No abstract available.
Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro*

A 36-year-old man presented to the hospital with protruding blood vessels in his left lower leg accompanied by cramping. An ultrasonographic examination of the leg revealed focal reflux without truncal vein reflux. During phlebectomy, the varix was found to be connected to the intraosseous vein through a tibial opening. Postoperative computed tomography and magnetic resonance imaging showed an osteolytic lesion in the tibial shaft and an intraosseous vascular anomaly. The patient was discharged without complications and scheduled for periodic follow-ups. This young man’s varicose vein seemed to be from a tibial intraosseous vascular anomaly, which is extremely rare.

No abstract available.
Child* ; Humans

Acute ophthalmoplegia is caused by various etiologies; cerebrovascular diseases, tumors, infections, diabetes mellitus, multiple sclerosis, and myasthenia gravis. Acute ophthalmoplegia without ataxia(AO), regarded atypical Miller-Fisher syndrome, can be defined as a progressive, relatively symmetric ophthalmoplegia by 4 weeks without ataxia or limb weakness, on circumstance of ruling-out other diseases. The additional features that are strongly supportive of the diagnosis of AO are as follows: 1) a history of infectious symptoms within 4 weeks before the onset of neurological symptoms; 2) cerebrospinal fluid albuminocytologic dissociation; and 3) presence of anti-GQ1b IgG antibody. AO has been sporadically reported, but there is still short of information for its clinical and laboratory characteristics in children. We report three children with AO, who were presented with acute ophthalmoplegia without other abnormal neurologic symptoms. All of the patients met the diagnostic criteria of AO, but only one of them had a positive serum anti-GQ1b antibody. So, we need to suspect the diagnosis of AO, even in the cases with negative result of serum anti-GQ1b antibody.
Ataxia ; Child ; Diabetes Mellitus ; Extremities ; Humans ; Immunoglobulin G ; Miller Fisher Syndrome ; Multiple Sclerosis ; Myasthenia Gravis ; Neurologic Manifestations ; Ophthalmoplegia

Background: As the population of patients with end-stage renal disease has grown older, the proportion of patients with poorly preserved vasculature has concomitantly increased. Thus, arteriovenous grafts (AVG) have been used more frequently to access blood vessels for hemodialysis. Despite this increasing demand, studies of AVG are limited. In this study, we examined the surgical outcomes of upper-limb AVG creation. Methods: Among the arteriovenous fistula formation procedures performed between January 2014 and March 2019 at Dankook University Hospital, 42 cases involved AVG creation. We compared patients in whom the axillary vein was used (group A; brachioaxillary AVG [B-Ax AVG]; n=20) with those in whom upper limb veins were used (group B; brachiobasilic AVG or brachioantecubital AVG; n=22). Results: The 1-year primary patency rate was higher in group A than in group B (57.9% vs. 41.7%; p=0.262). The incidence of postoperative complications was not significantly different between groups. Conclusion AVG using the axillary vein showed no major differences in safety or functionality compared to AVG using other veins. Therefore, accounting for age, underlying disease, and expected patient lifespan, B-Ax AVG can be considered an acceptable surgical method.

PURPOSE: This study investigated the effects of serum thyroid-stimulating hormone (TSH) levels in predicting malignancy-associated differentiated thyroid cancer (DTC) and benign thyroid nodules. METHODS: Between January 2005 and December 2007, 346 patients underwent thyroid surgery at one hospital. Their records were retrospectively reviewed. RESULTS: Sixty-nine percent (237 of 346) of the patients had DTC. The mean preoperative TSH level was higher than in the malignant group (5 uIU/ml vs 0.4 uIU/ml). The rate of malignancy was the 71% in patients with TSH levels >5 uIU/ml. The TSH level of DTC with metastasis of the lymph node was higher than that with non-metastasis (3.08 uIU/ml vs 2.09 uIU/ml, P<0.01) CONCLUSION: The likelihood of DTC increases with higher serum TSH concentration. Serum TSH level might be useful in predicting malignant nodular thyroid lesion.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyrotropin*

BACKGROUND: The present investigation was undertaken to evaluate the protective effect of propofol and etomidate against hydrogen peroxide (H2O2) induced oxidative damage in human hepatic SNU761 cells by measuring lactate dehydrogenase (LDH). METHODS: The cell line of human hepatocellular carcinoma was grown for 24 hours in dissociated cell culture. They were divided into eight groups: negative control (NC) group with no drug administration, positive control (PC) group with H2O2 250 micrometer and other groups pretreated with propofol (P; 1, 10, 50 micrometer) or etomidate (ET; 1, 10, 50 micrometer) followed H2O2 administration. After 7 hours, cell death was assessed by morphology under the light microscope and quantified by measuring the LDH in the culture media. RESULTS: In the light microscopic findings, the intact cells were increased in all three propofol groups compared to group PC. H2O2-induced LDH production was also significantly suppressed in all three propofol groups compared to group PC (P < 0.001). There were no significant differences in the microscopic findings and LDH production between the etomidate groups and group PC. CONCLUSIONS: These results suggest that the propofol has protective effect on the hepatocyte against H2O2-induced oxidative stress.
Carcinoma, Hepatocellular ; Cell Culture Techniques ; Cell Death ; Cell Line ; Culture Media ; Etomidate ; Hepatocytes ; Humans ; Hydrogen ; Hydrogen Peroxide ; L-Lactate Dehydrogenase ; Light ; Oxidative Stress ; Propofol

