Chylothorax is the most common cause of pleural effusion in the neonatal period and is defined as an effusion of lymph in the pleural cavity. We report a case of chylothorax in a 13-day-old male who was admitted due to respiratory difficulty. Chest AP showed pleural effusion of the left lung and milky yellow fluid was aspirated via thoracentesis upon which laboratory and lipoprotein electrophoresis of pleural fluid revealed findings compatible with that of chylothorax. Due to reaccumulation of chyle after daily thoracentesis, chest tube was inserted at the 4th hospital day, and MCT containing diet was given. He was discharged on the 21st hospital day in good health, and revealed no recurrence for 3 months during outpatient follow up visits.
Chest Tubes ; Chyle ; Chylothorax* ; Diet* ; Electrophoresis ; Follow-Up Studies ; Humans ; Infant, Newborn ; Lipoproteins ; Lung ; Male ; Outpatients ; Pleural Cavity ; Pleural Effusion ; Recurrence ; Thoracostomy* ; Thorax ; Triglycerides*

Sertoli-Leydig cell tumor or Brenner tumor is a relatively rare ovarian tumor. Other associated elements in the form of epithelial, mesenchymal, and tumor components of each tumor have been reported. The Sertoli-Leydig cell tumor with a Brenner tumor element has not been documented in the literature, so we are reporting on a case of Sertoli-Leydig cell tumor coexisting with a Brenner tumor. This 62-year-old woman presented with a 4 year history of lower abdominal mass and vaginal bleeding. Exploratory laparotomy was done. The left ovary showed a multiseptated, cystic, yellow-white solid mass, measuring 17.0x13.0x5.0 cm and weighing 985.0 gm. Microscopic examination revealed a tubular or trabecular arrangement of the Sertoli cells and variable numbers of Leydig cells. There were several tumor nests with cystic spaces composed of ovoid cells showing longitudinal nuclear grooving. Sarcomatoid or heterologous elements were not found.
Female ; Humans

In order to study the effects of aminoglycosides on leukochemotaxis in rats, the degree of leukocyte infiltration and differential leukocyte count were observed at the experimentally inflamed tissue by incision of the skin and the application of endotoxin subcutaneously after the administration of gentamicin and streptomycin respectively. The results obtained were as follows. 1) In the control group treated with physiological, saline, the infiltration of leukocytes was relatively scant in the first nne hour, conspicuously increased three hours later, and persisted for 24 hours. 2) In the gentamicin and streptomycin treated groups, infiltration of leukocytes was srnall in number in the first hour. There after it gradually increased over a period of time. However it was a little less in the gentamicin and streptomycin injected group compared with the control. 3)In the control group, about 90% of the infiltrated cells was neutrophils up to three hours. However 24 hours later, the neutrophils reached about 40%. On the other hand, monocytes and lymphocytes were 4% in the first hour, and after 24 hours the monocytes was 19 to 24% and lymphocytes were 31 to 36%. 4) In the gentamicin and streptomycin injected grougs, about 90% of the infiltrated cells was neutrophils for the first three hours. The numbers gradually decreased to 56-66% and 51~54% after 24 hours, respectively. The percentage of both monocytes and lymphocytes was 2~4% after ome hour, and increased to 15~29 and 17~29% after 24 houre, respectively.
Aminoglycosides* ; Animals ; Gentamicins ; Hand ; Leukocyte Count ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils ; Rats* ; Skin ; Streptomycin

PURPOSE: Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. METHODS: From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. RESULTS: Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times (P<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer (P<0.05), the mortality rate was not significantly different among the 2 groups. CONCLUSION: Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.
Accelerated Idioventricular Rhythm ; Arrhythmias, Cardiac ; Arteries ; Body Weight ; Cardiopulmonary Bypass ; Child ; Heart ; Heart Diseases ; Humans ; Incidence ; Intensive Care Units ; Medical Records ; Retrospective Studies ; Risk Factors ; Tachycardia, Ectopic Junctional ; Thoracic Surgery ; Ventilators, Mechanical

PURPOSE:Present evidences suggest that Ureaplasma urealyticum is a cause of pneumonia, septicemia, and bronchopulmonary dysplasia (BPD) in newborn infants, particularly those born prematurely. The purpose of this work was to examine the relationship between Ureaplasma urealyticum in the tracheal aspirates and adverse outcomes, such as BPD and early onset neonatal sepsis in premature infants. METHODS:A polymerase chain reaction (PCR) was performed on tracheal aspirates collected within 24 hour after birth in 176 premature infants less than 35 weeks of gestation and admitted to the neonatal intensive care unit of Bundang CHA Hospital. RESULTS:U. urealyticum was detected in 37 of 176 preterm infants (21.0%). Gestational age (29+5+/-2+5 wk vs. 30+6+/-2+5 wk, P=0.013) and birth weight (1.39+/-0.44 kg vs. 1.59+/-0.55 kg, P=0.037) were lower in the U. urealyticum-positive group compared to the control group. The incidence of early onset neonatal sepsis (16.2% vs. 6.5%, P=0.045) and BPD (45.9% vs. 29.5%, P=0.047) was higher in the U. urealyticum-positive group compared to the control group, but the severity of BPD was not different between two groups. However, multiple logistic regression analysis revealed that the presence of U. urealyticum was not independently related to the development of early onset neonatal sepsis and BPD. CONCLUSION:The results suggest that colonization of the lower respiratory tract by U. urealyticum might not be related to the development of neonatal sepsis and BPD directly in preterm infants.
Birth Weight ; Bronchopulmonary Dysplasia ; Colon ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Logistic Models ; Parturition ; Pneumonia ; Polymerase Chain Reaction ; Pregnancy ; Respiratory System ; Sepsis ; Ureaplasma ; Ureaplasma urealyticum

