Periventricular-intraventricular hemorrhage (PV-IVH)is one of the most important neurologic lesion of the low birth weight infants. Serial neurosonographic exeaminations were performed in 113 low birth weight infants who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from November 1, 1990to July 31, 1991. The results were summarized as follows: 1) The incidence of PV-IVH in the study was 54% 2) According to Papile's grading system of PV-IVH, grade I was 32.8%, grade II was 45.9%, grade IIIwas 11.5% and grade IV was 9.8%. 3) The onset of PV-IVH was within the first 7 days of life in 82%. 4) Poor activity, apnea, bradycardia and hypotension were statistically significant clinical findings associated with PV-IVH(P<0.05). 5) The risk factors associated with PV-IVH were gestational age, birth weight, hyaling membrane disease, patent ductus arteriosus and artifical ventilation. 6) The mortality of PV-IVH was 0% for grade I, 10.7% for grade II,42.9% for grade III and 83.3% for gradeIV.
Apnea ; Birth Weight ; Bradycardia ; Diagnosis* ; Ductus Arteriosus, Patent ; Gestational Age ; Hemorrhage* ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Membranes ; Mortality ; Protestantism ; Risk Factors ; Ventilation

Proper education about dermatology in medical college would have physicians appropriately diagnose and treat common dermatoses without referring patients to dermatologists. However, physicians who are not dermatologists have difficulty in diagnosing and treating common dermatoses. We have made up a questionnaire about treatment and a slide test for clinical diagnosis of common dermatoses in order to evaluate the knowledge of physicians about common dermatoses, which reflects indirectly the current status of medical education of dermatology in Korea and can be used as a basic data for modifying directions for education in medical college. Total 654 physicians answered the questionnaire, including 125 just graduated general physicians, 111 general physicians who had just finished internship and 418 medical specialists. 11 data from dermatologists were analyzed as a control for evaluation. The result showed that 84%(545) of them have difficulty in diagnosing dermatologic diseases. The probable causes answered by them are lack of easy illustrative textbook for general physician(48%), inadequate education of dermatology in their medical colleges(27%) and so on. In the field of therapy in the questionnaire, only 53% of them had proper knowledge about indication of topical steroids, 56% about acne therapy, 22% about treatment of tinea pedis, 35% about scabies and 41% about urticaria. The average score was 53%. The score of family medicine group and urologist group was 69% and 66% each, which were significantly higher than that of other major groups except 98% of dermatologist group. In the slide test for clinical diagnosis, the average score was 71%. The score of family medicine group which had received postgraduate education on dermatology in their resident training was 84%, also significantly higher than that of other major groups except 100% of dermatologist group. The percentage of correct responders about tinea faciei is only 13%, tinea versicolor 42%, tinea cruris 49%, impetigo 53%, pityriasis rosea 60%, atopic dermatitis 67%, psoriasis 72% and fixed drug eruption 74%, etc. The average score was 71%. In conclusion, this study showed that physicians who are not dermatologists have difficulty in diagnosing and treating even common dermatoses. We think it is important to put stress on the common dermatoses in the field of dermatologic education in medical college. Moreover we could find the importance and need of postgraduate education on dermatology in the resident training of primary care physicians such as not only family medicine doctors but also internists and pediatricians.
Acne Vulgaris ; Dermatitis, Atopic ; Dermatology ; Diagnosis ; Drug Eruptions ; Education ; Education, Medical ; Humans ; Impetigo ; Internship and Residency ; Korea ; Physicians, Primary Care ; Pityriasis Rosea ; Psoriasis ; Scabies ; Skin Diseases* ; Specialization ; Steroids ; Tinea ; Tinea Pedis ; Tinea Versicolor ; Urticaria ; Surveys and Questionnaires

