This study was conducted to evaluate the postnatal changes of serum creatine kinase (CK) and its isoenzymes in normal and asphyxiated newborns. In normal newborns total CK, CK-MM and CK-MB reached a plateau between 2 and 24 hr after birth whereas the serum CK-BB remained stable after birth. CK-MM, CK-MB and CK-BB respectivily composed 90~94%, 5~7% and 1~5% of total CK during study period. In asphyxiated newborns total CK, CK-MM and CK-MB reached maximal value at 12 hr after birth whereas CK-BB decreased after birth. There were no significant differences between normal and asphyxiated newborns in total CK, CK-MM and CK-MB during study period (up to 24 hrs after birth). But CK-BB of asphyxiated newborn was elevated significantly (p<0.05) within 6 hrs after birth compared to normal newborns. There were no significant differences of CK and its isoenzymes between patients evaluated by 5 min Apgar scores(0~3, 4~6 and 7~10) or degree of HIE (HIE stage 0~I, II and III). According to these results, the serum CK-BB is elevated in asphyxiated newborns during 1st 6hrs after birth but has no predictive values of the extent of cerebral damage.
Creatine Kinase* ; Creatine* ; Humans ; Infant, Newborn* ; Isoenzymes ; Parturition

The elevation of plasma total homocysteine(tHcy) is now established as a risk factro for cardiovascular disease. It is also well known that plasma levels of folate and vitamin B/sub 12/ influences homocysteine metabolism as cofactors. Recently, the effects of health-related lifestyle factors, such as smoking, alcohol drinking coffee consumption, regular exercise, and etc, on plasma tHcy have been determined. The Hordalane Homocysteine Study revealed that smoking and coffee consumption are major deter minants of plasma tHcy as well as folate levels; however, the influence of alcohol intake is still controversial. In Koreans, the effects of lifestyle factors of plasma tHcy have not yet been determined. Thus, we investigated the relationships of various lifestyle determinants with plasma tHcy, folate, and vitamin B/sub 12/ levels and the erythrocyte folate concentrations in Korean adults (99 males and 96 fermales). Plasma tHcy levels were significantly hight in male subjects. On the contrary, plasma levels of folate and vitamin B/sub 12/ and erythrocyte folate concentration of the females were significantly higher than those of the males. Among the five lifestyle factors determined in the study, regular exercise significantly affects plasma tHcy levels only in the females, Contrary to the expectation, there were on significant differences in plasma tHcy levels between alcohol drinkers and non-alcohol drinkers as well as smokers and non-smokers. And also, plasma tHcy leverls were not different between coffee consumers and non-coffee consumer and between green tea consumers and non-green tea consumers. Although alcohol intake did not influence plasma tHcy levels, the duration, frequency, and amount of alcohol drinking showed significant negative relationships with plasma folate levers. These results indicate the regular exercise and alcohol intake might influence plasma levels of tHcy and folate in Koreans, although the results were not reveled in both sexes.
Adult* ; Alcohol Drinking ; Cardiovascular Diseases ; Coffee ; Erythrocytes ; Female ; Folic Acid* ; Homocysteine* ; Humans ; Life Style* ; Male ; Metabolism ; Plasma ; Smoke ; Smoking ; Tea ; Vitamin B 12 ; Vitamins*

PURPOSE: To determine which CT findings are useful for the early diagnosis of esophageal perforation, and on the basis of these findings, to assess the accuracy of prediction of the perforation site. MATERIALS AND METHODS: A review of medical records indicated that between January 1995 and December 2001, 36 patients with esophageal perforation were admitted to our hospital. Thirteen of these [M:F=8:5; age: 28-69 (mean, 52.4) years], who had undergone CT chest scanning, were included in this study. The causes of esophageal perforation were trauma (n=5), infectious diseases (n=4), Boerhaave syndrome (n=1), lung cancer (n=1), esophageal cancer (n=1), and idiopathic (n=1). Two chest radiologists unaware of the clincal findings reviewed the CT scans and predicted whether the upper or lower esophagus was perforated. RESULTS: The most common CT finding was extraluminal air at the posterior mediastinum (n=11), while other findings included pulmonary consolidation (n=10), pleural effusion (n=7), discontinuity of the esophageal wall (n=6) and subcutaneous emphysema (n=4), fluid collection around the esophagus (n=4), esophageal wall thickening (n=4), pneumothorax (n=2), and lung abscess (n=2). The perforation site was accurately predicted in 76.9% of cases (10/13). CONCLUSION: The CT findings which help the diagnosis of esophageal perforation, and prediction of the sites at which it occurs, are extraluminal air or fluid collection, focal defect of the esophageal wall, and esophageal wall thickening.
Communicable Diseases ; Diagnosis ; Early Diagnosis ; Esophageal Neoplasms ; Esophageal Perforation* ; Esophagus ; Humans ; Lung Abscess ; Lung Neoplasms ; Mediastinum ; Medical Records ; Pleural Effusion ; Pneumothorax ; Subcutaneous Emphysema ; Thorax ; Tomography, X-Ray Computed

