BACKGROUND AND OBJECTIVE: The clinical manifestation of Henoch-Schonlein purpura and existance of renal involvement may influence on its course and prognosis. To verify prevention with early administration of steroid, we studied the efficacy of corticosteroid treatment. MATERIAL AND METHOD: We analysed 65 children under 15 years of age with Henoch-Scho nlein purpura according to their age, sex, and seasonal incidence. Forty children showed typical skin lesions, arthralgia and abdominal pain. We have divided them two groups. Group A consisted of 20 children who received 1 mg/kg of prednisolone/perday for 2 weeks and group B did not. We carried out their physical examination and urinalysis monthly for a year. RESULT: The main clinical manifestations were skin rash(100% ), abdominal symptoms(41.5 %), joint symptoms (49.2%), and renal involvement(34%). As for gastrointestinal symptoms, abdominal pain(66.7% ) was most commonly observed one and others were nausea or vomiting (44.7%) and melena(25.9%). The joint involvement was observed mostly in knee(56.3%) and ankle joint(31.3% ), Hematuria was observed in all cases with renal involvement and proteinuria, in 28% of them. The improvement of renal manifestations were noted in 84.2% of them within 4 months. Mild elevation of IgA was more frequently observed in renal involvement group than non-involved group (p< 0.01). There were no significant differences in immonologic parameters such as IgG, IgM, IgE, duration of the acute phase and severity of cutaneous symptoms between two growps. None of steroid treated growp showed progression of nephropathy. Of the 20 non-steroid treated growp, 2(10%) developed nephropathy. Conclusion We may suggest that existance of renal involvement in Henoch-Schonlein purpura influences its course and prognosis.
Abdominal Pain ; Ankle ; Arthralgia ; Child ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Joints ; Nausea ; Physical Examination ; Prognosis ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Seasons ; Skin ; Urinalysis ; Vomiting

We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1M0). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival.
Cardiopulmonary Bypass ; Extracorporeal Circulation* ; Fistula ; Heart Atria ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Invasiveness ; Neoplasm Staging ; Omentum ; Pericardium ; Pulmonary Edema ; Recurrence ; Transplants

No abstract available.
Adenoma*

No abstract available.
Kidney Transplantation*

Knotting of a pulmonary artery catheter (PAC) is a rare, but well-known complication of pulmonary artery (PA) catheterization. We report a case of a double-knotted PAC with a large loop in a patient with hepatocellular carcinoma (HCC) undergoing liver transplantation, which has been rarely reported in the literature. A PAC was advanced under pressure wave form guidance. PAC insertion was repeatedly attempted and the PAC was inserted 80 cm deep even though PAC should be normally inserted 45 to 55 cm deep. However, since no wave change was observed, we began deflating and pulling the balloon. At the 30-cm mark, the PAC could no longer be pulled. Fluoroscopy confirmed knotting of the PAC after surgery (The loop-formed PAC was shown in right internal jugular vein); thus, it was removed. For safe PA catheterization, deep insertion or repeated attempts should be avoided when the catheter cannot be easily inserted into the pulmonary artery. If possible, the insertion of PACs can be performed more safely by monitoring the movement of the catheter under fluoroscopy or transesophageal echocardiography.
Carcinoma, Hepatocellular ; Catheterization ; Catheterization, Swan-Ganz ; Catheters* ; Echocardiography, Transesophageal ; Fluoroscopy ; Humans ; Jugular Veins* ; Liver Transplantation ; Pulmonary Artery*

