No abstract available.
Peptic Ulcer Perforation* ; Peptic Ulcer*

Although the operation for the ventral lesion of craniovrtebral junction and atlantoaxial area is considered difficult to perform, the transoral approach made it safer and easier. The authors report 10 cases(9 patients) treated by the transoral approach for the lesion of craniovertebral junction over the past 13 years at the Ajou University Hospital and the Presbyterian Medical Center. Of these 10 cases, there were 4 odontoid type II fractures, 1 atlantoaxial dislocation, 1 os odontoideum, 1 chordoma at lower clival area, 1 rheumatoid arthritis, 1 epidural abscess and 1 wound revision due to slippage of grafted bone after clivoaxial fusion. The surgical methods included 4 cases of anterior decompression and clivoaxial fusion, 2 cases of anterior decompression and C1-2 interarticular joint fusion, 1 case of anterior decompression and clivoaxial fusion followed by posterior fusion, and 3 cases of anterior decompression and posterior fusion. In nonreducible atlantoaxial dislocation or ventral cord compression le sion, if the clivoaxial angle was less than 120 degree, the transoral approach was selected. The appropriate surgical approach must be selected according to the degree of compression of the neural tissue involving the craniovertebral junction and atlantoaxial dislocation.
Arthritis, Rheumatoid ; Chordoma ; Decompression ; Dislocations* ; Epidural Abscess ; Joints ; Protestantism ; Transplants ; Wounds and Injuries

No abstract available.
Neurilemmoma* ; Neurofibromatoses* ; Neurofibromatosis 2*

No abstract available.
Tibia*

OBJECTIVE: For the treatment of carotid cavernous fistula(CCF), transarterial detachable balloon occlusion(DBO) is the method of choice. When it has failed to occlude the fistula, various embolization methods are used to treat the fistula. Transvenous embolization through the superior ophthalmic vein(SOV) is another method of treatment. The venous approach through the SOV after surgical dissection and exposure of this vein has been recommended by some delete, but(here) delete delete(an) alternative treatment method by percutaneous puncture of the SOV without surgical dissection(is described). METHODS: A 19-year-old woman admitted to our hospital two months after accident, presented with proptosis, chemosis, occulomotor and abducens nerve palsies, and bruit of the right eye. The authors tried DBO via transarterial route in initial treatment and the fistula was occluded with subsequent disapearance of bruit. However, 2 weeks later, she complained of recurence of bruit. Transarterial approach was attempted again, but the fistula hole was too small for this approach. The venous approach via SOV by percutaneous puncture was then tried. Puncture was made at the medial one third of the superior orbital rim and the fistula was embolized with Guglielmi detachable coils (GDCs). RESULTS: The fistula was completely occluded and no early and late complications noted. The patient's clinical symptoms were improved within a few days. CONCLUSION: Treatment of CCF by percutaneous puncture of the SOV is an alternative and effective method when other approaches are not feasible.
Abducens Nerve Diseases ; Exophthalmos ; Female ; Fistula* ; Humans ; Orbit ; Punctures* ; Veins* ; Young Adult

BACKGROUND: This study was carried out to evaluate the efficacy of desferrioxamine as a chelating agent in iron overloaded patients with severe aplastic anemia due to multiple transfusion. METHODS AND MATERIALS: From Oct. 1995 to Aug. 1996, 15 patients with aplastic anemia, diagnosed from May 1995 to Jan. 1996 at St. Mary's Hospital, who had a transfusional hemosiderosis were included in this study. They received 19 courses of high-dose desfer-rioxamine therapy for 6 days(20 to 30 mg/kg daily as a 24-hour intravenous infusion) . Before and after treatment, we measured serum ferritin, iron, TIBC, 24-hour urinary excretion of iron. RESULTS: 1) The range of iron load before treatment was between 4.5 and 20.0 gram. 2) Because of limit of detection(1,800 microgram/L), it was difficult to compare the changes of serum ferritin level after therapy to those of before therapy. 3) There was no significant differences between the levels of serum iron before and after therapy(214.3+/-62.8 vs 220.0+/-53.3). And there was no significant differences between TIBC before and after therapy(235.8+/-64.6 vs 259.4+/-60.1). 4) Iron/TIBC ratios were significantly deceased after desferrioxamine treatment compared to those of before therapy(0.90+/-0.04 vs 0.85+/-0.04, P<0.001) and mean urinary excretions of iron were increased by high-dose desferrioxamine compared to those by test dose(6.5+/-7.6 vs 29.1+/-14.3, P<0.001) CONCLUSION: High-dose desferrioxamine therapy is very effective for chelating and excretion of iron in iron overloaded patients with severe aplastic anemia due to multiple transfusion. A repeat administration of desferrioxamine is necessary for the iron overloaded patient to eliminate the risk of a transfusional hemosidersis.
Anemia, Aplastic* ; Deferoxamine* ; Ferritins ; Hemosiderosis* ; Humans ; Iron ; Iron Overload

