Four newborn infants with hyperbilirubinemia, caused by ABO blood group incompatibility, were treated with high-dose intravenous immune globulin(IVIG). As soon as the diagnosis was clinically suspected, these infants received conventional treatment including phototherapy and were monitored closely for bilirubin levels. When bilirubin concentrations reached the risk point in spite of phototherapy, IVIG was given at a dose of 1g/kg for 6 hours. In all cases, bilirubin levels declined within 12 hours after LVIG therapy, and to rebound effect was seen, No side effects of IVIG treatment were observed. We suggest that high-dose IVIG therapy may be useful in the treatment of hyperbilirubinemia due to ABO incompatibility, and reduce the need for exchange transfusion.
Bilirubin ; Blood Group Incompatibility ; Diagnosis ; Humans ; Hyperbilirubinemia* ; Hyperbilirubinemia, Neonatal ; Immunoglobulins, Intravenous* ; Infant ; Infant, Newborn ; Phototherapy

A 20-year-old male patient was admitted to this hospital because of headache and high fever on October 10, 1974. He has insidiously develope frontal headache and high fever for these 10 days, followed by vomiting, convulsions, aphasia and motor weakness on the left extremities and subsequently fell into semicomatose state. Hemogram showed marked leukocytosis, 22500/mm3, and cerebrospinal fluid cell count revealed increased leukocyte, 1210/mm3. Simple skull Roentgenograms showed no significant abnormalities except for suspicious haziness on the left frontal sinus. Carotid angiogram showed distal shift of the anterior cerebral artery, medial displacement of the middle cerebral artery and small avascular area on the left temporo-parietal area. Brain scan showed high activities on the entire left cereral hemisphere. On October 12, 1974 a large fronto-temporo-parietal osteoplastic craniotomy was done. Yellowith green, foul odored pus gushed out from the subdural space of the entire operating fields. Preteus mirabilis was isolated in pus culture. He was discharged with good recovery two months later.
Anterior Cerebral Artery ; Aphasia ; Brain ; Cell Count ; Cerebrospinal Fluid ; Craniotomy ; Empyema, Subdural* ; Extremities ; Fever ; Frontal Sinus ; Headache ; Humans ; Leukocytes ; Leukocytosis ; Male ; Middle Cerebral Artery ; Mirabilis ; Odors ; Seizures ; Skull ; Subdural Space ; Suppuration ; Vomiting ; Young Adult

OBJECTIVE: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. METHOD: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. RESULT: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. CONCLUSION: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.
Adenocarcinoma ; Age Distribution ; Carcinoma, Squamous Cell ; Daejeon ; Humans ; Hysterectomy* ; Incidence ; Korea ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management according to the patient's age and nutritional phase were recommended. Dental management of PWS patients consists of active preventive measures in addition to dietary consultation according to age and nutritional phase.
Adolescent* ; Anesthesia, General* ; Conscious Sedation ; Dentistry ; Emergency Treatment ; Follow-Up Studies ; Humans ; Hyperphagia ; Male ; Practice Management, Dental ; Prader-Willi Syndrome*

Pseudoaneurysm of extracranial high internal carotid artery was rare lesion. Left hemiparesis was suddenly developed after 6 hours following penetrating injury at right mastoid area by air gun. On brain computerized tomography relatively well defined low density was noted at right temporo-parietal area. On right caratid angiography round aneurysmal dilatation, 2.5x3 cm sized was present at the site of metallic shadow in the atlas. The pseudoaneurysm was treated by the method of direct surgical approach, removal of aneurysm and end to end anastomosis with autogenous saphenous vein interposition bypass graft without difficulty. Postoperative course was not uneven.
Aneurysm ; Aneurysm, False* ; Angiography ; Brain ; Carotid Artery, Internal* ; Dilatation ; Mastoid ; Paresis ; Saphenous Vein ; Transplants

From March 1966 to July 1988, 22 patients were diagnosed as discitis among the 2106 operation with total or hemilaminectomy in Department of Neurosurgery of Catholic University Medical College. Main symptoms were severe low back(95%) and buttock pain(86%). Physical examination showed severe paravertebral spasm and tenderness. The erythrocyte sedimentation rate was always elevated in all cases and averaged to 43 mm/hr. X-ray examination of the lumbar spine showed typical findings of decreased intervertebral space, subchondral sclerosis and bony fusion. In bacterial culture staphylococcus aureus and streptococcus epididymis were grown. Good long-term results were seen in all cases.
Blood Sedimentation ; Buttocks ; Discitis* ; Epididymis ; Humans ; Male ; Neurosurgery ; Physical Examination ; Sclerosis ; Spasm ; Spine ; Staphylococcus aureus ; Streptococcus

