1.PVL in preterm infants:correlation of MR & US.
Joo Hyun YANG ; Yong Seok LEE ; Hyun Joo PARK ; Yu Mi CHA ; Kyung In KIM ; Hyung Sik KIM
Journal of the Korean Radiological Society 1993;29(6):1300-1305
MRI (magnetic resonance imaging ) had been the most up-to-dated modality in evaluating white matter disease in recent years, whereas US (ultrasonogram) has been used extensively in diagnosis of neonatal PVL(periventricular leukomalacia) conventionally. We evaluated the diagnostic value of MRI by reviewing the MR findings and correlation of MR and US of PVL in II preterm infants. Evaluation criteria were MR signal intensity and discrimination of PVL on each pulse sequences land comparision between MR and US findings performed simultaneously, on the extent of PVL, size of the largest cyst and detectability of hemorrhagic lesion. MR findings of 11 cases of PVL were of low signal patterns on T1WI (T1weighted image) in 7, low signal patterns of PDWI (proton density weighted image) in 9, iso signal patterns on T2WI(T2weighted image) in 8 and low signal patterns on STIR(short time inversion recovery) in 7 cases. The lesions of 11 PVL were well discriminated in all 11 cases of T1WI, 7 cases of STR, 5 case of PDWE and 2 cases of T2WI. The lateral ventricle was diffuse dilated (n=1) and focally dilated (n=3) in atrial area. In the comparative study, MR presented more extensive lesions in 7 cases, larger cysts in 6 cases out of 7 PVL and more definitive hemorrhage in 3 cases out of 4 cases than sonography. In conclusion MR was more valuable than sonography in evaluating the extent of lesions, size of the largest cystic lesion and detetion of hemorrhage. TIWI and STIR images were more useful in detection of PVL than T2WI and PDWI.
Diagnosis
;
Discrimination (Psychology)
;
Hemorrhage
;
Humans
;
Infant, Newborn
;
Infant, Premature
;
Lateral Ventricles
;
Leukoencephalopathies
;
Magnetic Resonance Imaging
2.Severe Rhabdomyolysis in Phacomatosis Pigmentovascularis Type IIb associated with Sturge-Weber Syndrome.
Bongjin LEE ; Hyung Joo JEONG ; Yu Hyeon CHOI ; Chong Won CHOI ; June Dong PARK
Korean Journal of Critical Care Medicine 2015;30(4):329-335
Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by concurrent nevus flammeus (capillary malformation) and pigmentary nevus. According to current research, the major pathophysiologic mechanism in PPV is venous dysplasia with resultant compensatory collateral channels and venous hypertension. Arterial involvement is rare. We herein report our experience on renovascular hypertension, intermittent claudication, and severe rhabdomyolysis due to diffuse stenosis of multiple arteries in a patient with PPV type IIb associated with SWS.
Arteries
;
Constriction, Pathologic
;
Humans
;
Hypertension
;
Hypertension, Renovascular
;
Intermittent Claudication
;
Intracranial Aneurysm
;
Neurocutaneous Syndromes*
;
Nevus
;
Port-Wine Stain
;
Rhabdomyolysis*
;
Sturge-Weber Syndrome*
;
Vascular Diseases
3.Extensive and Progressive Cerebral Infarction after Mycoplasma pneumoniae Infection.
Yu Hyeon CHOI ; Hyung Joo JEONG ; Bongjin LEE ; Hong Yul AN ; Eui Jun LEE ; June Dong PARK
Korean Journal of Critical Care Medicine 2017;32(2):211-217
Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain
;
Cerebral Infarction*
;
Child
;
Child, Preschool
;
Decompressive Craniectomy
;
Diagnosis
;
Enoxaparin
;
Humans
;
Immunoglobulins
;
Inflammation
;
Levofloxacin
;
Magnetic Resonance Imaging
;
Male
;
Mycoplasma pneumoniae*
;
Mycoplasma*
;
Pneumonia, Mycoplasma*
;
Stroke
;
Thrombophilia
;
Thrombosis
;
Vasculitis
4.A posteroanterior cephalometric study on craniofacial proportions of Koreans with normal occlusion.
