No abstract available.
Humans ; Infant* ; Infant, Very Low Birth Weight* ; Lung Diseases* ; Lung* ; Vitamin A* ; Vitamins*

PURPOSE: To compare the incidence and clinical characteristics of infants with atypical CLD and those with classic BPD among premature infants less than 32 weeks' gestation. METHODS: Clinical data was collected retrospectively from the 256 premature infants less than 32 weeks' gestation and their mothers during 3-year study period. RESULTS: Among 212 preterm infants less than 32 weeks' gestation who survived to 28 days of life, 19 (9%) had atypical CLD and 38 (17.9%) had classic BPD. Atypical CLD infants were significantly heavier and more mature than classic BPD infants (mean birth weights, 1,100+/-294 g vs 915+/-225 g; and mean gestational age, 26.9+/-1.6 weeks vs 21.1+/-1.3 weeks). Duration of ventilator therapy and oxygen inhalation within 28 days of age were shorter in atypical CLD infants than in classic BPD infants (mean duration of ventilator therapy, 16.3+/-6.9 days vs 27+/-6.8 days; and mean duration of oxygen inhalation, 25.5+/-13.5 days vs 53.8+/-39 days). Oxygen dependency in atypical CLD infants showed bimodal pattern, decreasing gradually to 3-week after birth and upturning to peak at about 5-week after birth. Comparing the respiratory indices between classic BPD and aypical CLD, FiO2 at day 2,7, and 10, and oxygen index at day 2, and 10 were significant in classic BPD, but MAP were not. Considering the birth weight, MAP per birth weight, and modified oxygen index showed more apparent differencies between the two groups. CONCLUSION: 35.5% of total CLD were atypical CLD and showed bimodal pattern in oxygen dependency. Atypical CLD infants were significantly heavier and more mature than classic BPD infants.
Birth Weight ; Bronchopulmonary Dysplasia ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Inhalation ; Lung Diseases* ; Lung* ; Mothers ; Oxygen ; Parturition ; Pregnancy ; Retrospective Studies ; Ventilators, Mechanical

BACKGROUND: Although a magnetic resonance imaging (MRI) is highly sensitive for changes associated with ischemic stroke, the detection of an acute ischemic lesion is usually impossible within 6 hours of the stroke onset on a conventional MRI. The perfusion MRI is a new imaging technique for diagnosing acute ischemic stroke. We evaluate the clinical usefulness of the perfusion MRI in predicting the final infarct extent in 18 patients with acute middle cerebral artery (MCA) territory ischemic stroke. METHOD: The perfusion MRI was performed within 6 hours after the stroke onset in all patients with a single-section dynamic contrast-enhanced T2*-weighted imaging in conjunction with a conventional routine MRI and MR angiography. Time-concentration curves and cerebral blood volume (CBV) maps were calculated from the dynamic MR imaging data by using numerical integration techniques. We compared findings of CBV maps with infarction on a follow-up CT or MRI. RESULTS: In 14 of 18 patients, the CBV in the occluded MCA territory were decreased. In the remaining 4 patients with a reversible ischemic neurologic deficit (RIND) or transient ischemic attack (TIA), the CBV were increased in 3 and normal in 1. Out of 14 patients with a decreased CBV, two had focal regions of increased CBV within the affected territory, indicating reperfusion hyperemia. The regions of increased or decreased CBV were eventually converted to infarction on follow-up images in all 14 patients. Out of 4 patients with RIND or TIA, one showed focal infarction in centrum semiovale on a follow-up image. CONCLUSIONS: The perfusion MRI was useful for the assessment of hemodynamic change about cerebral perfusion and may predict the extent of final infarction in acute MCA territory ischemic stroke. These results suggest that the perfusion MRI may play an important role in the diagnosis and management of acute ischemic stroke.
Angiography ; Blood Volume ; Diagnosis ; Follow-Up Studies ; Hemodynamics ; Humans ; Hyperemia ; Infarction ; Ischemic Attack, Transient ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Neurologic Manifestations ; Perfusion* ; Reperfusion ; Stroke*

