PURPOSE: To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk. MATERIALS AND METHODS: 120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis. RESULTS: Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk. CONCLUSION: Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.
Extremities ; Foot ; Forearm ; Hand ; Head ; Hemangioma ; Logistic Models ; Neck ; Recurrence ; Risk Factors

Osteomyelitis caused by nontuberculous mycobacterium (NTM) is rare in immunocompetent children, and is often difficult to differentiate from a bone tumor, juvenile rheumatoid arthritis, soft-tissue inflammation and subacute osteomyelitis. We report NTM osteomyelitis in immunocompetent children that developed at the left distal femoral epiphysis in a 24-month-old boy and at both tali in a 7-year-old boy.
Arthritis, Juvenile Rheumatoid ; Child ; Epiphyses ; Humans ; Inflammation ; Nontuberculous Mycobacteria ; Osteomyelitis ; Preschool Child

OBJECTIVE:To evaluate the biodurability of the covering material in retrievable metallic stents covered with polycarbonate polyurethane. MATERIALS AND METHODS: Using a peristaltic pump at a constant rate of 1ml/min, bile was recirculated from a reservoir through a long tube containing four stents. Each of these was removed from the system every two weeks and a radial tensile strength test and scanning electron microscopy (SEM) were performed. Each stent, removed at 2, 4, 6 and 8 weeks, was compared with a control stent not exposed to bile juice. RESULTS: Gross examination showed that stents were intact at 2 weeks, but at 4, 6 and 8 weeks cracks were observed. The size of these increased gradually in accordance with the duration of exposure, and at 8 weeks several large holes in the polyurethane membrane were evident. With regard to radial tensile strength, extension and peak load at break were 84.47% and 10.030 N/mm, 54.90% and 6.769 N/mm, 16.55% and 2.452 N/mm, 11.21% and 1.373 N/mm at 0, 2, 4 and 6 weeks, respectively. Scanning electron microscopy at 2 weeks revealed intermittent pitting and cracking, and examination at 4, 6 and 8 weeks showed that the size of these defects was gradually increasing. CONCLUSION: When the polyurethane membrane was exposed to bile, biodegradation was first observed at week two and increased gradually according to the duration of exposure.
Bile Acids and Salts/physiology ; Biodegradation ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning/*instrumentation ; Phantoms, Imaging ; *Polyurethanes ; *Stents ; Support, Non-U.S. Gov't ; Tensile Strength ; Time Factors

No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

OBJECTIVE: To compare the abortion time, success rate and efficiency of application of intravaginal misoprostol versus intracervical laminaria insertion and intravenous sulprostone administration for mid-trimester pregnancy termination. MATERIAL: Patients requesting termination of second trimester pregnancy were randomized into two groups. In Group I, the women were given 200 microg tablet of misoprostol placed in the posterior vaginal fornix. In Group II, the women were given laminaria insertion in cervical canal with intravenous sulprostone administration. Altogether 50 subjects were recruited with 25 women in each group. RESULTS: The mean interval from start of induction to vaginal delivery was 1480.84+/-37.73 minutes in Group I and 1236.16+/-77.59 minutes in Group II(p=0.232). The success rate of termination within 48 hours in Group I and Group II were 84%, 92%(p=0.384). There were no significant differences in the mean interval time and success rates. Measurement of blood loss(differs in hemoglobin between the admission and postabortive 24 hours) shows in Group I(1.0352+/-0.5774) and in Group II(1.5640+/-0.8976). Mean changes in hemoglobin level were significantly lesser in the misoprostol group(p=0.017). No serious complication occurred. CONCLUSION: Intravaginal misoprostol appears to be acceptably safe and effective agents for second trimester pregnancy termination.
Female ; Humans ; Laminaria* ; Misoprostol* ; Pregnancy Trimester, Second ; Pregnancy*

