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

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

PURPOSE: M. pneumoniae is knwon as a common causative agents of respiratory infection in school children. But, it tends to occur in infants and younger children recently. This study was performed to evaluate the incidence and clinical manifestations of M. pneumoniae pneumonia in infants. METHOD: A total of 142 children(33 infants{Group I : Infants group; 0-2 years} and 109 children{Group II : Children group; 3-6 years}) was admitted with M. pneumoniae pneumonia from January through December 1998. We reviewed medical records and evaluated the incidence, clinical manifestations and laboratory findings. RESULT: Number of patients with M. pneumoniae pneumonia in 0 to 2 years of age(infants group) comprised 23.2% of the total in contrast to 57.1% in 3 to 6 years of age group and 19.7% in 7 to 12 years of age group. Seasonal distribution showed the highest frequency in autumn in infant and children groups(45.5% and 39.4% respectively). The most frequent symptom was cough(90.9% and 96.3%, respectively), followed by sputum(81.8% and 90.8%, respectively), fever(72.7% and 66.0%, respectively) and rhinorrhea(72.7% and 64.0%, respectively). The common physical findings on admission were crackle(84.8% and 80.7%, respectively), wheezing(30.3% and 18.3%, respectively) and throat injection(39.4% and 35.8%, respectively). WBC count was within normal range in both groups(90.9% and 89%, respectively) and CRP was lower than 0.8 mg/dL in 63.6% of infant group and 54.1% of children group. The most common radiologic finding was bronchopneumonia in both groups (47% and 38%, respectively). CONCLUSION: Number of the patients with Mycoplasma pneumoniae pneumonia in infants age from 0 to 2 years comprised 23.2% of the total. Clinical manifestations of Mycoplasma pneumonia in infants were similar to those of older children. We recommened Mycoplasma pneumoniae should be considerd as a causative agent even in infant with respiratory infection.
Bronchopneumonia ; Child ; Humans ; Incidence ; Infant* ; Medical Records ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Reference Values ; Seasons

Pleomorphic xanthoastrocytoma is a recently characterized neoplasm with relatively favorable prognosis despite aggressive histological features. Two cases of pleomorphic xanthoastrocytoma involving the left temporal lobe are reported, both occurring in adolescents. The tumor is considered to arise from the subpial astrocytes of the superficial cortex. Electron microscopic examination and immunoperoxidase stains for glial fibrillary acidic protein(GFAP) are helpful in making a definitive histologic diagnosis. In contrast to malignant gliomas, pleomorphic xanthoastrocytoma does not appear to require aggressive postoperative radiation therapy or chemotherapy. Therefore, It is important to recognize and identify this type of glioma as a distinct entity.
Adolescent ; Astrocytes ; Coloring Agents ; Diagnosis ; Drug Therapy ; Glioma ; Humans ; Prognosis ; Temporal Lobe

Trigeminal neuralgia is a cranial rhizopathy characterized by paroxysms of hyperactivity strictly limited to the anatomical distributions of the fifth cranial nerve. One of a documented cause is vascular cross-compression at the root entry zone of the fifth cranial nerve near the brain stem. The offending vessels are the superior cerebellar artery, anterior inferior cerebellar artery, small arteriole, vein only, and vertebrobasilar artery in order of frequency. When trigeminal neuralgia and hemifacial spasm occur together in the same patient in rare occasions, they are termed "tic convulsif" We have recently experienced three cases of trigeminal neurlgia caused by unusual offending vessels and one case of tic convulsif. They were treated by microvascular decompression using Teflon felt. Post-operative courses were uneventful and marked symptomatic improvement had been achieved.
Arteries ; Arterioles ; Brain Stem ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery ; Polytetrafluoroethylene ; Tics* ; Trigeminal Nerve ; Trigeminal Neuralgia* ; Veins

A retrospective analysis of 219 mild head injured patients who were admitted to Chung-Ang University Hospital from January 1990 to December 1991 was made to correlate outcome to initial Glasgow coma scale(GCS) score, combined injuries and radiologic findings. The results were as follows: 1) The young males were most frequently affected. 2) The most common cause was motor vehicle accident followed by fall. 3) The most common combined injury was cervical sprain followed by subgaleal hematoma. 4) The skull fractures were shown in 29.2% but there was no correlation between outcome and skull fracture. 5) The most common abnormal CT finding was the subdural hematoma(20.3%). 6) The positive blood alcohol test was not correlated with the outcome. 7) The majority of the patients(91.8%) made a good recovery. 8) Thirteen patients(5.9%) were performed cranial operation under the diagnosis of epidural hematoma(5 patients), subdural hematoma(4 patients), contusion and FCCD.
Coma ; Contusions ; Craniocerebral Trauma* ; Diagnosis ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head* ; Hematoma ; Humans ; Male ; Motor Vehicles ; Prognosis ; Retrospective Studies ; Skull Fractures ; Sprains and Strains

No abstract available.
Heart* ; Thoracic Surgery*