The leukemias are the most common form of childhood cancer. The same kinds of leukemia are found in childrenand in adults. Because the radiologist is involved in the initial diagnosis, the evaluation of response to therapyand demonstration of complications, it is important that he understands the clinical and radiological features ofleukemia. This report is a clinical and radiological review of 80 cases who visited to Chonnam National UniversityHospital from Jan. 1977 to June 1981. The results are summarized as follows. 1. Most prevalent group of age wasbetween 10 to 14 years old(25%) and male was affected more frequently than female with the ratio of 1.4:1. Acuteform of leukemia was 95% and acute myelocytic leukemia was more frequent than acute lymphocytic leukemia. 2.Pallor with anemic conjuctiva was the most prominent clinical manifestation of the leukemia. Fever was the mostcommon symptom in childhood leukemia and general weakness was the most common in adult leukemia. 3. Hematologicexamination revealed marked anemia(Hemoglobin level was less than 8.0gm/100ml in 65%). In 17.5% the leukocytecount was less than 5,000/cu.mm and more than 10,000/cu.mm in 65%. Platelet count was less than 50,000/cu/mm in 23.8% and between 50,000 and 150,000/cu.mm in 43.7%. 4. The abnormal findings in chest X-ray films were observedin 35%. Pneumonia(18.8%) was the most common and lymphadenopathy(17.5%), pleural effusion(12.5%), leukemicinfiltration (3.75%), pulmonary congestion and pulmonary edema(3.75%) were descending order of frequency. 5. Theabnormal findings in long bone X-ray films were observed in 75% and the bone changes were more frequent in acutelymphocytic leukemia (57.1%) than in acute myelocytic leukemia(17.9%). Metaphseal transverse radiolucent band(75.0%) was the most common and osteolytic lesion(60.7%), periosteal reaction (35.7%), osteosclerosis(7.1%) were descending order of frequency. 6. The common sites of bony changes were femur(75%), tibia(57.1%), fibular(57.1%)humerus, radius and ulna in order of frequency. 7. In 35.7% of the cases who complained of bone or joint pain withabnormal findings in long bone x-ray films, leukocyte count was less than 5,000/cu.mm.
Adult ; Arthralgia ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fever ; Humans ; Jeollanam-do ; Leukemia ; Leukemia, Myeloid, Acute ; Leukocyte Count ; Male ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Radius ; Thorax ; Ulna ; X-Ray Film

BACKGROUND AND OBJECTIVES: Corrected transposition of the great arteries (C-TGA) is a rare congenital heart disease, of which prognosis depends on the associated cardiac defects, systemic ventricular function, competency of atrioventricular valves, and the presence of conduction disturbances. This study was aimed to assess the midterm follow-up status of C-TGA. PATIENTS AND METHODS: Retrospective review was performed on 89 cases with C-TGA and two ventricles of adequate size, which were diagnosed between January 1980 and June 1997. RESULTS: Study subjects consisted of 56 males and 33 females (average age at diagnosis, 9 months). Mean follow-up duration was 98 months (range, 2 months - 23 years 8 months). Based on the associated cardiac anomalies, there were 6 simple C-TGA and 83 complex C-TGA patients. Surgery including 19 palliative and 47 corrective operations was attempted on 61 cases at mean age of 69 months. Tricuspid regurgitation (TR) was noted at the time of first examination in 52 (mild in 39; moderate in 8; severe in 5) and progressed in 18 patients. TVR was done on 5 patients and double switch on 7 patients. Arrhythmia was noted preoperatively (complete AV block in 3) in 11 and postoperatively (postoperative complete AV block in 3) in 22 patients. A total of 13 cases died including 10 perioperative deaths during follow-up. Actuarial survival rate at 10 year was 84.5%. CONCLUSION: In this study, the midterm outcome of corrected TGA is acceptable. However, long-term follow-up is required in respect to the function of atrioventricular valve and the systemic ventricle.
Arrhythmias, Cardiac ; Arteries* ; Atrioventricular Block ; Child* ; Diagnosis ; Female ; Follow-Up Studies* ; Heart Defects, Congenital ; Humans ; Male ; Prognosis ; Retrospective Studies ; Survival Rate ; Tricuspid Valve Insufficiency ; Ventricular Function

