Retinal hemorrhages in the newborn infant were first described shortly after the invention of the ophthalmoscope(Jaeger. 1961). Frequency of the retinal hemorrhages in the newborn infant has been reported to be between 2.6 and 50%. We postulate that the retinal hemorrhages are caused by maternal factors and fetal factors. Maternal factors include delivery type, maternal age, duration of pregnancy, parity, duration of labor, and maternal blood pressure. Fetal factors include color of the amnionic fluid, body weight, and sex. We examined the fundus of 161 newborn infants and investigated the above factors that influenced the retinal hemorrhages. The results were as follows: 1. The overall incidence of the retinal hemorrhages were 35.4%. 2. According to the delivery types, retinal hemorrhages were found in 57.9% after vacuum extraction, in 41.7% after induction delivery, in 33.8% after spontaneous delivery, and in 13.5% after Cesarean section. 3. As the duration of pregnancy increased in complicated delivery, retinal hemorrhages also tendted to increase. 4. The incidence of hemorrhages were greater in the hypertensive mother and abnormal color of amnionic fluid in spontaneous delivery. 5. The incidence of retinal hemorrhages were greater in the high body weight, multipara, and normal duration of labor. 6. Retinal hemorrhages were not related the maternal age and fetal sex. 7. Retinal hemorrhages were absorbed within four weeks.
Amnion ; Blood Pressure ; Body Fluids ; Body Weight ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Inventions ; Maternal Age ; Mothers ; Parity ; Pregnancy ; Retinal Hemorrhage* ; Retinaldehyde* ; Vacuum

OBJECTIVES: Though a proportion of Alzheimer's disease(AD) patients treated with donepezil have shown positive response on cognition, but the responders' characteristics are still uncertain. This study attempts to identify whether a single oral dose of donepezil(5mg) can change cognition and the relationship between single dose responder items and long-term responder are examined. METHODS: Twenty-three AD patients for single donepezil challenge study group and eleven AD patients for controls were participated in the study. Seven days after baseline study for neuropsychological test and EEG, same studies were rechecked after donepezil medication in study group. In donepezil study groups, 12 weeks after donepezil medication, neuropsychological test and EEG were rechecked. RESULTS: After single donepezil challenge, forward digit span, Rey-Osterrieth Complex Figure Test copy, SVLT delayed recall were significantly improved, and beta spectra power in anterior, theta spectra power in posterior field were significantly decreased. According to linear regression analysis, forward digit span after single donepezil challenge was significantly positive correlated with long-term responders. CONCLUSIONS: This study suggests that single donepezil medication can significantly change cognitive functions and EEG in AD patients. Among these responsive items, forward digit span was significantly correlated with long-term responder.
Alzheimer Disease ; Coat Protein Complex I ; Cognition ; Electroencephalography ; Humans ; Indans ; Linear Models ; Neuropsychological Tests ; Piperidines

PURPOSE: The number of laparoscopy-assisted distal gastrectomy procedures for the treatment of early gastric cancer patient to improve the quality of life has been gradually increasing. This study evaluated the technical feasibility, safety, and surgical results of LADG with lymphadenectomy by reviewing the initial experience. METHODS: From May 2003 to December 2005, 202 LADG with lymphadenectomy were performed on patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. RESULTS: There were 128 males and 74 females with a mean age of 58 years (range 24~78). The mean operation time was 212 minutes (range 105~450) and the operation time has decreased gradually with increasing number of cases. There were 16 operative morbidities (7.9%) including three operative mortalities. The restoration of the bowel sound was noted at 3.1 postoperative days, soft diet was started at 4.4 postoperative days and the duration of the hospital stay was 7.7 days. There were 105 mucosal, 64 submucosal, 22 proper muscle, 4 subserosal and 7 serosal lesions. A total 163 patients were treated with D2, 37 with D1+beta and 2 with D1+alpha LN dissection. The mean number of lymph nodes retrieved was 35 (range=10~81). Lymph node metastasis was noted in 30 patients. CONCLUSION: This study shows that laparoscopic procedure can be applied safely and effectively for the patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for the short- and long-term surgical outcomes is needed.
Diagnosis ; Diet ; Female ; Gastrectomy* ; Humans ; Laparoscopy* ; Length of Stay ; Lymph Node Excision* ; Lymph Nodes ; Male ; Mortality ; Neoplasm Metastasis ; Quality of Life ; Stomach Neoplasms

