PURPOSE: Ventriculoperitoneal (VP) shunt insertion is an important treatment modality in children with hydrocephalus. VP shunt infection is a major complication and an important factor that determines the surgery outcome. This 15-year study was performed to evaluate the epidemiology of VP shunt infections in pediatric patients treated at our center. METHODS: A retrospective review of medical records was performed in patients 18 years old or younger who underwent VP shunt insertion surgery from April 1995 to June 2010. RESULTS: Three hundred twenty-seven VP shunt surgeries were performed in a total of 190 pediatric patients (83 females, 107 males). The median age of the patients was 2.4 years (range, 0.02-17.9 years). Having a malignant brain tumor was the most frequent cause for VP shunt insertion. The shunt infection rate was 6.7% (22/327) per 100 operations and 9.5% (18/190) per 100 patients, and the incidence rate was 0.45 infection cases per 100 shunt operations-year. The most common pathogen was coagulase-negative staphylococcus (n=7) followed by methicillin resistant Staphylococcus aureus (n=1). Ten cases were treated with vancomycin and beta-lactam antibiotic (cephalosporin or carbapenem) combination therapy and 7 cases were treated with vancomycin monotherapy. The median duration of antibiotic treatment was 26 days (range, 7 to 58 days). Surgical intervention was performed in 18 cases (18/22, 81.8%). CONCLUSION: Epidemiologic information regarding VP shunt infections in pediatric patients is valuable that will help guide proper antibiotic management. Additional studies on the risk factors for developing VP shunt infections are also warranted.
Brain Neoplasms ; Child ; Epidemiologic Studies ; Female ; Humans ; Hydrocephalus ; Incidence ; Medical Records ; Methicillin Resistance ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Staphylococcus aureus ; Vancomycin ; Ventriculoperitoneal Shunt

No abstract available.
Macrophages*

No abstract available.
Macrophages*

Recently, transsphenoidal approach is regarded as the principal method for the resection of pituitary tumor. The sublabial transseptal transsphenoidal hypophysectomy is a classical one, but it has certain limitations and postoperative problems. So various modifications of transsphenoidal hypophysectomy have been proposed. The columellar flap is one of such modified approaches.
Hypophysectomy ; Pituitary Neoplasms

Muscle transplanation surgery is presently widely accepted as a good precedure not only for cosmetic, but also for functional results, a concept to which Marina's observations on the absence of fixed and predetermined functions in the nuclei and associated tracts of the oculomotor system give great support; however, not everyone is in agreement with this concept. This paper report one case in which the total transplantation of the vertical rectus muscles midway between their insertions and the insertion of the lateral rectus muscle were carried out, in addition recession of the medial rectus muscle and resection of the paralyzed lateral rectus muscle. Our case have been followed up during 8 months to rule out late complications, aspecially ocular movement and diplopia. No late complications, however, have been found up to remaining underaction of the right superior and inferior oblique muscles and also medial rectus muscle. The eyes were straight with abduction of the right eye up to 40 prism diopters. Binocular vision was present and there was no diplopia. The cosmetic result was excellent.
Diplopia ; Muscles ; Paralysis* ; Vision, Binocular

Two cases of lymphatic type of Sporotrichosis were presented, 36-year-old and 46-year-old Korean farmers were affected over the right hands and arms. Authors made clinical analysis of ten cases of cutaneous sporotrichosis appeared in Korean literatures with additional two authors cases, and types of the disease reported were shown 9 cases of localized lymphatic cutaneous sporotrichosis and 3 cases of fixed ulcerative cutaneous sporotrichosis. Most highest instances of the diaease according to group of age, occupation, sex and involved region were found to be as follows: 25% in the age of 30 to 39 and under 10, 91.7% in farmer or among their family, 75% in male and 50% over right hands and arms, respectively. These results may indicate that sporotrichosis is one of occupational fungus diseases nf the farme: in Korea and whose age group is active worker or player in the farm.
Adult ; Arm ; Hand ; Humans ; Korea* ; Male ; Middle Aged ; Mycoses ; Occupations ; Sporotrichosis* ; Ulcer

