We report a cace of 69-year-old man who developed massive pulmonary hemorrhage and subsuquent adult respiratory distress syndrome following intravenous urokinase for acute myocardial infarction. Pulmonary hemorrhage is a rare but a potentially life-threatening complication after thrombolytic therapy and should be considered in the differential diagnosis of pulmonary infiltrates of falling hemoglobin after thrombolytic therapy for acute myocardial infarction with no obvious site of bleeding.
Adult* ; Aged ; Diagnosis, Differential ; Hemorrhage* ; Humans ; Myocardial Infarction* ; Respiratory Distress Syndrome, Adult* ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

PURPOSE: The aim for this study was to investigate clinical manifestation of seasonal influenza A and B during the 2012 winter season in Wonju, South Korea. Their clinical and laboratorial characteristics and effect of oseltamivir were compared and analyzed. METHODS: Children under the age of 18 years who visited the Wonju Severance Christian Hospital with fever or acute respiratory symptoms and who were diagnosed with influenza A or B by rapid antigen test from nasopharyngeal swab were selected for the study. The medical records of patients were retrospectively reviewed. RESULTS: Influenza A was detected in 374 patients (83.7%), and influenza B in 72 (16.6%). The incidence of influenza A was highest in February (n=186), while that of influenza B was highest in March (n=36). The most common symptoms were fever (n=434, 97.1%) and cough (n=362, 81.0%). No significant differences were observed between influenza A and B in symptoms and laboratory data. Patients who had used oseltamivir within 2 days showed statistically lower admission rate, shorter admission duration, and lower incidence of pneumonia. CONCLUSION: This study found no statistical difference between influenza A and B, in symptoms, progression, and laboratory test, but those who were treated with oseltamivir given within 2 days of the onset of fever experienced more positive outcomes.
Child ; Cough ; Fever ; Gangwon-do ; Humans ; Incidence ; Influenza, Human* ; Korea ; Medical Records ; Oseltamivir ; Pneumonia ; Retrospective Studies ; Seasons*

OBJECTIVE: To determine if birth weight greater than 4000gm can be predicted by ultrasound measurement of abdominal circumference(AC) and if shoulder dystocia in macrosomic infants can be predicted by ultrasound measurement of the difference between the abdominal diameter(AD) and biparietal diameter(BPD). METHODS: A Retrospective study was performed of births occuring from March, 1998 to August, 1999 at department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University. Among neonates of birth weight greater than 4000 gm, 50 cases in that ultrasound examination was done within 2 weeks before delivery were selected for macrosomic group and 50 cases were selected for control group during the same period, among neonate of birth weight from 3100gm to 3900gm. RESULTS: 1) Normal spontaneous vaginal delivery(NSVD) was 41 cases in control group and 30 cases in macrosomic group. Among NSVD, shoulder dystocia was 1 case in 41 cases of control group and was 7 cases in 30 cases of macrosomic group. 2) On ultrasound measurement, 6 cases had AC greater than 35 cm in control group and 45 cases in macrosomic group. Among 30 cases in NSVD was done in macrosomic group, difference between AD and BPD was 2.9 0.271 cm when shoulder dystocia was existed and was 2.1 0.409 cm when shoulder dystocia was not existed. Between the two groups, statistically significant difference was detected. 3) When AC(cutoff value of 35cm) was used for screening of macrosomia, sensitivity for macrosomia was 88.2% and specificity was 89.8% and when AD-BPD difference(cutoff value of 2.6cm) was used for prediction of shoulder dystocia, sensitivity for shoulder dystocia was 66.6% and specificity was 95.2%. CONCLUSIONS: In prenatal ultrasound measurement, AC measurement at third trimester of pregnancy will be a valuable indicator for macrosomia screening. The AD-BPD difference of shoulder dystocia group was greater than uncomplicated group in macrosomia and the AD-BPD difference cutoff value of 2.6cm was significant value statistically.
Birth Weight ; Dystocia* ; Female ; Gynecology ; Humans ; Infant ; Infant, Newborn ; Mass Screening ; Obstetrics ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder* ; Ultrasonography*

No abstract available.
Diagnosis* ; Heart Failure* ; Heart Septal Defects, Ventricular ; Heart*

BACKGROUND: The prostaglandin E1(PGE1) is a well known protent dilator of arteriosus. Maintaining of the patency of ductus arteriosus is crucial for the survival of patients suffering from ductus-dependent cyanotic congenital heart disease. We aimed to analyse the efficacy and the influencing factors upon PGE1 in patients suffering from this disease. METHODS: Between May 1991 and April 1993, 26 neonates and infants with ductus- dependent cyanotic congenital heart disease received on intravenous infusion of PGE1 in the Division of Pediatric Cardiology. Yonsei Cardiovascular Center. The result was a dramatic improvement in systemic arterial oxygen tension and oxygen saturation during infusion of PGE1with a dependency on the infusion of PGE1. We evaluated the arterial blood gas analysis both at the immediate pre-infusion stage and 2 hours after infusion. We aimed to analyse the factors which may influence the intravenous of PGE1to infant suffers of ducts-dependent cyanotic congenital heart disease, such as pulmonary atresia(n=14), severe pulmonary stenosis(n=7) or complete transposition of the great arteries(n=5). RESULTS: 1) There was a significant increase in PaO2 and Oxygen saturation 2 hours after the infusion of PGE1. This appeared to be unrelated to the different forms of the disease when compared with the pre-infusion values. 2) The infants' responsiveness of the ductus arteriosus appeared to be age related with significant differences emerging between the 2 group(p<.05). In infants younger than 9 hours old, the differences in PaO2 changes between pre-infusion and post-infusion of PGE1 were 16.3+/-3.7mmHg compared to just 10.4+/-0.4mmHg in infants older than 96 hours. 3) No significant difference emerged between an increase in PaO2or oxygen saturation relating to the shape of ductus arteriosus ; or the level of PaO2prior to the infusion. 4) The side effects of PGE1were as follows ; fever(84.6%),loose stool(61.5%), apnea(30.8%) and hypotension(15.4%), etc.. CONCLUSION: PGE1provides excellent medical palliation for infants suffering from ductus-dependent cyanotic congenital heart disease until the pulmonary arteries are large enough for a modified Blalock-Taussig shunt ; or until corrective surgery is possible.
Alprostadil ; Blalock-Taussig Procedure ; Blood Gas Analysis ; Cardiology ; Ductus Arteriosus ; Heart Defects, Congenital* ; Humans ; Infant* ; Infant, Newborn ; Infusions, Intravenous ; Oxygen ; Pulmonary Artery

