We anlized CT of 29 cases of various orbital disease in pediatric age group. Diagnoses were confirmed byeither operation or direct ophthalmoscopy. The patients were examined during the period of last 3 years. Theresults were as follows: 1. Of 29 cases, 21 were male and 8 were female, and the age ranged from 20 days to 15years. 2. Intraorbital tumors were 13 cases consisting of 7 retinoblastoma, 3 pseudotumor, and 1 each ofcongenital teratoma, cavernous lymphanngioma, and optic glioma, Of remaining 16 cases, 6 had orbital fracture, 5persistent hyperplastic primary viterous(PHPV), 3 vitreous opacity, and 2 primary glaucoma. 3. The CT findings ofthe retinoblastoma were a lobulated or oval soft tissue mass denisty (40-60HU) extending into the vitreous wtihoutsignificant enhancement on postcontrast scan. Of 7 cases, 4 had calcifications within the tumors. The extraglobalextension of the tumor was shown in 2 patients demonstrating markedly thickened sclera with enhancement anddilated optic nerve. 4. There were 5 patients with PHPV having a history of white pupil since birth, and all wereaffected unilateraly. Four patients had vitreous opacity and 3 of those showed either linear or branchingtree-like densities within the vitreous on the postcontrast scan. Another one had a lobulated increased densityprotruding into the vitreous which was difficult to differenciate from the similar finding of retinoblastoma.Remaining one case demonstrated a deformed and decreased density in the lesional lens without chaneg in thedensity of the vitreous. This was confirmed to be caused by persistence of the embryonic hyaloid artery attachedto the posterior capsule of the lens. 5. There were 3 patients with vitreous opacity and 2 of them were due toretinal detachment and 1 was caused by retrolental fibroplasia. The CT findings of retinal detachement werehomogenous or heterogenous opacities in the vitreous. In a case of retrolental fibroplasia, irregular, band-likedensity was seen along the posterior wall of the globe bilaterally. 6. Two cases of primary glaucoma showed largeglobe with a widened anterior chamber. 7. Among 6 cases of orbital fractures, 5 were blow-out fracture. Theblow-out fractures showed fractures of the medial orbital wall or orbital floor with herniated intraorbitalcontents into the neighboring ethmoid or maxillary sinus.
Anterior Chamber ; Arteries ; Diagnosis ; Female ; Glaucoma ; Humans ; Male ; Maxillary Sinus ; Ophthalmoscopy ; Optic Nerve ; Optic Nerve Glioma ; Orbit ; Orbital Diseases ; Orbital Fractures ; Parturition ; Posterior Capsule of the Lens ; Pupil ; Retinaldehyde ; Retinoblastoma ; Retinopathy of Prematurity ; Sclera ; Teratoma

The pregnancy-associated breast cancer is one of the most common malignacy developing during the period of pregnancy and occupies 1-2% of the all breast cancer patients. It is not easy to make an appropriate diagnosis due to difficulty of physical examination of the breast and limitation of proper diagnostic modalities. The pregnancy-associated breast cancer had been reported to portend an extremely poor outcome. But recent studies have found no difference in survival between general breast cancer and pregnancy-associated brest cancer. The treatment of choice is the modified radical mastectomy and adjuvant chemotherapy of needed. The authors report two patients of breast cancer diagnosed and treated during pregnancy with review of literature.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Diagnosis ; Humans ; Mastectomy, Modified Radical ; Physical Examination ; Pregnancy*

