PURPOSE:Effects of IDDM on bone mineral metabolism are still in controversy. Some reported that bone mineral density in IDDM had inverse relationship with HbA1c, some reported that spine BMD was normal while femur BMD was decreased. Others reported that increased urinary calcium excretion in IDDM induced early trabecular bone mineral loss. We studied the correlation of BMD with diabetic control and body measurements. METHODS:In sixteen IDDM patients, using dual energy X-ray absorptiometry, BMD was measured in lumbar spine as trabecular bone and femur neck as cortical bone. Z-score of BMD was obtained by comparing age and sex matched control data. Correlations between BMD and diabetic control parameters (HbA1c, duration of IDDM) and body measurements were calculated. RESULTS:The body measurements were in normal range in all IDDM patients, the duration of IDDM was 38.4+/-24.0months, HbA1c was in good control state (7.69+/-1.53%), and urinary Ca/creatinine ratio was not increased. The Z-score of BMD was not decreased statistically (lumbar spine: -0.255, femur neck: -0.404), and the Z-score had no correlationship with body measurements and diabetic control parameters. CONCLUSIONS:In well controlled childhood IDDM, BMD was not decreased significantly.
Absorptiometry, Photon ; Bone Density* ; Calcium ; Diabetes Mellitus, Type 1* ; Femur ; Femur Neck ; Humans ; Metabolism ; Reference Values ; Spine

No abstract available.
Pruritus*

It is well known that there is close relation of the left atrial pathology to atrial fibrillation(AF) in patients with mitral valvular disease. To evaluate such relation is existed or not in the right atrium, the right atrial wall biopsy was performed in 31 patients with mitral valvular disease during valve surgery. The specimens obtained were interpretated by the pathologist who had no information about the patients. The specimens were graded according to severity of morphological change. In Grade I, the atrial myocardium is degenerated and has moderate fibrosis in it. Grade II shows the atrial myocardial layer of the atrium and severe degenerated with pre and postoperative heart rhythm. Four patients had Grade I change and 3 patients among them had pre and postoperative AF. Eleven patients had Grade III changes and 9 among them had pre and postoperative AF. The results show there is strong tendency that the patients with pre and postopeative AF had Grade III change in the right atrium and the relation of the right atrial pathology to AF is same as that of the left atrium.
Atrial Fibrillation* ; Biopsy ; Fibrosis ; Heart ; Heart Atria ; Humans ; Myocardium ; Pathology*

We report a case of pneumonia in 36 year-old male patient who presented acute respiratory failure and associated radiologic findings of bilateral ground-glass opacity with focal cystic changes, showing rapidly aggravating course and was diagnosed as concomitant Pneumocystis carinii and Cytomegalovirus pneumonia accompanied by acquired immunodeficiency syndrome through antemortem open lung biopsy.
Acquired Immunodeficiency Syndrome ; Biopsy ; Cytomegalovirus ; Humans ; Lung ; Male ; Pneumocystis carinii ; Pneumonia ; Respiratory Insufficiency*

PURPOSE: Among the several transcatheter devices of PDA occlusion, Rashikind device was the most extensively experienced, but it had risk of occluder embolism and incomplete occlusion of PDA, approximately 27%. The authors used Duct-Occlud , made of 0.028 inch stainless steel coil. The coil is double cone-shape in released state, and used in streched condition through 4F implantation catheter for ductus occlusion. We are to report the short-term result of PDA occlusion using Duct-Occlud. METHODS: Six patients with internal ductal diameter of less than 3.5mm were selected for ductus occlusion. The Duct-Occlud was selected as follows : the diameter of aortic end was same as aortic ampulla, and the length was slightly shorter than that of ductus. The streched coil was introduced into descending aorta through implantation catheter, and the remaining coil was released in ductus and pulmonary artery subsequently. Postprocedure aortic angiogram was obtained and echocardiography was performed at 1day, 1 week, 1 month and 3 month after the procedure. RESULTS: Except one hourglass type, all the other PDA were tunnel shaped. The range of internal diameter of ductus was 0.83-2.4mm, the length 5.36-P12.4mm, and Qp/Qs 1.04-1.67. Three cases required repositioniong of coils, while the others were successful in one procedure. The residual shunts were resolved at 1 day in most cases, but two cases in 1 month after the procedure. There were no complications, such as coil embolism, migration, or pulmonary stenosis. CONCLUSIONS: In small PDA with internal diameter of less than 3.5mm, transcatheter occlusion using Duct-Occlud is easy, safe and accurate, except with high cost.
Aorta, Thoracic ; Catheters ; Echocardiography ; Embolism ; Humans ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Stainless Steel

