PURPOSE: To characterize the MR findings of hypoxic-ischemic brain injury and to assess the value of the MR imaging. MATERIALS AND METHODS: SE T1 -, T2-weighted, and IR brain MR images of 44 infants and children with the past history of perinatal hypoxic insults were reviewed. Abnormal brain MR findings of 8 patients with birth history of prematurity and 36 patients with birth history of full-term/posterm including 7 with severe anoxic insult history, were compared in regard to the location and the character of the lesions RESULTS: MRI demonstrated the followings;(1)abnormal signal intensity lesions of subcortical and/or deep cerebral white matter, cortex, and deep gray matter, (2)atrophy of the cerebral white matter, cortex and corpus callosum, with/without ventriculomegaly, and (3)delay in myelination. Periventricular and deep white matter lesions were demonstrated in the prematurity, the deep white matter lesions and/or subcortical white matter lesions in the term/post-term, and deep gray matter lesions in the 7 patients with severe anoxic insults history. CONCLUSION: MR imaging was useful in the diagnosis of the hypoxic-ischemic brain injury, and the white and gray matter lesions were correlated with the time of the injury and the severity of hypoxic insult.
Brain Injuries* ; Brain* ; Child ; Corpus Callosum ; Diagnosis ; Humans ; Infant ; Magnetic Resonance Imaging ; Myelin Sheath ; Reproductive History

PURPOSE: We report clinical charateristics of percutaneous central venous catheteriza- tion(PCVC) that is performed commonly as a vascular access procedure in the neonatal intensive care unit(NICU) including comparision between the success rate and com- plication rate of groups performed by a doctor and by nurses who were accustomed to the IV procedure. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan hospital over 2 years 5 rnonths from May, 1995 to September, 1997. The 24 cases of PCVC were performed by doctors and 134 cases of this proce- dures were performed by well trained nurses. We have compared success rates, clinical characteristics, insertion sites, indwelling time, causes of removal of the catheters, and associated complication of both doctor performed group (D) and nurse performed group (N) retrospectively. RESULTS: The mean gestational age, birth weight, weight at the time of insertion were significantly lower in the doctor performed group than in the nurse group(P<0.001). There were significant differences in postnatal age and mean duration per catheter in both groups. The overall success rate of insertions was 89.9%(142/158), the success rate of doctor performed group was 54.2%(13/24) and nurse group was 96.3%(129/134) and there was significant difference(P<0.001). In the doctor performed group, 100% were axillary however in the nurse group 43.4% were axillary, 38.8% were antecubital, 9.4% were temporal, and 5.4% were hand. The most common cause of the removal of the catheter was elective in both groups but there was also substantial spontaneous removal by the patients and mechanical complication. Cultures of catheter tips were done after removal in 110 cases, among then were positive in 36 cases(33.6%), the most common causes were Staphylococcus aureus and Candida albicans. CONCLUSION: In this report, the authors emphasize that percutanous central venous catheterization performed by well trained nurses has a higher success rates than the doctor performed group and can be considered safe. We would also like to emphasize that more attention should be paid to the maintanace of PCVC.
Birth Weight ; Candida albicans ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Chungcheongnam-do ; Gestational Age ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Retrospective Studies ; Staphylococcus aureus

Diabetes insipidus(DI) of central origin is a clinical syndrome resulting from low blood levels of antidiuretic hormone secreted from the posterior lobe of the pituitary gland, which is usually caused by lesions involving the hypothalamus-neurohypophyseal axis. MR imaging can reveal absence of the posterior pituitary bright signal(PPBS)in DI. The authors reviewed four patients with intracranial germinomas who had DI due to hypothalamus involvement. All patients before radiotherapy revealed absence of PPBS on MRI. Three cases recovered from DI after radiotherapy and showed reappearance of PPBS. Another one patients who continued DI didn't show signal change of the posterior pituitary gland. Ws speculated that the reappearance of PPBS is related to clinical improvement of DI.
Diabetes Insipidus* ; Follow-Up Studies* ; Germinoma* ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Gland, Posterior ; Radiotherapy*

