Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

Diffuse aspiration bronchiolitis is defined as a clinical entity characterized by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles. Clinical symptoms are bronchorrhea, bronchospasm, and dyspnea, and chest radiographs show the presence of regional or disseminated srnall nodular shadows and hyperlucency. Chest CT should help in detecting diffuse nodular shadows of bronchiolitis. Pathologic findings of diffuse aspiration bronchiolitis are characterized by localization of chronic mural inflammation with foreign body reaction in bronchioles. Recurrence of small amounts of aspiration might play an important role in the pathogenesis of diffuse aspiration bronchiolitis. We report a case of diffuse aspiration bronchiolitis in a 4-month- old female infant who had recurrent aspiration due to dysphagia and presented with recurrent fever, dyspnea and wheezing. She showed typical radiologic and histologic findings compatible to diffuse aspiration bronchiolitis. She was improved with treatment of nasogastric tube feeding. We emphasize the importance of recognizing this disease entity and differentiating it from pulmonary diseases associated with bronchospasm. (J Korean Pediatr Soc 2000;43:842-845)
Bronchial Spasm ; Bronchioles ; Bronchiolitis* ; Deglutition Disorders ; Dyspnea ; Enteral Nutrition ; Female ; Fever ; Foreign-Body Reaction ; Humans ; Infant* ; Inflammation ; Lung Diseases ; Radiography, Thoracic ; Recurrence ; Respiratory Sounds ; Tomography, X-Ray Computed

Little objective information is avilable on the influence of occlusive dressings on the healing of cutaneous partial skin defect wounds. Our purpose was to examine the effects of occlusive dressing by using the synthetic dressing mateial, PolyMem in the management of 2nd degree burn wounds and donor sites of split thicknes skin graft and partial-thickness wounds in rabbits. New Zealand white rabbits, 12 to 14 weeks of age, were divided into 2 groups. Two partial thickness skin wounds measuring approximately 40x30 mm were induced using a scalpel on the back of each anesthetized animal. They were designated as group I (dressing with conventional method, n=15), group II (dressing with PolyMen, n=15). Each treated wound was individually covered with the assigned dressing immediately after wounding. Wound were examined and measured at 10 days to determine the extent of healing. By day 10, the PolyMem dressed wounds were approximately 67% healed, while all vaseline gauze dressed wounds were about 50% healed. Standardized 20 mm full-thickness biopsy wounds were treated for 10 days. Section of PolyMem group at POD 10 days showed complete epidermal regeneration above fibrotic dermis (H&E, x40). Section of conventional group at POD 10 days showed marginal epidermal regeneration (H&E, x40). 72 patients (44 patients with 2nd degree burn and 28 patients with skin graft donor sites) were divided into four groups. They were designated as group I (Burn patients with PolyMem, n=24), group II (Burn patients with conventional methods, n=24), group III (S.T.S.G. patients with PolyMem, n=14), group IV (S.T.S.G. patients with conventional methods, n=14). We investigated wound site pain, healing time, comfort and numbers of dressing change. As compared with the control group, the PolyMem dressed group had less pain, more rapid healing time, more comfort, less frequent dressing changes. From these results, we concluded that the occlusive dressing with PolyMem was an effective alternative to the conventional gauze dressig on the wound healing. Our results suggest tat PolyMem is one of the ideal dressing materials.
Animals ; Bandages ; Biopsy ; Burns ; Dermis ; Humans ; Occlusive Dressings ; Petrolatum ; Pheniramine ; Rabbits ; Regeneration ; Skin ; Tissue Donors ; Transplants ; Wound Healing* ; Wounds and Injuries*

This study was aimed at evaluating the nutritional status of Korean lactating women, who were attending peripheral community clinics in low-income areas, by anthropometric measurement, estimating dietary intakes and analyzing the contents of breast milk components, serum lipid content and fatty acid composition. Regarding anghropometric measurements, maternal circumferences decreased significantly at the trunk but not at the limbs. The skinfold thickness on all regions had the tendency to decrease during lactation. It was found that intakes of energy, protein, lipid and carbohydrates were desirable while calcium, zinc, copper and vitamin A were low and sodium was excessive. The energy % of fat was 22.41% of the total energy which is higher than the RDA for adults but it is proper for lactating women, but energy % from each fatty acid was usually low and an intake ratio of omega6/omega3 fatty acids was desirable. Accordingly, it is thought that dietary fat intake was balanced in quality. Concentrations of the nutrients in matured human milk showed the same range as that reported form different regions with the exception of calcium and magnesium which were relatively low. Serum lipid contents were decreased with the time postpartum and the average serum lipid content of lactating women were similar to the normal range of adults. Serum polyunsaturated fatty acids. especially omega6 fatty acids have gradually increased with the time postpartum, but the composition were not greatly influenced by dietary intakes.
Adult ; Breast* ; Calcium ; Carbohydrates ; Copper ; Dietary Fats ; Extremities ; Fatty Acids ; Fatty Acids, Unsaturated ; Female ; Humans ; Lactation ; Magnesium ; Milk, Human* ; Nutritional Status ; Postpartum Period ; Reference Values ; Skinfold Thickness ; Sodium ; Vitamin A ; Zinc

Sex typing may become the start point in investigations that are usually performed through amelogenin typing. In cases involving genotype-phenotype discrepancy, amelogenin typing could yield misleading results. The rare XX male syndrome is characterized by a phenotypic male with a 46, XX female karyotype. In this point, this case report would help understand the importance of genotype-phenotype discrepancy.
Amelogenin ; Female ; Genes, sry ; Humans ; Karyotype ; Klinefelter Syndrome ; Male ; Y Chromosome

