No abstract available.
Arteriovenous Fistula* ; Child* ; Embolization, Therapeutic* ; Humans

Malignant melanoma of the anorectal region is rare and carries a poor prognosis. The clinical features of pain, bleeding or an external mass are similar to those encountered in many other disorders of the anal canal. We reports a case of anorectal malignant melanoma with regional lymph node involvement who was treated with abdominoperineal resection. Early diagnosis and accurate evaluation is important, as the prognosis was related to tumor size & the thickness. Abdominoperineal resection should be considered in patient without advanced disease.
Anal Canal ; Early Diagnosis ; Hemorrhage ; Humans ; Lymph Nodes ; Melanoma* ; Prognosis

PURPOSE: We studied the incidence and clinical course of BCG lymphadenitis to investigate the BCG related problem. SUBJECT AND METHODS: Three hundred and eighty-six infants received BCG vaccine (Pasteur-1173p2) in the Well Baby Clinic, Dept. of Pediatrics, Chonnam University Hospital from May 1993 and April 1994. Among them, twenty three infants developed regional lymphadenitis. We investigated the clinical course in twenty six infants with BCG lymphadenitis (three infants were transferred from the Public Health Center and they also had taken same BCG preparations). According to the lymph node size, we divided them into three groups (A : below 1cm, 5 infants; B : 1 to 2cm, 10; C : above 2cm, 11), and evaluated the clinical outcome. RESULTS: 1) The incidence of BCG lymphadenitis was 6.0% (23/386), the differences according to sex or age at vaccination were not observed. 2) Twenty three of twenty six infants (88.5%) showed one lymph node (left axillary 19 infants, left cervical 3 infants, left supraclaviclar 1 infant), but three (11.5%) showed multiple lymph node involvement. 3) Eight (30.8%) showed spontaneous improvement, but eighteen (69.2%) received single or double antituberculous medication at the beginning or after a period of observation. Two infants were treated by incision and drainage. CONCLUSIONS: The incidence of BCG lymphadenitis was relatively higher (6.0%) than previous reports, and the two thirds of the cases received antituberculous medication and or surgical treatment. Further prospective study according to the recent recommendation by the Korean Health Administration should be needed.
BCG Vaccine ; Drainage ; Humans ; Incidence ; Infant ; Jeollanam-do ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Mycobacterium bovis* ; Pediatrics ; Public Health ; Vaccination

The incidence of fetal cardiac arrhythmia is approximately 1-3%. Sustatined fetal tachyarrhythmia may cause fetal hydrops and rnay lead to fetal death. We experienced a case of fetal atrial flutter without fetal hydrops at 34 weeks of gestation, which was diagnosed by fetal echocardiography. Transplacental fetal therapy with maternal digoxin administration resulted in restoration of normal fetal sinus rhythm. At birth, the infant showed normal electrocardiographic finding with normal Apgar scores.
Arrhythmias, Cardiac ; Atrial Flutter* ; Digoxin ; Echocardiography ; Electrocardiography ; Fetal Death ; Fetal Therapies ; Humans ; Hydrops Fetalis ; Incidence ; Infant ; Mothers* ; Parturition ; Pregnancy ; Tachycardia

No abstract available.
Autoantibodies* ; Humans*

PURPOSE: We conducted the immunoassay of pertussis according to ages, in order to evaluate protective immunity against pertussis in Korean populations. METHODS: Healthy subjects were enrolled at four university hospitals in Korea. The subjects were grouped as seven age groups (every 10 years). Antibodies against pertussis toxin (PT) in sera were measured by enzyme linked immunosorbent assay (ELISA) kits. Geometric mean concentrations (GMC) of antibodies and the ratios of the subjects with seroprotective antibody levels were determined. The subjects with antibody titers > or =24.0 EU/mL were considered to seroprotective as the manufacturer's protocol. RESULTS: Total 1,605 subjects (age: 2 months-65 years) participated in this study, and their GMC was 56.16+/-50.54 EU/mL. Among seven age groups, age group <11 year showed the highest GMC (64.78+/-53.24 EU/mL) (P<0.001). In the analysis of the ratios of the subjects with seroprotective antibody titers, 68.2% of the subjects were proven to seroprotective, and age group <11 year also showed the highest ratio (76.5%) (P<0.001). CONCLUSIONS: We found that adolescences or adults (age group > or =11 year) showed lower levels of antibody against pertussis and lower ratio of the subjects with seroprotective antibody titers than children (age group <11 year).
Adult ; Antibodies ; Child ; Enzyme-Linked Immunosorbent Assay ; Hospitals, University ; Humans ; Immunization ; Immunoassay ; Korea ; Pertussis Toxin ; Whooping Cough

