In recent years, marked increase in incidence of congenital syphilis has occured throughout the world due tochanges in social norms and development of penicillin-resistant strains. Early diagnosis plays an important rolein congenital syphilis as the clinical manifestations may simulalte many other conditions in the paediatric agegroup. The authors analized 52 cases of congenital syphilis admitted tot he department of paediatrics, ChosumUniversity Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 caseswere admitted from OPD, during the period of 8 years from Jan. 1975 to Dec. 1982. The reults obtained were asfollows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Amongthe 52 cases, a male predominance was observed with a male to female ratio of 2:1. 3. The serologic test (VDRL) ofthe 52 studied cases showed reactive in 49 cases (94%), and that of syphilitic mothers except 6 cases, rective inall studied cases. 4. The major manifstations of the 52 cases were bone tenderness (12%) and swelling of thejoints(7%) inskeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. Theradiological skeletal changes were detected in 45 of 52 cases(87%), and the commonest findings were detected in 45of 52 cases (87%), and the commonest findings were metaphsitis(83%) and periostitis(81%). The most characteristictype of metaphysitis were transverse trophic line(74%) and zone of rarefaction (65%). 6. The comonest bones to beaffected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order offreqeuncy were radius (80%), ulna(80%), tibia(77%), femur(69%) and hymerus(40%).
Early Diagnosis ; Female ; Humans ; Incidence ; Knee ; Male ; Mothers ; Radius ; Serologic Tests ; Skin ; Social Norms ; Syphilis, Congenital ; Wrist

BACKGROUND: It was recently shown that human atherosclerotic plaque contains large numbers of T lymphocytes : this indicates that immune and inflammatory mechanism may be important factors in the pathogenesis of atherosclerosis. By measuring the soluble interleukin 2 receptor(sIL-2R) level we can evaluate the activation of T lymphocyte. The purpose of this study is to evaluate relationship between T cell activation and ischemic heart disease by measuring the soluble interleukin 2 receptor (sIL-2R) level in patient with ischemic heart disease. METHOD: Seventy-two patients(40 males and 32 female, mean age : 56.5+/-9.9 years) who were taken coronary angiography were included in this study. Among them, 49 patients showed abnormal coronary angiographic findings and 23 patients showed normal coronary angiographic findings. Ten mililiters of arterial blood was drawn at the time of coronary angiography. The blood was allowed to coagulate and then the serum was removed and tested in duplicate for soluble interleukin 2 receptor (sIL-2R) level by ELISA. RESULTS: 1) The soluble interleukin 2 receptor (sIL-2R) level was significantly different between abnormal coronary angiographic findings and normal coronary angiographic findings (P < 0.001). 2) According to clinical severity of ischemic heart disease (i.e. stable angina, unstable angina, acute myocardial infarction.), soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05), but showed increasing tendency with clinical severity. 3) According to numbers of involved coronary vessels, soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05). CONCLUSION: T lymphocyte activation, as reflected in elevated soluble interlekin 2 receptor (sIL-2R) level, is frequent in patient with ischemic heart disease. In the further we will investigate relationship between clinical diagnosis of ischemic heart disease of the numbers of involved coronary vessels and T cell activation.
Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Coronary Angiography ; Coronary Vessels ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Lymphocyte Activation ; Lymphocytes ; Male ; Myocardial Ischemia* ; Plaque, Atherosclerotic ; Receptors, Interleukin-2 ; T-Lymphocytes

No abstract available.
Aprotinin* ; Heart* ; Hemostasis* ; Thoracic Surgery*

PURPOSE: The purpose of this study is to analyze the usefulness of breast thermography in assessing the prognosis in breast cancer and to obtain correlative evidence between thermographic prognosis and prognostic factors for breast cancer. MATERIALS AND METHODS: Thermographic examinations were performed in a room maintained at 20C. The patient was undressed to the waist, with both arms elevated for 10 minutes prior to the examination in order to cool and equilibrate the breast skin at room temperature. Digital infrared thermographic system was used (NEC, San-ei, Therm Tracer 6T67). The thermographic prognosis was classified according to Dr. Hobbins (Sl good, S2=fair and S-poor) suggested by Dr. Hobbins. The results were analyzed by Chi-Squire. One hundred three patients of breast cancer were examined by digital infrared thermographic system between Jan 1992 and December 1996. RESULTS: The mean age was 48, with a range from 20 to 85. According to the TNM classification 25 (24%) were in stage I, 47 (46%) stage II, 29 (28%) stage III, and 2 (2%) stage IV. The tumor size ranged from 0.5 to 20 cm (mean 4 cm), On histologic examination, 43 (43.%) patients had metastasis in the axillary nodes, 40 (55%) patients was estrogen-receptor positive. The nuclear grade I was 46 (35%) patients, II 24 (28%) and III 16 (19%). The classification of thermographic prognosis were Sl in 47 cases (46%), 82 in 32 (31%) and 83 in 24 (23%). The classification of the thermographic prognosis was found to be statistically correlated with tumor size (p<0.0001), axillary node status (p<0.0001) and TNM tumor stage (p<0.0001). But nuclear grade and estrogen receptor were not statistically correlated with the thermographic prognosis. The correlation between thermographic prognosis and actual survival rate was not available. CONCLUSION: These results suggest that breast thermography would be useful as a predictor in breast cancer before surgery.
Arm ; Breast Neoplasms* ; Breast* ; Classification ; Estrogens ; Humans ; Neoplasm Metastasis ; Prognosis* ; Skin ; Survival Rate ; Thermography*

