Perinatal asphyxia is an insult to fetus or newborn due to lack of oxygen or perfusion to various organs, especially to brain, resulting in the important complication known as hypoxic ischemic encephalopathy. A clinical study was conducted on 30 newborns with perinatal asphyxia, who were admitted to Pediatric department of Ewha Women's University Hospital during 18 months period from Sep. 1990 to Feb. 1992. CPK, LDH and isoenzymes were measured in 30 asphyxated neonates and compared with control group. The results were as follows: 1) The serum CPK values at 1st and 7th day were not different in the asphyxia group and control group. 2) The serum CPK-BB and MB fraction at 1st day were highly significant in the asphyxia group. 3) The CSF CPK value at 1st day was highly significant in the asphyxia group. 4) The serum LDH values and the serum LDH isoenzyme 3 were highly significant in asphyxia group at 1st day. 5) The CSF LDH values and the CSF LDH isoenzyme 2 and 3 were highly significant in asphyxia group at 1st day. So, we concluded the serum CPK-BB fraction, the CSF CPK values, the serum LDH values, the serum LDH 2 fraction, the CSF LDH values and the CSF LDH 2,3 fraction as predictors of neurologic disability following perinatal asphyxia.
Asphyxia* ; Brain ; Fetus ; Humans ; Hypoxia-Ischemia, Brain ; Infant, Newborn ; Isoenzymes ; Oxygen ; Perfusion

Pulmonary vein velocities have recently been estimated in conjunction with mitral flow velocities to increase our understanding o ventricular filling. The advent of transesophageal echocardiography with pulsed Doppler imaging capability has provided a method by which both the mitral valve and pulmonary vein velocities can be easily recorded because of the posterior approach providing unimpeded interrogation of cardiac structures. The purpose of this present study was to evaluate the normal pulmonary venous, mitral and aortic flow pattern by transthoracic echocardiography in neonate according to the postnatal age. The results were as follows. 1) With regard to the aortic flow, the early systolic was of pulmonary flow peaked after the onset of aortic flow and the late systolic wave occured consistently before aortic valve closure. 2) The peak velocities of early systolic, late systolic, late systolic, diastolic and atrial systolic in the pulmonary venous flow were 36.4 (13.2cm/sec, 45.3 (15.3cm/sec, 48.5 (14.1cm/sec and 16.6( 5.7cm/sec at 1 day old. the difference according to the postnatal age was not significant. 3) The ratio of peak systolic to peak distolic velocity of pulmonary venous flow was 1.0( 0.3 at 1 day o1, 1.1( 0.4 at 1 week old and 1.2 (0.3 at 1 month old. The difference between old and 1 month old was statistically significant(p<0.05). 4) The peak early diastolic velocity of mitral flow was 51.3 (15.2cm/sec at 1 day old, 54.7( 13.7cm/sec at 1 week old and 80.7 (16.6cm/sec at 1 month old. The difference between 1 week old and 1month old was statistically significant(p<0.01). 5) The peak late diastolic velocity of mitral flow was 48.3 (14.6cm/sec at 1 day old, 50.1( 9.9cm/sec at 1 week old and 71.8 (16.6cm/sec at 1 month old. The difference between 1 week old and 1 month old was statistically significant(p<0.01). 6) The ratio of peak mitral early diastolic to peak late diastolic velocity was 1.1( 0.2 at 1 day old, 1.1( 0.3 at 1 week old and 1.2( 0.7at 1 month old. The difference between 1 week old and 1 month old was statistically significant(p<0.01). 7) The peak aortic valve flow velocity was 62.1 (14.2cm/sec at 1 day old, 67.8 13.4cm/sec at 1 week old and 76.6 14.1cm/sec at 1 month old. The difference between old and 1 month old was statistically significant(p<0.05). In conclusion, improvement of left ventricular diastolic function was noted at 1 month old by echocardiography. These normal data will be useful in comprisons with the data, which obtained in newborn with various congenital heart disease that affects flow dynamics.
Aortic Valve ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Transesophageal ; Heart Defects, Congenital ; Humans ; Infant, Newborn* ; Mitral Valve ; Pulmonary Veins

No abstract available.

PURPOSE: To evaluate mammographic and sonographic breast parenchymal changes and the risk of breast cancer in women on hormonal replacement therapy (HRT). MATERIAL AND METHODS: The study group consisted of 50 patients examined with serial mammograms and/or ultrasonograms during HRT. The control group consisted of 50 patients examined with serial mammogram for a routine health check. Mammographic parenchymal changes in both the study and control groups and so- nographic findings of 27/50 patients in study group were evaluated. RESULTS: Follow-up mammogram of the control group showed no interval change or slight evolution of parenchyma with increasing age, but the study group showed increasing parenchymal densities. Most frequently encountered finding on SOhogram in 11 women treated by estrogen alone, was ductal dilatation (7cases ;64%), whereas in 16 women treated by estrogen and progesteron it was ductal epithelial hyperplasia (8 cases; 50%). Overall, four breast cancers developed;one infiltrating ductal carcinoma and three ductal carcinoma in situ. CONCLUSION: HRT causes the changes of breast parenchyma on mammogram and sonogram of postmenopausal women, and increases the risk of developing breast cancer. Therefore, careful and regular examination should be followed in those on postmenopausal HRT.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Dilatation ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Ultrasonography

