Prediction of acetabular development after reduction in treatment of developmental dysplasia of thc hip (DDH) is earlier, the hetter results because it would help ensure optimal timing of additional procedure if necessary. In this respect, authors reviewed retrospectively the radiographs of the hips of 35 children with DDH who had unilateral involvement and treated hy senior author (S.H.Lee) from the heginning with single successful attempt of reduction. The radiographs which were made at the time of initial diagnosis, one, two year nfter reduction und final follow up were assessed of teardrop figures. The results of treatment were classified as satisfactory group(CE > 10degrees ) and unsatisfactory group(CE < 10degrees) judged hy center-edge angle(CE degrees) at final follow-ups. 1. The teardrop figures were classifiable into 4 distinct groups as i)absent. ii)V-shaped, iii)Ushaped, iv) inverted D-shaped. 2. The teardrop figures in normal sides of hip were all U-shaped. 3. In dislocated but with satisfactory result group(24 cases), absent at 2 cases(8%), U-shaped teardrop was seen at 13 cases(54%), V-shaped in 9 cases(38%), and inverted 2-shaped in 0 case at I year after reduction. 4. In dislocated but with unsatisfactory result group( 11 cases), they were mostly of V-shaped(7 cases, 64%). The rest were of ahsent in 4 cases(36%) . hut none of U-shaped and inverted 2-shaped. In conclusions, teardrop figures appeared as significant predictor of future development of hip joint. Teardrop figure which stay as V-shaped at one year after reduction seems suggestive of insufficient reduction of DDH, therehy calls for early additional procedure.
Acetabulum ; Child ; Diagnosis ; Dislocations* ; Dronabinol ; Follow-Up Studies ; Hip Joint ; Hip* ; Humans ; Retrospective Studies

Holoprosencephaly is a developmental malformation complex of forebrain and midface which arises from incomplete cleavage of the embryonic forebrain. It is subdivided into alobar, semilobar and lobar types based on the degree of growth disturbance within the anterior wall of the telencephalon, particularly in the midline. Cyclopia is the most severe form of alobar holoprosencephaly presenting a single median eye and a blind-ending proboscis usually located above the eye. We report a case of alobar holoprosencephaly with cyclopia and proboscis in premature infant.
Holoprosencephaly* ; Humans ; Infant, Newborn ; Infant, Premature ; Prosencephalon ; Telencephalon

No abstract available.
*Diagnostic Errors ; Eosinophilia/*diagnosis/pathology/radiography ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver Abscess/*diagnosis/pathology/radiography ; Liver Neoplasms/diagnosis/secondary ; Male ; Middle Aged ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed

BACKGROUND:With the application of early reperfusion by thrombolysis after acute MI, the importance of nontransmural infarction is increasing. We evaluated 1) the changes of LV dimension, LV fibrosis and transforming growth factor-beta1 (TGF-beta1) mRNA expression in a rat model of nontransmural infarction and 2) effects of angiotensin converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ATRB) treatment after nontransmural infarction. METHOD AND RESULTS: Female Sprague-Dawley rats were subjected to 45 minutes of coronary occlusion followed by reperfusion, and at 5 days after the operation, animals were randomized to untreated (MI-vehicle, n=19), captopril-treated (MI-captopril, n=15) and losartan-treated (MI-losartan, n=14) groups. LV dimension, measured by transthoracic echocardiography, was significantly increased at 26 days after MI, and both captopril and losartan treatment inhibited LV cavity dilatation (LV end-diastolic dimension (mm): MI-vehicle, MI-captopril, MI-losartan; 8.6 +/- 0.2, 7.8 +/- 0.2, 8.0 +/- 0.2, p<0.05 vs. MI-vehicle each). Interstitial fibrosis was reduced with both captopril and losartan treatment (p<0.05 vs. MI-vehicle). TGF-beta1 mRNA increased 2.6 fold at 10 days (p<0.05 vs. pre-MI), and normalized at 26 days after nontransmural MI. Captopril and losartan treatment blocked the induction of TGF-beta1 expression after nontransmural MI (p=S vs. pre-MI). CONCLUSION: After large nontransmural MI, ACEI and ATRB treatments attenuate LV remodeling and decrease interstitial fibrosis, at least partly by blocking the acute induction of TGF-beta1 mRNA expression.
Angiotensins* ; Animals ; Captopril ; Coronary Occlusion ; Dilatation ; Echocardiography ; Female ; Fibrosis ; Humans ; Infarction ; Losartan ; Models, Animal ; Peptidyl-Dipeptidase A* ; Rats, Sprague-Dawley ; Receptors, Angiotensin ; Reperfusion ; RNA, Messenger ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Ventricular Remodeling*

