We analysed 58 patients who were admitted to the Department of Pediatrics, Yonsei University College of Medicine due to infectious mononucleosis from January 1986 to August 1992. Of 58 patients who had responses to IgM to EBV viral capsid antigen and/or heterophil antibody, 35 patients had hapatitis. Of 35 hepatitis patients, group I consisted of 22 patients who had only EBV infection and group II consisted of 13 patients who had hepatitis B markers or cytomegaloviral markers. The results were as follows: 1) Sex distribution revealed males to females to be 1.1:1. In the age distribution, the proportion of patients with 1 to 3 years of age occupied 40.9% for group I and 30.8% for group II. In non-hepatitis group, 73.9% of patients were in 2 months to 3 years of age. 2) The common presenting symptoms and signs of hepatitis group included hepatomegaly in 24 cases (68.6%), fever in 19 (54.3%), anorexia in 17 (48.6%), throat injection in 16 (45.7%), splenomegaly in 5 (42.9%), and cervical lymphadenopathy in 10 cases (28.6%) etc. 3) In group I, complications or combined diseases included pneumonia in 4 case, disseminated intravascular coagulation in 2 and 1 case in acute pancreatitis. Group II included 1 case of iron deficiency anemia, acute renal failure, peritonitis and pulmonary hemorrhage respectively. 4) Anemia (Hb: <10g/dl) was found in 3 cases (13.6%) for group I, and in 2 cases (15.4%) for group II. Leukocytosis above 10,000/mm3 was demonstrated in 15 cases (68.2%)for group I and in 3 cases (23.1%)for group II. The higher percentage (>15%)of atypical lymphocytes were found in 3 cases (13.6%)for group I and in 1 case(7.7%) for group II. Thrombocytopenia (platelet: <100,000/mm3) was detected in 1 case (4.5%) for group I and in 3 cases (23.1%)for group II. Total bilirubin above 1.0mg/dl was found in 6 cases (27.3%)for group I and in 5 cases(58.1%)for group II. 5) AST level of 100~500IU/L was found in 10 cases(45.4%)for group I, and in 5 cases (38.5%) for group II. AST level above 500IU/L was demonstrated in 1 case (4.5%) and in 3 cases (23.1%) respectively. The mean values of AST level were 253.4 455.3IU/L and 316.7 102.4 IU/L, respectively. 6) Elevated ALT level of 100~500 IU/L was found in 9 cases (40.9%)for group I and in 9 cases(69.2%)for group II. ALT level above 500IU/L was detected in 5 cases (22.7%)for group I and in 3 cases (15.4%)for group II. The mean values of ALT level were 356.9 561.2IU/L and 308.3 259.1IU/L, respectively. 7) Elevated ALT levels returned to normal values within 3 weeks in 14 cases (82.4%) for group I and in 6 cases (66.7%)for group II. The mean duration of normalization of ALT level were 17.3 14.1 days for group I and 19.9 14.8 days for group II. Our results suggest that it AST/ALT levels are elevated and hepatitis A, B, C markers are negative, or if sudden elevated AST/ALT levels are noted in hepatitis B carriers or a patient with cytomegaloviral hepatitis, Epstein-Barr virus infection should be suspected.
Acute Kidney Injury ; Age Distribution ; Anemia ; Anemia, Iron-Deficiency ; Anorexia ; Bilirubin ; Capsid ; Disseminated Intravascular Coagulation ; Epstein-Barr Virus Infections ; Female ; Fever ; Hemorrhage ; Hepatitis A ; Hepatitis B ; Hepatitis* ; Hepatomegaly ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Infectious Mononucleosis ; Leukocytosis ; Lymphatic Diseases ; Lymphocytes ; Male ; Pancreatitis ; Pediatrics ; Peritonitis ; Pharynx ; Pneumonia ; Reference Values ; Sex Distribution ; Splenomegaly ; Thrombocytopenia

