No abstract available.
Rectocele*

No abstract available.
Classification* ; Fissure in Ano*

The ankle stability has a vital role in normal gait and walking. An accurate and anatomic reduction with rigid fixation has been emphasized as important regimens as well as early motion and weight bearing exercises. The authors analysed 90 cases(88 patients) of ankle fractures which were admitted and treated in orthopedic department, Chung-Ang Gil General Hospital from March 1987 to May 1992. Males were affected 1.7times than female and the age group of third and fourth decades constituted 60.2%. The most common cause was vehicle accident(35 cases; 38.9%). According to Lauge-Hansen classification, supination-external rotation type was most common(32 cases; 35.6%). Accoompanyng injuries were noted on 45 cases(50%) and fractures in lower extremities were most common(17 cases; 18.9%). According to meyer's assessment of result, the clinical and radiologic results were better in operative method than conservative ones. From the evaluation of clinical results, anatomic reduction and rigid internal fixation of lateral malleoli and distal tibiofibular joint are more important factors. Complications are resulted in 19cases(21.1%) and traumatic arthritis is the most common (10 cases; 11.1%). The extent and degree of injury was an important factor in an overall results of treatment as well as the anatomic reduction of fracture alignment.
Ankle Fractures ; Ankle ; Arthritis ; Classification ; Exercise ; Female ; Gait ; Hospitals, General ; Humans ; Joints ; Lower Extremity ; Male ; Methods ; Orthopedics ; Walking ; Weight-Bearing

PURPOSE: Refractory status epilepticus refers to patients who do not respond properly to adequate first-line drug treatment such as diazepam, phenytoin, phenobaribital, lorazepam and show longer than 60 minute seizure. This study was designed to determine the efficacy and safety of midazolam given as a continuous infusion in the treatment of status epilepticus in children. METHODS: Midazolam was infused to twelve children with seizures, for whom two time repeated doses of 0.3mg/kg of diazepam, 20mg/kg of phenobarbital, and 20mg/kg of phenytoin failed to bring the episode under control. All patients received a bolus of midazolam(0.15mg/kg) followed by a continuous infusion at 1microgram/kg/min. The dose was increased every 15 min until the episode of seizure was brought under control. Time required to control seizures, infusion rate, and side-effects were monitored. RESULTS: The mean age of the patient population was 6.06 yrs(range 2 months to 16 yrs; 6 females and 6 males). In 11 patients, seizures were controlled in a mean time of 60.1 min(range 15-180 min). The mean infusion rate was 8.5microgram/kg/min(range 1-20). The total treatment duration was 17.6 days(range 1-54 days). One patient who was confirmed to have cortical dysplasia failed to respond. Two of the patients showed respiratory depression and bradycardia. CONCLUSION: Midazolam is an effective and safe drug to control refractory seizures in children with status epilepticus.
Bradycardia ; Child* ; Diazepam ; Female ; Humans ; Lorazepam ; Malformations of Cortical Development ; Midazolam* ; Phenobarbital ; Phenytoin ; Respiratory Insufficiency ; Seizures ; Status Epilepticus*

BACKGROUND AND PURPOSE: The systemic inflammatory response syndrome(SIRS), as defied recently by critical-care specialists, may result from various etiologies including infection, bum, or trauma. The purpose of this study was to determine whether TNF- alpha is associated with the development of systemic inflammatory response syndrome caused by multiple trauma. METHODS: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study Multiple blood samples were serially drawn to measure seam TNF-alpha level on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-alpha was measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value far serum TNF-alpha. RESULTS: Serum TNF-alpha. levels of SIRS group were persistency elevated above reference value until 3 days after on admission. Peak seam TNF-alpha level at 12 hours after admission was higher in SIRS group than non-SIRS group(p< 0.05). There was no significant correlation between injury severity score and TNF-alpha levels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. CONCLUSION: the result of this study suggests that persistent elevation of TNF-alpha and degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.
Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Multiple Trauma* ; Reference Values ; Specialization ; Systemic Inflammatory Response Syndrome* ; Tumor Necrosis Factor-alpha* ; Volunteers

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Physical Examination

To evaluate the risk and factors associated with seizure recurrence in children with epilepsy while receiving the adequate anticonvulsant treament, we studied 58 patients with newly diagnosed epilepsy who were followed prospectively for a median of 26 months (range 7 to 54). The results were as follows: 1) Forty-four of the 58 patients (75.9%) had recurrence of seizure. 2) The rate of recurrence according to type of seizure was observed to be 22 patients (68.8%) in generalized tonic-clonic seizure, 6 patients (85.7%) in simple partial seizure, 5 patients (83.3%) in complex partial seizure, 3 patients (100%) in mixed seizure, 2 patients (100%) in absence, 3 patients (100%) in infantile spasm, 1 patient (100%) in atonic seizure, 2 patients (50%) in secondary generalized seizure. There was no significant difference in the risk of recurrence observed among these seizure types. 3) The risk of recurrence varied according to the history of seizure, seizure recurrence was observed in 100% of the cases with history of neonatal seizure, 72.7% of the cases with febrile convulsion, and 73.3% of the cases with non-specific history. No significant difference was observed among these past history of seizure. 4) The rate of seizure recurrence according to electroencephalographic abnormalities did not differ significantly. Seizure recurrence was noted in 13 of the 18 patients with mildly disordered tracings (72.2%), 15 of the 20 patients with moderate abnormality (75.0%), and 12 of the 16 patients with severe abnormality (75.0%). 5) Recurrence rate according to cause of seizure was more significantly frequent in those with symptomatic epilepsy than in those with idiopathic type (100% vs 70.2%, p<0.05). 6) The frequency percentage of seizure recurrence by age groups of below 1 year, 1 to 3 years, 4 to 6 years, and above 6 years at onset of seizure were 100, 66.7, 57.1, and 72.7, respectively. The rate of seizure recurrence was significantly highest in patients aged below 1 year at onset of seizure. 7) There was significant difference in seizure recurrence between those with and without abnormalities as shown by neurologic examination (100% vs 70.8%, p<0.05). 8) There was no consistent difference in valproic acid serum levels between those who had a recurrence and those who did not. The patients receiving phenobarbital had significantly high serum levels of the phenobarbital in recurrent groups than those who had no recurrence. In conclusion, factors associated with an increased risk of seizure recurrence were early age at onset of epilepsy, symptomatic epilepsy, and neurologic abnormalities. We found no associations between risks of recurrence and types of epilepsy, or electroencephalographic abnormalities.
Anticonvulsants* ; Child ; Epilepsy ; Humans ; Infant ; Infant, Newborn ; Neurologic Examination ; Phenobarbital ; Prospective Studies ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile ; Spasms, Infantile ; Valproic Acid

