One hundred seven consecutive patients aged 3 years to 34 years with simple ventricular septal defect were prospectively investigated with 2-dimensional Doppler echocardiography to assess the echocardiographic criteriae in defining the anatomic site of the VSD. The anatomy was confirmed in all patients at operation. Two-dimensional Doppler echocardiography correctly categorized the site and extension of VSDs in 104 of 107(97%). All doubly committed subarterial VSDs were correctly diagnosed as an area of discontinuity beneath the pulmonary valve in the parasternal short-axis plane taken at the aortic root level. Forty eight of 49 perimembranous VSDs with infundibular extension showed an area of discontinuity beneath the right aortic cusp in the parasternal long axis plane of the left ventricle. Of 17 perimembranous VSDs with trabecular extension, 16 had an area of discontinuity around the medial papillary muscle in the short axis plane taken at the level of high left ventricular outflow tract(LVOT). All 5 perimembranous VSDs with inlet extension showed an area of discontinuity adjacent to the septal leaflet attachment in the short axis plane taken at the level of high LVOT. One muscular trabecular VSD was categorized correctly by the short axis view and the apical 4-chamber view. Thus, these 2-dimensional Doppler echocardiographic criteriae are a simple and reliable in identifying the anatomic site of VSDs.
Axis, Cervical Vertebra ; Bays ; Classification* ; Echocardiography ; Echocardiography, Doppler* ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Papillary Muscles ; Prospective Studies ; Pulmonary Valve

No abstract available.
Alveolar Ridge Augmentation* ; Durapatite* ; Splints*

No abstract available.
Lithium Chloride* ; Lithium*

Despite significant advances in obstetric and pediatric health care, Streptococcus agalactiae(Lancefield group B β-hemolytic Streptococcus, GBS) remains one 91 the most prevalent and devastating pathogens in peripartum women and their newborn infants. It may cause urinary tract infection, chorioamnionitis and endometritis, bacteremia, and cesarean wound infection in the peripartum period. It was Pasteur who first identified microbes in the blood and lorchia of septic women. After that, in 1938 the isolation of S. agalactiae from three mortally ill women was reported, thereby implicating it as another cause of puerperal sepsis. S. agalactiae is now one of the most common causes of neonatal sepsis and meningitis in the United States. However, in Korea there have been only twenty-three cases of neonatal meningitis and/or sepsis due to group B β-hemolytic streptococcus reported. Recent studies have noted other serious infections in adults, including bacteremia, pneumonia, cellulitis, osteomyelitis, meningitis, and endocarditis. In Korean adults no case of pneumonia due to S. agalactiae has been reported till now. As minimal inhibitory concentration of penicillin was reported to be higher for S. agalactiae than for S. pyogenes, minimal inhibitory concentration of penicillin for S. agalactiae should be tested. Herein we describe the course of a case of S. agalactiae pneumonia and bacteremia in a 74-year-old diabetic man, and we review the literatures.
Adult* ; Aged ; Bacteremia ; Cellulitis ; Chorioamnionitis ; Delivery of Health Care ; Endocarditis ; Endometritis ; Female ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Osteomyelitis ; Penicillins ; Peripartum Period ; Pneumonia* ; Pregnancy ; Sepsis ; Streptococcus agalactiae* ; Streptococcus* ; United States ; Urinary Tract Infections ; Wound Infection

No Abstract Available.
Retinal Detachment* ; Retinaldehyde*

No abstract available.
Bile Ducts, Extrahepatic*

Apocrine carcinoma is a rare type of mammary cancer, which shows partial or total apocrine differentiation in either ductal or lobular carcinoma. The malignant transformation of apocrine epithelium of the breast was first described by Krompecher in 1916. It is well known that their relationship to true apocrine glands of the skin is only a morphological similarity, and this histological difference does not affect the prognosis. The authors experienced two cases of apocrine carcinoma of the breast which involved infiltrating ductal carcinoma of a 64-year old woman and intraductal carcinoma of a 69-year old woman respectively. Electron microscopic examination and brief review of literature was done.
Female ; Humans