OBJECTIVES: Since the 1990s, drug-resistant bacteria have become common pathogens of hospital-acquired infections. In recent years, healthcare-associated infections have come to the fore, and it is reported that distribution rates of these bacteria are comparable to those of hospital-acquired infections. However, there have been few studies on differences in resistant bacteria depending on the size of hospitals. Thus, the authors studied differences in drug-resistant bacteria between a tertiary hospital and smaller medical institutions. METHODS: We retrospectively analyzed the clinical findings and sputum culture results of patients transferred from tertiary hospitals (group A, n=74) and those transferred from smaller medical institutions (group B, n=65). RESULTS: The number of patients with malignancy was higher in group A than in group B. The length of intensive care unit stay was longer in group A than in group B. Antibiotic therapy and mechanical ventilation were more frequently used in group A than in group B. There were no significant differences between the 2 groups in bacterial species (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) and their resistance rates to carbapenem, while there were significant differences between the 2 groups in the bacterial species (Acinetobacter baumannii) and its resistance rate to carbapenem. CONCLUSION: In this study, there were significant differences between the 2 groups in the bacterial species and resistance rates to carbapenem for A. baumannii infection unlike other bacterial infections. Further studies on risk factors and patient classification are needed to confirm our results.
Acinetobacter baumannii ; Bacteria ; Bacterial Infections ; Drug Resistance, Bacterial* ; Escherichia coli ; Humans ; Intensive Care Units ; Klebsiella pneumoniae ; Pseudomonas ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers*

The initial presentation of breast malignancy as noninvasive carcinoma in an area of sclerosing adenosis is unusual. Especially, lobular carcinoma in situ in sclerosing adenosis sometimes can be a potential source of confusion with invasive lobular carcinoma. We report a case of lobular carcinoma in situ presenting in adenosis exhibiting patterns akin to invasive lobular carcinoma, thus leading to potential misdiagnosis. Overall architecture of the lesion as seen at lower power and immunohistochemistry can be useful to distinguish between sclerosing adenosis with lobular carcinoma in situ and infiltrating lobular carcinoma.
Breast Neoplasms/pathology* ; Carcinoma in Situ/pathology* ; Carcinoma, Lobular/pathology* ; Case Report ; Female ; Fibrocystic Disease of Breast/pathology* ; Human ; Immunohistochemistry ; Middle Age

BACKGROUND: DNA dependent protein kinase (DNA-PK) composed of Ku70, Ku80 and DNA-PK catalytic subunit (DNA-PKcs), plays an important role in the primary repair of break points of damaged DNA and is involved in the recombination of the V, D, and J genes. Loss of DNA-PK may lead to immunodeficiency and malignant lymphomas. This hypothesis has been supported by animal study in a Ku70 knock-out mouse model. The relationship between DNA-PK and human malignant lymphoma has not yet been studied. METHODS: We examined the loss of DNA-PK proteins in 85 representative cases of different subtypes of malignant lymphoma. Immunohistochemical stains for DNA-PK subunits were performed on formalin-fixed and paraffin-embedded tissue sections. RESULTS: Lymphomas demonstrated statistically significant loss of Ku70, Ku80 and DNA-PKcs. T cell lymphomas showed more loss of DNA-PK proteins in comparison with B cell lymphomas. According to the World Health Organization (WHO) classification system, both T cell lymphomas and high-grade subtypes of B cell lymphomas demonstrated similar degree of loss of DNA-PK proteins. CONCLUSIONS: We confirmed the loss of DNA-PK proteins in malignant lymphomas through the results of our study, and the loss of these proteins seems to be more significant in high-grade lymphomas. These findings support the role of DNA-PK as a tumor suppressor gene.
Animals ; Catalytic Domain ; Classification ; Coloring Agents ; DNA* ; DNA-Activated Protein Kinase* ; Genes, Tumor Suppressor ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Mice ; Protein Kinases ; Recombination, Genetic ; World Health Organization

