Neonatal lupus erythematous is a rare syndrome, which is characterized by a transient lupus dermatitis, hematologic abnormalities and isolated congenital heart block. We detected the atrioventricular dissociation, bradycardia and pericardial effusion by fetal echocardiography in a female fetus at 25th weeks of gestational age. The baby was born in the 38th week of pregnancy by Cesarean section with 1790 gram of body weight. In spite of atrioventricular dissociation with bradycardia and pericardial effusion, cardiac pacemaker was not needed during neonatal period because she was doing well, no evidence of congestive heart failure and around 80 beat per minute of heart rate. The serologic markers for diagnosis of neonatal lupus are the autoantibodies specific to SS-A/Ro and/or SS-B/La. These antibodies are produced by the mother and passed to the fetus through the placenta. Autoantibodies of cytoplasmic SS-A antigens or SS-B antigen were found in the blood of this patient and her mother. We report a case of neonatal lupus syndrome with congenital atrioventricular dissociation with Rt. Bundle branch block and hematologic abnormality.
Antibodies ; Autoantibodies ; Body Weight ; Bradycardia ; Bundle-Branch Block ; Cesarean Section ; Cytoplasm ; Dermatitis ; Diagnosis ; Echocardiography ; Female ; Fetus ; Gestational Age ; Heart Block* ; Heart Failure ; Heart Rate ; Heart* ; Humans ; Mothers ; Pericardial Effusion ; Placenta ; Pregnancy

Despite improvements in surgical technique, immunosuppressive therapy, and follow-up care, a considerable number of patients with kidney transplants die as a consequence of sepsis and throm-boembolism. The incidence of thromboembolism is higher in patients older than 40 years of age. Prominent among these is an increased incidence of acute myocardial infarction(AMI) in patients receiving corticosteroids. We encountered a rare case that septic shock due to artificial abortion, ARF, and DIC complicated by AMI. A 25-year-old female complained of fever, and watery diarrhea. She was emmergently admitted due to shock. Physical examination demonstrated hypotension and fever. WBC count was 45,300/mL. Elevated FDP, D dimer, CK with dominance of the MB isoenzyme, and troponin-I. EKG showed ST segment elevation in leads aVF, V3-V6. She was treated with cefuroxime, netilmycin, and dalteparin. Cultures obtained from the sputum, urine, and blood did not yield any microorganisms. Although sepsis could not be confirmed, sepsis was highly suspected from the clinical features. This is a rare case in which septic shock, ARF, and DIC complicated by AMI in a young female renal allograft patient. Since AMI in the absence of underlying conditions has been rarely described, we wish to bring attention to the diagnosis of this disorder in a young female allograft recipient and without any other predisposing abnormality.
Adrenal Cortex Hormones ; Adult ; Allografts* ; Cefuroxime ; Dacarbazine ; Dalteparin ; Diagnosis ; Diarrhea ; Electrocardiography ; Female ; Fever ; Follow-Up Studies ; Humans ; Hypotension ; Incidence ; Kidney ; Kidney Transplantation ; Myocardial Infarction* ; Physical Examination ; Sepsis* ; Shock ; Shock, Septic ; Sputum ; Thromboembolism ; Troponin I

Complications such as infection, seizure, or intracranial hemorrhage are relatively common after depressed skull fractures. However, indications, methods, and efficacy of the surgical treatment are controversial. This study includes 113 patients with depressed skull fractures who were treated at Soonchunhyang University Chonan Hospital between 1989 and 1992. Methods of treatment, complications, and the prognosis were retrospectively collected and the prognostic factors were analysed. Depressed skull fracture was common below the age of 20 years(38%). Male to female ration was 5.3:1. Traffic injury was the most common of depressed skull fracture(68.1%). Glasgow coma score(GCS) on admission was 13-15 in 52%, 9-12 in 18.6%, and closed in 32%. Intracranial injury was accompanied in 43%. The frontal area was the most common site of depression(53%), and the parietal region was the next(28%). In 65% of open fractures and 28% of closed ones, the lesions were surgically corrected. Cranitomy with primary reconstruction was the most common operative procedure. The mean hospital stay was 26 days in surgically treated patients, and it was 17 days in conservatively managed patients. Prophylactic anticonvulsants were administered in 43%. Seizures occured in 6.2%, and infections were encountered in 3.5%. The outcome was favorable(good recovery and moderate disability) in 80% and the mortality rate was 16%. The outcome was better when the GCS on admission was high(P<0.005), the pupillary response was normal(P<0.005), and the lesion was treated by surgery(P<0.005). Seizures were more common when the GCS was low(P<0.005). Although infections were developed in surgically treated patients only, this difference lacked a statistical significance.
Anticonvulsants ; Chungcheongnam-do ; Coma ; Craniocerebral Trauma ; Female ; Fractures, Open ; Humans ; Intracranial Hemorrhages ; Length of Stay ; Male ; Mortality ; Prognosis* ; Rabeprazole ; Retrospective Studies ; Seizures ; Skull ; Skull Fracture, Depressed* ; Surgical Procedures, Operative

