No abstract available.
Insurance* ; Ultrasonography*

In postanesthetic period, infants and children have a risk of hypoxemia due to decreased functional residual capacity(FRC) and increased alveolar-arterial O2 tension gradient(A-a DO2). We measured arterial oxygen saturation(SaO2) with a pulse oximeter in 60 ASA class 1 infants and children. Group 1 was breathing with supplemental oxygen(4L/min) by mask and Group 2 was breathing with room air in recovery room after general anesthesia. SaO2 was measured on arrival in the recovery room, 2,4,6, 8,10,15, and 20 minute after arrival The results were as follows: 1) Postanesthetic SaO2 measured on arrival in the recovery room had decreased significantly(p<0.05) to preanesthetic SaO2 2) SaO2 measured in room air had decreased significantly compared with SaO measured in supplemental oxygen. As a result of the study, it is thought to be safe that supplemental oxygen is administered to patient on transfer and in recovery room.
Anesthesia* ; Anesthesia, General ; Anoxia ; Child ; Humans ; Infant ; Masks ; Oxygen* ; Recovery Room ; Respiration

Alveolar Process ; Maxilla ; Osteotomy

Child ; Child, Preschool ; Cleft Lip ; Cleft Palate ; Congenital Abnormalities ; Consensus ; Humans ; Infant ; Leukocyte Count ; Male ; Palate ; Surgery, Oral

Displaced intra-articular fractures of the calcaneus result in serious and prolonged disability. These injuries continue to pose a therapeutic challange and there remains a great deal of controversy regarding treatment, operative versus nonperative. The lateral approach for open reduction, popularized by Palmer, has been used by many authors, with high percentage of excellent results. We treated 21 displaced intra-articular fractures of the calvaneus in 18 patients by open reduction and internal fixation through the lateral approach from July 1990 to May 1992 and the patients have been followed from 12 to 36 months from the time of their injury. The clinical and radiographic analyses were as follows; 1. The most common cause of injury was falls from a height: 19 fractures in 16 patients(88.8%), Spine fracture was most commonly associated injury : 5 patients (27.8%). 2. Fracture was classified according to classification of Paley and Hall. Eight fractures were tongue type(no comminution 4, with comminution 4), 12 joint depression type(no comminution 8, with comminution 4), and a comminuted type. 3. The average bohler tuber-joint angle was
Accidental Falls ; Calcaneus ; Classification ; Congenital Abnormalities ; Depression ; Follow-Up Studies ; Foot ; Fractures, Comminuted ; Heel ; Humans ; Hypesthesia ; Intra-Articular Fractures ; Joints ; Osteomyelitis ; Spine ; Toes ; Tongue ; Transplants

In cases of L4-5 spinal fusions, L5-S1 segment used to be included in the fusion traditionally for fear of progressive deterioration of the lumbosacral motion segment after fusion above. The purpose of this study was to evaluate the advisability of extension to L5-S1 segment in cases of L4-5 fusion for an isolated pathologic condition in L4-5 sement. A retrospective review of 72 patients with spinal fusion for an isolated pathologic condition in L4-5 segment was undertaken to compare the clinical results and adverse effects in two groups. One group consisted of 39 patients with floating L4-5 fusion(SF), and the other group consisted of 33 patients with L4-S1 fusion(LSF). The age, pathologic condition at L4-5, and the fusion method(lateral fusion) were matched in two groups. The mean follow-up period was 43.6 months(ranging 24-69 months). Comparisons were made for operative problems, post-operative complications, the amount of changes in angular motion at the adjacent segments to fusion at the last follow-up compared to the pre-operative motion, and the clinical results of treatment. The LSF group took 38 more minutes and lost 245 grams of more blood in averages to complete the additional surgical procedures compared with those in SF group. Several considerable post-operative complications were one deep infection in SF group and three metal failures of sacral fixation with subsequent two fusion failures in LSF group which were mostly concerned with the sacral fixations. The changes of angular motion at follow up compared to pre-operative motion in SF group were 1.5° gain in average (ranging 3° loss-6° gain) in L3-4 segment and 0.6° gain in average (ranging 5° loss-5° gain) in the L5-S1 segment. Those in L3-4 segment of LSF were 2.8° gain in average (ranging 2°-loss 9° gain). Therefore the higher stress and subsequent degeneration are more likely expected above the L4-S1 fusion rather than below the L4-5 fusion. The satisfactory clinical results were 89.7% in SF group and 87.9% in LSF group without significant difference between two groups. In conclusion there is no need to include the L5-S1 segment in the L4-5 fusion when the pathology is limited to L4-5 segment.
Follow-Up Studies ; Humans ; Pathology ; Retrospective Studies ; Spinal Fusion

