Intraventricular hemorrhage is a common hemorrhagic cerebral disorder in premature, but occurs much less frequently in the full-term newborn. In order to obtain documentation of clinical and ultrasonographic characteristics of intraventricular hemorrhage in full-term, we performed cerebral ultrasonography on 602 newborn infants who had been admitted to neonatal intensive care unit at the Deppartment of Pediatrics, Yonsei University College of Medicine between December 1989 and June 1991. 15 cases (2.5%) of intraventricular hemorrhage were analysed. The results were as follows: 1) Among 15 cases with intraventricular hemorrhage, there was no obstetrical and perinatal complication in 8 cases (53%) and 13 cases (87%) were neurologically normal at birth. 2) Sudden onset of dramatic neurologic abnormalitis inclued seizures, fever, bulging fontanel, irritability, lethargy, vomiting in cases (73%) and the remainder (27%) had no clinical symptoms and signs. 3) The age at diangosis of hemorrhage was before 72 hours in 5 cases (33%), between 4 and 7 days in 2 cases (13%), at 8 to 28 days in 8 cases (53%), 8 of 15 cases (53%) had Grade 1 IVH, four with Grade 2, cases with Grade 3, and 1 case of these infant demonstrated Grade IV IVH. The source of hemorrhage was subependymal germinal matrix in 12 cases (80%) and choroid plaxus in 3 cases (20%). 4) Precipitating factors were cerebral venous infarction in 7 cases, hypoxic injury in 5, and 3 other infants had no identifiable medical risk factors. 5) Among all 15 survivors, 2 of 3 infants with choroid plexus hemorrhage required placement of a ventriculo-peritoneal shunt, in the other case, ventriculomegaly decreased spontaneously.
Choroid ; Choroid Plexus ; Hemorrhage* ; Humans ; Infant ; Infant, Newborn* ; Infarction ; Intensive Care, Neonatal ; Lethargy ; Parturition ; Pediatrics ; Precipitating Factors ; Risk Factors ; Seizures, Febrile ; Survivors ; Ultrasonography ; Ventriculoperitoneal Shunt ; Vomiting

The antiplatelet aggregation effect of ticlopidine was studied in 22 cases of coronary artery disease(CAD) and 17 cases of control by obseving changes of plarma beta-thromboglobulin(beta-TG) and platelet factor 4(PF-4) before and after administration of ticlopidine 500mmg daily for 2 weeks. 1) Compared with the controls, CAD patients had significantly greater plasm levels of beta-TG(52.6+/-32.7ng/ml. mean +/-SD vs. 91.0+/-52.0, P<0.05) and PF-4(17.5+/-12.8 ng/ml vs. 32.9+/-24.5, P<0.05). 2) In controls, plasma levels of beta-TG and PF-4 didn't change significantly after taking ticlopidine. 3) In CAD patients, plasma levels of beta-TG (91.0+/-52.0ng/ml vs. 53.9+/-20.0, P<0.05) and PF-4(32.9+/-24.5ng/ml vs. 18.8 +/-11.9(P<0.05) decreased significantly after ticlopidine. 4) The side effects were observed in 2 cases such as mild indigestion and urticaria.
Blood Platelets ; Coronary Vessels ; Dyspepsia ; Humans ; Plasma ; Ticlopidine* ; Urticaria

Preoperative and postoperative echocardiography were performed in 33 patients with isolated ostium secondum atial septal defect(ASD), confirmed by right heart catheterization and operation at Seoul National University Hospital from November 1980 to June 1982. The ratio of right ventricular enddiastolic dimension to leftventricular enddiastolic dimension(RVED/LVED) was compared to the pattern of interventricular septum, before and after operation. In patients with persistent paradoxical septal motion during 2wks after operation, repeated echocardiograms were performed upto 9 months, postoperatively. The results obtained are as follows: 1) The ratio of RVED/LVED in patients with ASD, was 0.95+/-0.35(mean+/-standard deviation), which was significantly larger than that of 14 normal subjects(p<0.005). 2) There was statistically correlation between the ratio of pulmonary blood flow to systemic blood flow(QP/QS) and the ratio of RVED/LVED(r=0.44, p<0.025). 3) Thirty three patients were divided into 3 groups according to the pattern of intervent ricular septal motion.(Group "M": Patients with normal septal motion, Group "B": Patients with paradoxical type B septal motion, Group "A": Patients with paradoxical type A septal motion) Preoperatively, the ratio of RVED/LVED was 0.68+/-0.28 in Group "N" (N=9), and 0.88+/-0.23 in Group B (N=9) and 1.14+/-0.34 io Group "A" (N=15). In Group "A, the ratio of RVED/LVED was significantly larger than of Group "N" (p<0.005). Postoperatively, the ratio of RVED/LVED was 0.51+/-0.13 in Group "N" (n=23), and 0.68+/-0.15 in Group "B" (n=7), and 0.79+/-0.14 in Grop "A" (n=3). In Group "A" and Group "B, the ratio of RVED/LVED was significantly larger than that of Group "N" (p<0.005, p<0.01). 4) Postoperative RVED index(18.9+/-4.9) was significantly decreased, compared with preoperative RVED index(27.6+/-8.9) (p<0.005). But there was no significant change in LVED index, before and after operation. 5) Among 10 patients with persistent paradoxical septal motion, repeated echocardiograms were performed in 5 patients. Interventricular septal motion was normalized in 4 out of 5 patients. Thus the ratio of RVED/LVED has significant correlation with QP/QS and the pattern of interventricular septal motion. These results suggest the evidence that interventricular septal motion is determined by septal position at enddiastiole.
Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Heart Septal Defects, Atrial* ; Humans ; Seoul

