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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The aim of this study was to investigate the relationship between somatostatinergic tone (SST) and the size of growth hormone (GH)-producing pituitary tumors. GH levels of 29 patients with newly diagnosed acromegaly were measured using a 75-gram oral glucose tolerance test (OGTT), an insulin tolerance test (ITT), and an octreotide suppression test (OST). Differences between GH levels during the ITT and the OGTT (DeltaGH(IO)), and between the OGTT and the OST at the same time point (DeltaGH(OS)) were compared according to the size of the tumor and the response pattern to the OST. DeltaGH(IO) of macroadenomas (n=22) was non-significantly higher than those of microadenomas while DeltaGH(OS) of macroadenomas were significantly higher than those of microadenomas. According to further analyses of macroadenomas based on the response pattern to the OST, GH levels during the ITT were significantly higher in non-responders. DeltaGH(OS) showed near-significant differences between responders and non-responders. In conclusion, as the size of the pituitary tumor increases, the effect of glucose on SST appears to be attenuated. Macroadenomas that are non-responders to the OST possess a portion of GH secretion exceeding the range of regulation by SST.
Acromegaly/*diagnosis/*pathology ; Adenoma/drug therapy/*pathology ; Adult ; Aged ; Antineoplastic Agents, Hormonal/therapeutic use ; Female ; Glucose Tolerance Test ; Human Growth Hormone/*blood/secretion ; Humans ; Insulin/blood ; Insulin-Like Growth Factor I/analysis ; Male ; Middle Aged ; Octreotide/therapeutic use ; Pituitary Neoplasms/drug therapy/*pathology

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: 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: 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*

BACKGROUND: Aging population correspond with an increase in the numbers of dementia patients. Dementia decreases the quality of life of patients and care-givers. However, current pharmacological treatment is limited by modest efficacy and adverse effect. Nonpharmacological treatment for dementia has been considered to be a substitute treatment. Recently we developed a special planned program for dementia with depression. The aim of this study was to evaluate therapeutic effect of this program. METHODS: We included patients aged 65 and older who diagnosed dementia with depression in a geriatric institution from April to June, 2006. We surveyed their sex, age, education period, and histories of hypertension, smoking, and alcohol intake. Patients in experimental group carried out our program, including cooking, painting, recreation, and activity, 9 times for 60 minutes a session. All included patients were checked Korean Mini-Mental State Examination (K-MMSE) and Korean Form of Geriatric Depression Scale (KGDS) before starting program and after 3 months when programs finished. RESULTS: There was no difference in demographic factors between two groups. K-MMSE was significantly improved in experimental group compared with control group (P = 0.01). And, the KGDS was significantly improved in experimental group compared with control group (P = 0.00). CONCLUSION: Multidivisional program for social skill improvement was effective on treatment for patients of dementia with depression. Nonpharmacological treatment for dementia with depression would be developed and studied to enhance the qualities of life of patients and care of dementia.
Aged ; Aging ; Alzheimer Disease ; Cooking ; Dementia ; Demography ; Depression ; Humans ; Hypertension ; Paint ; Paintings ; Quality of Life ; Recreation ; Smoke ; Smoking

BACKGROUND: Women with gestational diabetes mellitus (GDM) are at high risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD); continuous life-style intervention, especially diet, is central to managing T2DM and CVD. However, little is known about the dietary patterns of women with GDM after delivery. The goal of this study was to compare the eating habits and food intakes of women diagnosed with GDM during the early postpartum period. METHODS: We performed a 75 g oral glucose tolerance test (OGTT) in 184 women with GDM between 6 and 12 weeks after delivery. Based on the results of the OGTT, the subjects were divided into three groups according to the American Diabetes Association criteria; normal glucose tolerance (NGT) (n=100), pre-diabetes (n=73), and diabetes mellitus (DM) (n=11). Eating habits and usual food intake after delivery were investigated using a questionnaire, based on 24 hour-recall, which was administered by a trained dietitian. The daily intake data were analyzed using CAN Pro 3.0. Blood tests were performed pre- and post-delivery. RESULTS: Eating habits were not significantly different among the three groups. However, animal fat consumption was significantly different among the three groups. The intake ratio of fat calories to total calories was also significantly higher in the pre-diabetes and DM groups. CONCLUSION: Although diet in the period 6 to 12 weeks postpartum did not influence glucose level, it may be important to educate women with GDM about the risks of excessive animal fat intake during pregnancy and the postpartum period in order to prevent later onset of T2DM.
Animals ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Diet ; Eating ; Female ; Glucose ; Glucose Tolerance Test ; Hematologic Tests ; Humans ; Postpartum Period ; Pregnancy ; Surveys and Questionnaires