No abstract available.
Child* ; Humans ; Learning Disorders* ; Learning*

No abstract available.
Pregnancy*

Torsion of the follopian tube is an infrequent but significant cause of acute lower abdominal pain in females that is difficult to recognize preoperatively, although prompt diagnosis and timely sugical treatment are vital to salvage the oviduct. Unless a high index of suspicion is maintained for torsion of the fallopian tube in a adolescent females, this disorder may not be detected until after tubal destruction.
Abdominal Pain ; Adolescent* ; Animals ; Diagnosis ; Fallopian Tubes ; Female* ; Humans ; Oviducts

Limb-Body Wall complex is a complicated with the essential features of neural-tube defects, body-wall disruption, and limb abnormalities. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall is uniformly poor. We have experienced one case of limb-body wall complex in a 22-year-old primigravida, which is presented with a brief review of the literature.
Extremities ; Gastroschisis ; Hernia, Umbilical ; Humans ; Prognosis ; Young Adult

Paget's disease of bone (osteitis deformans), a chronic osseous disease of unknown etiology, is extremely rarein Asia although well known in western countries. This disease is characterized by the simultaneous absorption ofbone and the new bone formation of abnormal character affecting middle and later age groups. The authorsexperienced a case of monostotic Paget's disease involving left pelvic bone in 56-years old female. To ourknowledge, this is the first cas report of monostotic Paget's in Korea.
Absorption ; Asia ; Female ; Humans ; Korea ; Osteitis Deformans ; Osteogenesis ; Pelvic Bones

Background and Objectives: This study aimed to describe the ischemic stroke subtypes and risk factors in young Korean adults, focusing mainly on traditional risk factors and management of ischemic stroke. Methods: The study patients were the fi rst-ever acute cerebral ischemic infarction age 49 years or below admitted to the Kyung Hee University Medical Centre from September 2003 to June 2009, with ischaemic stroke patients >50 years as control. The stroke subtypes was categorized according to Trial of Org 10172 in Acute Stroke Treatment classifi cation. The traditional risk factors of ischemic stroke were examined. For those known to have hypertension and diabetes prior to onset of stroke, their adherence to treatment of hypertension and diabetes was also assessed. Results: Close to half of the patients ≤49 years were due to premature atherosclerosis from small vessel occlusion and large artery atherosclerosis. The most common risk factor in declining order was hypertension, smoking, dyslipidemia and obesity. On logistic regression analysis, hypertension, dyslipidemia, and obesity were strongly associated with small vessel occlusion. In patients who were known to have hypertension and diabetes prior to the onset of stroke, the younger patients were less adherent to the treatment as primary prevention than the older stroke patients. Conclusion: This study suggests that premature atherosclerosis from small vessel occulusion is the most common cause of ischaemic stroke among young adults in Korea. Non-adherence to primary preventive treatment of hypertension and diabetes is common.

A clinical analysis of vasospasm as seen angiographically after the onset of subarachnoid hemorrhage was carried out in 22 out of 4 cases of ruptured intracranial aneurysms experienced in our department from January, 1978 to May, 1979. The following results were obtained. The incidence of vasospasm was 50%. 2) Angiographic filling abnormalities(vasospasm) were morphologically classified into 4 types:tapering, diffuse, segmental and nodular types. 3) No significant difference was found in the location of the arteries with vasospasm in relation to the site of the ruptured aneurysm. In this study, the most frequent occurance of spasm was noted in cases of internal carotid aneurysm(69.2%). 4) Discrepancy in the incidence of angiographic spasm between the group with only one subarachnoid hemorrhage(41.9% out of 31 cases) and the other group with more than one hemorrhage(50% out of 44 cases) was demonstrated. While vasospasm occurred frequently within 9 days after the last hemorrhage in cases with more than two hemorrhage, the appearance of vasospasm was frequently seen angiographically between 10 to 17 days after hemorrhage in cases with only one hemorrhage. 5) There was no relationship between the age and the incidence of spasm, and most cases with spasm showed bloody and xanthochromic C.S.F. 6) Neurological findings were as follows:mental disturbance 12 cases, cranial nerve palsy 3 cases, paresis 3 cases, seizure 2 cases and visual disturbance 2 cases. These neurologic deficits may not be related to the spasm. 7) Follow up carotid angiography was performed in 9 cases of those treated by direct approach. Among 5 cases with vasospasm in preoperative angiogram, the spasm persited in 2 cases and was not no longer visualized in 3 cases. On the other hand, in 2 cases without preoperative spasm, postoperative spasm was detected. 8) Of 23 cases of ruptured aneurysms treated surgically(including 3 cases of carotid ligation), 2 out of 15 cases with spasm expired and all 8 cases without spasm were cured. 9) The diffuse type(using above classification) had the worst postoperative prognosis:i.e., among 9 cases with that type of spasm, 2 cases expired and one case resulted in a mild neurologic deficit. Other types of spasm had no special relationship with the postoperative prognosis.
Aneurysm, Ruptured ; Angiography ; Arteries ; Cranial Nerve Diseases ; Follow-Up Studies ; Hand ; Hemorrhage ; Incidence ; Intracranial Aneurysm* ; Neurologic Manifestations ; Paresis ; Prognosis* ; Seizures ; Spasm ; Subarachnoid Hemorrhage

