No abstract available.

Spontaneous spinal epidural hemorrhage(SSEH) represent 0.3%~0.9% of spinal epidural-space-occupying lesions. The therapeutic outcome seems to be determined by the accuracy of the diagnosis and by the time interval between the onset of symptom and surgical decompression. Thus, SSEH is a rare spinal emergency and a diagnostic challenge. We experienced two such cases. In one case, the symptoms were confused with those for a ureter stone, aortic aneurysm, spinal cord infarction. That patient completely recovered spontaneously within 2 hours. In the other case, which was initially diagnosed incorrectly as a cerebral infarction, surgical decompression was performed. That patient recovered completely within 1 month.
Aortic Aneurysm ; Cerebral Infarction ; Decompression, Surgical ; Diagnosis ; Emergencies ; Hematoma, Epidural, Spinal* ; Humans ; Infarction ; Spinal Cord ; Ureter

Prenatal Ultrasonographic findings of meconium peritonitis show calcificalion, and abdominal echogenic masses such as pseudocyst. Also, we can find availability of 3 dimensional ultrasonography above these descriptions. We present a case of meconium peritonitis in uterus which was diagnosed by means of prenatal 2D & 3D ultrasonography with brief review of literatures.
Meconium* ; Peritonitis ; Ultrasonography ; Uterus

No abstract available.
Histiocytoma, Malignant Fibrous* ; Lung*

Between 1987 and 1992, 86 tibial fractures were treated with the Ilizarov external fixator at Gyeong-Sang National University Hospital and Okpo Hospital. The mean follow-up period was 31.4 months. Sixty-six were open fractures and twenty were closed fractures with severe comminution. In 66 open fractures, there were 9 Gustilo type I, 10 type II, and 47 type III fractures. Of 66 open fractures, 22 had bone defects ranged from 2cm to 17cm and 16 had extensive loss of soft tissue. Twenty-two bone defects were treated with cancellous bone grafts in 8 cases, bifocal osteosynthesis with bone graft in 12 cases, and trifocal osteosynthesis with bone graft in 2 cases. Thirty-four extensive soft tissue defects were treated with split-thickness skin graft, musculocutaneous flap, soft tissue transportation with ring used in bifocal, trifocal osteosynthesis, and acute shortening of fracture site. Of 20 closed fractures, 14 were treated with cancellous bone graft for decreasing union time and 6 were treated with monofocal compression without bone graft. The mean time to union was 20.5 weeks in closed fractures, and 35.4 weeks in open fractures. Of 40 complications, 12 were knee and ankle joint contractures, 12 were soft tissue and bone infections of pin tract, 5 were refracture, 5 were angular deformities of 10 degree or more, 5 were delayed union, and 2 were nonunion. According to Tucker's classification, the results were graded as excellent in 31, good in 38, fair in 12, and poor in 5 cases. Primary or secondary bone graft is necessary for early bony union and anatomical reduction combined with bone graft could prevent the complications of delayed union and nonunion.
Ankle Joint ; Classification ; Congenital Abnormalities ; Contracture ; External Fixators ; Follow-Up Studies ; Fractures, Closed ; Fractures, Open ; Ilizarov Technique ; Knee ; Myocutaneous Flap ; Skin ; Tibia ; Tibial Fractures ; Transplants ; Transportation