No abstract available.
Ellis-Van Creveld Syndrome*

This study was designed for the facial reconstruction of Father Dae -Gun (Andrea) Kim, who is the first priest in Korea. The study was entrusted by Seoul great parish, Myeongdong Cathedral and was conducted during 15 months from September 1999. To reconstruct the face of Father Dae -Gun (Andrea) Kim, we used photographs and metric data of Father Dae -Gun (Andrea) Kim's skull, which was measured by Department of Anatomy, Catholic Medical College at 1971. Based on above data, we found a skull similar to Father Dae -Gun (Andrea) Kim, replicated it, and modified it to be consistent with that of Father Dae -Gun (Andrea) Kim measured at 1971. The face of Father Dae -Gun (Andrea) Kim was reconstructed on the modified replica of Father Dae -Gun (Andrea) Kim's skull using the forensic anthropological data about the average skin depth and the relationships of skull morphology to facial features of Korean. The average skin depth of Korean face was obtained from direct measurement of cadavers and indirect measurement of live Korean using ultrasonography. The result of facial reconstruction of Father Dae -Gun (Andrea) Kim was made as the bronze bust. The forensic anthropologic method such as facial reconstruction is one of the methods to identify unidentified -skull. This study is the first facial reconstruction on the base of Korean physical anthropological data and is thought to be helpful to the facial reconstruction for identification.
Cadaver ; Fathers* ; Forensic Anthropology ; Humans ; Korea ; Seoul ; Skin ; Skull ; Ultrasonography

No abstract available.

No abstract available.
Aeromonas hydrophila* ; Aeromonas* ; Animals ; Histamine Release* ; Histamine* ; Mast Cells* ; Rats*

OBJECTIVE: The presence of an intracerebral hematoma from a ruptured aneurysm is a negative predictive factor and it is associated with high morbidity and mortality rates even though clot evacuation followed by the neck clipping is performed. Endovascular coil embolization is a useful alternative procedure to reduce the surgical morbidity and mortality rates. We report here on our experiences with the alternative option of endovascular coil placement followed by craniotomy for clot evacuation. MATERIALS AND METHODS: Among 312 patients who were admitted with intracerebral subarachnoid hemorrhage during the recent three years, 119 cases were treated via the endovascular approach. Nine cases were suspected to show aneurysmal intracerebral hemorrhage (ICH) on CT scan and they underwent emergency cerebral angiograms. We performed immediate coil embolization at the same session of angiographic examination, and this was followed by clot evacuation. RESULTS: Seven cases showed to have ruptured middle cerebral artery (MCA) aneurysms and two cases had internal carotid artery aneurysms. The clinical status on admission was Hunt-Hess grade (HHG) IV in seven patients and HHG III in two. Surgical evacuation of the clot was done immediately after the endovascular coil placement. The treatment results were a Glasgow Outcome Scale score of good recovery and moderate disability in six patients (66.7%). No mortality was recorded and no procedural morbidity was incurred by both the endovascular and direct craniotomy procedures. CONCLUSION: The results indicate that the coil embolization followed by clot evacuation for the patients with aneurysmal ICH may be a less invasive and quite a valuable alternative treatment for this patient group, and this warrants further investigation.
Treatment Outcome ; Tomography, X-Ray Computed ; Retrospective Studies ; Middle Aged ; Male ; Intracranial Aneurysm/radiography/*therapy ; Humans ; Hematoma/radiography/*therapy ; Female ; Embolization, Therapeutic/*methods ; Drainage/*methods ; Cerebral Angiography ; Aneurysm, Ruptured/radiography/*therapy ; Adult

Vertebral artery(VA) and posterior inferior cerebellar artery(PICA) have complex and variable anatomic configuration of origin and running course in its exctracranial and intracranial pathway. VA has four main segments: the first portion from their origin to the entry into the foramen transversarium of C6, V1; the second portion from the C6 foramen to the C1 foramen, V2; the third portion from the exit from the C1 foramen to their entry through the atlanto-occipital membrane, V3; and the fourth portion from the entry through the dura to the vertebrobasilar junction, V4 after usual origin from proximal subclavian artery. Anatomic variations including aplasia, hypoplasia, duplication, and fenestration have been reported and careful consideration and examination must be needed because these variations tend to have another vascular anomalies such as arteriorvenous malformation or aneurysm. Tortuosity of VA is not a unusual finding especially in the aged people and the branches of VA are composed of meningeal, spinal, muscular, and radicular artery. PICA is most prominent artery from VA and its trunk is divided into five segments: anterior medullary, lateral medullary, tonsilomedullary, telovellotonsillar, and cortical. The running pathway of this vessel is pretty various in each person. The branches of this vessel are composed of perforating, terminal (cortical), choroidal, and meningeal artery. The extradural origin of PICA is infrequent; however, awareness of the presence of such an anatomic variation may be a helpful adjunct to avoid injury to this vessel. Around the vertebrobasilar junction (VBJ), the anatomy of the main arteries was variable. In contrast, the perforators penetrated the adjoining brain stem at specific locations regardless of caliber of the main artery. The four major point of entry to brain stem are the lateral medullary area just caudal to the posterior olivary sulcus (Group I), the posterior olivary sulcus(Group II), the small lateral fossa at the superior olivary groove(Group III), and the foramen caecum(Group IV). Despite a small VA or its major branches, the perforators penetrating the brain stem are very important and may effect the outcomes of operation or neurointerventional procedure of VBJ unless careful manipulation and consideration was performed.
Anatomic Variation ; Aneurysm ; Arteries* ; Brain Stem ; Choroid ; Humans ; Membranes ; Meningeal Arteries ; Pica ; Running ; Subclavian Artery ; Vertebral Artery

