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

We report a case of prenatal diagnosis of fetal congenital goiter at 31weeks of gestation by ultrasonogram and fetal hypothyroidism confirmed at birth as thyroid function test by umbilical cord blood sampling. Maternal Graves' disease and the drugs used to treat hyperthyroidism in pregnant women can affect the fetus, causing hyperthyroidism or hypothyroidism and goiter. Fetal hypothyroidism may be caused by transplacental passage of either maternal thyrotropic-binding inhibitory immunoglobulin(TBII) antibodies or maternal treatment with propylthiouracil(PTU). Untreated fetal hypothyroidism may result in mental retardation, perceptual-motor, visual-spatial, and language developmental problems. In this article fetal thyroid function was not assessed by cordocentesis, but fetal congenital goiter was detected ultrasound. Ultrasound should be used to detect fetal goiter from 20 weeks onward. Fetal goiter should resolve when maternal PTU treatment is decreased. We have diagnosed fetal hypothyroidism in utero by ultrasonography. Significance of in utero management of fetal hypothyroidism is discussed.
Antibodies ; Congenital Hypothyroidism ; Cordocentesis ; Female ; Fetal Blood ; Fetus ; Goiter* ; Graves Disease ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Intellectual Disability ; Language Development ; Mothers* ; Parturition ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Thyroid Function Tests ; Thyroid Gland ; Ultrasonography

PURPOSE: Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development. METHODS: PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2000 and February 2007. The characteristics of each patient were analyzed through retrospective examination of their medical histories. RESULTS: Among 183 patients, 17 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P<0.05). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 72 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax. CONCLUSION: Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 72 h after birth.
Birth Weight ; Chorioamnionitis ; Emphysema ; Female ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Membranes ; Oxygen ; Partial Pressure ; Parturition ; Pneumothorax ; Pregnancy ; Pulmonary Surfactants ; Retrospective Studies ; Risk Factors ; Rupture ; Stress, Psychological ; Ventilators, Mechanical

PURPOSE: As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. METHODS: The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. RESULTS: Penile length was 3.02+/-0.25 cm (F=36.467, R(2)=0.180, P<0.001) when measured with CPLM, and 3.29+/-0.26 cm (F=9.149, R(2)=0.052, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. CONCLUSION: In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.
Child ; Genital Diseases, Male ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Outpatients ; Parents ; Penis ; Pregnancy ; Reference Values ; Syringes

PURPOSE: As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. METHODS: The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. RESULTS: Penile length was 3.02+/-0.25 cm (F=36.467, R(2)=0.180, P<0.001) when measured with CPLM, and 3.29+/-0.26 cm (F=9.149, R(2)=0.052, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. CONCLUSION: In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.
Child ; Genital Diseases, Male ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Outpatients ; Parents ; Penis ; Pregnancy ; Reference Values ; Syringes

PURPOSE: The purpose of this study was to present the results after functional reconstruction of the digits using palmaris longus tendocutaneous arterialized venous free flap in digits with compound defects. METHODS: This study is based on 29 cases of palmaris longus tendocutaneous arterialized venous free flaps harvested from the ipsilateral wrist for the reconstruction of compound defect of the digits. Over the past 10 years, we performed in 17 cases of complex defects of extensor tendon on dorsum of the digits, 7 cases of collateral ligament of the proximal or distal interphalangeal joint and 5 cases of flexor tendon defect with soft tissue defect on the palmar aspect of the digits. We assessed survival rate of the flaps and functional recovery of the digits. RESULTS: All free flaps completely survived except one with completele necrosis and another one with 50% necrosis. In cases of extensor tendon defect, the mean total active range of motion of the digits was 180degrees, in cases of flexor tendon reconstruction, it was 165degrees. In reconstruction of collateral ligament of interphalangeal joint of the thumb and digits, flexion and extension was within normal range and we got very good results without instability in all 7 cases. CONCLUSION: Palmaris longus tendocutaneous arterialized venous free flaps are very useful for reconstruction of composite defect of the digits with extensor or flexor tendons as well as collateral ligaments.
Collateral Ligaments ; Free Tissue Flaps* ; Joints ; Necrosis ; Range of Motion, Articular ; Reference Values ; Survival Rate ; Tendons ; Thumb ; Wrist

