No abstract available.
Follow-Up Studies* ; Spinal Stenosis*

Periodic alternating nystagmus(PAN) is a form of spontaneous nystagmus with a specific pattern. It may be of congenital origin in many cases, and may be related to vestibulo-cerebellar system disease. It usually causes not only many ophthalmic problems such as decreased vision but also neurologic symptoms such as ataxic gait. So, ophthalmologist must perform both ophthalmic and neurologic examinations. Nystagmus can be treated with muscle relaxant. We report our experience about 30-year-old woman who complained of involuntary ocular movement and ataxic gait, and were diagnosed as PAN associated with Chiari-1 malformation and syringomyelia through electronystagmography and brain MRF.
Adult ; Brain ; Electronystagmography ; Female ; Gait ; Humans ; Neurologic Examination ; Neurologic Manifestations ; Nystagmus, Pathologic* ; Syringomyelia*

BACKGROUND: This study was undertaken to reduce the side effects of epidural morphine through the addition of nalbuphine in 37 cesarean delivery. METHODS: Forty patients were divided into 2 groups; M(control) group: bolus administration of morphine 2 mg in 0.5% bupivacaine and continuous epidural 41 hour-infusion of morphine 7mg, N(experimental) group: bolus administration of morphine 2 mg in 0.5% bupivacaine combined with nalbuphine 10mg and continuous epidural 41 hour-infusion of morphine 7mg combined with nalbuphine 10mg via the Paragon infusor. RESULTS: During the postoperative 48 hours, their pain scores and side effects were recorded at 6, 12, 18, 24, 30, 36, 42 and 48 hours. The analgesic effects were good in two groups(mean VAS <3.0) and pain scores were statistically significant at 18 and 30 hour. The incidence of pruritus, nausea, vomiting and urinary retention was decreased in group N(p<0.05). CONCLUSIONS: We concluded that continuous epidural morphine combined with nalbuphine was one of recommendable methods to reduce side effects of morphine.
Bupivacaine ; Cesarean Section* ; Female ; Humans ; Incidence ; Infusion Pumps ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Urinary Retention ; Vomiting

PURPOSE: The purpose of this study was to identify the factors influencing Symptoms of Stress among hospital staff nurses. METHOD: Data was collected by questionnaires from 249 hospital staff nurses in three General Hospital. The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. RESULTS: The score of the symptoms of stress showed a significantly positive correlation with the score of work stress(r=.22, p=.00). The symptoms of stress showed a significantly negative correlation with the score of social support(r=-.28, p=.00), self efficacy(r=-.31, p=.00), and hardiness(r=-.24, p=.00). The most powerful predictor of symptoms of stress was social support and the variance explained was 16%. A combination of social support, ways of coping, and work stress account for 32% of the variance in symptoms of stress among hospital staff nurses. CONCLUSION: This study suggests that social support, ways of coping, self efficacy, hardiness, and work stress are significantly influencing factors on symptoms of stress among hospital staff nurses.
Adaptation, Psychological ; Adult ; Female ; Humans ; Nursing Staff, Hospital/*psychology ; Self Efficacy ; Social Support ; Stress, Psychological/diagnosis/etiology/*psychology

PURPOSE: Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy(AGB) is believed to be more diagnostic than materials from fine needle aspiration(FNA) by many cytopathologists. The authors evauated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complications. MATERIALS AND METHODS: We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients:AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. RESULTS: Biopsy samples sufficient for histologic diagnosis were obtained in 94(87.9%) of 107 patients, AG8 in 73(90.1%) of 81 patients and AGB and FNA in 21(80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. CONCLUSION: Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions.
Biopsy* ; Biopsy, Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax

PURPOSE: Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy(AGB) is believed to be more diagnostic than materials from fine needle aspiration(FNA) by many cytopathologists. The authors evauated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complications. MATERIALS AND METHODS: We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients:AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. RESULTS: Biopsy samples sufficient for histologic diagnosis were obtained in 94(87.9%) of 107 patients, AG8 in 73(90.1%) of 81 patients and AGB and FNA in 21(80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. CONCLUSION: Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions.
Biopsy* ; Biopsy, Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax

