No abstract available.
Anemia, Aplastic*

Intraventricular hemorrhage (IVH) is common in the premature infants and occurs mainly in subependymal germinal matrix. In contrast, IVH in the term infants is rare and different in pathogenesis and bleeding sites from those of the premature infants. Most studies of IVH in term infants have been studied by computerized tomography and postmortem examination. Brain ultrasonography which has become a frequently used diagnostic tool of IVH in the premature infants is reported to be also effective in diagnosis in the term infants. The study population comprised 11 term neonates admitted to the Neonatal Intensive Care Unit of Seoul National University Children's Hospital between July 1989 and June 1991, in whom IVH was diagnosed by ultrasonography. We analysed severity of birth asphyxia. ultrasonographic findings and clinical manifestations to investigate severity, timing, risk factors, and pathogenesis of IVH in the term neonates. 1) Apgar scores were available in 7 cases with severe asphyxia (Apgar at 1 min: less than 3), 1 cases with mild asphyxia (Apgar at 1 min: between 5~7), and 2 cases without asphyxia. 2) Clinically, 4 cases had fetal distress, and 3 cases had meconium aspiration pneumonia. 3) Bleeding sites by ultrasonography were subependymal germinal matrix in all 11 cases. IVH of choroid plexus was combined in 2 cases. Severity of IVH were grade I in 9 cases, grade II in 2 cases by Papile's classification. 4) There were no correlations between the grade of IVH and severity of perinatal asphyxia. In conclusion, ultrasonography is very useful in diagnosis and follow-up of IVH in term neonates. Subependymal germinal matrix could be common site of IVH in term neonates because germinal matrix still remains in term neonates despite of its regression. Also this can explain why IVH in our cases is not severe.
Asphyxia ; Autopsy ; Brain ; Choroid Plexus ; Classification ; Diagnosis ; Fetal Distress ; Follow-Up Studies ; Hemorrhage* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Parturition ; Pneumonia ; Risk Factors ; Seoul ; Ultrasonography

This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

The myoclonic epilepsies of infancy and early childhood pose the most difficult problems in the diagnosis and classification of epilepsies because they are often confused with the Lennox-Gastaut syndrome sharing a number of common features. However, their correct differentiation is easily justifiable because some of the myoclonic epilepsies of early childhood have better prognosis than the Lennox-Gastaut syndrome. We experienced and treated a 4-year-old boy who had normal intellectual function but frequent myoclonic and generalized clinic-tonic-clinic seizures, which were successfully controlled by anti-epileptic drugs. Hence we report a case with brief review of literatures.
Child, Preschool ; Classification ; Diagnosis ; Epilepsies, Myoclonic* ; Epilepsy ; Humans ; Male ; Prognosis ; Seizures

Apoptosis is a distinct mode of cell death that is responsible for deletion of cells in normal tissues. Apoptotic cell death plays an important role in the proliferation and turnover of cells in various tumors. Apoptosis occurs spontaneously in malignant tumors, often markedly retarding their growth, and increased in tumors responding to irradiation, cytotoxic chemotherapy, heating and hormone ablation. Flowcytometric analysis of the cellular DNA content appears to be a useful clinical prognostic indicator in colorectal cancer. The relationship of apoptotic index(AI) and proliferative indices have being investigated. We analyzed the tumor DNA content and AI in 84 patients who underwent resection for colorectal cancer between January 1989 and December 1994 in order to evaluate the prognostic significance of apoptosis, DNA ploidy and index using in situ apoptosis detection method and flowcytometry. The mean value of AI was 32.4, and median value 21. In the cellular DNA, forty-two percent of the tumors were diploidy, fifty-eight percent aneuploidy. The mean value of DNA index(DI) was 1.38, G0/G1 72%, S phase fraction 21.7%, G2/M 6.3%, and proliferative fraction 28%. There was no significant difference between AI and tumor invasion, LN metastasis, DNA ploidy, DI.(p>0.05) There was no significance between overall survival and AI, DNA ploidy, DI. But patients who had tumors with low DNA index had a significantly longer disease free survival than high DNA index.(p<0.05) As a result, this study shows that AI is a less useful as prognostic factor and DNA index is a more important prognostic factor in patients undergoing surgery for colorectal cancer.
Aneuploidy ; Apoptosis ; Cell Death ; Colorectal Neoplasms* ; Diploidy ; Disease-Free Survival ; DNA* ; Drug Therapy ; Heating ; Hot Temperature ; Humans ; Neoplasm Metastasis ; Ploidies ; S Phase

