No abstract available.
Female ; Labor, Induced* ; Pregnancy*

OBJECTIVE: To identify the incidence and characteristics of language disorders in patients with traumatic brain injury (TBI), and to understand the differences of language disorder according to the degree and lesion of brain damage and the outcomes after proper language training programs. METHOD: The subjects were 24 adult TBI patients. Seventeen patients with language disorder were examined with language disorder screening test. The characteristics of the language disorders were evaluated according to the degree and lesion site of the brain injury. Prognosis of the language disorders was studied. The tests were performed at the initiation and termination of the language treatment program. RESULTS: The incidence of language disorders was 91.7%. At the initial evaluation, all items showed a low rate of correct response, but at the final evaluation, the statistically significant improvement was noted in all items. There was no difference between moderate and severe brain damages at final evaluation. Focal lesion group revealed higher rate of correct response than diffuse lesion group on comprehension, expression, reading, and calculation at final evaluation. CONCLUSION: The TBI patients showed diffuse language dysfunction on fluency, comprehension, expression, reading, writing, and calculation. But the majority of these patients showed satisfactory recovery, especially the focal brain lesion showed the better outcome. These patients with focal lesion were needed precise language evaluation and more intensive language treatment program.
Adult ; Brain ; Brain Injuries* ; Comprehension ; Glasgow Coma Scale ; Humans ; Incidence ; Language Disorders* ; Language Therapy ; Mass Screening ; Prognosis ; Writing

PURPOSE: To evaluate the degree and change in refractive error and the relation of refractive error, the angle of deviation and amblyopia in patient with refractive accommodative esotropia. METHODS: Children with refractive accommodative esotropia were retrospectively included in the study. The factor studied were sex, age at the first visit, ocular alignment, refractive error and amblyopia. RESULTS: The average age at the first visit was 4.01+/-1.86 years. And, the average angle of esodeviation was 22.23+/-13.74PD for the near and 21.51+/-12.01PD for the distant. The average manifest and cycloplegic refraction measured at patient's first visit were +2.35+/-2.87D and +4.87+/-1.77D respectively. The difference between cycloplegic and manifest refraction decreased gradually. After 3 years, the average manifest and cycloplegic refraction were +3.42+/-1.80PD and +4.33+/-1.77D. The refractive error didn't significantly affect the degree of esodeviation (r=0.051). Twenty-three of patients were amblyopia. The refraction of amblyopic and non amblyopic patient was +5.07+/-1.85D and +4.50+/-2.47D, respectively. However, this difference was not statistically significant. CONCLUSIONS: Mean cycloplegic refraction decreased significantly over a 3-year period. After full correction with glasses, the difference between cycloplegic and manifest refraction decreased. The refractive error was not associated with the degree of deviation anlge, amblyopia occurrence and treatment success.
Amblyopia ; Child ; Esotropia* ; Eyeglasses ; Glass ; Humans ; Refractive Errors* ; Retrospective Studies

A clinical observation was made with particular attention to radiologic diagnosis, complication and management on 69 patients of renal injury admitted to the Catholic Medical Center during the last 10 years. The results were as follows: 1. Minor renal injury was in 49 cases (71%), major renal injury in 19 cases (27.5%) and pedicle injury in 1 case (1.5%) according to Scott's classification. 2. IVU was performed in 68 cases for initial diagnostic study and 18 cases (31%) needed additional radiologic study for accurate staging. 3. CT was performed in 14 cases and its diagnostic accuracy was 93%. 4. Renal angiography was performed in 6 cases. Angioinfarction was performed in 1 case due to continuous bleeding and the other 5 cases showed localized parenchymal infarction or normal finding. 5. Sonography was performed in 6 cases for initial diagnostic study and in 3 cases for follow up study. 6. In major renal injury patients, the group which decided treatment after CT study revealed 16 7% of complication rate but the group which decided treatment without CT study revealed 38 5% of complication rate. 7. In major renal injury or pedicle injury patients, initial operative treatment group resulted in kidney loss in 70% of cases without complication but initial conservative treatment group resulted in kidney loss in 60% of cases and the delay of operation resulted in 70% of complication rate.From these results, CT is the choice of additional staging technique after initial IVU and initial surgical operation is adequate treatment procedure in major renal injury or pedicle injury patients.
Angiography ; Classification ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Kidney

Background/Aims: Capsule endoscopy (CE) is widely used for the diagnosis of small bowel diseases. The clinical performance and complications of small bowel CE, including completion rate, capsule retention rate, and indications, have been previously described in Korea. This study aimed at estimating the recent changes in clinical performance and complications of small bowel CE based on 17-year data from a Korean Capsule Endoscopy Registry. Methods: CE registry data from 35 hospitals were retrospectively analyzed. Clinical information, including completion rate, capsule retention rate, and indications, was collected and analyzed. In addition, the most recent 5-year data for CE examinations were compared with the previous 12-year data. Results: A total of 4,650 CE examinations were analyzed. The most common indication for CE was obscure gastrointestinal bleeding (OGIB). The overall incomplete examination rate was 16% and the capsule retention rate was 3%. Crohn’s disease was a risk factor for capsule retention. Inadequate bowel preparation was significantly associated with capsule retention and incomplete examination. An indication other than OGIB was a risk factor for incomplete examination. A recent increasing trend of CE diagnosis of Crohn’s disease was observed. The most recent 5-year incomplete examination rate for CE examinations decreased compared with that of the previous 12 years. Conclusions The 17-year data suggested that CE is a useful and safe tool for diagnosing small bowel diseases. The incomplete examination rate of CE decreased with time, and OGIB was consistently the main indication for CE. Inadequate bowel preparation was significantly associated with capsule retention and incomplete examination.