BACKGROUND: The present study was done to evaluate the usefulness of SDS-PAGE in measuring glomerular proteins and tubular proteins in patients with type I DM without overt proteinuria. METHODS: The study population consisted of 76 children with type I DM who have been participated in the Taegu Diabetic Camp from 1997 to 2000. We measured urine albumin, NAG, beta2-microglobulin, creatinine level in urine samples collected for 12 hours in 22 children and simultaneously we analyzed urinary proteins by SDS-PAGE. In remainder 54 children, we measured urine albumin, NAG, creatinine level in random morning urines and urinary proteins by SDS-PAGE. RESULTS: In 22 of 76 children, urinary albumin-to-creatinine ratio (mg/mg), NAG (U/g) and beta2-microglobulin (microgram/g) were 0.021, 2.99 and 170.2, respectively. Positive correlation between urine albumin and NAG was statistically significant (r=0.51, p< 0.05). No significant relations between urinary proteins, such as albumin, NAG, beta2-microglobulin, and clinical characteristics, such as age, duration of illness, HbA1c, were observed. In diagnosing `microalbuminuria', sensitivity of SDS-PAGE was 63% and band of tubular proteins was not detected in any children. CONCLUSION: We thought that SDS-PAGE could be one of useful methods in diagnosing early stage of diabetic nephropathy. The more large scale study is necessary.
Child* ; Creatinine ; Daegu ; Diabetic Nephropathies ; Electrophoresis, Polyacrylamide Gel* ; Humans ; Proteinuria*

BACKGROUND: HLA-DR typing kits using reverse-SSO (sequence specific oligonucleotide) method show considerable ambiguities in HLA-DRB1 generic typing. We analyzed the ambiguities of the Dynal RELI(TM) SSO HLA-DRB test (Dynal DRB test) and developed an 'Interpretation Program for Koreans'. METHODS: A total of 3,000 Koreans were typed for HLA-DRB1/B3/B4/B5 using the 36 probe Dynal DRB test and all of the cases showing ambiguities in HLA-DRB1 generic typing were subjected to confirmatory typing using the PCR-single strand conformation polymorphism (SSCP) method. On the basis of these results, an 'Interpretation Program for Koreans'was developed for the 45 probe Dynal DRB test. RESULTS: Among 3,000 Koreans tested by the 36 probe Dynal DRB test, 456 cases (15.2%) showed ambiguities. In 95% of the ambiguity cases (433/456) and 99.2% of the total cases tested (433/3,000), the'most probable type'could be expected from the DRB1 gene frequencies and DRB1-B3/B4/B5 associations in Koreans and these results were in accordance with the confirmatory typing results as well as the results given by the 'Interpretation Program for Koreans'. Similarly, the 'Most Probable'could be assigned by the program in 99.4% (348/350) of the cases tested with the 45 probe Dynal DRB test. CONCLUSIONS: Ambiguity in the Dynal DRB test was observed in >15% of the Korean samples tested. The majority (95%) of the ambiguities could be resolved on the basis of HLA-DRB1 gene frequencies and DRB1-B3/B4/B5 associations in Koreans. Furthermore, using the program developed in this study, the correct assignment of DRB1 generic types was possible without additional typing in the majority (>99%) of the cases tested.
Dichlororibofuranosylbenzimidazole ; DNA ; Gene Frequency ; HLA-DR Antigens* ; HLA-DRB1 Chains

BACKGROUND: Third-generation tyrosine kinase inhibitors of the epidermal growth factor receptor (EGFR-TKIs) have proved efficacious in treating non-small cell lung cancer (NSCLC) patients with acquired resistance resulting from the T790M mutation. However, since almost 50% patients with the acquired resistance do not harbor the T790M mutation, retreatment with first- or second-generation EGFR-TKIs may be a more viable therapeutic option. Here, we identified positive response predictors to retreatment, in patients who switched to a different EGFR-TKI, following initial treatment failure. METHODS: This study retrospectively reviewed the medical records of 42 NSCLC patients with EGFR mutations, whose cancers had progressed following initial treatment with gefitinib or erlotinib, and who had switched to a different first-generation EGFR-TKI during subsequent retreatment. To identify high response rate predictors in the changed EGFR-TKI retreatment, we analyzed the relationship between clinical and demographic parameters, and positive clinical outcomes, following retreatment with EGFR-TKI. RESULTS: Overall, 30 (71.4%) patients received gefitinib and 12 (28.6%) patients received erlotinib as their first EGFR-TKI treatment. Following retreatment with a different EGFR-TKI, the overall response and disease control rates were 21.4% and 64.3%, respectively. There was no significant association between their overall responses. The median progression-free survival (PFS) after retreatment was 2.0 months. However, PFS was significantly longer in patients whose time to progression was ≥10 months following initial EGFR-TKI treatment, who had a mutation of exon 19, or whose treatment interval was <90 days. CONCLUSION: In patients with acquired resistance to initial EGFR-TKI therapy, switched EGFR-TKI retreatment may be a salvage therapy for individuals possessing positive retreatment response predictors.
Carcinoma, Non-Small-Cell Lung* ; Disease-Free Survival ; Erlotinib Hydrochloride ; Exons ; Humans ; Medical Records ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Retreatment* ; Retrospective Studies ; Salvage Therapy ; Treatment Failure

