No abstract available.
Granuloma* ; Microsporum* ; Tinea*

Cardiac tamponade with pleural and pericardial effusion is a rare but life-threatening complication of umbilical venous catheterization in the newborn. It requires a timely diagnosis and urgent treatment, such as pericardiocentesis, to save lives of affected patients. Recently, we experienced a 7 day-old, very low birth weight infant, who developed a cardiac tamponade with pleural and pericardial effusions complicated by umbilical venous catheterization. The patient was successfully treated with pleural and pericardial drainages. Here, we report this case with a review of literature, since there has been no such previous case reported in Korea.
Cardiac Tamponade* ; Catheterization ; Catheters ; Diagnosis ; Humans ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Korea ; Pericardial Effusion* ; Pericardiocentesis ; Pleural Effusion

Spinal gabapentin and adenosine have been known to display an antinociceptive effect. We evaluated the nature of the interaction between gabapentin and adenosine in formalin-induced nociception at the spinal level. Male Sprague-Dawley rats were prepared for intrathecal catheterization. Pain was evoked by injection of formalin solution (5%, 50 microliter) into the hindpaw. After examination of the effects of gabapentin and adenosine, the resulting interaction was investigated with isobolographic and fractional analyses. Neither gabapentin nor adenosine affected motor function. Gabapentin or adenosine decreased the sum of the number of flinches during phase 2, but not during phase 1 in the formalin test. Isobolographic analysis, in phase 2, revealed an additive interaction between gabapentin and adenosine. Taken together, intrathecal gabapentin and adenosine attenuated the facilitated state and interacted additively with each other.
*Adenosine/administration & dosage/metabolism/therapeutic use ; *Amines/administration & dosage/metabolism/therapeutic use ; *Analgesics/administration & dosage/metabolism/therapeutic use ; Animals ; *Cyclohexanecarboxylic Acids/administration & Dose-Response Relationship, Drug ; Formaldehyde/*toxicity ; Injections, Spinal ; Male ; Motor Activity/physiology ; Pain Measurement ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; *gamma-Aminobutyric Acid/administration & dosage/metabolism/therapeutic

OBJECTIVE: A fibrin sealant is commonly applied after closure of an incidental or intended durotomy to reduce the complications associated with the leakage of cerebrospinal fluid. Routine usage might not be essential after closure of an intended durotomy, which has clear cut-margins. We investigated the efficacy of fibrin sealants for primary intradural spinal cord tumor surgery. METHODS: A retrospective review was performed for 231 consecutive surgically treated patients with primary intradural spinal cord tumors without extradural extension. Fibrin sealants were not used for 47 patients (group I: age, 51.57±16.75 years) and were applied to 184 patients (group II: age, 48.8±14.7 years). The surgical procedures were identical except for the use of a fibrin sealant after closure of the durotomy. The primary outcome was the occurrence of complications (wound problems, hematoma collection, infection, and neurological deterioration). The covariates were age, sex, body mass index, operation time, pre-/postoperative ambulation, number of laminectomies, and type of tumor. RESULTS: Schwannoma was the most common pathology (n=134), followed by meningioma (n=35) and ependymoma (n=31). Complications occurred in 13 patients (3 in group I and 10 in group II, p=0.73). The postoperative ambulation status (p<0.01; odds ratio, 28.8; 95% confidence interval, 6.9-120.0) and operation time (p=0.04; cutoff, 229 minutes; sensitivity, 62%; specificity, 72%) were significant factors, whereas the use of a fibrin glue was not (p=0.47). CONCLUSION: The use of a fibrin sealant might not be essential to reduce complications after surgery for primary spinal intradural tumor.
Body Mass Index ; Cerebrospinal Fluid ; Ependymoma ; Fibrin Tissue Adhesive* ; Fibrin* ; Hematoma ; Humans ; Laminectomy ; Meningioma ; Neurilemmoma ; Odds Ratio ; Pathology ; Retrospective Studies ; Sensitivity and Specificity ; Spinal Cord Neoplasms ; Spine ; Surgical Wound Infection ; Walking