BACKGROUND: Cardiovascular disease is the major cause of morbidity and mortality. It is well known that androgen and sex hormone-binding globulin(SHBG) in women were associated with risk factors for cardiovascular disease such as obesity, central fat accumulation and atherogenic lipid profile. High resolution B-mode ultrasonography can visualize directly both luminal and vessel wall characteristics, and ultrasonic measurement of carotid intima-medial thickness(IMT) can be used to investigate the atherosclerosis of coronary, cerebral and peripheral arteries. The aim of this study was to evaluate the relationship between the serum dehydroepiandrosterone sulfate(DHEA-S) and SHBG, and body fat distribution pattern, cardiovascular risk factor and carotid atherosclerosis in women. METHODS: Blood pressure, fasting serum glucose, insulin, lipid profile, SHBG and DHEA-S were measured. Body fat distribution pattern was assessed by waist to hip ratio, waist to thigh ratio and subscapular to triceps skin fold thickness ratio, faf mass measured by bioelectric impedance analyzer, subcutaneous fat area, visceral fat area, and visceral to subcutaneous fat area ratio(VSR) at the level of umbilicus using the computed tomography. The IMT of the carotid artery was measured by high resolution B mode ultrasound as a marker of atherosclerosis. RESULTS: 1) There was no significant difference of age-adjusted values of carotid IMT among subjects with NGT(0.426+/-0.09mm), IGT(0.46+/-10.09mm) and NIDDM(0.453+/-0.11mm). 2) In postrnenopausal women, carotid IMT was greater(0.484+/-0.11mm, p=0.05) than premenopausal women(0.426+/-0.08mm), but it was not significant after age adjustment. Serum SHBG and DHEA-S levels in postmenopausal women were significantly lower(p<0.05) than premenopausal women, but they were not significant after age adjustment. 3) Carotid IMT was significantly correlated with age(r=0.37, p<0.01), fasting serum glucose (r=0.32, p<0.01), total cholesterol(r= 0.25, p<0.05), LDL-cholesterol(r=0.26, p<0.05), visceral fat area(r=0.35, p<0.01) and VSR(r=0.31, p<0.05). 4) By the stepwise multiple regression analysis, carotid IMT was positively and significantly associated with age(p<0.01) and serum DHEA-S concentration(p<0.05) in dent of age, body mass index, waist to hip ratio, fasting serum glucose. CONCLUSION: Carotid IMT was associated with age and serum DHEA-S concentration in women without cardiovascular disease. Therefore, serum DHEA-S may be one of risk factors for cardiovascular disease in women. However, we could not conclude its cause-result relationship because of cross sectional nature of our study, and prospective study will be needed.
Arteries ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery Diseases* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Electric Impedance ; Fasting ; Female ; Humans ; Insulin ; Intra-Abdominal Fat ; Mortality ; Obesity, Abdominal ; Phenobarbital ; Risk Factors ; Sex Hormone-Binding Globulin* ; Skin ; Subcutaneous Fat ; Thigh ; Ultrasonics ; Ultrasonography ; Umbilicus ; Waist-Hip Ratio

Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.
Breast* ; Diagnosis ; Diagnosis, Differential ; Factor VIII ; Female ; Fibroadenoma ; Fibroblasts ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Recurrence

Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification* ; Netherlands

The serum concentrations of the major minerals(calcium, phosphorus, magnesium, sodium, potassium) and trace elements(iron, Zinc, copper manganese)were datermined in 23 breast fed infants living in Eumsung, Choong-buk region. The results obtained are summarized as follows: 1)The mean levels of calcium, phosphorus, magnesium, sodium and potassium of the serum of total subjects were 8.15+/-0.33mg/dI, 11.06+/-0.16mg/dI, 2.00+/-0.14mg/dI, 3.4476+/-17.99mg/dI and 9.06+/-2.04mg/dI respectively. 2)The serum concentrations of iron, zinc, copper and manganese in total subjects averaged 95.83+/-0.33mg/dI, 93.79+/-7.06 microgram/dI and 98.57+/-7.06 microgram/dI and 4.93+/-0.62 microgram/dI respecitively. 3)Breast fed infants had significantly higher serum calcim, magnesium, sodium and iron concentrations than the formula fed groups. Otherwise, serum potassium, copper and manganese levels in breast milk fed infants were significantly lower than those in formula fed infants. 4) In formula fed infants, serum potassium and copper levels increased increased significantly with months after birth.
Breast ; Calcium ; Copper ; Humans ; Infant* ; Iron ; Magnesium ; Manganese ; Milk, Human ; Minerals* ; Parturition ; Phosphorus ; Potassium ; Sodium ; Trace Elements* ; Zinc

The term malignant mesenchymoma has been applied to those tumors of the soft tissue of mesenchymal origin which are composed of tumor cells differentiating into two or more unrelated malignant forms in addition to the fibrosarcomatous element. Recently authors experienced a case of malignant mesenchymoma in the right axillary area. Microscopically the sarcoma revealed multiple pattern of differentiation, including liposarcoma, malignant schwannoma, fibrosarcoma, malignant fibrous histiocytoma and rhabdomyoblastoma. The presence of rhabdomyblastic cells were proved by immunochemical study utilizing desmin. This patient was treated with surgical excision and radiation.