Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

No abstract available.
Sepsis*

PURPOSE: Apoptosis is a process of active cell death which has been suggested to be part of hippocampal cell loss caused by kainic acid (KA). Immature rats showed higher susceptibility and mortality to KA but did not develop recurrent seizure, long term behavioral or neuropathologic changes. We investigated whether this was due to age-dependent resistance, and elucidated the molecular mechanics which mediate P53-induced apoptosis, identifying bax and bcl-2 as P53 protein expressions that serve as a paradigm on how the balance of bcl-2 to bax is differentially altered by apoptotic stimuli. METHODS: Sprague-Dawley rats were classified into postnatal age (P) 10, 15, 20 and 30 days and given specific doses of i.p. KA (P10; 3mg/kg, P15; 4mg/kg, P20; 8mg/kg, P30; 10mg/kg). Only rats that achieved continuous clonic seizure were selected and decapitated at 24, 48, and 72h (n=15 each age). We analysed P53, bax and bcl-2 protein expressions by immunohistochemistry as well as apoptosis by TUNEL in each group. RESULTS: KA-induced hippocampal cell death first appeared in P20. Remarkable expressions of apoptosis, P53 and bax, while bcl-2 proteins were suppressed were observed at 48 hours following KA in P20 and the most prominently affected areas were hippocampal CA1 and CA3 neurons. Similar results were obtained in P30. CONCLUSOIN: A Induction of P53, a growth regulatory gene which has been implicated in apoptosis and the changes in bcl-2 to bax ratio may be important to KA mediated excitotoxicity of specific regions during the critical period of developing rat brain.
Animals ; Apoptosis* ; Brain ; Cell Death ; Critical Period (Psychology) ; Genes, Regulator ; Hippocampus* ; Immunohistochemistry ; In Situ Nick-End Labeling ; Kainic Acid ; Mechanics ; Mortality ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Seizures*

PURPOSE: The study aimed to explore the health consequences that women experienced after miscarriage and the factors related to them. METHODS: A convenience sample consisting of 102 women who had miscarried within 2 years was used. Women were recruited from hospitals and enterprises in Seoul and Gyeong-Gi Province. Participants completed a self-administered questionnaire containing a physical and psychological symptoms checklist developed for this study. RESULTS: More than 40% of the miscarriages occurred after 9 weeks of pregnancy and 35% of women were found to have had a previous miscarriage prior to this study. Psychological symptoms were more prevalent and prolonged than the physical symptoms, furthermore, the frequencies of the symptoms experiencedwere not consistent with the duration of symptoms. Employed women and women with early miscarriages complained of more physical symptoms; however, psychological symptoms were not different according to women's characteristics. Employment was a significant factor affecting physical symptoms. CONCLUSION: Health care professionals need to inform and educate women and the family of the potential health changes during the recovery after the miscarriage. Health consequences due to miscarriages also need to be incorporated in women's reproductive health care. Nursing care should consider factors of maternal age, employment status, and obstetrical conditions upon the apparent social changes.
Abortion, Spontaneous ; Checklist ; Delivery of Health Care ; Employment ; Female ; Humans ; Maternal Age ; Nursing Care ; Pregnancy ; Surveys and Questionnaires ; Reproductive Health ; Social Change

A series of clinical studies on the psychiatric aspects of hemodialysis and kidney transplantation were done with Korean patients, kidney donors, their families and unit nurses. All subjects were interviewed and evaluated for their psychiatric reactions and symptoms and for the underlying causes. Depression was the most common reaction, although the clinical features were somewhat different between groups studied. In addition, a unique and episodic psychotic syndrome was found in four patients. Depression and psychotic episodes seemed to reflect the psychodynamic components such as instinctual frustration, physical, familial and financial loss, dependency on a machine, sensory deprivation and the so-called fear of death and fear of life. These seemed to follow the unique features of hemodialysis and transplantation. The main defense mechanism seemed to be denial. The possible role of psychiatrists was discussed for evaluation, treatment, and prevention of these reactions and for the support of the family and the treatment team.
dult ; Aged ; Female ; Human ; Kidney Transplantation* ; Korea ; Male ; Middle Age ; Renal Dialysis/psychology* ; Transplantation, Homologous/psychology*

