This is a case report of a cystic hygroma with polycystic kidney in a fetus which was suspected by ultrasonography and was confirmed by autopsy. Recently, we have experienced this case in 25-year old woman repeatedly and we report that with a brief review of relevant literature.
Adult ; Autopsy ; Female ; Fetus ; Humans ; Lymphangioma, Cystic* ; Polycystic Kidney Diseases* ; Ultrasonography

PURPOSE: Acute appendicitis is one of the most common surgical problems in pregnancy requiring emergency surgical intervention. To evaluate the clinical characteristics of surgical emergency in pregnancy, we conducted this study. METHODS: A clinical and pathologic retrospective review was conducted of 42 pregnant and 87 non-pregnant patients who underwent appedectomy with preoperative diagnosis of acute appendicitis at Chonnam National University Hospital from January, to December, 2000. RESULTS: Thirty-four (81.0%) of the 42 pregnant patients and 75(86.0%) of the 87 non-pregnant patients had pathologically proven acute appendicitis. Among the 34 cases of acute appendicitis in pregnant patients, the gestational stage at presentation was first trimester in 5 (14.7%), second trimester in 23 (67.6%), and third trimester in 6 patients (17.7%). Two instances of combined Caesarian section and 6 of preterm labor or abortion were associated with surgery. Mean leukocyte count was 13,344/mm3 in the pregnant patients and 12,469/mm3 in the non-pregnant patients. Operation time from symptom presentation was 1.90 days in the pregnant patients and 2.70 days in non-pregnant patients. There were some differences between the two groups. Perforation occurred in 4 (11.8%) of the pregnant patients and 13 (17.8%) of the non-pregnant patients. Postoperative wound infection occurred in 9 (26.5%) of the pregnant patients and 11 (14.7%) of the non-pregnant patients. CONCLUSION: We concluded that there were more difficulties in the diagnosis of acute appendicitis during pregnancy, and that there were no significant differences in clinical findings except for the location of tenderness. Acute appendicitis in pregnancy was associated with fetal morbidity and more rapid progress. In acute abdomen pregnancy, early suspicion and prompt intervention may prevent maternal and fetal complications.
Abdomen, Acute ; Appendicitis* ; Diagnosis ; Emergencies ; Female ; Humans ; Jeollanam-do ; Leukocyte Count ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Retrospective Studies ; Surgical Wound Infection ; Tertiary Care Centers*

Truncus arteriosus is a rare congenital heart disease which is diagnosed in from 1 to 2 percent of congenital cardiac birth. Whithout surgical intervention, survival beyond infancy is unusual. Unoperated patients who survive to adult life have associated pulmonary stenosis or have developed pulmonary arteriolar disease. We report a case of truncus arteriosus in a 17-year-old man with a review of literature.
Adolescent ; Adult ; Heart Defects, Congenital ; Humans ; Parturition ; Pulmonary Valve Stenosis ; Truncus Arteriosus*

PURPOSE: This study was conducted to assess the effects of lights-out at nighttime on body weight, physiological variables, and behavioral status in premature infants and to provide basic data for applying lights-out at night time in premature infants. METHODS: Premature infants of over 32 weeks' corrected age were included in this study (January 2015-June 2015), and were allocated to two groups according to the lights-out at night for 5 hours: study group and control group. Lights-out was applied to the study group from midnight for five hours in a quiet environment. RESULTS: Fifty-two infants were included in the study: 26 in the study group and 26 in the control group. Growth rates of body weight, height, and head circumference were higher in the study group compared to the control group, but there were no statistical differences. In the physiological variables, heart rate decreased by 6.9 beats per minute in the study group, but it increased by 2.7 beats per minute in the control group (P<0.0001) during applied 5 hours at night. Anderson Behavioral State Score decreased in the study group compared to the control group (P=0.042). CONCLUSION: Lights-out at night decreased the heart rate and made the behavioral status more stable. To understand the effects of lights-out on long-term growth and development of premature infants at the highest risk of delayed growth and development, further studies with a larger number of premature infants are needed.
Body Weight* ; Circadian Rhythm ; Growth and Development ; Head ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature*