BACKGROUND AND PURPOSE: Restless legs syndrome (RLS) is a sleep disorder that frequently occurs in dialysis patients, which disturbs the sleep and reduces the quality of life. The aim of this study was to determine the risk factors for RLS in dialysis patients. METHODS: Patients who visited any of four outpatient dialysis clinics between September 2005 and May 2006 were included in this study. The diagnosis of RLS and the severity assessment were made using the criteria described by the International Restless Legs Syndrome Study Group. We collected basic demographic data, clinical information, and laboratory findings, and then analyzed their association with various aspects of RLS using univariate and multivariate analyses. RESULTS: RLS was present in 46 (28.0%) of 164 dialysis patients. We found no significant risk factor for inducing RLS. The predialysis serum blood urea nitrogen (BUN) level in the dialysis patients with RLS was significantly correlated with RLS symptom severity. CONCLUSIONS: Predialysis BUN is related to RLS symptom severity. Further studies on the underlying mechanism are needed.
Blood Urea Nitrogen ; Dialysis ; Humans ; Multivariate Analysis ; Outpatients ; Quality of Life ; Renal Dialysis ; Restless Legs Syndrome ; Risk Factors

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BACKGROUND: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. MATERIAL AND METHOD: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. RESULT: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. CONCLUSION: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.
Aorta ; Aortic Valve ; Arrhythmias, Cardiac ; Cardiopulmonary Bypass ; Catheterization ; Chest Tubes ; Coronary Disease ; Drainage ; Female ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hematoma ; Humans ; Intensive Care Units ; Intracranial Embolism ; Male ; Mammary Arteries ; Mitral Valve ; Mortality ; Myxoma ; Postoperative Complications ; Reoperation ; Respiration, Artificial ; Rupture ; Sternotomy ; Sternum ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery* ; Transplants ; Wounds and Injuries ; Wounds, Stab

BACKGROUND: Combined spinal epidural anesthesia (CSE) combines the rapid onset and intensity of a subarachnoid blockade with the flexibility of an epidural catheter, thereby allowing the intraoperative extension of anesthesia and postoperative epidural analgesia. This study investigated the effects of hyperbaric bupivacaine during CSE for lower limb orthopedic surgery in geriatric patients. METHODS: Group 1 received a subarachnoid injection of 8 mg of bupivacaine and an epidural catheter. Group 2 received a subarachnoid injection of 5 mg of bupivacaine and fentanyl, 10 microgram and an epidural top-up with 3 ml saline. Group 3 received a subarachnoid injection of 5 mg of bupivacaine and fentanyl 10 microgram with an epidural top-up of 6 ml saline. Group 4 received a subarachnoid injection of 6 mg of bupivacaine and an epidural top-up with 6 ml saline. The maximal level of the sensory blockade, the time of onset to the maximal sensory blockade, the two segment regression time, the time for sensory regression to the tenth thoracic dermatome (T10) and the motor recovery to modified Bromage Scale 0 were compared. After recording the baseline systolic blood pressure and heart rate, the systolic blood pressure and heart rate were recorded at 5 min intervals. RESULTS: There were significant differences in the two-segment regression times, the times to motor recovery between the groups. However, the intraoperative blood pressure and heart rate were similar. CONCLUSIONS: In terms of the peri-operative side effects and recovery from the blocks, CSE was better for lower limb orthopedic surgery in geriatric patients than spinal anesthesia.
Analgesia, Epidural ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine ; Catheters ; Fentanyl ; Heart Rate ; Humans ; Lower Extremity ; Orthopedics ; Pliability

This study investigated the expression of osteopontin (OPN) in rat lumbar spinal cords after lumbar nerve root avulsion, using in situ hybridization histochemistry, immunocytochemistry and western blot analysis. Cells expressing OPN were motoneurons and interneurons in the ventral horn, but no signals were observed in neurons in the dorsal horn of the normal lumbar spinal cord. From day 1 after avulsion injury, OPN mRNA-labeled neurons increased in the ventral horn and the intermediate zone. By day 3, relatively strong OPN mRNA signals were found throughout the gray matter of the injured side of the spinal cord with OPN mRNA-labeled cells scattered in the superficial dorsal horn. By day 7, the labeling patterns for OPN mRNA were similar to those on day 3, but the numbers of OPN mRNA-labeled cells in the ventral horn and the intermediate zone peaked. At this point, these labeled cells were also more densely packed and the intensity of signals was stronger. Interestingly, these labeled cells were neurons, but not glial cells such as astrocytes or microglia. This OPN mRNA-labeled cell profile in the dorsal horn had nearly disappeared by day 14 after avulsion injury, and the labeling pattern became similar to that on day 1. By day 28, after avulsion injury, the numbers of OPN mRNA-labeled cells decreased further below control values. These results suggest that increased expression of OPN in the rat lumbar spinal cord after avulsion injury might play an important role in the pathogenesis of damaged neurons.
Animals ; Astrocytes ; Blotting, Western ; Horns ; Immunohistochemistry ; In Situ Hybridization ; Interneurons ; Microglia ; Neuroglia ; Neurons ; Osteopontin* ; Radiculopathy ; Rats* ; RNA, Messenger ; Spinal Cord*