BACKGROUND: Serious organ shortage necessitates ABO incompatible (ABOi) kidney transplantation (KT). Recent reports utilizing rituximab instead of splenectomy and tacrolimus (FK)-based triple immunosuppressants showed excellent graft outcome. METHODS AND RESULTS: Thirteen cases of ABOi living donor KT have been performed since Feb. 2007 in our center. Donor and recipient blood group was B to O (n=5), A1 to O (2), AB to B (2), AB to A1 (1), A1 to B (2) and B to A1 (1). Rituximab was given at 4 weeks before transplantation. Plasmapheresis (PP) was initiated at 7~14 days before transplantation with concurrent immunosuppressants. The number of pretransplant PP was 5.7+/-1.4. Posttransplant PP was also performed in 6 patients with higher initial titer of ABO antibody (IgG > or =256; n=2), rapidly rising antibody titer during the critical period of 2 weeks posttransplantation (n=2), or increase in serum creatinine during the critical period while awaiting pathology report of graft biopsy (n=2). Mean number of posttransplant PP in these 6 patients was 2.2+/-1.3. Median IgG anti-ABO antibody titer before precondition, at transplantation, at 2 weeks and at 6 months was 64 (8~512), 2 (1~8), 2 (1~16) and 6 (1~16), respectively. IgM titer at corresponding time point was 16 (2~128). 1 (1~1), 1 (1~2) and 1.5 (1~4), respectively. Median follow up was 8 (5~27) months. No patient or graft was lost. No patient developed acute humoral rejection. Graft function remained stable with latest serum creatinine 1.2+/-0.3 mg/dl. CONCLUSIONS: ABOi living donor KT without splenectomy can be safely performed with the use of current preconditioning and immunosuppressive regimen, and is therefore a valuable option for expanding donor pool and should be actively performed in Korea.
Antibodies, Monoclonal, Murine-Derived ; Biopsy ; Creatinine ; Critical Period (Psychology) ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Living Donors ; Plasmapheresis ; Rituximab ; Rejection (Psychology) ; Splenectomy ; Tacrolimus ; Tissue Donors ; Transplants

Low back pain is common during pregnancy and has been reported in as many as 56% of pregnant women.However, the incidence of symptomatic lumbar disc displacement in pregnancy is exceedingly rare, and anesthetic management is particularly important in such cases because the attending anesthesiologist and surgeon must consider the effects of the anesthesia, the patient's position, and surgery on the fetus.We administered an epidural anesthesia for percutaneous endoscopic lumbar discectomy at 35 weeks of gestation with the patient in the prone position.The patient maintained an uneventful pregnancy and delivered a healthy baby at 38 weeks of gestation
Anesthesia ; Anesthesia, Epidural ; Back Pain ; Diskectomy ; Displacement (Psychology) ; Humans ; Incidence ; Pregnancy ; Prone Position

BACKGROUND/AIMS: This study compared the efficacy and safety of combined peginterferon alfa (PEG-IFN) and ribavirin with that of combined interferon alpha (IFN-alpha) and ribavirin, according to the treatment duration in Korean patients with chronic hepatitis C. METHODS: Medical records of 86 patients treated with PEG-IFN and ribavirin (mean age, 50.7 years; males/females, 57/29; genotypes 1/2, 59/27) and 134 patients treated with IFN-alpha and ribavirin (mean age, 50.9 years; males/females 74/60; genotypes 1/2, 79/55) were reviewed. Ribavirin was administered at doses of 600-1,200 mg and 600-800 mg in patients with genotypes 1 and 2, respectively. RESULTS: Sustained virological responses (SVRs) were evident in 68.4% and 41.7% of genotype 1 patients treated for 48 weeks in the PEG-IFN and IFN-alpha groups, respectively (P=0.021), and in 94.1% and 64.9% of genotype 2 patients treated for 24 weeks (P=0.026). Some genotype 1 patients treated for 24 weeks in the PEG-IFN group, who all exhibited negative HCV PCR results at week 12, showed an SVR of 87.5% (7/8). CONCLUSIONS: The rate of SVRs in Korean patients with chronic hepatitis C was higher for combined PEG-IFN and ribavirin than for combined IFN-alpha and ribavirin. Further study is needed to clarify the outcome of short-term therapy in patients with a rapid or early virological response.
Adult ; Aged ; Antiviral Agents/*administration & dosage ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/genetics ; Hepatitis C, Chronic/*drug therapy/genetics ; Humans ; Interferon Alfa-2a/*administration & dosage ; Interferon Alfa-2b/*administration & dosage ; Male ; Middle Aged ; Polyethylene Glycols/*administration & dosage ; RNA, Viral/blood/genetics ; Retrospective Studies ; Ribavirin/*administration & dosage ; Treatment Outcome