Morphological evaluations accounting the associated anomalies were performed in the 60 cases of tricuspid atresia, diagnosed at Division of Pediatric Cardiology. The following results were obtained. 1) Twenty one out of the 6 cases had transposition of the great vessels, among which 8 cases were in complete A-transposition. 2) Seven cases were associated with pulmonany atresia, in 1 case, aorta arise from morphological right ventricle and in 6 case, aorta from morphological left ventricle. Pulmonary stenosis or pulmonary outflow obstruction was found in 52 cases except the rest 8 cases. 3) Four cases were associated with double outlet right ventricle and double outlet left ventricle in 1 case. In conclusion, for the classification of tricuspid atresia on the clinical basis, every possible interrelation of great vessels should be put into full consideration and pulmonary atresia, with very few exceptions, be separated as and isolated item due to the impracticability to verify the origin of pulmonary arteries.
Aorta ; Cardiology ; Classification* ; Double Outlet Right Ventricle ; Heart Ventricles ; Pulmonary Artery ; Pulmonary Atresia ; Pulmonary Valve Stenosis ; Tricuspid Atresia*

The persistent left superior vena cava (LSVC) is not rare cardiovascular developmental anomaly occurring both in association with congenital heart disease and as an isolated anomaly of no hemodynamic importance. We have studied 73 cases of the LSCV out of 1,060 cases of congenital heart disease catheterized at Yonsei Cardiovascular Center. We conducted the study with a view point of position of the heart and abdominal organs and segmental analysis of the underlying congenital heart disease. We also analysed the associated extracardiac vascular anomalies. The following results were obtained: 1) The incidence of this anomaly among congenital heart disease was 6.9% and 41 cases(56.2%) had cyanosis. 2) We observed 20 cases(27.3%) with the malposition of the heart and 17 cases(23.3%) with malposition of the abdominal organs. The ventricular loops revealed D-loop in 60 cases, L-loop in 7 cases and in the remaining 6 cases, it was uncertain. 3) With a view point of type of LSVC by Lucas & Krabill, type A was in 50 cases(68.5%), type D in 14 cases(19.2%), type B in 5 cases(6.8%) and type C in 4 cases(5.5%). 4) Associated cardiovascular anomalies were as follows: ventricular septal defect; 42 cases(57.5%), atrial septal defect; 33 cases(45.2%), patent ductus arteriosus; 27 cases(36.9%), and tetralogy of Fallot; 18 cases(24.7%). In conclusion, LSVC usually has no hemodynamic importance, but this cardiac anomaly is frequently combined with complex intracardiac anomalies. Therefore, it is important to making accurate diagnosis and successful management for preventing the risk of it.
Catheters ; Classification* ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemodynamics ; Incidence ; Tetralogy of Fallot ; Vena Cava, Superior*

PURPOSE: Many articles have proposed that osteonecrosis of the femoral head (ONFH) is caused by fat embolism or intravascular coagulation linked to hyperlipidemia. To determine whether hyperlipidemia is an associated factor for ONFH, serum lipid levels were measured. MATERIALS AND METHODS: Nighty-eight patients presenting with ONFH and 110 controls were investigated. We compared the average value of serum lipid levels and the incidence of hyperlipidemia of the two groups. RESULTS: ONFH group showed generalized increase in lipid level and statistically significant difference in the average value of total cholesterol (P=0.0001), HDL-cholesterol (P=0.0261) and phospholipid (P=0.0465) compared with the control. The incidence of hyperlipidemia of the two groups showed statistically significant difference in HDL-cholesterol (P=0.019) and triglyceride (P=0.024). CONCLUSION: Hyperlipidemia seems to be associated with pathogenesis of ONFH. We speculated that hyperlipidemia might be a contributing factor of ONFH. Hyperlipidemia may play a role as a triggering factor in the pathogenetic process that results in osteonecrosis. However, it can not be ruled out that secondary hyperlipidemia might be a finding following ONFH.
Cholesterol ; Embolism, Fat ; Head* ; Humans ; Hyperlipidemias ; Incidence ; Osteonecrosis* ; Triglycerides

Intraosseous lipoma is one of the rarest primary benign tumors of bone and it is characterised by a neoplastic overgrowth of univacuolar fat cells. The incidence is less than one per 1,000 bone tumors. Most commonly, long bones are affected, with a tendency for metaphyseal involvement. Because of its rarity and nonspecific clinicopathologic findings, biopsy is needed for accurate diagnosis. Currettage and bone-grafting is the treatment of choice if the lesion is painful or if structural stability is threatened. We report 3 cases of intraosseous lipoma in long tubular bones with review of literatures. Two cases were treated by surgical intervention and the other case by conservative management.
Adipocytes ; Biopsy ; Diagnosis ; Incidence ; Lipoma*

Anxiety* ; Depressive Disorder ; Depressive Disorder, Major* ; Electroencephalography ; Humans