No abstract available.
Leukemia* ; Leukemia, Megakaryoblastic, Acute*

Respiratory distress syndrome (RDS) of newborn is a disease revealed high morbidity and mortality rate, especially in premature infant. To evaluate the predictive value of Stable Microbubble Rating (SMR) and Shake test on RDS in premature infant, the anthors carried out the gastric aspirates Shake test and SMR test at birth, 3 and 6 hours after birth respectively on 124 premature infants who were born at the department of Pediatrics, Dong-San Hospital, Keimyung University during the period of 6 months form June 1993 to November 1993. The following results were obtained: 1) Among the 124 premature infants, RDS was developed on 23 (18.5%). 2) The birth weight, gestational age and Apgar score were significantly lowered in RDS cases than non-RDS cases (p<0.005). 3) The sensitivity, specificty, positive-and negative-predictive values of Shake test were 87.0% 79. 2% 48.8% and 96.4%, and those of SMR test were 100% 93.1% 76.7% 100% at birth, 95.7% 88.1% 64.7% 98.9% at 3rd-hour of life, and 95.7% 72.3% 44% 98.6% at 6th-hour of life. With the results of this study we concluded that SMR test at 6th-hour of life.
Apgar Score ; Birth Weight ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Microbubbles* ; Mortality ; Parturition ; Pediatrics

'Marjolin' ulcer' is used to describe the malignant transformation of a chronic ulcer which has developed in a burn scar. Clinically, although the lesions is slowly progressive, it comes to be more aggressive when the scar barrier is disrupted. We reviewed 24 cases in patients who complained of chronic burn wounds suspected to be Marjolin's ulcer. The mean latent period for developing pathologic lesions was 31 years. Histologically, chronic ulcer and pseudoepitheliomatous hyperplasia were 21% respectively, while malignancy including squamous cell carcinoma and leiomyosarcoma was 56%. The mean elapsed time to diagnose squamous cell carcinogma was 33.2 years. In pseudoepitheliomatous hyperplasia which is considered as a transitional state to malignant tumor, wide excision and reconstruction with free muscle flap was a better procedure than skin graft for the prevention of recurrence and malignant transformation. As well, the same modality of treatment was also applied in malignant tumors.
Burns* ; Carcinoma, Squamous Cell ; Cicatrix ; Humans ; Hyperplasia ; Leiomyosarcoma ; Recurrence ; Skin ; Transplants ; Ulcer ; Wounds and Injuries*

To characterize the sympathetic nervous system response to congestive heart failure in infants and children, plasma norepinephrine levels were measured in 29 patients aged 4 months to 15 years undergoing routine cardiac catheterization at Dong San Hospital, Keimyung University during the period of 4 months from November 1990 to February 1991. Plasma norepinephrine levels were significantly higher in patients with heart disease and congestive heart failure than in those without congestive heart failure(P<0.001). A significant association was found between the level of plasma norepinephrine and severity of the symptoms of congestive heart failure. Plasma norepinephrine levels correlated well with size of the shunt (Qp/Qs)(gamma=0.75), degree of pulmonary arterial pressure (gamma=0.79) and degree of right ventricular pressure (gamma=0.82).
Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Estrogens, Conjugated (USP)* ; Heart ; Heart Diseases ; Heart Failure* ; Humans ; Infant* ; Norepinephrine* ; Plasma* ; Sympathetic Nervous System ; Ventricular Pressure

A clinical study was made on 12 cases of neonatal Group B beta-hemolytic streptococcal (=GBS) meningitis, who were admitted to the department of pediatrics, Dong-San Hospital, Keimyung University during the period of 3 years from Aug 1989 to Jul 1992. The following results were obtained: 1) GBS was cultured in 12 cases (57.1%) among 21 neonatal meningitis admitted during the same period. 2) Male and female ratio was 1.4:1, and 4 cases had early-onset and 8 cases had late-onset. 3) In 6 (50%) out of 12 cases, obstetric factors were noted, including premature rupture of membrane (2 caes), premature delivery(1 case), asphyxia (1 case), cesarean section (1 case) and maternal toxemia (1case). 4) The clinical manifestations were fever (91.7%), lethargy and poor feeding (83.3%),vomiting and irritability (50%), convulsion and bulging fontanel in order. 5) Associated diseases were GBS sepsis (8 cases), pneumonia (2 cases), hyperbilirubinemia (2 cases), etc. 6) Cerebrospinal fluid findings were increased cells(250-12600/mm3), decreased sugar (1-11), increased protim (220-678mg%) and the CBC differential ratio was less than 1.0 in all cases. 7) Overall survival rate was 83.3% with 75% in early-onset disease, and 87.5% in late-onsetdisease. 8) The acute neurologic complications were noted in 5 cases (45.5%) including subdural hemorrhage, brain swelling and cerebral infarction.
Asphyxia ; Brain Edema ; Cerebral Infarction ; Cerebrospinal Fluid ; Cesarean Section ; Female ; Fever ; Hematoma, Subdural ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Lethargy ; Male ; Membranes ; Meningitis* ; Pediatrics ; Pneumonia ; Pregnancy ; Rupture ; Seizures ; Sepsis ; Survival Rate ; Toxemia