Human papillomavirus (HPV) infection is a major cause of cervical cancer and its precancerous diseases. Cervical cancer is the second deadliest cancer killer among women worldwide. Moreover, HPV is also known to be a causative agent of oral, pharyngeal, anal and genital cancer. Recent application of HPV structural protein (L1)-targeted prophylactic vaccines (Gardasil(R) and Cervarix(R)) is expected to reduce the incidence of HPV infection and cervical cancer, and possibly other HPV-associated cancers. However, the benefit of the prophylactic vaccines for treating HPV-infected patients is unlikely, underscoring the importance of developing therapeutic vaccines against HPV infection. In this regard, numerous types of therapeutic vaccine approaches targeting the HPV regulatory proteins, E6 and E7, have been tested for their efficacy in animals and clinically. In this communication, we review HPV vaccine types, in particular DNA vaccines, their designs and delivery by electroporation and their immunologic and antitumor efficacy in animals and humans, along with the basics of HPV and its pathogenesis.
Animals ; Cervical Intraepithelial Neoplasia ; DNA ; Electroporation ; Female ; Humans ; Incidence ; Proteins ; Uterine Cervical Neoplasms ; Vaccines ; Vaccines, DNA

The authors developed a biodegradable polymer that releases an antibiotic (nalidixic acid) slowly and continuously, for prevention of catheter-induced infection during drainage of cerebrospinal fluid. We investigated the in vitro antibiotic releasing characteristics and bacterial killing effects of the new polymer against E. coli. The novel fluoroquinolone polymer was prepared using diisopropylcarbodiimide, poly (e-capro-lactone) diol, and nalidixic acid. FT-IR, mass spectrometry, and elemental analysis proved that the novel antibacterial polymer was prepared successfully without any side products. Negative MS showed that the released drug has a similar molecular weight (M.W.=232, 350) to pure drug (M.W.=232). In high pressure liquid chromatography, the released drug and drug-oligomer showed similar retention times (about 4.5-5 min) in comparison to pure drug (4.5 min). The released nalidixic acid and nalidixic acid derivatives have antibacterial characteristics against E. Coli, Staphylococcus aureus, and Salmonella typhi, of more than 3 months duration. This study suggests the possibility of applying this new polymer to manufacture drainage catheters that resist catheter-induced infection, by delivering antibiotics for a longer period of more than 1 month.
Anti-Bacterial Agents/*administration & dosage ; Biodegradation ; Biofilms ; Catheterization/*adverse effects ; Cerebrospinal Fluid/*physiology ; Chromatography, High Pressure Liquid ; Drainage/*adverse effects ; *Drug Delivery Systems ; Humans ; Nalidixic Acid/*administration & dosage ; Polymers/administration & dosage ; Research Support, Non-U.S. Gov't ; Spectrum Analysis, Mass

OBJECTIVES: Advancements in medical endoscopy and techniques of rigid bronchoscopy for foreign body removal have enabled higher diagnostic accuracy, reduced morbidity and precise manipulation. However, in pediatric patients, endoscope-combined forceps may be too big to fit into the small sized airway. Here we present our method of endoscope assisted rigid bronchoscopy in pediatric patients and compare the clinical benefits with conventional naked-eye rigid bronchoscopy. METHODS: We used a 2.7 mm, 0degrees straight endoscope and small caliber grasping forceps with 3.0 to 4.5 mm sized rigid bronchoscopy for very young (<3 years of age) patients of foreign body aspiration. As an assistant held the rigid bronchoscope in situ, the operator could manipulate the endoscope and forceps bimanually. With endoscopic guidance, the foreign body retrieval was performed carefully. The clinical advantages were compared between our endoscope-assisted method (n=29) and the conventional bronchoscopy method (n=33) in terms of operation time and recovery (hospital stay). RESULTS: Bimanual endoscope-assisted rigid bronchoscopy method was technically feasible and safe. The operation time was less, compared to the conventional technique and the patients recovered more quickly. In all cases, our method completely removed the foreign body without need of a second bronchoscopy procedure. CONCLUSION: Bimanual endoscope-assisted retrieval of airway foreign body in very young age pediatric patients was superior to the conventional naked-eye method concerning accurate manipulation and safety.
Airway Obstruction ; Bronchoscopes ; Bronchoscopy ; Child, Preschool ; Endoscopes ; Endoscopy ; Foreign Bodies* ; Hand Strength ; Humans ; Surgical Instruments

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis