We had experienced 2 cases of acute subdural hematoma due to vitaimin K(vit. K) deficiency. They were 44-and 42-day-old. After the adminstration of vit.K1, prolonged prothrombin time(PT) and activated partial thromboplastin time(APTT) were corrected, so the surgical treatment ws performed. We supposed the predisposing factors were breast feeding and unknown hepatic pathology. No complication remained to one infant but the other multiple cerebral infarctions. The etiology, pathogenesis, diagnosis, prevention are discussed. We insist on neonatal administration of vit. K1 for the prevention of bleeding tendency. If intracranial hemorrhage develops, we must keep in mind that the early neurosurgical intervention may be needed.
Breast Feeding ; Causality ; Cerebral Infarction ; Diagnosis ; Hematoma, Subdural, Acute* ; Hemorrhage ; Humans ; Infant* ; Intracranial Hemorrhages ; Partial Thromboplastin Time ; Pathology ; Prothrombin ; Prothrombin Time ; Thromboplastin ; Vitamin K Deficiency ; Vitamins*

Chylothorax is the most common cause of pleural effusion in the neonatal period and is defined as an effusion of lymph in the pleural cavity. We report a case of chylothorax in a 13-day-old male who was admitted due to respiratory difficulty. Chest AP showed pleural effusion of the left lung and milky yellow fluid was aspirated via thoracentesis upon which laboratory and lipoprotein electrophoresis of pleural fluid revealed findings compatible with that of chylothorax. Due to reaccumulation of chyle after daily thoracentesis, chest tube was inserted at the 4th hospital day, and MCT containing diet was given. He was discharged on the 21st hospital day in good health, and revealed no recurrence for 3 months during outpatient follow up visits.
Chest Tubes ; Chyle ; Chylothorax* ; Diet* ; Electrophoresis ; Follow-Up Studies ; Humans ; Infant, Newborn ; Lipoproteins ; Lung ; Male ; Outpatients ; Pleural Cavity ; Pleural Effusion ; Recurrence ; Thoracostomy* ; Thorax ; Triglycerides*

ICAM-l(Intercellular adhesion molecule-1) is an important early marker of immune activation and response. ICAM-1 is expressed on varous cell types and observed in a variety of diseases, including patients with asthma, melanoma, prostatic cancer, ovarian and colon cancer. Some authors demonstrated the expression of ICAM-1 protein in high-grade intraepithelial squamous neoplasia of cervix by immunohistochemistry and suggested that the expression was related to human papillomavirus infection. The aim of this study was to determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-1) in patients with squamous cell carcinoma of the cervix, Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA), We evaluate invasive squamous cell carcinoma of the cervix (40), carcinoma in situ (16) and control (15) patients. Serum levels of sICAM-1 in healthy volunteers, in parients with carcinoma in situ and invasive cervical cancer were 150.1+/-41.3, 182.7+/-105.9, 189.8+/-60.0 ng/ml, respectively. Although the serum levels of sICAM-1 in patients with carcinoma in situ did not increase, serum levels of ICAM-1 in patients with invasive cervical cancer were significantly increased (control vs invasive cervical cancer, p < 0,05). From the above results, sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.
Asthma ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Female ; Healthy Volunteers ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Melanoma ; Papillomavirus Infections ; Prostatic Neoplasms ; Uterine Cervical Neoplasms*

No abstract available.
Diabetes Mellitus* ; Hearing* ; Humans

No abstract available.
Spine*

Acromioclavicular joint injuries are recently increased, but there are still controversies as to the proper choice of treatment. We treated thirty cases of acromioclavicular injuries, among these, twenty five cases were done by operative method and five cases conservatively from August 1979 to June 1988. The results were as follows, 1. The injuries were composed of one case of Type 1, 7 cases of Type 2 and 22 cases of Type 3. 2. The result of conservative treatment consisted of 2 cases of good, 1 case of fair and 2 cases of poor. 3. The final outcome of operative method was better than that of conservative one, which consisted of 16 cases of good and 9 cases of fair. 4. The cause of fair results in operative method was thought to residual lexity of the repaired coracoclavicular ligament. 5. The key point of operative treatment in acromioclavicular separation was firm and strong reconstruction of the coracoclavicular ligament. 6. Modified method of coracoclavicular ligament reconstruction using coracoacromial ligament with bone block has been tried.
Acromioclavicular Joint ; Ligaments ; Methods

