Focal segmental glomerulosclerosis is the renal histopathologic lesion observed in 10% of children with idiopathic nephrotic syndrome. Complications include infection, thrombosis, hypocalcemia and adverse effect of steroid use. The incidence of thrombosis reported ranges from 10~40%. The pathogenesis are changes in coagulation system, decrease of Antithrombin III, increase platelet aggregability and steroid or diuretics use. These changes take place passively as a result of increased protein synthesis and urinary loss of low molecular weight protein. We experienced a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome in a 11 year old male patient who had been hospitalized because of convulsion and semicoma. MRI showed an evolving infarct in the occipital lobe, decreased antithrombin III and increased factor VIII on coagulation factor assay. We hereby report a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome with a brief review of related literature.
Antithrombin III ; Blood Coagulation Factors ; Blood Platelets ; Cerebral Infarction* ; Child ; Diuretics ; Factor VIII ; Glomerulosclerosis, Focal Segmental* ; Humans ; Hypocalcemia ; Incidence ; Magnetic Resonance Imaging ; Male ; Molecular Weight ; Nephrotic Syndrome* ; Occipital Lobe ; Seizures ; Thrombosis*

No abstract available.
Intervertebral Disc* ; Retrospective Studies*

OBJECTS: There was a trend to perform fusion and instrumentation in spinal stenosis surgery, because of extensive decompression and instability. However, the introduction of microscope in spine operation can minimize the range of excision of anatomical structure and reduced the decompressin level in the multiple lesions and the incidence of spinal fusion. The purpose of this study were to assess the outcome of this procedure in 3 years follow up and to identify the clinical features of the patients and technical aspects of the operation that were associated with a poor outcome. MATERIALS AND METHODS: Twenty-one patients were identified as having had a microscopic decompression without arthrodesis, for degenerative lumbar spinal stenosis over 60 years or their who had osteoporosis with Saville's index 2 or higher. The follow up period was more than 3 years. The clinical results was evaluated by Kim's criteria. RESULTS: Eleven cases were above good results in two levels involved 14 cases, 2 cases above good results in three levels involved 5 cases and 1 case above good results in four levels involved 2 cases. In the cases of affected duration, 7 cases are less than 1 year or more than 5 years each 6 cases and 2 cases were above good results by the criteria. We concluded that the long-term outcome of decompressive surgery in the elderly is good; it does not differ from that reported for younger patients . CONCLUSIONS: Selective microscopic decompression is one of the effective method for the elderly patients or patients with osteoporosis in addition to multiple stenotic lesions.
Aged ; Arthrodesis ; Decompression* ; Follow-Up Studies* ; Humans ; Incidence ; Osteoporosis* ; Spinal Fusion ; Spinal Stenosis* ; Spine

No abstract available.
Female ; Humans ; Placental Extracts* ; Pregnant Women*

No abstract available.
Immunoglobulins* ; Tetanus Toxoid* ; Tetanus* ; Vaccination*

A key factor in successful application of PBL is creation of good problems. Unfortunately, published collections of problems do not exist for many subjects. Consequently, instructors usually write their own problems and case studies if they want to use problem-based instruction. In this study we proposed principles for creation of PBL problems and presented its example. If effective problems suitable to educational goals are engaged, PBL can be introduced to the first grade medical students who do not have any knowlege about medicine. However, additional factors such as number of faculties and students, budget, availability of learning materials also affect successful implementation of PBL.
Budgets ; Humans ; Learning ; Students, Medical

No abstract available.
Lichens* ; Mucinosis, Follicular*

Meigs' syndrome consists of an ovarian fibroma, or fibroma-like benign tumor, associated with fluid in both abdomen and chest. Characteristically, the ascites and hydrothorax disappeared and do not recurred following removal of the ovarian tumor. The authors presented a case of Meigs' syndrome that was cured by surgical removal of ovarian tumor and resulted in normal pregnancy outcome in 27-year-old pregnant woman with a brief review of literatures.
Abdomen ; Adult ; Ascites ; Female ; Fibroma ; Humans ; Hydrothorax ; Meigs Syndrome* ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women ; Thorax

The classification of thoracolumbar spinal injuries has been based on morphological criteria, mechanism or both. Recently Denis and Macfee insisted no the middle column of the spine but their classification is useful as a morphologic description. Especially, the classification and decision of treatment are difficult in the burst fracture. So we have applied the new classification described by Gertzbein that considers the morphologic patterns and mechanism of injury and compared with another classifications. We studied 28 cases of the thoracolumbar burst fracture who were treated and followed up at Wonkwang university hospital from May, 1988 to March, 1992. We classified burst fracture according to the three kind of classifications and CT finding. 1. The burst fracture associated with flexion-distraction injury was revealed 5 cases(about 18%). 2. In the treatment, Type A injuries requires the use of distractive and type B requires compressive forces in the correcting the deformity.
Classification ; Congenital Abnormalities ; Spinal Injuries ; Spine

The management of fractures of os calcis remains highly controversial. The fractures involving subtalar joint may cause serious and persistent disabilities. Recently, the computed tomography (CT) scan has been shown to he superior in evaluating the intraarticular fractures of calcaneus and the most widely used classification is based on the number of fragments especially seen on. Although the classification of calcaneal fractures hy CT, tongue type and joint depression type fractures hy plain radiographic views have been commonly used. Generally, closed reduction and axial fixation with metallic pin for tongue type fractures and open reduction and internal fixation for joint depression type fractures have been performed. The authors did so. The 13 fractures were tongue types and 17 fractures were joint depression types. The intraarticular calcaneal fractures of 30 feet in 26 patients who were treated at Our Lady of Mercy Hospital were analyzed in clinical and radiological aspects from Mar.1991 to Apr.1996. The results were as follows: 1. Of 30 cases, 16 fractures were treated with closed reduction and pinning, and 14 fractures were treated with open reduction and internal fixation. 2. The preoperative, postoperative and the last follow-up average Bohlers angle were 6.0, 21.0 and 20.5 respectively. 3. The preoperative, postoperative and the last follow-up average Gissanes angle was 106, 129 and 126 respectively. 4. Based on assessment of the criteria of Salama et al 19), excellent results were 5, good results were 14, fair results were 6 and poor results were 5. 5. All the five cases of poor results were tongue type fractures and they were treated with closed reduction and axial pinning. 6. Of 7 fractures using autogenous iliac bone graft, 6 fractures were good, I fracture was fair and there was no poor results. Therefore, open reduction and internal fixation for joint depression type calcaneal fractures was thought to be a good method of treatment. But we must consider whether axial fixation with metallic pin for tongue type calcaneal fractures will be a good method of treatment.
Calcaneus ; Classification ; Depression ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tongue ; Transplants