BACKGROUND: To examine the influencing factors on patients' satisfaction in the emergency department(ED) far quality assurance. METHODS: Patients who visited to the ED were prospectively investigated from November 1 to December 31,1997. Authors developed questionnaire to investigate influencing factors on patients' satisfaction.4 Chi-square test and 115-REL 7.0 were applied far statistical analysis. RESULTS: Patients' satisfaction was significantly related to physical environment variables, accessibility variables, kindness of hospital personnel variables, and patient's trust for doctors variables. In path analysis, willingness for revisit was influenced by patients' satisfaction, accessibility, physical environment, patients' trust for doctors in order, and willingness for recommendation was influenced by accessibility, patients' satisfaction, and kindness of hospital personnel in order. CONCLUSIONS : The influencing factors on patients' satisfaction are physical environment, accessibility, kindness of hospital personnel, and patient's trust far doctors. Willingness far revisit and willingness far recommendation are influenced by patients' satisfaction. In spite of some limitations, the results of this study can be used as a baseline information for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the study of patients' satisfaction in the ED.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Personnel, Hospital ; Prospective Studies ; Surveys and Questionnaires

Nesidioblastosis is characterized by a diffuse proliferation of islet cells arising from pancreatic ducts and is the most common cause of hyperinsulinemic hypoglycemia in newborns and infantile. It is exceedingly rare in adults and no concensus regarding its diagnosis and management is available. We herein describe an elderly man with fasting hypoglycemia, inappropriate insulin hypersecretion. And pathologic examination of his pancreas revealed the characteristic finding of nesidioblastosis confirmed by immunohistochemical stain.
Adult ; Aged* ; Diagnosis ; Humans ; Hypoglycemia* ; Infant, Newborn ; Insulin ; Islets of Langerhans ; Nesidioblastosis* ; Pancreas ; Pancreatic Ducts

PURPOSE: Granulocyte colony stimulating factor (G-CSF) has been known to increase neutrophil production and have anti-inflammatory properties, but the effect of G-CSF on pulmonary system is in controversy. We investigated whether G-CSF treatment could attenuate hyperoxia-induced lung injury, and whether this protective effect is mediated by the down-modulation of inflammatory responses in a neonatal rat model. MATERIALS AND METHODS: Newborn Sprague-Dawley rats (Orient Co., Seoul, Korea) were subjected to 14 days of hyperoxia (90% oxygen) beginning within 10 h after birth. G-CSF (20 microg/kg) was administered intraperitoneally on the fourth, fifth, and sixth postnatal days. RESULTS: This treatment significantly improved hyperoxia-induced reduction in body weight gain and lung pathology such as increased mean linear intercept, mean alveolar volume, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling positive cells. Hyperoxia-induced activation of nicotinamide adenine dinucleotide phosphate oxidase, which is responsible for superoxide anion production, as evidenced by upregulation and membrane translocation of p67phox was significantly attenuated after G-CSF treatment, as were inflammatory responses such as increased myeloperoxidase activity and mRNA expression of transforming growth factor-beta. However, the attenuation of other proinflammatory cytokines such as tumor necrosis factor-alpha and interleukin-6 was not significant. CONCLUSION: In sum, G-CSF treatment significantly attenuated hyperoxia-induced lung injury by down-modulating the inflammatory responses in neonatal rats.
Animals ; Animals, Newborn ; Blotting, Western ; Female ; Granulocyte Colony-Stimulating Factor/*therapeutic use ; Hyperoxia/*complications ; In Situ Nick-End Labeling ; Interleukin-6/genetics ; Lung/*drug effects/*metabolism ; Lung Injury/*drug therapy/etiology/genetics/metabolism ; NADPH Oxidase/metabolism ; Peroxidase/metabolism ; Pregnancy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta/genetics ; Tumor Necrosis Factor-alpha/genetics ; Weight Gain/drug effects