Agenesis of the dorsal pancreas is one of the rare congenital anomalies of the pancreas. Six cases of them have been reported. We have experienced an autopsy case of agenesis of the dorsal pancreas associated with fetal death in the uterus. Grossly, the body and tail of the pancreas and uncinate process were not found and those were partially replaced by adipose tissue. No abnormality was noted in the other organs. Microscopically, pancreatic tissue with autolytic change was identified only in the head portion of the pancreas.

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Incidence* ; Tricuspid Valve Insufficiency*

Arteriovenous malformation of the uterus is rarely encountered. It is potentially lethal because of profuse, uncontrollable bleeding at the time of diagnostic dilatation and curettage. To our knowledge, only 38 cases of localized uterine arteriovenous malformation have been reported in English and Korean literature. Recently we experienced a case of uterine arteriovenous malformation in a 28-year-old multiparous woman. Under the clinical impression of uterine tumors or arteriovenous malformation, a total hysterectomy was done. Gross examination demonstrated a vascular nature of the mass in the posterior wall of the fundus. Microscopically, there was an ill-defined mass composed of numerous irregular, anastomosing large vessels with various diameters.
Female ; Humans

Leiomyosarcoma is a malignant tumor showing smooth muscle differentiation, and it accounts for 2% to 8% of soft tissue sarcoma. Clinically, substantial mortality and morbidity are related to the propensity for distant metastasis and local recurrence, respectively. Microscopic findings characteristically reveal intersecting bundles of spindle-shaped cells having fibrillar cytoplasm and blunt-ended nuclei. Immunohistochemistry for intermediate filaments is helpful in establishing a definitive diagnosis. We experienced a case of large protruding leiomyosarcoma that developed on an old burn scar of the medial calf of a 45-year-old man. On preoperative evaluation, we recommended amputation due to a distant metastasis to the lung(stage IV). As the patient refused amputation of his lower leg, the tumor was radically excised and immediate reconstruction was done using free latissimus dorsi muscle flap and skin graft. Four months after excision despite adjuvant chemotherapy, amputation was performed due to local recurrence.
Amputation ; Burns ; Chemotherapy, Adjuvant ; Cicatrix ; Cytoplasm ; Diagnosis ; Humans ; Immunohistochemistry ; Intermediate Filaments ; Leg ; Leiomyosarcoma* ; Middle Aged ; Mortality ; Muscle, Smooth ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin ; Superficial Back Muscles ; Transplants ; Ulcer*

In the past 5 years, the authors have performed microsurgical reconstruction of the lower leg in 37 patients. Among them, modified microsurgical salvage procedures were performed in 11(29.7) cases with vascular compromise, suggested by the preoperative angiogram of the affected lower leg demonstrating no visible, or only one visible major arter. Modified salvage procedures included free flap operations using distally-based arterial inflow(n=2), temporary diversion of the single main artery with secondary vein grafting(n=2), Jungcross-leg fashioned free flaps(n=4), and end-to-side anastomosis of the main artery((n=1). In absence of arterial flow after lower leg trauma, as interpositional vein graft(n=2) was performed to restore blood flow. No vascular problems occurred after the free flap transfer. However, 9 patients experienced different degrees of limping gait, ranging from as mild(n=2), moderate(n=6) to severe(n=1) at the mean follow-up period of 18 months. In reconstruction of a vascular compromised lower leg, modified salvage procedures should be reviewed and selected after exploration of all vessels, both proximal and distal to the zone of the injury. When evaluating what method is the most appropriate, socioeconomic efficiency and patients' individual requirments should be considered.
Arteries ; Follow-Up Studies ; Free Tissue Flaps ; Gait ; Humans ; Leg* ; Veins