We report two cases of supratentorial gangliocytomas mimicking an extra-axial tumor. MR imaging indicated that the tumors were extra-axial, and meningiomas were thus initially diagnosed. Relative to gray matter, the tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. On contrast-enhanced T1-weighted images, homogeneous enhancement was observed, while CT scanning revealed calcification in one of the two cases.
Adult ; Brain Neoplasms/*diagnosis/pathology ; Case Report ; Female ; Ganglioneuroma/*diagnosis/pathology ; Human ; *Magnetic Resonance Imaging ; Middle Age

OBJECTIVES: To determine the effectiveness and clinical utility of antenatal corticosteroids in the reduction of neonatal morbidity and mortality on preterm birth Material and method: Neonatal outcomes of 312 preterm babies were evaluated retrospectively. One hundred and two preterm babies(study group) were given dexamethasone more than 1 dose antenatally and 210 preterm babies(control group) were not given dexamethasone antenatally. Antenatal steroids were administered in the form of four 5mg intramuscular doses of dexamethasone 12 hours apart. Maternal and neonatal outcomes of study group were compared with those of control group. Student t- test, x2 test, Fisher's exact test, and logistic regression analysis were used where appropriate. p-value< 0.05 was considered significant. RESULTS: Antentenatal corticosteroid significantly decreased the incidence of RDS(OR:0.47, 95% CI:0.25-0.86), IVH/PVL(OR : 0.32, 95% CI : 0.12-0.86), necrotizing enterocolitis(OR : 0.49, 95% CI : 0.25-0.98), and neonatal death(OR: 0.30, 95% CI: 0.10 - 0.89) in preterm delivery. In the presence of PROM, antenatal corticosteoid seemed to have no protective effect on the neonatal complications such as RDS, IVH/PVL, NEC, PDA, and neonatal death. CONCLUSIONS: Antenatal administration of corticosteroids was effective to decrease the incidence of neonatal morbidity and neonatal mortality in the preterm neonates with no apparent maternal complications.
Adrenal Cortex Hormones ; Dexamethasone ; Humans ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; Logistic Models ; Mortality ; Premature Birth* ; Retrospective Studies ; Steroids

No abstract available.
Granular Cell Tumor ; Scalp

The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.
Cholestasis ; Fluconazole ; Hepatic Encephalopathy ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatocytes ; Humans ; Incidence ; Korea ; Liver ; Liver Transplantation ; Massive Hepatic Necrosis ; Necrosis ; Portal Vein ; Sepsis ; Serologic Tests ; Veins

This study was aimed at evaluating the nutritional status of Korean lactating women, who were attending peripheral community clinics in low-income areas, by anthropometric measurement, estimating dietary intakes and analyzing the contents of breast milk components, serum lipid content and fatty acid composition. Regarding anghropometric measurements, maternal circumferences decreased significantly at the trunk but not at the limbs. The skinfold thickness on all regions had the tendency to decrease during lactation. It was found that intakes of energy, protein, lipid and carbohydrates were desirable while calcium, zinc, copper and vitamin A were low and sodium was excessive. The energy % of fat was 22.41% of the total energy which is higher than the RDA for adults but it is proper for lactating women, but energy % from each fatty acid was usually low and an intake ratio of omega6/omega3 fatty acids was desirable. Accordingly, it is thought that dietary fat intake was balanced in quality. Concentrations of the nutrients in matured human milk showed the same range as that reported form different regions with the exception of calcium and magnesium which were relatively low. Serum lipid contents were decreased with the time postpartum and the average serum lipid content of lactating women were similar to the normal range of adults. Serum polyunsaturated fatty acids. especially omega6 fatty acids have gradually increased with the time postpartum, but the composition were not greatly influenced by dietary intakes.
Adult ; Breast* ; Calcium ; Carbohydrates ; Copper ; Dietary Fats ; Extremities ; Fatty Acids ; Fatty Acids, Unsaturated ; Female ; Humans ; Lactation ; Magnesium ; Milk, Human* ; Nutritional Status ; Postpartum Period ; Reference Values ; Skinfold Thickness ; Sodium ; Vitamin A ; Zinc

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

No abstract available.
Humans ; Infant* ; Infant, Very Low Birth Weight*

To elucidate the complex of insulin-like growth factor binding proteins (IGF-BPs) in short stature patients, we carried out a prospective study on three patients who were diagnosed as complete GH deficiency at the department of pediatrics from July 1992 to June 1993. The results were summarized as follows: 1) Two circulating IGFs complexed to specific binding protein existed in normal serum. Binding activity was found to be in the 150,000 molecular weight area (the large complex) and 50~60,000 molecular weight area (the small complex). 2) Binding activity for the large complex was seen to be dependent on advancing age, level of large IGF-BP3 complex peacked at the age of 15~16 years. 3) The binding activity for large complex diminished in three GH deficient patients and increased after hGH injection to near or above normal level. 4) Increased growth rate after GH treatment in GH deficient patient was closely related with increasing level of the large IGF-BP3 complex. Therefore we suggest that the large IGF-BP3 complex is regulated by GH. Estimating its serum level is useful for screening of GH deficiency and the monitoring of response to GH therapy.
Carrier Proteins ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I* ; Mass Screening ; Molecular Weight ; Pediatrics ; Prospective Studies

CHAP syndorme consists of choreoathetosis, orofacial dyskinesia, affective change, hypotonia, and pseudobulbar signs. CHAP syndrome was firstly des- cribed with onset 1 to 7 days after induced profound hypothermia and complete circulatory arrest for con- genital heart lesion repair. Since then, only a few cases have been reported until now. Case We report a patient who demonstrated all of the elements of the CHAP syndrome in severe cachexic state. Brain SPECT(99mTC-ECD) shows decreased perfusion in left fronto-parieto-temporal lobe. Comments The pathogenesis of CHAP syndrome is obscure. However our case led us to suggest that more essential component pre- disposing to the CHAP syndrome is hypoxia rather than hypothermia. Furthermore, it seems to be related with circulatory insufficiency in extrapyramidal nervous systems.
Anoxia ; Brain ; Heart ; Humans ; Hypothermia ; Movement Disorders ; Muscle Hypotonia ; Nervous System ; Perfusion

No abstract available.
Aged* ; Humans