A pulmonary thromboembolism (PTE), which is a sudden blockage in a pulmonary artery, usually due to a blood clot, is rare in children. The clinical presentation is often subtle or masked by the underlying clinical condition and the condition must be suspected during clinical testing. Although the choice of treatment depends on the clinical presentation, anticoagulation is the mainstay of therapy for children with PTE. We report the case of a healthy 1-month-old boy who presented with hemoptysis without hemodynamic instability. He was diagnosed based on chest computed tomography with angiography and 99mTc macroaggregated albumin lung perfusion scintigraphy and treated with low-molecular-weight heparin.
Angiography ; Child ; Hemodynamics ; Hemoptysis ; Heparin, Low-Molecular-Weight ; Humans ; Infant* ; Infant, Newborn ; Lung ; Male ; Masks ; Perfusion Imaging ; Pulmonary Artery ; Pulmonary Embolism* ; Thorax

The laparoscopic cholecystectomy is now a standard part of general surgical practice. Conversion from a laparoscopic cholecystectomy to an open cholecystectomy is sometimes required. To identify the factors predisposing to conversion, we retrospectively reviewed all patients undergoing a laparoscopic cholecystectomy from December 1991 to June 1996 at Chosun University Hospital. Factors evaluated were age, sex, history of acute cholecystitis, previous abdominal surgery, associated disease, laboratory findings, and thickened gallbladder wall identified by preoperative ultrasound. Conversion to an open cholecystectomy was required in 42(9.0%) of the 465 patients. The most common reason for conversion was the inability to define the anatomy secondary to inflammation or adhesions. Significant predictors of conversion to an open cholecystectomy were increasing age (age over 60 years), presense of associated disease, a thickened gallbladder wall found by preoperative ultrasound, acute cholecystitis, and increased alkaline phosphatase level. Multivariate analysis found a patients age of over 60 years to be an independent predictor of conversion to an open cholecystectomy. An appreciation for these predictors of conversion will allow appropriate planning by the patients, the institution, and the surgeons. Although data are lacking, increasing experience with laparoscopic cholecystectomy has likely resulted in earlier recognition of the need for conversion to an open cholecystectomy with a resultant decrease in morbidity.
Alkaline Phosphatase ; Cholecystectomy* ; Cholecystectomy, Laparoscopic ; Cholecystitis, Acute ; Gallbladder ; Humans ; Inflammation ; Multivariate Analysis ; Retrospective Studies ; Ultrasonography

BACKGROUND: The flowcytometric analysis of HLA-B27 gives more objective results and is performed more rapidly than traditional serologic methods. We have used a flowcytometric method using only anti-HLA-B27 monoclonal antibody, but it gave frequently borderline mean fluorescence intensity (MFI) results. The authors compared the method using anti-HLA-B27 antibody (HLA- ABC-m3, Serotec) with the Becton Dickinson (BD) method which uses different HLA-B27 antibody (GS145.2) with CD3 antibody. METHODS: The 59 patients that requested HLA-B27 testing were measured by two methods. In the former method, the mononuclear cells were stained with HLA-B27-FITC and the MFIs were determined in lymphocytes. In the BD method, the whole blood was directly stained with CD3-PE and HLA-B27-FITC. The MFIs were determined in the CD3+ cells, and compared with the MFI of the standard. For the cases showing discrepancy in the two methods or borderline values, the HLA-ABC typing was done. RESULTS: Of 21 showing discrepancy, 10 samples had undergone HLA typing. Among nine samples that were positive by the Serotec method but negative by the BD method, four samples were B7, one B40, one B54 and three B7 CREG negative. One that was negative by the Serotec method but positive by the BD method was confirmed as HLA-B27. CONCLUSIONS: The Serotec method showed significant overlap between the MFIs of HLA-B27 and non B27 samples that resulted in a relatively low efficiency compared with the BD method. The discrepant results of the two methods seem to be due to maily the specificity of the antibody used.
Fluorescence ; Histocompatibility Testing ; HLA-B27 Antigen* ; Humans ; Lymphocytes ; Sensitivity and Specificity

No abstract available.
Feeding Methods* ; Humans ; Infant, Newborn*