BACKGROUND: To compare the diagnostic value between Phalen's test and reverse Phalen's test using a morphological change of the median nerve and the carpal tunnel in diabetics and normal controls seen by high-resolution ultrasonography and to research on an ultrasonography as an available tool for the screening and follow up aid-test of the carpal tunnel syndrome(CTS). METHODS: A cross-sectional area and a flattening ratio of the median nerve, and a cross-sectional area of the carpal tunnel were measured in neutral, maximally flexed(Phalen's test), and maximally extended (reverse Phalen's test) positions in 59 wrists of 30 normal controls and 60 wrists of 30 diabetics. RESULTS: 1) In controls and diabetics, the mean cross-sectional area of median nerve at the hamatum were 8.8/10.2 mm2, 8.0/9.5 mm2, 8.3/9.4 mm2, the mean flattening ratio were 3.0/3.0 mm2, 2.4/2.0 mm2, 3.2/3.0 mm2, the mean cross-sectional area of carpal tunnel were 176.5/197.7 mm2, 157.9/187.0 mm2, 170.6/192.5 mm2 in neutral, maximal flexion and maximal extension. 2) In controls, the cross-sectional area of median nerve and carpal tunnel were significantly decreased in maximal flexion(p<0.01), and in maximal extension(p<0.01). 3) In controls, the mean flattening ratio of median nerve was revealed significant change in maximal flexion(p<0.01), and in maximal extension(p<0.01). 4) In diabetics, the flattening ratio was significantly decreased in maximal flexion(p<0.01) with com- paring to neutral position. 5) In diabetics, the cross-sectional area of median nerve and carpal tunnel were significantly increased in all positions(p<0.05), and the mean flattening ratio of median nerve was similar to controls. CONCLUSION: In diabetics, increased cross-sectional area of median nerve can be explained by swelling of median nerve, also increased cross-sectional area of carpal tunnel is can be said to have taken place by the decreasing of the useful space in between the median nerve and carpal tunnel, this show that the diabetics have the high risk of the CTS. Phalen's test reveals higher degree of irritation to median nerve, The high-resolution ultrasonography is suggested as an available tool for the screening and follow up aid-test for the CTS
Carpal Tunnel Syndrome ; Follow-Up Studies ; Mass Screening ; Median Nerve* ; Ultrasonography ; Wrist*

Beals-Hecht syndrome, also known as congenital contractural arachnodactyly, is a rare autosomal dominant, connective tissue disorder characterized by congenital joint contractures, arachnodactyly, dolichostenomelia, crumpled ear, and kyphoscoliosis. We report a case of Beals-Hecht syndrome in a 4 days old female newborn baby, associated with congenital knee and elbow joint contractures, arachnodactyly, dolichostenomelia, crumpled ear, and 4 umbilical arteries, with brief review of the related literatures.
Arachnodactyly ; Connective Tissue ; Contracture ; Ear ; Elbow Joint ; Female ; Humans ; Infant, Newborn ; Joints ; Knee ; Umbilical Arteries

Purpose: The aims of this study were to test the efficacy of vapocoolant spray to decrease the symptoms associated with pain in newborns undergoing heel stick and intramuscular injection and compare the pain relief effect of oral glucose. Methods: Randomized, controlled study including sixty newborns undergoing heel stick and intramuscular injection. Group 1 was heelsticked, Group 2 was intramuscular injected, Group A did not recieve any treatment, Group B recieved 30% glucose solution orally, Group C was applied vapocoolant spray symptoms and signs associated with pain at heel stick and intramuscular injection were measured with the premature Infant Pain Profile (PIPP) scale. Results: There was no significant difference in the PIPP score between intramuscular injected group control and heel stick group control (P=0.07). The mean PIPP score of Group 1A (control) 10.6+/-2.4, Group 1B 5.5+/-2.0, Group 1C 5.2+/-1.8. The mean PIPP score 1B and 1C were significantly lower than control (1B P<0.001, 1C P<0.001). The mean PIPP score of Group 2A (control) 12.5+/-1.4, Group 2B 7.0+/-1.7, Group 2C 6.4+/-1.6. The mean PIPP score 2B and 2C were significantly lower than control (2B P<0.001, 2C P<0.001). Conclusion: The antinociceptive effect of vapocoolant sparay is as effective as 30% oral glucose solution for pain control. So this study support the use of vapocoolant spray for reducing pain during painful procedure in the neonatal intensive care units.
Glucose ; Heel ; Humans ; Infant, Newborn ; Infant, Premature ; Injections, Intramuscular ; Intensive Care Units, Neonatal