BACKGROUND/AIMS: Patient compliance and resistance to antibiotics are main factors determining the success of Helicobacter pylori eradication. This study provides basic data to verify the efficacy of currently implemented eradication therapy and reports changes in H. pylori resistance to all antibiotics used at Asan Medical Center, Seoul, Korea from 2004 to 2010. METHODS: We investigated the resistance rates to amoxicillin, clarithromycin, metronidazole, ciprofloxacin, and levofloxacin in 88, 100, and 47 strains isolated from adult patients without H. pylori eradication history in 2004, 2007, and 2010. RESULTS: The resistance rate to amoxicillin increased from 5.0% in 2007 to 10.6% in 2010. The resistance rate to clarithromycin increased from 10.2% in 2004 and 11.0% in 2007 to 14.8% in 2010. However, no difference was observed in the resistance rate to metronidazole, and strains resistant to tetracycline were not detected at all in this study. The resistance rates to quinolone lingered at 15-17% for 3 years. The non-resistant strains to antibiotics accounted for 56% of the total in 2004 and 62% in 2007. In contrast, a decreasing tendency was found for those strains in 2010 (43%). No significant differences were shown in the multi-drug resistance rate or the co-resistance rates of amoxicillin and clarithromycin over the 3 years. CONCLUSIONS: We showed increased resistance rates to clarithromycin and amoxicillin over the last 7 years, aligning with the results of previous studies performed domestically. Efforts are needed to inhibit the increase in resistant bacteria to maintain the effectiveness of eradication therapy.
Adult ; Amoxicillin ; Anti-Bacterial Agents ; Bacteria ; Chungcheongnam-do ; Ciprofloxacin ; Clarithromycin ; Drug Resistance, Microbial* ; Drug Resistance, Multiple ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Levofloxacin ; Metronidazole ; Patient Compliance ; Seoul* ; Tetracycline

PURPOSE: Transforming growth factor-beta(TGF-beta) is a potent modulator of cell proliferation, differentiation, angiogenesis and immune system. We evaluate the significance of the expression of TGF-beta1 and TGF-beta2 and correlation with Ki-67 as prognostic factors in prostate cancer. MATERIALS AND METHODS: In order to investigate the expression of TGF-beta1, TGF-beta2 and Ki-67, we analyzed immunohistochemical staining from paraffin blocks of 22 cases of the prostate carcinoma and adjacent normal prostate. RESULTS: The TGF-beta1 staining scores of the tumor cells were higher than those of the adjacent normal epithelial cells(p=0.001). The TGF-beta2 staining scores of the tumor cells were also higher than those of the adjacent normal epithelial cells(p=0.003). However no correlation was observed between tumor surrounding stroma and normal stroma in TGF-beta1 and TGF-beta2 staining scores. The serum PSA level, the clinical stage, the Gleason score and the lymph node metastasis of the tumor was not correlated with the staining score of TGF-beta1 and TGF-beta2. Ki-67 labelling index(LI) was significantly associated with the histologic grade, while no relationship was observed between Ki-67 LI and clinical stage. TGF-beta1 and TGF-beta2 staining score was not statistically correlated with the Ki-67 LI. CONCLUSIONS: These results indicate that the prostatic cancer was associated with alteration of TGF-beta1 and TGF-beta2 expression by prostatic epithelial cells which may be biologically important in the development of prostate cancer and TGF-beta1 and TGF-beta2 expression may be new target of treatment of prostate cancer. Prognostic value of TGF-beta1 and TGF-beta2 expression was not statistically significant but Ki-67 LI was significantly associated with Gleason score.
Cell Proliferation ; Epithelial Cells ; Immune System ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Paraffin ; Prostate* ; Prostatic Neoplasms* ; Transforming Growth Factor beta ; Transforming Growth Factor beta1* ; Transforming Growth Factor beta2*

Sir James Paget described the first case of Paget's disease of the breast in 1874, and Du-breuilh, in 1901, reported the first case of extramammary Paget's disease of the vulva. Paget's disease of vulva is a rare intraepithelial neoplasm of uncertain histogenesis. Recently we expe-rienced a case of Paget's disease of the vulva that we present a brief review of literature.
Carcinoma in Situ ; Paget Disease, Extramammary ; Paget's Disease, Mammary ; Vulva*

PURPOSE: We evaluated the therapeutic effect of combined androgen blockade (CAB) compared with that of medical, or surgical, castration monotherapy, in the treatment of the metastatic prostate cancer. MATERIALS AND METHODS: Of 53 patients with metastatic prostate cancer, we compared the overall survival between CAB and monotherapy groups, using a Kaplan-Meier survival curve. We also compared the therapeutic effect of flutamide and bicalutamide in the CAB group. RESULTS: There were no differences in known prognostic factors between the CAB and monotherapy groups. The mean survival after treatment were 43 months in the CAB group, and 38 months in monotherapy group, with no significant difference (p=0.470). There were also no differences in the survival rates between the flutamide and bicalutamide groups (p=0.158). CONCLUSIONS: These results implicate that the CAB was no better than medical, or surgical, castration monotherapy in patients with metastatic prostate cancer, and that flutamide or bicalutamide, in CAB, resulted in similar efficacies and tolerabilities.
Castration ; Flutamide ; Humans ; Neoplasm Metastasis ; Prostate* ; Prostatic Neoplasms* ; Survival Rate