The T cell responses to hepatitis B surface antigen (HBsAg) were analyzed in acute hepatitis patients, chronic active hepatitis (CAH) patients and asymptomatic carriers. Neither proliferative responses nor substantial cytokine production of peripheral blood mononuclear cells (PBMC) in response to HBsAg was detected. For further studies, HBsAg- reactive T cell lines were prepared from PBMC of the hepatitis patients and asymptomatic carriers. No proliferative response of the T cell lines was observed. Interestingly, however, T cell lines obtained from acute hepatitis patients were found to produce IFN-r, but not IL- 4, in response to HBsAg stimulation, whereas T cell lines obtained from CAH patients and carriers were not. Results of this study suggest that HBsAg-reactive T cells producing Thl type cytokines may play an important role in the viral clearance during acute infections, while defects in those T cells may be responsible for the viral persistency.
Cell Line ; Cytokines ; Hepatitis ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; T-Lymphocytes*

BACKGROUND: In women, the prevalence of depression is known to be more than twice as high as in men. Because many depressive women complain of their somatic symptoms instead of neurovegetative ones, many cases of depression have been misdiagnosed. Women also tend to use medicine more frequently than men do to manage depression. So we investigated the relationship between somatic symptoms and drug use in housewives for better management. METHODS: From 1st. March to 31st. March in 1996, the prepared questionnaires were presented to housewives living in the area of Kyung-ju city, who responded the questionnaires under direct interview. The questionnaire was composed of two parts. One part included demographic data, somatic complaints, drug use, places of drug purchase, current diseases that had been diagnosed by doctors. The other included Korean standard Beck Depression Inventory-questionnaire. The subjects were divided into two groups by BDI score(21 point), which was the cut-off point for depression in Korea. The relationships of somatic symptoms and drug use between the two groups were analyzed. RESULTS: There were 110 housewives who had depressive trends among 569 respondents. In general characteristics, there was significant difference between the two groups except the item of religion. In the items of somatic symptoms, there were more somatic symptoms in the group of high BDI score(>_21) except fatigue(P<0.01). More drug users were found in the group of high BDI score(>_21) (P<0.05). In the group of high BDI score(>_21), there was definite correlation between the items of somatic symptoms and drug use. There was no difference between the two groups in the item of drug purchase site. The most common site of drug purchase was the drug store in both groups. CONCLUSIONS: Depressive housewives complained of more somatic symptoms and more often used drugs as well.
Surveys and Questionnaires ; Depression ; Drug Users ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Prevalence

In order to evaluate the genotoxic hazard among workers potentially exposed to low level petrochemical substances, the analyses of micronuclei (MN) and sister chromatid exchanges (SCEs) in lymphocytes were performed in 46 male workers (as exposed group) and 46 nonexposed subjects (as control group). Mean frequencies of MN and SCEs (respectively, 12.9/1000 cells and 6.5/cell) in exposed group were very significantly higher than those (10.2/1000 cells and 5.4/cell) in control group. And there were also significant differences in mean frequencies of MN and SCEs adjusted for age, employment duration, smoking, and drinking between two groups. Median frequencies of MN and SCEs in exposed group were very significantly higher than those in control group. Frequencies of SCEs were higher in smokers than in non-smoker. Frequencies of MN in smokers, however, were similiar to those of non-smoker. Interaction between exposure and smoking on MN and SCEs induction was not observed. The results suggest that there is genotoxic hazard in high risk group like workers handling carcinogens in petrochemical plants and the analyses of MN and SCEs are useful biomarkers for the exposure to hazard substances even at the level below the exposure limit.
Biological Markers ; Carcinogens ; Drinking ; Employment ; Humans ; Lymphocytes ; Male ; Sister Chromatid Exchange ; Smoke ; Smoking

Distance teaming has been the tuning point for accomplishing adult teaming in nursing education. This study was conducted to demonstrate the effectiveness of the distance learning courseware with the RN-BSN students at Yonsei university, College of Nursing. The distance learning courseware was developed cooperatively by content experts, instructional designers. programmers and graphic designers. The course subject, 'Growth and Development' was made by a computerized instructional module using the internet. The programming developed with the virtual school developing support system of Samsung SDS based on the Web Sever and Oracle DB through the Internet. The instructional courseware was developed after taking into consideration the learners' levels of competencies and knowledge and utilized the integrate information through the multimedia, mainly via screens in the computer network. The students learned about the growth and development of infants to adolescents through the interaction with peers as well as instructors using many functional keys on the internet. The effects of learning were evaluated as their satisfaction of this distance learning courseware by 60 RN-BSN students. The student's responses have been very positive. The distance learning courseware for RN-BSN students developed at Yonsei University's Collage of Nursing is an available and interactive method used a Multimedia Instructional Design through the Internet.
Adolescent ; Adult ; Education, Distance* ; Education, Nursing ; Growth and Development ; Humans ; Infant ; Internet* ; Learning ; Multimedia ; Nursing*