No abstract available.
Krukenberg Tumor*

No abstract available in English.
Gangrene

Apert syndrome is an uncommon congenital disorder characterized by malformation of the skull, most often acrocephaly or oxycephaly, in association with symmetrical syndactyly of both hands and feet. It is due to a disturbance in the growth of bone and soft tissue, affecting principally the head, hands, and feet. Recently we experienced a typical Apert syndrome expressed only in one neonate of dizygotic twin.
Acrocephalosyndactylia* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniosynostoses ; Foot ; Hand ; Head ; Humans ; Infant, Newborn* ; Skull ; Syndactyly ; Twins, Dizygotic*

Guillain-Barr syndrome is rarely complicated by hypertension, which has been ascribed to sympathetic nervous system hyperactivity. We report a 11 years old female with Guillain-Barr syndrome complicated by persistent hypertension associated with elevated renin-angiotensin. So we report this case with brief review of related literatures.
Child ; Female ; Humans ; Hypertension* ; Sympathetic Nervous System

Neonatal ascites is an uncommon problem with many etiologies. The common causes include hematologic diseases, bowel perforation, obstructive uropathy, cardiovascular diseases, chylous ascites, intrauterine infection, and meconium peritonitis. Recently, the wide application of sonography has greatly narrowed the list of differential diagnosis of neonatal ascites. Meconium peritonitis is readily diagnosed if calcification in the abdomen or scrotum can be seen radiologically or sonographically in a neonate with abdominal distension at birth. We report a case of generalized meconium peritonitis without intraabdominal calcification by radiologic and sonographic study and notable meconium hydrocele at birth.
Abdomen ; Ascites ; Cardiovascular Diseases ; Chylous Ascites ; Diagnosis, Differential ; Hematologic Diseases ; Humans ; Infant, Newborn ; Meconium* ; Parturition ; Peritonitis* ; Scrotum ; Ultrasonography

PURPOSE: The clinical findings of early neonatal hypocalcemia are variable and it is difficult to find relationship between the symptoms and hypocalcemia due to complex causes. The purpose of this study is to establish the relationship between early neonatal hypocalcemia and clinical manifestations and to propose a guideline for appropriate treatment of early neonatal hypocalcemia, especially in asymptomatic cases. METHODS: Study subjects were all sick babies admitted to nursery and NICU and randornly selected 43 healthy babies at Sun General Hospital from January 1996 to December 1996. We examined serum calcium level within 72 hours after birth. Then we evaluated prospectively clinical findings according to each disease category in hypocalcemic cases and analysed the relationship of time course of clinical findings with hypocalcemia and compared serum calcium concentration followed by each therapy after 3 days. RESULTS: The results were as follows. 1) The incidence of early neonatal hypocalcernia was high in premature infants, low birth weight infants, infants with neonatal asphyxia, hyaline membrane disease and transient tachypnea. 2) Tremor, seizure, apnea, dyspnea, abdominal distension, cyanosis, and vomiting were frequently presented symptoms in early neonatal hypocalcemia. 3) In the cases of early hypocalcemia with symptoms, these symptoms persisted continuously after norrnalization of serum calcium concentration. 4) Among asymptomatic hypocalcernic group, mean serum calcium levels changed from 6.7 mg/dL to 8.7 mg/dL in 23 cases of no treatment, from 5.4 mg/dL to 10.3 mg/dL in 4 cases of calcium gluconate infusion, and from 6.3 mg/dL to 8.7 mg/dL in 7 cases of feeding low phosphorus containing milk. None persisted in hypocalcemic state irrespective of treatment methods. CONCLUSION: It is difficult to regard these symptoms as a rule to treatment because these symptoms were present after normalizaton of serum calcium concentration. In addition, asymptomatic hypocalcemia was improved shortly without any treatment without any problem. We conclude that for asymptomatic hypocalcemia, withholding dangerous calcium gluconate infusion would be perrnissible.
Apnea ; Asphyxia ; Calcium ; Calcium Gluconate ; Cyanosis ; Dyspnea ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Hypocalcemia* ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Milk ; Nurseries ; Parturition ; Phosphorus ; Prospective Studies ; Seizures ; Solar System ; Tachypnea ; Tremor ; Vomiting