Congenital lobar emphysema (CLE) is an overinflation of infantile pulmonary lobe caused by air trapping within the affected area. This is usually diagnosed on radiological findings postnatally. Most cases present in the neonatal period with signs of acute or chronic respiratory distress. There are only a few reports of CLE in the literature with prenatal sonographic feature documented. The routine use of prenatal sonography has helped to find fetal anomalies, such as fetal lung mass, that pose a challenge to early diagnosis, appropriate counselling, postnatal follow-up, and better outcome. A boy with CLE was detected by prenatal sonogram. He had a uniformly echogenic right lung with mediastinal shift to the left which was suspected type III congenital cystic adenomatoid malformation prenatally. He showed no evidence of respiratory distress at birth, but experienced progressive tachypnea and chest retraction. He had right middle lobectomy on the seventh postnatal day and pathologic diagnosis of CLE had been made. We report this rare case with brief review of literature. This is the first domestic case which was detected prenatally and confirmed pathologically after lobectomy.
Cystic Adenomatoid Malformation of Lung, Congenital ; Diagnosis ; Early Diagnosis ; Emphysema* ; Follow-Up Studies ; Humans ; Lung ; Male ; Parturition ; Tachypnea ; Thorax ; Ultrasonography

Malignant lymphoma of the bladder is a rare lesion, representing approximately 0.2% of the primary lesions and approximately 1.8% of the secondary lesions. A disseminated lymphoma presenting as a bladder mass is an infrequent phenomenon. The authors report the case of a 71-year-old patient with concurrent bladder lymphoma and bladder cancer presenting as metastatic bladder cancer. To the best of our knowledge, this is the first report of concurrent bladder lymphoma and bladder cancer.
Aged ; Carcinoma, Transitional Cell ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Urinary Bladder ; Urinary Bladder Neoplasms

BACKGROUND: Vancomycin assay was performed to evaluate the clinical significance of therapeutic drug monitoring (TDM) of vancomycin and to compare pharmacokinetic parameters of vancomycin in our patients with population pharmacokinetic parameters. METHODS: In seventy-eight patients (45 males, 33 females), vancomycin serum concentrations were measured by fluorescence polarization immunoassay. At steady-state, peak levels were obtained one hour postinfusion, and trough levels were obtained just before a next dose. And also predicted serum vancomycin levels were determined by CAPCIL program in all subjects and compared with measured values, respectively. All patients were divided into two groups. Sixty-two patients in group I had a creatinine concentration in serum of < or =1.2 mg/dL and sixteen patients in group IIhad abnormal renal function as defined by a creatinine concentration in serum of >1.2 mg/dL. Follow-up second vancomycin concentrations were measured in 22 of 78 patients several days after initial TDM and were compared with initial TDM results. RESULTS: Mean values of peak and trough vancomycin concentration were 30.1 and 10.4, and 37.3 and 14.5 microgram/mL in groups I, and II, respectively. Predicted mean values of those were 26.3 and 9.2, and 28.2 and 7.8 microgram/mL in groups I, and II, respectively. Statistically significant differences between predicted and measured values in peak levels of group I,and IIand in trough level of group IIwere observed (P<0.01). Dose modification were required in 13 (21%) of 62 patients with normal renal function, and in 9 (56%) of 16 patients with abnormal renal function. Among 79 paired samples with a trough value below 15 mg/L, there were no peaks greater than 40 mg/L except two samples. CONCLUSION: Significant differences were noted between predicted and measured serum vancomycin concentrations and so TDM of vancomycin is needed to obtain effective dose and interval of vancomycin. More data about measured peak and trough values should be collected to establish pharmacokinetic parameters of vancomycin in Korean population.
Creatinine ; Drug Monitoring* ; Fluorescence Polarization Immunoassay ; Follow-Up Studies ; Humans ; Male ; Vancomycin*

