Leukemia is a rare disease in the newborn infant. We have presented an autopsy case of congenital acute myelocytic leukemia in a female neonate and discussecd with review of literature. At birth, she was relatively in good health with 4.2 kg in body weight except a large cephalhematoma on left parietal scalp and multiple subcutaneous nodules with ecchymosis on entire body surface. Hemoglobin concentration was 12.0 gm/, Hct 34.6% and erythrocyte count was 2.24 millions. Of 212,400 leukocytes/mm2, 47% were myeloblast. Biopsy of skin nodules reveal leukemia cutis, which disappear dramatically with anticancer drug. The infant was expired 12 days after admission due to intracerebral hemorrhage and acute renal failure.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Biopsy

Leukemia is a rare disease in the newborn infant. We have presented an autopsy case of congenital acute myelocytic leukemia in a female neonate and discussecd with review of literature. At birth, she was relatively in good health with 4.2 kg in body weight except a large cephalhematoma on left parietal scalp and multiple subcutaneous nodules with ecchymosis on entire body surface. Hemoglobin concentration was 12.0 gm/, Hct 34.6% and erythrocyte count was 2.24 millions. Of 212,400 leukocytes/mm2, 47% were myeloblast. Biopsy of skin nodules reveal leukemia cutis, which disappear dramatically with anticancer drug. The infant was expired 12 days after admission due to intracerebral hemorrhage and acute renal failure.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Biopsy

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*

PURPOSE: This study was conducted to investigate the effects of a school based smoking prevention program for college freshmen. METHOD: The nonequivalent control group, pretest-post-test design was used. Among 16 departments in a University located in S city, students in 8, randomly selected, departments received 6 sessions of smoking prevention program consisted of small group discussion led by smoking cessation leaders, video watching, and lectures from March 15 to June 9, 2004. Students in remaining 8 departments did not receive any education. Student's attitude, intention, stress, temptation, knowledge and self efficacy was measured. RESULT: The level of stress and smoking temptation was significantly decreased in the experimental group over that of the control group. CONCLUSION: It was proven that this school based smoking prevention program was effective for decreasing smoking temptation in college freshmen. In the future, more efforts should be given to college age students to prevent them becoming chronic smokers.
Education ; Humans ; Intention ; Lectures ; Self Efficacy ; Smoke* ; Smoking Cessation ; Smoking*

Percutaneous radial artery cannulation has become a common technique for continuous monitoring of arterial blood pressure and serial sampling fo arterial blood in critically ill patients and hypotensive anesthesia. Although the method is generally safe and simple it frequently results in temporary radial artery occlusion, which is usually asymptomatic and resolves spontaneously. But occationally which the ulnar arterial collateral circulation is poor, occlusion of the radial artery can cause ischemia or even frank gangrene of the hand. The influence of cannula size or shape, duration of cannulation, frequency of puncture trial and patient's age on the incidence of vessel occlusion remains controversial. We evaluated radial arterial function utilizeing physical examination and Doppler flow measurement in fourty-seven patients following percutaneous cannulation. Arterial occlusion occured in 12.8% and hematoma in 31.9% of fourty-seven patients. The incidences of occlusion and hematoma were more frequent when the attempted puncture was more than three times and the duraion of cannulation was more than six hours. Hematoma disappeared spontaneously several days after and collateral circulation was good without other vascular complication in all six patients who had arteiral occlusion.
Anesthesia ; Arterial Pressure ; Catheterization* ; Catheters ; Collateral Circulation ; Critical Illness ; Gangrene ; Hand ; Hematoma ; Humans ; Incidence ; Ischemia ; Physical Examination ; Punctures ; Radial Artery*

