Perinatal asphyxia is an insult to fetus or newborn due to lack of oxygen or perfusion to various organs, especially to brain, resulting in the important complication known as hypoxic ischemic encephalopathy. A clinical study was conducted on 30 newborns with perinatal asphyxia, who were admitted to Pediatric department of Ewha Women's University Hospital during 18 months period from Sep. 1990 to Feb. 1992. CPK, LDH and isoenzymes were measured in 30 asphyxated neonates and compared with control group. The results were as follows: 1) The serum CPK values at 1st and 7th day were not different in the asphyxia group and control group. 2) The serum CPK-BB and MB fraction at 1st day were highly significant in the asphyxia group. 3) The CSF CPK value at 1st day was highly significant in the asphyxia group. 4) The serum LDH values and the serum LDH isoenzyme 3 were highly significant in asphyxia group at 1st day. 5) The CSF LDH values and the CSF LDH isoenzyme 2 and 3 were highly significant in asphyxia group at 1st day. So, we concluded the serum CPK-BB fraction, the CSF CPK values, the serum LDH values, the serum LDH 2 fraction, the CSF LDH values and the CSF LDH 2,3 fraction as predictors of neurologic disability following perinatal asphyxia.
Asphyxia* ; Brain ; Fetus ; Humans ; Hypoxia-Ischemia, Brain ; Infant, Newborn ; Isoenzymes ; Oxygen ; Perfusion

The influence of Propofol on regional cerebral function and CBF were studied using 24 male Spragus-Dawley rat by quantitative autoradiographic technique for glucose ( (14C)deoxyglucose) and (14C) Iodoantipyrine. Rats had both femoral artery and vein cannulated and were placed on lead weight. Propofol was infused intravenously at a rate of 0.35 mg/kg/min. for induction and 0.3 mg/kg/min for maintenance untill loss of corneal reflex with stable vital signs. Local cerebral glucose utilization and CBF were checked from conscious control rats and propofol anesthetized rats. The results were as follows; 1) There was no physiologically significant effect of propofol on body temperature, MAP, PaCO, and pH. 2) Regional cerebral glucose utilization was markedly decreased in many, but not all, cerebral structures. 3) The order of decreased glucose utilization was Diencephalone>Telencephalone>Mesence-phalone>Mylencephalone. which means the forebrain was more affected than hindbrain. 4) The most affected area of glucose utilization were cerebral association area, visual system and sensory motor cortex, but the auditory system was not so much affected. 5) During combined use of N,O and propofol, there was no significant stimulation effect of N,O to propofol in glucose utilization. 6) Regional CBF were markedly decreased in many brain regions which means low local cerebral glucose utilization with low CBF. 7) Propofol has specific effect of lowering cerebral metabolic rate, CBF, and intracranial pressure but no signigicant effect on cardiovascular system, pulmonary system, or temperature.
Anesthesia* ; Animals ; Body Temperature ; Brain ; Cardiovascular System ; Femoral Artery ; Glucose* ; Humans ; Hydrogen-Ion Concentration ; Intracranial Pressure ; Male ; Motor Cortex ; Propofol* ; Prosencephalon ; Rats* ; Reflex ; Rhombencephalon ; Veins ; Vital Signs

No abstract available.
Dermoid Cyst*

Pheochromocytoma is an unusual tumor in pediatric age group and there are several different aspects from adult counterparts. Children have fewer malignant, more extra-adrenal, and greater bilaterality and multiplicity of tumor. We present a case of 14-year old boy with pheochromocytoma who has symptoms such as episodic headaches, vomiting, seizure and paroxysmal hypertension which is less common in children. Although the duration of preoperative preparation was not long enough, we decided to remove the tumor because symptoms were disappeared rather rapidly after alpha and beta adrenergic blocker treatment. The patient was managed with continuous epidural block and light general anesthesia but extra use of adrenergic receptor blocker and vasodilator were demanded during tumor manipulation. The patient has remained well postoperatively but long-term follow up is essential because of the possibilities of recurrence.
Adolescent ; Adrenergic Antagonists ; Adult ; Anesthesia, General ; Child ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Male ; Pheochromocytoma* ; Receptors, Adrenergic ; Recurrence ; Seizures ; Vomiting

