No abstract available.
Extremities* ; Hyperplasia* ; Nevus*

PURPOSE: Successful management of epileptic patients requires complete control of seizures without adverse effect. The purpose of this study is to evaluate the hematologic effect and hepatic enzyme change of antiepileptic drugs in epileptic children and compare the changes of these values according to serum drug level. METHODS: The study included 89 epileptic children with antiepileptic drugs such as phenobarbital, valproate, and carbamazepine from May 1990 to July 1999. We classified these patients into 3 groups according to the drug they had taken; group 1 : patients treated by phenobarbital, group 2 : valproate, group 3 : carbamazepine. Baseline screening tests before the start of therapy for all patients included complete blood count(CBC) and differential, platelet count, serum alanine aminotransferase(ALT), aspartate aminotransferase(AST). The tests wee repeated at follow-up visits in 2nd week, 4th week, 6th week, 12th month on the new drug. We compared their mean hematologic and liver enzyme values, which were examined before and after taken the medications, such as white blood cell counts(WBC), red blood cell(RBC), platelets, hemoglobin(Hgb), hamatocrit(Hct), mean corpuscular volume(MCA), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), AST, and ALT. Statistically significant change of each value was observed according to drug blood levels. RESULTS: No significant differences were found between before and after medication on AST, ALT, Hgb, MCHC in all the groups. The WBC count diminished after medication of carbamazepine, significantly. But the correlation between WBC count and serum carbamazepine level was no statistically significant. The mean platelet count diminished significantly after medication of phenobarbital and valproate, and the correlation of maximum serum valproate level with the degree of platelets count was statistically significant. Statistically significant changes were found on MCV and MCH values before and after the medication in 3rd group. But it did not depend on carbamazepine blood level. CONCLUSION: Statistically significant correlations was found between the platelet count and the plasma valproate level. Significant increase of MCV and MCH, and decrease WBC count was observed after the medication of carbamazepine.
Alanine ; Anticonvulsants* ; Aspartic Acid ; Carbamazepine ; Child* ; Erythrocyte Indices ; Follow-Up Studies ; Humans ; Leukocytes ; Liver* ; Mass Screening ; Phenobarbital ; Plasma* ; Platelet Count ; Seizures ; Valproic Acid

The clinical role of tumor markers to detect the extent of tumor invasion and recurrence in cervical cancer has been debated. To evaluate the chncal significance of SCC, CEA and TPA as tumor markers in cervical, we studied 744 patients weith cervieal cancer from June 1990 to Mey 1994. The cut-off val ues of SCC, CEA and TPA were 1.5 ng/ml, 4.5 ng/mi and 110 U/I respectively. Followings were the results. 1. The serum concentration and positive rates of SCC before therapy(567 cases) were 3,0+/-7.0ng/ml(40.4%) for stage I,8.7+/-13.9 ng/ml(71.6%) for stage II, 10.8+/-14.7 ng/ml(85.7%) for stage III, 23.9+/-24.3 ng/ml(94.7%) for stage IV, and 13.4+/-19.1 ng/ml(75.0%) for recurrent cancer. It was increased with advancing clinical stage(p<0.01). 2. The seum levels and positive rate of CEA before therapy(627cases) were 3.4+/-4.3 ng/ml (18%) for stage I, 7.1+/-12.3 ng/ml(37.2%) for stage II, 8.4+/-9.6 ng/ml(57.9%) for stage III, 15.4+/-22.2 ng/ml(52.6%) for stage IV, and 10.3+/-16.2 ng/ml(46.4%) for recurrent cancer. It was increased with advancing clinical stage from stage Ito stage III(p<0.01). 3. The serum concentration and positiceive rate of TFA before therapy(301cases) were 51.7+/-53.8 U/l(9.5%) for stage I, 105.3+/-108.8 U/l(32.3%) for stage II, 186.3%+/-159.8 U/l(50%) for stage III, 191.3+/-l06.2 U/I(63.6%) for stage IV, and 135.4+/-117.0 U/l(46.4%) for recurrent cancer. It was increased with advencing clinical stage(p<0.01). 4. In 64 patients{24.2%) with lymph node invasion of 265 patients treated by operation, the mean serum levels of SCC, CEA and TPA were higher than lymph node negative group(p<0.05). 5. The serum levels of SCCand CKA after therepy were 82.8% in sensitivity. 94.3% in specificity, 67.9% in positive predictive value, 97.4% in negative predictive value.
Humans ; Lymph Nodes ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