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.
Abscess ; Adult ; Cellulitis ; Child ; Diagnosis ; Diplopia ; Eye Movements ; Humans ; Necrosis ; Orbit* ; Orbital Cellulitis ; Prognosis ; Sinusitis* ; Sutures

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.
Animals ; Ascitic Fluid* ; Culture Media ; Diagnosis ; Embryonic Development* ; Embryonic Structures* ; Endometriosis* ; Family Characteristics ; Female ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Laparoscopy ; Mice* ; Microscopy ; Morula ; Oocytes ; Pelvis ; Phagocytosis ; Pregnancy ; Serum Albumin, Bovine ; Spermatozoa ; United States

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.
Animals ; Ascitic Fluid* ; Culture Media ; Diagnosis ; Embryonic Development* ; Embryonic Structures* ; Endometriosis* ; Family Characteristics ; Female ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Laparoscopy ; Mice* ; Microscopy ; Morula ; Oocytes ; Pelvis ; Phagocytosis ; Pregnancy ; Serum Albumin, Bovine ; Spermatozoa ; United States

BACKGROUND AND OBJECTIVES: Spontaneous nystagmus may have an influence on the results of sinusoidal harmonic acceleration (SHA) test, although it has not been ascertained through sufficient studies. This study evaluated the effect of spontaneous nystagmus on the gain, asymmetry and phase values of the SHA test. SUBJECTS AND METHOD: We retrospectively analyzed 19 patients with acute unilateral vestibular weakness and spontaneous nystagmus (sn). All patients underwent a battery of vestibular testing including videonystagmography, bithermal caloric test, and SHA test. Gain, asymmetry, and phase were calculated with the conventional method without correcting for sn, thus the non-corrected SHA (nSHA). Then the same three parameters were calculated again after manually correcting for spontaneous nystagmus, thus the corrected SHA (cSHA). The two methods were compared with respect to gain, asymmetry and phase values. Correlation between the SHA test and caloric test was also analyzed. RESULTS: The gain of nSHA was significantly larger than that of cSHA in all frequencies. There was no difference in the phase values between the two analysis methods. The asymmetry of nSHA was 2.8 times larger than that of cSHA. The asymmetry values of both nSHA and cSHA showed a significant correlation between the caloric test and degree of spontaneous nystagmus. CONCLUSION: It seems that the SHA test is significantly influenced by spontaneous nystagmus. Although correcting for spontaneous nystagmus may not always be necessary, we should consider the effect of spontaneous nystagmus when interpreting the SHA test results of a patient who has spontaneous nystagmus.
Acceleration ; Caloric Tests ; Humans ; Retrospective Studies ; Vertigo

Postoperative vertigo after tympanomastoidectomy can be attributed to several causes such as inner ear damage due to excessive ossicle handling, labyrinthitis, BPPV resulting from vibration of drilling, iatrogenic lateral semicircular canal damage, and perilymphtic fistula. Differential diagnosis is critical for the proper management and prognosis of accompanied sensorineural hearing loss, but it may be difficult in some cases. Especially it is quite difficult to distinguish between the serous and suppurative labyrinthitis. In this article we present a case with simultaneous serous labyrinthitis and BPPV. The patient developed whirling vertigo and hearing loss on the 5th day after tympanomastoidectomy. After conservative treatment with steroid and antibiotics, his hearing recovered to preoperative level. We retrospectively reviewed the pitfalls to make a correct diagnosis in this patient and the serial change in nystagmus during the treatment period. The usefullness of the rotation chair test to predict the prognosis of sensorineural hearing loss in labyrinthitis was also discussed.
Anti-Bacterial Agents ; Diagnosis, Differential ; Ear, Inner ; Fistula ; Handling (Psychology) ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis ; Mandrillus ; Prognosis ; Retrospective Studies ; Semicircular Canals ; Vertigo ; Vibration