PURPOSE: Alterations in cerebral blood flow are very important for understanding the neurological consequences of all varieties of perinatal asphyxia. The purpose of this study is to measure the change of cerebral blood flow velocity and resistance index (RI) of middle cerebral artery (MCA) according to the time in asphyxiated infants. METHODS: We studied 7 asphyxiated term infant and 27 normal term infant who were born at Ewha Womans University Hospital from January 1996 to August 1997. Using the Doppler ultrasound, we examined blood flow velocity and RI of the middle cerebral artery. RESULTS: Clinical characteristics were not significantly different in both groups. Peak systolic flow velocity (PSFV) in asphyxiated infants significantly decreased than control (P<0.05). End diastolic flow velocity (EDFV) was not significantly different in both groups. RI in asphyxiated infants significantly decreased for 24 hours (P<0.05). No control infant ever had a RI value of 0.55 or below, three (42.9%) asphyxiated infants had a RI value of 0.55 or below. The changes of the systemic BP and heart rate were not significant. Two (28.6%) asphyxiated infants were proven periventricular white matter ischemia by ultrasonography. CONCLUSION: It is therefore very important to monitor RI in asphyxiated infants even if the degree of asphyxia is mild.
Asphyxia ; Blood Flow Velocity* ; Female ; Heart Rate ; Humans ; Infant* ; Ischemia ; Middle Cerebral Artery ; Ultrasonography

PURPOSE: Alterations in cerebral blood flow are very important for understanding the neurological consequences of all varieties of perinatal asphyxia. The purpose of this study is to measure the change of cerebral blood flow velocity and resistance index (RI) of middle cerebral artery (MCA) according to the time in asphyxiated infants. METHODS: We studied 7 asphyxiated term infant and 27 normal term infant who were born at Ewha Womans University Hospital from January 1996 to August 1997. Using the Doppler ultrasound, we examined blood flow velocity and RI of the middle cerebral artery. RESULTS: Clinical characteristics were not significantly different in both groups. Peak systolic flow velocity (PSFV) in asphyxiated infants significantly decreased than control (P<0.05). End diastolic flow velocity (EDFV) was not significantly different in both groups. RI in asphyxiated infants significantly decreased for 24 hours (P<0.05). No control infant ever had a RI value of 0.55 or below, three (42.9%) asphyxiated infants had a RI value of 0.55 or below. The changes of the systemic BP and heart rate were not significant. Two (28.6%) asphyxiated infants were proven periventricular white matter ischemia by ultrasonography. CONCLUSION: It is therefore very important to monitor RI in asphyxiated infants even if the degree of asphyxia is mild.
Asphyxia ; Blood Flow Velocity* ; Female ; Heart Rate ; Humans ; Infant* ; Ischemia ; Middle Cerebral Artery ; Ultrasonography

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.
Abscess ; Bicuspid ; Dental Pulp Calcification ; Dental Pulp Cavity ; Dental Pulp Necrosis ; Female ; Gutta-Percha ; Humans ; Incisor ; Tooth ; Tooth Bleaching ; Ultrasonics ; Young Adult

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PURPOSE: The renal manifestations of tuberous sclerosis complex (TSC) are remarkably diverse, including polycystic kidney disease, simple renal cysts, renal cell carcinomas, and angiomyolipomas. All of these occur in children as well as adults in TSC. Angiomyolipomas, which can cause spontaneous life-threatening hemorrhages, are by far the most prevalent and the greatest source of morbidity. Here, we will address our experience, adding to the literature on pediatric patients with TSC requiring evaluation and treatment for renal manifestations. METHODS: A retrospective analysis was made on 19 patients in whom TSC was diagnosed between May 2001 and Oct. 2005 at Severance Hospital. All patients had clinical diagnoses of TSC as defined by the 1998 tuberous sclerosis complex consensus conference. RESULTS: The patients consisted of 13 boys and 6 girls with a mean age of 7.3 years (range 1 to 22). The renal disease associated with TSC included angiomyolipoma in nine patients (47.4 percent), renal simple cyst in one (5.3 percent), hydronephrosis in one (5.3 percent) patient. Eight patients (42.1 percent) presented with normal kidney contours at abdominal ultrasonography. One patient underwent renal replacement therapy due to chronic renal insufficiency after nephrectomy. Hemorrhage from angiomyolipoma was not detected. CONCLUSION: In our review of 19 cases of TSC, renal manifestations are reported in 57.9 percent of patients. Asymptomatic angiomyolipoma associated with TSC grow gradually, although severe hemorrhages are rare. So patients with TSC should be followed up with serial computerized tomography or abdominal ultrasonography. And also, renal function should be monitored conservatively.
Adult ; Angiomyolipoma ; Carcinoma, Renal Cell ; Child ; Consensus ; Diagnosis ; Female ; Hemorrhage ; Humans ; Hydronephrosis ; Kidney ; Kidney Failure, Chronic ; Nephrectomy ; Polycystic Kidney Diseases ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Retrospective Studies ; Tuberous Sclerosis* ; Ultrasonography

