Perinatal asphyxia can cause ischemic injury to immature kidney of neonates. Proximal renal tubule is the most sensitive area, showing various manifestations ranging from mild reversible injury to irreversible tubular necrosis. Aminoglycosides can be nephrotoxic in therapeutic range in immature or damaged kidney. Thess are the very important factors to be taken into corsideration on fluid therapy and nephrotoxic drugs in neonates. The purpose of this study is to detect renal dysfunction resulting from asphyxia and gentamicin treatment. The results were as follows; 1) Urinary 2-microglobulin concentration was significantly higher in neonatal asphyxia group irrespective of meconium stain (p<0.05). The group with neonatal asphyxia only (Ia) showed a gradual decline in urinary 2-microglobulin concentration and no significant difference shown when compared with control group on 7 days old (p>0.05). The group with neonatal asphyxia and meconium stain (Ib) received gentamicin for 7 days. Their urinary 2-microglobulin concentration dropped on 4 the day and increased again on 7 th day (p<0.05). The group with meconium stain only(3) showed no significant difference in urinary 2-microglobulin concentration when compared with control group (p>0.05). 2) No differences were shown in serum creatinine, serum sodium level and urinary creatinine concentrations between each group (p>0.05). 3) No differences were shown in creatinine clearance between each group (p>0.05).Fractional excretion of urinary sodium (FENa) was significantly higher on lst day in group, I, but no differences were shown afterwards (p>0.05). 4) There is no relationship between urinary 2-microglobulin concentration and serum creatinine level, creatinine clearance of FENa. 5) No differences were shown in incidence of renal dysfunction between each group. In conclusion, acute tubular injury by perinatal asphyxia recovered soon after birth. But nephrotoxic gentamicin worsened the recovering tubular injury. In case of mild fetal hypoxia without neonatal asphyxia, proximal tubular injury was not significant.
Aminoglycosides ; Asphyxia* ; Creatinine ; Fetal Hypoxia ; Fluid Therapy ; Gentamicins* ; Humans ; Incidence ; Infant, Newborn* ; Kidney ; Kidney Tubules, Proximal ; Meconium ; Necrosis ; Parturition ; Sodium

No abstract available.
Adult* ; Humans ; Respiratory Distress Syndrome, Adult*

No abstract available.
Child* ; Guillain-Barre Syndrome* ; Humans ; Plasmapheresis*

BACKGROUND/AIMS: The purpose of this study was to evaluate the effectiveness of lamivudine treatment in patients with chronic liver disease caused by chronic infection of hepatitis B virus (HBV). METHODS: Thirty-ive patients with chronic infection of HBV were included in this study who were diagnosed at Hanyang University Hospital from January 1998 to January 1999. They received 150mg of lamivudine per oral once daily for 6 months with follow-p of liver function test, serum HBV DNA and serologic markers for hepatitis B virus every two months. Lamivudine was well tolerated. Eight patients underwent liver biopsies before entering the study and follow-p biopsies were done at 5 patients. RESULTS: Out of all 35 patients, chronic hepatitis patients histologically confirmed were 8, chronic hepatitis patients clinically diagnosed were 25 and liver cirrhosis patients clinically diagnosed were 2. The mean age was 35.7 years. Male-female ratio was 2.2:1. There was no hepatitis B surface antigen (HBsAg) negative seroconversion. The HBeAg loss rate was 26.9%(7/26) and HBeAg seroconversion rate was 10.7%(3/28) at the end of follow-p. Ten patients were anti-Be positive prior to treatment, 3 of them became anti-Be negative at the end of follow-p. Five patients underwent follow-p liver biopsies, in which histologic improvements were shown in 4 cases. Serum replicative HBV DNA by bDNA assay was decreased in all patients and HBV DNA was undetectable in 52.9%(9/17) at the end of treatment. Out of the 15 patients with abnormal alanine aminotransferase (ALT) levels at baseline, ALT level in 7 patients(46.7%) was normalized at treatment completion. Pretherapy ALT level was the only predictive factor for loss of HBeAg by stepwise logistic regression analysis(odds ratio : 1.0208) (95% Confidence Interval : 1.0023 ~ 1.0396) (p value=0.0271). CONCLUSIONS: Lamivudine induced sustained suppression of HBV replication during treatment in all patients. In treating patients with lamivudine, who had chronic liver disease due to chronic infection of HBV, the improvement of liver function test and suppression of viral replication appeared early and was sustained during the 6months treatment. This, in turn, may induce histological improvement as well. Pretherapy ALT level was the only predictive determinant for HBeAg loss during lamivudine therapy, and that should be kept in mind in selecting patients for treatment.
Alanine Transaminase ; Biopsy ; Branched DNA Signal Amplification Assay ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Lamivudine* ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Logistic Models ; Prospective Studies*