The plasma cholesterol, TG,LDG,HDL of 101 Korean hypertensive patients were measured to compare with plasma cholesterol, TG,LDL,HDL level of healthy people(control group). The plasma cholesterol level in hypertensive patients was 189.6+/-39.5mg% and was 188.7+/-33.7mg% in healthy people(P>0.5). The plasma TG level in hypertensive patients was 200.5+/-154.2mg% and was 116.1+/-32.4mg% in healthy people(P<0.05). The plasma HDL level in hypertensive patients was 44.6+/-15.5mg% and was 45.1+/-9.8mg% in healthy people(P>0.05). The plasma LDL level in hypertensive patients was 119.0+/-68.6mg% and was 98.1+/-53.4mg% in healthy people(P>0.05). The serum level of the total cholesterol, HDL and LDL cholesterol in the hypertensive patients group were not significantly different from the control group, but the serum level of the TG was significantly increased in the patients group. We thought that this difference of plasma TG level is due to exogenous TG in hypertensive patient group but further evalution in properties of TG is required.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Plasma

Computerized Tomography can make accurate diagnosis in most of the mediastinal tumors and cysts by assessingtheir location, shape and internal architecture. Authors analysed and present CT findings of 89 surgically provenmediastinal tumpors and cysts that were studied and treated in Seoul National University Hospital during recent 5years. The results are as follows; 1. The most common tumor was teratoma(25 cases). Neurogenic tumor (20 cases),thymic tumor or cyst (16 cases), lymphoma(7 cases), bronchogenic cyst (6 cases), intrathoracic goiter (6 cases),pericardial cyst(3 cases) and cystic hygroma(2 cases) were next in order of frequency. 2. The most constant findings of teratoma was thick walled cystic area(100%), while pathognomonic fat and calcified density were seenonly in 52% and 48% of cases, respectively. 22 cases were located in anterior mediastinum, 2 cases were inposterior mediastinum and a case is in middle mediastinum. 3. There were 20 cases of neurogenic tumor consiting of6 neurilemmomas, 7 ganglioneuromas, 4 neurofibromas, 1 ganglioneuroblastoma, 1 neuroblastoma and 1 malignantschwannoma. Most of them were located in posterior mediastinum with exception of 2 neurilemmomas arising from leftvagus nerve and left recurrent laryngeal nerve in middle mediastinum. Cystic change was seen in 2 cases ofneurilemmoma and in a case of ganglioneuroma. Calcification was seen in 3 cases, of neuroblastoma, aneurilemmoma,and a ganglioneuroma. 4. There were 11 cases of thymoma showing homogeneous solid mass with speckeldcalcification in 4 cases and irregular cystic change in 3 cases. 2 cases were invasive thymoma and myastheniagravis was present in 4 cases. A case of thymolipoma and a case of thymic cyst were included. 5. Lymphoma(2Hodgkin's and 4 non-Hodgkin's) appeared as lobulated, matted mass in anterior mediastinum especially inprevascular area expnading bilaterally. 6. Intrathoracic goiter appeared as slingtly high density mass within termingled calcification and cystic area in 5 cases of secondary goiter and homogeneous high densitymass(100-110 H.U. in precontrast scan) in a case of primary goiter. 7. Among the 6 bronchogenic cysts, 3 werelocated in subcarinal area, 2 were above carina and one was in left hilar area. 3 cases showed high CT number morethan 70 H.U. and others showed water density. 8. 3 cases of pericardial cyst were located in right cardiophrenicangle and all of them showed water density. 9. 2 cases of cystic hygroma were located in superior mediastinum,with extension to lower neck and all of them showed water density.
Bronchogenic Cyst ; Diagnosis ; Ganglioneuroblastoma ; Ganglioneuroma ; Goiter ; Goiter, Substernal ; Granuloma ; Lymphangioma, Cystic ; Mediastinal Cyst ; Mediastinum ; Neck ; Neurilemmoma ; Neuroblastoma ; Neurofibroma ; Recurrent Laryngeal Nerve ; Seoul ; Teratoma ; Thymoma ; Water

