PURPOSE AND BACKGROUND: Recently several clinical studies suggested that maternal treatment with magnesium sulfate had protective effects against cerebral palsy in premature infants. But previous studies with differing perinatal animal models resulted in inconclusive results with regard to magnesium neuroprotection. Our purpose was to study the neuroprotective effect of magnesium sulfate and optimal dosage on hypoxicischemic brain damage in the newborn rat. METHOD: Seven-day-old rats(n=68) underwent right carotid ligation, followed by 3 hours of hypoxia(8% oxygen in 92% nitrogen). Rats received magnesium sulfate immediately before and again after hypoxia(two doses, 150mg-600mg/kg/dose, n=39), or saline solution(n=29). Severity of injury was assessed 5 days later, by visual evaluation of ipsilateral hemisphere infarction and by measurement of bilateral hemispheric cross sectional areas. RESULTS: Magnesium sulfate pre-treatment reduced the incidence of liquefactive cerebral infarction and atrophy from 80.8% in controls to 22.2% with magnesium sulfate(450 mg/kg/dose, P<0.05). Quantitation of hemispheric areas confirmed these findings. Percent protection based on inter-hemisphere area differences by pre-treatment with magnesium sulfate 450mg/kg/dose ranged from 71.1%(hippocampus) to 90.8%(striatum). However higher dose of magnesium(600mg/kg/dose) did not attenuate hypoxic-ischemic brain injury in the newborn rat but increased mortality. CONCLUSION: Pretreatment of magnesium sulfate has neuroprotective effects against hypoxia-ischemia in the newborn rat and adequate dose of magnesium sufate is important to protect the brain. Magnesium pretreatment may be an effective strategy to decrease the severity of neonatal hypoxic-ischemic brain injury in the adequate dose.
Animals ; Atrophy ; Brain ; Brain Injuries ; Cerebral Infarction ; Cerebral Palsy ; Humans ; Incidence ; Infant, Newborn* ; Infant, Premature ; Infarction ; Ligation ; Magnesium Sulfate* ; Magnesium* ; Models, Animal ; Mortality ; Neuroprotective Agents* ; Oxygen ; Rats*

Anti-HLA antibody related neonatal thrombocytopenia is an uncommon disorder caused by platelet antigen incompatibility between mother and fetus in Korea. Mothers who lack the specific platelet antigen produce the IgG against the platelet antigen which the fetus inherits from the father. These IgG antibodies are then transported across the placenta into the fetal circulation where they lead to the destruction of fetal platelets. We report a case of neonatal alloimmune thrombocytopenia related with anti-HLA antibody in second baby of dizygotic twin who had petechia on trunk and platelet count 43,000/mm. Initially, mother and twin showed the positives in antiplatelet antibodies. In microlym- phocytotoxic test at 6 months of age, anti-HLA antibodies was negative in twins but anti-HLA A2, A24 was positive in their mother. The patient was treated with intravenous immunoglobulin and clinically improved and her platelet count was norrnalized.
Antibodies ; Blood Platelets ; Fathers ; Fetus ; Humans ; Immunoglobulin G ; Immunoglobulins ; Infant, Newborn ; Korea ; Mothers ; Placenta ; Platelet Count ; Thrombocytopenia, Neonatal Alloimmune ; Twins ; Twins, Dizygotic

About one tenth of all CNS neoplasms involves the brain. Due to their location in the ventricles they often present similar nonspecific clinical manifestation. Localization and differential diagnosis are dependent on radiological investigation. For the identification of specific CT characteristics of the intraventricular tumors and the differental diagnosis, we retrospectively analyzed 22 pathologically proved cases seen on CT. Important differential features included age and sex of the patient, the location within the ventricle, and the morpholgic appearance of the mass and density on CT before and after intravenous administration of contrast material. Meningiomas (4 cases) and a germinoma showed increased density on the precontrast CT scans, and demonstrated dense uniform enhancement of the postenhanced scan. Choroid plexus papillomas (3 cases) showed dense uniform contrast enhancement. Intraventricular neurocytomas (3 cases) demonstrated characteristic attachment to the septum pellucidum, confinement of the lateral and third ventricle, and calcification within the mass Colloid cysts (2 cases) showed characteristic location of anterosuperior aspect of the third ventricle. In conclusion, CT findings of intraventricular tumors are usually nonspecific. The location of the mass and the patient's age are the most helpful information in the differential diagnosis.
Administration, Intravenous ; Brain ; Colloid Cysts ; Diagnosis ; Diagnosis, Differential ; Germinoma ; Humans ; Meningioma ; Neurocytoma ; Papilloma, Choroid Plexus ; Retrospective Studies ; Septum Pellucidum ; Third Ventricle ; Tomography, X-Ray Computed