No abstract available.
Acute Kidney Injury*

OBJECTIVE: To evaluate the perinatal prognosis of fetuses with a single umbilical artery. METHODS: From 1992 to 1998, nineteen cases with single umbilical artery(SUA) was observed in 8,704 deliveries at Chonnam University Hospital. RESULTS: Out of nineteen fetuses, thirteen fetuses with single umbilical artery were detected by antenatal ultrasonographic examination and six fetuses were detected after birth. The male to female ratio was 0.9: 1. Congenital malformations were observed in 8 babies(42.1%) and included leg deformity, esophageal atresia, imperforated anus, ventriculomegaly, meningocele, hydronephrosis, ventricular septal defect, joint contracture, cleft lip and palate, toe anomaly, imperforated anus, kyphosis, no urethra and testis, clubfoot, patent ductus arteriosus and rnild mitral regurgitation. Among 10 cases of karyotyping analysis three cases were diagnosed as trisomy 18. Fourteen fetuses(77.8%) showed growth restriction at delivery. Antenatal obstetric complications were hydramnios(n = 3), oligohydramnios(n =2), and severe preeclampsia(n = 3). CONCLUSION: Careful ultrasonographic evaluation for the identification of a SUA is necessary because of its frequent association with congenital anomaly, growth restriction and cytogenetic abnormality.
Anal Canal ; Chromosome Aberrations ; Cleft Lip ; Clubfoot ; Congenital Abnormalities ; Contracture ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Female ; Fetus ; Heart Septal Defects, Ventricular ; Humans ; Hydronephrosis ; Jeollanam-do ; Joints ; Karyotyping ; Kyphosis ; Leg ; Male ; Meningocele ; Mitral Valve Insufficiency ; Palate ; Parturition ; Prognosis* ; Single Umbilical Artery* ; Testis ; Toes ; Trisomy ; Urethra

We report a case of primary cutaneous cryptococcosis on the left knee of a 67 year-old woman. She had a large ulcerated and indurated plaque with yellowish purulent exudates on her left knee. A histopathological examination from the lesion showed numerous encapsulated, round spores. Cultures from the lesion showed the presence of Cryptococcus neoforrnans. This may have resulted from an immunosuppressive state due to long-term use of oral corticosteroids.
Adrenal Cortex Hormones ; Cryptococcosis* ; Cryptococcus ; Exudates and Transudates ; Female ; Humans ; Knee ; Spores ; Ulcer

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

Background and Objectives: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and some patients require mechanical ventilation and tracheostomy. Owing to the risks of aerosol spreading to health care workers, the protocols and guidelines related to the novel timing and technique for tracheostomy are rapidly changing. We investigated the characteristics of tracheostomy with patients with COVID-19 over a year.Subjects and Method We measured the mean time from intubation to the tracheostomy, survival rate, the incidence of infection to medical staff, and operation time, complications for tracheostomy, and the time of decannulation. All patients underwent a novel percutaneous tracheostomy without bronchoscope (hybrid modified percutaneous dilatational tracheostomy, hybrid MPDT) in the negative pressure intensive care unit. Results: Of the 448 patients with COVID-19 patients, 34 required invasive mechanical ventilation at a tertiary hospital from February 2020 to April 2021. Of those, 15 patients underwent tracheostomy. Of the tracheostomy patients, survival rate was 93.33%. The mean time from intubation to the tracheostomy was 18.27±14.74 days (range, 8-36 days). The incidence of infection to medical staff was zero percent whereas racheostomy-related bleeding was the most common complication (2 patients). Operation time for hybrid MPDT was 5.45±1.12 min. Conclusion The optimal timing of tracheostomy procedure for COVID-19 patients is still unknown, but it is believed that the treatment of COVID-19 can be achieved better if the hybrid MPDT is used at the right time.

No abstract available.
Child* ; Humans ; Lung*

Although trimethoprim-sulfamethoxazole (TMP-SXT) is considered the first-line therapy for Stenotrophomonas maltophilia infections, there is debate on the use of the bacteriostatic drug in serious infections, and recently, there has been an increasing occurrence of acquired resistance to TMP-SXT. In the present study, the effect of efflux pump inhibitors on the susceptibility of TMP-SXT and other antibiotics were investigated in S. maltophilia complex. The sul and/or dfrA genes were identified in only up to 27.8% of all 36 TMP-SXT-resistant S. maltophilia complex isolates. Thus, TMP-SXT resistance in S. maltophilia was not explained completely by the presence of sul and dfrA genes. Carbonyl cyanide-m-chlorophenylhydrazone (CCCP) decreased the minimum inhibitory concentration (MIC) of TMP-SXT by eight to 128 folds in all 14 isolates. In contrast, 2,4-dinitrophenol (DNP), phenyl-arginine-β-naphthylamide (PAβN), and reserpine did not reduce the MIC of TMP-SXT. In addition to TMP-SXT, slight decrease in MICs was observed for tigecycline and piperacillin/tazobactam by CCCP (by two folds) in one isolate. Although efflux pump may play a role in TMP-SXT resistance in S. maltophilia, inhibition of the efflux pump could be done by active proton pore.
2,4-Dinitrophenol ; Anti-Bacterial Agents ; Carbonyl Cyanide m-Chlorophenyl Hydrazone ; Korea* ; Microbial Sensitivity Tests ; Protons ; Reserpine ; Stenotrophomonas maltophilia* ; Stenotrophomonas* ; Thiram* ; Trimethoprim, Sulfamethoxazole Drug Combination*