PURPOSE: The purpose of the study were to examine the nutritional status of severe brain injury adult patients in critical period, and to compare the nutritional states before and after tube feeding. METHODS: Data from 19 patients admitted to the SICU in a university hospital due to severe brain injury were analyzed. Nutritional states were measured by anthropometric and blood biochemical indicators. RESULTS: MAC and MAMC were significantly decreased only at 7 days after admission compared with those on the day of admission. TSF was significantly decreased from 7 days to 14 days after admission. Fat rate was significantly decreased from 3 days to 14 days after admission. Hb was significantly decreased only at 3 days after admission. Albumin was significantly decreased from 3 days to 14 days after admission. However, lymphocyte was significantly increased at 14 days after admission. TSF and Albumin became significantly worse even after initiating tube feeding. CONCLUSIONS: Nutritional status of severe brain injury patients in SICU became worse after admission whichever indicators were adopted to evaluate nutritional status, anthropometric or blood biochemical indicators, and became worse even after initiating tube feeding.
Adult ; Brain ; Brain Injuries ; Critical Period (Psychology) ; Enteral Nutrition ; Humans ; Lymphocytes ; Nutrition Assessment ; Nutritional Status ; Tosyl Compounds

Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
Adult ; Animals ; Antibodies, Antinuclear ; Autoimmune Diseases ; Cells, Cultured ; Diagnosis ; DNA ; Edema ; Humans ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Pancytopenia ; Rheumatic Diseases

Neonatal meningitis caused by the Group B beta-hemolytic streptococcus was first reported in 1958. In recent years this organism has assumed major importance in the etiology of neonatal infection. In Korea, this organism is likely to play an increasing role in neonatal infection. So this investigation was designed to report the 9 cases of Group Bbeta-hemolytic streptococcus infected neonates admitted to the NICU, department of Pediatrics, Hanil Hospital from January 1990 to June 1993. The results were as followings. 1) Onset of disease was between 12days and 32 days of age and male to female ratio is 1:2. 2) Two cases were delivered by c-section, seven cases were by NFSD and all of the infants had normal birth weight with full term at delivery. Maternal obstetric and neonatal complications were not detected in all cases. 3) The common presenting symptoms were fever in all cases, seizure in 6 cases, feeding difficulty, lethargy, vomiting, etc. 4) Group Bbeta-hemolytic streptococcus was isolated in CSF of all cases and in blood of 6 cases. 5) There were abnormal brain CT findings in 4 cases of group Bbeta-hemolytic streptococcal meningitis. 6) The sensitive antibiotics were Cefotaxime, Cefazoline, Erythromycin, Ampicillin, Chloramphenicol, Clindamyucin and Penicillin. 7) All cases were reconvered except one case that expired on the 1st day of admission and 6 cases were followed up for the period of 2months to 33months without neurologic sequelae, of which 1 case revealed decreased wave on Lt. hemisphere in ABR.
Ampicillin ; Anti-Bacterial Agents ; Birth Weight ; Brain ; Cefazolin ; Cefotaxime ; Chloramphenicol ; Erythromycin ; Female ; Fever ; Humans ; Infant ; Infant, Newborn ; Korea ; Lethargy ; Male ; Meningitis* ; Pediatrics ; Penicillins ; Seizures ; Streptococcus ; Vomiting

This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day; Group 1, 60 workers, lesser than 4 hours a day and group 11, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0. 15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group Ii, 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05). The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of sever-subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker (2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P < 0. 01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the, work place and control of excessive VDT work are recommended to prevent such eye symptoms.
Adult ; Asthenopia ; Corneal Opacity ; Glass ; Humans ; Keratitis ; Lighting ; Linear Models ; Male ; Plants* ; Surveys and Questionnaires ; Tears ; Vision, Ocular ; Visual Acuity ; Workplace

