Risk Factors Associated with Germinal Matrix-Intraventricular Hemorrhage in Preterm Neonates

OBJECTIVE: The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity. METHODS: A total of 168 premature neonates whose birth weight < or =1500 g or gestational age < or =34 weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed. RESULTS: In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10). CONCLUSION: Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.

The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

OBJECTIVE: The objective of this study is to verify the relationship between subarachnoid hemorrhage (SAH) volume (not Fisher grade) and development of cerebral vasospasm prospectively. METHODS: Patients who visited our hospital with a diffuse or localized thick subarachnoid blood clot seen on computed tomography (CT), taken within 48 hours after SAH and the aneurysm was confirmed by CT Angiogram (CTA) from March 2010 to July 2011 were enrolled in this study. CTA was checked at least twice after admission. Angiographic vasospasm (AVS) on CTA was defined as irregularity or narrowing of intracranial vessels on follow up CTA compared with initial CTA. Total intracranial hemorrhage (ICH) volume (subdural, SAH, intracerebral and intraventricular) was calculated and SAH volume (all supratentorial and infratentorial cisterns) was also calculated using the MIPAV software package. RESULTS: A total of 55 patients were included in our study. Thirty six patients did not show AVS on CTA or clinical deterioration (non vasospasm group: NVS). AVS without ischemic neurologic symptoms was observed in four patients and development of symptomatic vasospasm (SVS), defined as AVS with ischemic symptoms, was observed in 15 patients. SAH volume in SVS patients was statistically larger than that in NVS patients (p < 0.05). Total ICH volume in SVS patients was larger than that in NVS patients. However, the difference was not statistically significant. CONCLUSION: Results of this study indicate an association of development of vasospasm with the SAH volume, not intracranial hemorrhage.

Our Experience with Surgically Treated Epidural Hematomas in Children

OBJECTIVE: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and region of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. METHODS: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (CT) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe extracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. RESULTS: The mean (SD) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient. The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. CONCLUSION: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

Our Experience with Surgically Treated Epidural Hematomas in Children

OBJECTIVE: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and region of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. METHODS: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (CT) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe extracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. RESULTS: The mean (SD) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient. The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. CONCLUSION: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

A Case of the Audiotory Neuropathy / 대한이비인후과학회지

Auditory neuropathy is a recently described hearing disorder in which patients demonstrate hearing loss for pure tones, impaired word discrimination out of proportion to pure tone loss, absent or abnormal auditory brainstem responses (ABR), but normal outer hair cell function as measured by otoacoustic emissions and cochlear microphonics. Auditory neuropathy affects the normal synchronous activity in the auditory nerve, without affecting the amplification function in the inner ear. There is impairment in their temporal processing in the auditory nerve. So patients can hear sounds, but can not understand speech. Auditory neuropathy occurs either in isolation or as a part of a generalized neuropathy. We have identified one pediatric patient who demonstrated hearing defects and developed signs for peripheral neuropathy. We report it with a review of literatures.

The Significance of E-cadherin Expression in Transitional Cell Carcinomas of the Bladder / 대한비뇨기과학회지

PURPOSE: To investigate the significance of E-cadherin expression in transitional cell carcinoma of bladder, as the prognostic value. MATERIALS AND METHODS: We have analyzed its immunoreactivity in 41 transitional cell carcinomas using a labelled streptavidin-biotin immunoperoxidase technique on the formalin-fixed and the paraffin-embedded tissues. E-cadherin is a Ca2+-dependent intracellular adhesion molecule of the epithelial tissue and the urothelium. We determined the E-cadherin expression in bladder carcinoma using immunohistochemical method and investigated relationship between pathological and clinical data. RESULTS: The percentage of cases showing weak pattern was higher in cases with high-grade or high-stage tumors as compared with those of low grade or low stage. The E-cadherin was expressed in a normal membranous pattern in all control cases. Abnormal E-cadherin expression was found in 8 of 20 superficial tumors and in 19 of 21 invasive tumors. Abnormal immunoreactivity was related to tumor differentiation and stage. Eight of 13 well-differentiated tumors showed preservation of membranous E-cadherin immunoreactivity, while 2 of 28 moderately and poorly differentiated tumors demonstrated normal staining patterns. CONCLUSIONS: We conclude that the loss of expression of E-cadherin in high grade or high stage transitional cell carcinoma of bladder is associated with bladder wall invasion, indicates metastasis, and may be clinical value in the assessment of prognosis.

A Case of Fibrous Pseudotumor Originating from the Testicular Albuginea in the Children / 대한비뇨기과학회지

The fibrous pseudotumor arising from testicular albuginea in child is very rare benign tumor We experienced a case of this tumor in 6 year old boy who present with painless and nontender scrotal mass, which was movable on palpation. It was a hyperechoic lesion with calcification and had unclear relationship with testis in ultrasonography. Orchiectomy was performed after clamping of spermatic cord due to possibility of malignancy. The excised mass was 2.2xl.5cm sized, ovoid, white-yellowish, had a short stalk arising from testicular albuginea and showed whorled pattern in cut section. Microscopically, abundant collagenous fiber, proliferative fibroblast and calcification were noted.

Nesidioblastosis in an Elderly Patient with Hyperinsulinemic Hypoglycemia / 대한내분비학회지

Nesidioblastosis is characterized by a diffuse proliferation of islet cells arising from pancreatic ducts and is the most common cause of hyperinsulinemic hypoglycemia in newborns and infantile. It is exceedingly rare in adults and no concensus regarding its diagnosis and management is available. We herein describe an elderly man with fasting hypoglycemia, inappropriate insulin hypersecretion. And pathologic examination of his pancreas revealed the characteristic finding of nesidioblastosis confirmed by immunohistochemical stain.

Prevalence of abnormal thyroid function test and significance of TSH in health examination

No abstract available.

A clinical study on patients presenting with upper gastrointestinal symptoms

No abstract available.