Neonatal infective endocarditis is fatal and rare disease but recently there is a trend of an increase in incidence even without congenital heart disease when there are high risk as prematurity, central vein catheterization and neonatal cardiopulmonary resuscitation. Symchych reported that in about 3% of autopsy cases of an year, the findings of infective endocarditis were noted. In Korea, there was a case report but it was case of a premature infant who had umbilical vein catheterization and respiratory ventilator treatment. We experienced a case of neonatal infective endocarditis in a female infant who was delivered at 34 weeks gestational age without receiving central vein catheterization or neonatal cardiopulmonary resuscitation. Although she received intensive antibiotic therapy for staphylococcus cultured in blood, she died necessarily. We reported a case of neonatal infective endocarditis without cardiac anomaly with brief review of related literature.
Autopsy ; Cardiopulmonary Resuscitation ; Catheterization ; Catheters ; Endocarditis* ; Female ; Gestational Age ; Heart Defects, Congenital ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Korea ; Rare Diseases ; Staphylococcus ; Staphylococcus aureus ; Umbilical Veins ; Veins ; Ventilators, Mechanical

Doppler echocardiography was performed to evaluate the tricuspid regurgitation in 786 infants and children with heart disease. 3 Doppler methods were used. : The duration of systolic turbulence of tricuspid regurgitation in thr right atrium was evaluated by continuous wave Doppler method, the distance of systolic turbulence within right atrium from the tricuspid plane, by pulsed Doppler method and the retrograde systolic hepatic vein regurgitation, by color Doppler method. The following results were obtained. 1) Incidence of pan systolic tricuspid regurgitation in each disease were as follows. 68% of ECD, 66% of Ebstein's anomaly, 54% of pulmonary atresia, 50% of arrhythmia, 45% of ASD, 38% of TAPVR, 15% of VSD, 26% of TOF, 12% of PDA, 13% of normal children. 2) In about 90% of children with tricuspid regurgitation, hepatic vein regurgitation was detected by color Doppler echocardiography.
Arrhythmias, Cardiac ; Child* ; Ebstein Anomaly ; Echocardiography, Doppler ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Diseases* ; Heart* ; Hepatic Veins ; Humans ; Incidence ; Infant* ; Pulmonary Atresia ; Scimitar Syndrome ; Tricuspid Valve Insufficiency*

No abstract available.

The fashion of vascular anastomosis, end-to-end or end-to-side (E-to-S), are depended upon surgeon's preference or surgical situations. In E-to-S anastomosis two different methods of arteriotomy are applicable but it has been suggested the type, either elliptical or slit arteriotomy, play a different role in the flow hemodynamics. We thought that the difference is more considerable in microvascular surgery. This study examines the effects of elliptical versus slit arteriotomy on morphologic vessel patency. Twenty male Sprague-Dawley rats were divided into two groups of ten rats each. Both carotid arteries were selected as a experimental model. During the procedures the rat brain was tolerable to ischemia and all animals were survived after operations. The morphologic analysis of anastomosis site was through resin-casting method with scanning electromicroscopic examination. The results showed notable difference between two groups in three-dimensional morphology at two-month of operation. This difference may affect the flow hemodynamics and long-term vessel patency. In microvascular anastomosis, the mortpologic difference of the elliptical arteriotomy is worse than slit arteriotomy which compromises the vessel circumference.
Animals ; Brain ; Carotid Arteries ; Hemodynamics ; Humans ; Ischemia ; Male ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley

No abstract available.
Lung* ; Oxygen* ; Rabbits* ; Ventilation*

Desmoplastic small round cell tumor (DSRCT) is a rare neoplasm of young adults and it is characterized by polyphenotypic differentiation. We experienced a case of abdominal DSRCT that occurred in a 19-year-old female who presented with painful swelling of her right forearm. The tumor was cytokeratin-negative and it exhibited some tumor cells with intranuclear inclusions. Molecular demonstration of EWS-WT1 fusion transcripts is particularly useful to confirm the diagnosis of DSRCT without epithelial differentiation. We report here on a case of cytokeratin-negative DSRCT that showed an unusual feature of intranuclear inclusions.
Desmoplastic Small Round Cell Tumor ; Female ; Forearm ; Humans ; Intranuclear Inclusion Bodies ; Keratins ; Young Adult

No abstract available.
Multiple Myeloma* ; Osteosclerosis*