PURPOSE: To measure the magnetization transfer ratio(MTR) of intracranial tumors and to evaluate the difference of the character and the border of tumors on magnetization transfer image. MATERIALS AND METHODS: We prospectively reviewed magnetization transfer imaging(MTI) findings of intracranial tumors of 13 patients. 1.0T MRI machine was used. T1 weighted image(TRITE=700/14) and T1 weighted magnetization transfer image were obtained. The offset and bandwidth of magnetization transfer pulse were 1000 Hz and 250Hz, respectively. Postcontrast images were also obtained. MTR was measured at lesion area. RESULTS: The mean of normal MTR of white matter and gray matter in 7 normal volunteers were 37% and 29%, respectively. The MTR of each tumor was as follows;metastatic tumors(mean 16.3%), meningioma(mean 27.3%), oligodendroglioma(mean 20.2%), glomus jugulare tumor(mean 17.3%), gliomatosis cerebri(mean 27. 0%). The contrast of lesions were better at magnetization transfer image than at T1 weighted image. CONCLUSION: The MTR of the intracranial tumors is lower than normal tissue. Measurement of MTR at muirpie areas within the tumor can be useful for evaluation of indistinct border of the tumor.
Glomus Jugulare ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Prospective Studies

BACKGROUND: This study investigated the effects of total knee arthroplasty (TKA) on bone mineral density (BMD) of the proximal femur in patients who underwent the procedure. METHODS: Forty-eight patients scheduled to undergo unilateral TKA because of primary knee osteoarthritis were included in this study, which was conducted at a medical center between October 2006 and October 2009. In these 48 patients, 96 hips were evaluated. Measurement of BMD was performed preoperatively and one month, three months, six months, and one year after unilateral TKA. Repeated measured analysis of variance and paired t-tests for comparison of two repeated samples were used to compare differences between time points (preoperation, one, three, six, and 12 months) and between the operative and nonoperative sides. RESULTS: Preoperatively, BMD of the femoral neck, trochanter, and total hip on the operative side were lower than on the nonoperative side; however, there was no statistical difference. BMD of both femoral neck areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both trochanter areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both total hips was significantly lower than preoperative BMD at three months after TKA. However, no statistical differences of changes in BMD were observed between the operative and nonoperative sides at each measurement time. CONCLUSIONS: According to our results, TKA was found to affect both proximal femurs during the acute period. However, TKA did not affect a change in BMD of the proximal femur during one year postoperative.
Aged ; Arthroplasty, Replacement, Knee/*adverse effects ; Bone Density/*physiology ; Female ; Femur Neck/*physiopathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged

No abstract available.

From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5+/-12.2 years. Seventeen (63.0%) patients had the mitral valve replacement, 8 (29.6%) the aortic valve, 1 (3.7%) the aortic composite graft, and 1 (3.7%) the tricuspid valve. Mean follow-up period was 49.5+/-30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9+/-34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis (1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2+/-43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak (4/15, 26.7%), and valve thrombosis (3/15, 20.0%). Posto-perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.
Aortic Valve ; Bioprosthesis ; Cardiac Output, Low ; Endocarditis ; Female ; Follow-Up Studies ; Heart Valve Prosthesis* ; Heart Valves* ; Humans ; Male ; Mitral Valve ; Prostheses and Implants ; Reoperation* ; Thrombosis ; Transplants ; Tricuspid Valve

BACKGROUND AND OBJECTIVES: The status of cervical lymph node is important factor influencing the prognosis of patients with oral cavity squamous cell carcinoma. There has been some controversy regarding the treatment of clinical N0 neck in oral cavity squamous cell carcinoma, and the purpose of this study is to analyze the outcomes and efficacy of the elective neck dissection. SUBJECTS AND METHOD: Authors analyzed outcomes of elective neck dissection by a retrospective study with a review of medical records of 41 oral cavity squamous cell carcinoma patients who had clinical N0 neck. RESULTS: The overall rate of occult neck metastasis was 27%, and the rate of occult metastasis beyond T2 stage was 45%. The occult metastasis rates of the primary sites in the oral tongue, floor of mouth and retromolar trigon were 26.7%, 40% and 33.3%, respectively. Three cases had bilateral occult metastasis and other three had nodal recurrence after elective neck dissection. CONCLUSION: Because there were high occult neck metastasis rate but no significant postoperative complications in using the elective neck dissection, it could be used in T2, T3 or T4 oral cavity squamous cell carcinoma with clinical N0 neck.
Carcinoma, Squamous Cell* ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Medical Records ; Mouth ; Mouth Floor ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Postoperative Complications ; Prognosis ; Recurrence ; Retrospective Studies ; Tongue