PURPOSE: The subareolar area is often difficult to evaluate ultrasonographically due to tissue shadowing, which obscures visualization of ducts and parenchymal tissue. The purpose of this study is to determine if real-time compound imaging improves evaluation of normal subareolar tissue and solid nodules in subareolar area compared to conventional ultrasonography. METHODS: 190 images of the subareolar area were obtained from 135 patients from March 2001 to July 2002. Thirty-three of 190 images showed solid nodules, extraductal nodules in 30 and intraductal nodules in three. We scanned both conventional and compound imaging with a stationary probe, to maintain an identical projection and tissue pressure. We used two compound techniques; survey mode (S) is made by 3 coplanar images and target mode (T) by 9 coplanar images. The evaluating points were 1) reduction in the density of shadowing, 2) resolution of duct wall, 3) resolution of duct lumen, 4) margin of nodule, and 5) internal echoes of nodule. In a blinded fashion, three radiologists graded the quality of images on a 5-point scale. RESULTS: For reviewer 1/2/3, S showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.1 0.6/0.5+/-0.5), 2) resolution of duct wall (0.9+/-0.2/1.5+/-0.6/1.0+/-0.5), 3) resolution of duct lumen (0.9+/-0.2/1.6 +/-0.6/0.7+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.5/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/- 0.5/1.2+/-0.4) and T showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.2+/-0.6/0.7+/-0.7), 2) resolution of duct wall (1.0+/-0.3/1.5+/-0.6/1.1+/-0.5), 3) resolution of duct lumen (0.9+/-0.3/1.6+/-0.6/0.8+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.6/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/-0.6/1.3+/-0.4). In all evaluating points, two modes of real-time compound imaging were superior to conventional imaging (P<0.05). There was no significant difference between two modes of compound imaging. CONCLUSION: Real-time compound imaging improves evaluation of normal subareolar tissue and subareolar solid nodules compared to conventional ultrasonography by reducing shadowing and increasing anatomic resolution of ducts.
Breast ; Humans ; Shadowing (Histology) ; Ultrasonography*

Intrahepatic arterioportal fistulae are rare, but can induce serious complications such as portal hypertension. We present a patient who developed portal hypertension secondary to an intrahepatic arterioportal fistula which was successfully embolized with occlusive balloon and microcoils. A 47-year-old previously healthy male was admitted to our hospital following an episode of melena and abdominal distension. The noteworthy feature in his previous medical history was a hepatic injury caused by a traffic accident when he was aged 9. He didn't drink liquor at all. General appearance was pale and acutely ill. The abdomen was markedly distended and a very noisy bruit over the liver area was continously heard. Laboratory findings, including liver function tests were completely normal except for anemia (Hb 5.7g/dL) and hepatitis viral markers were all negative. Endoscopy demonstrated gastroesophageal varices as the source of bleeding which was treated with variceal ligation. Computed tomography showed a dilated vascular structure in the periphery of the liver at the arterial phase, which suggested a intrahepaic arterioportal fistula. The fistula was also subsequently identified with duplex ultrasound and angiography. Occlusion of the right hepatic artery was performed with occlusive balloon and microcoils. Ascites was rapidly corrected in accordance with a large amount of diuresis and gastroesophageal varices were also completely disappeared whithin a month. On follow-up examination 18 months after hepatic embolization, duplex ultrasound and selective angiography revealed a minute flow of blood through this fistula, but the patient remains well with no recurrence of signs of portal hypertension.
Abdomen ; Accidents, Traffic ; Anemia ; Angiography ; Ascites ; Biomarkers ; Diuresis ; Endoscopy ; Fistula* ; Follow-Up Studies ; Hemorrhage ; Hepatic Artery ; Hepatitis ; Humans ; Hypertension ; Hypertension, Portal* ; Ligation ; Liver ; Liver Function Tests ; Male ; Melena ; Middle Aged ; Recurrence ; Ultrasonography ; Varicose Veins