OBJECTIVE: To assess the reliability of triple marker screening test in midtrimester pregnancy for fetal Down syndrome. METHODS: From October 1, 1996 to May 31, 1998 at Nowon Eulji Hospital, 3700 Pregnant women underwent serum tiple marker screening for Down syndrome during 15-20weeks of gestational age. The results of serum triple marker screenig tests for Down syndrome and the outcomes of pregnancies were retrospectively assesed. RESULTS: Sixty seven of 3700 cases(1.81%) were positive in screening test, and 3633(98.18%) cases were negative. Among 67 cases of positive screening test, 1 case(1.49%) was diagnosed as Down syndrome. Among 3633 cases of negative screening test, 4 cases(0.1%) were diagnosed as chromosomal abnormalies postnatally. Two of these 4 cases of chromosomal abnormalies were Down syndrome. CONCLUSION: With this results, sensitivity of triple marker screeing test for Down syndrome is very low as 33.3%. In order to increase the sensitivity, some compensatory adjustment is required in triple marker screening test.
Down Syndrome* ; Equidae ; Female ; Gestational Age ; Humans ; Mass Screening* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Retrospective Studies

Sarcomatous carcinoma of the gallbladder is a very rare disease. There are few case reports worldwide. We experienced a case of sarcomatous carcinoma of the gallbladder. This 45-year-old male patient complained abrupt and continuos right upper quadrant pain for 4 hours. He was diagnosed as acute calculous cholecystits on abdominal sonography. He received laparoscopic cholecystectomy after conservative treatment for 3 days. During the operation the wall of gallbladder was so hard, thickened that cancer was suspected and the frozen biopsy proved osteogenic sarcomatous carcinoma. So, operation was converted to open laparotomy and a right hepatic lobectomy and choledochus resection with regional lymph node dissection was done. On 25th day of surgery, ascitic fluid collection was noticed on abdomen and multiple hematogenous metastasis on remnant liver was found on abdominal CT scan. The patient expired on 48th day of surgery due to cancer cachexia.
Abdomen ; Ascitic Fluid ; Biopsy ; Cachexia ; Cholecystectomy, Laparoscopic ; Common Bile Duct ; Gallbladder* ; Humans ; Laparotomy ; Liver ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Metastasis ; Rare Diseases ; Tomography, X-Ray Computed