Hyoung Seon BAIK ; Hyung Seog YU ; Kie Joo LEE
Korean Journal of Orthodontics 1997;27(4):643-659
For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vertical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement (Bjork Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.
Cephalometry
;
Dentofacial Deformities
;
Diagnosis
;
Facial Asymmetry
;
Female
;
Humans
;
Malocclusion
;
Orthognathic Surgery
;
Reference Values
;
Sutures
5.Primary Esophageal Malignant Melanoma in Korea: Clinical features, Management and Prognosis
Hyung-Hoon OH ; Yong-Wook JUNG ; Bora HAN ; Chan-Muk IM ; Hyung-Joo YU ; Young-Eun JOO
The Korean Journal of Gastroenterology 2022;79(5):222-227
Primary esophageal melanoma is a rare disease with a poor prognosis. To date, 18 cases have been reported in Korea. Four patients visited the Chonnam National University Hwasun Hospital with dysphagia, followed by epigastric pain and discomfort, odynophagia, and weight loss. Esophagogastroduodenoscopy revealed a black pigmented polypoid mass, protruding mass, or black-pigmented flat lesions. Two patients had distant metastases and lymphadenopathies in imaging studies. Two patients underwent esophagectomy and intrathoracic esophagogastrostomy. One patient was treated with chemotherapy and interferon-alpha. The other patient declined further treatment. The routine histology using H&E revealed brown-colored atypical melanocytes. Immunohistochemical staining exhibited strong reactivity for Melan-A, S-100, and HMB-45 proteins. The biopsy specimens were interpreted to be malignant melanoma.One patient had multiple distant metastases 13 months after surgery. The other patient had no recurrence for 33 months after surgery. The patient treated with chemotherapy and interferon-alpha showed disease progression in the follow-up examination. Primary esophageal melanoma in Korea is a rare disease characterized by aggressive behavior, early metastasis, and poor prognosis.
6.Risk Factors for Ciprofloxacin-Resistant Escherichia coli Strains in Pediatric Patients with Acute Urinary Tract Infection.
Joo Hyung HONG ; Jeesuk YU ; Gilho LEE
Korean Journal of Urology 2009;50(12):1219-1224
PURPOSE: Previous exposure to fluoroquinolone is an important risk factor for acquiring resistant strains of microorganisms. However, the mechanisms of fluoroquinolone resistance in Escherichia coli from pediatric patients with urinary tract infection (UTI) are not well defined because fluoroquinolone prescription for children is not permitted around the world. We investigated the risk factors for ciprofloxacin-resistant E. coli isolates from the urine of pediatric patients with UTI. MATERIALS AND METHODS: Data from 72 patients who showed > or =10(5) E. coli colony-forming units in urine culture were retrospectively collected from a university hospital between June 2006 and June 2009. The minimum inhibitory concentration of ciprofloxacin resistance was determined by the agar dilution method on Mueller-Hinton agar. RESULTS: The rates of E. coli resistance to ciprofloxacin, cefazolin, ampicillin, co-trimoxazole, and fosfomycin were 8.3%, 20.8%, 77.7%, 25%, and 0%, respectively. Differences in sex, age intervals, and previous antimicrobial use in recent years were significantly associated with ciprofloxacin resistance, whereas admission level, the presence of fever, and the type of UTI were not. In addition, female gender, previous antimicrobial use, and older age significantly increased the risk for ciprofloxacin resistance in a univariate analysis. Only co-trimoxazole resistance was positively associated with ciprofloxacin resistance, whereas resistance to other antimicrobials was not. CONCLUSIONS: Even though the incidence was not high, ciprofloxacin resistance was found in E. coli from pediatric UTIs. Because the characteristics of ciprofloxacin resistance in pediatric patients are not well defined, further study of the mechanism of acquiring ciprofloxacin resistance in children is needed.
