We observed clinical features of 18 bronchopulmonary dysplasia (BPD) patients who were admitted to the neonatal intensive care unit in the Severance Hospital of Yonsel University College of Medicine from January 1. 1987 to June 30. 1991. Eight patients in whom ventilator settings were unchanged for more than 5 days because of lack of improvement in pulmonary function. The effects of dexamethasone in ventilator-dependent were included in the short-term dexamethasone therapy. 1) Eighteen BPD patients consisted of 15 premature infants (83%), 1 full-term infant, and 2 post-term infants, The mean gestational age of the patients were 30 weeks and the mean birth weight was 1,420gm. And there were 13 male and 5 female infants. 2) The underlying conditions which necessitated ventilatory support support were hyaline membrane disease in 13 patients (72%), apnea in 2 (11%), and meconium aspiration syndrome in 3. There patients with meconium aspiration syndrome were either full-term or post-term infants, of whom 2 had neonatal persistent pulmonary hypertension. 3) The mean age at the start of ventilator care was 8 hours and the mean PIP was 32 cm H2O. The mean duration of ventilator care of oxygen therapy and of high O2 requirement (FiO2>0.8) were 39 days, 75 days and 20 days, respectively. 4) Patent ductus arteriosus developed in 8 patients during mechanical ventilation, but they were all closed with the use of mefenamic acid, There were also 4 cases of pneumothorax, 2 cases of pulmonary parenchymal emphysema, and 1 case each of pneumomediastinum and pneumoperitoneum. 5) The mean gestational age of the dexamethasone-treated group was 30 weeks and the mean birth weight was 1,320gm, The mean age at which dexamethasone therapy was started was 39 days after birth, and in only 3.3 days 6 patients were successfully weaned from ventilator, In 5 cases the first trial of dexamethasone therapy was enough but the rest needed the 2nd trial for ventilator weaning. 6) In 6 BPD patient who were weaned from the ventilator after dexamethasone therapy, there were significant decreases in MAP (11.1 vs 8.0 cmH2O), and FiO2 (0.73 vs 0.61), but a significant increase in the urine output (2.56 vs 3.7ml/kg/hr) for the pretreatment (5 days prior to therapy) versus posttreatment period (first day of therapy). 7) The complications of dexamethasone treatment were transient hypertension and hyperglycemia in 3 patients, and systemic candidiasis and gastrointestinal bleeding in 2 patients who failed to be weaned after dexamethasone therapy. Our results suggest that the short-term dexamethasone therapy in bronchopulmonary dysplasia patients who are dependent on mechanical ventilation enables weaning in a short period of time. The inspiratory oxygen concentration and the mean airway pressure may be decreased and the urine output may be increased from the first day of medication, improves pulmonary function and decreases pulmonary interstitial edema.
Apnea ; Birth Weight ; Bronchopulmonary Dysplasia* ; Candidiasis ; Dexamethasone* ; Ductus Arteriosus, Patent ; Edema ; Emphysema ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyaline Membrane Disease ; Hyperglycemia ; Hypertension ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Male ; Meconium Aspiration Syndrome ; Mediastinal Emphysema ; Mefenamic Acid ; Oxygen ; Parturition ; Pneumoperitoneum ; Pneumothorax ; Respiration, Artificial ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning

Chronic bronchiolitis is a condition associated with cigarette smoking, and later associated with pulmonary parenchymal alteration and progressive deterioration of lung function. Early respiratory bronchiolitis was produced in Sprague-Dawley rats by indirect inhalation of cigarette smoke daily in a smoke exposure chamber designed by authors for 1 month. Experimental group A (n=5) was sacrificed after having smoked 30 cigarettes, group B (n=5) after 80 cigarette, and group C (n=7) after 140 cigarettes, respectively. Examination of morphologic changes in the lungs was done on light microscope, transmission and scanning electron microscopes. Light microscopically, increase in number of goblet cells in the bronchial mucosa, brown-pigmented macrophages in the alveoli, multifocal alveolar collapse adjacent to the bronchioles, dilatation of alveolar ducts and alveolar spaces were observed. Transmission electron microscopically, irregularly shaped Clara cells, alveolar wall collapse, and focally type I epithelial cell injury were seen. Scanning electron microscopically, scattered alveolar collapse, irregular dilatation of alveolar ducts, alveolar spaces and interalveolar pores (pores of Kohn) were seen. The terminal and respiratory bronchioles showed morphological alteration of Clara cells, but no evidence of cellular bronchiolitis or bronchiolar obstruction. We conclude that sidestream smoke induces an early respiratory bronchiolitis including aggregates of brown pigmented macrophages and varying degrees of structural alteration of adjacent pulmonary parenchyma.
Bronchioles ; Bronchiolitis ; Dilatation ; Epithelial Cells ; Goblet Cells ; Inhalation ; Lung ; Macrophages ; Mucous Membrane ; Rats, Sprague-Dawley ; Smoke* ; Smoking ; Tobacco Products*