No abstract available.
Adult* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

Pneumocephalus is defined as the presence of air or gas within the cranial cavity. It is usually associated with disruption of the continuity of the skull after head and facial trauma, neuro or otorhinolaryngologic surgery, and rarely, spontaneously. But a case of pneumo-hydrocephlus, a special subtype of pneumocephalus, has been rarely reported. This is a case of a 26-year-old quadriplegic patient who traumatic brain injury with left frontoparietal skull bone fracture and epidural hemorrhage with developed of pneumo-hydrocepahlus in the ventricle 6 months after injury. The mechanism of this case can be explained by the "inverted bottle" hypothesis. Clinical observation suggests that the leakage of cerebrospinal fluid through the ventricle-peritoneal shunt tube caused negative pressure gradient differences resulting in the inflow of outside air into the ventricle through fissures created by concealed fracture of the skull base.
Adult ; Brain Injuries ; Fractures, Bone ; Head ; Hemorrhage ; Humans ; Pneumocephalus ; Skull ; Skull Base ; Ventriculoperitoneal Shunt

Truncus arteriosus is a rare congenital heart disease which is diagnosed in from 1 to 2 percent of congenital cardiac birth. Whithout surgical intervention, survival beyond infancy is unusual. Unoperated patients who survive to adult life have associated pulmonary stenosis or have developed pulmonary arteriolar disease. We report a case of truncus arteriosus in a 17-year-old man with a review of literature.
Adolescent ; Adult ; Heart Defects, Congenital ; Humans ; Parturition ; Pulmonary Valve Stenosis ; Truncus Arteriosus*

OBJECTIVE: The present study was performed to investigate whether apoptosis occur in human embryos by annexin staining and detect the expression of Fas, Fas-ligand (FasL), Bax, and Bcl-2 in human fragmented embryos derived from IVF-ET by immunofluorescence and Western blot analysis. MATERIALS AND METHODS: Using annexin staining, immunofluorescence and Western blot analysis on normal and fragmented embryos, we were able to detect apoptotsis and apoptotic gene products in fragmented embryos. RESULTS: Phosphatidylserine (PS) translocation, the marker for apoptosis, were detected frequently in fragmented embryos. Bcl-2 and Bax protein were detected in both fragmented and non-fragmented embryos. When fragmented embryos compared to normal embryos, immunofluorescent intensity of Bcl-2 tended to be lower in fragmented embryos. Bax gene expression increased in the fragmented embryos compared to the normal embryos. This result supports a model in which the molar ratio of Bcl-2 to Bax determines whether apoptosis induced or inhibited in human embryo. Fas was highly expressed in human preimplantation embryos but not FasL. It suggests that embryo may undergo apoptosis by binding with FasL produced by follicular or immune cells. CONCLUSION: The over expression of Bax and Fas will trigger apoptosis to lead embryo fragmentation and change embryo to be nonviable.
Apoptosis* ; bcl-2-Associated X Protein ; Blastocyst ; Blotting, Western ; Embryonic Structures* ; Fluorescent Antibody Technique ; Gene Expression ; Humans* ; Molar

