No abstract available.
Hemorrhage* ; Humans ; Infant* ; Infant, Very Low Birth Weight*

No abstract available.
Child* ; Humans ; Plasma* ; Renal Veins* ; Renin* ; Veins*

BACKGROUND: Exofocal neuronal death in the substantia nigra (SN) is a well-known form of anterograde transsynaptic cell death. Exofocal neuronal death could theoretically also occur in the globus pallidus (GP) after striatal injury. CASE REPORT: Case 1. A 70-year-old woman visited the emergency room because of decreased mentality. On admission, blood-gas analysis indicated that her oxygen tension was 69.1 mm Hg. The caudate nucleus, putamen, and temporooccipital cortex on both sides of the brain exhibited high-intensity diffusion-weighted magnetic resonance imaging (MRI) signals. At 10 days after admission, new high-intensity signals had developed in the SN and GP on both sides. Case 2. A 48-year-old man visited the emergency room because of right-sided weakness. Lesions were noted in the left caudate nucleus and putamen. At 4 days after admission, newly developed high-intensity MRI signals were observed in the left SN and GP. CONCLUSIONS: Exofocal neuronal death can occur in the GP as well as in the SN; these findings need to be clearly distinguished from those of recurrent ischemic injuries, such as recurrent stroke.
Brain ; Caudate Nucleus ; Cell Death ; Emergencies ; Female ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging ; Neurons ; Oxygen ; Putamen ; Stroke ; Substantia Nigra

The 45 neonates with bronchopulmonary dysplasia among 355 neonates who were managed with mechanical ventilation and oxygen therapy in NICU of Seoul National University Chhildren's Hospital from January 1, 1968 to December 31, 1991, were analyzed for risk factors and outcome. The results were as follows: 1) The incidence of bronchopulmonary dysplasia was 12.7% 2) Respiratory Distress Syndrome was most common underlying problem. 3) The common radiologic findings of BPD were peripheral streaky density, emphysematous change, reticular or granular perihilar density, pulmonary interstitial emphysema, bubbly or small cystic change, and pneumothorax. 4) The survival rate of BPD showed 80% in the follow-up study. 5) Retinopathy of prematurity and intraventricular hemorrhage were more frequent significantly in the BPD group (p<0.05). 6) The risk factors of BPD were lower birth weight, shorter gestational age, longer duration of oxygen therapy an mechanical ventilation, and the presence of PDA.
Birth Weight ; Bronchopulmonary Dysplasia* ; Emphysema ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Retinopathy of Prematurity ; Risk Factors* ; Seoul ; Survival Rate

To evaluate the change in valvular morphology and occurence and severity of mitral regurgitation produced by PMV, 45 patients(33 women and 12 men,mean age 38+/-10 years) were studied using two-dimensional(2-D) and Doppler echocaediography before and 1-2 days after this procedure. Mitral valve area after PMV increased in all patients, from 0.9+/-0.2 to 1.8+/-0.4cm2(P<0.0001). In valve area estimation, the correlation between Gorlin`s method and 2-Dechocardiography was better(r=0.61, p<0.0001) than that between Gorlin`s method and Doppler pressure halftime(r=0.38, P<0.01) before valvuloplasty, but after the procedure Gorlin`s and 2-D image valve area correlated less well(r=0.33, P<0.05) than Gorlin`s-Doppler pressure halftime correlation(r=0.46, P<0.002). Before PMV, 37 patients had no mitral regurgutation, 7 had grade 1 and 1 had grade 2 mitral regurgutation. After PMV, new mitral regurgutation occurred in 14 patients, increased in severity in 5 patients and so mitral regurgutation newly developed or increased in severity in 19(42%) patients. There were no differences between the patients with and those without an increase in mitral regurgutation after PMV, in age, sex, caediac rhythm, initial mitral valve area, increase in mitral valve area and fluoroscopic calcification. However, morphologic characteristics especially mobility(P<0.01) and thickening(P<0.05) of mitral leaflets were better pressured, and EBDA/BSA(effective balloon dilating area/body surface area) was significantly smaller(P<0.02) in patients without an increase in mitral regurgutation. Thus, an increase in mitral regurgutation after PMV might be related to the features of valve morphology especially and thickand EBDA/BSA.
Female ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis

Hydroxyurea is an antineoplastic agent with selective cytotoxicity for cells in the DNA synthesizing phase, or S phase, of the cell cycle. It is commonly used in the treatment of myeloproliferative disorders, e.g., chronic myelogenous leukemia, essential thrombocythemia and polycythemia vera. Its major adverse reactions are reversible and dose dependent marrow suppression and gastroenteric disturbances. Cutaneous side effects such as erythema, hyperpigmentation, lichen planus-like dermatitis, nail discoloration and alopecia, atropy of the skin occur, especially with long-term treatment. Painful leg ulcers in association with hydroxyurea have only rarely been reported. The ulcers were usually extremely painful and typically located near the malleoli but were occasionally found over the tibia, on the dorsal aspect of the feet, calves, knees, heels, and hands. Any minor trauma could precipitate skin breakdown and ulceration and these ulcers tended to heal slowly. No consistent correlation between the dose or duration of hydroxyurea therapy and the occurrence of ulcers. Complete wound healing was achieved by simply discontinuing treatment with hydroxyurea. We describe 2 patients who developed spontaneous painful lower leg ulcers during long-term hydroxyurea therapy for a myeloproliferative disorder(chronic myelogenous leukemia and essential thrombo cythemia). All ulcers were painful and typically located both lateral malleoli. These ulcers healed only after hydroxyurea was withdrawn and with conservative therapy including manual debridement and occlusive dressing.
Alopecia ; Bone Marrow ; Cell Cycle ; Debridement ; Dermatitis ; DNA ; Erythema ; Foot ; Hand ; Heel ; Humans ; Hydroxyurea ; Hyperpigmentation ; Knee ; Leg Ulcer* ; Leg* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid ; Lichens ; Myeloproliferative Disorders ; Occlusive Dressings ; Polycythemia Vera ; S Phase ; Skin ; Thrombocythemia, Essential ; Tibia ; Ulcer ; Wound Healing