BACKGROUND: Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA) has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. METHODS: We analyzed the data of 51 patients who underwent the atrial switch operation for complete TGA at Seoul National University Hospital between January 1981 and June 1993 retrospectively. RESULTS: The patients were composed of 36 males and 15 females (mean age at operation, 15+/-30 months, range 2 months-18 years). Senning operation was undertaken in 43 and Mustard operation in 8. Among these, 27 had simple and 24 complex complete TGA. The early mortality rate within 1 month postoperatively was 39% and the late mortality rate 16%. The actuarial survival rate after 10 years was 78%. Of these, 17 cases have been followed up so far. Although the significant tricuspid regurgitation was noted in 9, right ventricular systolic function was maintained in all of them. Preoperative sinus node dysfunction was noted in 1 case. Postoperatively, premature ventricular contractions were found in 8 cases, atrial flutter in 4, and sinus node dysfunction in 7. Subclinical pulmonary venous obstruction was found in 2 and systemic venous obstruction in 1. At present, one takes digoxin for prevention of atrial flutter and 7 take digoxin, furosemide, and/or angiotensin-converting enzyme inhibitors for prevention of ventricular functional deterioration. Twelve cases were in New York Heart Association functional class I at the latest follow-up and 5 were in class II. CONCLUSION: This study revealed that morbidity and mortality were not low after atrial switch operation. However, considering the good long-term functional status in the survivors, atrial switch operation could be an alternative to arterial switch operation in complicated cases of TGA.
Angiotensin-Converting Enzyme Inhibitors ; Arteries* ; Atrial Flutter ; Digoxin ; Female ; Follow-Up Studies* ; Furosemide ; Heart ; Humans ; Male ; Mortality ; Mustard Plant ; Postoperative Complications ; Retrospective Studies ; Seoul ; Sick Sinus Syndrome ; Survival Rate ; Survivors ; Tricuspid Valve Insufficiency ; Ventricular Premature Complexes

BACKGROUND: Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA) has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. METHODS: We analyzed the data of 51 patients who underwent the atrial switch operation for complete TGA at Seoul National University Hospital between January 1981 and June 1993 retrospectively. RESULTS: The patients were composed of 36 males and 15 females (mean age at operation, 15+/-30 months, range 2 months-18 years). Senning operation was undertaken in 43 and Mustard operation in 8. Among these, 27 had simple and 24 complex complete TGA. The early mortality rate within 1 month postoperatively was 39% and the late mortality rate 16%. The actuarial survival rate after 10 years was 78%. Of these, 17 cases have been followed up so far. Although the significant tricuspid regurgitation was noted in 9, right ventricular systolic function was maintained in all of them. Preoperative sinus node dysfunction was noted in 1 case. Postoperatively, premature ventricular contractions were found in 8 cases, atrial flutter in 4, and sinus node dysfunction in 7. Subclinical pulmonary venous obstruction was found in 2 and systemic venous obstruction in 1. At present, one takes digoxin for prevention of atrial flutter and 7 take digoxin, furosemide, and/or angiotensin-converting enzyme inhibitors for prevention of ventricular functional deterioration. Twelve cases were in New York Heart Association functional class I at the latest follow-up and 5 were in class II. CONCLUSION: This study revealed that morbidity and mortality were not low after atrial switch operation. However, considering the good long-term functional status in the survivors, atrial switch operation could be an alternative to arterial switch operation in complicated cases of TGA.
Angiotensin-Converting Enzyme Inhibitors ; Arteries* ; Atrial Flutter ; Digoxin ; Female ; Follow-Up Studies* ; Furosemide ; Heart ; Humans ; Male ; Mortality ; Mustard Plant ; Postoperative Complications ; Retrospective Studies ; Seoul ; Sick Sinus Syndrome ; Survival Rate ; Survivors ; Tricuspid Valve Insufficiency ; Ventricular Premature Complexes