Vertebral artery(VA) and posterior inferior cerebellar artery(PICA) have complex and variable anatomic configuration of origin and running course in its exctracranial and intracranial pathway. VA has four main segments: the first portion from their origin to the entry into the foramen transversarium of C6, V1; the second portion from the C6 foramen to the C1 foramen, V2; the third portion from the exit from the C1 foramen to their entry through the atlanto-occipital membrane, V3; and the fourth portion from the entry through the dura to the vertebrobasilar junction, V4 after usual origin from proximal subclavian artery. Anatomic variations including aplasia, hypoplasia, duplication, and fenestration have been reported and careful consideration and examination must be needed because these variations tend to have another vascular anomalies such as arteriorvenous malformation or aneurysm. Tortuosity of VA is not a unusual finding especially in the aged people and the branches of VA are composed of meningeal, spinal, muscular, and radicular artery. PICA is most prominent artery from VA and its trunk is divided into five segments: anterior medullary, lateral medullary, tonsilomedullary, telovellotonsillar, and cortical. The running pathway of this vessel is pretty various in each person. The branches of this vessel are composed of perforating, terminal (cortical), choroidal, and meningeal artery. The extradural origin of PICA is infrequent; however, awareness of the presence of such an anatomic variation may be a helpful adjunct to avoid injury to this vessel. Around the vertebrobasilar junction (VBJ), the anatomy of the main arteries was variable. In contrast, the perforators penetrated the adjoining brain stem at specific locations regardless of caliber of the main artery. The four major point of entry to brain stem are the lateral medullary area just caudal to the posterior olivary sulcus (Group I), the posterior olivary sulcus(Group II), the small lateral fossa at the superior olivary groove(Group III), and the foramen caecum(Group IV). Despite a small VA or its major branches, the perforators penetrating the brain stem are very important and may effect the outcomes of operation or neurointerventional procedure of VBJ unless careful manipulation and consideration was performed.
Anatomic Variation ; Aneurysm ; Arteries* ; Brain Stem ; Choroid ; Humans ; Membranes ; Meningeal Arteries ; Pica ; Running ; Subclavian Artery ; Vertebral Artery

BACKGROUND: This study examined the efficacy of patient-controlled epidural analgesia (PCEA) during labor and compared the suitability of fentanyl and butorphanol mixed with bupivacaine. METHODS: After establishing effective epidural analgesia with 10 ml of 0.125% bupivacaine mixed with fentanyl 5 microgram/ml or butorphanol 1 mg/ml, 60 parturients in active labor were randomly assigned to one of two groups: PCEA using 0.0625% bupivacaine with fentanyl 2 microgram/ml (fentanyl group); PCEA using 0.0625% bupivacaine with butorphanol 20 microgram/ml (butorphanol group). PCEA pumps were programmed to deliver a 4 ml/hr basal infusion, 4 ml on-demand bolus, 10-min lockout intervals between doses, and a 20 ml hourly limit. Visual analogue pain scores, side effects, parturients' satisfaction scores, duration of labor and Apgar scores were recorded during and after labor. RESULTS: The quality of analgesia, side effects, duration of labor, overall satisfaction and Apgar scores didn't differ between the two groups. Average hourly infusion rates were 11.8 0.3 ml/hr (fentanyl group) and 13.9 0.4 ml/hr (butorphanol group). CONCLUSIONS: PCEA is a safe and effective method for labor analgesia and both solutions, the 0.0625% bupivacaine plus fentanyl 2 microgram/ml and the 0.0625% bupivacaine plus butorphanol 20 microgram/ml, appear suitable for PCEA use for labor pain. There is no difference in effectiveness between fentanyl and butorphanol.
Analgesia ; Analgesia, Epidural* ; Bupivacaine ; Butorphanol* ; Female ; Fentanyl* ; Labor Pain* ; Pregnancy