Classic pulmonary blastoma is a variant of carcinosarcoma which is seen almost exclusively in adults. By contrast, most cases of pulmonary blastoma in children have been described as having an exclusive mesenchymal composition, which was proposed as pleuropulmonary blastoma. Recently we experienced a case of pleuropulmonary blastoma, type 1. This 27-month-old male baby was transferred to our hospital due to the left tension pneumothorax. Chest CT revealed a subpleural pulmonary cystic lesion on the left upper lung and an open cystectomy was performed. Histologically the lesion was composed of variable-sized cystic structures lined with a single layer of respiratory-type epithelium. the underlying stroma was composed of sheets of small, round to oval, primitive tumor cells. Some of them had eccentric, eosinophilic cytoplasm, suggestive of rhabdomyoblastic differentiation. These rhabdomyoblastic cells were fuchsinophilic and positive with desmin and vimentin on immunohistochemistry.
Child ; Adult ; Male ; Female ; Humans

PURPOSE: Neonatal surgical conditions affecting the gastrointestinal tract are varied, can affect any part of the intestinal tract, and frequently require urgent surgical intervention. Unfortunately, nonspecific and overlapping symptomatology exists among the conditions affecting the intra-aMominal intestinal tract and requires of the evaluating physician a thorough understanding of their pathophysiology. So we studied signs and symptoms, frequency and incidence, ages at diagnosis, and diagnostic method of the neonatal gastrointestinal obstructions. METHOD: We reviewed retrospectively the charts of patients, who had been diagnosed as gastrointestinal obstruction during the neonatal period, and had been admitted to Gyeongsang National University Hospital from Feb. 1988 to Feb. 1997. RESULT: Total 77 cases were enrolled in this study. There were 59 rnales (76.796) and female 18 cases (23.4%). The male to female ratio was 3.28: 1. Twenty-two cases of imperforate anus (28.6%), 18 cases of hypertrophic pyloric stenosis (23.4%), 15 cases of congenital megacolon (19.5%) were observed. Other diseases causing the neonatal gastrointastinal obstruction were annulus pancreas (7.8%), jejunal atresia (6.5%), duodenal atresia (1.3%), duodenal web (2.6%), ileal atresia (2.6%), midgut volvulus (2.6%), intussusception (1.3%), and trachoesophageal fistula (2.6%). The rnost common symptom was vomiting with 32 cases (41.6%), followed by abdominal distension with 31 cases (40.3%), absence of anus with 17 cases (22.1%), and delayed meconium passage with 9 cases (11.7%). Associated other anomalies were observed in 18 cases (23%). Imperforate anus was seen with the highest rate of associated anomalies. The most common associated anomaly was the cardiac anomaly. Colon study (26%), physical examination (24.7%), abdominal sonography (15.6%), upper GI series (11.7%), and simple abdomen (9.1%) were diagnostic in the neonatal gastrointestinal obstructions. Seventeen cases (22%) were died before or after the surgical intervention. CONCLUSION: Neonatal gastrointestinal obstructions were associated with the high mortality rate. Abdominal distension and vomiting were the specific symptoms of neonatal gastrointe- stinal obstructions. Extensive search for the associated anomalies are reqiured because of its high frequency in the patients of the neonatal gastrointestinal obstructions. Thorough physical examination, colon study, abdominal sonography, upper GI series, and simple abdomen were essential in the diagnosis of the neonatal intestinal obstructions.
Abdomen ; Anal Canal ; Anus, Imperforate ; Colon ; Diagnosis ; Female ; Fistula ; Gastrointestinal Tract ; Hirschsprung Disease ; Humans ; Incidence ; Infant, Newborn ; Intestinal Atresia ; Intestinal Obstruction ; Intestinal Volvulus ; Intussusception ; Male ; Meconium ; Mortality ; Pancreas ; Physical Examination ; Pyloric Stenosis, Hypertrophic ; Retrospective Studies ; Vomiting

To elucidate the significance of the nesidiodysplasia of pancreas, histological re-evaluation and immunohistochemical studies for insulin, glucagon and somatostatin were done on 16 consecutive cases (5 premature babies, 2 stillborns, 5 infants and 3 adults) in which paraffin blocks of the pancreas were available. Only one infant was hypoglycemic. All 16 pancreases showed changes of nesidiodysplasia which appeared immunohistochemically to have isulin, glucagon and /or somatostatin. The histologic patterns of nesidiodysplasia included ductoendocrine proliferation, endocrine cell dysplasia, adenomatosis, septal islet, islket cell hypertrophy and islet hypertrophy. All the patterns of nesidiodysplasia except for the adenomatosis were seen in premature babies, infants, stillborns and adults with or without hypoglycemia. The adenomatosis was found only in the hypoglycemic infant. The result suggests that all patterns of nesidiodysplasia of other than the adenomatosis does not imply the pathologic basis of hypoglycemia.
Infant ; Adult ; Male ; Female ; Humans