Malacoplakia is an uncommon granulomatous inflammatory disease, which predomina- ntly affected the urinary tract, particularly the urinary bladder. The prostatic involve- ment of malacoplakia is extremely rare and may clinically mimic prostate cancer. A correct diagnosis of malacoplakia can be made by histopathologic findings characterized by accumulations of macrophages containing typical intracytoplasmic inclusions(Michael is-Gutmann bodies). We report a case of prostatic malacoplakia, which was incidentally found in prostate biopsy performed to confirm clinically suspected prostate cancer.
Biopsy ; Diagnosis ; Macrophages ; Malacoplakia* ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Tract

PURPOSE: We wanted to investigate the incidence of posterior diaphragmatic defect on chest CT in various age gropus and its lateral chest radiographic appearances. MATERIALS AND METHODS: The chest CT scans of 78 patients of various ages with posterior diaphragmatic defect were selected among 1,991 patients, and they were analyzed for the incidence of defect in various age groups, the defect location and the herniated contents. Their lateral chest radiographs were analyzed for the shape of the posterior diaphragm and the posterior costophrenic sulcus. RESULTS: The patients' ages ranged from 34 to 87 with the tendency of a higher incidence in the older patients. The defect most frequently involved the medial two thirds (n= 49, 50.4%) and middle one third (n=36, 37%) of the posterior diaphragm. The retroperitoneal fat was herniated into the thorax through the defect in all patients, and sometimes with the kidney (n=8). Lateral chest radiography showed a normal diaphragmatic contour (n=51, 49.5%), blunting of the posterior costophrenic sulcus (n=41, 39.8%), focal humping of the posterior diaphragm (n=7, 6.8%), or upward convexity (n=4, 3.9%) of the posterior costophrenic sulcus on the affected side. CONCLUSION: The posterior diaphragmatic defect discovered in asymptomatic patients who are without a history of peridiaphragmatic disease is most likely acquired, and this malady increases in incidence according to age. An abnormal contour of the posterior diaphragm or the costophrenic sulcus on a lateral chest radiograph may be a finding of posterior diaphragmatic defect.
Diaphragm ; Hernia, Diaphragmatic ; Humans ; Incidence* ; Intra-Abdominal Fat ; Kidney ; Radiography ; Radiography, Thoracic* ; Thorax* ; Tomography, X-Ray Computed*

Multilocular thymic cyst (MTC) has been reported to develop in concert with various mediastinal neoplasms that have intrinsic inflammatory components, such as thymoma, thymic carcinoma, Hodgkin's disease, and seminoma. However, development of mediastinal teratoma without intrinsic inflammation in association with MTC has rarely been reported. Here, we report the findings of a case of MTC associated with mediastinal mature cystic teratoma on computed tomography (CT) with CT-histopathologic correlation.
Hodgkin Disease ; Inflammation ; Mediastinal Cyst* ; Mediastinal Neoplasms ; Mediastinum ; Seminoma ; Teratoma* ; Thymoma

Multilocular thymic cyst (MTC) has been reported to develop in concert with various mediastinal neoplasms that have intrinsic inflammatory components, such as thymoma, thymic carcinoma, Hodgkin's disease, and seminoma. However, development of mediastinal teratoma without intrinsic inflammation in association with MTC has rarely been reported. Here, we report the findings of a case of MTC associated with mediastinal mature cystic teratoma on computed tomography (CT) with CT-histopathologic correlation.
Hodgkin Disease ; Inflammation ; Mediastinal Cyst* ; Mediastinal Neoplasms ; Mediastinum ; Seminoma ; Teratoma* ; Thymoma