PURPOSE: This study was to determine the incidence and severity of venous irriation in patients receiving vinorelbine tartrate (Navelbine ) in combination chemotherapy. MATERIAL AND METHODS: Twenty four patients histologically confirmed non-small cell lung cancer were enrolled in this study who receiving vinorelbine in combination chemotherapy through a peripheral vein from Oct. 1997 to Mar. 1999 with retrospective study design method. One group was 6~10 minutes infusion rate, the other was 10~20 minutes infusion rate with the same free-flow intravenous infusion. RESULTS: A total of 126 infusions were observed in this study. Sixty-two infusions were admi nistered at the 6~10 minutes, and 64 infusions were administered at the 10~20 minutes. The incidence of any venous irritation was 3.2% (2/62) in the group that received the infusion in 6~10 minutes and 10.9% (7/64) in 10~20 minutes (p=0.164), so we could not acquire any statistical significance. However the incidence of severe venous irritation (grade 3, 4) was 0% (0/62) in 6~10 minutes infusion group and 9.4% (6/64) in 10~20 minutes infusion group. There was a significant difference between two groups (p=0.028) CONCLUSION: Our results suggest that venous irritation associated with vinorelbine tartrate infusion can be reduced by shorter duration of administration and vinorelbine tartrate might be recom mended to administer at 6~10 minutes infusion in clinical practice.
Carcinoma, Non-Small-Cell Lung ; Drug Therapy, Combination ; Humans ; Incidence* ; Infusions, Intravenous ; Retrospective Studies ; Veins

BACKGROUND: The accurate information about the volume of pericardial effusion can assist in clinical decisions and has impartant prognostic value. In addition, accurate quantification of serial change in effusion volume is necessary in assessing pericardial disease and making a decision of immediate drainage. This study was performed to evaluate the efficacy of 2-D echocardiographic quantification of pericardial effusion. METHOD: The study populations are 22 patients with large pericardial effusion whose volume of effusion is confirmed by paracentesis or surgical drainage. Through the echocardiographic reviw, the volume of pericardial sac and heart was calculated by method of D'cruz and then, the effusion volume was derived as the difference of two volumes. Each echocardiographically calculated volume of pericardial effusion was compared with the measured volume drained percutaneously or surgically. RESULTS: The volume of pericardial effusion calculated echocardiographically was excellently correlated with the drained volume(r=0.90, p < 0.01). The echo-free space was well correlated with the volume of pericardial effusion in the anterior aspect of the heart(r=0.71, p < 0.01), but not in the posterior aspect. CONCLUSION: 2-D echocardiographic Quantification of pericardial effusion is simple and reliable method, and its clinical efficacy may be great.
Drainage ; Echocardiography ; Heart ; Humans ; Methods ; Paracentesis ; Pericardial Effusion ; Treatment Outcome

OBJECTIVE: Total laparoscopic hysterectomy (TLH) is becoming more commonly used as an alternative to traditional abdominal hysterectomy and Analyzing the turning point of a learning curve can be useful in planning training programs. This study was to define the average turning point of a learning curve of TLH by comparing three separate gynecologists in one institute. METHODS: Retrospective analysis of the first 140 consecutive cases of TLH performed by three separate gynecologists A, B, and C. Patients of each gynecologist were divided into 7 equal groups of 20 operations classed chronologically. Patient's age, uterus weight, operation time and pre-post operative hemoglobin difference of the three gynecologists were compared. Operation time and pre-post operative hemoglobin difference were evaluated to build learning curves for each gynecologist. RESULTS: Learning curve built by operation time showed turning point after 80~100 cases in all three gynecologists. Learning curve built by pre-post operative hemoglobin difference did not show a decreasing pattern. There were no statistical differences in patient's age and pre-post operative hemoglobin difference between the three gynecologists. However, mean uterine weight of gynecologist C was significantly lighter than that of gynecologist A and B. Operation time was significantly longer in cases by gynecologist C than in cases by A and B. CONCLUSION: At least 80~100 cases of experience in TLH is needed for a gynecologist to reach the turning point of the learning curve. This result can be used as a guide to the training program of TLH.
Hemoglobins ; Humans ; Hysterectomy ; Learning ; Learning Curve ; Retrospective Studies ; Uterus