PURPOSE: To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. MATERIALS AND METHODS: One hundred and seventy three patients with clinical diagnosis of avascular necrosis of fthe emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of involvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. RESULTS: Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8% ; the location of 79 lesions was other than the femoral head, This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. CONCLUSION: in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to avoid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated.
Alcoholism ; Calcaneus ; Diagnosis ; Diagnostic Errors ; Femur ; Head* ; Humans ; Humerus ; Kidney Transplantation ; Knee Joint ; Lower Extremity ; Necrosis* ; Neoplasm Metastasis ; Osteonecrosis ; Risk Factors ; Steroids ; Technetium Tc 99m Medronate*

PURPOSE: To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. MATERIALS AND METHODS: One hundred and seventy three patients with clinical diagnosis of avascular necrosis of fthe emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of involvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. RESULTS: Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8% ; the location of 79 lesions was other than the femoral head, This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. CONCLUSION: in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to avoid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated.
Alcoholism ; Calcaneus ; Diagnosis ; Diagnostic Errors ; Femur ; Head* ; Humans ; Humerus ; Kidney Transplantation ; Knee Joint ; Lower Extremity ; Necrosis* ; Neoplasm Metastasis ; Osteonecrosis ; Risk Factors ; Steroids ; Technetium Tc 99m Medronate*

PURPOSE: We wanted to evaluate the clinical and radiological results after performing arthroplasty for an intertrochanteric fracture in patients 70 years of age or older, and we used a new fixation technique of the greater trochanter. MATERIAL AND METHODS: From January, 2004 to August 2007, we treated 21 cases (M/F: 3/18) of intertrochanteric fracture with hemiarthroplasty with modified double tension band wiring. All the cases were above type 2 (AO/OTA A1.3) according to the Jensen modification of the Evans classification, and all the patients were elderly. The fractures were evaluated for the fracture pattern by using simple radiography and 3D computed tomography. We analyzed the clinical and radiological results at a minimum of 12 months (range: 12~36 months). RESULTS: We performed hemiarthroplasty with modified double tension band wiring. Two cases (9.5%) among the 21 cases developed loss of reduction due to an additional injury and one of them underwent reoperation using a greater trochanter reattachment device (GTRD). The greater trochanters were well maintained without displacement and excellent union was seen at the fracture site of 19 cases. CONCLUSION: The modified double tension band wiring technique, along with several other fixation methods, should be considered to easily obtain rigid fixation in an unstable intertrochanteric fracture.
Aged ; Arthroplasty ; Displacement (Psychology) ; Femur ; Hemiarthroplasty ; Humans ; Reoperation

Although central catheter-related complications are frequently reported and are inevitable in the neonatal care unit, the incidence of pericardiac tamponade is low but may be fatal. Index of suspicion, prompt diagnosis, and urgent pericardiocentesis are crucial for lifesaving. We encountered two premature cases of central venous catheter-related pericardial tamponade. The first case was a 4-day-old male premature infant (gestational age [GA], 33(+5) weeks; birth weight [BW], 1,864 g), and the second case was a 4-day-old female premature infant (GA, 28(+6) week; BW, 1,050 g). Each infant had an indwelling central venous catheter since birth and at the third day of hospitalization. The conditions of the babies suddenly deteriorated, but both babies were successfully resuscitated with urgent echocardiography and prompt pericardiocentesis.
Birth Weight ; Cardiac Tamponade* ; Central Venous Catheters ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Male ; Parturition ; Pericardiocentesis

Peritoneal desmoplastic small round cell tumor is a very rare malignant neoplasm and has specific clinical features; It is predominant in children and young males and has a well-demarcated large intra-abdominal tumor, which has not been associated with a primary visceral organ, with diffusely scattered multiple small tumors and rarely involves ovaries. It is a very aggressive and fast growing tumor along the peritoneal surfaces of the abdomen and pelvis. It has a typical histologic features and a specific immunohistochemical staining pattern. There is no definite treatment. It responses to surgery and chemotherapy at early period of therapy but relapses soon and rapidly progresses and then causes the death. We have experienced a peritoneal desmoplastic small round cell tumor which involved both ovaries, so we report this case with a brief review of literature.
Abdomen ; Child ; Desmoplastic Small Round Cell Tumor* ; Drug Therapy ; Female ; Humans ; Male ; Ovary* ; Pelvis ; Recurrence