BACKGROUND: We reviewed retrospectively the clinical features and contrast material-enhanced computed tomography(CT) after blunt abdominal trauma demonstrated a characteristic hypoperfusion complex. Our purpose were to evaluate the hypothesis that children with this 'hypoperfusion complex' CT finding were associated with a tenuous hemodynamic state, severe injury and a poor outcome. METHODS: Between January 1996 and December 1999, 39 consecutive children who sustained blunt trauma and were suspected clinically of having intraabdominal injury underwent CT. Demographic data, blood pressure, indication for CT, pediatric trauma score(PTS) and Glasgow coma score(GCS) were recorded at the time of the initial examination. RESULTS: Three of the 39 children(8%) demonstrated a characteristic finding at CT which was described as the hypoperfusion complex. The 'hypoperfusion complex' was present in the 3 of the 39 traumatized children(8%), but was the main radiographic finding in the 3 of the 14 children with a severe pediatric trauma score(PTS<8) and in the 3 of the 6 children with a Glasgow coma score(GCS<8) who were examined with CT. CONCLUSION: The CT finding in all children with the hypoperfusion complex by definition included marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidney and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava(IVC); and moderate to large peritoneal fluid collection. This 'hypoperfusion complex' is a relatively rarely observed in injured children but appears to be associated with severe injury and a poor outcome. The pediatric trauma score provides a useful profile of injury severity in children. Prompt diagnosis of hypovolemic shock is important so that supportive therapy can be instituted to prevent further metabolic abnormalities and their potential cardiotoxic effects. In summary, the intense multiorgan enhancement pattern seen in the hypoperfusion complex indicates tenuous hemodynamic stability and is associated with a poor outcome.
Aorta, Abdominal ; Ascitic Fluid ; Blood Pressure ; Child* ; Coma ; Diagnosis ; Dilatation ; Hemodynamics ; Humans ; Hypovolemia* ; Intestines ; Kidney ; Mesentery ; Pancreas ; Retrospective Studies ; Shock* ; Tomography, X-Ray Computed*

No abstract available.
Asthma*

Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically it manifests as generalized erythema, erythema multiforme and amicrobial pustules with fever. Histologically, AGEP is composed of neutrophilic subcorneal and spongiform pustules. A 70-year-old female, with no personal or family history of psoriasis, was given medication including diltiazem for hypertension. Fourteen days after taking the medications, pustular eruptions appeared on the face and rapidly spread to the trunk and limbs. A Laboratory examination revealed neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate. The skin biopsy showed subcorneal and spongiform pustules. We report here a case of AGEP probably due to diltiazem.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Biopsy ; Blood Sedimentation ; Diltiazem ; Erythema ; Erythema Multiforme ; Extremities ; Female ; Fever ; Humans ; Hypertension ; Leukocytosis ; Neutrophils ; Psoriasis ; Skin

No abstract available.
Stomach Neoplasms*

PURPOSE: Information has been limited on the genetic control of germ cell apoptosis and its role in the pathogenesis of male infertility. The object of this study was to investigate the effects of c-kit gene expression and apoptosis on human spermatogenesis. MATERIALS AND METHODS: Testicular specimens were obtained from 90 infertile males with nonobstructive azoospermia(NOA) due to primary testicular failure and from 9 healthy volunteers. The specimens of infertile men were divided into 4 groups according to hitopathologic findings: Sertoli cell only(SCO) syndrome(A), maturation arrest(B), hypospermatogenesis(C) and disorganization with sloughing(D). C-kit gene expression and apoptosis were detected with immunohistochemical stain. RESULTS: The frequency of c-kit expression was lower(p<0.05) and that of apoptosis was higher(p<0.01) in infertility groups B, C, and D compared to that of the control group. A significant inverse correlation was observed in the c-kit gene expression and apoptosis in groups B, C and D(p<0.05). A similar relationship was also observed in the Sertoli cells in group D and the control group. CONCLUSIONS: With the result, we suggest that variation in c-kit gene expression and apoptosis are associated with abnormal spermatogenesis and play a role in the pathophysiology of male infertility.
Apoptosis* ; Gene Expression ; Germ Cells ; Healthy Volunteers ; Humans ; Infertility ; Infertility, Male ; Male ; Sertoli Cells ; Spermatogenesis* ; Testis