OBJECTIVE: To investigate the prevalence and risk factors of carpal tunnel syndrome in diabetic patients. METHOD: Electrodiagnostic study was performed to diagnose carpal tunnel syndrome and polyneuropathy in 266 (male 151, female 115) diabetic patients. General charateristics, diabetes related factors, anthropometric factors were compared between non-carpal tunnel syndrome and carpal tunnel syndrome groups to identify the risk factors for carpal tunnel syndrome. RESULTS: Prevalence of carpal tunnel syndrome in diabetic patients was 16.2 % (43 subjects). Female, farming, wrist depth width ratio (>or=0.7) were associated with carpal tunnel syndrome in diabetic patients. In right hand, odds ratio was 12.82 (95% confidence interval: 2.97~55.3) in female, 5.15 (95% confidence interval: 1.17~22.7) in farming, 28.53 (95% confidence interval: 1.80~451.1) in wrist depth width ratio (>or=0.7). The similar results were also observed in left hand. CONCLUSION: The results suggest that occupation, sex, and anthropometric factor like wrist shape were more associated with carpal tunnel syndrome in diabetic patients than diabetes mellitus itself.
Carpal Tunnel Syndrome* ; Diabetes Mellitus ; Female ; Hand ; Humans ; Occupations ; Odds Ratio ; Polyneuropathies ; Prevalence* ; Risk Factors* ; Wrist

PURPOSE: Contrast enhanced multidetector computed tomography (MDCT) has been used as an alternative to coronary angiography for the assessment of coronary artery disease in the patient of the intermediate risk group. However, coronary calcium is a known limiting factor for MDCT evaluation. We investigated the diagnostic accuracy of 64-channel MDCT with each coronary artery calcium score (CACS) by compared with intravascular ultrasound (IVUS) imaging. MATERIALS AND METHODS: A total of 54 symptomatic patients with intermediate-risk (10 females, mean age 59.9+/-6.9 years, Framingham point scores 9-20) with 162 sites who had a culprit lesion on 64-channel MDCT before performing coronary angiography with IVUS were enrolled. Patients were divided into 4 subgroups depending on CACS: 0, 1-99, 100-399, and >400. Lesion length, external elastic membrane (EEM) cross sectional area (CSA), minimal luminal area, and plaque area were measured and compared between IVUS and MDCT. RESULTS: The correlation coefficients for the measurements of the EEM CSA, lumen CSA, and plaque area were r=0.514, r=0.837, and r=0.578, respectively. Furthermore, there were close correlation of plaque area between four subgroups of CACS (r=0.671, r=0.623, r=0.562, r=0.571, respectively). CONCLUSION: Despite the increase in CACS, the geometric analysis of coronary arteries using with 64-channel MDCT was comparable with IVUS in symptomatic patient of the intermediate risk group.
Aged ; Coronary Artery Disease/*diagnosis/*radiography/ultrasonography ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/*methods ; Predictive Value of Tests ; Ultrasonography, Interventional/*methods

The authors had performed stereotactic surgery to diagnose and treat 2 cases of neurocysticercosis under the local anethesia. Generally, such the open surgery need a general anethesia which may increase the chance of brain parenchyml injury. However, the stereotactic surgery has the advantage of being an easy and precise procedure under local anethesia. The authors reviewed the literature and discussed the stereotactic surgery in the diagnosis, and treatment of neurocysticercosis.
Albendazole ; Brain ; Diagnosis ; Neurocysticercosis* ; Praziquantel

PURPOSE: Canaliculocele is a rare cause of eyelid mass which is formed by dilation of the canaliculus. We introduce a case of canaliculocele treated with punctoplasty and marsupialization. CASE SUMMARY: A 35-year-old woman visited our clinic complaining of a right medial upper eyelid mass. It started 3 months ago and had the wax and wane feature. On slit lamp examination, cystic lesion was visible in the medial area of the right upper eyelid, and the punctum was obscure. Right upper canaliculus was not shown in dacryocystography. One-snip punctoplasty was performed for the diagnosis, and turbid contents were drained leading to collapse of the cyst. After diagnosis of canaliculocele, marsupialization was added by excision of the posterior wall of the mass. On histopathologic examination, the cystic wall was composed of nonkeratinized squamous epithelium with an attenuated superficial cell layer. The patient healed without recurrence of a cyst after 6 months of follow up.
Adult ; Diagnosis ; Epithelium ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Recurrence

