PURPOSE: Recent studies show that chorioamnionitis has an important role in the pathogenesis of bronchopulmonary dysplasia(BPD) and it induces thymic involution. The purpose of this study is to test the usefulness of thymic size at birth as a predictor of BPD. METHODS: This study was conducted on 91 very low birth weight infants of <1, 500 g with mean gestational age of 29.3 weeks and mean birth weight of 1, 161 g who were admitted at NICU of Dong Kang General Hospital for past 4 years of whom 21 infants had BPD. Thymic size was measured on routine chest radiographs taken in the first 3 hours after birth and measured as the ratio between the width of the cardiothymic shadow at the level of the carina and that of the thorax at the costophrenic angles (CT/ T). RESULTS: Correlation of thymic size with gestational age was statistically significant (P=0.003). CT/T of BPD group was smaller than that of non-BPD group (0.27+/-0.06, 0.33+/-0.07, respectively, P<0.01). A significant positive correlation between small thymus at birth and BPD was detected (P=0.003, odds ratio, 21.7), but not in other disease groups. CONCLUSIONS: We concluded that a small thymus at birth on the chest radiograph could be used as an early predictive parameter of the BPD.
Birth Weight ; Bronchopulmonary Dysplasia* ; Chorioamnionitis ; Female ; Gestational Age ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Odds Ratio ; Parturition* ; Pregnancy ; Radiography, Thoracic ; Thorax ; Thymus Gland

Pulmonary hamartoma is uncommon benign tumor-like malformation, which comprises abnormal mixing of the normal components of the lung i.e., cartilage, fat, smooth muscle or respiratory epithelium. The majority occurs in fourth and fifth decades of life, but extremely rare in the pediatric age. Pulmonary hamartoma is clinically classified to endobronchial and intrapulmonary hamartoma. The majority of the pulmonary hamartomas have no clinical symptoms and are detected incidentally by routine chest roentgenograms. But definite diagnosis should be necessary, because of its difficulty to differentiate from malignant and inflammatory lesions. We report a case of intrapulmonary hamartoma which was detected by routine chest roentgenogram check up and diagnosed by fine needle aspiration biopsy and pathological examination with the review of the literature.
Biopsy ; Biopsy, Fine-Needle ; Cartilage ; Child ; Diagnosis ; Hamartoma* ; Humans ; Lung ; Muscle, Smooth ; Respiratory Mucosa ; Thorax

Isolated submandibular suppurative sialadenitis occurring in the neonatal period is extremely rare. At present, only 15 cases of isolated submandibular sialadenitis in the neonatal period have been reported in the literature. We report a rare case of multiple deep neck abscess in association with both submandibular suppurative sialadenitis in a term neonate.
Abscess* ; Humans ; Infant, Newborn ; Neck* ; Sialadenitis*

Cavernous sinus thrombophlebitis is characterized by edema of the eyelids and the conjunctivae, and paralysis of the cranial nerves. It is rare, often misdiagnosed or underestimated by neurosurgeons, and is generally related with high rates of mortality and morbidity. High rate of suspicion is required for early diagnosis, and aggressive managements can lead to better outcomes. With recent advancements in antibiotic therapies, the mortality rate has been decreased to less than 30%. However, the morbidity remains high and complete recovery is rare. A 69-year-old woman presented with headache and right ocular pain with sixth cranial nerve palsy for one week. Under the suspicion of Tolosa-Hunt syndrome, steroid treatment was done. On discharge, there was improvement in right ocular pain, but the cranial nerve palsy remained. Subsequently, the patient returned with left ocular pain, lid swelling, redness, ecchymosis of conjunctiva, and ptosis. Enhanced brain magnetic resonance imaging revealed an asymmetrically enlarged left cavernous sinus with heterogeneously enhancing contour. Intravenous antibiotics and oral steroids along with anticoagulant medications were administered.
Abducens Nerve Diseases ; Aged ; Anti-Bacterial Agents ; Brain ; Cavernous Sinus ; Cavernous Sinus Thrombosis ; Caves ; Conjunctiva ; Cranial Nerve Diseases ; Cranial Nerves ; Early Diagnosis ; Ecchymosis ; Edema ; Exophthalmos ; Eyelids ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Paralysis ; Steroids ; Tolosa-Hunt Syndrome

PURPOSE: We analyzed pediatric death patients who visited Dong-Kang Hospital emergency center, in order to minimize unexpected pediatric deaths. METHODS: The authors analyzed retrospectively the medical records of 110 pediatric patients who died before and within 24 hours after admission to the emergency center of Ulsan Dong-Kang General Hospital from January 1997 to December 2002. RESULTS: We classified three categories by the cause of death, accident group(AG) 46 cases(41.8%), disease group(DG) 37 cases(33.6%), unknown cause group(UG) 27 cases(24.6%) respectively. The most common age was between two and five years of age(50.0%) in AG, under one month (40.5%) in DG, between one month and one year(51.9%) in UG respectively. The most common season was summer(37.0%) in AG, winter(51.4%) in DG, spring(37.1%) in UG respectively. The most common time on arrival was from 13:00 to 18:00(37.0%) in AG, from 7:00 to noon(43.2%) in DG, from midnight to 6:00(29.6%) and from 7:00 to noon(29.6%) in UG respectively. The most common type of accident was traffic accident(47.8%). The most common cause of death in DG was respiratory disorder(40.5%). Sudden infant death syndrome was the most common(37.1%) in unknown cause of death. CONCLUSION: Accidental injuries and severe chronic illnesses are the major cause of unexpected pediatric death. Legislation related to accidents and a parents teaching program for emergency situations are necessary to decrease cases of unexpected pediatric death.
Cause of Death ; Chronic Disease ; Emergencies* ; Hospitals, General ; Humans ; Medical Records ; Parents ; Retrospective Studies ; Seasons ; Sudden Infant Death ; Ulsan