PURPOSE: Pulmonary function test is an important diagnostic tool in neonatal intensive care. These tests provide a detailed assessment an infant's pulmonary status that can be used in several ways: to monitor the progression of lung disease, to streamline ventilator management, and to assess the infant's response to new treatments, such as surfactant replacement therapy or bronchodilator. The purpose of this study was to evaluate the pulmonary function test including tidal volume, minute ventilation, respiratory rate, flow-volume curve, respiratory system compliance, and respiratory system resistance in newborns with several respiratory diseases. METHODS: This study was performed on 101 newborns with respiratory diseases including hyaline membrane disease(HMD), bronchopulmonary dysplasia(BPD), pneumonia, meconium staining, congenital heart disease(CHD) from Febrary, 1994 to Febrary, 1995. Pulmonary function test including tidal volume, % V/PTEF, TEF25/ PTEF, ME/MI, respiratory system compliance, and respiratory system resistance was performed by System 2600 Pediatric Pulmoary Fuction Cart(SensorMedics, CA. USA) using pneumotachography and passive expiratory flow-volume technique. RESULTS: 1) Gestational age, birth weight, and birth height in neonates with HMD or BPD were significantly lower than normal neonates(p<0.05). 2) Respiratory rate in neonates with HMD was significantly higher than normal neonates(p<0.05). Tidal volume in neonates with HMD or BPD was significantly lower than normal neonates(p<0.05). Respiratory rate and tidal volume in neonates with meconium staining, pneumonia, pneumothorax, or CHD were not significantly different from normal neonates(p>0.05). 3) In the results of tidal breathing flow volume loop, % V/PTEF, TEF25/PTEF and ME/MI in neonates with HMD or BPD were significantly lower than normal neonates(p<0.05), but these results in neonates with meconium staining, pneumonia, pneumothorax, or CHD were not significantly different from normal neonates(p>0.05). 4) Respiratory system compliance in neonates with HMD, BPD, or pneumonia was significantly lower than normal neonates, and respiratory system resistance in neonates with HMD, BPD, or pneumonia was significantly higher than normal neonates(p<0.05). Respiratory system compliance and resistance in neonates with meconium staining, pneumothorax, or CHD were not significantly different from normal neonates(p>0.05). CONCLUSIONS: Pulmonary function tests in neonates with HMD, BPD, or pneumonia showed differnt findings with that in normal neonates, but pulmonary function tests in neonates with meconium staining, pneumothorax, or CHD showed normal findings.
Birth Weight ; Compliance ; Gestational Age ; Heart ; Humans ; Hyalin ; Infant, Newborn* ; Intensive Care, Neonatal ; Lung Diseases ; Meconium ; Membranes ; Parturition ; Pneumonia ; Pneumothorax ; Respiration ; Respiratory Function Tests* ; Respiratory Rate ; Respiratory System ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary, accounting for less than 0.5% of all primary ovarian neoplasm. This tumor is the most common type of all virilizing ovarian tumors. However, only one-third of patients develop virilization. Recently, we experienced a case of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.
Amenorrhea ; Female ; Humans ; Ovarian Neoplasms ; Ovary ; Sertoli-Leydig Cell Tumor* ; Sex Cord-Gonadal Stromal Tumors ; Virilism

PURPOSE: Fc receptors and Mac-1 play an important role in the protective response of granulocytes and monocytes against microbial infection. FcgammaRl, FcgammaRll, FcgammaRlll as well as CD11b/ CD18 have never been measured in a quantitative way during hemopoiesis. Thus we quantified the expression of Fc Rl, Fc Rll, Fc Rlll, and CD11b/CD18 during hematopoietic differentiation using HL-60 cells, which was induced to differentiate by DMSO, or PMA. METHODS: HL-60 cells (ATCC CCL-240) were induced to differentiate by adding 1.0% DMSO, or 16nM PMA. On the 4th and 7th day after stimulation as well as before stimulation, phenotypic analysis was performed by flow cytometry after staining the cells with PE-conjugated anti- human CD64, CD32, CD16, CD11b, CD18, and isotype controls. And the measured fluorescent intensity was transformed into Molecules of Equivalent Soluble Fluorochromes (MESF). RESULTS: Percent positive cells and MESF of CD11b on HL-60 cells increased upon induction by DMSO, but not by PMA. Percent positive cells of CD18 on HL-60 cells was 99% regardless of differentiation. But MESF of CD18 was increased on the 4th day and decreased on the 7th day by DMSO or PMA. Percent positive cells and MESF of FcgammaRl on HL-60 cells increased upon induction by DMSO or PMA. Percent positive cells of FcgammaRll on HL-60 cells was above 90% regardless of differentiation. MESF of FcgammaRll showed no significant change by DMSO or PMA. CONCLUSION: Quantitative expression of FcgammaRl, FcgammaRll, FcgammaRlll, and CD11b/CD18 of HL-60 cells changed during induction of differentiation by DMSO or PMA. MESF of FcgammaR and CD11b/ CD18 a better indicator than percent positive cells to compare the differentiation of HL-60cells.
Dimethyl Sulfoxide ; Flow Cytometry ; Fluorescent Dyes ; Granulocytes ; HL-60 Cells* ; Humans ; Monocytes ; Receptors, Fc

