No abstract available.
Circumcision, Male* ; Female ; Male ; Sensation*

No abstract available.
Humans ; Hyperbilirubinemia, Hereditary* ; Siblings* ; Twins, Monozygotic*

Congenital factor Vll deficiency is a rare bleeding disorder with an estimated incidence of 1 in 500,000. It is inherited as an autosomal recessive pattern with variable expression and high penetrance. In severely affected patients, repeated hemarthroses, chronic crippling hemarthropathy, and dangerous hematomas can occur. Other types of hemorrhage include epistaxis, menorrhagia, hematuria, gastrointestinal and gingival bleeding. Fetal cerebral hemorrhage has been reported, although less frequently than in severe hemophilia A or B. It is characterized by normal partial thromboplastin time and prolonged prothrombin time. Definitive diagnosis rests on a specific assay for factor Vll clotting activity. Replacement therapy is necessary to control the hemorrhage. Conventional prophylaxis and therapy in this disorder have consisted of fresh frozen plasma (FFP) or prothrombin complex concentrate. We experienced a case of intraventricular hemorrhage and hydrocephalus in a 4-year-old girl who had been diagnosed with congenital factor Vll deficiency during her neonatal period. She presented with episodes of frontal headache, frequent vomiting and malnutrition. We report this case with a brief review and related literatures.
Cerebral Hemorrhage ; Child, Preschool ; Diagnosis ; Epistaxis ; Factor VII Deficiency* ; Factor VII* ; Female ; Headache ; Hemarthrosis ; Hematoma ; Hematuria ; Hemophilia A ; Hemorrhage* ; Humans ; Hydrocephalus* ; Incidence ; Malnutrition ; Menorrhagia ; Partial Thromboplastin Time ; Penetrance ; Plasma ; Prothrombin ; Prothrombin Time ; Vomiting

We have reviewed 1211 burn patients who had visited our emergency department of Keimyung University Dongsan medical center between April 1995 to March 1997. The following results were obtained; 1) On age and sex distribution, the highest incidence of age group was under 10 year and old in 321 cases(26.5%). Male was affected more frequently than female, the incidence being 847 cases(70.1%) and 364 cases(29.9%). The ratio of male to female was 2.3:1. 2) No monthly and seasonal differences could be recognized. We found winter season having the highest 319 cases(26.3%), followed by autumn, spring and summer. 3) An analysis of causes in burns showed that flame burns were 527 cases(43.1%), scalding burns, 486 cases(40.2%), electrical burns, 96 cases(8.1%) and chemical burns, 48 cases(4.1%). 4) Domestic accidents accounted for 639 cases(52.7%), occupational for 286 cases(23.6%), traffic accidents for 160 cases(13.2%), suicides for 122 cases(10.1%), formentation for 4 cases(0.4%). 5) Most of patients 699 cases(57.7%) were affected with 2nd degree burn in depth, 1st degree for 413 cases(34.1%) and 3rd degree for 99 cases(8.2%). 6) The trunk was the anatomical region most commonly affected followed by upper and lower limbs. 7) 243 cases(20.5%) of all were accompanied by some complications. The main complications were would infection noted in 212 cases(17.5%), pneumonia in 179 cases(14.8%), acute renal failure in 160 cases(13.2), contracture in 155 cases(13.0), urinary tract infection in 24 cases(2.0%), Curling ulcer in 20 cases(1.6%) in order. 8) The over-all mortality rate was 73 cases(6.1%). The mortality rate of the patients with inhalation injury were 33 cases(45.3%). Causes of death were due to sepsis in 54 cases(4.5%), ARDS in 11 cases(0.9%), acute renal failure in 5 cases(0.4%), upper GI bleeding in 2 cases(0.2%), purmonary edema in 1 cases(0.1%).
Accidents, Traffic ; Acute Kidney Injury ; Burns* ; Burns, Chemical ; Cause of Death ; Contracture ; Duodenal Ulcer ; Edema ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Incidence ; Inhalation ; Lower Extremity ; Male ; Mortality ; Pneumonia ; Seasons ; Sepsis ; Sex Distribution ; Suicide ; Urinary Tract Infections

This study was designed retrospectively to evaluate Ranson's criteria and APACHE II scores as a predictor of mortality in patients with acute pancreatitis. Acute pancreatitis is a common disorder. From mild disease to multiorgan failure, it is a disorder that has numerous causes, an obscure pathogenesis. An accurate history and through physical examination will often raise clinical suspicion of acute pancreatitis in the differential diagnosis of a patient with acute abdominal pain. The retrospective analysis by chart review of 86 cases of acute pancreatitis who visited emergency department of Dongsan hospital from Jan to Dec 1996. The results were as follows. The majority of the patients with acute pancreatitis presented with chief complaints of abdominal pain. The male patient outnumbered female by the ratio of 2.9:1. The highest incidence of age group was between 40 and 50. The majority of our patients had past histories of either chronic alcoholic or gallbladder problems e.g.. the number being 53 cases(61.6%) and 31 cases(36%) respectively. Among 7 patients who had changes in consciousness, 5 were expired. Of those expired, 3 patients had less than 90 mmHg of systolic blood pressure. The overall mortality rate was 10.5%(9 cases). It has been known that acute pancreatitis would be the results of traumatic and non-traumatic causes. The exact mechanism of its pathophysiolgy has not been known yet, but it has been well known that the majority of patients who in forties and fifties had history of alcoholic abuse, the rest being mainly gallbladder problem and, some other diseases implicated too. The relationship of acute pancreatitis with familiar Ranson's criteria was such that 3 patients of the Ranson's out of 9 death were noted to have more than 3 of the criteria, but another 3 had less than 3. Among the 60 patients in whom the required physiologic variables were available out of total 86 patients studied, 9 were expired and 51 survived, average APACHE II scores for the survival and the expired being 6.92+/-3.99 & 18.11+/-5.68 respectively (P<0.05). We concluded that the APACHE II score could be used to better than Ranson's criteria to predict hospital mortality in patients with acute pancreatitis.
Abdominal Pain ; Alcoholics ; APACHE ; Blood Pressure ; Consciousness ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Gallbladder ; Hospital Mortality ; Humans ; Incidence ; Male ; Mortality ; Pancreatitis* ; Physical Examination ; Retrospective Studies