BACKGROUND: This study was designed to evaluate the clinical, endocrinological and histological characteristics of adrenal incidentalomas. METHODS: Eighty patients (41, males; 38, females; age range 17-80 years) who were diagnosed with adrenal incidentaloma at Korea University Hospital from 1992 to 2003 were studied retrospectively. RESULTS: Endocrinological investigation revealed 16 pheochromocytomas (20%), nine Cushing's syndromes (11%), eight primary aldosteronism (10%) and 46 non-functioning tumors (58%). Forty-four patients received operations, and biopsies were performed on two patients. Pathologic examination revealed 16 adrenocortical adenomas (20%), five carcinomas (6%), 13 pheochromocytomas (16%), three metastatic cancers (4%), and other tumors (10%). The diameter of the carcinomas (mean: 10.8 cm, range: 5-19 cm) were significantly larger than the diameter of benign adenomas (mean: 2.84 cm, range: 1-6 cm) (p=0.002). According to the receiver operating charactenstic (ROC) curve analysis, the cut-off value of tumor size for discriminate malignant tumor was 4.75 cm (sensitivity 90%, specificity 58%). Twenty-four patients with non-functioning tumors were followed up for a period of 3 to 72 months. During the follow up period, two patients showed an increase in tumor size of more than 1 cm, and one patient developed Cushing's syndrome. Changes in mass size and function were observed only between 10 and 26 months after the initial diagnosis. CONCLUSIONS: These data show that an endocrine evaluation should be performed in all adrenal incidentalomas, and an adrenalectomy is recommended for tumors 5 cm or greater or tumors with adrenocortical hyperfunction. In addition, these tumors should be monitored for changes in mass size and function for a follow up period of approximately 26 months.
Retrospective Studies ; Pheochromocytoma/diagnosis ; Middle Aged ; Male ; Korea ; *Incidental Findings ; Humans ; Female ; Carcinoma/diagnosis ; Aged, 80 and over ; Aged ; Adult ; Adrenocortical Adenoma/diagnosis ; Adrenal Gland Neoplasms/*diagnosis ; Adolescent

We measured the ciliary beat frequencies (CBFs) in respiratory ciliated epithelia obtained from the nasal cavity, trachea, and bronchus of 40 subjects during fiberoptic bronchoscopy, using a video-computerized analysis technique. The subjects were classified into various groups based on a range of parameters, including sex, age, history of smoking and whether or not a local anesthetic has been used and mean values of CBFs were analyzed between these groups. The ciliary beat of nasal epithelial cells was significantly faster than that of the trachea or bronchus (p=0.008). There were significant positive correlations between the CBFs at the nasal cavity and trachea (R2=0.467, p<0.001), nasal cavity and bronchus (R2=0.566, p<0.001), and trachea and bronchus (R2=0.541, p<0.001). Subjects older than 60 years of age had significantly slower CBFs at all three sites and than their younger counterparts (p<0.001). Neither sex nor smoking affected the ciliary motility at any site of the respiratory tract. There was no significant difference in the nasal CBFs between the anesthetized and non-anesthetized sides. In conclusion, this study can provide important clinical data on the CBFs of respiratory tracts in humans.
Bronchi ; Bronchoscopy ; Cilia ; Epithelial Cells ; Humans* ; Lidocaine* ; Nasal Cavity ; Respiratory System ; Smoke* ; Smoking* ; Trachea

PURPOSE: It is increasingly important to diagnosis asymptomatic infections which make up a majority (90%) of congenital cytomegalovirus (CMV) infections and that they may have sequeles such as sensorineural hearing loss and mental retardation. Recently antigenemia assay has been developed by using monoclonal antibodies against early structural protein pp65 of CMV. This CMV antigenemia assay seems to be more quicker to diagnosis than conventional viral culture or other tests. In this study, we evaluated the CMV antigenemia assay in neonatal congenital asymptomatic CMV infections comparing it to the CMV specific IgM test that uses enzyme immunoassay. METHODS: From October 1995 to May 1996, 231 normal term newborns delivered with asymptomatic in St. Holy Hospital of Catholic University were included. The CMV antigenemia assay was performed with CMV-vueTM Kit by immunocytochemical staining and the CMV specific IgM test was performed with Enzygnost Anti-CMV/IgM by using an enzyme immunoassay. RESULTS: Three cases (male 2, female 1) were CMV pp65 antigenemia assay positive, but none of them were CMV specific IgM antibody test positive. The CMV pp65 antigenemia assay was more sensitive than CMV specific IgM antibody test for detection of congenital asymptomatic CMV infections by 1.3% and 0%, respectively. CONCLUSION: According to previous results, we suggest that the rate of congenital CMV infections using only CMV specific IgM tests have been underestimated. We recommend the CMV antigenemia assay as the preferred method for more rapid and accurate diagnosis of CMV infections. And congenital asymptomatic CMV infections should be diagnosed and followed up because of possible future sequeles.
Antibodies, Monoclonal ; Asymptomatic Infections ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis ; Female ; Hearing Loss, Sensorineural ; Humans ; Immunoenzyme Techniques ; Immunoglobulin M* ; Infant, Newborn ; Intellectual Disability