The congenital long-QT syndrome (LQTS) is characterized by recurrent syncope, prolonged QT intervals, QT interval lability, polymorphic ventricular tachycardia, and sudden death. We report a case of congenital long QT syndrome in a 28-day-old male infant who presented with syncope, bradycardia with 2: 1 pseudo-atrioventricular block and a markedly prolonged QT inteval. One episode occured after crying and degenerated into ventricular fibrillation and terminated after cardioversion. A VVI type cardiac pacemaker was implanted. Subsequently, the infant's heart rate was over 110/min and 2: 1 AV block and any other arrhythmia were absent. The infant recovered from the accompanied pneumonia and sepsis and was discharged 47 days after adrnission. However, 13 days after discharge, the infant returned to our hospital ER with syncope. Ventricular fibrillation ceased after cardioversion. Despite medication with propranolol, ventricular tachycardia persisted. The infant expired the day after he was discharged against medical advice.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bradycardia ; Crying ; Death, Sudden ; Electric Countershock ; Heart Rate ; Hospitals ; Humans ; Infant ; Long QT Syndrome ; Male ; Pneumonia ; Propranolol ; Sepsis ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation

This is a case report of pulmonary embolism which occurred as a complication of mesenteric venous stasis with sepais. This 49 year old nun was operated upon for an obstructed intestine under general anesthesia with halothane and d-tubocurarine. She had a hystrectomy for myoma 2 years ago and has ailed for 6 days from this condition. The patient became dyspneic and cyanotic suddenly three hours after the surgery. The chest X-ray revealed three or four bilateral, rounded and moderately increased densities, and her ECG showed a large S wave in limb leads, P-pulmonare, and right ventricular strain pattern with right axis deviation. CPPV with 100% oxygen by the manual method improved the condition of the patient for about three hours, but tachycardia and a failing heart could not be corrected in site of digitalis, steroid, diuretics and heparinization. The patient died 11 hours after the operation.
Anesthesia, General ; Digitalis ; Diuretics ; Electrocardiography ; Extremities ; Halothane ; Heart ; Heparin ; Humans ; Intestinal Obstruction* ; Intestines ; Methods ; Myoma ; Nuns ; Oxygen ; Pulmonary Embolism* ; Tachycardia ; Thorax ; Tubocurarine

PURPOSE: Long time total parenteral nutrition (TPN) can induce irreversible liver damage. In this study, we investigated the associated factors of parenteral nutrition associated cholestasis (PNAC) in neonates. METHODS: We retrospectively reviewed 227 neonates (male:female=110:117) those who had received TPN over 2 weeks from March 2010 to February 2014. PNAC was defined as direct bilirubin was higher than 2.0 mg/dL without any cause except TPN. RESULTS: Overall incidence was 28.6%. PNAC was frequently developed in younger gestational age with lower birth weight. Episodes of sepsis, underlying bronchopulmonary dysplasia, history of necrotizing enterocolitis, and experience of gastrointestinal surgery increase the incidence of PNAC. PNAC was directly associated the duration of TPN and long period to full enteral feeding, reaching 60 and 150 mL/kg/day. Overall mortality rate was 9.7%. It was higher in PNAC group despite PNAC was not the primary cause of death. All survivors were recovered from cholestasis with encourage of enteral nutrition. CONCLUSION: PNAC in neonate was associated with younger gestational ages and lower birth weights, duration of TPN, or who experienced sepsis, necrotizing enterocolitis, gastrointestinal surgery or bronchopulmonary dysplasia.
Bilirubin ; Birth Weight ; Bronchopulmonary Dysplasia ; Cause of Death ; Cholestasis* ; Enteral Nutrition ; Enterocolitis, Necrotizing ; Gestational Age ; Humans ; Incidence ; Infant, Newborn* ; Liver ; Mortality ; Parenteral Nutrition* ; Parenteral Nutrition, Total ; Retrospective Studies ; Sepsis ; Survivors