Chylothorax is an accumulation of lymphatic fluid or chyle in the pleurual cavity resulting from a leak of the thoracic duct or one of its major divisions. If the loss of chyle persist, life threatening nutritional and immunologic deficiencies ensue. Initial conservative managements consist of tube thoracostomy drainage and dietary modification(low fat diet and total parenteral nutrition). In some refarctory cases, surgical intervention is required. Pleuroperitoneal shunt is an alternative surgical method recommended prior to thoracic duct ligation. The shunted fluid in the peritoneal cavity is reabsorbed by peritoenal lymphatic vessels running to join the right lymphatic duct. We experienced a case of chylothorax in a two-month-old female infant. Because there was no underlying disease to cause chylothorax, the diagnosis of idiopathic chylothorax was made. She failed to respond to conservative management and showed severe hypoalbuminemia and lymphopenia. On day 22, a pleuroperitoneal shunt was inserted between the right pleural cavity and the peritoneal cavity. Three weeks after insertion of the shunt, there was no fluid in the right pleural space. After one more week of observation, the shunt was removed.
Chyle ; Chylothorax* ; Diagnosis ; Diet ; Drainage ; Female ; Humans ; Hypoalbuminemia ; Infant ; Ligation ; Lymphatic Vessels ; Lymphopenia ; Peritoneal Cavity ; Pleural Cavity ; Running ; Thoracic Duct ; Thoracostomy

An experiment was planned to observe the histopathological alteration with administration of the Rheomacrodex and blood pressure changes in induced cerebral infarct after occlusion. Eighty well developed cats, weighing 2.3 to 3.5kg, were used in this experiment. The right MCA was exposed through temporal approach and the proximal part of the MCA was occluded with a silver clip. The animals were divided into 4 groups: The control group was comprised of 20 cats with occlusion of the right MCA alone, Rheomacrodex-treated group was comprised of 20 cats after occlusion of right MCA, induced hypotension and hypertension groups consisted in each 20 cats following occlusion of the MCA. The animals were sacrificed at intervals of 3 hours, 6 hours, 24 hours, 1 week and 2 weeks respectively after occlusion of the MCA. The animals were studied for clinical deficits and histopathological changes of the cerebral infarct according to the time courses. The results obtained were as follows: 1) In the control group, severe contralateral hemiplegia was developed in the early stage following the MCA occlusion, however the neurological deficits were progressively improved to the state of abnormal walking in 24 hours to 2 weeks. The hemorrhagic infarct was involving the basal ganglia, internal capsule and extending to the cortex with mild brain edema in the early stage and the area of the infarct was gradually enlarged from 6 hours to 24 hours following the MCA occlusion. Although the brain edema of surrounding area of the lesion was remained unchanged, the size and distribution of the infarct were decreased in one week to 2 weeks. Extensive ischemic neuronal damage was observed in the control group. 2) In the Rheomacrodex-treated group, mild to moderate neurological deficit was developed in the early stage after MCA occlusion and the deficit was less severe than control group. The clinical deficit was improving in the time course and one case had shown completely normal activity in 2 weeks. The distribution of the infarct was well defined and it was smaller than control group. The infarct mainly involved the basal ganglia and internal capsule. The area of the infarct was gradually enlarged from 6 hours to one week after MCA occlusion, then the extent of the infarct was decreased in 2 weeks. The ischemic neuronal change in this group was less severe than control group. 3) In the induced hypotension group, the early neurological deficit was worse than that of the control group and severe hemiplegia was developed in one week. There was minimal improvement of the neurological deficit in 2 weeks. The area of the infarct was ill-defined and hemorrhagic extending a large portion of the brain with severe brain edema. The infart was involving the basal ganglia, internal capsule, claustrum and the cortex from 3 hours to 24 hours after the occlusion and the area of the infarct was not changed during the observation. Severe ischemic nerve cell change or resolution of the cells was oserved in this group. 4) In the induced hypertension group, the neurological deficit was mild and it was better than that of the control group. The distribution of the infarct was well localized and minimum in extent. The extent of the infarct was not changed during the observation. There was no observable gross brain edema and the ischemic nerve cell changes were not severe.
Animals ; Basal Ganglia ; Blood Pressure* ; Brain ; Brain Edema ; Cats ; Dextrans* ; Hemiplegia ; Hypertension ; Hypotension ; Internal Capsule ; Middle Cerebral Artery* ; Neurons ; Silver ; Walking

PURPOSE: Hypogammaglobulinemia has been observed in nephrotic syndrome, but its pathophysiology remains unknown. We evaluated the relationship between the serum IgG and albumin levels for children with minimal change nephrotic syndrome(MCNS). METHODS: The levels of immunoglobulin G(IgG), albumin and total cholesterol of a total of 46 children with MCNS(proteinuria >40 mg/m2/h, and serum albumin level <2.5 g/dL) were analyzed. RESULTS: The mean values of albumin, IgG and total cholesterol in MCNS children were 1.7+/-0.3 g/dL, 368+/-143 mg/dL and 431+/-78 mg/dL, respectively. There was an inverse correlation between the albumin values and the total cholesterol values(r=0.68, P=0.0001), whereas there was a direct-proportional correlation between albumin values and the IgG values(r=0.4, P=0.01). CONCLUSION: The IgG level is associated with albumin level, and it may reflect the severity of urinary protein loss in MCNS. Further studies are needed to evaluate this phenomenon.
Agammaglobulinemia ; Child ; Cholesterol ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Serum Albumin*

It is well known that both acute glomerulonephritis and rheumatic fever are a common sequelae of group A streptococcal infection. However, their simultaneous occurrence is uncommon. Only a few cases have been reported because they are different in epidemiologic, clinical, serologic and immunopathogenic characteristics. We experienced a 10-year-old boy who presented the manifestation of acute rheumatic fever and acute poststreptococcal glomerulonephritis. We report this case with brief review of literature.
Child ; Glomerulonephritis* ; Humans ; Male ; Rheumatic Fever* ; Streptococcal Infections