Numerous cause of the carpal-tunnel syndrome have been reported, but we could not find a reference for tuberculosis of the median nerve causing this syndrome. Therefore, we are presenting the case report of this rare condition as another cause of the carpaltunnel syndrome.
Carpal Tunnel Syndrome ; Median Nerve ; Tuberculosis

Neuroblastoma is one of the most common extracranial solid tumor of childhood, and treatment of refractory neuroblastoma remains a significant clinical problem. Iodine-131-metaiodobenzylguanidine ((131)I-MIBG) therapy is an alternative approach to treat stage IV neuroblastoma. We report the palliative effect of (131)I-MIBG in three cases of relapsed neuroblastoma after autologous peripheral blood stem cell transplantation. (131)I-MIBG is an effective and relatively nontoxic palliative therapy resulting in reduction of pain and prolongation of survival.
Neuroblastoma ; Palliative Care ; Peripheral Blood Stem Cell Transplantation

PURPOSE: This study was performed to compare the effects and side effects of amphotericin B deoxycholate infusion over 6 versus 24 hours in febrile children with cancer. METHODS: Twenty-four children with cancer who were mostly neutropenic, febrile and suspected to have fungal infection and treated with amphotericin B deoxycholate from March 2001 to July 2002 at the Yeungnam University Hospital, Department of Pediatrics were enrolled for a cross-over study. All patients received 0.5 mg/kg amphotericin B deoxycholate infusion for average 7 days by two different infusion rates, one group by continuous infusion over 24 hours and the other by rapid infusion over 6 hours with at least 4 weeks of washout period. The side effects related to the infusion rates, fever, chilling or rigor, vomiting, headache, serum and urine electrolytes, beta2-microglobulin and creatinine clearance were monitored. The effect of amphotericin B deoxycholate infusion were studied by the days required for defervescence. RESULTS: There were no significant differences (P=0.11) in the effects between continuous and rapid infusion. But less side effects of chilling or rigor (P=0.01) were observed when amphotericin B deoxycholate was infused continuously. The serum phosphate (P=0.05) and magnesium (P=0.04) were lower and creatinine clearance was more reduced (P=0.01) when it was infused rapidly. CONCLUSION: Continuous infusion over 24 hours of amphotericin B deoxycholate could reduce the nephrotoxicity, such as hypophosphatemia, hypomagnesemia, low creatinine clearance and chilling reactions related to the rapid infusion without compromising the effects of amphotericin B deoxycholate in children with cancer.
Amphotericin B* ; Child* ; Creatinine ; Cross-Over Studies ; Deoxycholic Acid* ; Electrolytes ; Fever ; Headache ; Humans ; Hypophosphatemia ; Magnesium ; Pediatrics ; Vomiting

PURPOSE: This study was performed to survey the prevalence of obesity, hypertension, hyperglycemia and dyslipidemia in survivors of childhood acute lymphoblastic leukemia (ALL). METHODS: Retrospective Cohort study of 45 subjects (median age, 15.3 years; median interval after completion of therapy, 5 years) who were diagnosed and treated with ALL and 30 subjects (median age 14 years; median interval after completion of therapy, 5.3 years) with other cancers (control group) at Yeungnam University Hospital from January 1983 to December 1998 was performed. The ratio of male to female was 1.4: 1 in the ALL group and 1.7: 1 in the control group. Body mass index (BMI), blood pressure, fasting serum glucose and lipids were analyzed. Fourty three of the 45 subjects (96%) with ALL received cranial irradiation and 30 control subjects did not. RESULTS: Only two of 45 (4.4%) were found to be obese (BMI < 95 percentile for age and sex) which was similar to the control group (2/30 subjects, 6.7%). Hypertension was found in only 1 subject (1/45 subjects, 2.2%) with ALL. Dyslipidemia (at least one of high cholesterol, high triglyceride or low high density lipid-cholesterol) was detected in 12 of 39 subjects (30.7%) with ALL and in 8 of 22 subjects (36.4%) with other cancers. No one of either group had hyperglycemia. CONCLUSION: Young survivors of childhood ALL do not seem to be at increased risk for obesity, hypertension and hyperglycemia, but seem to be at increased risk for dyslipidemia.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Cohort Studies ; Cranial Irradiation ; Dyslipidemias ; Fasting ; Female ; Humans ; Hyperglycemia ; Hypertension ; Male ; Obesity* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prevalence* ; Retrospective Studies ; Risk Factors* ; Survivors* ; Triglycerides

The authors present a case of interstitial keratitis due to congenital syphilis in a 25-years old Korean army soldier, who had admitted to our Eye clinic at 2nd Feb. 68'. The patient may be present, such as interstitial keratitis, deafness and Hutchinson's teeth. Syphilitic interstitial keratitis is known as a rare case in recent time. A brief review of the related literatures is present.
Adult ; Deafness ; Humans ; Keratitis* ; Military Personnel ; Syphilis, Congenital*

The presense of pectus excavatum in Marfan's syndrome may complicate cardiac operation by making midline sternotomy technically more difficult and limiting the operative exposure of the heart. We operated on a 33 year old male patient with Marfan's syndrome and severe pectus excavatum who had severe mitral regurgitation and moderate aortic regurgitation with 52mm aortic root dilation. The operative field was adequately exposed through a midline sternal incision with two sternal retactors. The patient underwent Bentall operation and mitral valve replacement. The repair of pectus excavatum was performed after completion of CPB and the administration of protamin. Permanent internal stabilization achieved by overlapping of the ends of lower ribs and reinforced with sternal closure wire.
Adult ; Aortic Valve Insufficiency ; Funnel Chest* ; Heart* ; Humans ; Male ; Marfan Syndrome* ; Mitral Valve ; Mitral Valve Insufficiency ; Ribs ; Sternotomy ; Thoracic Surgery*