Although alendronate was considered generally safe and effective to osteoporosis in short-long term studies, it remains the potential risk of severely suppressed bone turnover that causes insufficient fracture of femur. In this report, we describe a patient of atypical subtrochanteric fracture who treated with prolonged alendronate. A 68-years old woman who had a history of medication of alendronate for 12 years was presented to the outpatient clinic with right thigh pain. The radiographs revealed thickening and fracture line of the lateral side of subtrochanteric area of the right femur. She discontinued taking the medicine and follow up closely. After 1 month later, she sustained atypical subtrochanteric femoral fracture after simple fall, and underwent an internal fixation with compression hip screw. After operation, bone biopsy was done with tetracycline staining for valuation of bone metabolism and severe osteoporosis was observed. Although long-term use of bisphosphonate could increase bone mineral density, this case showed that it could lead insufficient fracture by decreasing bone strength through severely suppressed bone turnover, inhibition of normal bone formation and decreased bone quality.
Alendronate ; Ambulatory Care Facilities ; Biopsy ; Bone Density ; Diphosphonates ; Female ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip ; Humans ; Osteogenesis ; Osteoporosis ; Tetracycline ; Thigh

PURPOSE: B1 field of birdcage RF (radiofrequency) coil that is used most for brain imaging in magnetic resonance imaging (MRI) decreases toward endring from the coil center. We investigated how much RF B1 homogeneity effect the endcap shield brings form the coil center as it towards to endcap region. MATERIALS AND METHODS: We compared RF B1 field distribution by each finite difference time domain (FDTD) simulations for lowpass, highpass and hybrid birdcage RF coils. We selected the highpass birdcage RF coil that was the highest RF B1 field condition as simulation result, and studied how much RF B1 homogeneity effect was occurred when endcap shield was applied to endring area. RESULTS: B1 field of the highpass birdcage RF coil was higher than other birdcage RF coil types as simulation result. However, the RF B1 homogeneity was lower than other coil types. RF B1 field of highpass birdcage RF coil with endcap shield is similar with RF B1 field of hybrid birdcage RF coil and the overall RF B1 homogeneity in sagittal direction was better. CONCLUSION: In this paper, proposed method can apply improving RF B1 homogeneity of RF coil in clinical examination.
Magnetic Resonance Imaging* ; Neuroimaging

Recently, water birth - labor and/or delivery under warm water - is acceptable and natural to many foreign countries as a method of gentle birth. Although some limitations after water birth were reported, a recent international conference explored many of the issuses and indicated the potential scale and the advantages for its inclusion among the options for labor and delivery under water. We experienced a case of water birth who underwent labor and delivery under water. She delivered normal healthy female baby without conventional episiotomy. No obstetrical ans fetal complications were observed during entire procedure of water birth. So, we report this case with brief review of the literatures.
Episiotomy ; Female ; Humans ; Parturition*

In acute phase, cerebral infartion is usually hypodense on CT and hyperintense on T2-weighted MR image. This hyperintensity on T2-weighted MR image gradually approaches an isointensity stage after 2 or 3 weeks of onset. In the later stage, cerebral infarction is observed hyperintense on T2-weighted MR image. This sequential phenomenon is so-called "fogging effect". We experienced two cases of "fogging effect". The first case did not show abnormal signal intensity on TI or T2 weighted MR images taken after 14 days of onset and the second case also did not show abnormal signal intensity after 17 days of onset. Each case revealed hyperintense in T2-weighted image with contrast enhancement taken after 20 weeks and 8 weeks of onset, respectively. We present two cases with MRI and brief review of literatures.
Cerebral Infarction ; Magnetic Resonance Imaging ; Weather*