In order to identify the risk factors for shunt dependency and to select the optimal treatment modality of hydrocephalus in medulloblastoma patient, fifty two patients with medulloblastoma, who were treated at Seoul National University Hospital from 1982 to 1992, were reviewed. Retrospectively the authors analyzed the types of treatment and the results in the fifty patients of hydrocephalus associated with medulloblastoma. Two cases of perioperative death were excluded from the statistical analysis. The initial management of hydrocephalus in 50 patients included:1) ventriculoperitoneal shunt(VPS) before the removal of tumor in 6, 2) external ventricular drainage(EVD) bfore the removal of tumor in 4, 3) intraoperative ventricular puncture and placement of EVD or internalized reservoir(IVD, internalized ventricular drainage) for continuous or intermittent cerebrospinal fluid(CSF) drainage postoperatively in 29, 4) no procedures of CSF drainage before or during the operation for tumor removal in 11. Among the 44patients in whom preoperative VPS was not inserted, 16 finally required permenent VPS after tumor removal and 28 remained shunt-free. Factors which might predict the need for permanent VPS were analyzed and tested statistically. The presence of symptoms and signs of increased intracranial pressure, the severity of hydrocephalus on computerized tomography(CT), T and M stage, and the type of initial management of hydrocephalus were not statistically significant factors influencing the shunt dependency. The only two statistically significant features predicting the need for a subsequent permanent shunt were:1) incomplete tumor removal(p=0.025) and 2) postoperative hematoma in the fourth ventricle(p=0.004) Among the 11 patients without preoperative or intraoperative EVD, 4 required shunt placement after tumor removal, of which 3needed urgent placement of EVD. Preoperative or intraoperative EVD could have played a role as a safety mechanism in those patients. On the other hand, the preoperative or intraoperative EVD did not enhance the rate of infection or shunt dependency. In the cases of ventricular installations for CSF drainage, simple externalization of ventricular catheter and postoperative continuous CSF drainage(EVD) seemed to be associated with a lower rate of infection compared with the method of postoperative intermittent puncture and drainage through the internalized reservoir(IVD), but the difference of infection rates between the two groups were statistically insignificant(p=0.557). The average duration of CSF drainage in the externalized EVD roup was shorter than that of internalized reservoir group(5.4 versus 10.7 days). In conclusion, 1) the preoperative or intraoperative EVD is useful as a safety mechanism while it dose not enhance the possibilities of shunt dependency and infection, 2) for the patients in whom the placement of subsequent permanent shunt is highly expected, the EVD with the internalized reservoir can be a good choice. An algorithm for the management of hydrocephalus was suggested.
Catheters ; Drainage ; Hand ; Hematoma ; Humans ; Hydrocephalus* ; Intracranial Pressure ; Medulloblastoma* ; Punctures ; Retrospective Studies ; Risk Factors ; Seoul ; Ventriculoperitoneal Shunt

A 4-year-old girl developed acute motor, sensory impairment, lower abdominal pain and urinary dysfunction after URI. In acute stage of disease, MRI showed diffuse spinal cord swelling and high signal intensity on T2WI below T2 body level. The patient did not improved and one month later, follow-up MRI showed diffuse spinal cord atrophy and syrinx formation as sequelae of ATM on T1WI below T9 level. To our knowledge, this is the first case showing the sequelae of acute transverse myelitis seen in Korea.
Abdominal Pain ; Atrophy* ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Myelitis, Transverse* ; Spinal Cord*

No abstract available.
Endodermal Sinus Tumor* ; Lung* ; Neoplasm Metastasis* ; Yolk Sac*

BACKGROUND: Melanocytes synthesize melanin pigment by the action of specific enzyme tyrosinase. Melanogenesis inhibitors such as ascorbic acid, kojic acid, arbutin, hydroquinone have been developed for use in cosmetic preparations for the skin hyperpigmentation,but they are still unsatisfactory to efficacy and tolerance. OBJECTIVES: In this study, the inhibitory effects of seaweed extract(SCH-T2)on tyrosinase activity and melanogenesis were investigated with B-16 melanoma cell line. METHODS: The patients were randomly assigned to one of three groups;control, diazepam, and ketorolac plus diazepam groups. Pain intensity was assessed 5 times at every ten minutes from the beginning of the peeling using visual analog scale(VAS). RESULTS: The seaweed was added with 21 organic solvents and extracted during 12 hours at 20-To evaluate the inhibitory effects of SCH-T2 on tyrosinase activity following to extraction time and temperature, this study was done at 4, 8, 12, 24, 72 hours and 4, 10, 20, 30, 40℃. Also, the effects of whitening agents (kojic acid, arbutin, licorice extracts,SCH-T2)on tyrosinase activity were compared by measuring the IC50,the concentration of the compound at which half of the original tyrosinase activity is inhibited. RESULTS: 1.The inhibitory effects of SCH-T2 on tyrosinase activity were high at 60-80% ethanol as an extraction organic solvent and showed increase in proportion to concentration following to extract concentration, but showed little differences following to extraction time and temperature. 2.SCH-T2 has relatively stronger inhibitory effects on tyrosinase activity than arbutin and licorice extracts. 3. The inhibitory effects of SCH-T2 on melanogenesis following to extract concentration were greatly increased at more than 20㎍/ml. CONCLUSION: This study showed that SCH-T2 seaweed extract has strong inhibitory effect on tyrosinase activity and melanogonesis. So, the results of this study suggest that SCH-T2 seaweed extract can be used as a new whitening agent.
Arbutin ; Ascorbic Acid ; Bleaching Agents ; Cell Line ; Diazepam ; Ethanol ; Glycyrrhiza ; Humans ; Ketorolac ; Melanins ; Melanocytes ; Melanoma ; Monophenol Monooxygenase ; Seaweed* ; Skin ; Solvents