Cryptococcosis is a cosmopolitan mycotic disease caused by a yeast like fungus, Cryptococcus neoformans. Resiratory tract, as portal of entry, is the initial focus of infection. Initial pulmonary lesion may heal with orwithout dissemination of the disease. Authors reviewed 8 cases of confirmed cryptococcosis during Jan. 1973 toJune 1981 at Seoul National University Hsopital. The resuls are as follows; Majority of the cases are below 5years old. The most common symptoms are fever, abdominal pain and distension, and respiratory symptoms in only 2cases. The involved organs are liver, lymph node, spleen, meninges, and skin in the order of frequency. Chest P-Aroentgenograms show both hilar enlargement with perihilar and basilar, linear and small nodular infiltrations. Miliary nodular lesions and mediastinal lymphadenopathy were also noted.
Abdominal Pain ; Cryptococcosis ; Cryptococcus neoformans ; Fever ; Fungi ; Liver ; Lymph Nodes ; Lymphatic Diseases ; Meninges ; Seoul ; Skin ; Spleen ; Thorax ; Yeasts

Severe postoperative strictures in two children and infant and mild postoperative stricture in a child weretreated with balloon catheter. A child with post-fundoplication stricture showed symptomatic improvement.Anastomotic strictures after esophageal atresia repair in an infant and a child were successfuly dilated withimproved luminal diameter and symptoms, in a child with mild postoperative stricture, balloon dilatation wasperformed to prevnet stricture of the anastomotic site. Radiological esophageal dilatation using balloon cathetersis a safe and effective method for dilating symptomatic esophageal strictures which obviates surgery and allowssubsequent standard bougienage.
Catheters ; Child ; Constriction, Pathologic ; Dilatation ; Esophageal Atresia ; Humans ; Infant ; Methods ; Phenobarbital

The Currarino triad is a unique complex of congenital anomalies including anorectal malformation, scral bonyabnormality, and presacral mass. The usual symptomatology is constipation due to anorectal stenosis. Threepatients with this triad confirmed by surgical operation during recent two yeas in Seoul National Universitychildren's Hospital were presented with a brief review of clinical features, unique radiologic appearance andpostulated pathophysiology. The presacral mass was a mature teratoma in the first patient, alipomyelomeningocele-epidermoid inclusion cyst in the second patient, and myelomeningocele in the third patient. Acorrect diagnosis of the Currarino triad by radiologists is important, and may help the phsicians to investigatedetailed family history and associated anomalies and to establish adequate surgical plans.
Constipation ; Constriction, Pathologic ; Diagnosis ; Humans ; Meningomyelocele ; Seoul ; Teratoma

The purpose of this study is to identify the effect of sexual rehabilitation education on the knowledge and adjustment of sexual of spinal cord injury clients by the method of nonequivalant control group pretest-posttest group. The data were collected from Jan. 19 through Feb. 16. 2000. The experimental group was 26 spinal cord injury client from one rehabilitation center, and the control group was 26 spinal cord injury client from two rehabilitation center. Sexual rehabilitation education was done with manuals, videotapes and chart. Education time was 120 minutes a week for 2 weeks. The study tool was about Sexual Knowledge, designed Song, Chung Sook(1990) and SIAC (Sexual. Interest, Activity, & Satisfaction) designed Kruter, Sullivan, Siosteen(l994) translated by Kang, Hyun Sook, Koh, Jung Eun, Suh, Yeon Ok, Yee, Oon Hee(1999). The collected data were analyzed SPSS program. The Data were analyzed descriptive statistics and chi test, Pearson's Correlation Coefficient, t-test, F-test(ANOVA). Duncan's multiple comparison test. The result were as follows. 1. The first hypothesis was accepted: The group educated about sexual rehabilitation has more sexual knowledge than those of the uneducated group(t=7.412, p= .001). 2. The second hypothesis was accepted: The group educated about the sexual rehabilitation has more adjustment of sexual than those of the uneducated group(t=5.524, p= .001). 3. The third hypothesis was accepted: The higher sexual knowledge state, the higher sexual adjustment(r=.449, p= .003). According to results, sexual rehabilitation education helps Spinal cord Injury Clients to gain knowledge and adjustment of sexual.
Education* ; Music ; Rehabilitation Centers ; Rehabilitation* ; Spinal Cord Injuries* ; Spinal Cord* ; Videotape Recording

The errors were discovered after publication: missing references and missing words.

