No abstract available.
Child* ; Humans

PURPOSE: To characterize the MR findings of hypoxic-ischemic brain injury and to assess the value of the MR imaging. MATERIALS AND METHODS: SE T1 -, T2-weighted, and IR brain MR images of 44 infants and children with the past history of perinatal hypoxic insults were reviewed. Abnormal brain MR findings of 8 patients with birth history of prematurity and 36 patients with birth history of full-term/posterm including 7 with severe anoxic insult history, were compared in regard to the location and the character of the lesions RESULTS: MRI demonstrated the followings;(1)abnormal signal intensity lesions of subcortical and/or deep cerebral white matter, cortex, and deep gray matter, (2)atrophy of the cerebral white matter, cortex and corpus callosum, with/without ventriculomegaly, and (3)delay in myelination. Periventricular and deep white matter lesions were demonstrated in the prematurity, the deep white matter lesions and/or subcortical white matter lesions in the term/post-term, and deep gray matter lesions in the 7 patients with severe anoxic insults history. CONCLUSION: MR imaging was useful in the diagnosis of the hypoxic-ischemic brain injury, and the white and gray matter lesions were correlated with the time of the injury and the severity of hypoxic insult.
Brain Injuries* ; Brain* ; Child ; Corpus Callosum ; Diagnosis ; Humans ; Infant ; Magnetic Resonance Imaging ; Myelin Sheath ; Reproductive History

On the contrary to congenital anomalies of intestinal rotation in pediatric patients, those in adults are generally nonsymptomatic and of little consequence. Occasionally, however, an adult may have midgut nonrotation and complain of chronic or recurrent abdominal pain. Intestinal nonrotation can be divided into complete or partial failure of rotation and into abnormalities affecting the proximal segment, the distal segment or both. We report herein a 43-year old female patient with symptomatic partial, cecocolic nonrotation.
Abdominal Pain ; Adult* ; Female ; Humans

Adenosine deaminase(ADA)has been used for the diagnosis of localized tuberculosis.The titer of ADA was measured from the ocular fluid of the patients who had undergone vitreoretinal surgery due to non-tuberculous vitreoretinal disease. Forty five patients were included and twenty patients were male. Mean age was 51.9 years. Four patients had diabetes mellitus and two had essential hypertension. The most frequent cause of vitreoretinal surgery was proliferative vitreoretinopathy(12 eyes). For the analysis of ADA titer, vitreous fluid(group I)was aspirated in 36 patients undergoing pars plana vitrectomy and subretinal fluid(group II)in 9 patients undergoing scleral encircling. Mean titer of ADA was 9.01+/-15.69 IU/L, and there was no significant difference on the statistics between group I(6.06+/-13.75 IU/L)and group II(20.83+/-18.17 IU/L). All 45 eyes showed negative reaction to polymerase chain againt tuberculosis, and 25 of 29 patients had positive reaction to tuberculin skin test. There was no statistically significant relationship between ADA titer and tuberculin skin test. This result suggests that ADA may be used for the diagnosis of posterior ocular tuberculosis, since the normal concentration in the posterior ocular fluid was compatible with the one in other body fluids where it has been used for the diagnosis of localized tuberculosis.
Adenosine Deaminase* ; Adenosine* ; Body Fluids ; Diabetes Mellitus ; Diagnosis ; Humans ; Hypertension ; Male ; Skin Tests ; Tuberculin ; Tuberculosis ; Tuberculosis, Ocular ; Vitrectomy ; Vitreoretinal Surgery

Diltiazem(Herben(R)) was orally administered in a daily dose of 180mg over 8 weeks to 15 patients with angina pectoris requiring minimum 5 tablets of nitroglycerin per week. The symptom of angina pectoris was scored according to frequency and character of anginal attacks and the number of nitroglycerin tablets used was recorded during the Diltiazem therapy. We noted significant decrease of the score of anginal attack and the number of nitroglycerin tablets used during the course of Diltiazem therapy. No significant change in blood pressure, heart rate and the product of systolic blood pressure and heart rate was noted during the course of Diltiazem therapy. It is possibel that Diltiazem improved ischemic heart disease by slightly decreasing myocardial oxygen demand and increasing blood flow to the ischemic areas by dilatation of coronary arteries and collateral vessels. There was no abnormal change in laboratory findings during the Diltiazem treatment. These findings suggest that Diltiazem(Herben(R)) is a favorable and safe antianginal agent useful for longterm treatment of anginal pectoris.
Angina Pectoris* ; Blood Pressure ; Coronary Vessels ; Dilatation ; Diltiazem ; Heart Rate ; Humans ; Myocardial Ischemia ; Nitroglycerin ; Oxygen ; Tablets

PURPOSE: Proliferation of bile duct-like structures and fibrosis is a hepatic cellular reaction observed in most forms of human liver disease and in a variety of experimental conditions associated with liver injury. The aim of this study was to investigate the activation of Ito cells and bile duct proliferation in the rat after common bile duct ligation (CBDL). METHODS: Hepatic morphological abnormalities were examined in rats whose bile ducts had been irreversibly ligated for 15, 21, 24 and 28 days. The liver was examined by immunohistochemical staining for alpha-smooth muscle actin, the known marker of activated Ito cells, and light and electron microscopes. RESULTS: After CBDL, the bile canalicular proliferation and interstitial fibrosis were gradually increased in the periportal areas extended to hepatic sinusoids. Ito cells positive for alpha-smooth muscle actin were frequently observed in the periductular space and in perisinusoidal space of Disse. Ito cells and myofibroblasts were gradually increased in the interstitial fibrosis until the 28th day after CBDL. Ito cells and myofibroblasts had microfilaments with dense body at the periphery of the cell. CONCLUSIONS: Our results suggest that Ito cells may be fibroblastic or myogenic. It has also been postulated that during the development of hepatic fibrosis, Ito cells become myofibroblasts or fibroblast like cells.
Actin Cytoskeleton ; Actins ; Animals ; Bile ; Bile Ducts ; Common Bile Duct* ; Fibroblasts ; Fibrosis* ; Hepatic Stellate Cells ; Humans ; Ligation* ; Liver ; Liver Diseases ; Myofibroblasts ; Rats*

