Intracranial hemorrhage is the most common neuropathologic finding in premature infants. But in full-term infants, it is less common and rarely causes death. We found out intracranial hemorrhages in 21 full-term neonates by real-time neurosonography and concluded as followings. 1) Among 21 neonates, 17 infants were male and 4 infants were female. 2) In 11 (52.3%) infants the hemorrhage was detected within 7 days after birth. 3) The intracranial hemorrhage was not related with delivery type nor Apgar score. 4) In 13 cases (61.9%) the hemorrhage was in the subependymal germinal matrix and the degree was Grade I. 5) Precipitating or associated factors were asphyxia, pneumonia, ventilator care, RDS and congenital heart disease. 6) Symptoms and signs were seizure, apnea, lethargy, cyanosis, jaundice, anemia or bulging fontanel.
Anemia ; Apgar Score ; Apnea ; Asphyxia ; Cyanosis ; Female ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Intracranial Hemorrhages* ; Jaundice ; Lethargy ; Male ; Parturition ; Pneumonia ; Seizures ; Ultrasonography* ; Ventilators, Mechanical

Three cases of synchronous carcinomas of endometrium-fallopian tube, endometrium-cervix and endometrium-ovary are reported. Case 1 is endometrial endometrioid adenocarcinoma with FIGO stageIb, Grade 2 and tubal serous adenocarcinoma with FIGO stage Ib, Grade 2. Case 2 is endometrial serous carcinoma with FIGO stage Ilb and squamous cell carcinoma with FIGO stage Ial. Case 3 is endometrial endometrioid adenocarcinoma with FIGO stage Ia, Grade 1 and ovarian mucinous adenocarcinoma with FIGO stage IIIa, Grade 2. There is much confroversy with respect to staging and management of such cases since these tumors may represent either two synchronously occuring primaries or single primary with metastases. It is suggested that when each tumor is different histological subtype the tumors may be considered as two separate primaries and treatment may be less aggressive. It may be a favorable prognosis. The authors present three cases of synchronous carcinomas with a review of literature.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Carcinoma, Endometrioid ; Carcinoma, Squamous Cell ; Neoplasm Metastasis ; Prognosis

PURPOSE: We aimed to evaluate the clinical characteristics and etiological organisms associated with lobar/lobular pneumonia in Korean children. METHODS: Children hospitalized due to radiographically confirmed lobar/lobular pneumonia were evaluated prospectively between June 2006 and May 2008. Anti-Mycoplasma pneumoniae IgM/IgG (at admission and follow-up), blood cultures, throat swabs for bacterial detection or sputum culture, respiratory viruses (Respiratory syncytial virus, Adenovirus and Influenza A/B) antigen testing, and urinary antigen testing for S. pneumoniae were performed. RESULTS: Two hundred eighty-eight immunocompetent children (mean age, 5.9 years) were enrolled. The age distribution showed a peak frequency at 2-6 years of age (<2 years, 8.7%; 2-6 years, 60.8%; 7-10 years, 22.6%; 11-15 years, 8.0%). Typical respiratory organisms were identified in 64.9% of cases. Identified organisms were Mycoplasma pneumoniae (50.7%), bacteria in (5.9%), viruses (2.1%) and mixed infection (5.9%). Mycoplasma pneumoniae was the most commonly identified organism in all age groups. The majority (88.9%) of bacterial pneumonias including mixed infection were caused by Streptococcus pneumoniae. Mycoplasma pneumonia was the most frequent at 5-6 years of age, but bacterial pneumonia was most frequent at 1-2 years of age. Lobar/lobular pneumonia began to increase from August and showed peak incidence in November and December. The levels of WBC, ESR, and CRP more significantly elevated in those with bacterial pneumonia than in children with mycoplasma pneumonia. Pleural effusion was present in 18.1% of cases. In these cases, the duration of fever and hospitalization was prolonged, and the ESR and CRP levels were significantly higher, than those without pleural effusion. CONCLUSION: Mycoplasma pneumoniae was the most common organism causing lobar/lobular pneumonia in children. Mycoplasma pneumoniae was the most frequent causative organism at 5-6 years of age. On the other hand, bacterial pneumonia was more common at 1-2 years of age. Thus, age may be a significant factor for the diagnosis and treatment of lobar/lobular pneumonia in children.
Adenoviridae ; Age Distribution ; Bacteria ; Child ; Coinfection ; Fever ; Hand ; Hospitalization ; Humans ; Incidence ; Influenza, Human ; Mycoplasma ; Mycoplasma pneumoniae ; Pharynx ; Pleural Effusion ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Prospective Studies ; Sputum ; Streptococcus pneumoniae ; Viruses