PURPOSE: Recent trials of preventive dexamethasone therapy in preterm neonates at high risk of developing bronchopulmonary dysplasia(BPD) have required the objective criteria for prediction of BPD in the early neonatal period. The purpose of this study is to determine whether a chest radiographic scoring system at 7 days of age can be used to predict BPD. MATERIALS AND METHODS: Chest radiographs taken at 7 days and 28 days of age in 59 preterm neonates(gestational age of less than 33 weeks) were scored prospectively according to the consensus of two radiologists. The 7-day radiographs were scored according to a system derived from Yuksel's method : endotracheal tube insertion, degree of lung inflation, lung opacification, interstitial changes and cardiomegaly were measured. The radiographs taken at 28 days were scored according to a modification of Toce's method. The BPD group was defined as consisting of patients who needed oxygen therapy for more than 28 days and showed abnormality on chest radiographs. Scores were analysed to determine whether there were any statistical differences between the BPD and non-BPD groups, whether there was a significant correlation between scores at 7 days and 28 days, and whether there was any relationship between scores at 7 days of age and the development of BPD. We tried to determine which factors, as indicated by the scores at 7 days, significantly contributed to the development of BPD. RESULTS: The mean scores at 7 days of age in the BPD group (n=18) were 4.3+/-1.5 (2-7), and those in the non-BPD group (n=41) were 2.2+/-1.2 (0-4). The differences were statistically significant(p<.0001). Significant correlation was found between scores at 7 days and at 28 days of age (r:0.57, p<.0001). Analysis showed that endotracheal tube insertion, cardiomegaly, and degree of interstitial change, as seen on radiographs at 7 days, were factors which significantly contributed to the development of BPD(p<0.05 each). All neonates with a score of 5 or more developedBPD(7/7), while those with a score of less than 2 did not (0/11). CONCLUSION: The chest radiographic scoring system used at 7 days of age can be helpful in predicting the development of BPD. We believe that this system can be used to indicate the need for early preventive steroid therapy.
Bronchopulmonary Dysplasia* ; Cardiomegaly ; Consensus ; Dexamethasone ; Humans ; Infant, Newborn ; Inflation, Economic ; Lung ; Oxygen ; Prospective Studies ; Radiography, Thoracic* ; Thorax*

PURPOSE: Recent trials of preventive dexamethasone therapy in preterm neonates at high risk of developing bronchopulmonary dysplasia(BPD) have required the objective criteria for prediction of BPD in the early neonatal period. The purpose of this study is to determine whether a chest radiographic scoring system at 7 days of age can be used to predict BPD. MATERIALS AND METHODS: Chest radiographs taken at 7 days and 28 days of age in 59 preterm neonates(gestational age of less than 33 weeks) were scored prospectively according to the consensus of two radiologists. The 7-day radiographs were scored according to a system derived from Yuksel's method : endotracheal tube insertion, degree of lung inflation, lung opacification, interstitial changes and cardiomegaly were measured. The radiographs taken at 28 days were scored according to a modification of Toce's method. The BPD group was defined as consisting of patients who needed oxygen therapy for more than 28 days and showed abnormality on chest radiographs. Scores were analysed to determine whether there were any statistical differences between the BPD and non-BPD groups, whether there was a significant correlation between scores at 7 days and 28 days, and whether there was any relationship between scores at 7 days of age and the development of BPD. We tried to determine which factors, as indicated by the scores at 7 days, significantly contributed to the development of BPD. RESULTS: The mean scores at 7 days of age in the BPD group (n=18) were 4.3+/-1.5 (2-7), and those in the non-BPD group (n=41) were 2.2+/-1.2 (0-4). The differences were statistically significant(p<.0001). Significant correlation was found between scores at 7 days and at 28 days of age (r:0.57, p<.0001). Analysis showed that endotracheal tube insertion, cardiomegaly, and degree of interstitial change, as seen on radiographs at 7 days, were factors which significantly contributed to the development of BPD(p<0.05 each). All neonates with a score of 5 or more developedBPD(7/7), while those with a score of less than 2 did not (0/11). CONCLUSION: The chest radiographic scoring system used at 7 days of age can be helpful in predicting the development of BPD. We believe that this system can be used to indicate the need for early preventive steroid therapy.
Bronchopulmonary Dysplasia* ; Cardiomegaly ; Consensus ; Dexamethasone ; Humans ; Infant, Newborn ; Inflation, Economic ; Lung ; Oxygen ; Prospective Studies ; Radiography, Thoracic* ; Thorax*

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*