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

Purpose: To investigate changes in eye movement amplitude after conjunctival recession and conjunctivo-limbal autograft for treating recurrent pterygium with ocular motility restriction. Methods: We retrospectively analyzed 18 eyes of 16 patients who had recurrent pterygium with ocular motility restriction, who had received conjuntivo-limbal autografts from January 2011 to December 2019 and who had been followed-up for more than 6 months. We evaluated changes in eye movement amplitude, best corrected visual acuity, uncorrected visual acuity, corneal astigmatism and keratometry, and recurrence and complication rates before and after surgery. Results: The mean age of the patients was 63.9 ± 9.7 years. Eye movement amplitude increased significantly from 5.80 ± 1.70 mm preoperatively to 7.02 ± 1.37 mm postoperatively (p < 0.001). The mean UCVA increased from 0.67 ± 0.46 preoperatively to 0.36 ± 0.35 postoperatively (p < 0.001). The mean corneal astigmatism decreased from 3.51 diopters (D) preoperatively to 1.22 D postoperatively (p = 0.001). According to the power vector analysis, M and B were significantly reduced after the surgery, but the changes in J0 and J45 were not significant. No recurrence of pterygium was observed. Conclusions Eye movement amplitude for severe recurrent pterygium with symblepharon or ocular motility restriction quantitatively measured the range of ocular movement clinically and was applied to determine the severity of recurrent pterygium and predict the surgical outcome. Conjunctivo-limbal autograft for severe recurrent pterygium is thought to be a safe and effective surgical method because it solves the ocular motility restriction caused by adhesions and has low recurrence rates, although it requires the skilled experience and techniques of the operator and a long operation time.

Intra-abdominal desmoplastic small round cell tumor has been described in the literature since 1989. It is characterized by the occurrence in ages less than 40 with male predominance, an intra-abdominal location, and small round to oval shaped tumor cells with divergent differentiation in the background of the desmoplastic stroma. We recently experienced this tumor in an inguinal lymph node of a 36-year-old man. It is suspected that it metastasized from a lower intra-abdominal tumor. Immunohistochemical stains for keratin, epithelial membrane antigen, vimentin, S-100 protein and neuron specific enolase were positive. This is the first documented case in Korea. Herein, we report on this tumor with a review of literature.
Male ; Humans

Cutaneous metastasis from visceral malignancies shows diverse manifestations. Very rarely, cutaneous metastasis mimicks benign mesenchymal tumors. We describe a case in which metastasis from gastric adenocarcinoma mimicked fibrohistiocytic tumors. The diagnosis of cutaneous metastasis was confirmed by the presence of atypical cells and signet-ring cells, positive staining for mucin and positive immunohistochemical stainings for keratins, carcinoembryonic antigen(CEA), and lysozyme within the tumor cells infiltrated in the irregular, intertwining bundles of collagen in the reticular dermis.
Adenocarcinoma* ; Collagen ; Dermis ; Diagnosis ; Mucins ; Muramidase ; Neoplasm Metastasis

Cold urticaria is a group of distinct clinical entities with different clinical manifestations that share the common feature of an urticarial response to cold exposure. In the localized cold urticaria, it is confined to portions of the body that have contact with the cold. In this article, we report an unusual patient with cold urticaria in which cold exposure causes hives in localized region of the face and the ice-cube test was positive only in that area.
Humans ; Urticaria*

Angiomyofibroblastoma of the vulva is a rare mesenchymal tumor. It has been diagnostically confused with aggressive angiomyxoma which has a somewhat different clinical course and therapy. Herein we report a case of angiomyofibroblastoma of the vulva in a 46-year-old female. Microscopically, there were alternating hypercellular and hypocelluar edematous zones in which abundant capillary blood vessels were irregularly distributed. Spindle, plump spindle, and oval stromal cells were concentrated around the blood vessels, or loosely dispersed in the hypocellular area. Immunohistochemically, the stromal cells were positive for desmin, vimentin, muscle-specific actin and weakly positive for S-100 protein. Ultrastructural studies showed well developed rough endoplasmic reticulum, abundant intermediate filaments, and pinocytic vesicles in the stromal cells.
Female ; Humans