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation

PURPOSE: To evaluate of the role in carcinogenesis of p53 over-expression and bcl-2 inhibition in early gastric and advanced gastric cancers, we investigated the immunohistochemical tissue status of 31 primary early gastric-cancer patients and 31 primary advanced gastric-cancer patients. METHODS: DO7, the monoclonal antiserum to the P53 protein, and clone 124, the monoclonal antibody to the bcl-2 protein, were used for the immunohistochemical analysis of the 31 surgically resected primary early gastric cancer specimens and the 31 surgically resected advanced gastric-cancer specimens. The expressions were scored and divided into negative, positive, low expression, and overexpression. RESULTS: The clinicopathologic parameter; tumor depth of invasion, histologic type, and differentiation, were not related with the expression status of p53 or bcl-2. Of the 31 primary early gastric-cancer patients, 14 exhibited p53 overexpression and 16 showed negative the bcl-2 expression; 5 cases had both p53 overexpression and negative bcl-2 expression. Of the 31 advanced gastric cancer patients, 19 showed the p53 overexpression, and negative bcl-2 expression, 15 exhibited both p53 overexpression and negative bcl-2 expression. CONCLUSION: These results suggest that cell cycle alteration and apoptosis control by p53 and bcl-2 may play roles in the carcinogenesis of gastric cancer. However, there are many other mediators that may facilitate carcinogenesis. This study proved that bcl-2 is a valuable prognostic factor.
Apoptosis ; Carcinogenesis ; Cell Cycle ; Clone Cells ; Humans ; Stomach Neoplasms*

Primary cutaneous cryptococcosis is a fungal infection caused by Cryptococ cus neoformans which is frequently occurred in the immunosuppressed host. The treatment of primary cutaneous cryptococcosis is mainly fluconazole, and the prognosis is relatively good. We report a case of primary cutaneous cryptococcosis due to intravenous line on the left forearm after lumbar stenosis surgery in a patient with rheumatoid arthritis, who finally underwent second, fourth, and fifth ray amputation.
Amputation ; Arthritis, Rheumatoid* ; Constriction, Pathologic ; Cryptococcosis* ; Fluconazole ; Forearm ; Humans ; Immunocompromised Host ; Injections, Intravenous ; Prognosis ; Surgical Flaps

PURPOSE: We evaluated the diagnostic accuracy and useful ness of FDG-PET to determine the proper extent of surgery in recurrent papillary thyroid cancer patients with elevated thyroglobulin levels and negative I131 WBS. METHODS: FDG-PET was performed in 16 recurrent papillary thyroid cancer patients with elevated thyroglobulin levels and negative I131 WBS. In 9 patients, FDG-PET was performed to localize the recurrent lesions. In 7 patients, the recurrent lesions were initially diagnosed by physical examination or other image studies and the FDG-PET was subsequently performed to detect additional recurrent lesions. All suspected lesions detected by FDG-PET and other studies were explored. RESULTS: Among the 9 patients in whom FDG-PET was performed to localize the recurrent lesions, the recurrent lesions were detected only by FDG-PET in 4 patients. Among the 7 patients in whom FDG-PET was performed additionally to detect additional recurrent lesions, another recurrent cervical regions were detected by FDG-PET in 2 patients. However, the same lesions were able to be identified by ultrasonography. A total of 26 cervical regions were explored in 16 patients. There were 4 FDG-PET false positive regions and 2 FDG-PET false negative regions. Unnecessary surgery was performed in 4 cervical regions in 4 patients. CONCLUSION: FDG-PET was very useful in detecting small early recurrent lesions but was unable to contribute to the detection of additional recurrent cervical regions in the pa-tients in which the recurrent lesion had already been by physical examination or other studies. Other image studies are necessary to supplement the FDG-PET in false positive or false negative cases.
Humans ; Physical Examination ; Reoperation* ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Ultrasonography ; Unnecessary Procedures

Migraine equivalents include cyclic vomiting, acute confusional states, and benign paroxysmal vertigo. Cyclic vomiting is characterized by recurrent, sometimes monthly, boults of severe vomiting that may be so intense dehydration and electrolyte abnormalities occur, particularly in an infact. We experienced a 3-year-old girl who showed manifestations of cyclic vomiting and abdominal pain. We report this case with a review of related literatures.
Abdominal Pain ; Child, Preschool ; Dehydration ; Female ; Humans ; Migraine Disorders* ; Vertigo ; Vomiting