To investigate the functioning periods and the causes of cerebrospinal fluid shunt failures, 246 shunts inserted in 208 children from October 1985 to August 1992 at the authors' institute were retrospectively reviewed. The mean age at shunt insertion was 4.0 years and the reasons for the shunting procedures were congenital hydrocephalus (47.6% per procedure), tumor-associated hydrocephalus (21.1%), postmeningitic hydrocephalus (11.8%), congenital cyst (10.6%) and others (8.9%). All except 2 were shunted to the peritoneal cavity. Forty-five operations for shunt failure were done (18.3%) during the follow-up period (mean, 32 months). The functioning (shunt survival) rates at 6, 12, 24 and 36 months after surgery were 91.6%, 86.6%, 83.6% and 82.9%, respectively. The complications were mechanical malfunction (12.2%), infection (4.1%), subdural fluid collection which required drainage (1.6%) and migration (0.4%). About half of the mechanical malfunctions and infections which had occurred during the follow-up period were within 6 months and 2 months after surgery, respectively. There was no shunt-related mortality. These chronological data should be considered in the planning of follow-up schedules.
Adolescent ; Cerebrospinal Fluid Shunts/*adverse effects/mortality ; Child ; Child, Preschool ; Female ; Human ; Infant ; Infant, Newborn ; Infection/etiology ; Male ; Support, Non-U.S. Gov't ; Survival Rate ; Time Factors

No abstract available.
Carcinoma, Renal Cell* ; Neoplasm Metastasis*

No abstract available.
Carcinoma, Renal Cell* ; Neoplasm Metastasis*

Aneurysmal dilatation of the ductus arteriosis has been considered a rare but potentially fatal abnormality. The mechanism of ductal aneurysmal formation remains uncertain. Plain chest radiography has proven helpful in the diagnosis of ductus arteriosus aneurysm (DAA), before the application of transthoracic echocardiography. The transthoracic echocardiography is an important tool for the diagnosis and follow-up of DAA. We present a case of congenital ductus arteriosus aneurysm in a newborn, that was an incidental discovery. The diagnosis was made by echocardiography, three-dimensional surface rendering computed tomography (CT), and spontaneous regression after four weeks of follow-up.
Aneurysm* ; Diagnosis ; Dilatation ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Echocardiography ; Echocardiography, Three-Dimensional ; Follow-Up Studies ; Humans ; Incidental Findings ; Infant, Newborn ; Radiography ; Thorax

No abstract available.
Parathyroid Neoplasms* ; Radionuclide Imaging* ; Thymoma*

A variety of complications in endoscopic third ventriculostomy have been reported, including neurovascular injury, hemodynamic alterations, endocrinologic abnormalities, electrolyte imbalances, cerebrospinal fluid leakage, fever and infection. Even though most complications are transient, the overall rate of permanent morbidity is 2.38% and the overall mortality rate is 0.28%. To avoid these serious complications, we should keep in mind potential complications and how to prevent them. Proper decisions with regard to surgical indication, choice of endoscopic entry and trajectory, careful endoscopic procedures with anatomic orientation, bleeding control and tight closure are emphasized for the prevention of complications.
Cerebrospinal Fluid Leak ; Fever ; Hemodynamics ; Hemorrhage ; Mortality ; Neuroendoscopy ; Ventriculostomy*

X-linked ichthyosis (XLI) is a recessively inherited ichthyosis. Skin barrier function of XLI patients reported in Western countries presented minimally abnormal or normal. Here, we evaluated the skin barrier properties and a skin barrier-related gene mutation in 16 Korean XLI patients who were diagnosed by fluorescence in situ hybridization and array comparative genomic hybridization analysis. Skin barrier properties were measured, cytokine expression levels in the stratum corneum (SC) were evaluated with the tape stripped specimen from skin surface, and a genetic test was done on blood. XLI patients showed significantly lower SC hydration, but normal basal trans-epidermal water loss and skin surface pH as compared to a healthy control group. Histopathology of ichthyosis epidermis showed no acanthosis, and levels of the pro-inflammatory cytokines in the corneal layer did not differ between control and lesional/non-lesional skin of XLI patients. Among the mutations in filaggrin (FLG), kallikrein 7 (KLK7), and SPINK5 genes, the prevalence of KLK7 gene mutations was significantly higher in XLI patients (50%) than in controls (0%), whereas FLG and SPINK5 prevalence was comparable. Korean XLI patients exhibited unimpaired skin barrier function and frequent association with the KLK7 gene polymorphism, which may differentiate them from Western XLI patients.
Adolescent ; Adult ; Asian Continental Ancestry Group/*genetics ; Child ; Chromosomes, Human, X ; Comparative Genomic Hybridization ; Cytokines/metabolism ; Humans ; Hydrogen-Ion Concentration ; Ichthyosis/diagnosis/*genetics/pathology ; In Situ Hybridization, Fluorescence ; Intermediate Filament Proteins/genetics ; Kallikreins/*genetics ; Male ; Polymorphism, Single Nucleotide ; Proteinase Inhibitory Proteins, Secretory/genetics ; Republic of Korea ; Skin/metabolism/*pathology ; Young Adult