BACKGROUND: Airway hyperresponsiveness is expressed as the provocative dose or concentration of the stimulus required to achieve bronchoconstriction, a 20% fall in FEV1 (PD20 and PC20, respectively). A decrease in PC20 may be due to a steeper dose-response curve (hyperreactivity) or to a shift in the curve to the left (hypersensitivity), or both. It has been suggested that many factors, such as genetic factor, airway inflammation, epithelial damage or airway remodeling, are involved in the airway hyperresponsiveness in asthma. OBJECTIVE: In this study, we analyzed the relationship of airway sensitivity and reactivity with bronchial inflammation and structural change in asthmatics. METHOD: The PC20 for methacholine, as the airway sensitivity parameter, and the slope between PC20 and PC40, as the airway reactivity parameter, were measured. Total cell counts and differential cell counts in BAL fluid, percentage of epithelial shedding (ES), basement membrane thickness (BMT) and depth of submucosal collagen deposition (SMC) on bronchial tissue were measured. The patients (n=27) were divided into two groups by median values of ES, BMT, or SMC (32%, 7.3 micrometer, 68 micrometer, respectively). RESULTS: The PC20 showed a significant correlation with baseline FEV1% (r=0.498, p<0.05), and was significantly lower in patients with over 32% of ES than in those with under 32% of ES (2.89+/-1.05 mg/ml vs 5.70+/-3.70 mg/ml, p<0.05). The slope was significantly steeper in patients with thicker BMT or SMC. CONCLUSION: These results suggest that airway hypersensitivity is affected by airway caliber, and airway hyperreactivity is affected by bronchial remodeling in asthma.
Airway Remodeling ; Asthma ; Basement Membrane ; Bronchoconstriction ; Cell Count ; Collagen ; Humans ; Hypersensitivity ; Inflammation ; Methacholine Chloride ; Pathology*

Preventive and therapeutic effects of egg yolk antibody, immunoglobulin Y (IgY), against canine parvovirus (CPV) was evaluated in 25 pups orally challenged with CPV-2a. Oral administration of IgY using powder, paste and coated paste delivery systems was compared. Each type of IgY was administered orally for 17 days from 3 days before challenge. The group of pups administered coated IgY showed mild symptoms such as a moderate decrease in total white blood cell count, no depression, vomiting and diarrhea when compared with other groups. The overall clinical score of the group of pups administered coated IgY was significantly lower than that of the challenge control group. However, mortality did not differ among groups because not all pups received symptomatic treatment. These results implied that oral treatment of coated IgY could improve therapeutic effects against CPV challenge if pups received symptomatic treatment.
Administration, Oral ; Chickens* ; Depression ; Diarrhea ; Egg Yolk* ; Enteritis* ; Immunoglobulins ; Immunotherapy ; Leukocyte Count ; Mortality ; Parvovirus, Canine ; Vomiting

Boerhaave's syndrome, spontaneous esophageal rupture, is lethal and associated with a 70% survival rate despite emergent surgical management in recent reports. Early diagnosis and management is critical for more favorable outcome. But, it is difficult to diagnose early because of the low incidence and lack of specific symptoms and signs. We experienced 37 year-old male patient with Boerhaave's syndrome who was heavy drinker, and suffered from chronic renal failure. He visited a hospital because of hematemesis and severe back pain. He was transferred to our hospital with a nasogastric tube insertion, which was penetrating the distal esophagus. A radiologic examination revealed that the distal tip was located in the left pleural cavity. It was assumed that the tube had passed through the preexisting perforation site. Operation was not performed emergently due to delay in diagnosis and severe hyperkalemia. The patient was in a septic condition, but had recovered slowly after systemic broad spectrum antibiotic therapy, pleural drainage and intrapleural antibiotic injections. An esophagography revealed no leakage of gastro-grafin on the 14th hospital day, and he later completely recovered from sepsis.
Adult ; Back Pain ; Diagnosis ; Drainage ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Hematemesis ; Humans ; Hyperkalemia ; Incidence ; Kidney Failure, Chronic ; Male ; Pleural Cavity* ; Rupture ; Sepsis ; Survival Rate

The purpose of this study was to investigate the genetic features of canine coronavirus (CCV) strains detected in Korea. M gene sequences obtained for isolates from 22 dogs with enteritis over a 5-year period were evaluated. Sequence comparison revealed that the 22 Korean CCV strains had an 87.2 to 100% nucleotide homology. Comparing to the typical reference CCV strains (type II), the nucleotide sequence of Korean strains had homology ranged from 86.3% to 98.3% (89.1% to 99.2% for the amino acid sequence) and 87.7% to 97.8% (92.4% to 100% for the amino acid sequence) when compared to FCoV-like CCV strains (type I). Three amino acid variations in the M gene were characteristic for the Korean CCV strains. Phylogenetic analysis demonstrated that the 22 Korean CCV strains belonged to four typical CCV clusters (i.e., a unique Korean CCV cluster, a type II and transmissible gastroenteritis virus cluster, an intermediate cluster between type I and II, and a type I cluster). This study was the first to identify genetic differences of the M gene from Korean CCV strains and provided a platform for molecular identification of different Korean CCV strains.
Amino Acid Sequence ; Animals ; Coronavirus Infections/epidemiology/*veterinary/virology ; Coronavirus, Canine/*isolation & purification ; Dog Diseases/*epidemiology/virology ; Dogs ; Female ; Male ; Molecular Sequence Data ; Phylogeny ; Polymerase Chain Reaction/veterinary ; Republic of Korea/epidemiology ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Viral Matrix Proteins/*genetics/metabolism