OBJECTIVES: The objective of this study is to analyze 1,068 cases of prenatal genetic amniocentesis and to compare the results with reported studies. METHOD: We analyzed 1,068 cases of midtrimester prenatal genetic amniocenteses from September 1994 to February 1999, and investigated the fetal chromosomal abnormality, obstetric outcomes and complications by the indications of genetic amniocentesis and prophylactic antibiotic use at the Department of Obstetrics and Gynecology, Ajou University School of Medicine. RESULTS: Abnormal maternal serum markers were the most common indication of amniocentesis (57.7%) and the most common age distribution was 25-29 years (39.2%). One case of early amniocentesis (14 gestational weeks) was performed. The overall incidence of chromosomal aberration was 5.2% (56/1,068), of which there were 28 cases (50.0%; 28/56) of numerical aberrations and 28 cases (50.0%; 28/56) of structural aberrations. There were 50 cases (4.7%) of autosomal chromosomal aberrations and 6 cases (0.6%) of sex chromosomal aberrations. The pregnancy outcome was full-term delivery in 86.5%, preterm delivery in 7.6%, termination of pregnancy in 4.0%. There were no cases of serious complications including fetal death except for a case of self-limited amniotic fluid leakage(high leakage) in which the pregnancy was maintained. There were no significant differences between prophylactic antibiotics user group and non-user group in obstetric complications and outcomes. CONCLUSION: We could confirm that the trend in the indication of genetic amniocentesis had changed from advanced maternal age(35 year-old) toward abnormal maternal serum marker(triple test), and we recognized the importance of genetic amniocentesis according to the various antenatal screening tests of maternal serum marker, antenatal ultrasound, past history of fetal anomaly or family history of fetal chromosomal anomaly in the younger age groups(< 35 year-old) that are involved in more than half of the chromosomal anomaly. Further study will be needed to elucidate the efficacy of using prophylactic antibiotics in amniocentesis.
Age Distribution ; Amniocentesis* ; Amniotic Fluid ; Anti-Bacterial Agents ; Biomarkers ; Chromosome Aberrations ; Female ; Fetal Death ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Ultrasonography

PURPOSE: To compare the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus optical coherence tomography (OCT) to detect photographic retinal nerve fiber layer (RNFL) defects. METHODS: This retrospective cross-sectional study included 45 eyes of 45 consecutive glaucoma patients with RNFL defects in red-free fundus photographs. The superior and inferior temporal quadrants in each eye were included for data analysis separately. The location and presence of RNFL defects seen in red-free fundus photographs were compared with those seen in GDx-VCC deviation maps and OCT RNFL analysis maps for each quadrant. RESULTS: Of the 90 quadrants (45 eyes), 31 (34%) had no apparent RNFL defects, 29 (32%) had focal RNFL defects, and 30 (33%) had diffuse RNFL defects in red-free fundus photographs. The highest agreement between GDx-VCC and red-free photography was 73% when we defined GDx-VCC RNFL defects as a cluster of three or more color-coded squares (p<5%) along the traveling line of the retinal nerve fiber in the GDx-VCC deviation map (kappa value, 0.388; 95% confidence interval (CI), 0.195 to 0.582). The highest agreement between OCT and red-free photography was 85% (kappa value, 0.666; 95% CI, 0.506 to 0.825) when a value of 5% outside the normal limit for the OCT analysis map was used as a cut-off value for OCT RNFL defects. CONCLUSIONS: According to the kappa values, the agreement between GDx-VCC deviation maps and red-free photography was poor, whereas the agreement between OCT analysis maps and red-free photography was good.
Adult ; Aged ; Cross-Sectional Studies ; Diagnostic Techniques, Ophthalmological ; Female ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Retina/*pathology ; Retrospective Studies ; *Scanning Laser Polarimetry ; *Tomography, Optical Coherence ; Young Adult

We designed a new electrophoresis apparatus. This was consisted of the body into which agarose could be poured directly and the cover from which the platinium electrodes were suspended. After running the nucleic acid in this electrophoresis, we observed the band of nucleic acid on the ultraviolet transilluminator without touching the agarose gel, keeping the cover with the electrodes and discarding the gel in body. We compared the variuos types of the electrophoresis apparatus. In the electrophoresis apparatus which body was consisted of the flat bottom, the migration of dyes was the fastest among studied types. The high migration velocity of dyes was due to high electric current.
Coloring Agents ; Electrodes ; Electrophoresis* ; Running ; Sepharose