BACKGROUND: To evaluvate the hypothesis that reperfusion injury and reperfusion arrhythmia could be caused by oxyzen free redicals and that prolonged myocardial dysfunction could be induced by oxyzen free redical. METHODS: Experimnetal model of anesthetized open chest dogs was used. Coronary artery was occluded for 60 minutes and reperfusion was performed 4 hours. In 5 dogs, superoxide dismutase and catalase were infused concomitantly 15 minutes after coronary occlusion to 15 minutes after reperfusion. In 9 dogs, 0.9% saline was infused instead of free redical scavengers. Hemodynamic parameters such as heart rate, left ventricular peak systolic pressure, end-diastolic pressure, peak positive dP/dt, and peak negative dP/dt were analysed. Infarct size was estimated by the unstained area in nitroblue tetrazolium staining and risk area was calculated from the unstained area after methylen blue infusion. Regional systolic function was observed in systolic thickening of ischemic area by echocardiogram. RESULTS: 1) Reperfusion arrhythmia occurred in 67% of control group and in 50% of drug treated group. 2) Systolic hemodynamic parameters such as peak systolic pressure, peak positive dP/dt showed no difference between control and drug-treated group. 3) Diastolic parameters such as end-diastolic pressure and peak negative dP/dt were not different in two groups. 4) Regional systolic parameter measured by systolic thickening in ischemic area improved after reperfusion and continued to be better in drug treated group than in control group. 5) Infarct size, risk area, ratio of infarct size to risk aera were not different in two groups. CONCLUSION: Superoxide dismutase and catalase showed no effect in reducing the infarct size in anesthetized open chest canine model with 60 minutes of coronary occlusion 4 hours of reperfusion. However, postischemic prolonged myocardial dysfunction tended of improve-after reperfusion in drug treated group.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Catalase* ; Coronary Occlusion ; Coronary Vessels ; Dogs ; Heart Rate ; Hemodynamics ; Myocardial Infarction* ; Necrosis* ; Nitroblue Tetrazolium ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase* ; Superoxides* ; Thorax

OBJECTIVE: This study is to determine the cross-cultural adaptation and validation of the Korean version of the EQ-5D (KEQ-5D) in various rheumatic patients. METHODS: We performed translation, backward translation and cognitive debriefing by the guidelines of the EuroQol group. The validity was evaluated by using the KEQ-5D, Korean Short- Form 36 (KSF-36) and disease-specific measures on 508 out-patients with ankylosing spondylitis, fibromyalgia syndrome, rheumatoid arthritis, osteoarthritis or systemic lupus erythematosus. Construct validity were evaluated by testing a-priori hypotheses of the association between the KEQ-5D and other measures. For the verification of reliability, we gave the same questionnaires twice to another 57 patients 1-week apart, and intra-class correlations and Kappa statistics were estimated. To test responsiveness, 60 patients with RA repeated the KEQ-5D at 12-week intervals within the context of 12-week clinical trials of a TNF blocker, and we calculated the t-test, effect size and standardized response mean RESULTS: There were no major modifications on the cross-cultural adaptation. The relationships between the KEQ-5D and the generic or disease-specific measures were observed to be as we expected previously in a-priori hypotheses:higher KEQ-5Dindex and KEQ-5DVAS scores were correlated with generic or disease-specific measures on the better health status, and groups with a better functional class showed higher KEQ-5D scores. The intra-class correlations of the KEQ-5Dindex and KEQ-5DVAS were 0.751 and 0.767, respectively, and Kappa statistics for agreement ranged from 0.455 to 0.772 across five dimensions. The standardized response means of KEQ-5Dindex and KEQ-5DVAS were 0.649 and 0.410. CONCLUSION: The KEQ-5D had good validity and sensitivity in several rheumatic conditions. Also, its reliability and responsiveness were moderate to good.
Arthritis, Rheumatoid ; Fibromyalgia ; Humans ; Korea ; Lupus Erythematosus, Systemic ; Osteoarthritis ; Outpatients ; Quality of Life ; Surveys and Questionnaires ; Rheumatic Diseases* ; Spondylitis, Ankylosing

BACKGROUND: C-type natriuretic peptide (CNP), secreted from endothelial cells, dilates the vessel and increases the renal excretion of sodium and water. Plasma CNP level is not elevated in patients with congestive heart failure (CHF), but the myocardial content of CNP is increased, suggesting paracrine or autocrine role of CNP. We studied to compare the effect of ANP and CNP on vasorelaxation in CHF rat model. METHODS: Coronary artery ligation was performed in Sprague Dawley rats, resulting in CHF (n=5) and they were fed with ordinary chow for 10 weeks. After measuring hemodynamics, aorta and pulmonary artery were incised and studied in organ chamber to measure the isotonic force to KCl and to observe the relaxation response to atrial natriuretic peptide (ANP), and CNP in vessels precontracted with phenylephrine. Normal Sprague Dawley rats (n=5) were used as control. RESULTS: There were no difference in vasorelaxation responses to ANP between control and CHF rats. The response to CNP was significantly impaired in both aorta and pulmonary artery of CHF rats compared to control rats.
Animals ; Aorta* ; Atrial Natriuretic Factor ; Coronary Vessels ; Endothelial Cells ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hemodynamics ; Humans ; Ligation ; Models, Animal ; Myocardial Infarction ; Natriuretic Peptide, C-Type* ; Natriuretic Peptides ; Phenylephrine ; Plasma ; Pulmonary Artery* ; Rats* ; Rats, Sprague-Dawley ; Relaxation* ; Sodium ; Vasodilation