PURPOSE: Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). METHODS: A retrospective analysis was made on 46 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. RESULTS: Median follow-up time was 30 months(range 2-102 months). All patients underwent radionuclide scans and voiding cystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). CONCLUSION: In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.
Child* ; Follow-Up Studies ; Humans ; Hypertension ; Multicystic Dysplastic Kidney* ; Nephrectomy ; Prognosis ; Renal Insufficiency ; Retrospective Studies ; Ultrasonography ; Urinary Tract

No abstract available.
Anaphylaxis* ; Animals ; Antibodies, Monoclonal* ; Hypersensitivity* ; Immunoglobulin G* ; Interferons* ; Mice*

Juvenile rheumatoid arthritis(JRA) is the most common major connective tissue disease in children. Renal involvement in JRA is rare. Among the renal lesions that have been reported in JRA, amyloidosis and drug-induced nephropathy are the most common. Crescentic glomerulonephritis in JRA has rarely been reported. We report a case of ANCA-associated pauci-immune crescentic glomerulonephritis in JRA. The patient was a 15-year old boy with a 3-year history of JRA. He presented with gross hematuria, proteinuria, positive p-ANCA and elevation of BUN and creatinine. Pathologic findings revealed focal necrotizing and crescentic glomerulonephritis. There were no significant immunoglobulin or complement deposits. His renal function recovered after intravenous methylprednisolone pulse therapy and oral steroid use. In Korea, this is the first reported case of pauci-immune crescentic glomerulonephritis in JRA.
Adolescent ; Amyloidosis ; Antibodies, Antineutrophil Cytoplasmic ; Arthritis, Juvenile* ; Child ; Complement System Proteins ; Connective Tissue Diseases ; Creatinine ; Glomerulonephritis* ; Hematuria ; Humans ; Immunoglobulins ; Korea ; Male ; Methylprednisolone ; Proteinuria

PURPOSE: To report a case of corneal ulcer due to Alcaligenes faecalis in a patient with a preexisting corneal ulcer. CASE SUMMARY: A 58-year-old male patient presented with a corneal ulcer without a history of any trauma. The patient had a history of corneal ulcer 9 months earlier. The patient had previously been diagnosed with diabetic retinopathy and neovascular glaucoma, and his visual acuity was no light perception. Corneal scraping and culture yielded Alcaligenes faecalis susceptible to most antibiotics in the antibiotic susceptibility test. After treatment with empirical systemic antibiotics and eyedrops, his eye improved with a remaining corneal scar. CONCLUSIONS: Alcaligenes faecalis should be considered as a causal pathogen of corneal ulcer in patients with suspicious compromised ocular surface, such as previous corneal ulcer.
Alcaligenes ; Alcaligenes faecalis ; Anti-Bacterial Agents ; Cicatrix ; Corneal Ulcer ; Diabetic Retinopathy ; Eye ; Glaucoma, Neovascular ; Humans ; Light ; Male ; Middle Aged ; Ophthalmic Solutions ; Visual Acuity

PURPOSE: The aim of this case report is to present the longitudinal results of sinus grafting using a new demineralized bovine bone material (DBBM) in human cases. METHODS: A patient with a resorbed maxilla was treated by maxillary sinus grafting using a new deproteinized bovine bone material. After a healing period of 6.5 months, three implants were placed and restored. The patient was periodically recalled and followed up for 5 years after restoration. RESULTS: Twelve partially edentulous patients (average age, 55.7 years) were followed up. All patients had insufficient residual height in their maxillary posterior area and underwent maxillary sinus graft surgery to increase the height of their maxilla. In all, 27 fixtures were placed in the augmented bone area. On average, 8.6 months later, implants were loaded using provisional or final restorations. The observation period ranged from 27 to 75 months (average, 43.3 months), and the patients did not show any severe resorption of the graft material or any infection during this time. CONCLUSIONS: Our results show that the new DBBM is useful for a maxillary sinus graft procedure. Good healing responses as well as reliable results were obtained for an average follow-up period of 43.3 months.
Bone Substitutes ; Follow-Up Studies ; Humans ; Maxilla ; Maxillary Sinus* ; Sinus Floor Augmentation ; Transplants*