STUDY DESIGN: This is a retrospective study analyzing the results of posterior lumbar interbody fusion(PLIF) with TPM cages in spondylolisthesis OBJECTIVES: The purpose of this study was to evaluate the clinical, radiologic results & affecting factors of PLIF with TPM cages in spondylolisthesis. SUMMARY OF LITERATURE REVIEW: The ordinary PLIF has 86-98% of radiologic union rate and clinical satisfactory rate. The problems of ordinary PLIF were graft breakage, donor site morbidity, limited bone resources, high failure rate using only transpedicular screw fixation. MATERIALS AND METHODS: From October 1995 to January 1999, 108 consecutive patients with spondylolisthesis were treated by PLIF with TPM cages, in which morcellized bone chips salvaged from posterior neural arch applied, and pedicle screw fixation. RESULTS: Preoperative Low Back Pain score(total 100 points) was improved from 47.4 points to 88.7 points at last follow-up. 10 point visual analogue scale was reduced to 1.5 point at last follow-up. In the end results, Ninty-two percent of patients rated as excellent or good. The preoperative value of slippage, 18.6% was achieved to 5.5% at last follow-up. The anterior intervertebral disc space height was increased from 10.0 to 16.2mm postoperatively. Fusion occurred in all patients except one. Groups below 60-year-old patient at the time of surgery showed better clinical results than those above 60 (p<0.05). No clear correlations were noted between sex, the types of spondylolisthesis, bone mineral density, smoking habits and obesity in clinical, radiologic results. CONCLUSION: PLIF with TPM cages is appeared to be a recommended procedure of choice to treat lumbar spondylolisthesis and this operation should be performed with a caution in aged patients.
Bone Density ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Low Back Pain ; Middle Aged ; Obesity ; Retrospective Studies ; Smoke ; Smoking ; Spondylolisthesis* ; Tissue Donors ; Transplants

STUDY DESIGN: A retrospective study. OBJECTIVES: To examine the radiologic and clinical results of patients classified as excessive translation and excessive angulation, treated by posterolateral fusion only, or posterolateral fusion with posterior lumbar interbody fusion in isthmic spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Isthmic spondylolisthesis is usually treated by PLF only or PLF with PLIF. But it is not reported the clinical and radiologic results classified by translation type. MATERIALS AND METHODS: Patients who had received surgery for spondylolisthesis between January 2005 to January 2010, there were 56 for whom follow-up observations were possible for 2 years. According to the fusion methods and preoperative flexion-extension simple radiograph, we classified as excessive translation and excessive angulation by segmental instability and as PLF and PLIF by surgical methods. We examine the clinical results(Visual Analogue Scale, Oswestry Distability Index, operation time, blood loss, complication rate) and the radiologic results(reduction rate of slippage, change of segmental angle, reduction ratio of disc height, bone union). RESULTS: In radiologic results, excessive angulation(group II) did not show significant difference from excessive translation(group I) in terms of reduction rate of slippage, change of segmental angle, reduction ratio of disc height, bone union. But we found excessive translation-PLIF(group I-B) was better than excessive translation-PLF(group I-A) and excessive angulation-PLIF(group II-B) was better than excessive angulation-PLF(II-A) in terms of reduction ratio of disc height(P<0.05). In clinical results, both sides group did not show significant difference in operation time, blood loss, complication rate. CONCLUSIONS: In spondylolisthesis patients, excessive translation group(I) and excessive angulation group(II) did not show significant difference in radiologic results and clinical results. But both sides group showed the PLF with PLIF was better than the PLF only in terms of reduction ratio of disc height.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spondylolisthesis

MELAS syndrome is a rare but distinct clinical entity belonging to a group of mitochondrial encephalomyopathies characterized by the tetrad of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes. We experienced a case of MELAS syndrome in an 8 year-old boy who showed headache, pain of the eyeball, vomiting, stroke-like episodes such as visual disturbance and dysarthria, myoclonic seizure, confusion, and walking disturbance. His serum lactate level was elevated up to 48 mg/dl. MRI findings showed high signal intensities T2-weighted image and low signal intensities in T1-weighted image in the right thalamus and parietooccipital lobe and bilateral symmetric high signal intensity in T1-dweighted image in the basal ganglia. We have seen the dispersed ragged-red fibers with modified Gomori trichrome staining on light microscope, and abundant and dysmorphic mitochondria on electon microscope in the specimen of muscle biopsy. esis of SLE.
Basal Ganglia ; Biopsy ; Child ; Dysarthria ; Headache ; Humans ; Lactic Acid ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Encephalomyopathies ; Seizures ; Thalamus ; Vomiting ; Walking