Agar
;
Ampicillin
;
Cefazolin
;
Child
;
Ciprofloxacin
;
Escherichia
;
Escherichia coli
;
Female
;
Fever
;
Fosfomycin
;
Humans
;
Incidence
;
Microbial Sensitivity Tests
;
Pediatrics
;
Prescriptions
;
Retrospective Studies
;
Risk Factors
;
Stem Cells
;
Trimethoprim, Sulfamethoxazole Drug Combination
;
Urinary Tract
;
Urinary Tract Infections
7.Thyroid Function Studies in Patients Who Underwent Open Heart Surgery.
Hyung Joo SOHN ; Yu In PARK ; Chang Sung SON ; Joo Won LEE ; Young Chang TOCKGO
Journal of the Korean Pediatric Society 1998;41(9):1250-1255
PURPOSE: Alteration in the serum level of thyroid hormone can occur following open heart surgery due to major stress and hemodilution after extracorporeal circulation but these changes have been ignored. The purpose of this study is to evaluate the changes of thyroid hormone level after open heart surgery and if these changes influence the prognosis. METHODS: We evaluated 26 children who had undergone open heart surgery from Sept. 1994 to Jun. 1996 at Korea University Hospital. Five ml of blood were collected before surgery, immediately after surgery and 24 hours after surgery. The blood was centrifused and the serum stored at -40degrees C until examinations were made. Serum T3, T4, reverse T3 were measured by sensitive and specific radioimmunoassay. RESULTS: The mean T3 level was 1.49 +/- 0.50ng/ml (normal 0.08-2.0ng/ml) at pre op, 0.75 +/- 0.40ng/ ml immediately after surgery and 0.69 +/- 0.50ng/ml 24 hours after surgery. The mean T4 level was 10.73 +/- 4.40ug/dl (normal 6.1-11.8 microgram/dl) at pre op, 5.80 +/- 1.90ug/dl immediately after surgery and 5.60 +/- 2.10ug/dl 24 hours after surgery. The mean TSH level was 1.69 +/- 1.13uIU/ml (normal 0.25-4.0 uIU/ml) at pre op, 1.37 +/- 0.80uIU/ml immediately after surgery and 1.61 +/- 1.00uIU/ml 24 hours after surgery. Serum T3 and T4 levels in cardiac surgical patients were significantly reduced (P<0.01), and serum reverse T3 levels were significantly increased (P<0.05), and serum TSH levels were not significantly different in comparison with the preoperative state. CONCLUSION: We conclued that patients with congenital heart disease who underwent open heart surgery show euthyroid sick states like other severely ill patients. It is likely that reduction in T3 and T4 without increased TSH represents an adaptive response by the body to minimize catabolism when undergoing major stress.
Child
;
Extracorporeal Circulation
;
Heart Defects, Congenital
;
Heart*
;
Hemodilution
;
Humans
;
Korea
;
Metabolism
;
Prognosis
;
Radioimmunoassay
;
Thoracic Surgery*
;
Thyroid Gland*
8.Clinical Observation on Ruptured Aneurysm of the Sinus of Valsalva.