OBJECTIVES: According to preceding studies, many people with mental disability have unbalanced dietary habits or excessive intake of calories. Most of them are overweight or obese due to lack of self-control for food consumption, swallowing with inadequate chewing and physical inactivity. Therefore, this study aimed to assess the nutritional intake, including carotenoid, in mentally disabled people and find out a possible solution for nutritional improvement. METHODS: People with intellectual disability (N=28), emotional disability (N=44) participated in this study. The disorder grades were from I to III and ages were between 20 and 65 years. Assessments included anthropometry, daily intake of nutrients, including carotenoid, ROMA III questionnaire for assessing bowel movement. RESULTS: The average BMI of intellectually disabled people and emotionally disabled people was in the range of overweight and obesity respectively (23.7 +/- 6.3 kg/m2, 25.8 +/- 4.1 kg/m2). Overall, the frequencies of vegetable and dairy product intakes were lower in this population. When compared with Recommended Nutrient Intake (RNI) from Dietary Reference Intakes for Koreans 2010, the intakes of vitamin B1, vitamin B2 and calcium were insufficient in both groups. Also, lycopene intakes of carotenoid were low, compared with traditional Korean diet of the non-disabled people from the second year 2008 of the 4th National Health and Nutrition Survey. In addition, emotionally disabled people also had lower intake of cryptoxanthin. CONCLUSIONS: The mentally disabled people in this study showed lower intakes of vitamin B1, vitamin B2, calcium and carotenoids. Based on these findings, we recommend that it is important to encourage mentally disabled people to consume sufficient amounts of such nutrients in order to promote nutritional status.
Adult* ; Anthropometry ; Calcium ; Carotenoids ; Dairy Products ; Deglutition ; Diet ; Food Habits* ; Humans ; Intellectual Disability ; Mastication ; Mentally Disabled Persons* ; Nutrition Surveys ; Nutritional Status ; Obesity ; Overweight ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Riboflavin ; Thiamine ; Vegetables

OBJECTIVE: A spinal cord subependymoma is an uncommon, indolent, benign spinal cord tumor. It is radiologically similar to a spinal cord ependymoma, but surgical findings and outcomes differ. Gross total resection of the tumor is not always feasible. The present study was done to determine the clinical, radiological and pathological characteristics of spinal cord subependymomas.METHODS: We retrospectively reviewed the medical records of ten spinal cord subependymoma patients (M : F=4 : 6; median 38 years; range, 21–77) from four institutions.RESULTS: The most common symptoms were sensory changes and/or pain in eight patients, followed by motor weakness in six. The median duration of symptoms was 9.5 months. Preoperative radiological diagnosis was ependymoma in seven and astrocytoma in three. The tumors were located eccentrically in six and were not enhanced in six. Gross total resection of the tumor was achieved in five patients, whereas subtotal or partial resection was inevitable in the other five patients due to a poor dissection plane. Adjuvant radiotherapy was performed in two patients. Neurological deterioration occurred in two patients; transient weakness in one after subtotal resection and permanent weakness after gross total resection in the other. Recurrence or regrowth of the tumor was not observed during the median 31.5 months follow-up period (range, 8–89).CONCLUSION: Spinal cord subependymoma should be considered when the tumor is located eccentrically and is not dissected easily from the spinal cord. Considering the rather indolent nature of spinal cord subependymomas, subtotal removal without the risk of neurological deficit is another option.
Astrocytoma ; Diagnosis ; Ependymoma ; Follow-Up Studies ; Glioma, Subependymal ; Humans ; Medical Records ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Spinal Cord Neoplasms ; Spinal Cord ; Spine

Keratoelastoidosis marginalis is a rare skin disorder. Clinically it consists of small, firm, linear hyperkeratotic papules, characteristically along the margin of the hands. Histopathologically it shows hyperkeratosis, acanthosis, solar elastosis, and degeneration of collagen and elastic fibers. Long-term ultraviolet radiation exposure and chronic trauma are considered to be precipitating factors. Herein, we report a case of keratoelastoidosis marginalis and a review of the related literature.
Collagen ; Elastic Tissue ; Hand ; Precipitating Factors ; Skin