Implant-supported overdenture is a reliable treatment option for the patients with edentulous mandible when they have difficulty in using complete dentures. Several options have been used for implant-supported overdenture attachments. Among these, bar attachment system has greater retention and better maintainability than others. SFI-Bar(R) is prefabricated and can be adjustable at chairside. Therefore, laboratory procedures such as soldering and welding are unnecessary, which leads to fewer errors and lower costs. A 67-year-old female patient presented, complaining of mobility of lower anterior teeth with old denture. She had been wearing complete denture in the maxilla and removable partial denture in the mandible with severe bone loss. After extracting the teeth, two implants were placed in front of mental foramen, and SFI-Bar(R) was connected. A tube bar was seated to two adapters through large ball joints and fixation screws, connecting each implant. The length of the tube bar was adjusted according to inter-implant distance. Then, a female part was attached to the bar beneath the new denture. This clinical report describes two-implant-supported overdenture using the SFI-Bar(R) system in a mandibular edentulous patient.
Aged ; Dental Prosthesis, Implant-Supported ; Denture, Complete ; Denture, Overlay ; Denture, Partial, Removable ; Dentures ; Female ; Humans ; Jaw, Edentulous ; Joints ; Mandible ; Maxilla ; Retention (Psychology) ; Tooth ; Welding

Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late (later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.
Cause of Death ; Debridement ; Drainage ; Esophageal Perforation ; Esophagus ; Foreign Bodies ; Hemorrhage ; Humans ; Mortality ; Mucous Membrane ; Pleura ; Rupture* ; Stomach Ulcer

Ascites following radical hysterectomy with retroperitoneal lymphadenectomy for invasive cervical cancer has been reported previously. Most of these reports described chylous ascites. The chylous ascitic fluid is milky; further, chylous ascites leads to nutritional problems. Authors present the case of a patient who developed serous ascites following radical hysterectomy with bilateral pelvic lymphadenectomy. The amount of ascites was approximately 18,000 ml over 52 days. The patient had no nutritional problems or complications. Although the etiology could not be determined, Authors surmise that the ascites may have been due to massive drainage from injured lymphatic channels below the cisterna chyli. Authors could not found any literatures which described massive serous ascites following surgery in gynecologic malignancy and reports this case with review of literatures.
Adenocarcinoma ; Ascites ; Ascitic Fluid ; Chylous Ascites ; Drainage ; Humans ; Hysterectomy ; Lymph Node Excision ; Thoracic Duct ; Uterine Cervical Neoplasms

BACKGROUND: Mirror movement is common in young children, and it could be seen in normal adults. Several mechanisms including motor pathway reorganization involved in motor recovery after stroke. Motor pathway reorganization has been reported to be a mechanism in several studies of patients with mirror movement. However, the correlation of motor recovery and mirror movement has been debated. We studied the degree of mirror movement in stroke patients compared with a controlled group to look into their relationship. METHODS: Our controls were 50 adults without neurologic symptoms and signs. The hemiparetic group was comprised 94 patients who had incurred unilateral brain lesion: 36 patients were acute stroke patients, 58 patients were chronic stroke patients. Mirror movements were assessed by three different tasks: abduction of thumb, sequential finger tapping, and grasping. We analyzed mirror movements in controls and patients, and tried to find a correlation between the degree of mirror movement and the recovery of motor power in chronic stroke patients. RESULTS: In controls, male exhibited more frequent mirror movement than female at specific tasks, and there was no difference between tasks of right or left hand. In stroke patients, there was more mirror movement in the nonparetic hand than in the paretic one during the movement of contralateral hand. In acute stroke, the frequency of mirror movement had no variability according to the degree of motor power. The recovery of motor power at a late stage was not correlated with the degree of mirror movement. Consclusions: Motor pathway reorganization seems to be insignificant for motor recovery because the degree of mirror movement was not correlated with the recovery of motor power in this study.
Adult ; Brain ; Child ; Female ; Fingers ; Hand ; Hand Strength ; Humans ; Male ; Neurologic Manifestations ; Stroke* ; Thumb