Seung Jae JOO ; Kwang Gon KOH ; Yu Ho KIM ; Young Bae PARK ; Yun Shik CHOI ; Jeong Don SEO ; Young Woo LEE ; Jae Hyung PARK ; Kyung Phill SUH
Korean Circulation Journal 1987;17(1):149-158
From May, 1975 to August, 1986, we experienced 21 patients with ruptured aneurysm of the sinus of Valsalva. 1) Their ages ranged from 15 to 52 years with a mean age of 26.7 years, and 14 patients were male and 7 patients were female. Among 18 cases of which aneurysms occurred on the right sinus of Valsalva, 15 cases (83%) ruptured into the right ventricle, 1 case (6%) ruptured into the right atrium and 2 cases (11%) ruptured into the pulmonary artery. All 3 cases of which aneurysms occurred on the noncoronary sinus ruptured into the right atrium. 2) Clinical symptoms consisted of dyspnea (95%), palpitation (81%), chest pain (43%), orthopnea (33%), cough (14%), hemoptysis (5%), oliguria (5%), and fever (5%). In all patients continuous heart murmur was audible. Hepatomegaly (48%), pulmonary basal rale (14%), and pretibial pitting edema (19%) were also observed. 3) In all patients diagnosis was made with cardiac catheterization and angiography, and confirmed by operation excetpt one case. 4) Among 20 patients who had been performed corrective surgery, ventricular septal defect was observed in 16 patients (85%), aortic insufficiency in 5 patients (25%), pulmonary infundibular stenosis in 1 patient (5%), patent foramen ovale in 1 patient (5%), and tricuspid insufficiency in 1 patient (5%). Ventricular septal defect was observed in all 16 patients whose aneurysms of the right coronary sinus of Valsalva ruptured into the right ventricle and the pulmonary artery. 5) All patients survived operation, and no postoperative complication was found except 1 patient to whom reoperation was performed because of postoperative aortic insufficiency and detachment of the patch closure for ventricular septal defect. There was symptomatic improvement in all patients.
Aneurysm
;
Aneurysm, Ruptured*
;
Angiography
;
Cardiac Catheterization
;
Cardiac Catheters
;
Chest Pain
;
Coronary Sinus
;
Cough
;
Diagnosis
;
Dyspnea
;
Edema
;
Female
;
Fever
;
Foramen Ovale, Patent
;
Heart Atria
;
Heart Murmurs
;
Heart Septal Defects, Ventricular
;
Heart Ventricles
;
Hemoptysis
;
Hepatomegaly
;
Humans
;
Male
;
Oliguria
;
Postoperative Complications
;
Pulmonary Artery
;
Pulmonary Subvalvular Stenosis
;
Reoperation
;
Respiratory Sounds
;
Sinus of Valsalva*
9.Diffusion-Weighted MRI in Recurrent Wernicke's Encephalopathy: a Remarkable Cerebellar Lesion.
Jung Eun KIM ; Tae Hyung KIM ; In Kyu YU ; Bo Ram LEE ; Soo Joo LEE ; Gun Sei OH
Journal of Clinical Neurology 2006;2(2):141-145
We report unusual MRI findings (including those from diffusion-weighted imaging (DWI)) in a patient with recurrent Wernicke's encephalopathy with a remarkable cerebellar lesion. DWI showed high signal intensities in the superior portion of the cerebellar hemisphere and vermis area. After thiamine administration, clinical symptoms improved and the lesions with high signal intensities disappeared on follow-up DWI.
Cerebellum
;
Follow-Up Studies
;
Humans
;
Magnetic Resonance Imaging*
;
Thiamine
;
Wernicke Encephalopathy*
10.Prenatally Diagnosed Dural Sinus Thrombosis.
In Kook JUNG ; Yu Li SOL ; Jong Kil JOO ; Dong Hyung LEE ; Seung Chul KIM
Korean Journal of Perinatology 2011;22(4):350-355
Thrombosis of the dural sinus in the fetal period is an extremely rare congenital cerebrovascular condition. The exact etiologies and prognosis of dural sinus thrombosis in the fetal period are still unknown due to the extremely limited clinical information available. Therefore, we present a case of dural sinus thrombosis diagnosed by prenatal ultrasound and fetal magnetic resonance imaging that spontaneously regressed, with a brief review of the relevant literature.
Magnetic Resonance Imaging
;
Prenatal Diagnosis
;
Prognosis
;
Sinus Thrombosis, Intracranial
;
Thrombosis