Coronary artery fistula is an unusual anomaly that consists of a communication between one of the coronary arteries and a cardiac chamber or vein. It has hemodynamic significance, complicated by congestive heart failure, bacterial endocarditis, rupture or thrombosis of the fistula or an associated arterial aneurysm, myocardial ischemia, and arrhythmias. It occurs in congenital, traumatic, neoplastic, or artherosclerotic cardiac disorders. It is being diagnosed with increasing frequency with widespread use of selective coronary angiography. However, acquired coronary artery fistula after acute myocardial infarction is a rare clinical entity, and it has not been reported in Korea yet. We observed a 62-year-old male patient with intermittent chest pain at rest, in whom serial coronary angiography showed newly developed communications from the left anterior descending coronary artery to the left ventricular chamber several months after acute myocardial infarction of the anteroseptal wall. The area of communication corresponded to the site of infarction as established by contrast echocardiography.
Aneurysm ; Arrhythmias, Cardiac ; Chest Pain ; Coronary Angiography ; Coronary Vessels* ; Echocardiography ; Endocarditis, Bacterial ; Fistula* ; Heart Failure ; Heart Ventricles* ; Hemodynamics ; Humans ; Infarction ; Korea ; Male ; Middle Aged ; Myocardial Infarction* ; Myocardial Ischemia ; Rupture ; Thrombosis ; Veins

Astrovirus is frequently associated with diarrhea in children. It can not be readily isolated by cell culture, and an electronmicroscope is usually used for detection of this agent. Recently in 1995 a combined method of reverse transcription-polymerase chain reaction (RT-PCR) was designed for easier detection of astrovirus, which is based on the conserved sequence in 3'-end of genomes of the 7 known serotypes of human astrovirus. As of yet there has not been any report of astrovirus data in Korea using the RT-PCR methods. The purpose of this study was to detect astrovirus incidence, severity of symptoms, seasonal variation and coinfection rate with rotavirus in Korean children inpatients with diarrhea. Fecal specimens from 61 young children hospitalized with gasteroenteritis Korea from Jan. 1996 through Mar. 1997. They were examined for astroviurs infection by RT-PCR method. Results are as follows: 1. Astrovirus was detected at 9.8% (6/61) from fecal specimens of children with severe diarrhea by EIA using monoclonal antibody coated plates. 2. Astorvirus was detected at 29.5% (18/61) from fecal specimens of children with severe diarrhea by RT-PCR. 3. The age of the 18 children affected by astrovirus ranged from 2 monthes to 7 years with mean of 3.0 years. 4. Mean hospital stay of the 1S children was 6.1 days. 5. Five (27.8%) astrovirus RT-PCR positive strains were confirmed in November and in December, respectively out of 18 specimens in total. 6. Astrovirus coinfection with rotavirus type G1 was confirmed in 15/16 specimens (93.8%), and with type G2 was in 1/16 specimens (6.3%).
Cell Culture Techniques ; Child* ; Coinfection ; Conserved Sequence ; Diarrhea ; Feces* ; Genome ; Humans ; Incidence ; Inpatients ; Korea ; Length of Stay ; Mamastrovirus ; Polymerase Chain Reaction* ; Reverse Transcription* ; Rotavirus ; Seasons

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome. RESULTS: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis. CONCLUSION: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
Appendicitis* ; Diagnosis ; Humans ; Incidence ; Multivariate Analysis ; Postoperative Complications

Intracavernous (IC) injection therapy of vasoactive agents is now being widely choser as the first armamentarium for the treatment of male erectile dysfunction, nevertheless, has a troublesome problems due to the drug delivery vehicle with needle. Therefore, the less invasive route of drug administration has been needed. We investigated the efficacy and safety of intraurethral (IU) instillation of lyposomal prostaglandin E1 on the induction of penile erection. Thirty patients with male erectile dysfunction were enrolled in a prospective study. Overall, 73.3% of cases were responded with 33.3% of full erection and 40% of partial erection after IU instillation. IU self-instillation at home was more effective than at clinic on the induction of penile erection. It is somewhat effective in cases of diabetogenic, psychogenic, neurogenic and mild vasculogenic erectile dysfunction but much less effective in severe vasculogenic and cavernosal disease. Interval of onset and duration of erection were delayed and shortened in IU instillation rather than IC injection. Side effect were mild and transient urethral pain with the most frequent incidence and followed by transient hypotension in less. In conclusion, intraurethral instillation of lyposomal prostaglandin E1 can be selected as one of therapeutic modality to restore the penile erection for some limited patients with erectile dysfunction to want to select a less invasive treatment lternative.
Alprostadil* ; Erectile Dysfunction ; Humans ; Hypotension ; Incidence ; Male ; Needles ; Penile Erection* ; Prospective Studies