BACKGROUND: Intrauterine surgical intervention for certain cardiac anomalies may have a therapeutic advantage over postnatal repair or palliation. However, it is essential to establish methods for intrauterine extracorporeal circulation and myocardial preservations which can maintain the hemodynamics and gas exchange in fetal lamb perioperatively. This study was aimed to observe the changes in hemodynamics and gas exchange according to the methods of fetal cardiac bypass. METHODS: Twelve fetal lambs (4.5 5.2 kg) at 120 to 150 days of gestation under ketamine anesthesia were subjected to cardiac bypass for 30 minutes. Six served as a group in which placenta was excluded from the extracorporeal circulation by clamping the umbilical cord during the bypass (the oxygenator group) and in the remaining six, the placenta worked as an in vivo oxygenator (the placenta group). The fetuses were observed every 10 minute during a 30-minute bypass and 30-minute post bypass period. The hemodynamic variables and fetal blood gases were measured at specific intervals. RESULTS: In the oxygenator group, mean arterial pressure (MAP), PaO2, heart rate and bypass flow rate were 62 to 74 mmHg, 220 to 282 mmHg, 169 to 182 /min and 134 to 164 ml/kg/min, respectively during bypass. But rapid deterioration of fetal cardiac and placental gas exchange function was observed following cessation of bypass. In the placenta group, MAP decreased from 61 to 34 mmHg and PaCO2 progressively increased from 56 to 74 mmHg during bypass. Flow rate was suboptimal (74 to 115 ml/kg/min) during bypass. All hearts of the placenta group was fibrillated immediately after discontinuation of bypass. CONCLUSION: The both methods of CPB, use of oxygenator and placenta as gas exchanger, under only ketamine anesthesia did not provide adequate hemodynamics and gas exchange without additional treatment for protection placental reaction. The methods of fetal cardiac bypass using either neonatal membrane oxygenator or placental as an in vivo oxygenator caused severe placental dysfunction and blood gas abnormalities.
Anesthesia* ; Arterial Pressure ; Constriction ; Extracorporeal Circulation ; Fetal Blood ; Fetus ; Gases ; Heart ; Heart Rate ; Hemodynamics* ; Ketamine* ; Oxygen ; Oxygenators ; Oxygenators, Membrane ; Placenta ; Pregnancy ; Umbilical Cord

To characterize rotavirus G and P genotypes circulating among infants and young children hospitalized with severe diarrhea in a university hospital in Gyeonggi province, Korea, and to examine any association of the genotypes and nosocomial infections, we genotyped 103 isolates of rotavirus by multiplex RT-PCR. In July 2001-June 2002, we found that globally common strains constituted 64.2% (G2P[4] 28.3%, G3P[8] 28.3%, G4P[8] 5.7%, and G1P[8] 1.9%), and the uncommon strain, G4P[6], constituted 26.4%. During July 2002-June 2003, the percentage of common strains decreased to 44.0% (G3P[8] 18.0%, G2P[4] 16.8%, and G1P[8] 10.0%), but G4P[6] increased to 36.0%. G9P[8] was identified in 10.0% of cases, and thus can be considered an emerging strain in Korea. Eight-eight percent of G4P[6] was isolated from newborn babies. Among the 103 patients, there was an evidence of nosocomial rotavirus infection in 23 children (22.3%). Of these, 19 (82.6%) were newborns infected with G4P[6] strains of rotavirus. Most of the children who acquired rotavirus infection nosocomially showed symptoms of diarrhea, vomiting, fever, poor sucking, or dehydration, regardless of the genotype. This study revealed that G4P[6] has been the major genotype causing nosocomial rotavirus infection in our hospital.
Rotavirus Infections/classification/*microbiology ; Rotavirus/*classification/*genetics ; Male ; Infant ; Humans ; Genotype ; Feces/microbiology ; Diarrhea/*microbiology ; Cross Infection/classification/*microbiology ; Child, Preschool