Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

Emphysematous cholecystitis is an uncommon condition which may mimic acute cholecystitis. But it differs from acute cholecystitis in its relatively greater frequency in men and diabetics and has graver prognosis. The condition is diagnosed by demonstration of air in lumen,wall of gallbladder and/or pericholecystic space using a variety of radiographic techniques: simple abdominal radiography, ultrasonography and CT scanning. One illustrative case is presented herein and the pertinent literature is reviewed.
Cholecystitis, Acute ; Emphysematous Cholecystitis* ; Gallbladder ; Humans ; Male ; Prognosis ; Radiography, Abdominal ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Urease*

The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

Satisfactory surgical reconstruction of the external ear and nose is still a major challenge for the plastic surgeon. Therefore, the use of prosthesis in selected cases should be considered as viable alternative. During the period from December, 1995 to January, 1998, 10 patients, including 9 patients of ear defect and 1 patient of nose defect resulting from the resection of recurrent tumor ablation, were reconstructed by using osseointegration and prosthesis. The surgery was performed in two stages. All procedures were performed under local anesthesia and on an outpatient. At the first stage, the fixtures of titanium implant were placed in the mastoid process and maxilla. These implants were then left for 3 months before the second stage takes place, in which the skin penetrating abutments were attached. After 3-4 weeks, the impression of the defect area were taken and the silicone prosthesis was made by Anaplastologist. Two patients had focal infection but healed without problem. One patient had soft tissue infection, then flap was excised and skin graft performed. There was one loss from 20 fixtures, that was 3 years after implantation. We have concluded that osseointegration for reconstruction of the ear and nose defect is simple, soft, reliable method, which is more than autologous reconstruction and provides excellent aesthetic results.
Anesthesia, Local ; Ear ; Ear, External ; Focal Infection ; Humans ; Mastoid ; Maxilla ; Nose* ; Osseointegration* ; Outpatients ; Prostheses and Implants ; Silicones ; Skin ; Soft Tissue Infections ; Titanium ; Transplants

It has recently been known that the temperature of the brain during a period of transient cerebral ischemia can critically influence neuropathologic outcome in experimental animals. Thus the severity of brain edema may be thought to be changed according to body temperature during acute stage of cerebral ischemia. We investigated the effects of hypothermia and hyperthermia on the acute brain edema during the transient global ischemia in Mongolian gerbils. During 20 miuntes of global ischemia, body temperatures were maintained at 35* in the hypothermic group (n=10). 37* in the normothermic group (n=10). 39* in the hyperthermic group (n=10). Respectively. During the period of reperfusion. Body temperatures were maintained at 37* in each group. Two hours after reperfusion. The animals were decapitated and the waler content of the brain was determined by oven dry method. The uater content were high in (1) the hyperthermic group (79.5+0.3%). (2) the normothermic group (79.2+0.2%). (3) the hypothermic group (79.0+0.2%) the control group (78.6+0.3%) in order of amount. Also there were significant differences of the water content among four groups according to the changes of intraischemic body temperature (p<0.05). At the same time we carried out another experiment for comparing the survival rates in each group. The survival rate of the hypothermic group was sillgificantly higher than that of the normothermic or the hyperthermic groups (p<0.005).
Animals ; Body Temperature* ; Brain Edema* ; Brain Ischemia ; Brain* ; Fever ; Gerbillinae* ; Hypothermia ; Ischemia* ; Ischemic Attack, Transient ; Reperfusion ; Survival Rate* ; Water

PURPOSE: To establish normal reference ranges of urinary flow rate related to age, body surface area and voided volume in normal Korean pediatric females, uroflowmetry was performed and analyzed statistically. MATERIALS AND METHODS: Uroflowmetry was performed on total 270 normal pediatric females who ranged in age from 4 to 12 years(mean+/-SD: 7.23+/-1.97 years). The height and weight were measured then body surface area was calculated by Mosteller`s formula. The uroflow data(peak and average flow) were grouped by age(4 to 6, 7 to 9 and 10 to 12 years old) and body surface area( 1.1 and<1.1 m2) then plotted in volume-related nomograms. RESULTS: Mean values of peak and average flow rates were 13.33+/-4.44 & 7.51+/-2.6, 14.01+/-5.22 & 7.76+/-3.15, 20.40+/-6.84 & 10.89+/-3.97 ml/sec in each age group, and 13.57+/-4.87 & 7.61+/-2.96, 20.14+/-6.44 & 10.65+/-3.79 ml/sec in each body surface area group, respectively. Flow rates were increased significantly with voided volume, age and body surface area. Body surface area was found to be a more reliable index than age in the establishment of nomograms(p<0.05). CONCLUSIONS: Nomograms of peak and average flow rates of normal Korean pediatric female were presented. These may be useful for diagnosing lower urinary tract disturbances in pediatric female over a wide range of age, body size and voided volumes.
Body Size ; Body Surface Area ; Female* ; Humans ; Nomograms* ; Pediatrics ; Reference Values ; Urinary Tract

No abstract available.

PURPOSE: To assess the CT findings of pulmonary edema and to compare them, according to the cause. MATERIALS AND METHODS: CT findings (thin section, 20 ; thick section, 16) of pulmonary edema in 36 patients [cardiacdisease (group I, n=20), renal disease (group II, n=13), ARDS (group III, n=3)] were analyzed and compared. Therewere 21 men and 15 women ranging in age from 27 to 77 years. Distribution (even, central, or peripheral) andpatterns of pulmonary edema were compared between the three groups. RESULTS: The distribution of edema, appearingas consolidation or ground-glass opacity, was even in 75% (n=15) of group I, even in 46% (n=6) and central in 38%(n=5) of group II, and peripherally predominant in 100% (n=3) of group III. Interlobular septal thickening wasseen in 80% (n=16), 69% (n=9), and 0% of group I, II and III, respectively. Centrilobular ground-glass opacity wasnoted in six patients. CONCLUSION: In spite of various findings and considerable overlapping of the findings ofpulmonary edema, the distribution and pattern of edema differed according to the cause, and this can be helpfulfor differential diagnosis.
Diagnosis, Differential ; Edema ; Female ; Humans ; Male ; Pulmonary Edema*

Necrotizing pneumonia causes necrosis of pulmonary parenchyma and may lead to pulmonary gangrene. Prior to theantibiotic era, extensive pulmonary involvement was potentially fatal, but the incidence of necrotizing pneumoniais now less common. On contrast-enhanced CT scans, consolidation with contrast enhancement containing necroticfoci with low attenuation and cavities is characteristic. Radiologic findings do not differ according to thecausative organism and in most of cases, specific diagnosis may be impossible. Clinical findings and certaincharacteristic radiologic findings may be helpful for narrowing the differential diagnosis. We illustrate theclinical and radiologic characteristics of necrotizing pneumonia according to causative bacterial organisms.
Diagnosis ; Diagnosis, Differential ; Gangrene ; Incidence ; Necrosis ; Pneumonia* ; Tomography, X-Ray Computed