No abstract available.
Incidence* ; Nurseries* ; Parenteral Nutrition, Total* ; Pharmacy* ; Sepsis*

No abstract available.
Citrobacter freundii* ; Citrobacter* ; Humans ; Infant, Newborn* ; Meningitis*

We report two cases of hyalinizing trabecular carcinoma (HTC) of the thyroid gland. These two patients were euthyroid women aged 36 and 65 years of age. The tumors were encapsulated and measured 0.8 and 4.0 cm in diameter, respectively. Histologically, the tumors were composed of a compact proliferation of cells in a lobular and trabecular pattern with an intervening hyalinized, fibrotic vascular stroma. Occasionally the cells were arrayed in microfollicles. Multiple and serial sections showed cords of tumor cells invading into the capsule in both cases and vascular invasion in one case. These findings suggested that HTCs are a malignant counterpart of hyalinizing trabecular adenoma, similar to conventional follicular tumor. Positive immunostaining of tumor cells for thyroglobulin and negative staining for high molecular weight cytokeratin, cytokeratin 19, neuron specific enolase, chromogranin, and synaptophysin allowed distinction from medullary carcinoma. Even though HTCs are an heterogeneous group of tumors, the present two cases are probably variants of follicular carcinoma rather than papillary carcinoma.
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Female ; Humans ; Hyalin* ; Keratin-19 ; Keratins ; Molecular Weight ; Negative Staining ; Phosphopyruvate Hydratase ; Synaptophysin ; Thyroglobulin ; Thyroid Gland*

Median raphe canal is an uncommon disease and represents a defect abnormality of the male genitalia. It occurs along the ventral median raphe from the glans penis to the anus. Histologically the canal is lined by stratified squamous epithelium which dose not communicate with the urethra. Surgical excision is the treatment of choice. Recently we observed a 25-year-old male patient who had had a median raphe canal located in the ventral aspect of penis.
Adult ; Anal Canal ; Epithelium ; Genitalia, Male ; Humans ; Male ; Penis* ; Urethra

BACKGROUND: Several abnormalities of the autonomic regulation of the heart have been noted after acute myocardial infarction(AMI). Measurement of heart rate(HR) variability has been reported to provide indirect, noninvasive estimate of the cardiac efferent parasympathetic activity. The purposes of this study were to get the information on heart rate variability after AMI and to determine its relation to clinical and hemodynamic data. METHODS: We measured HR variability in 28 patients(23 men and 5 women : mean age, 56.6+/-10.4 years) 3-15days after AMI, in 25 patients with unstable angina and in 21 normal subjects by using triangular interpolation of the frequency distribution histogram om normalto-normal RR intervals from Holter tapes. RESULTS: HR variability was lower in AMI than unstable angina patients(357.9+/-118.6 versus 426.1+/-122.5 msec : p<0.05) and normal subjects(525.1+/-137.4 msec : p<0.025). There was no difference for infarct site, thrombolytic therapy, presence of Q-wave. HR variability was significantly related to mean 24-hour HR, left ventricular ejection fraction(all p<0.0001), left ventricular end diastolic diameter(p<0.05). HR varability was lower in patients belonging to Killip class 2-4 and who reqired the use of diuretics or digitalis(all p<0.05). CONCLUSION: After AMI, HR variabillity was reduced and significantly related to clinical and hemodynamic indexes of severity. Measurement of HR variability early after AMI may offer important clinical information for the early high stratification of patients.
Angina, Unstable ; Autonomic Nervous System ; Diuretics ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Infarction* ; Thrombolytic Therapy

PURPOSE: To evaluate the pattern of colonic diverticulosis according to age and sex, and recent trend. MATERIALS AND METHODS: The authors retrospectively reviewed 120 cases of colonic diverticulosis in 1,020 patients who had undergone a double contrast barium enema examination between January 1st, 1993, and December 31st, 1995, and analyzed the frequency, size, multiplicity and anatomical site, according to age and sex. Diverticulum size was classified into one of three groups : less than 5mm, 5-10mm, over 10mm in diameter. RESULTS: The overall incidence of colonic diverticulosis was 120 cases among 1,020 patients(11.8%) with an incidence 5.3 times higher in males than in females. Peak incidence was in the fifth decade, with 19 cases (15.8%) among males, and after the sixth decade, with four cases(3.3%) among females. Mean age was 57.7 years. Diverticulum size of 5-10mm in diameter was predominant 2% of cases) ; average diameter was 5-6mm. The incidence of colonic diverticulosis was 5.1 times more frequent in the right colon(101 cases) than in the left (20 cases). CONCLUSION: The overal overall incidence of colonic diverticulosis has continually increased; in addition it has also recently increased slightly in left-sided colon. This is thought to be due to various factors, both congenital and acquired, including longer life with good health care, constipation, irritable bowel syndrome, stress and the tendency of eating patterns to more closely resemble those of the west.
Barium* ; Colon* ; Constipation ; Delivery of Health Care ; Diverticulosis, Colonic* ; Diverticulum ; Eating ; Enema* ; Female ; Humans ; Incidence ; Irritable Bowel Syndrome ; Male ; Retrospective Studies