A typical case of gelinerazed cutalineous lichen amyloidosus is reported. A 62-year-old female had had brownish papular lesions on the lower legs, hands, and shoulders for about 8 years. Three years later, the papular lesions extended through the whole body surface. She complained of severe itching and tingling sensation. Physical findings were confined to the skin. The skin lesions were diffusely distributed. The size of the lesion was from pin-head to rice, The color was dark brownish. The papules were over generalized skin except for the face, palms, and sole.. Diagnosis was made by the characteristic clinical manifestations and histopathologic findings of the skin. However, the specimens of the liver and rectal biopsies did not show amyloid deposits. Based on these findings, authors concluded that this is a case of generalized cutaneous lichen amvloidosus and this is the second case in the literature in Korea. Even though the subjective symptom such as itching is getting decrease, the clinical course of this disease could not be aliernated by classical and conventional therapeutic regimens.
Biopsy ; Diagnosis ; Female ; Hand ; Humans ; Korea ; Leg ; Lichens* ; Liver ; Middle Aged ; Plaque, Amyloid ; Pruritus ; Sensation ; Shoulder ; Skin

PURPOSE: The periventricular leukomalacia(PVL) tends to increase the risk of developing motor neurologic sequelae, delayed cognitive development, visual impairment, and epilepsy. Although several developmental screening test methods are being used, one of the oldest and best known developmental screening test was restandardized and revised as Denver Development Screening Test II(Denver II). The objective of this study is to analyse the correlation between the degree of PVL on MRI and the results of Denver II. METHODS: Among the children brought into Pusan National University Hospital between January 1996 and August 1999 with developmental delay, all of the 36 children with PVL on MRI were selected for the study. Denver II was checked in all these patients for screening of developmental delay with the review of medical records. Depending on the grade of PVL, total sample was classified into three groups, and it was based on abnormally increased signal intensity in periventricualr white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and the results of Denver II. RESULTS: The 36 total patients were composed of 22 boys and 14 girls, with the age distribution between 11 to 72 months and the mean of 34.4 months. Delayed occurrence of gross motor sector were 5 cases(44.4%) in group 1, 16 cases(80.0%) in group 2, 7 cases(100.0%) in group 3. Incidence of delay was significantly higher in the high grade PVL group. Delayed rate of other sectors(fine motor-adaptive, personal-social) were higher in the high grade PVL group. But it was not statistically significant. Delayed rate of language sector has no correlation with grade of PVL on MRI. CONCLUSION: Incidence of dealy of gross motor sector was significantly higher in the high grade PVL group. However, language sector has no correlation with grade of PVL on MRI.
Age Distribution ; Brain* ; Busan ; Child ; Epilepsy ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Mass Screening* ; Medical Records ; Vision Disorders

PURPOSE: Periventricular leukomalacia(PVL) is associated with various neurologic sequelae such as cerebral palsy and cortical blindness. The aim of this study was to analyse the correlation between the degree of PVL on MRI and clinical features or its severity. METHODS:Thirty-eight children with PVL on MRI among children brought to Pusan National University Hospital between January 1996 and August 1999 with development delay, cerebral palsy or epilepsy were included into the study group. We reviewed medical records of the patients including the gestational age, birth weight and neurologic sequelae. The grade for PVL was divided into 1 to 3, and it was based on abnormally increased signal intensity in periventricular white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and various clinical findings. RESULTS: The age ranged from 11 months to 13 years old with a mean of 42 months. History of cesarean delivery and ventilator care were significantly frequent for the severe grade of PVL. Birth weight was significantly lower according to grade of PVL. Gestational age was lower according to the grade of PVL, but was not significant statistically. Incidence of cerebral palsy was significantly higher on the severe grade of PVL. Incidence of epilepsy and mental retardation were 34.2Yo and 23.9M, not associated with the grade of PVL. CONCLUSION: Incidence of cerebral palsy was associated with the severe grade of PVL, so we think MRI can be helpful in predicting neurodevelopmental outcome. (J Korean Pediatr Soc 2000;43 798-805)
Adolescent ; Birth Weight ; Blindness, Cortical ; Brain* ; Busan ; Cerebral Palsy ; Child ; Epilepsy ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Medical Records ; Ventilators, Mechanical

No abstract available.
Enterotoxigenic Escherichia coli* ; Enterotoxins*

The standard vision test using visual acuity is not always an accurate indicator of functional visual loss. The contrast sensitivity was measured in low vision patients. the contrast sensitivity of low vision patients showed a substantila decrease in all spatial frequencies(P<0.001). Of the 34 patients, the preferred eye was the eye with better peak sensitivity in 31 patients(91%) while the perferred eye was the eye with better visual acuity in 24 patients(71%). There were no characteristics of contrast sensitivity according to the diagnosis. The contributions of the contrast sensitivity function to the low vision care are evaluated.
Contrast Sensitivity* ; Diagnosis ; Humans ; Vision Tests ; Vision, Low* ; Visual Acuity