Congenial mitral stenosis may be defined as a develpment abnormality of the mitral valve leaflets,commissures, interchordal spaces, papillary muscle,s annulus or immediate supravalvular area producing obstructionto left ventricular filling. Authors had experience of nine cases of congenital mitral stenosis confirmed by twodimenstional echocardiography, angiocardiography and surgery in recent 5 years since 1979, and analyzed them withemphasis on the angiographic findings. The results are as follows; 1. Among 9 cases, 6 patients were male and 3 were female. Age distribution was from 4 months to 11 years. 2. The types of congenital mitral stenosis were 1typical congenital mitral stenosis, 5 cases of parachute mitral valve and 3 cases of supramitral ring. 3. Angiographically typical congenital mitral stenosis showed narrowing of mitral valvular opening, parachute mitralvalve displayed single large papillary muscle with narrowed valvular opening and supramitral ring disclosedsemilunar shaped filling defect between left atrium and ventricle. 4. Associated cardiac and extracardiacanomalies of congenital mitral stenosis, as frequency wise, were ventricular septal defect, patent ductusarteriosus, coarctation of aorta, supra and subvalvular aortic stenosis, mitral regurgitation and double outletright ventricle. 5. Cardiac angiography is essential to diagnose congenital mitral stenosis, but the need of two dimensional echocardiography cannot be ignored.
Age Distribution ; Angiocardiography ; Angiography ; Aortic Coarctation ; Aortic Stenosis, Subvalvular ; Echocardiography ; Female ; Heart Atria ; Heart Septal Defects, Ventricular ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Papillary Muscles

Patients with severe congestive heart failure due to rheumatic heart disease generally have both reduced cardiac output and increased pulmonary and systemic venous pressures. A study was therefore made of the use of vasodilator therapy with orally administered hydralazine, which acts on arteriolar resistance vessels and thus reduces afterload. 55 children aged from 4 years old to 15 year old were divided into two groups. Group I received oral hydralazine(4mg/kg/kay in 4 divided doses) in addition to digoxin therapy for mean duration of 10.5 months. Group II received oral digoxin only. The hemodynamic results using M-mode echocardiography, chest X-ray, and EKG between two groups were analyzed. 1) 4(78%) of 55 patients had only mitral valve involvement and another 12 patients had double valve involvement and all the patients belonged to functional class III or IV fo New York heart Association. 2) Left venticular end-diastolic dimensions and the height of R in V6 on EKG were not changed significantly in both groups. 3) Shortening fraction, LPEP/LVET, and RPEP/RVET were markedly improved in both groups, but the degree of improvement in group I was more significant than in group II. 4) 21(80%) of 26 patients in group I showed significant improvement in functional class(t=1.92, 0.05 Adolescent ; Cardiac Output ; Child* ; Child, Preschool ; Digoxin ; Echocardiography ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Hemodynamics ; Humans ; Hydralazine ; Mitral Valve ; Rheumatic Heart Disease ; Thorax ; Venous Pressure

No abstract available.
Acupuncture* ; Tattooing*

Keratosis punctata of palmar creases has been considered an uncommon variant of keratosis punctata, which itself is considered rare condition. Clinically our case, 32-year-old seaman, shows cup-shaped depression of the epidermis of varying size, from 1-3mrn in diameter, limited to the large flexor creases of the palms and digit. The histologic features are hyperkeratotic and slight acanthotic central epidermal depression without parakeratosis and loss of granular layer. A sparse mononuclear infilterate are seen arround the capillaries in the dermal papillas. No relationship to arsenical agents, syphilis, or genetic factors can be ascertained by history.
Adult ; Capillaries ; Depression ; Epidermis ; Humans ; Keratosis* ; Parakeratosis ; Syphilis

Using immunohistochemical methods, the authors investigated the distribution of tubulin in normal skin and 31 skin tumors, including 11 benign skin tumors and 20 malignant skin tumors, In normal skin, tubulin was strongly expressed in basal cells of the epidermis, sebaceus celis and dermal nerves. Myoepithelial cells, ductalI cells of sveat ducts and outer root sheath cells of hair follicles stained moderat,ely. Lermal fi broblasts showed no staining. In benign tumors including keratoacanthoma, trichoepithelioma, and nevocellular nevus the strornal fibroblast.s were entirely tubulin negative as well as the turnor cells. In basal cell carcinoma, the stromal fibroblasts were negative',whereas tumor cells were weakly positive. In squarnous cell carcinoma(SCC), tumor cells weri, tubulin positive weakly, the degree of tubulin expression of its stroma1 fibroblasts tencied to be in proportional to the grade of malignanr.u. Tumor cells of malignant melanoma and nevocellular nevus were tubulin positive moderately bist the stromal fibrobla.sts were strongly positive only in the cases of malignant melanoma. These results show that the degree of the tubulin; expression in adjacent, stromal cells of epidermal tumors is in proportiona.l to that of their malignancy, These suggest that the expression of tubulin in fibroblasts surrounding tumor cells of malignant melanoma and SCC reflects a stromal alt,eration that might contribute to tumor in vasion, and play a role for cellular motility.
Carcinoma, Basal Cell ; Epidermis ; Fibroblasts ; Hair Follicle ; Keratoacanthoma ; Melanoma ; Nevus ; Skin* ; Stromal Cells ; Tubulin*