The 1q terminal deletion syndrome is a rare chromosomal disorder which was first reported by Mankinen et al. in 1976. This disorder has shown to have broad and diverse clinical phenotypes. Specific phenotypes of 1q terminal deletion syndrome include microcephaly, seizures, psychomotor retardation, growth retardation, abnormalities of extremities, corpus callosum, heart and genitalia. Although this disorder has diverse clinical manifestations, almost all cases of 1q44 deletion syndrome have growth, psychomotor, and mental retardation and progressive microcephaly. The first diagnosis of 1q44 deletion syndrome in Korea was made by fluorescent in situ hybridization analysis in a 4-month-old girl with craniofacial anomalies, multiple congenital anomalies, and growth and psychomotor retardation. We report the second domestic case of 1q44 deletion syndrome with cleft palate, facial dysmorphism, single umbilical artery, foot abnormality, progressive microcephaly, growth and psychomotor retardation which was confirmed by microarray for comparative genomic hybridization. We also compare this case with previously reported cases of 1q44 deletion syndrome.
Chromosome Disorders ; Chromosomes, Human, Pair 1 ; Cleft Palate ; Comparative Genomic Hybridization ; Corpus Callosum ; Developmental Disabilities ; Diagnosis ; Extremities ; Female ; Foot ; Genitalia ; Heart ; Humans ; In Situ Hybridization, Fluorescence ; Infant ; Intellectual Disability ; Korea ; Microcephaly* ; Oligonucleotide Array Sequence Analysis ; Phenotype ; Seizures ; Single Umbilical Artery

Cyberlindnera fabianii (previously known as Hansenula fabianii, Pichia fabianii, and Lindnera fabianii) is a yeast species that forms a biofilm, allowing it to resist azole drugs. In this study, we report a case of fungemia with C. fabianii that was successfully treated with anidulafungin. In this case, the organism was initially misidentified as Candida utilis (with a high probability of 93%, suggesting good identification) using the VITEK 2 yeast identification card (YST ID; bio-Merieux, USA). The species responsible for the patient's fungemia was correctly identified after sequencing the internally transcribed spacer region and the D1/D2 domain of the large subunit (26S) rDNA gene. The CLSI M27-A3 broth microdilution method was used to determine the in vitro antifungal activity of anidulafungin and fluconazole against C. fabianii. The MICs of anidulafungin and fluconazole were found to be 0.03 microg/mL and 2 microg/mL, respectively. The patient recovered after 14 days of anidulafungin treatment.
Biofilms ; Candida ; Danazol ; DNA, Ribosomal ; Fluconazole ; Fungemia* ; Humans ; Pichia ; Yeasts

Hemimegalencephaly is a rare congenital malformation of the cortical development arising from abnormal proliferation of anomalous neuronal and glial cells. The characteristic clinical manifestations are macrocephaly, psycomotor retardation, intractable seizure and hemihypertrophy of face, body and extremities, but musculoskeletal deformities are reported only in case of epidermal nevus syndrome. We report a case of hemimegalencephaly that was associated with foot deformity, without symptoms and signs of epidermal nevus syndrome.
Congenital Abnormalities ; Extremities ; Foot Deformities ; Foot Deformities, Congenital ; Macrocephaly ; Malformations of Cortical Development ; Neuroglia ; Neurons ; Nevus ; Nevus, Sebaceous of Jadassohn ; Seizures