BACKGROUND: The delivery of proper diabetes care and preventive services is essential for diabetic patients in family practice. However, there are few studies on preventive service practice. This study aimed to survey the delivery of preventive services among diabetic patients in an outpatient department of family medicine in a general hospital. METHODS: We reviewed all of the electronic medical records and charts of patients with a recent diagnosis code of type II diabetes mellitus in an outpatient department of family medicine at Asan Medical Center from January 1, 2001, to December 31, 2002, encompassing documentation of laboratory tests, treatment, and cancer screening. RESULTS: This study included 124 patients with diabetes. Blood pressure measurement, fundus examination, and nutritional counseling were performed in 96.7%, 80.6%, and 50% of subjects, respectively. Lipid profiles and urine microalbumin were checked in 91.1% and 58.2%, respectively. Anti-platelet and anti-smoking agents were prescribed in 17.7% and 13.2%, respectively. In males, the rate of cancer screening for stomach and colon were 55.9 and 53.2%, respectively. In females, the rate of cancer screening for stomach, colon, breast, and cervix were 45.5, 51.6, 43.2, and 38.6%, respectively. CONCLUSION: Diabetic care related services were delivered more often than those of preventive services, such as cancer screening and prescription of anti-smoking or anti-platelet agents. Efforts to improve the delivery of preventive services are needed among diabetic patients in family practice.
Blood Pressure ; Breast ; Cervix Uteri ; Chungcheongnam-do ; Colon ; Counseling ; Diabetes Mellitus ; Diagnosis ; Early Detection of Cancer ; Electronic Health Records ; Family Practice* ; Female ; Hospitals, General ; Humans ; Male ; Outpatients ; Prescriptions ; Stomach

OBJECTIVES: To investigate the effect of a worksite-based dietary intervention program for the management of metabolic syndrome (MS) among male employees. METHODS: A dietary intervention program combining individual and environmental approach was implemented targeting white-collar employees at a worksite located in Seoul for 10 weeks. Out of 104 employees having agreed to participate in the program, those having three or more out of five components of MS and having two components, including a waist circumference component were classified into "the high risk group" (n=41) and received group nutrition education and individual nutrition counseling three times each. The rest of the study subjects were considered as "the low risk group" (n=63). The food environment at the worksite, where both the high and low risk groups were exposed, was changed to promote healthy eating. Physical data including MS components were collected and a questionnaire on dietary behaviors was administered before and after the intervention. The data from the high risk group (n=17) and the low risk group (n=20), excluding the subjects ineligible for or failed to complete the study (n=67), were analyzed. The difference before and after intervention was tested for significance by Wilcoxon signed-rank tests. RESULTS: Weight, body mass index (BMI), waist circumference, blood pressure, HDL-cholesterol, and HbA1c and the healthy dietary practice score improved significantly after intervention in the high risk group. The median number of MS components decreased significantly from 3.0 to 1.0 in the high risk group. In the low risk group, only HbA1c significantly decreased. Conclusions: The 10-week worksite-based dietary intervention program combining individual and environmental approach was found to be effective for managing MS of male employees. CONCLUSIONS: The 10-week worksite-based dietary intervention program combining individual and environmental approach was found to be effective for managing MS of male employees.
Blood Pressure ; Body Weight ; Counseling ; Eating ; Education ; Humans ; Male ; Seoul ; Waist Circumference ; Workplace

Cancer-associated rheumatic disorders are sometimes present concurrently with a tumor, but are not recognized initially. We report a case of dermatomyositis with breast cancer. A 46 year-old woman diagnosed with breast cancer with axillary lymph node metastasis had been treated by neoadjuvant chemotherapy and a lumpectomy with axillary lymph node dissection. She presented with a red rash on her face, eyelids, neck, and shoulders. A skin biopsy did not rule out dermatomyositis. Laboratory values were within normal limits, except muscle enzymes (Creatine kinase). Electromyography showed the presence of early myopathy. A PET CT-scan showed muscle uptake in left infraspinatus, r/o myositis. No abnormalities were presented in the muscle biopsy. Symptoms were improved by steroid therapy.
Biopsy ; Breast ; Breast Neoplasms ; Dermatomyositis ; Electromyography ; Exanthema ; Eyelids ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mastectomy, Segmental ; Muscles ; Muscular Diseases ; Myositis ; Neck ; Neoplasm Metastasis ; Shoulder ; Skin