PURPOSE: The purpose of this study was to evaluate clinical manifestation, etiology and prognosis of hypocalcemic infants who were admitted with seizure. METHODS: We reviewed medical records of 32 infants admitted at the Asan Medical Center with hypocalcemic seizure retrospectively. We classified patients into vitamin D deficiency group(n=7, 21.9%), transient hypoparathyroidism group(n=4, 12.5%), relative hypoparathyroidism with hyperphosphatemia group(n=16, 50%), and others(n=5, 15.6%) according to the laboratory results. RESULTS: Of the 32 patients, 29 patients were improved. There were no differences in gestational age and birth weight among the three groups. In the vitamin D deficiency group, age of onset was later than those of the transient hypoparathyroidism group and relative hypoparathyroidism with hyperphosphatemia group(51.6+/-2.7 vs 8.3+/-.5, 8.2+/-.6 days). In the age when all laboratory results were normalized, transient hypoparathyroidism group was younger than those of vitamin D deficiency group and relative hypoparathyroidism group(33.2+/-4.6 vs 93.6+/-8.5, 77.1+/-2.4 days). In the total treatment period, relative hypoparathyroidism with hyperphosphatemia group was longer than those of vitamin D deficiency group and transient hypoparathyroidism group(68.9+/-3.5 vs 42.0+/-5.0, 25.0+/-4.3 days). Others included two 22q11.2 deletion syndrome patients, a congenital hypoparathyroidism, a pseudohypoparathyroidism, and an early neonatal hypocalcemia. CONCLUSION: Transient hypoparathyroidism and hyperphosphatemia were major causes of neonatal hypocalcemia. And high calcitonin and peripheral organ resistance to parathyroid hormone act on hypocalcemia. In infants after one month, vitamin D deficiency was also an important cause of hypocalcemia. Most of the patients were improved within 1-2 months after proper management, but relative hypoparathyroidism with hyperphosphatemia group needed longer treatment. So, it is necessary to perform a systematic study for several complex causes that explain above fact.
Birth Weight ; Calcitonin ; Chungcheongnam-do ; DiGeorge Syndrome ; Gestational Age ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Infant* ; Medical Records ; Parathyroid Hormone ; Prognosis ; Pseudohypoparathyroidism ; Retrospective Studies ; Seizures ; Vitamin D Deficiency

No abstract available.
Hamartoma*

PURPOSE: To evaluate the diagnostic accuracy of T-tube cholangiography(TTC), selective cholangiography (SC) and noncontrast CT(NCT) in the evaluation of intrahepatic stone disease. MATERIALS AND METHODS: We retrospectively analyzed the radiological findings of these methods in thirty patients with intrahepatic stones proved by percutaneous removal. Findings of each procedure were reviewed and correlated with findings of stone removal procedure. RESULTS: Detection of stones was possible in 87. 0% for TTC, 90. 0% for SC, 96. 7% for NCT(p > 0.05). Selective cholangiography was as good as or superior to 1-I'C in determining the presence and extent of the stones in all patients(p < 0. 01). NCT was better than SC in 9;as good as SC in 18;inferior to SC in 3 patients in determining the extent and location of the stones(p > 0.05). Of 12 patients who had additional findings such as biliary cirrhosis or accompanied cholangiocarcinomas, only NCT could detect the lesions in 11 patients. CONCLUSION: Although there was no statistically significant difference between NCT and SC, one procedure sometimes gave valuable informations for interventional procedure which the other could not. Thus we conclude that both procedures are complementary studies and should be done in all patients who are subjected to biliary intervention.
Cholangiocarcinoma ; Cholangiography* ; Humans ; Liver Cirrhosis, Biliary ; Retrospective Studies

Profound reduction of anterograde coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite technically successful procedure. We found interesting coronary flow pattern in a patient with acute myocardial infarction, showing angiographic no reflow phenomenon after direct PTCA. The coronary blood flow pattern of the angiographic no-reflow phenomenon in this case was characterized by minimal systolic flow and sharp deceleration of diastolic flow. Coronary flow reserve calculated by the ratio of adenosine induced maximal hyperemic velocity and basal velocity was reduced. The Dopplertipped guide wire was useful for observation of phasic coronary flow pattern of angiographic no-reflow phenomenon.
Adenosine ; Deceleration ; Humans ; Ischemia ; Myocardial Infarction* ; No-Reflow Phenomenon ; Percutaneous Coronary Intervention

No abstract available.
Lymphedema*

No abstract available.
Meningitis* ; Salmonella*

We present a case which seems identical to REM(Reticular Erythematous Mucinosis) syndrome in 26 year-old male. The lesion was initiated about 2 years ago and waxed and waned. The clinical findings were localized, grouped, erythematous papules and vesicles on the anterior middle chest with intermittent mild itching. Histopathology showed normal epidermis, extensive mucin deposition, telangiectasia and mild perivascular round cell infiltrations on the upper dermis. The mucin was stainable with alcian blue at pH 2. 5, but was not stained by either PAS or mucicarmine. Skin lesions were not responded to the oral steroid, but improved slowly after topical application of 5% para-aminobenzoic acid in ethanol for 9 months. The lesion does not recur until present time.
4-Aminobenzoic Acid ; Adult ; Alcian Blue ; Dermis ; Epidermis ; Ethanol ; Humans ; Hydrogen-Ion Concentration ; Male ; Mucins ; Pruritus ; Skin ; Telangiectasis ; Thorax

No abstract available.
Echocardiography, Three-Dimensional ; Echocardiography, Transesophageal* ; Heart Septal Defects, Atrial*

No abstract available.
Adolescent ; Humans

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis