No abstract available.
Gene Expression* ; Microscopy, Electron, Scanning* ; Virulence*

A case of congenital diaphragmatic hernia in a newborn was presented, who had characteristic clinical and X-ray findings. The case manifested dyspnea, cyanosis and shift of the heart and mediastinum to the right immediately after birth, which was throught to be congenital diaphragmatic hernia and verified by autopsy. On autopsy, a large left diaphragmatic defect resulting massive diaphragmatic hernia and ipsilateral pulmonary hypoplasia were found. The authors report the case with review of pertinent literature.
Autopsy ; Cyanosis ; Dyspnea ; Heart ; Hernia, Diaphragmatic* ; Humans ; Infant, Newborn ; Lung* ; Mediastinum ; Parturition

The authors experienced a case of generalized bytomegalic inclusion diseas, characterized by numerous petechiae associated with anemia and hepatomegly, in the premature infant who was hypotonic and cyanosed, with respiratory difficulty and an Apgar score of 4 at 1 minute. The rapid deterioration of the case condition was followed by the death occurring nine hours after birth. The diagnosis was confirmed by the autopsy, and a brief review of the literature was made.
Anemia ; Apgar Score ; Autopsy* ; Cytomegalovirus Infections* ; Diagnosis ; Humans ; Infant, Newborn ; Infant, Premature ; Parturition ; Purpura

No abstract available.
Purpura, Schoenlein-Henoch*

One of the rarest anomalies of the urinary tract is crossed renal ectopia. In Crossed Renal Ectopia, the kidney may be fused or unfused. The fused type is more common. The Diagnosis is made by a combination of urologic and radiologic technics including intravenous pyelography, Cytoscopic examination, retrograde pyelography and retroperitoneal air insufflation. The treatment of renal ectopia without fusion is that of the complicating disease in a kindney normally placed. This paper presented one care of crossed renal ectopia with fusion in a 5 month old female patient who admitted with high fever, oliguria and a palpable abdominal mass. The literatures were reviewed briefly.
Diagnosis ; Female ; Fever ; Humans ; Infant ; Insufflation ; Kidney ; Oliguria ; Urinary Tract ; Urography

Caudal anesthesia has become increasingly widespread in pediatric surgery in recent years, especially for operation below the umbilicus. A prospective study was made to determine the efficacy of caudal anesthesia for pediatric urologic surgery. Seventy five patients who had analogous age and disease were entered in this study (caudal block with light general anesthesia in 47 patients and general anesthesia alone in 28 patients). The children who had caudal block were in psychologically ideal condition with reduced postoperative pain and less demand of analgesics during postoperative period. There were no toxic reactions of local anesthetics and technical faults in the caudate anesthesia. In conclusion, caudal anesthesia was notable for its simplicity, safety and effectiveness and was particularly useful in patients who have the propensity to develop bladder spasm.
Analgesics ; Anesthesia ; Anesthesia, Caudal* ; Anesthesia, General ; Anesthetics, Local ; Child ; Humans ; Pain, Postoperative ; Postoperative Period ; Prospective Studies ; Spasm ; Umbilicus ; Urinary Bladder ; Urology*

This study examines the combined effects of caloric restriction on body composition, blood lipid, and satiety in slightly overweight women by varying food density and aerobic exercise. Twenty-three women were randomly assigned to one of two groups for a four-week weight management program: the high-energy density diet plus exercise (HDE: n = 12, 22 +/- 2 yrs, 65 +/- 7 kg, 164 +/- 5 cm, 35 +/- 4 % fat) and low-energy density diet plus exercise (LDE: n = 11, 22 +/- 1 yrs, 67 +/- 7 kg, 161 +/- 2 cm, 35 +/- 4 % fat) groups. Subjects maintained a low-calorie diet (1,500 kcal/day) during the program. Isocaloric (483 +/- 26 for HDE, 487 +/- 27 kcal for LDE) but different weight (365 +/- 68 for HDE, 814 +/- 202 g for LDE) of lunch was provided. After lunch, they biked at 60% of maximum capacity for 40 minutes, five times per week. The hunger level was scaled (1: extremely hungry; 9: extremely full) at 17:30 each day. Before and after the program, the subjects' physical characteristics were measured, and fasting blood samples were drawn. The daily energy intake was 1,551 +/- 259 for HDE and 1,404 +/- 150 kcal for LDE (P > 0.05). After four weeks, the subjects' weights and % fat decreased for both LDE (-1.9 kg and -1.5%, P < 0.05) and HDE (-1.6 kg and -1.4%, respectively, P < 0.05). The hunger level was significantly higher for HDE (2.46 +/- 0.28) than for LDE (3.10 +/- 0.26) (P < 0.05). The results suggest that a low-energy density diet is more likely to be tolerated than a high-energy density diet for a weight management program combining a low-calorie diet and exercise, mainly because of a reduced hunger sensation.
Adult ; Body Composition ; Caloric Restriction ; Diet ; Energy Intake ; Exercise ; Fasting ; Female ; Humans ; Hunger ; Lunch ; Overweight ; Sensation ; Weights and Measures

BACKGROUND: Gastric cancer remains the main cause of cancer-related death in Korea. Accurate preoperative staging of gastric cancer is essential to predict prognosis and to plan optimal treatment. Although there are many reports dealing with the diagnostic values of conventional methods, controversies are still present especially in the field of preoperative staging. In this study, we evaluated the accuracy of gastroscopy and upper gastrointestinal series(UGI) for diagnosis of gastric cancer, and determined the usefulness of ultrasonography and computed tomography for preoperative staging. METHODS: One hundred twenty-three patients, who underwent operation from Aug. 1991 to Mar. 1995 under the diagnosis of gastric cancer were analyzed. We excluded 15 patients because their postoperative definitive stagings were undetemined. RESULTS: 1) Among 123 patients, the proportion of early gastric cancer was 26.0%(32/123) and that of the advanced gastric cancer was 74.0%(91/123). 2) The sensitivity of endoscopic diagnosis of gastric cancer was 96.7%(119/123), and the accuracy to determine the depth of invasion was 82.9% (102/123). 3) The sensitivity of UGI study for gastric cancer was 89.9%(98/109), and the accuracy to determine the depth of invasion was 61.5%(61/109). 4) The sensitivity of abdominal ultrasonography to detect the tumor was 11.3%(8/71), the accuracy to determine the T stage was 29.2%(28/96), and the sensitivity and specificity to detect lymph node metastasis was 13.6%(8/59), 100%(37/37), respectively. 5) The sensitivity of abdominal CT to detect the tumor was 74.3%(26/35), the accuracy to determine the T stage was 32.5%(13/40), and the sensitivity and specificity to detect lymph node metastasis were 34.5%(9/29), 72.7%(8/11), respectively. 6) The accuracy of preoperative staging was 45.5%(56/123). The 49.6%(62/123) of gastric cancer was downstaged, whereas only 4.1%(5/123) was overstaged. CONCLUSION: Our results show that high accuracy for diagnosis of gastrie cancer with the gastroscopy and UGI. However preoperative staging with ultrasonography and computed tomograpy was often underestimated, which could be concluded that the usefulness of the radiologic methods was limited.
Diagnosis* ; Gastroscopy ; Humans ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Blood glucose control in diabetic mothers during pregnancy is very important because it can affect fetal and neonatal outcomes. We therefore investigated the clinical outcomes of infants of diabetic mothers in relation to the maternal HbA1c level. METHODS: The subjects were diabetic mothers and their newborns who were admitted in Wonkwang University Hospital from July 2007 to June 2012. We retrospectively reviewed the medical records of 73 neonates, out of the 128 born to diabetic mothers and investigated neonatal and maternal characteristics based on the differences in maternal HbA1c levels. 55 neonates was excluded because maternal HbA1c was not measured. RESULTS: The mean time for testing the maternal HbA1c was 30+/-5.0 weeks, and the mean level was 6.7+/-1.4%. The mean birth weight in neonates was 3,094+/-831.6 g and was higher in the group with > or =7% HbA1c than in the group with < or =6.4% HbA1c (3,370+/-950.8 g vs. 2,855+/-661.97 g, P=0.0113). When assessing neonatal morbidity, the rates of hypoglycemia (56.0% vs. 28.6%, P=0.0381), large baby (36.0% vs. 4.8%, P=0.0015) and congenital heart disease (CHD) (28% vs. 0%, P=0.0055) were higher in the group with > or =7% HbA1c than in those with < or =6.4% HbA1c. Serum blood sugar level was significantly lower in the group with > or =7% HbA1c than those with < or =6.4% HbA1c (26.5+/-10.5 vs. 35.9+/-8.3 mg/dL, P=0.0196). When considering the rate of large babies (> or =4,000g), there were no differences in birth weights between both groups. CONCLUSION: If the maternal HbA1c level during pregnancy is above 7% with glucose control failure, infants born to diabetic mothers are susceptible to hypoglycemia, large baby syndrome and CHD.
Birth Weight ; Blood Glucose ; Glucose ; Heart Defects, Congenital ; Humans ; Hypoglycemia ; Infant* ; Infant, Newborn ; Medical Records ; Mothers* ; Pregnancy ; Retrospective Studies

PURPOSE: Baby-walkers are used by many parents because of the convenience they provide in keeping children occupied, quiet, happy, and in stimulating ambulation. But, these devices have more risks than benefits. Therefore, we performed a study to evaluate the effects of baby-walkers on motor development of human infants according to the hours used in a day, total duration(months), and types of injuries associated with the walkers, and to establish effective methods. METHODS: 1,045 questionnaires were filled out by parents who had a baby whose aged between 8 months and 15 months that visited local pediatric clinics and medical centers in Chonju and Iksan from May 1, 2002 to July 31, 2002. They were analyzed in a control group that didn't use baby- walkers, a low-user group that used baby-walkers less than 2 hours a day and a high-user group that used them more than 2 hours a day. RESULTS: The mean age of the 1,045 babies whose parents responded to the question investigation was 12.6+/-2.4 months. The number of babies who used the baby- walkers were 811(77.6%). Crawling and walking alone were delayed in the high-user group. The parents who knew the side effects of the baby-walkers totalled 392(48.3%). CONCLUSION: The findings of this study revealed that many parents didn't know the effects of baby-walkers on motor development in their infants and the risks associated with baby-walkers. Therefore, we should educate parents on the risks of baby-walkers and recommend reducing the use of baby-walkers.
Child ; Humans* ; Infant* ; Jeollabuk-do ; Parents ; Surveys and Questionnaires ; Walkers ; Walking