Surgical repair has been widely accepted for full thickness tear of the rotator cuff. In traditional method, hony trough on the greater tuberosity of the humerus has heen used for tendon to hone suture. Recently, there have been some suggestions that hony trough would not he essential for repairing the rotator cuff. Purpose of this study was to investigate the clinical result of rotator cuff repair without bony trough. We evaIuated the clinical results of 23 operative repairs of the full-thickness tear of the rotator cuff, using modified ASES scoring system, at an average of l4 months postoperatively. For these cases, all the tendon to hone sutures were done without makin bony trough. There were 3 cases of small tear. 14 case of medium tear, 1 case of large tear and 5 cases of massive tear. Mini-open repairs with arthroscopic acromioplaslies were used for 9 cases with small or medium sized tear. Open acromioplasties and repairs were done for 14 cases. Nine cases were rated excellent (39%), and twelve cases showed good results (52%). Two cases showed fair results (9%). Averagc increase of score was 40 (ranee, 18 to 78). There were no complications or deteriorations of function. No patient needed additional surgery. Repair without hony trough is more simple and easier than the traditional method making bony trough. There would he possibility of less tension to the tendons and preserving more natural course of tendons. The authors believe that this method provides larger contact surface between the tendon and hone. The repairing method without hony trough is considered to he a safe and efficient method for the full thickness tear of the rotator cuff. This technique can he useful not only for ordinary open repair, but also for mini-open repair.
Humans ; Humerus ; Rotator Cuff* ; Shoulder ; Sutures ; Tendons

Desmoplastic trichoepithelioma is a solitary tumor of the hair follicle with female preponderance, most commonly located on the face. Clinically, the lesions appear annular and firm with a raised border and a depressed nonulcerated center, but the appearance is not so distinctive to hair follicle tumors that definite diagnosis is established by the histopathologic findings. We report a case of desmoplastic trichoepithelioma in a 67-year-old woman who had an asymptomatic, hard, annular lesion measuring 0.8 cm in diameter, with a raised border and a depressed center on the right cheek. Histopathologic findings showed narrow strands of basaloid cells, horny cysts, and desmoplastic stroma, with the features corresponding to the desmoplastic trichoepithelioma.
Female ; Humans

Expression of the nm23 and E-cadherin proteins has been studied in a number of tumors. Reduced expression of the nm23 and E-cadherin proteins seems to be associated with metastasis or disease progression in some tumors, including breast carcinoma. To assess the role of nm23 and E-cadherin in tumor differentiation and metastasis of breast carcinoma, immunohistochemical staining for the nm23 and E-cadherin proteins was performed in paraffin embedded tumor samples from 86 breast carcinomas. The results were as follows: 1) Expression of the nm23 protein in breast carcinoma was strong positive in 32 cases (37.2%), weak positive in 26 cases (30.2%), and negative in 28 cases (32.6%) of the cases. Expression of the nm23 protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 2) Expression of the E-cadherin protein in breast carcinoma was strong positive in 50 cases (58.1%), weak positive in 24 cases (27.9%), and negative in 12 cases (14%) of the cases. Expression of the E-cadherin protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 3) There was a statistically significant correlation between the expression of the nm23 protein and the E-cadherin protein in breast carcinoma (p<0.05). These results suggest that the expression of the nm23 and E-cadherin proteins is related to tumor differentiation, and may also be an useful prognostic factor in breast carcinoma.
Breast Neoplasms* ; Breast* ; Cadherins* ; Disease Progression ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin

Chemonucleolysis with chymopapain has been shown to be an effective alternative to surgery for the treatment of Sciatica secondary to lumbar disc herniation after failure of conservative treatment. 92 lumbar herniated disc patients had been treated by chemonucleolysis in Eul Ji General Hospital during 3 years from March 1988 to 1991 and were evaluated clinically. 1) Of 92 patients, 60 patients(65%) were between 20 and 30 years old age group and male was predominent. 2) The lesion was the most common in L4-5space(52 patients, 56.6%). 3) The results were better in the younger group and the more limited straight leg raising group. 4) The excellent and good results were obtained in 82.6%. 5) In noncompensation cases, 69 patients(88.0%) had marked improvement, but in compensation cases, 7 patients(50%) had marked improvement. 6) In conclusion, above finding suggest that chemonucleolysis is a safe and effective nonsurgical method for treatment of herniated lumbar disc before surgical intervention.
Adult ; Chymopapain ; Compensation and Redress ; Hospitals, General ; Humans ; Intervertebral Disc Chemolysis ; Intervertebral Disc Displacement ; Leg ; Male ; Sciatica ; Spine*