BACKGROUND: The nutritional status of critical-ill patients is important for recovering from the disease itself. Therefore, this present study was designed to assess the biochemical and nutritional parameters of Intensive-Care Unit (ICU) patients on mechanical ventilation. METHODS: We retrospectively reviewed the medicial records of 126 patients (male/female=72/54) who were on mechanical ventilationin the ICU. The nutritional parameters such as serum total protein, albumin, hemoglobin, hematocrit, calcium, phosphorus, total cholesterol, % lymphocytes, blood urea nitrogen (BUN), and creatinine (Cr) were measured at the beginning of mechanical ventilation. We also measured the outcome variables such as the duration of mechanical ventilation, the ICU length of stay and the hospitalization period. We analyzed the relationship between the nutritional parameters and the outcome variables of ICU patients on mechanical ventilation. RESULTS: The level of hemoglobin was negatively correlated with the outcome variables; the ICU length of stay (p<0.05), the hospitalized period (p<0.01), and the duration of mechanical ventilation (p<0.01). The creatinine level was positively correlated with the outcome variables; the ICU length of stay (p<0.01), the hospitalized period (p<0.01) and the duration of mechanical ventilation (p<0.05). On the multiple regression analysis, the serum total protein, albumin, calcium, inorganic phosphorus, BUN and creatinine were independent factors affecting the duration of mechanical ventilation. CONCLUSIONS: These findings indicate that ICU patients with mechanical ventilation have a risk for malnutrition and anemia. So, an adequate nutritional intervention is required for these patients in order to decrease the prevalence of malnutrition and anemia.
Anemia ; Blood Urea Nitrogen ; Calcium ; Cholesterol ; Creatinine ; Hematocrit ; Hospitalization ; Humans ; Length of Stay ; Lymphocytes ; Malnutrition ; Nutrition Assessment ; Nutritional Status ; Phosphorus ; Prevalence ; Regression Analysis ; Respiration, Artificial* ; Retrospective Studies

BACKGROUND: Patients with severe atopic dermatitis (AD) can benefit from cyclosporin (CSA) treatment. Some studies reported that CSA can cause infectious diseases as side effects. OBJECTIVE: To investigate the possible association of CSA treatment in AD patients with infectious diseases. METHODS: We performed a case-controled study on 202 patients with AD, 101 of whom were taking CSA and 101 who were not. Retrospective medical record review was held, and the incidence of infectious disease in both groups was compared. RESULTS: The total number of infectious diseases in the CSA group was slightly lower than in control group but that was not statistically significant. Similarly, the incidence density was almost the same in the two groups. In both groups, eczema herpeticum was the most common infection. CONCLUSION: Our results suggest that CSA therapy in AD does not increase the incidence of infectious disease.
Case-Control Studies ; Communicable Diseases ; Cyclosporine ; Dermatitis, Atopic ; Humans ; Incidence ; Kaposi Varicelliform Eruption ; Medical Records ; Retrospective Studies

We analyzed 62 cases of intracranial AVM treated in the department of neurosurgery of Soonchunhyang University Hospital during the period from January 1984 to May 1994. The results are summarized as follows: 1) The ratio of male to female was 1.58 : 1 and 44 cases(71%) were distributed under the age of forty, with a peak incidence in the 2nd and 4th decade. 2) Forty five patients(72.6%) experienced symptoms due to spontaneous intracerebral/intraventricular hemorrhage, and the next most common symptom was seizure in 9 patients(14.5%) 3) Intracerebral hemorrhage(ICH) was the most common cause of symptoms, constituting 90.4% of intracranial hemorrhage. Among the patients with intracerebral hemorrhage, the size of AVM nidus was less than 3cm in 70.2%, between 3cm to 6cm in 27.7%, and over 6cm in 2.1%, respectively. 4) Ten(58%) of the patients presenting with over 30cc of ICH had the AVM located in the eloquent area. 5) The most common location of AVM was the supratentorial subcortical region, especially the parietal lobe(33.9%). 6) Forty five patients were managed surgically, and the operative mortality was 2.2% and significant morbidity, 24.4%. 7) As for surgical intervention, total excision of AVM was carried out in 33(73.3%), partial excision in 10(22.2%), and only arterial feeder clipping in 2(4.4%). The lower the Spetzler grade of AVM, the better the surgical result and the postoperative outcome. 8) Postoperative neurological deterioration was noticed in 3 of 33 cases(9%) in the group of total excision of AVM, and their causes were cerebral edema and normal perfusion pressure break-through. 9) The clinical outcome of surgical management for AVM was superior than that of conservative treatment(p<0.01).
Brain Edema ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Incidence ; Intracranial Arteriovenous Malformations* ; Intracranial Hemorrhages ; Male ; Mortality ; Neurosurgery ; Perfusion ; Rabeprazole ; Seizures