PURPOSE: Neonatal immune hemolytic jaundice due to blood group incompatibility is important to treat properly because of an early rise and a high peak of serum bilirubin level and a risk of kernicterus. The conventional therapeutic modalities for neonatal immune hemolytic jaundice due to blood group incompatibility are phototherapy and exchange transfusion. We evaluated the effect of intravenous immune globulin (IVIG) therapy on hyperbilirubinemia due to ABO incompatibility. METHODS: This study included 6 infants with hyperbilirubinemia due to ABO incompatibility who were admitted to the nursery of Eulji Medical Center, Nowon Hospital, from January 2000 to February 2001. All 6 infants had a positive direct Coombs test. Their serum bilirubin levels were above 12 mg/dl within 24hours of age and above 20 mg/dl after 24hours of age. They were treated with intensive phototherapy and IVIG. RESULTS: We classified the effective group when a decline in serum bilirubin level was more than 2 mg/dl in 3-4 hours after IVIG therapy, and the ineffective group when there was a decline in serum bilirubin level less than 2 mg/dl, a re-rise after the initial response to IVIG, or a decline after the combined therapy with intensive phototherapy and IVIG equal or less than that after intensive phototherapy alone. In the effective group (n=2), the average decline in serum bilirebin level was 4.1 mg/dl in 3-4 hours and 8.1 mg/dl in 12-16 hours after IVIG therapy, while in the ineffective group (n=4), the average decline was 1.9 mg/dl and 2.7 mg/dl, respectively. Five among 6 infants were treated with IVIG therapy and 1 infant was treated with exchange transfusion. No serious side effect was detected during and after IVIG therapy. CONCLUSION: We demonstrated the effectiveness of IVIG therapy in 2 infants out of six who were treated with intensive phototherapy and IVIG for hyperbilirubinemia due to ABO incompatibility. IVIG therapy could be considered if hyperbilirubinemia due to ABO incompatibility does not respond to intensive phototherapy alone. Further prospective and randomized studies would be needed.
Bilirubin ; Blood Group Incompatibility ; Coombs Test ; Humans ; Hyperbilirubinemia ; Immunoglobulins, Intravenous* ; Infant ; Jaundice* ; Kernicterus ; Nurseries ; Phototherapy

Practice parameters for non-pharmacological treatment of children and adolescents with pervasive developmental disorders are based on the scientific literature for evidence-based practices. Appropriate educational and behavioral interventions are important in improving the long-term outcome in pervasive developmental disorders. Early and sustained intervention appears to be particularly important. The goal for interventions is to gain pragmatic skills for verbal communication, playing with peers, daily living routines, self-management, and social adaptation. Appropriate involvement and collaboration with parents and family are essential for well-functioning intervention programs. The life-long nature of autism implies that the clinician should maintain an active role in long-term treatment planning and family support. Vocational training and training for more independent living are important for adolescents with autism. Professionals should be knowledgeable about local and national resources and opportunities for family support as well as support of the individual.
Adolescent ; Autistic Disorder ; Child ; Cooperative Behavior ; Humans ; Independent Living ; Parents ; Self Care

The objective of this review is to establish practice parameters for pharmacological treatment of children and adolescents with pervasive developmental disorders. We performed a detailed review of the literature, including a wide range of controlled clinical trials, open trials, case reports, and side-effect profiles of related drugs. Few medications have a treatment indication for pervasive developmental disorders, and few studies with well-controlled methodology are available for evaluating treatment results. Pharmacological treatments focus on associated target symptoms because symptom reduction may improve educational and social ability and enhance quality of life. Well-controlled trials have been conducted for some SSRI(selective serotonin reuptake inhibitor) antidepressants, risperidone, and methylphenidate, and showed reduction of some target symptoms. Since the medications are not specific to autism and do not treat core symptoms of the disorder, their potential side effects should be carefully considered. Family education is necessary to give proper information on target symptoms, limitation of drug treatments, and risks.
Adolescent ; Antidepressive Agents ; Autistic Disorder ; Child ; Education ; Humans ; Methylphenidate ; Quality of Life ; Risperidone ; Serotonin