No abstract available.
Hypertension, Renovascular*

PURPOSE: It was noted some changes of clinical manifestations of mycoplasma pneumonia. we reviewed and compared these changes and saught any clues causes for proper dignosis and treatment. METHODS: We divided patients with mycoplasma pneumonia into two groups, Group 1 (from Jan. to Dec. 1996) and Group 2 (from Jan. to Dec. 1994), and analyzed clinical, radiologic, and serologic differences. RESULTS: Mean age of onset lowered markedly from was 8.34 +/- 2.56 years to 6.91 +/- 3.28 years (P<0.05). In clinical symptoms, high fever lasted longer and gastrointestinal symptoms were more frequent noted group 1. Serologically, high titers of mycoplasma-specific antibody (>1 : 1280) were more frequently observed in group 1 and correlated with severity of clinical manifestations. In radiologic findings, alveolar consolidation were significantly prominent findings in Group (P<0.05). The mean period of response to Roxithromycin was not difference between two groups but longer lasting fever (> or = 3 days) in spite of medication were more prevalent in Group 1 (P<0.05), suggesting increased cases of diminished responsiveness to treatment. CONCLUSIONS: Recently, there was some clinical changes of mycoplasma pneumonia, lowering of onset age, severe clinical symptoms, and more decreased responsiveness to antibiotic treatment. We suggest that it is to neccessary to make some efforts to prevent antibiotics abuse and to decrease the occurrence of resistant strains by introducing of new method for early diagnosis, selective identification of micro-organism and minute sensitivity test for antibiotics.
Age of Onset ; Anti-Bacterial Agents ; Early Diagnosis ; Fever ; Humans ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Roxithromycin

BACKGROUND: There were several studies for the incidence of gastroesophageal reflux associated with the laryngeal mask airway(LMA), but the results of those studies were much different much different from one another. The aim of this study was to compare the incidence of gastroesophageal reflux and regurgitation of gastric contents between the LMA and the endotracheal tube(ETT). METHOD: Ninety patients scheduled for elective orthopedic surgery with a standardized general anesthetic technique were randomly allocated to receive either a LMA(n-49) or a ETT(n=41) for airway management. The esophageal manometry was carried out for the exclusion of esophageal motility disorders and the 24-hour ambulatory pH metry was done from one day before the operation. A methylene blue(50mg) capsule was swallowed just before the induction and the simultaneous recordings of pH were maintained during anesthesia. At the end of anesthesia, the episodes of regurgitation of gastric contents above hypopharynx were analyzed by the pharyngeal blue staining and the pH metric data were analyzed for the detection of gastroesophageal relux episodes during anesthesia. RESULTS: There was no significant difference in the incidence of gastroesophageal relux(pH< or =4) between two groups; only two patients in LMA and three patients in ETT had reflux episodes during the removal or arousal phase. There was no episode of the pharyngeal blue staining in both group. All of the gastroesophageal reflux patients in both group developed a cough or straining during those phases. There was no clinical evidence of aspiration of gastric contents in both group. CONCLUSION: In comparison with ETT, use of LMA does not appear to increase the incidence of gastroesophageal reflux and regurgitation above hypophryngeal level in positive pressure ventilating patients during long surgical procedures. Therefore, the risk of aspiration in LMA will not be much more than ETT.
Airway Management ; Anesthesia ; Arousal ; Cough ; Esophageal Motility Disorders ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Manometry ; Masks* ; Orthopedics

Since Jacob and associates in 1959 were the first to report a case of triple X syndrome associated with ovarian failure, the incidence of trisomy X in newborn population is estimated to be 1 in 1,000 live born female. Most of them have normal physical appearance and puberty. We report a case of a newborn with triple X syndrome confirmed by chromosomal study whose clinical features included left preauricular pit, broad nose, thin lip, anogenital anomaly. Echocardiography showed atrial septal defect and ventricular septal defect.
Adolescent ; Echocardiography ; Female ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Infant, Newborn ; Lip ; Nose ; Puberty ; Trisomy