Hyperthyroidism has been reported to be associated with cardiac complication, such as heart failure, atrial fibrillation, heart block and acute coronary syndrome. Acute coronary syndrome in hyperthyroidism has been known mainly due to coronary spasm, but plaque rupture of atherosclerotic lesion has been rare. We reported a case of acute myocardial infarction associated with hyperthyroidism which had been confirmed plaque rupture by intravascular ultrasound.
Acute Coronary Syndrome ; Atrial Fibrillation ; Heart Block ; Heart Failure ; Humans ; Hyperthyroidism* ; Myocardial Infarction* ; Rupture* ; Spasm ; Ultrasonography

BACKGROUND: Hypercapnia augments cardiac output and can initiate a sympathetically mediated release of catecholamines to increase cardiac output. Many studies of hemodynamic changes by hypercapnia under general anesthesia with inhalation anesthetics besides sevoflurane. This study examined the hemodynamic changes by increasing end-tidal carbon dioxide (EtCO2) under sevoflurane-N2O anesthesia. METHODS: Twenty patients were enrolled in the study. We studied stable, mechanically ventilated patients under general anesthesia maintained with O2 2 L/min - N2O 2 L/min - sevoflurane (1.5-2.5 vol%). Hypercapnia were obtained by reducing tidal volume and respiratory rate. EtCO2 was adjusted to 30, 40, 50 mmHg with each concentration maintained for 15 min. Global hemodynamic variables were monitored with a pulmonary artery catheter. RESULTS: There were no changes in mean arterial pressure or heart rate by hypercapnia. Acute moderate hypercapnia increased cardiac output (4.9 +/- 1.7, 5.5 +/- 1.7, 6.2 +/- 2.1 L/min; P < 0.05), cardiac index (3.0 +/- 0.9, 3.4 +/- 0.9, 3.8 +/- 1.1 L/min/m2; P < 0.05), pulmonary artery pressure (16.9 +/- 3.7, 19.6 +/- 4.2, 23.0 +/- 4.7 mmHg), but did not decrease systemic vascular resistance (1,558.3 +/- 500.4, 1,423.5 +/- 678.6, 1,156.8 +/- 374.0 dynes.sec/cm5; P > 0.05). CONCLUSIONS: When we changed patient EtCO2 to 30, 40, and 50 mmHg, there were no changes in mean arterial blood pressure and heart rate, but systemic vascular resistance decreased, and cardiac output, cardiac index and mean pulmonary arterial pressure increased significantly.
Anesthesia ; Anesthesia, General ; Anesthetics, Inhalation ; Arterial Pressure ; Carbon Dioxide ; Cardiac Output ; Catecholamines ; Catheters ; Heart Rate ; Hemodynamics ; Humans ; Hypercapnia ; Methyl Ethers ; Pulmonary Artery ; Respiratory Rate ; Tidal Volume ; Vascular Resistance

Heterotaxy syndrome (HS) is a congenital disorder resulting from an abnormal arrangement of visceral organs across the normal left-right axis in the embryonic period. HS is usually associated with multiple anomalies, including defects of the major cardiovascular system and the extracardiovascular system such as intestinal malrotation, abnormal lung lobulation, bronchus anomalies, and pancreatic dysplasia. Although pancreatic dysplasia is occasionally accompanied with HS, the occurrence of diabetes mellitus (DM) due to pancreatic dysplasia in HS is rarely reported. We here report a case involving 13-year-old girl with DM caused by agenesis of the dorsal pancreas and HS diagnosed on the basis of the presence of a double-outlet right ventricle with bilateral pulmonary stenosis and intestinal malrotation with duodenal cyst. Timely diagnosis and treatment with insulin improved glycemic control.
Adolescent ; Bronchi ; Cardiovascular System ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diabetes Mellitus* ; Diagnosis ; Double Outlet Right Ventricle ; Female ; Heterotaxy Syndrome* ; Humans ; Insulin ; Lung ; Pancreas* ; Pulmonary Valve Stenosis