OBJECTIVE: As the number of North Korean adolescent refugees drastically increased in South Korea, there is a growing interest in them. Our study was conducted to evaluate the mental health of the North Korean adolescent refugees residing in South Korea. METHODS: The subjects of this study were 102 North Korean adolescent refugees in Hangyeore middle and high School, the public educational institution for the North Korean adolescent refugees residing in South Korea, and 766 general adolescents in the same region. The Korean version of Child Behavior Check List (K-CBCL) standardized in South Korea was employed as the mental health evaluation tool. RESULTS: The adolescent refugees group showed a significantly different score with that of the normal control group in the K-CBCL subscales for sociality (t=29.67, p=0.000), academic performance (t=17.79, p=0.000), total social function (t=35.52, p=0.000), social withdrawal (t=18.01, p=0.000), somatic symptoms (t=28.85, p=0.000), depression/anxiety (t=13.08, p=0.000), thought problems (t=6.24, p=0.013), attention problems (t=4.14, p=0.042), internalized problems (t=26.54, p=0.000) and total problems (t=5.23, p=0.022). CONCLUSION: The mental health of the North Korean adolescent refugees was severe particularly in internalized problems when compared with that of the general adolescents in South Korea. This result indicates the need for interest in not only the behavior of the North Korean adolescent refugees but also their emotional problem.
Adolescent ; Child ; Child Behavior ; Humans ; Mental Health ; Refugees ; Republic of Korea

BACKGROUND/AIMS: The principle of the rapid urease test is the assessment of the color change of the pH indicator, phenol red, by ammonium and bicarbonate ions which were produced by the urease. We modified a conventional rapid urease test, and quantified H. pylori infection by measuring the change of spectrophotometric absorbance. METHODS: 202 patients with upper gastrointestinal symptoms were endoscopically examined and three biopsies were performed in each antrum and fundus. Two biopsy specimens were stained with Giemsa and scored from 0 to 4 according to the distribution of bacteria by the Wyatt method. Another specimen was used for the quantitative rapid urease test. The tissue was incubated in a cuvette containing 10% of urea solution and phenol red at 37C. We measured optical densities in 550 nm at 5 min, 10 min, 15 min, 30 min, 1 hrs, 2 hrs, 4 hrs and 24 hrs time points.
Ammonium Compounds ; Bacteria ; Bicarbonates ; Biopsy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hydrogen-Ion Concentration ; Phenolsulfonphthalein ; Urea ; Urease*

Gallbladder carcinoma is an uncommon neoplasm, and hemobilia caused by this disease is rare. We present a case of hemobilia in a patient with gallbladder carcinoma, which was recognized at forward duodenoscopy. A 42-year-old man visited our hospital due to intermmittent right upper quadrant pain. Duodenoscopy revealed blood clots with bile juice around the ampulla of Vater and the second portion of the duodenum. Endoscopic ultrasonography for the gallbladder showed a dumbell-shaped mass with a homogenous internal echogenicity on the body of the gallbladder. MR cholangiography showed a lobulated mass with low-signal intensity in the T1-weighted and T2-weighted images. Subsequently, laparoscopic cholecystectomy with regional lymph node dissection was performed, and adenocarcinoma was confirmed.
Adenocarcinoma ; Adult ; Ampulla of Vater ; Bile ; Cholangiography ; Cholecystectomy, Laparoscopic ; Duodenoscopy ; Duodenum ; Endosonography ; Gallbladder* ; Hemobilia* ; Humans ; Lymph Node Excision

The demand for intravenous sedated upper gastrointestianl endoscopy is currently increasing steeply. Despite this trend, patient status complication due to this procedure is largerly neglected by most physicians. Recently, in three patients, mouthpiece fragment were left within the patients' body after intravenous sedated upper gastrointestinal endoscopy. They were transferred to our institution for the removal of the fragment. The patients complained of an uneasy sensation from within their body, around their necks and chests. After conducting therapeutic endoscopy, the fragment could be located around the distal part of their esophagus and within their stomach. The fragment were removed successfully by using snare in two patients, and by using forceps in another patient.
Eating* ; Endoscopy ; Endoscopy, Gastrointestinal* ; Esophagus ; Humans ; Neck ; Sensation ; SNARE Proteins ; Stomach ; Surgical Instruments ; Thorax