No abstract available.
Hemolysis*

BACKGROUND: The pilots with cardiovascular events have a possibility for a risk of suffering from sudden incapacitation which is closely related to flying safety. The coagulation factors such as fibrinogen, factor VII, and factor VIII are possibly related to cardiovascular events. Several studies for general population have shown that an increase of those coagulation factors with age, a correlation of Factor VII and fibrinogen with BMI, and of fibrinogen with smoking. However, this study is to find out whether pilots' age, body weight, body mass index (BMI) and smoking are related to the baseline measurement of coagulation factor VII, factor VIII and fibrinogen. METHOD: Samples were taken from 21 pilots from Asiana Airlines: 11 smokers and 10 non-smokers. In order to measure the relationship between age, body weight, BMI, and the coagulation factors, Pearson correlation was used in this analysis. Independent two sampled t-test was used to analyze the correlation between smoking and the coagulation factors. RESULTS: Mean age, mean height, mean body weight and mean BMI of pilots were examined: 38 years, 171.81 cm, 70.67 Kg and 23.94 Kg/m(2). Mean fibrinogen, mean factor VII, and mean factor VIII were also obtained: 236.0 mg/dl, 92.93%, and 60.16%. The coagulation factor VII, factor VIII and fibrinogen were not significant related to age, body weight, BMI, smoking of pilots. CONCLUSION: This study has no correlation between age, body weight, BMI, smoking and the coagulation factors because the age of this study does not have pilots with over 60 years old and healthy behaviors (e.g., exercise, smoking, drinking, etc.) of most pilots are relatively well.
Blood Coagulation Factors* ; Body Height* ; Body Mass Index ; Body Weight* ; Cardiovascular Diseases ; Diptera ; Drinking ; Factor VII* ; Factor VIII ; Fibrinogen* ; Humans ; Middle Aged ; Smoke* ; Smoking*

Cystic lymphangiomas are comparatively rare, benign tumors of lymphatic system and their histogenesis are uncertain. About 75% of theses lesions are in the neck, 20% are in the axillary region, and 5% are in the mediastinum, retroperitoneal region or groin. But retroperitoneal cystic lymphangiomas are very rare. Retroperitoneal cystic lymphangiomas are usually found incidentally during diagnostic procedures performed for unrelated clinical reasons or at surgery. Although retroperitoneal cystic lymphangioma is a benign lesion, it may cause significant morbidity due to its large size and its often invasive character with a strong tedency to secondary infection. They generally present as a palpable mass or abdominal pain and fever related to hemorrhage or inflammation of the cystic wall. The treatment of choice is surgical excision. We experienced a case of retroperitoneal cystic lymphangioma in a 4-year-old boy who had developed rapid abdominal distention and abdominal pain for 4 days. We have completely excised large cystic mass & histologically confirmed cystic lymphangioma. A brief review of literature was made.
Abdominal Pain ; Child, Preschool ; Coinfection ; Fever ; Groin ; Hemorrhage ; Humans ; Inflammation ; Lymphangioma, Cystic* ; Lymphatic System ; Male ; Mediastinum ; Neck

Hepatocellular carcinoma (HCC) is the 2nd most common cause of cancer related death in Korea and well-known malignancy with poor prognosis. Sorafenib is the first-line molecular targeted agent in patients with extra-hepatic spread of HCC. However, complete response is extremely rare in patients treated with sorafenib and the disease control rate is only 43%. We report a 53-year-old man with advanced HCC with pulmonary metastasis who showed complete response by cytotoxic chemotherapy with doxorubicin and cisplatin with relatively tolerable adverse effects after failure of treatment with sorafenib.
Carcinoma, Hepatocellular* ; Cisplatin ; Doxorubicin ; Drug Therapy* ; Humans ; Korea ; Middle Aged ; Neoplasm Metastasis* ; Prognosis