PURPOSE: The purpose of this study was to evaluate the role of mast cell and histamine as typical product of mast cell in ischemia-reperfusion injury of muscle flap using H2 receptor blocker and mast cell stabilizer. METHODS: Thirty-five Sprague-Dawley rats weighing 250-300 gm were divided into four groups; Group I: Control group without ischemia, Group II: Normal saline injection group with ischemia, Group III: Cimetidine injection group with ischemia, Group IV: Sodium cromoglycate injection group with ischemia. Well established single pedicled transverse rectus abdominis musculocutaneous(TRAM) flap was designed in all rats and were rendered ischemia by clamping the artery for 150 minutes. All injections were applied intramuscular around gluteal area 30 minutes before reperfusion. The flap survival was evaluated at 7 days after operation. Neutrophil counts and mast cell counts were evaluated 24 hours after reperfusion. RESULTS: The difference of skin flap survival between control group and cimetidine injection group was not significant. In the normal saline injection group flap survival was markedly decreased compared to that of control group. The muscle flap survival was similar to the results of skin flap survival. The neutrophil counts were significantly decreased in control group and sodium cromoglycate injection group than normal saline injection group. The mast cell counts were significantly decreased in cimetidine injection group and control group than both normal saline injection and sodium cromoglycate injection groups. The protective effect of sodium cromoglycate was not seen in the skin flap, but the muscle flaps showed protective effects of sodium cromoglycate compared to normal saline injection group. CONCLUSION: It is suggests that commonly used antihistamine(H2 receptor blocker) has protective effect against ischemia-reperfusion injury to skin and muscle flaps by reducing neutrophil and mast cell. The mast cell stabilizer was not effective for skin flap but, possibly, for muscle flap.
Animals ; Arteries ; Cimetidine ; Constriction ; Cromolyn Sodium ; Histamine ; Ischemia ; Mast Cells* ; Neutrophils ; Rats* ; Rats, Sprague-Dawley ; Rectus Abdominis ; Reperfusion ; Reperfusion Injury* ; Skin

Ectopic pancreas is commonly located at stomach, duodenum and jejunum. It is a relatively rare entity and is usually of no clinical importance which especially is a very rare source of massive upper gastrointestinal bleeding. We have recently experienced a case of an ectopic pancreas in the second portion of the duodenum which was proven to be a source of massive gastrointestinal bleeding by duodenoscopy and was confirmed by surgical exploration.
Duodenoscopy ; Duodenum* ; Esophagus* ; Hemorrhage* ; Intestines* ; Jejunum ; Pancreas* ; Stomach*

No abstract available.
Female ; Fetal Heart* ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

STATEMENT OF PROBLEM: Standard type of ITI solid implant model in the 6.2mm thick jaw bone was axisymmetrically modelled for finite element stress analyses. PURPOSE: Primary objective was to investigate the influences of the characteristic design configuration of the ITI solid implant model on the bone stress with the course of osseointegration process at the bone/implant interfaces. To simulate the characteristics of the osseointegration process, five different stages of the bone/implant interface model were implemented. As load conditions, vertical load of 50N was taken into consideration. Bone at the cervical region of implant was the areas of concern where the higher level of stress were likely to take place. RESULTS: The results indicated that rather slightly different stress level could be obtained as a function of the osseointegration conditions. CONCLUSION: Under vertical load, the lower level of stress was observed at the cervical cortical bone in the initial and final stages of osseointegration. Relatively higher stress level, however, was observed during the transitional stages where the osseointegration at the cancellous bone interface were yet to fully develop.
Jaw ; Osseointegration*

Although Soft tissue contrast and direct multiplanar imaging capability of MRI are well recognized, myelo Been the imaging modality of choice in evaluationg cervical root injury. We assessed the role of M compared its diagnostic accuracy with myelography in the evaluation of cervical root injury. MR finding Root injury in ten patients (55 roots) were retrospectively reviewed. In 26 explored roots (6 patin Frndings were compared with myelography and surgical results. In 29 roots (8 patients), which were By myelography or exploration, the MR findings were focal extraudral CSF collections (pseudomem In 21/29(72.4%, 8 patients), thickening of extradural roots in 4/29 (13.6%, 5 patients), and thickern Darn in 12/29 (41.4%, 6 patients) roots. T2-weighted axial image was superior to Tl weighted and Density-weighted images for delineationg root avulsion. The sensitivity and specificity of MRI were 7 93.3% respectively, while those of myelography were 83% and 90%. Overall diagnostic accuracy of Myelography were comparable (84.6% vs 87.5%). In conclusion, myelography is still considered as the Of choice in the preoperative evaluation of the cervical root avulsion because of its higher sensi, however, may obviate the myelography with some technical refinements.
Humans ; Magnetic Resonance Imaging* ; Myelography ; Retrospective Studies ; Sensitivity and Specificity