No abstract available.
Pressure Ulcer*

No abstract available.
Wilms Tumor*

Pigmented Paravenous Retinochoroidal Atrophy(PPRCA) is a type of pigmentary retinopathy that affects mostly both eyes symmetrically without inheritance. The PPRCA occurs in both progressive and non-progressive forms, but most cases are non-progressive forms. The fundus appearance of PPRCA is characteristic, with peripapillary pigmentary change as well as areas of retinochoroidal atrophy adjacent to the perivenular pigmentary change. The authors have studied a case of PPRCA which was diagnosed through the characteristic fundus appearance and other ophthalmological examinations.
Atrophy ; Retinitis Pigmentosa ; Wills

A 32 year-old man was scheduled for tracheal reconstruction after having special radiological studies and pulmonary function tests. Atropine was given preoperatively. A radial artery cannula was inserted for blood gas sampling and direct arterial pressure monitoring. The E,K.G. was monitored continuously. With the patient breathing a high concentration of oxygen from a mask, halothane was added to the inspired gas. After intramuscular injection of ketamine, halothane was discontinued. Spontaneous respiration was preserved with assistance when necessary. The larynx, pharynx and trachea were topically anesthetized and then a large-bore rubben orotracheal tube was placed in the trachea above the lesion. Anesthesia was maintained with additional ketamine injection. The trachea was explored through an anterior transverse cervical incision with a median sternotomy. The segment distal to the obstruction as dissected and found to be maligant tissue extending down to near the carina and behind the aortic arch. So, it was imperative to postpone further the surgery. Immediately after skin closure, the trachea was almost completely obstructed and PaCO2 value was above 150 mmHg. Therefore the airway was preserved by a pediatric bronchoscope, which was replaced by a pediatric endotracheal tube. Anesthetic management and tracheal resection and reconstruetion have been reviewed problems of induction in a patient with tracheal obstruction are discussed, and the technics for retaining control of the airway and reducing the hazards of hypoxia and hypercarbia are also stressed.
Adult ; Anesthesia* ; Anoxia ; Aorta, Thoracic ; Arterial Pressure ; Atropine ; Bronchoscopes ; Catheters ; Halothane ; Humans ; Injections, Intramuscular ; Ketamine ; Larynx ; Masks ; Oxygen ; Pharynx ; Radial Artery ; Respiration ; Respiratory Function Tests ; Skin ; Sternotomy ; Trachea

Background: Cellulitis is an inflammatory disease of the skin and subcutaneous tissue caused by bacterial infection and is one of the most common reasons for admission to the Department of Dermatology. There are many biomarkers to help diagnose inflammatory diseases, and the neutrophil-to-lymphocyte ratio (NLR) has recently been raised as an option. Objective: This study aimed to evaluate the efficacy of pretreatment NLR for predicting the severity and prognosis of cellulitis. Methods: We reviewed the medical records of 102 patients diagnosed with cellulitis over the past 5 years. White blood cell count, erythrocyte sedimentation rate, C-reactive protein (CRP) level, procalcitonin level, and NLR were measured on the first day of admission. The associations of CRP, procalcitonin, and NLR ratio with body temperature and number of hospitalization days were assessed. Results: The CRP level and NLR were positively correlated with body temperature. In addition, positive correlations were found between the number of hospitalization days and biomarkers (p＜0.05), with the NLR showing the highest coefficients. Conclusion In patients with cellulitis, the NLR is a helpful parameter for evaluating the severity and prognosis of the disease. However, further studies are required to confirm this.

Orthostatic headache after suboccipital craniectomy has been rarely reported. A 32-year-old man underwent emergent suboccipital craniectomy due to acute bilateral cerebellar infarctions with massive brain edema. Although his neurological deterioration halted after the craniectomy, he still suffered from a severe disabling orthostatic headache. We performed two epidural blood patches at the levels of the lumbar and thoracic spine. He improved considerably a few days after the repetitive epidural blood patches. Epidural blood patches may be a useful treatment modality for post-craniectomy postural headaches.
Adult ; Blood Patch, Epidural* ; Brain Edema ; Headache* ; Humans ; Infarction ; Spine

