Periventricular-intraventricular hemorrhage (PV-IVH)is one of the most important neurologic lesion of the low birth weight infants. Serial neurosonographic exeaminations were performed in 113 low birth weight infants who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from November 1, 1990to July 31, 1991. The results were summarized as follows: 1) The incidence of PV-IVH in the study was 54% 2) According to Papile's grading system of PV-IVH, grade I was 32.8%, grade II was 45.9%, grade IIIwas 11.5% and grade IV was 9.8%. 3) The onset of PV-IVH was within the first 7 days of life in 82%. 4) Poor activity, apnea, bradycardia and hypotension were statistically significant clinical findings associated with PV-IVH(P<0.05). 5) The risk factors associated with PV-IVH were gestational age, birth weight, hyaling membrane disease, patent ductus arteriosus and artifical ventilation. 6) The mortality of PV-IVH was 0% for grade I, 10.7% for grade II,42.9% for grade III and 83.3% for gradeIV.
Apnea ; Birth Weight ; Bradycardia ; Diagnosis* ; Ductus Arteriosus, Patent ; Gestational Age ; Hemorrhage* ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Membranes ; Mortality ; Protestantism ; Risk Factors ; Ventilation

Inflammatory myopathies are comprised of three major subsets, polymyositis, dermatomyositis and inclusion body myositis. Although their etiology is unclear, each group retains its characteristic clinical, immunopathologic features. In polymyositis, a CD8+ T-cell mediated cytotoxicity against muscle fibers has emerged as the main pathologic event, whereas in dermatomyositis complement-mediated injury by antibody may be the primary pathology. There has been several reports on polymyositis internationally but we could find only a few reports in Korea. We report here a 8-year old female patient admitted with a stuporous mentality. After coughing and fever for 3 days, she got myalgia, abruptly developed gross hematuria and dyspnea. After admission, she showed weak self respiration and exclussively elevated muscle enzyme in blood chemistry. In muscle biopsy, lymphocytic infiltrations were found in the fascicles without endomysial fibrosis and these lymphocytes were composed of T lymphocytes on immunohistochemical stain. She received two infusions of intravenous immunoglobulin(1g/kg/day), and showed dramatic improvement in symptoms and signs.
Biopsy ; Chemistry ; Child ; Cough ; Dermatomyositis ; Dyspnea ; Female ; Fever ; Fibrosis ; Hematuria ; Humans ; Immunoglobulins* ; Korea ; Lymphocytes ; Myalgia ; Myositis ; Myositis, Inclusion Body ; Pathology ; Polymyositis* ; Respiration ; Stupor ; T-Lymphocytes

Inflammatory myopathies are comprised of three major subsets, polymyositis, dermatomyositis and inclusion body myositis. Although their etiology is unclear, each group retains its characteristic clinical, immunopathologic features. In polymyositis, a CD8+ T-cell mediated cytotoxicity against muscle fibers has emerged as the main pathologic event, whereas in dermatomyositis complement-mediated injury by antibody may be the primary pathology. There has been several reports on polymyositis internationally but we could find only a few reports in Korea. We report here a 8-year old female patient admitted with a stuporous mentality. After coughing and fever for 3 days, she got myalgia, abruptly developed gross hematuria and dyspnea. After admission, she showed weak self respiration and exclussively elevated muscle enzyme in blood chemistry. In muscle biopsy, lymphocytic infiltrations were found in the fascicles without endomysial fibrosis and these lymphocytes were composed of T lymphocytes on immunohistochemical stain. She received two infusions of intravenous immunoglobulin(1g/kg/day), and showed dramatic improvement in symptoms and signs.
Biopsy ; Chemistry ; Child ; Cough ; Dermatomyositis ; Dyspnea ; Female ; Fever ; Fibrosis ; Hematuria ; Humans ; Immunoglobulins* ; Korea ; Lymphocytes ; Myalgia ; Myositis ; Myositis, Inclusion Body ; Pathology ; Polymyositis* ; Respiration ; Stupor ; T-Lymphocytes

No abstract available.
Abdomen ; Syringoma

No abstract available.
Abdomen ; Syringoma

No abstract available.
Gait*

A 61-year-old man was admitted to the emergency room complaining of a severe left exophthalmos caused by frontal and ethmoid sinus mucoceles that were visualized on a brain computerized tomogram. In addition, he had coexisting ankylosing spondylitis with a 20 year duration that resulted in total fixation of the cervical spine and progressive thoracic kyphosis. An unruptured anterior communicating artery aneurysm was found incidentally on the cerebral angiogram. We report that the anesthetic management for endoscopic sinus surgery of a frontal sinus mucocele in a patient with coexisting severe cervical spine ankylosing spondylitis and an unruptured cerebral aneurysm requires a detailed preoperative assessment of the airway, cardiac, pulmonary, and neurologic system. This case highlights the need for careful measures to avoid rupturing the cerebral aneurysm by the increased blood pressure induced by endotracheal intubation and the infiltration of an epinephrine-containing local anesthetic.
Blood Pressure ; Brain ; Emergencies ; Ethmoid Sinus ; Exophthalmos ; Frontal Sinus ; Humans ; Intracranial Aneurysm ; Intubation, Intratracheal ; Kyphosis ; Middle Aged ; Mucocele ; Spine ; Spondylitis, Ankylosing