BACKGROUND: An adequate uteroplacental and fetal blood flow during labor and cesarean delivery is of prime importance for fetal well-being and neonatal outcome. METHODS: Using the vascular smooth muscle of the human isolated umbilical arteries, this study was performed to see whether commonly used local anesthetics (bupivacaine, lidocaine and 2-chloroprocaine) and opioids (morphine,fentanyl and meperidine) could induce contracion or relaxation of these resting and precontracted vessels. Rings from human umbilical arteries were prepared by microdissection. The vessel rings were mounted in tissue baths for an isometric recording of the contractile activity. For resting muscles, the reactivity to drugs is expressed as a percentage of a maximal KCl-induced contraction, and for precontracted muscle, it is expressed as a percentage of a submaximal KCl-induced contraction. RESULTS: Bupivacaine, lidocaine and 2-chloroprocaine all induced contractions. Bupivacaine showed a maximal contraction (46.7 +/- 10.5%) at concentrations of 43 micrometer, lidocaine 19.7 +/- 4.8% at 0.11 mM. and 2-chloroprocaine showed 14.6 +/- 2.9% at 0.65 mM. Morphine, fentanyl and meperidine all induced contractions. Morphine showed a maximal contraction (19.6 +/- 7.1%) at a concentration of 10 4 M, meperidine at 17.2 +/- 8.4% at 3 x 10 5 M, and fentanyl at 1.7 +/- 2.0% at 3 x 10(-6)M. When umbilical arteries were induced to contract with a submaximal concentration of KCl, bupivacaine and lidocaine showed an ability to increase the magnitude of the sustained contraction, but 2-chloroprocaine showed a relaxation of the sustained contraction. Morphine, fentanyl and meperidine showed no change in the sustained contraction. CONCLUSIONS: This study demonstrates these local anesthetics and opioids as vasoactive on human umbilical arteries. If applicable in vivo, these drugs might have some influence on umbilical vessel tone and thus might reduce umbilical blood flow.
Analgesics, Opioid* ; Anesthetics, Local* ; Baths ; Bupivacaine ; Fentanyl ; Fetal Blood ; Humans* ; Lidocaine ; Meperidine ; Microdissection ; Morphine ; Muscle, Smooth, Vascular ; Muscles ; Relaxation ; Umbilical Arteries*

Parry-Romberg syndrome(Progressive hemifacial atrophy), described in the last century by Parry(1825) and Romberg(1846), is a very rare disorder characterized by a slowly progressive and self-limited unilateral(rarely bilateral) atrophy of the faces affecting variably the skin, subcutaneous fat tissues, musculature, connective tissue, cartilage and bones. And this disorder is usually accompanied by contralateral Jacksonian epilepsy, trigerminal neuralgia, and changes in the eyes and hair. The onset is slow and progressive, starting at 5-15 years of age and lasting from 2-10 years, ending with the face being "burned out". There are a few cases of this disease which presented during the neonatal period. This disorder seems to affect females more than males, and its etiology and incidence has yet to be determined. Trauma, infection with a slow virus, sympathetic dysfunction, immunological abnormality and cranial vascular malformation are proposed causes. No typical or consistent neuropathologic findings occur. No specific treatment for the syndrome exists; however, various reconstructive surgical procedures can have in reasonably good cosmetic effects, as well as antiinflammatory or immunosuppressive treatment. We report a case of Parry-Romberg syndrome, which was presented at 1 month of age, and has progressd to contralateral hemiparesis.
Atrophy ; Cartilage ; Connective Tissue ; Epilepsy ; Facial Hemiatrophy* ; Female ; Hair ; Humans ; Incidence ; Infant, Newborn* ; Male ; Neuralgia ; Paresis ; Reconstructive Surgical Procedures ; Skin ; Subcutaneous Fat ; Vascular Malformations

PURPOSE: We compared the treatment results and complications between retropubic route of IVS (intravaginal sling) & SPARC (suprapubic arc) and transobturator route of TOT (transobturator tape) & TVT-O (tension-free vaginal tape-obturator). MATERIALS AND METHODS: Targeting group was limited to 104 patients who were diagnosed with female stress urinary incontinence from January 2004 to July 2005. The preoperative evaluation included careful history taking, physical examination, stress and pad test. The postoperative evaluation included a questionnaire, stress test and complications. RESULTS: The numbers of the patients with IVS, SPARC, TOT and TVT-O were 16, 18, 53, 17, respectively. The success rates (cured+improved) were 93.8 (75+18.8)%, 94.4 (83.3+11.1)%, 98.2 (92.5+5.7)%, 100 (88.2+11.8)%, respectively (p>0.05). There was no serious complication. Although urinary tract infection, supurapubic pain, inguinal pain were reported, all the complications got better with conservative therapy. Transobturator route groups took a bit shorter than retropubic route groups as the operation of IVS, SPARC, TOT, TVT-O took 31.8 minutes, 30 minutes, 20 minutes and 21.2 minutes, respectively (p<0.05). CONCLUSIONS: There were no differences in complications and the results of treatment among IVS, SPARC, TOT and TVT-O. Consequently, if all the operation methods are regarded as the proper ones, transobturator route would be preferred to retropubic route, due to shorter operation time and unnecessary for cystoscopy.
Cystoscopy ; Exercise Test ; Female* ; Humans ; Physical Examination ; Surveys and Questionnaires ; Suburethral Slings ; Treatment Outcome ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Tract Infections