Posttransplant lymphoproliferative disease(PTLD) has emerged as a potential life-threatening complication of immunosuppressive therapy after organ transplantation. The occurrence of PTLD is usually associated with an Epstein-Barr virus(EBV) infection in patients who are treated by aggressive immunosuppressive therapy. PTLD is represented by diverse manifestations ranging from reactive lymphoid hyperplasia to high grade malignant lymphoma. This is a case report of a late PTLD in a child. The patient is a 14-year-old girl, who presented as malignant lymphoma 44 months after successful renal transplantation. There was no evidence of EBV infection. On bone marrow study, many neoplastic lymphoid cells were detected. Aggressive chemotherapy for PTLD had resulted in clinical remission. However the patient expired from uncontrolled sepsis and septic shock after 77 days.
Adolescent ; Bone Marrow ; Child* ; Drug Therapy ; Epstein-Barr Virus Infections ; Female ; Herpesvirus 4, Human ; Humans ; Kidney Transplantation* ; Lymphocytes ; Lymphoma ; Organ Transplantation ; Pseudolymphoma ; Sepsis ; Shock, Septic ; Transplants

Abdominal pregnancy is very rare and potentially life-threatening variation of ectopic pregnancy. Early diagnosis is very difficult. In the last several decades prenatal care has improved and noninvasive procedures such as ultrasound scanning and fetal cardiotocography have led to us a better assessment of fetal and maternal disorders. In the last 30 years an increase of diagnosed ectopic pregnancies has been noted and attributed to the greater frequency of pelvic inflammatory disease. Although the incidence of ectopic pregnancy is rising, the incidence of abdominal pregnancy, which is primarily a sequel of a missed ruptured ectopic pregnancy, remains low. We presented a case of secondary abdominal pregnancy in 14 wks with its review of literature.
Cardiotocography ; Early Diagnosis ; Female ; Incidence ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Prenatal Care ; Ultrasonography

This study was conducted to compare the severity of cannulation pain in hemodialysis patients after topical application of EMLA cream and local injection of lidocaine and evaluated side effects and problems accompanied by the former. Twenty patients, who were on hemodialysis from September 1 to October 15, 1994 at the Kangnam St. Mary's Hospital, Catholic University Medical College, were divided into two groups of ten. To conduct a cross over study, two groups were placed on four repeated methods with lidocaine followed by four repeated methods with EMLA cream and vice versa, respectively, while the severity of cannulation pain was being measured according to a Visual Analogue Scale with each methods. The results are follows : 1) The scale of pain was recorded as 4.56+/-1.38 and 2.05+/-1.36 points for methods with lidocaine and EMLA cream, respectively, indicating the less severe pain with EMLA cream. 2) Local side effects such as itching(4 cases, 5.0%) and pallor(5 cases, 6.3%) were observed with methods with EMLA cream but disappeared before the completion of hemodialysis. 3) Problems associated with local lidocaine were pain at the injection of anesthetic (27 cases, 16.9%) and fear for needle insertion (6 cases, 3.8%). The most frequent problems with EMLS cream application were an inconvenience in use (11 cases, 6.9%) and tedious long pretreatment time (11 cases, 6.9%), those associated with inconvenience in cream applying procedures. 4) Twelve out of twenty patients(60.0%) responded with yes to a continued use of EMLA cream in spite of problems with cream application and economical difficulties in purchasing. These results indicate that 5% EMLA cream used as a local anesthetic in hemodialysis significantly reduces cannulation pain and lacks side effects, thus serving as a suitable method for the alleviation of cannulation pain and inconvenience in hemodialysis and the relief of psychological stress of nurses.
Catheterization ; Humans ; Lidocaine* ; Needles ; Renal Dialysis* ; Stress, Psychological

OBJECTIVES: Maternal anemia is common hematologic disorders during pregnancy. Although mild maternal anemia is not associated with fetal anemia, neonatal morbidity including fetal anemia are common with severe maternal anemia during pregnancies. We aim to analyze each variable of FHR using linear and nonlinear methods to detect maternal anemia during pregnancies. METHODS: Seventy antepartal anemic pregnant women(Hb<10.0g/dL) and the contrast group, 70 normal pregnant women were selected among the women who underwent nonstress test(NST) during 3rd trimester in Hanyang University Hospital. The calculated FHR parameters(NST time=20 min) from collected FHR data(40-50min) were made by HYFM II data file. To assess the difference between the anemic and normal pregnancy group, the parameters such as baseline FHR, variability (AMP, MMR), acceleration and deceleration(15bpm-15seconds), gestational age at the time of NST, loss of record, the number of fetal movement, FHR were evaluated. We compared the canonical correlation between each groups using variables of NST. The overall complexity of each FHR time series was quantified by its approximate entropy(ApEn), measure of regularity derived from nonlinear dynamics, "chaos theory". Finally we extract the value of ApEn and were compared between two groups, normal and anemic pregnant women. RESULTS: There were significant decrease of FHR variability(amplitude and mean minute interval) in anemic group. Canonical correlation ensemble was significantly high in 36th-37th and 38th-39th gestational weeks in anemic group(p-value=0.03048 and 0.03421). The value of ApEn was significantly low(0.68+0.26) in anemic group comparing with normal pregnant group(0.95+0.08), respectively. CONCLUSIONS: This study shows that FHR of maternal anemia is different from that of normal pregnant women, and that subtle behavioral differences could be demonstrated in uterus using computerized FHR analysis. The anemic women during pregnancy have more linear and less complicated FHR than the normal pregnancy group. ApEn, which is bound to be used as an index of fetal well-being would be used as an evaluating tool of intrauterine fetal function in the near future.
Acceleration ; Anemia* ; Anemia, Neonatal ; Information Storage and Retrieval ; Entropy* ; Female ; Fetal Movement ; Gestational Age* ; Heart Rate, Fetal ; Humans ; Infant, Newborn ; Nonlinear Dynamics ; Pregnancy* ; Pregnant Women ; Uterus