OBJECTIVE: To determine the prognostic factors for local recurrence of nodular hepatocellular carcinoma after segmental transarterial chemoembolization. MATERIALS AND METHODS: Seventy-four nodular hepatocellular carcinoma tumors < or = 5 cm were retrospectively analyzed for local recurrence after segmental transarterial chemoembolization using follow-up CT images (median follow-up of 17 months, 4-77 months in range). The tumors were divided into four groups (IA, IB, IIA, and IIB) according to whether the one-month follow-up CT imaging, after segmental transarterial chemoembolization, showed homogeneous (Group I) or inhomogeneous (Group II) iodized oil accumulation, or whether the tumors were located within the liver segment (Group A) or in a segmental border zone (Group B). Comparison of tumor characteristics between Group IA and the other three groups was performed using the chi-square test. Local recurrence rates were compared among the groups using the Kaplan-Meier estimation and log rank test. RESULTS: Local tumor recurrence occurred in 19 hepatocellular carcinoma tumors (25.7%). There were: 28, 18, 17, and 11 tumors in Group IA, IB, IIA, and IIB, respectively. One of 28 (3.6%) tumors in Group IA, and 18 of 46 (39.1%) tumors in the other three groups showed local recurrence. Comparisons between Group IA and the other three groups showed that the tumor characteristics were similar. One-, two-, and three-year estimated local recurrence rates in Group IA were 0%, 11.1%, and 11.1%, respectively. The difference between Group IA and the other three groups was statistically significant (p = 0.000). CONCLUSION: An acceptably low rate of local recurrence was observed for small or intermediate nodular tumors located within the liver segment with homogeneous iodized oil accumulation.
Adult ; Aged ; Carcinoma, Hepatocellular/*pathology/radiography/*therapy ; Chemoembolization, Therapeutic/*methods ; Chi-Square Distribution ; Female ; Humans ; Iodized Oil/administration & dosage ; Liver Neoplasms/*pathology/radiography/*therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local/radiography ; Prognosis ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed

OBJECTIVE: We wanted to evaluate whether tumors located in a segmental border zone are predisposed to local recurrence after performing segmental transarterial chemoembolization for hepatocellular carcinoma. MATERIALS AND METHODS: Seventy-three hepatocellular carcinoma nodules were retrospectively analyzed for local tumor recurrence after performing segmental transarterial chemoembolization by using follow-up CT studies (median follow-up period: 20 months, range: 4-77 months). The tumors were divided into two groups according to whether the lesions were located at the segmental border zone (Group I) or not (Group II). Comparison of the tumor characteristics and chemoembolization methods between the two groups was performed using the chi-square test. The local recurrence rates were compared by Kaplan-Meyer method and analyzed with the log rank test. RESULTS: Local tumor recurrence occurred for 25 hepatocellular carcinoma nodules (42.9%). The follow-up periods, tumor characteristics and chemoembolization methods between Groups l and ll were comparable. The local recurrence rate was 64.0% (16/25) in Group I and 18.8% (9/48) in Group II. The difference was statistically significant on the univariate and multivariate analyses (p = 0.000 for both). CONCLUSION: Tumor location in a segmental border zone was a significant risk factor for local tumor recurrence after performing segmental transarterial chemoembolization for hepatocellular carcinoma.
Risk Factors ; Retrospective Studies ; Proportional Hazards Models ; Neoplasm Recurrence, Local ; Middle Aged ; Male ; Liver Neoplasms/*pathology/*therapy ; Iodized Oil/administration & dosage ; Humans ; Female ; Doxorubicin/administration & dosage ; Chi-Square Distribution ; *Chemoembolization, Therapeutic ; Carcinoma, Hepatocellular/*pathology/*therapy ; Aged ; Adult

Nodular regenerative hyperplasia (NRH) of the liver is an uncommon disease entity, especially in the pediatricage group. A few cases have been reported in the radiologic literature, but follow-up imaging studies are rare. We describe a case of NRH, diagnosed by ultrasound-guided needle biopsy, in a seven-month-old infant with cri-du-chat syndrome. Initial ultrasound revealed several small hypoechogenic nodules in the liver, but CT and MR failed to demonstrate their presence. Two follow-up sonographic examinations were performed 7 and 20 months later, revealing increases in the size and number of the nodules.
Biopsy, Needle ; Cri-du-Chat Syndrome ; Follow-Up Studies ; Humans ; Hyperplasia* ; Infant* ; Liver* ; Ultrasonography