PURPOSE: To investigate the relationship of transrectal ultrasound (TRUS) findings with the pathological characteristics of prostate cancer (PCa). MATERIALS AND METHODS: The study was conducted retrospectively by analyzing the data for 970 patients who underwent prostate biopsies. Gleason scores and other clinical variables were compared between PCa patients with and without hypoechoic lesions on TRUS. RESULTS: Of the 970 patients, PCa was diagnosed in 291 (30%). Of these, high-grade PCa (Gleason score of 7 or more) was diagnosed in 190 (65%). The cancer detection rate was higher in patients with hypoechoic lesions (43.9%) than in those without hypoechoic lesions (21.4%, p<0.001). High-grade PCa was detected more often in patients with hypoechoic lesions than in those without hypoechoic lesions (p<0.001). Independent predictors for high-grade PCa by logistic regression analysis included hypoechoic lesions on TRUS and abnormal digital rectal examination findings. CONCLUSIONS: Patients with PCa who had hypoechoic lesions on TRUS had more aggressive pathological disease than did those without lesions. Therefore, hypoechoic lesions on TRUS could be a marker for clinically significant PCa.
Biomarkers ; Biopsy ; Digital Rectal Examination ; Humans ; Logistic Models ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Retrospective Studies

BACKGROUND: CATCH-22 syndrome is a common genetic disorder with features of cardiac defect, abnormal face, thymic hypoplasia, cleft palate, and hypocalcemia, along with microdeletion at chromosome 22. This study is to report twelve Korean patients with CATCH-22 syndrome diagnosed by the fluorescent in situ hybridization (FISH) method. METHOD: Clinical features were analyzed according to the FISH result and the Southern blot analysis using new probes DGCR680 and pDH-1 was performed to correlate with the clinical findings and FISH results. Twelve patients were studied by FISH method and eight of them were studied by Southern blot analysis. RESULTS: Seven patients had typical facial features for CATCH-22 syndrome, but five patients had equivocal face, although they were originally suspected to have the conotruncal face. The main cardiac lesion of eight patients were tetralogy of Fallot (TOF) and seven of them had pulmonary atresia. Two cases had other anomalies in the ventricular outflow tract, being common arterial trunk or pulmonary stenosis. Two cases had a patent arterial duct or atrial septal defect (ASD). All of twelve patients had positive result on FISH study. Among eight patients with positive FISH study, six cases were positive for Southern blot analysis. CONCLUSION: We conclude that CATCH-22 syndrome has variable facial, cardiac and genetic features, and the combined use of probes is recommended for a more accurate diagnosis.
Blotting, Southern ; Chromosomes, Human, Pair 22 ; Cleft Palate ; Diagnosis* ; DiGeorge Syndrome ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Humans ; Hypocalcemia ; In Situ Hybridization, Fluorescence ; Pulmonary Atresia ; Pulmonary Valve Stenosis ; Tetralogy of Fallot

Hemophagocytic lymphohistiocytosis(HLH) is a rare and fatal disorder in children. Persistent fever, hepatosplenomegaly and pancytopenia are observed in the most cases with the characteristic change of serum triglyceride, fibrinogen, ferritin and LDH level. CNS manifestation were developed in 50-70% of HLH. 20% of cases revealed seizure and irritability at diagnosis. Abnormalities on brain imaging, such as diffuse white matter abnormalities and necrotic area with parenchymal volume loss appeared to roughly parallel the severity of clinical manifestations. In HLH, EBV is the major triggering agent inducing hemophagocytosis as well as the fulminant course of disease. Many cases of EBV-HLH had monoclonal origin and respond well to etoposide-containing regimens. Early induction of an etoposide based regimen is critical factor in securing long-term survival in patients with EBV-HLH. We report a case that 13 year-old female patient with seizure and loss of consciousness was diagnosed as EBV-HLH and treated with protocol HLH-94 consistd of etoposide, dexamethasone, cyclosporin.
Adolescent ; Central Nervous System ; Child ; Cyclosporine ; Dexamethasone ; Diagnosis ; Etoposide ; Female ; Ferritins ; Fever ; Fibrinogen ; Herpesvirus 4, Human ; Humans ; Lymphohistiocytosis, Hemophagocytic* ; Neuroimaging ; Pancytopenia ; Seizures* ; Triglycerides ; Unconsciousness*