No abstract available.
Lingual Thyroid*

The content of meconium in amniotic fluid(AF) is important for assessing the risk of several perinatal problems such as asphyxia, meconium aspiration syndrome and various perinatal infections. This estimate is usually performed subjectively by visual inspection. The purpose of this study is to develop the objective method for quantitative measurement of meconium content in AF. Absorption spectra and meconium-crit of the solutions with various concentrations of meconium were measured. EfFects of filtration and blood contamination on the measurement of meconium content were also estimated by the same methods. Optical densities(OD) were correlated with concentrations of meconium in the whole range of scanned wavelengths. A specific peak of meconium was not available but the highest OD around 410 nm was shown. OD were linearly related to the concentrations of meconium. Meconium-crits were also well-correlated with the concentrations of meconium. Filtration of AF as well as blood contamination in AF severely affected the measurement of meconium content in AF. From the results of this study, both the spectrophotometric method and meconium-crit couid be objective methods for measuring meconium content. Both methods had merits and shortcomings. Filtration and blood contamination should be avoided for the measurement of meconium content in AF. We hope that both or either one of the two methods will be clinically used.
Absorption ; Amniotic Fluid* ; Asphyxia ; Female ; Filtration ; Hope ; Infant, Newborn ; Meconium Aspiration Syndrome ; Meconium*

PURPOSE: We report a case of neuromyelitis optica (Devic's syndrome) with hepatocellular carcinoma. CASE SUMMARY: A 70-year-old male with hepatocellular carcinoma presented with bilateral visual loss. A relative afferent pupillary defect was not observed in either eye due to bilateral mydriasis. On brain MRI, there was no specific finding, however, on spine MRI, multiple and severe myelopathies were observed. After high-dose methylprednisolone pulse therapy, the visual acuity was 0.03 in the right eye and counting fingers at 30 cm in the left eye. CONCLUSIONS: We encountered a case of neuromyelitis optica involving bilateral optic neuropathy in hepatocelluar carcinoma. Therefore, in patients with an optic neuropathy of uncertain etiology, clinicians should consider performing a systemic evaluation.
Aged ; Brain ; Carcinoma, Hepatocellular* ; Eye ; Fingers ; Humans ; Male ; Methylprednisolone ; Mydriasis ; Neuromyelitis Optica* ; Optic Nerve Diseases ; Optic Neuritis ; Paraneoplastic Syndromes* ; Pupil Disorders ; Spinal Cord Diseases ; Spine ; Visual Acuity

BACKGROUND: In athlete's heart, functional and structural alteration are main features. We studied electrocardiograms(ECG's) and echocardiograms(UCG's) in soccer players before and after intensive training. METHODS: Fifteen soccer players with the mean age and career of 19.3 and 8.5 years,respectively,underwent intensive training for 5-5.5 months, which included running of 2 km daily during the last 2-2.5 months. Comparisons of ECG's and UCG's recorded before and after the training were made. RESULTS: The major abnormal finding in pre-training ECG's was high voltage being seen in 40% of the cases, and in UCG's left ventricular(LV) dilatation and/or hypertrophy or asymmetrical septal hypertrophy(ASH) were noted in approximately 80% of the cases. The incidences of these finding after the intensive training were essentially unchanged, and the mean of pre-and post-training fractional shortening(FS) and LV and left atrial dimensions were similar. The high voltage in ECG's showed no close correlation with LV dilatation or hypertrophy on UCG's. After the training, however, the mean values of the thickness of LV posterior wall and ventricular septum along with LV mass were significantly increased, and the right ventricular dimension was significantly decreased. CONCLUSIONS: The most frequent finding in ECG's and UCG's in soccer players, before and after intensive training,were high voltage, LV dilatation and /or hyperophy with or without ASH. The intensive training of 5-5.5 months duration caused no change in F8,but caused significant increase in the thickness of LV posterior wall and ventricular septum, and LV mass.
Dilatation ; Electrocardiography* ; Heart ; Hypertrophy ; Incidence ; Running ; Soccer* ; Ventricular Septum