BACKGROUND: Confluent and reticulated papillomatosis (CRP) is a rare cutaneous disorder, characterized by persistent, scaling brown papules, patches, and plaques located on the trunk, neck, axillae, and shoulders. Many different treatments with variable success have been attempted, and oral minocycline treatment is effective in most patients with CRP. There were a few case reports of CRP responding to topical retinoid, but no clinical studies on the efficacy of the topical retinoid treatment for CRP have been reported. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of the topical tretinoin treatment for CRP. METHODS: A retrospective study was performed based on the medical records and clinical photographs of patients with CRP treated with 0.025% tretinoin cream. RESULTS: Nine patients (4 men and 5 women) were enrolled in the study. The mean age of the patients was 17.4 (11~34) years and the mean age at onset of CRP was 15.1 (3~33) years. The duration of disease varied from 1 month to 7 years. Six of the nine patients showed complete remission, and CRP lesions improved markedly after averagely 6.2 weeks from the beginning of the topical tretinoin treatment. The treatment response was better in patients without itch than in patients with itch (p=0.048). Adverse effects were detected in 3 patients, and were mild irritant contact dermatitis to the topical tretinoin. CONCLUSION: We think that topical 0.025% tretinoin treatment is an effective and safe treatment modality for CRP and this treatment can be an alternative or additional modality to the systemic treatment.
Axilla ; Dermatitis, Contact ; Humans ; Male ; Medical Records ; Minocycline ; Neck ; Papilloma ; Retrospective Studies ; Shoulder ; Tretinoin

Thymoma with psuedosarcomatous stroma is a recently described, rare variant of thymomas that are characterized by having a biphasic histologic pattern which consists of both an epithelial and a spindle cell stromal component. So far only 11 cases having similar histologic findings have been reported world wide. At this time we report a case of this rare variant of thymoma which occurred in a 53-year-old Korean man. This previously healthy patient presented with coughing and an anterior mediastinal mass was then detected radiographically. Mediastinal exploration revealed a 9 x 8 x 8 cm-sized well- encapsulated, ovoid, cystic mass. Histological examination showed a biphasic neoplasm composed of anastomosing nests of epithelial cells and somewhat cellular stromal spindle cells that had advanced degenerative changes. Immunohistochemical staining using the antibodies for cytokeratins, EMA, e-cadherin, and p75NGFR showed a strong expression of these markers in the epithelial component but no expression in the spindle stromal cells. The epithelial tumor cells showed no reactivity to CD5 and L26 and a high proportion of the infiltrated lymphocytes were the cortical type that expressed CD99 and terminal deoxynucleotidyl transferase. Ultrastructural examinations revealed tonofilaments in the spindle cells. Follow up has been done for 5 years after the surgical excision and the patient has been free of disease during that period. Similar to previous reports, this patient had a benign clinical course that was unassociated with myasthenia gravis which appears to be a characteristic of this histologic variant of thymoma. However, our case also showed advanced degenerative features and we could demonstrate ultrastructural evidence of epithelial differentiation in the stromal spindle cells that were not mentioned in the previously reported cases. Based on the results of our studies, we suggest this entity is a distinct type of organotypic thymoma that shows cortical differentiation and abundant cellular stroma.
Case Report ; Human ; Immunohistochemistry ; Male ; Microscopy, Electron ; Middle Age ; Sarcoma/*pathology ; Stromal Cells/*pathology ; Thymoma/*pathology/surgery ; Thymus Neoplasms/*pathology/surgery

No abstract available.
Female ; Humans ; Myiasis

Atrophying pityriasis versicolor is a rare variant of pityriasis versicolor. Clinically, atrophying pityriasis versicolor is characterized by well defined, slightly scaly, depressed macules and patches with minimal symptoms. The etiology of the atrophy is unknown, though several hypotheses have been suggested, including immune reaction to antigens of Malassezia species. A 23-year-old male was presented with multiple, slightly brown colored macules and patches on the chest and back. In the potassium hydroxide preparation, lots of yeasts and hyphae were found. A histopathologic study showed multiple yeasts and hyphae on the stratum corneum, focal epidermal thinning, and perivascular lymphocytic infiltration on the upper dermis. The patient was treated with 100 mg itraconazole a day with topical antifungal agents. After 3 weeks of treatment, clinical improvement and mycological improvement were achieved. We present an additional case of atrophying piryriasis versicolor developed on the chest and back with the review of the relevant literature.
Antifungal Agents ; Atrophy ; Dermis ; Humans ; Hydroxides ; Hyphae ; Itraconazole ; Malassezia ; Male ; Pityriasis ; Potassium ; Potassium Compounds ; Thorax ; Tinea Versicolor ; Yeasts ; Young Adult