BACKGROUND: The possible role of apolipoprotein E (APOE for gene, apoE for protein) allele in atherosclerotic diseases is not clearly understood. For the putative role of APOE genotypes, we examined APOE polymorphism among patients with stroke. METHODS: A total of 202 ischemic stroke patients were involved in this study. The genotype DNA was isolated from whole blood and the APOE alleles were determined by polynicrase chain reaction. RESULTS: The genotype of APOE epsilon3/3 was the most common allele in the stroke group and the control group. The frequencies of APOE epsilon2, epsilon3, epsilon4 allele in stroke group were 0.052, 0.851, and 0.097, respectively. There was no significant difference in APOE genotypes between the stroke group and the control group. No significant associations lions were found for the APOE genotypes and the serum lipid profiles. CONCLUSION: These findings suggest that APOE was not related to the stroke,
Alleles ; Apolipoprotein E2 ; Apolipoproteins E ; Apolipoproteins* ; DNA ; Genotype ; Humans ; Lions ; Stroke

No abstract available.
Meningioma* ; Neoplasm Metastasis*

Ewing's sarcoma, originating primarily in the spinal epidural space is exceptionally rare. There are only 6 case reports in English literature until 1986. We experienced a case of epidural Ewing's sarcoma originated in thoracic spinal canal at T6~T7 level with myelopathy. Initial neural decompression was very effective and complete recovery was achieved. But local recurrence occurred in relatively short follow up period(8 months). Subsequent radiotherapy showed us dramatic tumor regression and improvement of neurologic deficit. The problems that concerned in this tumor are its accurate diagnosis and appropriate therapeutic modality. We reviewed the literatures that deal with exceptional locations of Ewing's sarcoma and current therapeutic approaches with their outcomes.
Decompression ; Diagnosis ; Epidural Space ; Follow-Up Studies ; Neurologic Manifestations ; Radiotherapy ; Recurrence ; Sarcoma, Ewing* ; Spinal Canal ; Spinal Cord Diseases

To achieve optimal decalcification in tissue and tissue preservation, we have tried magnetic field method and made some promising results. We used pulsed unipolar magnetic field obtained by rectification of 250 V-60 cycle, A.C. As a new method of bony decalcification, using 5% nitric acid, 10% formic acid and 10% formic acid+3% hydrochloric acid solutions, experimental groups were decalcified in the center of the magnetic field. The concentration of calcium ion in the decalcifying solution was measured by calcium-oxalate turbidity test by photometry method, and direct visualization of calcium radiopacity was obtained by soft X-ray view during the decalcification process. The pH change during decalcification was continuously checked and needle penetration method was also used. All the decalcification solution used in this study showed accelerated effect of bony decalcification in the strong magnetic field. Among them 5% nitric acid produced complete decalcification for the medium size bony specimen (less than 10x10x10 mm) within 24 hours, and the histologic feature was almost free of acid-chemical degeneration. The pH of all the decalcification solutions decreased in the strong magnetic field, maximum within 4~6 hours, and kept strong acidity throughout the decalcification procedure. After removal of the magnetic field the pH of all the decalcification solution returned to their original values after 24 hours. It was presumed that the cause of the accelerated decalcification in the magnetic field was due to combined effects of the rapid increase of acidity and the increased molecular resonance to stimulate the ionization of mineral elements.

Transpedicular screw fixation of the lumbar spine has evolved rapidly and become one of the reliable methods to application. We treated 42 cases of lumbar spine disease using above method from October, 1987, to Febuary, 1993. The disease entities were spondylolisthesis 24 cases(58%), spondylolysis 14 cases(33%), fracture and dislocation 3 cases(7%), postsurgical instability 1 case(2%). The most frequent clinical symptom and sign was low back pain with radiating pain accompanying limitation of straight leg raising, which clinical outcome was excellent with wide laminectomy. The transpedicular screw fixation allow adequate neural decompression, short segment fixation and prevention of motion limitation of lumbar spine. But one of the important complication driven with this method was root injury which must be prevented by surgen's throught knowledge to pedicular anatomy and meticulous operative technique. The instrument failure is also the troublesome problem. The appropriate bone fusion will be the acceptable strategy to overcome the eventual possibility of instument failure.
Decompression ; Dislocations ; Laminectomy ; Leg ; Low Back Pain ; Spine* ; Spondylolisthesis ; Spondylolysis