No abstract available.
Korea*

OBJECTIVE: To compare COH characteristics and IVF outcomes among IVF-ET patients who were treated with various therapeutic modalities for ovarian endometriomas and to propose effective pre-cyclic therapeutic modalities to improve IVF-ET outcomes in the patients with ovarian endometriomas. METHODS: All cases that had undergone IVF-ET after laparoscopy between January 1997 to August 2003 were reviewed. Forty-eight patients with tubal factor were assigned to Group I. Twenty seven, 22 and 38 patients diagnosed as severe pelvic adhesion with ovarian endometriomas by laparoscopy received only medical therapy (Group II), cyst aspiration (Group III), and sclerotherapy (Group IV), respectively. Laparoscopic cystectomy was performed in 20 patients (Group V). Resistance index was measured on day administering hCG. RESULTS: As compared with Group I, in Group II resistance index increased (p<0.05) but number of oocytes, good-quality oocyte ratio (mature and intermediate oocytes/total retrieval oocytes), fertilization rate, and embryo development rate decreased (p<0.05). In Group III fertilization rate and embryo development rate decreased (p<0.05). There was no difference between Group IV and Group I in all parameters except basal FSH which increased (p<0.05). In Group V basal FSH, and resistance increased (p<0.05) and number of oocytes and good-quality oocytes ratio decreased (p<0.05). CONCLUSION: Sclerotherapy is an effective therapeutic option which can be done prior to IVF-ET cycles in the patients with ovarian endometriomas. Further studies on a large scale are necessary to confirm these data.
Cystectomy ; Embryonic Development ; Endometriosis* ; Female ; Fertilization ; Humans ; Laparoscopy ; Oocytes ; Pregnancy ; Sclerotherapy

The upper thoracic vertebrae through anterior approach depends upon several variables; The diameter of the thoracic inlet, the height of the clavicles and manubrium anteriorly, and the extent of the cervicothoracic kyphosis. Preoperatively, the upper margin of the manubrium should be compaired with the vertebral body level on a standard lateral roentegenogam or mid-sagittal MRI of the upper thoracic spine. We measured the distance and the level of the corresponding vertebra of line A(horizontal line from the suprasternal notch to the corresponding vertebra) and line B(perpendicular line from the suprasternal notch to the corresponding vertebra ; thoracic inlet) on mid-sagittal MRI of normal subjects. The results were as follows: 1) In 95 cases(94 cumulative %), the line A fell to the T2 lower one third through T4 lower one third and the mean distance was 49.8+/-4.2mm(means standard deviation). 2) In 92 cases(91 cumulative %), the line B fell to the T1 lower one third to T3 middle one third and the mean distance was 45.5+/-4.9mm(means standard deviation). 3) The relation of the height and the distance with age, sex, weight, height, and body mass index were not statistically significant. We concluded that anatomical analysis of the mid-sagittal MRI of the cervicothoracic vertebrae will be helpful in selecting the access route to the cervicothoracic lesion.
Adult* ; Bays ; Body Mass Index ; Clavicle ; Humans ; Kyphosis ; Magnetic Resonance Imaging ; Manubrium ; Spine* ; Thoracic Vertebrae

PURPOSE: Tumor necrosis factor (TNF)-alpha is thought to contribute to pulmonary hypertension. We aimed to investigate the effect of infliximab (TNF-alpha antagonist) treatment on pathologic findings and gene expression in a monocrotaline-induced pulmonary hypertension rat model. METHODS: Six-week-old male Sprague-Dawley rats were allocated to 3 groups: control (C), single subcutaneous injection of normal saline (0.1 mL/kg); monocrotaline (M), single subcutaneous injection of monocrotaline (60 mg/kg); and monocrotaline + infliximab (M+I), single subcutaneous injection of monocrotaline plus single subcutaneous injection of infliximab (5 mg/kg). The rats were sacrificed after 1, 5, 7, 14, or 28 days. We examined changes in pathology and gene expression levels of TNF-alpha, endothelin-1 (ET-1), endothelin receptor A (ERA), endothelial nitric oxide synthase (eNOS), matrix metalloproteinase (MMP)2, and tissue inhibitor of matrix metalloproteinase (TIMP). RESULTS: The increase in medial wall thickness of the pulmonary arteriole in the M+I group was significantly lower than that in the M group on day 7 after infliximab treatment (P<0.05). The number of intra-acinar muscular arteries in the M+I group was lower than that in the M group on days 14 and 28 (P<0.05). Expression levels of TNF-alpha, ET-1, ERA, and MMP2 were significantly lower in the M+I group than in the M group on day 5, whereas eNOS and TIMP expressions were late in the M group (day 28). CONCLUSION: Infliximab administration induced early changes in pathological findings and expression levels of TNF-alpha, and MMP2 in a monocrotaline-induced pulmonary hypertension rat model.
Animals ; Antibodies, Monoclonal ; Arteries ; Arterioles ; Endothelin-1 ; Gene Expression ; Humans ; Hypertension, Pulmonary ; Injections, Subcutaneous ; Male ; Monocrotaline ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; Receptors, Endothelin ; Tumor Necrosis Factor-alpha ; Infliximab