In 101 jaundiced patients, gray scale ultrasonography of longitudinal scan in RAO position demonstrated themeasurable extrahepatic biliary system in 73 patient; 17 cases (50%) of those with nonobstructive jaundice and 56cases (84%) of those with obstructive jaundice. The size of the internal diameter of extrahepatic biliary systemindicated that obstructive jaundice was best differentiated from non-obstructive jaundice when diameter above 7mm served as abnormal extrahepatic duct in jaundiced patients, giving sensitivity 85.5% specificity 97% anddiagnostic accuracy 89.5% by decision matrix analysis. The overall etiological diagnostic accuracy in obstructivejaundice was 40% which had higher one in choledocholithiasis and pancreas head carcinoma than other diseases. Thesonography should be imaging procedure of choice in differential diagnosis of jaundiced patients, which is simple, safe, noninvasive and has high diagnostic accuracy in differentiation between the two.
Bile Ducts, Extrahepatic ; Choledocholithiasis ; Diagnosis, Differential ; Head ; Humans ; Jaundice ; Jaundice, Obstructive ; Pancreas ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: Ventriculoperitoneal (VP) shunt insertion is an important treatment modality in children with hydrocephalus. VP shunt infection is a major complication and an important factor that determines the surgery outcome. This 15-year study was performed to evaluate the epidemiology of VP shunt infections in pediatric patients treated at our center. METHODS: A retrospective review of medical records was performed in patients 18 years old or younger who underwent VP shunt insertion surgery from April 1995 to June 2010. RESULTS: Three hundred twenty-seven VP shunt surgeries were performed in a total of 190 pediatric patients (83 females, 107 males). The median age of the patients was 2.4 years (range, 0.02-17.9 years). Having a malignant brain tumor was the most frequent cause for VP shunt insertion. The shunt infection rate was 6.7% (22/327) per 100 operations and 9.5% (18/190) per 100 patients, and the incidence rate was 0.45 infection cases per 100 shunt operations-year. The most common pathogen was coagulase-negative staphylococcus (n=7) followed by methicillin resistant Staphylococcus aureus (n=1). Ten cases were treated with vancomycin and beta-lactam antibiotic (cephalosporin or carbapenem) combination therapy and 7 cases were treated with vancomycin monotherapy. The median duration of antibiotic treatment was 26 days (range, 7 to 58 days). Surgical intervention was performed in 18 cases (18/22, 81.8%). CONCLUSION: Epidemiologic information regarding VP shunt infections in pediatric patients is valuable that will help guide proper antibiotic management. Additional studies on the risk factors for developing VP shunt infections are also warranted.
Brain Neoplasms ; Child ; Epidemiologic Studies ; Female ; Humans ; Hydrocephalus ; Incidence ; Medical Records ; Methicillin Resistance ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Staphylococcus aureus ; Vancomycin ; Ventriculoperitoneal Shunt

BACKGROUND: Oxygen-derived free radicals are known to contribute to tissue injury during myocardial ischemia and reperfusion. Recent in vitro studies have shown that propofol has potent antioxidant properties. The present study was aimed to investigate the effects of propofol on recovery of mechanical and coronary endothelial function in a myocardial stunning model. METHODS: Thirty-five dogs were acutely instrumented under halothane anesthesia to measure aortic and left ventricular pressure, pulmonary and left anterior descending coronary artery (LAD) flow, and subendocardial segment length. After completion of the surgery, halothane was replaced by fentanyl- midazolam. Animals were then subjected to 15 min of LAD occlusion and 3 hrs of reperfusion under either intracoronary (i.c.) propofol (5 microgram/mL, n=11; 20 microgramg/mL LAD flow, n=12) or vehicle (saline, n=12) for 1 hr beginning 30 min before LAD occlusion. Percent segment shortening (%SS) and the slope of the preload recruitable stroke work (Mw), as an index of regional myocardial contractility, and peak lengthening rate (dL/dtmax) and percent post-systolic shortening (%PSS), as an index of regional diastolic function, were evaluated. Coronary endothelial function was assessed by examining LAD flow response to i.c. acetylcholine (ACh, 1 microgram over I min) and i.c. sodium nitroprusside (SNP, 20 microgram over I min). The myocardial content of malondialdehyde (MDA) from LAD area was measured to evaluate lipid peroxidation. RESULTS: Despite equally severe ischemic dysfunction during LAD occlusion, recovery of %SS was significantly improved during reperfusion by either dose of propofol compared to controls. However, Mw recovered to the baseline within 60 min of reperfusion in all three groups. In addition, propofol-treated dogs showed better recovery of both indices of regional diastolic function (dL/dtmax and %PSS) as compared to controls. Ischemia-reperfusion similarly attenuated the increases in the LAD flow by ACh in all the groups, whereas it had no significant effect on these increases in LAD flow by SNP. The increase in MDA induced by ischemia and reperfusion was significantly suppressed by either dose of propofol. CONCLUSIONS: The results indicate that propofol attenuates mechanical but not coronary endothelial dysfunction in postischemic, reperfused myocardium in an open-chest canine model. The protective action of propofol against mechanical dysfunction is probably due to its effect to reduce lipid peroxidation.
Acetylcholine ; Anesthesia ; Animals ; Coronary Vessels ; Dogs* ; Endothelium* ; Free Radicals ; Halothane ; Ischemia ; Lipid Peroxidation ; Malondialdehyde ; Midazolam ; Myocardial Ischemia ; Myocardial Stunning* ; Myocardium ; Nitroprusside ; Propofol* ; Reperfusion ; Stroke ; Ventricular Pressure

E-cadherin (ECD) is a Ca++ -dependent adhesion molecule which plays a major role in the maintenance of intercellular adhesion in epithelial tissues. The expression pattern of ECD in 77 surgically resected gastric adenocarcinomas was examined by immunohistochemistry, using a rat monoclonal antibody raised against murine E-cadherin (DECAM-1). ECD was strongly expressed uniformly at cell to cell borders in normal gastric epithelium without exception. But, various staining patterns were observed in the cancer tissues. The frequency of tumors with preserved ECD expression (Pre-type) and reduced ECD expression (Rd-type) was 44% and 56%, respectively. Using Lauren's classification, the high frequency of the Pre-type expression in adenocarcinoma of the intestinal type was significantly higher than that in adenocarcinoma of the diffuse type (p<0.05). But, no significant correlation between the ECD expression and the gross type, invasion depth, growth pattern or metastasis was observed. These results suggest that ECD might play a key role in the morphogenesis of gastric adenocarcinoma.
Adenocarcinoma* ; Animals ; Cadherins* ; Classification ; Epithelium ; Immunohistochemistry ; Morphogenesis ; Neoplasm Metastasis ; Rats