Pagonimus Westmani, occuring as an important human infestation of the lung, is widely distributed in the Far East ; Korea, Japan, China and the Philippines. Since Otani found the parasites for the first time in the human brain in 1887, it has been established that cerebral infestation occurs with the highest frequency among extrapulmonary involvement. In 0.8 to 25 percent of patients infested with the lung flukes cerebral paragonimiasis may be developed. The larvae may procedure arachnoiditis, abscess, fibrous cystic lesions and granulomas in the brain. Based on a review of the literatures and upon the 7 cases of cerebral paragonimiasis which have been observed by the authors at the National Medical Center, Seoul, Korea, the following points are stressed. 1) Males had a significantly higher prevalence than females. Cerebral paragonimiasis was most commonly found in young adults(16 to 25yrs). 2) Clinically the patients with cerebral involvement were characterized by Jacksonian type of epilepsy, headache and visual disturbance. Mental deterioration, hemiplegia, hemihypesthesia, homonymous hemianopsia and optic atrophy were the five major signs. 3) The patients having symptoms for less than 6 months developed mild leukocytosis in many cases. All the cases of cerebral paragonimiasis revealed positive reaction in the intradermal tests with purified antigens of P. Westermani. 4) On skull films multiple round or oval cystic calcification was diagnostic value for cerebral paragonimiasis. On angiogram vascular staining and abnormal vessels were not disclosed. On pneumoencephalogram subcortical atrophy or filling defect of the ventricle may be showed. 5) The predilection area of the granuloma and fibrous cystic mass were the occipital, posterior parietal and posterior temporal lobes. 6) The patients with chronic stabilized cerebral paragonimiasis. having intractable symptoms and signs, could not be improved with Bithionol treatment. But headache, vomiting, visual disturbance, facial weakness and especially intractable seizure were improved in our cases treated with surgical operation.
Abscess ; Arachnoid ; Arachnoiditis ; Atrophy ; Bithionol ; Brain ; China ; Epilepsy ; Far East ; Female ; Granuloma ; Headache ; Hemianopsia ; Hemiplegia ; Humans ; Intradermal Tests ; Japan ; Korea ; Larva ; Leukocytosis ; Lung ; Male ; Optic Atrophy ; Paragonimiasis* ; Parasites ; Philippines ; Prevalence ; Rabeprazole ; Seizures ; Seoul ; Skull ; Temporal Lobe ; Trematoda ; Vomiting

BACKGROUND: To find compatible rare bloods, the Korean Red Cross (KRC) blood center is currently testing many units randomly selected from the units in storage. Since this procedure is usually very time-consuming, it is necessary to establish a new donor management system for the rare blood types. METHODS: We evaluated 261 units of red blood cells (RBCs), which were supplied as compatible bloods to the requests of hospitals in 2003. RESULTS: A total of 14 hospitals requested 248 units of compatible RBCs for their 39 patients through 64 occasions and 261 units were supplied. The blood types of 35 patients were identified using the medical records of the hospitals. A total of 19 kinds of specific antigens were negative and, among them, 10 kinds of single specific antigens were negative and 9 kinds of multiple antigens were negative. The frequencies of the negative antigens were C+e(17.9%), E+c(10.3%) and Jka(10.3%), respectively. The number of tested blood units was 1,894 and the rate of compatibility was 13.8%. The mean age of 257 blood donors was 22.5 and, among them, 220 donors (85.6%) were multiple donors with 7.5 collections on average. CONCLUSION: We conclude that the rare blood type donor registration system is necessary and suggest the following preconditions. First, the results of compatible blood test and irregular antibody screening test for the blood donor need to be registered automatically by the blood information management system(BIMS). Second, the test system should be improved to enhance the irregular antibody detection rate. Third, establishment of a frozen-thawing system for RBCs is needed. Fourth, the donors need to be informed of the results of their rare blood type, if any, including irregular antibody. Fifth, a new organization should be established to manage the rare blood type donor registration system. Finally, well cooperation with hospitals and KRC blood center is needed to ensure the stability of blood service for rare blood type RBCs.
Blood Donors ; Erythrocytes ; Hematologic Tests ; Humans ; Information Management ; Mass Screening ; Medical Records ; Red Cross ; Tissue Donors*