Chronic inflammatory demyelinating polyradiculoneuropathy(CIDP) is a rare acquired demyelinating disease of peripheral nervous system(PNS), characterized by relapsing or progressive proximal and distal muscle weakness with possible sensory loss. It is one of several chronic neuropathic syndromes that are believed to have an autoimmune etiology. We experienced a case of CIDP in a 3-month-old boy associated with perianal abscess by Klebsiella pneumoniae who had a precipitous onset of symptoms after anesthesia. He was treated with intravenous immunoglobuline with little improvement but showed a remarkable clinical and electrophysiologic improvement after methylprednisolone pulse therapy. We report this case with a brief review of related literature.
Abscess* ; Anesthesia ; Demyelinating Diseases ; Humans ; Immunoglobulins ; Infant ; Klebsiella pneumoniae* ; Klebsiella* ; Male ; Methylprednisolone ; Muscle Weakness ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating*

A 30 year-old woman with a history of Behcet's disease was admitted to our clinic because of a paroxysmal attack of palpitations, headache, and ocular pain. Initially, we did not suspect a pheochromocytoma. We evaluated Behcet's disease activity because the cardiovascular and neurological symptoms mimicked those of Behcet's disease. Pheochromocytoma is often overlooked and can be fatal if not recognized and treated appropriately. In the present case, abdominal computerized tomography incidentally revealed a mass confirmed to be a pheochromocytoma in the left adrenal gland, and the tumor was successfully removed. This is the first Korean report of a pheochromocytoma in a patient with Behcet's disease. We suggest that pheochromocytoma should be included in the differential diagnosis of Behcet's disease if a patient presents with cardiovascular or neurological symptoms.
Adrenal Glands ; Behcet Syndrome ; Diagnosis, Differential ; Female ; Headache ; Humans ; Pheochromocytoma

Herein, a case of missed upper lumbar disc herniation, diagnosed by thorough neurological examination, digital infrared thermographic imaging(DITI), and repeated magnetic resonance(MR) image study, is reported. A 36-year-old female presented with intractable leg pain on left anterior thigh. Although she underwent lumbar MR image at other hospital, she was misdiagnosed as acute sprain. Neurological examination suggested the possibility of upper lumbar disc herniation, which was confirmed by DITI, MRI, and selective root block. After operation, her leg pain was significantly improved. It should be considered that upper lumbar disc herniation might be misdiagnosed as an acute sprain, as in our case. A high index of suspicion based on thorough neurological examination is most important in such cases. Then, multi-access such as DITI, MR image, and selective block, base on thorough neurological examination, are warranted.
Adult ; Diagnosis* ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Neurologic Examination ; Sprains and Strains ; Thigh

OBJECTIVE: To quantitatively evaluate the asymmetry of the multifidus and psoas muscles in unilateral sciatica caused by lumbar disc herniation using magnetic resonance imaging (MRI). METHODS: Seventy-six patients who underwent open microdiscectomy for unilateral L5 radiculopathy caused by disc herniation at the L4-5 level were enrolled, of which 39 patients (51.3%) had a symptom duration of 1 month or less (group A), and 37 (48.7%) had a symptom duration of 3 months or more (group B). The cross-sectional areas (CSAs) of the multifidus and psoas muscles were measured at the mid-portion of the L4-5 disc level on axial MRI, and compared between the diseased and normal sides in each group. RESULTS: The mean symptom duration was 0.6+/-0.4 months and 5.4+/-2.7 months for groups A and B, respectively (p<0.001). There were no differences in the demographics between the 2 groups. There was a significant difference in the CSA of the multifidus muscle between the diseased and normal sides (p<0.01) in group B. In contrast, no significant multifidus muscle asymmetry was found in group A. The CSA of the psoas muscle was not affected by disc herniation in either group. CONCLUSION: The CSA of the multifidus muscle was reduced by lumbar disc herniation when symptom duration was 3 months or more.
Demography ; Humans ; Magnetic Resonance Imaging ; Paraspinal Muscles* ; Psoas Muscles ; Radiculopathy ; Sciatica*