Although outcomes of neonatal cardiac surgery have dramatically improved in the last two decades, low body weight still constitutes an important risk factor for morbidity and mortality. In particular, cardiac surgery in neonates with very low birth weight (< or =1.5 kg) is carried out with greater risk because most organ systems are immature. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,480 gram neonate.
Aortic Coarctation ; Body Weight ; Heart Septal Defects, Ventricular ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight ; Risk Factors ; Thoracic Surgery

PURPOSE: The results for treatment of fistula-in-ano have much improved, along with the development of anatomical knowledge, classification, and operative techniques, during last several decades. The authors retrospectively reviewed the results for treatment of fistula-in-ano, especially complex fistulas, during the last 11 years. METHODS: A retrospective study of fistula-in-ano was performed for 229 patients who had been operated on in St. Benedict Hospital between January 1988 and December 1998. Complex fistulas (IIH, III & IV) were analyzed separately. RESULTS: The most common type was IILs (92 cases, 40.2%), and the most common horseshoe type was IIIBc (5 cases, 2.2%). The average hospital stay was 11.5 days for all fistula-in-ano types, but 15.1 days for complex fistulas. Non-specific inflammation (209 cases, 91.3%) was the most common pathologic finding. Various operative procedures were used : fistulotomy (80 cases, 34.9%), fistulectomy (74 cases, 32.3%), coring out fistulectomy (63 cases, 27.5%), seton technique (11 cases, 4.8%), and muscle-filling technique (1 case, 0.4%). There was no difference in the recurrence rate among the operative types. Various procedures were tried for complex fistulas, but the sphincter-preserving fistulectomy by Takano seemed to have a low recurrence rate and a short postoperative course. However, because of the small number of cases, this difference in recurrence rate and postoperative course was not statistically significant. The overall postoperative complication rate was 7%: anal infection (4 cases, 1.7%), anal bleeding (3 cases, 1.3%), and urinary retention (2 cases, 0.9%). CONCLUSIONS: The operations for most of the fistulae, IH, IL & IIL, were simple and uneventful. However, the operations for complex fistulae were complicated and more skill was required. We have thought Takano's operation to be a good curative procedure with less postoperative deformity and shortened postoperative course. However this research couldn't prove that with statistical significance, probably because of the insufficient number of patients. If further cases are collected and continuous follow-up is done, then a better result can be expected.
Classification ; Congenital Abnormalities ; Fistula ; Hemorrhage ; Humans ; Inflammation ; Length of Stay ; Postoperative Complications ; Recurrence ; Retrospective Studies* ; Surgical Procedures, Operative ; Urinary Retention

PURPOSE: The anthracyclines (AC) are widely used chemotherapeutic agents for pediatric cancers. However, the therapeutic use of these agents is limited by their cardiotoxicity. The aim of the present study was to investigate the usefulness of plasma B-type natriuretic peptide (BNP) levels as a marker for AC-induced cardiotoxicity compared to echocardiography in Korean children with cancer. METHODS: Fifty-five pediatric cancer patients who had received chemotherapy including AC were enrolled. The cumulative AC doses, clinical symptoms, and two echocardiography parameters, left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF), were studied and compared with plasma BNP levels. RESULTS: In 55 patients, plasma BNP levels were measured 115 times and echocardiographies were performed 64 times. The median cumulative dose of AC was 325 mg/m2 (range 120-600; mean 345) and the median plasma BNP level was 10 pg/mL (range 5-950; mean 31). The cumulative AC doses correlated significantly with the plasma BNP levels (P=0.002). The plasma BNP levels correlated significantly with LVFS (P=0.018) and LVEF (P=0.025). Dilated cardiomyopathies were identified in three patients. LVFS and LVEF decreased and plasma BNP levels increased in a patient with acute dilated cardiomyopathy and in that with symptomatic chronic dilated cardiomyopathy. However, LVFS, LVEF and plasma BNP levels were normal in a patient with asymptomatic chronic dilated cardiomyopathy. CONCLUSION: The results of this study demonstrated that plasma BNP levels could be used as a marker for AC-induced cardiotoxicity; they showed good correlation with echocardiography findings in pediatric cancer patients. Plasma BNP levels may be used for the detection and management of AC-induced cardiotoxicity in Korean children with cancer.
Anthracyclines ; Cardiomyopathy, Dilated ; Child* ; Drug Therapy ; Echocardiography ; Humans ; Natriuretic Peptide, Brain* ; Plasma* ; Stroke Volume

In patient with severe adhesion between lung and aorta, there is some limitation in approaching the distal arch or descending thoracic aorta through the usual left thoracotomy. We report a case of a successfully managed distal arch and descending thoracic aortic aneurysm through the median sternotomy without any manipulations of the lung in a 66 year old man who presented hemoptysis.
Aged ; Aorta ; Aorta, Thoracic* ; Aortic Aneurysm, Thoracic ; Hemoptysis ; Humans ; Lung ; Sternotomy* ; Thoracotomy