BACKGROUND: Three cell separators are being used and they collect platelets with different centrifuge speed and duration. Because centrifugation may cause platelet activation, the differences of centrifuge speed and duration are important in controlling the quality of apheresis platelet products. We compared many parameters of activation of platelets collected by Spectra (Cobe BCT, Lakewood, CO, USA), CS3000plus (Baxter Healthcare, Fenwal Division, Round Lake, IL, USA) and Mobile Collection SystemTM (MCS, Haemonetics co., Braintree, MA, USA). METHODS: Platelets were collected from ninety-five normal donors with Spectra (n=39), CS3000plus (n=19) and MCS (n=37). We underwent the procedure according to the automatic program set. We measured platelet yield and assayed pH, hypotonic shock respose (HSR), CD62 (p-selectin, GMP140) expression and beta-thromboglobulin in each stored unit on day 0 and day 3 for evaluation of the storage lesions. RESULTS: Platelet yield per product was 3.7 +/- 1.2 x 1011, mean final product volume was 316 +/- 69 mL and mean procession time was 100 +/- 19 minutes. Mean collection efficiency was 42.5 +/- 8.3%. The cell separator volume of product collected by CS3000plus was the smallest while platelet concentration and total yield were the highest in the product collected by Spectra. The pH of the products were 7.1 +/- 0.1 on day 0 and 6.7 +/- 0.4 on day 3. Hypotonic shock response was 69 +/- 13 % on day 0 and 28 +/- 17 % on day 3. P-selectin expression was 19 +/- 9 % (4.2 +/- 1.9 relative fluorescence intensity, RFI) on day 0 and 60 +/- 22 % (17.9 +/- 14.2) on day 3. beta-thromboglobulin was 28.5 +/- 7.0 IU/107 platelets on day 0 and 31.3 +/- 7.2 IU/107 platelts on day 3. The comparison of the three cell separators showed that on day 0 platelet product of MCS has lower pH and higher beta-thromboglobulin release than others (p<0.05). And on day 3 platelet product of MDS has better hypotonic shock response than others (p<0.05). Other parameters revealed no differences among three cell separators. The expression of p-selectin was shown to correlate highly with pH reduction (r=0.72), but not with the release of beta-TG (r=0.24). CONCLUSIONS: Most parameters showed no differences among three cell separators, but apheresis platelet concentrates processed by MCS showed lower pH on day 0 and higher beta-thromboglobulin concentration on day 0 and day 3 than apheresis platelet concentrates processed by Spectra or CS3000plus and hypotonic shock response on day 3 was the lowest in CS3000plus. So platelet activation produced during apheresis processing was lowest in apheresis platelet concentrates with Spectra.
beta-Thromboglobulin ; Blood Component Removal* ; Blood Platelets* ; Centrifugation ; Delivery of Health Care ; Fluorescence ; Humans ; Hydrogen-Ion Concentration ; Lakes ; Osmotic Pressure ; P-Selectin ; Platelet Activation* ; Tissue Donors

BACKGOUND: The present study was undertaken to determine the effect of remifentanil on the bispectral index (BIS) during intubation under TIVA (total intravenous anesthesia) using propofol. METHODS: In this prospective, randomized, double-blind study, 80 healthy patients aged 18~60 years undergoing elective surgery were investigated. Anesthesia was induced using propofol (target effect-site concentration 4microgram/ml). After the loss of consciousness, rocuronium (0.9 mg/kg) and remifentanil was infused. The patients in the R group were infused with remifentanil using a target effect-site concentration of 4 ng/ml, and patients in the P group were infused with saline. The BIS value, mean arterial pressure (MAP) and heart rate (HR) were measured before induction, before remifentanil infusion and before and after tracheal intubation. RESULTS: The BIS value remained constant after intubation in the two groups. The MAP and HR increased significantly after intubation in the two groups, but the degree of increase of MAP and HR was less in group R than in group P significantly. CONCLUSIONS: We suggest that the BIS value is not affected by the administration of remifentanil during intubation under TIVA using propofol.
Anesthesia ; Arterial Pressure ; Double-Blind Method ; Heart Rate ; Humans ; Intubation* ; Propofol* ; Prospective Studies ; Unconsciousness