody and/or in antismooth muscle antibody (ANA/ASMA) or liver-kidney microsomal type 1 antibody (LKM-1). Type I (ANA/ASMA positive) and type II (LKM-1 positive) autoimmune hepatitis in children have clinical, biochemical, and histologic differences. We have experienced a case of type I autoimmune hepatitis in a 9-year-old girl. She had shown highly elevated IgG, high serum transaminase and marked hepatosplenomegaly. And so serologically ANA and ASMA were positive, histological findings of the liver biopsy were compatible with chronic active hepatitis. She was medicated with prednisone, but symptoms did not improved. Now she is receving conservative regimens.
Antibodies, Antinuclear ; Autoantibodies ; Biopsy ; Child* ; Female ; Hepatitis, Autoimmune* ; Hepatitis, Chronic ; Humans ; Immunoglobulin G ; Liver ; Liver Diseases ; Prednisone

OBJECTIVE: To evaluate the changes of gait patterns during crossing obstacles of different heights in hemiplegic stroke patients and to compare gait characteristics with those of healthy control subjects. METHOD: Subjects were 13 hemiplegic stroke patients and 9 age-matched healthy adults. Subjects stepped over obstacles with each height of 3, 8 and 13 cm. The three- dimensional gait analysis was performed. Temporospatial, kinematic and kinetic parameters were measured in both lead and trail limb. The pre- and post-obstacle distance, pre- and post-obstacle swing time and toe clearance were also measured. RESULTS: With increase in height of obstacles, ratio of single limb support time, angle of hip, knee flexion in swing phase and hip extensor moment increased in both lead and trail limbs. In the lead limb, post-obstacle distance and toe clearance also increased (p<0.05). Compared with control groups, the angle of knee flexion, hip extensor and hip flexor moment and pre- and post-obstacle distance decreased significantly in the lead limb of hemiplegic patients (p<0.05). In the trail limb of hemiplegic patients, the angle of hip flexion, hip flexor moment and post-obstacle distance decreased (p<0.05). CONCLUSION: Understanding strategies for adequate control and coordination of the swing limb during crossing obstacles may be the basis for the safe training of obstacle crossing in hemiplegic stroke patients.
Adult ; Extremities ; Gait ; Hip ; Humans ; Knee ; Stroke ; Toes

A recent study showed that comparative sequence analysis of rpoB DNAs could reveal natural relationships in genus Mycobacterium [J Clin Microbiol. 37 (6). 1999]. rpoB DNAs showed interspecies variation and intraspecies conservation, Based on these data, we developed polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) protocols which enable species differentiation in genus Mycabacterium. When this assay was applied to 24 clinical isolates identified as M. avium complex (MAC) by biochemical test, these were successfully differentiated into M. avium and M. intracellulare. These results were concordant with those obtained by 16s rDNA analysis. It is the first report that PCR-SSCP analysis of rpoB DNA could be used for species differentiation of MAC strains.
DNA* ; DNA, Ribosomal ; Mycobacterium avium Complex* ; Mycobacterium avium* ; Mycobacterium* ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational* ; Sequence Analysis

BACKGROUND: Standard PET (peritoneal equilibration test) is time consuming and it cannot reflect the water removal accurately because it measures solute transport by diffusion only. Thus, it is important to find parameters that can be used to predict both the diffusive permeability of peritoneal membrane and the peritoneal fluid removal. Sodium removal in CAPD is strongly related to the ultrafiltration and the recent study has suggested that dialysate sodium concentration at 240 minutes could reflect both peritoneal fluid removal and peritoneal transport characteristics. In this study, we investigated whether a single dialysate sodium test after overnight dwell could provide the same information as the standard PET and could reflect ultrafiltration failure. METHODS: A 9-hour overnight dwell study with 2L of 3.86% glucose dialysis solution was carried out in 48 clinically stable CAPD patients. All patients underwent a PET test with 2L of 2.27% glucose solution in the morning after an overnight dwell study. According to ultrafiltration (UF) failure (net UF<100 mL/4 hour on 2.27% glucose solution), patients were divided into two groups (group I, UF failure group; group II, non UF failure group). D/P(Na540) and D(Na540) at the end of the 9-hour dwell were compared between two groups RESULTS: D/P(Na540) was significantly correlated with D/Pcreatinine (r=0.551, p<0.001) and drained volume (r=-0.536, p<0.001) at 240 minutes on PET. There was also a significant correlation between D/P(Na540) and drained volume (r=-0.555, p<0.001) at 540 minutes after overnight dwell. D(Na540) was significantly correlated with D/Pcreatinine (r=0.448, p<0.01) at 240 minutes on PET and also weakly correlated with drain volume at 240 minutes (r=-0.37, p<0.01). There was a significant difference in D/P(Na540) between the group I and group II (p<0.05), but not in D(Na540). CONCLUSION: Overnight 9-hour dwell study with 3.86% glucose solution is a simple procedure and easy to perform on outpatient basis. D/P(Na540) is comparable with PET results and may discriminate the different transport groups. D/P(Na540) may also be used as an indicator of ultrafiltration failure.
Ascitic Fluid ; Dialysis ; Diffusion ; Glucose ; Humans ; Membranes ; Outpatients ; Peritoneal Dialysis, Continuous Ambulatory* ; Permeability ; Sodium* ; Ultrafiltration