X-linked ichthyosis (XLI) is a recessively inherited ichthyosis. Skin barrier function of XLI patients reported in Western countries presented minimally abnormal or normal. Here, we evaluated the skin barrier properties and a skin barrier-related gene mutation in 16 Korean XLI patients who were diagnosed by fluorescence in situ hybridization and array comparative genomic hybridization analysis. Skin barrier properties were measured, cytokine expression levels in the stratum corneum (SC) were evaluated with the tape stripped specimen from skin surface, and a genetic test was done on blood. XLI patients showed significantly lower SC hydration, but normal basal trans-epidermal water loss and skin surface pH as compared to a healthy control group. Histopathology of ichthyosis epidermis showed no acanthosis, and levels of the pro-inflammatory cytokines in the corneal layer did not differ between control and lesional/non-lesional skin of XLI patients. Among the mutations in filaggrin (FLG), kallikrein 7 (KLK7), and SPINK5 genes, the prevalence of KLK7 gene mutations was significantly higher in XLI patients (50%) than in controls (0%), whereas FLG and SPINK5 prevalence was comparable. Korean XLI patients exhibited unimpaired skin barrier function and frequent association with the KLK7 gene polymorphism, which may differentiate them from Western XLI patients.
Adolescent ; Adult ; Asian Continental Ancestry Group/*genetics ; Child ; Chromosomes, Human, X ; Comparative Genomic Hybridization ; Cytokines/metabolism ; Humans ; Hydrogen-Ion Concentration ; Ichthyosis/diagnosis/*genetics/pathology ; In Situ Hybridization, Fluorescence ; Intermediate Filament Proteins/genetics ; Kallikreins/*genetics ; Male ; Polymorphism, Single Nucleotide ; Proteinase Inhibitory Proteins, Secretory/genetics ; Republic of Korea ; Skin/metabolism/*pathology ; Young Adult

BACKGROUND: Recently, resistance to activated protein C(APC) is known to be an important risk factor for venous leg ulcers. Leiden mutation in clotting factor V is the most common genetic defect leading to APC resistance in western countries. Until now, the prevalence of APC resistance and Leiden mutation in Korean patients with venous ulcers has been ill defined. OBJECTIVE: We performed this study in order to investigate the prevalence of APC resistance and Leiden mutation in Korean patients with venous ulcers. METHODS: The functional analysis for APC resistance(APC resistance ratio) and genetic study for Leiden mutation were conducted in 40 patients with venous ulcers. RESULTS: 1. Of the 40 patients with venous ulcers, resistance to APC was documented in 11 individuals (27.5%). 2. We could not find factor V Leiden mutation in 40 patients. 3. Patients with APC resistance more frequently represented recurrence of venous ulcers and venous thrombosis than in their non-APC resistant counterparts. CONCLUSION: APC resistance may be one of the thrombophilic defects in relation with venous ulcers in Korea. However, Leiden mutation may be rare in Korean patients with venous ulcers than in Caucasians. These findings suggested that the other genetic or non-genetic factors may be involved in the pathogenesis of APC resistance in Korea.
Activated Protein C Resistance* ; Factor V ; Humans ; Korea ; Leg Ulcer ; Prevalence* ; Recurrence ; Risk Factors ; Varicose Ulcer* ; Venous Thrombosis

Erectile dysfunction(ED) is defined as the inability to achieve and/or maintain an erection which is sufficient for satisfactory sexual activity. Risk factors for ED include many of the same risk factors for cardiovascular disease: hypertension; lipid abnormalities, including low high-density lipoprotein cholesterol; diabetes; and smoking. Therefore, some patients with ED will have ischemic heart disease. Viagra(R), an oral therapy for ED, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate(cGMP)-specific phosphodiesterase 5(PDE5). The adverse effects of sildenafil include headache, flushing, dyspepsia, nasal congestion, visual disturbance, and cardiovascular complications. A general impression exists that cardiovascular complications of sildenafil occur mainly when the drug is taken concomitantly with nitrate. We report the case of a 52-year-old man who developed an acute myocardial infarction shortly after taking one tablet of sildenafil without sexual activity. The patient had not been using nitrates. Physicians treating patients with chest pain should be aware of the potential consequences of giving nitrates to patients taking sildenafil. We suggest that before initiating therapy, the history of sildenafil ingestion be obtained from patients with suspected myocardial infarction.
Cardiovascular Diseases ; Chest Pain ; Cholesterol ; Citric Acid ; Dyspepsia ; Eating ; Erectile Dysfunction ; Estrogens, Conjugated (USP) ; Flushing ; Guanosine ; Headache ; Humans ; Hypertension ; Lipoproteins ; Male ; Middle Aged ; Myocardial Infarction* ; Myocardial Ischemia ; Nitrates ; Risk Factors ; Sexual Behavior ; Smoke ; Smoking ; Sildenafil Citrate