We conducted a study to determine whether the hemocontrol biofeedback system (HBS) can improve intradialytic hypotension (IDH) in hypotension-prone hemodialysis (HD) patients compared with conventional HD. In this multicenter prospective crossover study, 60 hypotension-prone patients were serially treated by conventional HD for 8 weeks (period A), by HD with hemoscan blood volume monitoring for 2 weeks (period B0), and by HBS HD for 8 weeks (period B1). The number of sessions complicated by symptomatic IDH during 24 HD sessions (14.9+/-5.8 sessions, 62.1% in period A vs 9.2+/-7.2 sessions, 38.4% in period B1, P<0.001) and the number of IDH-related nursing interventions in a session (0.96+/-0.66 in period A vs 0.56+/-0.54 in period B1, P<0.001) significantly decreased in period B1 than in period A. Recovery time from fatigue after dialysis was significantly shorter in period B1 than in period A. The patients with higher post-dialysis blood pressure, lower difference between pre- and post-dialysis blood pressure, less frequent IDH, and higher pre- and post-dialysis body weight in period A responded better to HBS in period B1 in regard to the reduction of IDH. In conclusion, HBS may improve the patient tolerability to HD by reducing the IDH frequency and promoting faster recovery from fatigue after dialysis.
Adolescent ; Adult ; Aged ; *Biofeedback, Psychology ; Blood Pressure ; Blood Volume ; Body Weight ; Cross-Over Studies ; Fatigue ; Female ; Humans ; Hypotension/etiology/*prevention & control ; Kidney Failure, Chronic/*therapy ; Male ; Middle Aged ; Prone Position ; Prospective Studies ; Renal Dialysis/adverse effects ; Young Adult

BACKGROUND: Opioid tolerance may involve activation of the N-methyl-D-aspartate (NMDA) system. The possible involvement of the NMDA system suggests that one of the NMDA receptor antagonists, magnesium may be a useful adjunct to opioids for the treatment of postoperative pain following remifentanil infusion. METHODS: For this study, 70 patients scheduled for major abdominal surgery under remifentanil-based anesthesia were randomly allocated into groups that received either magnesium sulfate (group M) or saline (group C) intravenously. The patients in the group M received 25% magnesium sulfate at a dose of 50 mg/kg in 100 ml of saline, and those in the group C received an equal volume of saline prior to the induction of anesthesia. In addition, patients in both groups received 10 mg/kg/h infusion of either magnesium sulfate (group M) or an equal volume of saline (group C) until the end of surgery. Pain was assessed using a visual analog scale at 30 min, and 6, 12, 24, and 36 hours after operation. The time to the first use of postoperative analgesic and cumulative analgesic consumption in both groups were also evaluated. RESULTS: The visual analog scale scores for pain and cumulative analgesic consumption were significantly lower in the group M than in the group C. The time to the first use of postoperative analgesic was significantly shorter in group C than in the group M. CONCLUSIONS: Use of the NMDA-receptor antagonist, magnesium sulfate as an adjuvant analgesic reduced postoperative pain in patients undergoing major abdominal surgery under remifentanil-based anesthesia.
Analgesics, Opioid ; Anesthesia ; Humans ; Magnesium ; Magnesium Sulfate ; N-Methylaspartate ; Pain, Postoperative ; Piperidines