The incidence of malaria in Korea is significantly on the rise since its reemergence in 1993 and no screening test that can prevent the infection has been available. Very low birth weight infants are especially susceptible to malaria infection due to transfusions from multiple donors. We report a case of transfusion transmitted Plasmodium vivax infection in a 120-day-old infant of a gestational age 24 weeks with birth weight of 700 gm who was successfully treated with hydroxychloroquine.
Birth Weight ; Gestational Age ; Humans ; Hydroxychloroquine ; Incidence ; Infant* ; Infant, Very Low Birth Weight ; Korea ; Malaria* ; Mass Screening ; Plasmodium vivax ; Tissue Donors

OBJECTIVE: This study was aimed to compare immunohistochemical expression of estrogen receptor (ER)-alpha, progesterone receptor (PR), and calponin in gonadotrophin-releasing hormone agonist (GnRH-a)-sensitive and -resistant uterine fibroids. METHODS: We collected data retrospectively. The sensitive group consisted of women who had reduction in uterine volume greater than 40% following GnRH-a treatment. Uterine volume was either reduced by less than 10%, or was increased in the resistant group. A tissue microarray was constructed using formalin-fixed, paraffin-embedded tissues, 31 and 26 patients for the sensitive and resistant groups, respectively. Tissue sections were immunostained with antibodies against ER-alpha, PR, and calponin. The intensity and area of the immunohistochemical reactions were evaluated using a semi-quantitative scoring system. The Mann-Whitney U-test, Fisher's exact test, and Spearman's rank correlation test were used for analysis of data. RESULTS: PR (P = 0.04) and calponin (P = 0.03) showed a significantly higher staining intensity in the resistant group than in the sensitive group. Both groups showed comparable expression of ER-alpha (P = 0.23). In correlation analysis between changes in uterine volume after GnRH-a therapy and clinicopathological factors, the immunohistochemical intensity of PR (P = 0.04) and calponin (P = 0.03) was significantly correlated with changes in uterine volume. CONCLUSION: This study shows that GnRH-a resistance of uterine fibroids is not related to ER-alpha content, but the expression of PR and calponin is related with GnRH-a resistance.
Antibodies ; Estrogens* ; Female ; Humans ; Leiomyoma* ; Progesterone* ; Receptors, Progesterone* ; Retrospective Studies

BACKGROUND: Arterial conduits using in coronary artery bypass grafting (CABG) have been known a great long term patency rates, and improved short and long term clinical outcomes. It has been reported that Off pump CABG has better clinical results than CABG using cardiopulmonary bypass. To evaluate the advantage of arterial conduits over venous conduits and to avoid the adverse effects of cardiopulmonary bypass, we performed total arterial Off pump CABG. MATERIALS AND METHOD: From January 2001 to October 2004, Off pump CABG using only arterial conduits was performed on 325 patients with a mean age of 59.3+/-11.9 years (36~83). Mean ejection fraction was 55.4+/-14.0% (15~86). Angiography showed left main disease or triple-vessel disease in 81.9% of the patients. Indications of using arterial conduits was stenosis > or =50% of left anterior descending artery, stenosis > or =80% of branches of left circumflex artery, and stenosis > or =90% of right coronary artery and its branches. Multi-slice computed tomography was performed on 194 patients to evaluate the short term patency rates. RESULT: A total of 928 distal anastomoses were performed and the average anastomoses per a patient were 2.86+/-0.78. There was 1 operative mortality. Postoperative complications were mediastinitis in 6 patients (1.8%), renal failure in 4 patients (1.2%), perioperative myocardial infarction in 3 patients (0.9%), reoperation for bleeding in 3 patients (0.9%). There was no postoperative stroke. Patency rate of arterial conduits was 99.3% (581/585). There were 4 stenoses or competitive flows in 2 radial arteries and 2 right internal mammary arteries. CONCLUSION: Total arterial Off pump CABG appears to be safe, showing a low surgical mortality and morbidity and excellent short term patency rates of arterial conduits.
Angiography ; Arteries ; Cardiopulmonary Bypass ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Vessels ; Hemorrhage ; Humans ; Mammary Arteries ; Mediastinitis ; Mortality ; Myocardial Infarction ; Myocardial Revascularization* ; Postoperative Complications ; Radial Artery ; Renal Insufficiency ; Reoperation ; Stroke