Schizophyllum commune is an edible and medicinal mushroom widely distributed in the world. The optimal growth conditions for the mycelia of 10 strains of the fungus were investigated. The temperature suitable for the mycelial growth and density was obtained at 30~35degrees C. Among the tested conditions, the minimum mycelial growth was found at 15degrees C. In case of pH, the most favorable growth was found at pH 5. The results indicated that this mushroom well adapted to high temperature and low pH for its mycelial growth. Considering growth phenotype of mycelia, Hamada, Hennerberg, PDA and YM were the most suitable and Lilly, Glucose triptone, Glucose peptone and Hoppkins were the most unfavorable among tested media for the mycelial growth of S. commune. Out of tested carbon sources, dextrin and fructose were the most suitable and lactose, mannose and sorbitol were the unsuitable for the fungus. Compact mycelial density was obtained from most of the carbon sources. Among used nitrogen sources, calcium nitrate, potassium nitrate and alanine were the most appropriate and the most incompatible were ammonium phosphate, histidine, urea and arginine for mycelial growth of S. commune on the culture media. Calcium nitrate, histidine and potassium nitrate showed moderately thin or thin, and rest of nitrogen sources showed compact or moderately compact mycelial density.
Agaricales ; Alanine ; Arginine ; Calcium ; Calcium Compounds ; Carbon ; Culture Media ; Dimenhydrinate ; Fructose ; Fungi ; Glucose ; Histidine ; Hydrogen-Ion Concentration ; Lactose ; Mannose ; Nitrates ; Nitrogen ; Peptones ; Phenotype ; Phosphates ; Potassium ; Potassium Compounds ; Quaternary Ammonium Compounds ; Schizophyllum ; Sorbitol ; Urea

Vegetative growth of four different strains of Hericium erinaceus was observed. The temperature suitable for optimal mycelial growth was determined to be 25degrees C, with growth observed in the extend temperature range of 20~30degrees C. The different strains of this mushroom showed distinct pH requirements for their optimum vegetative growth, with the most favorable growth observed at pH 6. Considering vegetative mycelial growth, PDA, YM, Hennerberg, Hamada, and Glucose peptone were the most favorable media, and Czapek Dox, Hoppkins, Glucose tryptone, and Lilly were the most unfavorable media for these mushroom strains. With the exception of lactose, most of the carbon sources assayed demonstrated favorable vegetative growth of H. erinaceus. For mycelial growth, the most suitable nitrogen source was alanine and the most unsuitable was histidine. Oak sawdust medium supplemented with 10~20% rice bran was the best for mycelial growth of the mushroom.
Agaricales ; Alanine ; Carbon ; Culture Media ; Ecosystem ; Glucose ; Histidine ; Hydrogen-Ion Concentration ; Lactose ; Nitrogen ; Peptones

RPGN is a catastrophic form of acute glomerulonephritis characterized by an abrupt onset and rapid deterioration of renal function resulting in oliguria within weeks or months. RPGN is seen in a variety of systemic disorders, including systemic lupus erythematosus, poly arteritis nodosa, Wegener's granulomatosis and subacute bacterial endocarditis. In addition, RPGN is seen in association with a variety of primary renal diseases such as poststreptococcal glomerulonephritis, membranoproliferative glomerulonephritis, and IgA nephropathy, Goodpasture's syndrome. Toxic epidermal necrolysis(TEN) is a drug induced life threatening disease characterized by extensive epidermal detachment, necrosis, and mucosal erosion. TEN may involve liver, lung, intestine, and kidney. But renal involvement has seldom been reported. We report on a 63-year-old patient who developed a RPGN with a TEN. Renal biopsy showed pauci-immune crescentric glomerulonephritis and skin biopsy showed edematous change with extravasated erythrocytes in upper dermis and several individually necrotic keratinocytes. ANCA and FANA test was negative. Our patient recovered renal function with steroid pulse therapy. The pathophysiology of TEN is unresolved but abnormal cytokine release(e.g., tumor necrosis factor) has been implicated in pathogenesis of TEN. Because various cytokines have direct toxic effect on kidney structure, the tubular and glomerular damage may be related to the cytokines involved in TEN. To our knowledge, this is the first case documenting the presence of RPGN in patients with TEN. And there maybe some relations between PRGN and TEN which require further study.
Anti-Glomerular Basement Membrane Disease ; Antibodies, Antineutrophil Cytoplasmic ; Arteritis ; Biopsy ; Cytokines ; Dermis ; Endocarditis, Subacute Bacterial ; Erythrocytes ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Humans ; Intestines ; Keratinocytes ; Kidney ; Liver ; Lung ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Oliguria ; Skin ; Stevens-Johnson Syndrome* ; Wegener Granulomatosis