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

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

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

No abstract available.
Hyperplasia*

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*

No abstract available.
Humans ; Spinal Cord*

A case of neurofibroma in cauda equina which had been misdiagnosed as lumbar herniated nucleus puposus 6 years ago in other hospital was presented. In January 1984, the patient had taken the operation of total laminectomy and disckectomy at L2~3 level and symtoms were relieved thereafter. However severe low back pain and right sciatic radiation recurred in April 1990. In this hospital, lumbar myelography and spin C-T examination revealed the intradural extramedullary mass shadow at L2~3 level. On surgery, the dumbbell-shaped neurofibroma at the site was removed.
Cauda Equina* ; Humans ; Laminectomy ; Low Back Pain ; Myelography ; Neurofibroma

Idiopathc Central Serous Chorioretinopathy (ICSC)is a self-limited disorder that typically affects healthy middle-aged men. Although extensive information is available pertaining to the clincial features of ICSC in men, little is known about this condition in women. The authors reviewed the medical records and photographic files of 41 CSC cases of women, and comparison was made with 52 cases of men. Thirty eight cases of women were idiopathic, two women were pregnant in the third trimester, and one woman was taking exogenous corticosteroids for asthma. The findings in women with ICSC were similar to those in men, with exception that women tend to have lower initial visual acuity(p<0.05) and smaller size of serous elevation(p<0.01). Our results also reverade a tendency toward increased multiple leaks, higher incidence of smoke stack types, shorter duration of illness and lower recurrence rate in women, but the differences are not statistically significant(p>0.05). The average duration of illness was 3.3 months and the final visual acuity was 0.8 or better in 84.2% and worse than 0.1 in one patient who developed SRNVM. The recurrent elevation was observed in 10.5% of patients. Thus ICSC in women is similar to or more benign than those generally described in men.
Adrenal Cortex Hormones ; Asthma ; Central Serous Chorioretinopathy* ; Female ; Humans ; Incidence ; Male ; Medical Records ; Pregnancy ; Pregnancy Trimester, Third ; Recurrence ; Smoke ; Visual Acuity

In this study, we investigated whether the single nucleotide polymorphisms (SNPs) associated with telomere length (TL) were associated with the incidence of hypertension (HTN)/coronary heart disease (CHD) and cardiovascular risk factors in the Korean population. Data from 5,705 (ages 39–70) participants in the Korean Genome Epidemiology Study (rural Ansung and urban Ansan cohorts) were studied. Twelve SNPs known to be associated with telomere biology were tested for an association with HTN/CHD. As results, no significant associations were found between the selected TL-related SNPs and prevalence of HTN and CHD. Among non-alcohol users, subjects with minor alleles in rs1269304 and rs10936601 (TERC and LRRC34, respectively) exhibited a higher rate of CHD occurrence (odds ratio [OR], 1.862; 95% confidence intervals [CIs], 1.137, 3.049; OR, 1.855; 95% CIs, 1.111, 2.985; respectively). However, alcohol users with minor alleles in rs398652 (PELI2) were significantly associated with higher HTN prevalence (OR, 1.179; 95% CIs, 1.040, 1.336). Of the 3 SNPs related to disease outcomes, rs1296304 was significantly associated with increased levels of diastolic blood pressure (β estimate, 0.470; 95% CIs, 0.013, 0.926). The minor allele in rs398652 was significantly associated with higher levels of body mass index (OR, 0.128; 95% CIs, 0.010, 0.246) and γ-glutamyl transpeptidase (OR, 0.013; 95% CIs, 0.001, 0.024). In conclusion, there were no significant associations between the selected TL-related SNPs and the occurrence of HTN/CHD in Koreans. However, the results suggest the presence of a possible interaction between related SNPs and alcohol behavior associated with HTN/CHD occurrence.
Alleles ; Biology ; Blood Pressure ; Body Mass Index ; Coronary Disease* ; Epidemiology ; Genetic Variation* ; Genome ; Gyeonggi-do ; Heart Diseases ; Hypertension* ; Incidence ; Polymorphism, Single Nucleotide ; Prevalence* ; Risk Factors ; Telomere*

The functional knee hrace has been used to provide or to assist knee stahility in the anterior cruciate ligament (ACL) deficient knee, Nowadays, it is more indicated in the postoperative care of ACL injury to protect the reconstructed or repaired ligament, but eontroversies still exist regarding the effectiveness and the selection of an appropriate model. For successful application, it must restrict the knee motion within the range of certain arc, especially hyperextension, during weight bearing together with convenience and comfort.. The six commercial functional knee braces, which were introduced in Korea, were ehecked to detect the angle discrepancy between angle of brace and knee joint motion. The purpose of this study was to guide correct application of the functional knee brace in preventing hyperextension of the knee joint. Each brace was grouped into small, medium and large by size, and fixed with the arc of motion 30 to 90. The brace was applied to 3 healthy volunteers whose size was just fit mth the brace size small, rnedium and large, respectively. True lateral X-ray of the knee joint was taken in active flexion and extension state under the fluoroscopic control and measured the lateral intershaft angle of femur and tibia. Average angle discrepancy between the brace and the intershaft ang]e of femur and tibia in active extension was 22 and 3 in acTive flexion. In active extension at 30, angle discrepancy of Denzo brace was the large:st recording 26, that of Sentry hrace was the smallest recording 17. In active flexion at 90', angle discrcyancy of Sentry hrace was the largest recording 13, that of ACL brace (custom made modified Sentry brace) was the smallest recording 2. There was no statistically significant difference of the angle discrepancy among each size of brace. This study suggests that, at least 20 of angle discrepancy must be considered in appling the knee brace for prevention of hyperextension of the knee joint and careful selection of the brace, which may be affected by the design of hrace and the soft tissue compliance, is mandatory.
Anterior Cruciate Ligament ; Braces* ; Compliance ; Femur ; Healthy Volunteers ; Knee Joint ; Knee* ; Korea ; Ligaments ; Postoperative Care ; Tibia ; Weight-Bearing