No abstract available.
Giant Cell Tumors* ; Giant Cells* ; Ribs*

BACKGROUND: Cicletanine is a new antihypertensive agent, derived from the furopyridine family. It acts directly on vascular smooth muscle by increasing prostacyclin synthesis and decreasing intracytosolic calcium. In order to investigate the efficacy and safety of cicletanine, a clinical study was performed in the patients with mild to moderate essential hypertension. METHOD: The study subject consisted of 30 patients with diastolic blood pressure of 95mmHg~114mmHg(mean age : 55.1+/-7.9 years, 13 males and 17 females). Cicletanine was administrated orally in a daily dose of 100mg Q.D. for 12 weeks after the administration of a placebo for 2 weeks. During cicletanine medication, antihypertensive efficacy, clinical side effects and laboratory changes were monitored. RESULT: Cicletanine decreased mean blood pressure from the baseline value of 123.6+/-3.4mmHg to 108.6+/-7.5mmHg(p<0.001) after 2 weeks, 105.0+/-7.4mmHg after 4 weeks, 103.9+/-6.6mmHg after 6 weeks, 102.5+/-8.9mmHg after 8 weeks, 101.4+/-6.8mmHg after 10 weeks and 99.6+/-6.6mmHg after 12 weeks of medication. There was a highly significant decrease in blood pressure at each of the assessments after 2,4,6,8,10 and 12 weeks of medication when compared to the baseline value(p<0.001). Mean blood pressure after 4 weeks of medication showed a significant decrease when compared to the value after 2 weeks of medication, and the value after 12 weeks of medication showed a significantly decrease when compared to the value after 8 weeks of medication. Heart rate did not change significantly with cicletanine monotherapy for 12 weeks. There was no significant changes in blood chemistry, glucose, lipid and electrolytes. The side effect was pruritus(1 case, 3.3%). CONCLUSION: Cicletanine monotherapy with 100mg once a day regimen was effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Epoprostenol ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Muscle, Smooth, Vascular

Takayasu's arteritis(TA) is a nonspecific areritis of unknown etiology affecting segmentally the aorta and its main branches, which result in stenosis, occlusion or aneurysm of involved arteries. The clinical manifestations present with a variety of symptoms such as headache, dyspnea on exertion, pain and weakness of extremities, pulse deficit, and hypertension according to involves arteries. Usually it can be managed by medical or surgical treatment, and recently by percutaneous transluminal balloon angioplasty. The type III classified by Lupi-Herrena and associates is the most frequent variety of TA. However the case of type III involving both subclavin arteries and both renal arteries has rarely been reported. We experienced a case of TA involving both subcalvian arteries, and both renal arteries presented with paroxysmal hypertension and right flank pain, in which the stenosis of both subclavian arteries were managed by percutaneous transluminal balloon angioplasty and the stenosis and occlusion of both renal arteries were successfully managed by aorto-renal bypass surgery with autogenous right iliac artery and synthetic vessel(Gortex). The patient was discharged uneventfully.
Aneurysm ; Angioplasty, Balloon ; Aorta ; Arteries* ; Constriction, Pathologic* ; Dyspnea ; Extremities ; Flank Pain ; Headache ; Humans ; Hypertension ; Iliac Artery ; Renal Artery* ; Subclavian Artery ; Takayasu Arteritis*

BACKGROUND: Exercise-induced coronary spasm is occasionally recognized in patients with variant angina, but the patterns of exercise-induced coronary spasm and its relation to clinical features are still not clear. METHODS: Eight consecutive patients with variant angina without significant stenosis of the coronary artery performed serial treadmill exercise tests during early morning, late morning, and in the afternoon. The subjects repeated the tests after administration of atropine and doxazosin or phentolamine. RESULTS: (Upon drug administration), anginal episodes with ST-segment changes (elevation 5, depression 1) Occurred repeatedly in 6 of the 8 patients during early morning; the episodes occurred in only 2 patients during the afternoon exercise test. Four patients showed exercise-induced angina and ST-segment changes during early morning but not in the afternoon, and 2 of them showed mild episodes of exercise-induced angina and ST-segment changes during late morning. Three of the four patients had the characteristic clinical history of angina in early morning during usual activities but not during daytime activities despite the activities being more strenuous. Another 2 patients showed both exercise-induced ST-segment elevation and angina in early morning and afternoon, and they had the characteristic history of more episodes at night and in early morning but only occasionally in the daytime with or without relation to activity. One of the two patients showed intermittent ST-segment elevation during the exercise test. The other two patients had exercise-induced episodes neither in the early morning nor in the afternoon; they had a characteristic history of episodes only at night during sleep but never in the early morning nor in the daytime. Atropine did not suppress the exercise-induced angina in 4 of 5 patients studied. Doxazosin or phentolamine suppressed the exercise-induced episodes in 3 of 5 patients studied but aggravated spontaneous episodes in 3 patients. CONCLUSION: These data suggest that there's possibility of presence of different patterns of exercise-induced coronary spasm, which may be induced by different mechanisms from those in spontaneous episodes in patients with variant angina.
Atropine ; Constriction, Pathologic ; Coronary Vessels ; Depression ; Doxazosin ; Exercise Test ; Humans ; Phentolamine ; Spasm*