BACKGROUND: Pulmonary artery banding (PAB)in the functional univentricular heart (UVH)is a palliative procedure for staging toward the Fontan procedure;however,it is known to be a risk factor. MATERIALS AND METHOD: The records of all 37 patients with functional UVHs who underwent surgical palliation using PAB between September 1989 and August 1999 were reviewed retrospectively.We investigated the aortic arch obstruction,the development and progression of subaortic stenosis after PAB,and risk factor of mortality according to surgical method. RESULT: In 37 neonates and infants with single ventricular physiology,aortic arch obstruction was combined in 7.There were 6 early deaths (16.2%)after PAB and 3 late deaths (8.1%)after Fontan operation.The actuarial overall survival including early mortality at 3 and 5 years were 8 0 .7+/-6.6%,72.2 +/-8.2% respectively. Among 31 patients who survived PAB,27 patients (87.1%)could become candidates for Fontan operation;22 patients(71.0%)completed Fontan operation with 3 deaths and 5 were waiting bidirectional cavopulmonary shunt(BCPS)or Fontan operation (follow-up mean 4.5 year,minimal 2 year). Subaortic stenosis developed in 8 patients after PAB (8/29,27.6%);3 cases in the patients without arch anomaly (3/22,13.6%)and 5 in those with arch anomal y (5/7,71.4%).The subaortic stenosis was managed with Damus-Kaye-Stansel procedure (DKS)in 6 patients without operative mortality and conal septum resection in 2 without long-term survivor. Analysis of risk factors established that aortic arch obstruction was strongly associated with subaortic stenosis (p<0.001).The only risk factor of late mortality was Fontan procedure without staged palliation by BCPS (p=0.001). CONCLUSION: PAB is effective as an initial palliative step in functional UVH.And the high risk group of patients with aortic obstruction can undergo effective short-term PAB as an initial palliative step,with subsequent DKS for subaortic stenosis.This strategy,initial PAB and careful surveillance,and early relief of subaortic stenosis can maintain acceptable anatomy and hemodynamics for later Fontan procedures.
Aorta, Thoracic ; Constriction, Pathologic ; Fontan Procedure ; Heart* ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Mortality ; Pulmonary Artery* ; Risk Factors ; Survivors

BACKGROUND/AIMS: Recently, treatment using an endoscopic device is actively being developed. Techniques for incision and bleeding control have been developed, but endoscopic suturing remains to be perfected. Using an endoscopic suturing technique, a variety of diseases could be managed noninvasively. We have attempted to use a new endoscopic suturing device which enables a continuous suture using a flexible upper endoscope. METHODS: A suturing device was designed where a semicircular needle could sew through tissue by rotation making a continuous suture possible. RESULTS: We successfully sutured the stomach tissue of a dog using an optimized suturing device model. CONCLUSIONS: The initial model was found to have some problems. However, we hope to develop a continuous suturing device for flexible upper endoscope procedures in Korea.
Animals ; Dogs ; Endoscopes ; Endoscopes, Gastrointestinal* ; Endoscopy ; Hemorrhage ; Hope ; Korea ; Needles ; Stomach ; Sutures*

These guidelines aim to establish the standard practice for diagnosing and treating patients with differentiated thyroid cancer (DTC). Based on the Korean Thyroid Association (KTA) Guidelines on DTC management, the “Treatment of Advanced DTC” section was revised in 2024 and has been provided through this chapter. Especially, this chapter covers surgical and nonsurgical treatments for the local (previous surgery site) or regional (cervical lymph node metastasis) recurrences. After drafting the guidelines, it was finalized by collecting opinions from KTA members and related societies. Surgical resection is the preferred treatment for local or regional recurrence of advanced DTC. If surgical resection is not possible, nonsurgical resection treatment under ultrasonography guidance may be considered as an alternative treatment for local or regional recurrence of DTC. Furthermore, if residual lesions are suspected even after surgical resection or respiratory-digestive organ invasion, additional radioactive iodine and external radiation treatments are considered.