No abstract available.
Child* ; Humans ; Leukemia, Myeloid, Acute* ; Typhlitis*

PURPOSE: To compare clinical results and radiologic changes after arthroscopic and microscopic discectomy of lumbar disc herniation in teenagers who have no degenerative change. MATERIALS AND METHODS: From Jan 1990 to Aug 2001. 70 lumbar disc herniations were performed in patients below 20 years old who were admitted to our department, among these 67 cases (49:male, 18:female) were evaluated for at least 1 year. Their aver-age age was 18.1 years (13 ~20 years). Forty-six received microscopic discectomy and 21 arthroscopic discectomy. Mean follow-up duration was 26.4 months (12 ~88 months). RESULTS: Clinical results and disc height change were compared between the arthroscopic and microscopic discectomy groups using the criteria of MacNab, and the relationship between disc height change and clinical results, excised disc volume, opera-tive technique, body mass index and symptom duration were investigated. Clinically there was no significant difference between the two groups (p=0.425), and their results were the same as those of adults. At the 1 year-follow up, disc height changes showed no correlation with the method of operation (p=0.996) or the volume of the excised disc. Postoperative disc height in teenagers of lumbar disc herniation who showed no degenerative change significantly decreased with time, but no significant relation was observed between disc height changes and clinical results, operative technique, excised disc volume, body mass index, involved disc site or symptom duration between the two groups. CONCLUSION: We believe that arthroscopic discectomy is an effective method, if the patients status permits, because it has the advantages of non-invasiveness, short hospitalization period and earlier return to normal life.
Adolescent* ; Adult ; Body Mass Index ; Diskectomy* ; Follow-Up Studies ; Hospitalization ; Humans ; Young Adult

STUDY DESIGN: A retrospective study OBJECTIVES: To demonstrate the early experience of operative treatment about adjacent segments degeneration after lumbar fusion. SUMMARY OF LITERATURE REVIEW: The treatment of degenerative changes at adjacent segment after lumbar spinal fusion have not been well described in literature. MATERIALS AND METHODS: A retrospective reviews of radiographs, medical records and follow up study were undertaken in eight patients who had been treated surgically due to degenerative changes at adjacent segment after lumbar fusion. Average follow up duration was 25 months. Causes of secondary operation were 3 cases of segmental instability, 2 cases of degenerative spondylolisthesis, 2 cases of degenerative spinal stenosis, 2 cases of cauda equina syndrome, 1 case of disc degeneration. Clinical results were evaluated by using of author's criteria. For the radiographic evaluation, plain roentgenogram(AP, Lat. flextion/extension Lat.), CT, MRI were checked. RESULTS: The mean time interval to secondary operation from first operation was seven years nine months. At the preoperative CT or MRI film review, there were initial adjacent segment degenerative changes in half of the cases preoperatively. The level developing degenerative changes were upper segment in 5 cases, lower segment in 2 cases and both segment in 1 case. Most common segment was L3,4 in 5 cases. The second operations were mainly PLIF in 7 cases and PL fusion in 1 case. All cases showed solid fusion. Clinical results were excellent in 3 cases, good in 4 cases, fair in 1 case and poor in no case. CONCLUSION: The early clinical and radiographic results of surgical treatment was satisfactory. If the degenerative changes of adjacent segments are detected preoperatively, there are some needs to consider the extension of surgery according to the severity of the lesions. We think that the results of secondary operation was better in case of PLIF than posterolateral fusion because PLIF provided more rigid stability which enabled early walking stability and better corrective power. But long term results of that should be followed up.
Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Magnetic Resonance Imaging ; Medical Records ; Polyradiculopathy ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis ; Spondylolisthesis ; Walking