BACKGROUND/AIMS: Colchicine is an established drug for microtubule stabilization that may reduce tissue injury. No data were available that its effects may depend on the dosage of colchicine. We investigated the anti-fibrotic and apoptotic effects of various dose of colchicine in a unilateral ureteral obstruction (UUO) model. METHODS: Thirty-six Sprague-Dawley rats were randomly assigned into six groups. Two sham groups were divided into a vehicle-treated or colchicine-treated group (100 μg/kg/day). Four UUO groups were treated with either vehicle or three different doses of colchicine for 7 days (30, 60, and 100 μg/kg/day, intraperitoneally). All of the animals were sacrificed on day 7. RESULTS: Colchicine treatment diminished acetylated α-tubulin and tumor growth factor-β immunoreactivities in the cortical area of the 7-day obstructed kidneys, which was in dose dependent manner. Colchicine attenuated tubulointerstitial damage and apoptosis in both cortical and medullary area, and beneficial effects of colchicine therapy were dramatically shown at the higher dosage of colchicine. The expression levels of cleaved caspase-3, ED-1, and fibronectin were decreased in UUO animals. CONCLUSIONS: We found that the proper dosage of colchicine may have anti-fibrotic and anti-apoptotic effects in obstructed kidneys. For clinical applications, an optimal dose of colchicine should be evaluated to maximize the prevention of renal disease progression.
Animals ; Apoptosis* ; Caspase 3 ; Colchicine* ; Disease Progression ; Fibronectins ; Fibrosis* ; Kidney* ; Microtubules ; Rats, Sprague-Dawley ; Ureteral Obstruction

The case of sigmoid volvulus combined with a transomental hernia is reported. A 70-year-old man was admitted to our hospital with mild abdominal pain and distension. Although no signs of peritoneal irritation were apparent, a plain abdominal X-ray showed a markedly dilated loop of the sigmoid colon, and CT revealed a whirl pattern of the sigmoid mesentery. These findings suggested sigmoid volvulus. Colonoscopic reduction was attempted as an initial nonoperative treatment, and an urgent laparotomy was performed after the reduction failed. The sigmoid loop was herniated through the great omentum, with torsion in the clockwise direction. The colon was manually untwisted in the counter-clockwise direction, and the sigmoid loop was released by dividing the great omentum. During this one-stage operation, intraoperative colonic irrigation, sigmoid resection, and primary anastomosis were performed. The postoperative course was uneventful. Although sigmoid volvulus combined with a transomental hernia is rare, urgent surgical intervention is essential on failure of endoscopic reduction.
Abdominal Pain ; Aged ; Colon ; Colon, Sigmoid ; Hernia ; Humans ; Intestinal Volvulus ; Laparotomy ; Mesentery ; Omentum

PURPOSE: Although early neurological deterioration (END) during the acute stroke period is known to be associated with poor functional outcomes, there is little data regarding the impact of END on long-term outcomes according to the characteristics of END. The aim of this study was to investigate whether there are differences in long-term mortality according to the characteristics of END among acute ischemic stroke or transient ischemic attack patients. MATERIALS AND METHODS: END was defined as any increase (> or =1) in National Institute of Health Stroke Scale score within 7 days after admission. We assessed the characteristics of END, such as the etiology and severity of END, as well as recovery after END. The relationship between 30-day or long-term mortality and each characteristic of END was investigated using multiple logistic analysis or Cox regression model. RESULTS: Among 2820 patients, END was observed in 344 patients (12.2%). After adjustment for age, sex, underlying cardiovascular diseases, stroke severity, and stroke subtypes, END was associated with long-term mortality, whether it was mild or severe and whether or not it was followed by recovery. However, 30-day mortality was strongly related to the severity of END or the absence of recovery after END. Among the causes of END, recurrent stroke and medical illness were related to 30-day mortality, as well as long-term mortality, while brain herniation and intracranial hemorrhagic complications were only associated with 30-day mortality. CONCLUSION: The results of the present study demonstrated that END is associated with higher mortality and the effects of END on short-term and long-term mortality depend on END characteristics.
Aged ; Brain Ischemia/mortality/*physiopathology ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stroke/mortality/*physiopathology