PURPOSE: We investigated the incidence of gastroesophageal reflux disease (GERD) by 24-hour esophageal pH monitoring in patients who had chronic cough for more than 3 weeks. METHODS: From January 1995 to August 1996, 33 patients with chronic cough which had lasted for more than 3 weeks were enrolled in the 24-hour esophageal pH monitoring. The result was interpreted with the standard value which was suggested by Yvan Vandenplas in 1991 for patients younger than 15 months and with the De Meester Score for patients older than 15 months. We performed esophagoscopy and lower esophageal biopsy for patients who proved to have gastroesophageal reflux disease by 24-hour esophageal pH monitoring. RESULTS: Among 33 cases, 13 cases (39.4%) were proved to have GERD. Comparing between the normal group and the GERD group, there was no difference of gastroesophageal reflux incidence according to meal or position. We performed esophagoscopy in 10 patients among 13 GERD cases. There were 3 cases of gross esophagitis. Papillary height was elongated by more than 50% of normal in 7 cases, and basal cell layer increased by more than 20% of normal in 6 cases. Neutrophil or eosinophil infiltration was found in 2 cases, and lymphocyte infiltration was found in 7 cases. CONCLUSION: We suggest that 24-hour esophageal pH monitoring and appropriate treatment should be considered in prolonged unexplained chronic cough.
Biopsy ; Child* ; Cough* ; Eosinophils ; Esophageal pH Monitoring ; Esophagitis ; Esophagoscopy ; Gastroesophageal Reflux* ; Humans ; Incidence ; Lymphocytes ; Meals ; Neutrophils

PURPOSE: The development of postnatal pneumothorax and its common causes and clinical aspects were studied to promote early diagnosis and proper management. METHODS: A retrospective study of neonates who were hospitalized in the neonatal intensive care unit at Soonchunhyang University Bucheon Hospital from 2001 to 2010 was performed. Term neonates were divided into a spontaneous pneumothorax group and a secondary pneumothorax group. The secondary group was divided into term and preterm groups. RESULTS: Of 4,414 inpatients, 57 (1.3%) were diagnosed with pneumothorax. Of term newborn patients, 28 (80%) had a secondary pneumothorax, and seven (20%) had a spontaneous pneumothorax. No differences were observed for gender, birth weight, resuscitation, or duration of admission between the spontaneous and control groups. The duration of treatment with a thoracostomy (20 patients, 57%) was longer in the spontaneous group (5.4+/-2.9 days vs. 2.7+/-2.0 days) than that in the control group. Patients with respiratory distress syndrome (RDS) developed a pneumothorax 22.8 hours after surfactant treatment, whereas patients with transient tachypnea of the newborn (TTN), pneumonia, and meconium aspiration syndrome (MAS) developed pneumothorax after 16.6 hours. Of 50 patients with a secondary pneumothorax, 19 (38%) had RDS, 11 (22%) had MAS, 7 (14%) had TTN, and six (12%) had pneumonia. Among term newborns, 42.9% were treated only with 100% oxygen. Among preterm newborns, 72.6% and 27.3% needed a thoracostomy or ventilator care, respectively. CONCLUSION: A pneumothorax is likely to develop when pulmonary disease occurs in neonates. Therefore, it is important to carefully identify pneumothorax and provide appropriate treatment.
Birth Weight ; Early Diagnosis ; Humans ; Infant, Newborn ; Inpatients ; Intensive Care, Neonatal ; Lung Diseases ; Meconium Aspiration Syndrome ; Oxygen ; Pneumonia ; Pneumothorax ; Resuscitation ; Retrospective Studies ; Thoracostomy ; Transient Tachypnea of the Newborn ; Ventilators, Mechanical

Purpose: This study was conducted to assess the antidepressant effects of capsaicin in chronic depressive rats and elucidate the mechanism underlying its effects. Methods: Male Wistar rats (280~320 g, 8 weeks of age) were subjected to depression induced by chronic unpredictable mild stresses. The rats were exposed to 8 kinds of stresses for 8 weeks. In the last 2 weeks, fluoxetine or capsaicin was injected subcutaneously. The dose of fluoxetine was 10 mg/kg (body weight), while the doses of capsaicin consisted of low (1 mg/kg), middle (5 mg/kg), and high (10 mg/kg). The forced swim test (FST) was conducted to evaluate the immobility time of rats. The immobility time indicates despair, one of symptoms of depression. The change of tryptophan hydroxylase (TPH) in the dorsal raphe was investigated using immunohistochemistry. In the hippocampus cornu ammonis (CA) 1 and 3, glucocorticoid receptor (GR) expression was measured. Results: The immobility time in the FST was significantly lower (p < .05) in the low-dose (M = 32.40 ± 13.41 seconds) and middle-dose (M = 28.48 ± 19.57 seconds) groups than in the non-treated depressive rats (M = 90.19 ± 45.34 seconds). The amount of TPH in the dorsal raphe was significantly higher (p < .05) in the middle-dose (M = 249.17 ± 35.02) and high-dose (M = 251.0 ± 56.85) groups than in the non-treated depressive rats (M = 159.78 ± 41.16). However, GR expression in the hippocampus CA1 and CA3 did not show significant differences between the non-treated depressive rats and the capsaicin-injected rats. Conclusion This study suggests that capsaicin produces an antidepressant-like effect on chronic unpredictable mild stress-induced depression in rats via the serotonin biosynthesis pathway.