No abstract available.
Humans ; Survival Rate*

BACKGROUND: Administering extracorporeal membrane oxygenation (ECMO) to critically ill patients with acute respiratory distress syndrome has substantially increased over the last decade, however administering ECMO to patients with hematologic malignancies may carry a particularly high risk. Here, we report the clinical outcomes of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO. METHODS: We performed a retrospective review of the medical records of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO at the medical intensive care unit of a tertiary referral hospital between March 2010 and April 2015. RESULTS: A total of 15 patients (9 men; median age 45 years) with hematologic malignancies and severe acute respiratory failure received ECMO therapy during the study period. The median values of the Acute Physiology and Chronic Health Evaluation II score, Murray Lung Injury Score, and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score were 29, 3.3, and -2, respectively. Seven patients received venovenous ECMO, whereas 8 patients received venoarterial ECMO. The median ECMO duration was 2 days. Successful weaning of ECMO was achieved in 3 patients. Hemorrhage complications developed in 4 patients (1 pulmonary hemorrhage, 1 intracranial hemorrhage, and 2 cases of gastrointestinal bleeding). The longest period of patient survival was 59 days after ECMO initiation. No significant differences in survival were noted between venovenous and venoarterial ECMO groups (10.0 vs. 10.5 days; p = 0.56). CONCLUSIONS: Patients with hematologic malignancies and severe acute respiratory failure demonstrate poor outcomes after ECMO treatment. Careful and appropriate selection of candidates for ECMO in these patients is necessary.
Adult* ; APACHE ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hematologic Neoplasms* ; Hemorrhage ; Humans ; Intensive Care Units ; Intracranial Hemorrhages ; Lung Injury ; Male ; Medical Records ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency* ; Retrospective Studies ; Tertiary Care Centers ; Weaning

No abstract available.
Colorectal Neoplasms* ; Exons*

PURPOSE: To determine whether preoperative CT is helpful in predicting the development of recurrent tumor following surgical resection in patients with esophageal cancer. MATERIALS AND METHODS: Thirty patients with esophageal cancer in whom preoperative CT of the chest had been performed were included in the study. All had undergone esophagectomy, esophagogastrostomy and lymph node dissection at our institution between 1995 and 1997. They were divided into two groups according to the development of tumor recurrence during the follow-up period of three years. Sixteen patients (group I) suffered tumor recurrence, while the other 14 (group II) remained tumor-free after surgery. In each group, a review of the preoperative CT scans indicated the length, thickness, location and margin of the tumor, and the presence or absence of lymphadenopathy in the mediastinum and/or upper abdomen. Differences in preoperative CT findings between the two groups were assessed by statistical testing. RESULTS: Lymphadenopathy of the mediastinum and/or upper abdomen was seen in 11 (69%) of 16 patients in group I and three (21%) of 14 in group II (p<.05). The tumor margin was indistinct in seven patients (44%) in group I and in one (7%) in group II (p<.05). The average length and thickness of esophageal tumors were 5.2 and 1.4 cm, respectively, in group I, and 3.5 and 1.5 cm, respectively, in group II (p>.05). In group I, five esophageal tumors were located in the middle esophagus and eleven in the lower esophagus. In group II, such tumor was located one in the upper esophagus, six in the middle esophagus, and seven in the lower esophagus (p>.05). CONCLUSION: Patients with preoperative CT findings of lymphadenopathy and/or an indistinct primary tumor margin are more likely to develop tumor recurrence following surgical resection than those without these findings.
Abdomen ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Diseases ; Mediastinum ; Recurrence* ; Thorax ; Tomography, X-Ray Computed

Carcinoid tumors of the intestinal tract are uncommon neoplasms thought to arise from argentaffin cells in the base of the intestinal crypts. Carcinoid tumors of other sites have since been reported with increasing frequency. We experienced one case of rectal carcinoid tumor and the other case of stomach carcinoid turnor. A 52-year-old male patient was admitted to the hospital because of right upper abdominal discomfort. On the CT scan, multiple low density masses were noticed. Sigmoidoscopy revealed the whitish yellow ulcerofungating mass which had vague margin. And a 31-year-old male patient was admitted to the haspital because of hematemesis. On the gastrofiberscopic examination, an ovoid shallow ulcer crater which had elevated margin, smooth tapered fold and vissible vessel was noticed on the anterior wall side of the high body. The biopsy specimen in both these cases showed carcinoid cells. 24h urine 5-HIAA of these cases was negative. Awareness of carcinoid tumor in differential diagnosis of hepatic metastasis and of gastric ulcer is necessary.
Adult ; Biopsy ; Carcinoid Tumor* ; Diagnosis, Differential ; Enterochromaffin Cells ; Hematemesis ; Humans ; Hydroxyindoleacetic Acid ; Male ; Middle Aged ; Neoplasm Metastasis ; Rectum* ; Sigmoidoscopy ; Stomach Ulcer ; Stomach* ; Tomography, X-Ray Computed ; Ulcer

Surgical extrusion, immediate extrusion following tooth luxation, is a method to preserve one's natural tooth and achieve esthetic restoration without additional periodontal surgery when subgingival dental caries or crown fracture occurs. A 16-year-old male was referred to the clinic from the department of operative dentistry for the esthetic restoration of maxillary left lateral incisor. Due to the crown to root fracture, the tooth was endodontically treated with a buccal crown length of 4 mm. When the palatal flap was elevated, the mesiopalatal cervical fracture area was situated 3 - 4 mm subgingivally. Crown lengthening was achieved through surgical extrusion. After 3 months of clinical observation and provisional restoration, the maxillary left central incisor was restored with all ceramic crown and obtained a satisfactory clinical result.
Adolescent ; Ceramics ; Crown Lengthening ; Crowns ; Dental Caries ; Dentistry, Operative ; Humans ; Incisor ; Male ; Tooth ; Tooth Avulsion

No abstract available.
Duodenal Ulcer* ; Pepsinogen A*