PURPOSE: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of Tc(99m) DISIDA scan and presence of acholic stool. METHODS: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent Tc(99m) DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. RESULTS: Patients who had negative intestinal activity on Tc(99m) DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on Tc(99m) DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on Tc(99m) DISIDA scan. The result of Tc(99m) DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on Tc(99m) DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on Tc(99m) DISIDA scan showed higher serum level of ALT. CONCLUSION: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.
Biliary Atresia ; Bilirubin ; Biopsy ; Cholestasis* ; Diagnosis, Differential ; Hepatitis ; Humans ; Infant ; Liver ; Radionuclide Imaging* ; Retrospective Studies

PURPOSE: To investigate the incidence and predisposing factors of macular pucker formation after pars plana vitrectomy in patients who developed primary rhegmatogenous retinal detachment. METHODS: We retrospectively reviewed a consecutive series of 284 eyes in 284 patients who underwent primary retinal detachment repair by pars plana vitrectomy alone between January 1, 2009 and December 31, 2010. Patients with a history of retinal surgery or another visually significant ocular problem were excluded. RESULTS: Postoperatively, of the 264 eyes that completed at least six months of follow-up, 16 (6.1%) eyes developed obvious macular pucker at clinical examination. Of these 16 eyes, ten (70.0%) underwent repeat vitrectomy with membrane peeling for macular pucker removal during the follow-up period. The mean time from primary vitrectomy for the retinal reattachment to the secondary vitrectomy with membrane peeling for macular pucker was 7.9 months. The mean improvement in vision after membrane peeling surgery was 0.37 (logarithm of the minimum angle of resolution). Using an independent t-test, chi-square test, and Mann-Whitney U-test, we found that the number or size of retinal break and vitreous hemorrhage could be significant risk factors of macular pucker. CONCLUSIONS: In our study, 6.1% of eyes which underwent pars plana vitrectomy alone for primary retinal detachment developed a postoperative macular epiretinal membrane. Multiple or large retinal breaks and postoperative vitreous hemorrhage were related to macular pucker formation. Overall, the 70.0% of eyes which underwent secondary vitrectomy with membrane peeling for removal of macular pucker showed a favorable visual outcome.
Adolescent ; Adult ; Aged ; Chi-Square Distribution ; Epiretinal Membrane/*pathology/surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Reoperation ; Retinal Detachment/*surgery ; Retrospective Studies ; Risk Factors ; Statistics, Nonparametric ; Visual Acuity ; Vitrectomy/*methods

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular disorder, and its pathophysiology is still unclear and most cases occur sporadically. Cutaneous lesions are observed at birth with a marbled bluish and deep-purple appearance. The associated anomaly is manifest as body asymmetry, macrocephaly, hydrocephalus, mental retardation, syndactyly and congenital glaucoma. We report our experience of CMTC1 in a female infant with the gestational age of 34 weeks and 6 days and birth weight of 2,300 g who was born by cesarean section with abnormal skin lesions. The cutaneous lesions covered most of the lower body and they faded as she continues to grow. She also had onychodysplasia in her left 2nd phalanges. In this case, close follow up by not only pediatricians but also ophthalmologist and neurologists to treat various forms of lesions involved, though the prognosis of CMTC is generally good.
Birth Weight ; Cesarean Section ; Female ; Follow-Up Studies ; Gestational Age ; Glaucoma ; Humans ; Hydrocephalus ; Infant ; Intellectual Disability ; Macrocephaly ; Parturition ; Pregnancy ; Prognosis ; Skin ; Skin Diseases, Vascular ; Syndactyly ; Telangiectasis ; Vascular Malformations

PURPOSE: This study was to determine the relationships between C-reactive protein (CRP) level of acute perforated and nonperforated appendicitis. METHODS: We retrospectively investigated 200 patients who was diagnosed to appendicitis in emergency medical center from January 2005 to August 2005. All patients were operated for suspected acute appendicitis and diagnosis was confirmed by histology after operation. The patients were divided two groups: group A with nonperforated appendicitis and group B with perforated appendicitis. We assessed and compared epidemiologic, clinical and laboratory data between two groups. For comparison of diagnostic value, the receiver operating characteristic (ROC) curve and the logistic regression analysis were done. RESULTS: Of the 200 patients, 149 patients were group A, and 51 patients were group B. The mean CRP level in the group B was higher than in patients with group A (109.25+/-87.18 mg/L vs 20.39+/-39.34 mg/L, p<0.05). Also WBC counts was higher in the group B (15.43+/-5.58x1000/microliter vs 12.47+/-4.5x1000/microliter, p<0.05). Though the area under the ROC curve (AUC) of CRP level was greater than WBC counts (0.853 vs 0.659), so CRP level was found to be significantly superior to WBC count in predicting perforated appendicitis. In logistic regression analysis, CRP level (odds ratio 1.024, 95% CI 1.016 to 1.035) was only independent predictor of perforated appendicitis. CONCLUSION: Increased CRP level in patients who were suspected appendicitis in emergency medical center was valuable in predicting perforated appendicitis. In such circumstances, we should consider the necessities of preoperative antibiotics, the surgical techniques and the early aggressive management for postoperative complications.
Anti-Bacterial Agents ; Appendicitis* ; C-Reactive Protein* ; Diagnosis* ; Emergencies ; Humans ; Logistic Models ; Postoperative Complications ; Retrospective Studies ; ROC Curve