BACKGROUND: Induction of general anesthesia with tracheal intubation and skin incision are potent stimuli that can induce increased sympathetic activity, heart rate and blood pressure. We compared the hemodynamic response and catecholamine concentration during general anesthesia with intravenous clonidine pretreatment, a centrally acting -2 adrenoceptor agonist, and without pretreatment. METHODS: Forty ASA I or II patients aged from 20 to 60 years undergoing elective surgery were randomly allocated to two groups. In group I, 5 ml of 0.9% normal saline as control administered intravenously 10 minutes before induction of anesthesia, and anesthesia was induced with thiopental sodium, succinylcholine and maintained with N2O (2.5L/min)-O2 (2.5L/min)-enflurane (1.3~1.8 vol%). In group II, 4 g/kg clonidine diluted in 5ml of normal saline administered intravenously 10 minutes before induction of anesthesia, and anesthesia was induced with thiopental sodium, succinylcholine and maintained with N2O-O2-enflurane (0.5~1.0vol%) and 2 g/kg/hr clonidine was continuously infused. We measured blood pressure, heart rate and plasma catecholamine at preinduction, 1 minute after intubation (T1), 1 (T2) and 30 minutes after skin incision (T3) and compared with group I. RESULTS: There was statistical significance in systolic and diastolic pressure at T1 between two groups. There was statistical significance in heart rate, epinephrine and norepinephrine at T1, T2 and T3 between two groups. CONCLUSION: The elevation of blood pressure, heart rate and plasma catecholamine accompanying tracheal intubation and skin incision may be prevented by administration of intravenous clonidine.
Adult ; Anesthesia ; Anesthesia, General* ; Blood Pressure* ; Brain ; Clonidine* ; Epinephrine ; Heart Rate* ; Heart* ; Hemodynamics ; Hemorrhage ; Hope ; Humans ; Incidence ; Intubation* ; Larynx ; Male ; Norepinephrine ; Plasma* ; Skin ; Spondylitis, Ankylosing ; Succinylcholine ; Thiopental

OBJECTIVE: Our purpose was to evaluate whether maternal body mass index measured before pregnancy are associated with an increased risk of cesarean delivery. METHODS: Maternal weight and height were prospectively collected on 819 women who delivered between 37 weeks and 42 weeks in the College of Medicine, Catholic University of Taegu-Hyosung. Statistical analysis was done using Chi-square tests, prepregnancy maternal weight and height were used to calculate the body mass index, and its contribution to the risk of cesarean delivery was determined. Women with congenital anomaly and pregestational diabetes were exclude from analysis. RESULTS: The analysis of risk factors for cesarean delivery in the 819 women revealed a decreased risk of cesarean delivery with maternal age < or =20 years and multiparity; increased risk of cesarean delivery was noted with maternal age >30 years. Increase in prepregnancy maternal body mass index and total weight gain were significantly associated with increase in the odds of cesarean delivery. CONCLUSION: The risk of cesarean delivery is associated with incremental changes in maternal weight and body mass index before pregnancy after adjustment for potential confounding factors. Prepregnancy counseling about optimizing maternal weight and monitoring weight gain during pregnancy to decrease the risk of cesarean delivery are supported by this study.
Body Mass Index* ; Counseling ; Female ; Humans ; Maternal Age ; Parity ; Pregnancy ; Prospective Studies ; Risk Factors ; Weight Gain