BACKGROUND: Hyperhomocysteinemia as a risk factor for cerebrovascular disease is well known. Our aim of this study was to demonstrate positive association between elevated homocysteine levels and cerebrovascular diseases in Koreans. METHODS: With a case-control design, 186 stroke (infarction 134, hemorrhage 52) patients, diagnosed by brain CT or MRI and 359 control patients were evaluated. We used multiple logistic regression analyses conditioned on the matching variables (sex, age, hypertension, DM, smoking, hyperlipidemia, hyperhomocysteinemia) and calculated odds ratio and 95% CIs. RESULTS: Multivariated adjusted odds ratios (OR) for cerebrovascular diseases associated with hypertension compared with normal blood pressure were 2.45 (95% CI, 1.16 to 5.15) in prehypertension and 3.33 (95% CI, 1.56 to 7.10) in stage 1 hypertension and 3.77 (95% CI, 1.32 to 10.74) in stage 2 hypertension. OR for cerebrovascular diseases associated with hyperhomocysteinemia compared with <10micromol/L were 2.06 (95% CI, 1.09 to 3.91) in 13.0 to 16.9micromol/L and 3.17 (95% CI, 1.70 to 5.90) in > or =17 micromol/L. CONCLUSION: Not only hypertension but also hyperhomocysteinemia was a significant risk factor for cerebrovascular diseases in Koreans.
Asian Continental Ancestry Group ; Blood Pressure ; Brain ; Case-Control Studies ; Hemorrhage ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Hyperlipidemias ; Hypertension ; Logistic Models ; Magnetic Resonance Imaging ; Odds Ratio ; Prehypertension ; Risk Factors ; Smoke ; Smoking ; Stroke

We observed one patient who developed sudden unilateral blindness following general anesthesia. After genera1 anesthesia with the prone position of the patient, the affected eye had no perception of light. Three days after, funduscopic features revealed narrowing of retinal artery, whitening or opacification of the retinal and a cherry-red spot. Central retinal artery occlusion can occur after surgery, possible etiologic factors being hypotension, extrinsic pressure on the eyeball. Proper positioning of the head on an adequate headrest and avoidance of an ocular compression will prevent the extrinsic pressure on the eyeball.
Anesthesia* ; Anesthesia, General ; Blindness ; Head ; Humans ; Hypotension ; Prone Position ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde

No abstract available.
Thyroglobulin* ; Thyroid Gland*

Fatal airway obstruction due to the presence of blood clot occurs in a variety of clinical settings. Initial efforts to remove an airway clot, if warranted, involve suctioning, lavage, and forceps extraction through a flexible bronchoscope. If unsuccessful, further management options include rigid bronchoscopy, balloon-tip embolectomy catheter dislodgement, and the application of topical thrombolytic agents. We report a case of complete airway obstruction that developed after the aspiration of a blood clot during emergency operative vessel ligation in a 86-year-old female patient with gastric ulcer bleeding. Initial conventional suctioning was unsuccessful, in this case, due to a large firmly adherent clot. Therefore we peformed the alternative suctioning technique using suction attached directly to the existing tracheal tube in situ, with the cuff deflated. However, repeated direct tracheal suctioning alone failed to prevent cardiac arrest. Thereafter, simultaneously with several CPR chest compressions, large cylindrical clots were sucked up by direct tracheal suctioning. Presumably simultaneous chest compression has the potential advantage of creating higher airway pressures that provide effective kinetic energy to obstructing object.
Aged, 80 and over ; Airway Obstruction ; Bronchoscopes ; Bronchoscopy ; Cardiopulmonary Resuscitation ; Catheters ; Embolectomy ; Emergencies ; Female ; Fibrinolytic Agents ; Heart Arrest* ; Hemorrhage* ; Humans ; Ligation ; Resuscitation ; Stomach Ulcer ; Suction ; Surgical Instruments ; Therapeutic Irrigation ; Thorax ; Trachea

PURPOSE: To examine the effect of simvastatin on vascular endothelial growth factor (VEGF) expression in cultured human retinal pigment epithelial (RPE) cells under oxidative stress. METHODS: RPE cell viability was measured using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay after 24 hours of incubation with various concentrations of simvastatin or H2O2. Cultured human RPE cells were pretreated with various concentrations of simvastatin and then incubated with 100 microm H2O2. After 24 hours of incubation, an enzyme-linked immunosorbent assay (ELISA) was performed to evaluate the expression of VEGF. RESULTS: Simvastatin showed no toxicity up to 10 microm, but cell viability gradually decreased with increased concentration of simvastatin. Human RPE cells showed increased VEGF expression when exposed only to H2O2. When RPE cells were preincubated with simvastatin and later exposed to H2O2, VEGF expression was relatively lower. CONCLUSIONS: Simvastatin downregulated the expression of VEGF in human RPE cells under oxidative stress. Simvastatin may have some clinical benefits in preventing retinal diseases associated with VEGF.
Cell Survival ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Humans ; Macular Degeneration ; Oxidative Stress ; Retinal Diseases ; Retinaldehyde ; Simvastatin ; Tetrazolium Salts ; Thiazoles ; Vascular Endothelial Growth Factor A