No abstract available.
Hemangioma, Cavernous*

No abstract available.
Infant ; Infant, Newborn ; Spasms, Infantile*

BACKGROUND: The purpose of the study was to compare the degree of degeneration of the articular and bursal layers of delaminated supraspinatus tendons based on histological examination. METHODS: Fifty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from the lateral torn edges of the articular and bursal layers of the delaminated tear. Harvested samples were stained with H&E dye and evaluated based on a semi-quantitative grading scale. RESULTS: There were no significant differences in the seven histological characteristics of tendon degeneration: fiber structure, fiber arrangement, round nuclei, regional variations in cellularity, vascularity, collagen stainability, and hyalinization between the articular and bursal layers of the delaminated rotator cuff tear (all p>0.05). Total degeneration scores of articular and bursal sides were 13.1 ± 3.85 points and 13.2 ± 3.42 points, respectively, and were not significantly different (p=0.958). CONCLUSIONS: The study demonstrates that tendon degeneration was similar in the articular and bursal sides of the delaminated fullthickness rotator cuff tear, suggesting that degeneration would be a main etiology for the rotator cuff tear not only in the articular side but also in the bursal side. Considering potential disadvantages of subacromial decompression, this study tentatively suggests routine use of subacromial decompression as well as the need for halting or recovery from rotator cuff degeneration for better rotator cuff repair.
Collagen ; Decompression ; Humans ; Hyalin ; Rotator Cuff* ; Tears* ; Tendons

BACKGROUND/AIMS: As a tumor marker, alpha-etoprotein is widely used. Diagnositic cut-ff value is known as 400 ng/mL in sera. This study is aimed to determine the clinical features of hepatocellular carcinoma (HCC) with reference to serum AFP levels in Korean patients. METHODS: From May 1990 to March 1998, 367 patients diagnosed as HCC, hospitalized and followed-p at Hanyang University Hospital, have been retrospectively analyzed with special reference on serum AFP level at time of diagnosis. The differences in clinical, hematological, and radiological features of HCC, as well as the survival rate in the two groups have been compared. Group 1 (N=182) was defined as an AFP level lower than 400 ng/mL, group 2 (N=185) was defined as an AFP level greater than 400 ng/mL. Comparisons were made by student's t test or chi-quare test. Survival rate was calculated from the time of diagnosis by Kaplan-eier method. Survival curves were also compared using log-ank test. P values less than 0.05 were considered significant. RESULTS: The patients with serum AFP levels above 400 ng/mL showed (1) a lower mean age; (2) a higher level of AST; (3) a higher level of AST/ALT ratio; (4) a high incidence of liver cirrhosis; (5) a high incidence of portal vein thrombosis; (6) a high incidence of positive HBsAg; (7) a low incidence of anti-CV; (8) a low incidence of small HCC but high incidence of large HCC; (9) a high incidence of more advanced TNM stage; (10) a low incidence of single nodular type and high incidence of diffuse type. CONCLUSIONS: Depending on the value of AFP, HCC has some clinical features. In hepatocellular carcinoma, high levels of AFP represent young age, HBV infection more than HCV infection and advanced disease state.
Carcinoma, Hepatocellular* ; Diagnosis ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Liver Cirrhosis ; Retrospective Studies ; Survival Rate ; Venous Thrombosis

“Poland’s syndrome” is a rare congenital disease whereby defects can accompany the chest, nipple, chest wall, and extremities on one side of the body. We diagnosed a 19-year-old male patient who presented to another hospital for a routine physical exam before enlisting in the military and was suspected of having a left brachial plexus injury. His chief complaint was the flatness of the left anterior chest wall without any significant functional inconvenience. Aplasia of the pectoralis minor and costosternal portion of the pectoralis major was observed through physical examination and computed tomography (CT). The patient was diagnosed with left-sided Poland’s syndrome without any limb abnormalities. Poland Syndrome should be highly considered in patients presenting with bilateral chest wall imbalance in the absence of with a recent traumatic history.

Myocardial bridging is defined as segmental engulfment of a major epicardial coronary artery by myocardial fibers, causing a systolic narrowing or milking effect of the coronary arterial segment. During systole, the intramuscular part of coronary artery is compressed by contraction of overbridging ventricular muscle, therefore blood flow distal to the lesion is impaired and angina pectoris or acute myocardial infarction may occur. We experienced a case of Non-Q myocardial infarction in a 42 years-old female patient with myocardial bridge at the proximal and middle part of left anterior descending coronary artery.
Adult ; Angina Pectoris ; Coronary Vessels ; Female ; Humans ; Milk ; Myocardial Bridging* ; Myocardial Infarction ; Systole