PURPOSE: Anaplastic thyroid carcinoma is characterized with rapid growing mass of the neck and early infiltration into the surrounding tissue. Because of its advanced presentation in elderly patients with poor general condition, difficulty in diagnosis and lack of effective treatment, it is one of the most lethal cancers in human. The aim of this study was to investigate the clinicopathologic character of anaplastic thyroid carcinoma and analyze the prognostic factors affecting survivals. METHODS: Twenty patients diagnosed anaplastic thyroid carcinoma in Seoul National University Hospital between 1985 and 1999 were reviewed retrospectively. RESULTS: The most common symptom was a rapidly enlarging neck mass. Ten (55.5%) of 18 patients had a concomitant well differenciated thyroid carcinomas and 5 (27.8%) patients had benign thyroid disease on pathologic features. The median survival was 5.5 months and the 2-year survival rate was 27.3%. Among several factors analyzed, tumor size smaller than 5 cm (p<0.001), absence of distant metastases at presentation (p=0.020), patients selected for curative surgical resection (p=0.002), and postoperative radiotherapy (p=0.003) were associated with prolonged survival time. CONCLUSION: In the selected patients(tumor size <5 cm, the absence of distant metastases at presentation, young age (<55), curative surgical resection and adjuvant radiotherapy may be associated with an increased survival time.
Aged ; Diagnosis ; Humans ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Seoul ; Survival Rate ; Thyroid Carcinoma, Anaplastic* ; Thyroid Diseases ; Thyroid Neoplasms

BACKGROUND AND OBJECTIVES: Turner and colleagues introduced a new method that can detect tinnitus in animals. The stimulus is composed of a small background noise that is identical to the pitch of the tinnitus and a large pulse noise that can evoke a startle response. In normal rats, the gap decreases the startle reflex. However, in tinnitus rats, the gap does not decrease the startle reflex. The goal of this study was to optimize the stimulation paradigm so that the prepulse inhibition of N1-P2 amplitude would be maximized in the normal human subjects. SUBJECTS AND METHODS: Seven normal control subjects without tinnitus were recruited. The stimulus was composed of two different sounds: the softer background noise and the louder pulse noise. A 50 msec silent gap was inserted before the pulse noise as the gap condition (G condition) but not in the no-gap condition (N condition). The averaged amplitude of the N1-P2 cortical response was recorded for the G and N conditions. RESULTS: The G/N ratio was the smallest when the gap was 20 msec prior to the pulse noise. The G/N ratio was 84.8+/-16.8% with the Hanning window and 78.5+/-5.9% without the window. The G/N ratio was 91.1+/-24.9%, 78.0+/-5.4%, and 79.0+/-18.1% when the intensity of the background noise was 10, 20, and 32 dB SL, respectively. When the intensity of the background noise was 20 and 32 dB SL, the N1-P2 amplitude of the G condition was significantly smaller than that of the N condition. CONCLUSIONS: The optimal stimulus should be composed of the 1 kHz pulse noise without Hanning window. The intensity of the background noise should be 20 dB HL and the location of the gap should be 20 msec prior to the pulse noise. It seems that with these optimized parameters we could expect a 78.0% inhibition of N1-P2 amplitude in normal subjects without tinnitus.
Animals ; Humans* ; Methods ; Noise ; Rats ; Reflex ; Tinnitus

PURPOSE: This study aims to investigate postnatal growth and examine the longitudinal change of leptin, insulin, insulin-like growth factor-I (IGF-I), adiponectin, and ghrelin in very low birth weight (VLBW) infants. METHODS: Weight, height, and head circumference (HC) were prospectively measured at birth, full term, and at 2, 4, 6, 12 and 24 months of corrected age (CA) in 91 VLBW infants (41 females and 50 males). They were evaluated as either being small for gestational age (SGA) or appropriate for gestational age (AGA). Blood samples were serially taken for IGF-I, insulin, leptin, adiponectin, and ghrelin. RESULTS: 1) Weight, height, and HC Z scores decreased from birth to 2 months of CA at a deeper rate for AGA and birth weight < 1,000 g than for SGA and < 1,000 g birth weight < 1,500 g infants. 2) Weight, height, and HC Z scores increased from 2 months to 24 months of CA for the whole population. 3) 25.0% in the SGA and 5.4% in the AGA group did not show weight catch up growth (< -2 SDS) at 1 year of age (P < 0.05). 4) At 12 months of CA, 16.7% in the SGA and 13% in the AGA group did not show height catch up growth. 5) Leptin, ghrelin, IGF-I concentrations increased during the first 2 years of life in VLBW. 6) 1 year weight Z score is related to term weight Z score (beta = 0.775, P = 0.001). One year height Z score is related to term weight Z score. (beta = 0.632, P = 0.000) CONCLUSION: Rapid catch up growth occurred mainly during the first year of life, irrespective of SGA or AGA. Leptin, ghrelin, and IGF-I concentration increased during the first 2 years of life in VLBW. Rapid catch up growth is thus required to give rapid and enough nutrition after birth in VLBW.
Adiponectin ; Birth Weight ; Female ; Gestational Age ; Ghrelin ; Head ; Humans ; Infant ; Infant, Very Low Birth Weight ; Insulin ; Insulin-Like Growth Factor I ; Leptin ; Parturition ; Prospective Studies