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.
Tibia*

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

BACKGROUND: Hypothermia is a condition that can lead to serious complications and even to death in newborn. Although the temperature control is essential in neonatal care, it is often neglected during urgent transfer from local private hospitals. The purpose of this study is to evaluate the incidence and clinical outcomes of transfer induced neonatal hypothermia. SUBJECTS AND METHOD: In this retrospective study, subject is limited to transferred outborn babies with age less than 24 hours from June 1996 to May 1999. A total of 3,086 patients were admitted in NICU during the study period and inborn and outborn babies were 1,743(56%) and 1,343(44%) respectively. Among the 1,343 outborn babies, 212 babies were transferred from the private hospital within 24 hours of birth and were eligible for the study. Rectal temperature on arrival, transfer time, birth weight, gestational age, initial arterial gas study, and clinical outcome were compared. Statistical analysis has been done with chi-sqaure test and multiple logistic regression analysis. RESULTS: There were 84 cases(39.6%) hypothermia(<36degrees C> among the 212 babies and the rate of hypothermia in transfered babies have not decreased over the study period. There were significantly more hypothermia in lower gestational age (less than 28 weeks) and lower birth weight (less than 2,000gm) caused hypothermia significantly more than normal gestational age or normal range of birth weight. And time interval (less than 12 hour) from birth to arrival at emergency department was also significant factor in hypothermia. The mortality rate was three fold higher in hypothermia than normothermic or hyperthermic babies. CONCLUSION: This study shows that hypothermia during neonate transportation is a major cause of neonatal mortality and morbidity in prehopital care. Body temperature control during transport of neonates under 24 hours of age should be emphasized for the better outcome of treatment.
Birth Weight ; Body Temperature ; Emergency Service, Hospital ; Gestational Age ; Hospitals, Private ; Humans ; Hypothermia* ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn* ; Logistic Models ; Mortality ; Parturition ; Reference Values ; Retrospective Studies ; Transportation*

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*

It is important to detect binocular suppression of pediatric strabismic patients, especially in accommodative esotropes and intermittent exotropes. However, it may take a long time and false results may be obtained in young children. In order to examine binocular suppression, we selected 103 accommodative esotropes with binocular suppression. Vectograph test, Worth 4 dot test, and 4 prism base-out test were performed at distance, and Worth 4 dot test, TNO test, and Bagolini test at near. Titmus fly test and Randot stereotest were administerd to know the relationship between stereoacuity and suppression. In detecting binocular suppression, the true rate of vectogram was 95%, which was the highest result of all tests and 4 prism base-out test was the next with 88% of the true rate. The stereoacuity was increased in proportional to the absence of suppression. The vectographic porject test was the easiest and the most accurate test to identify normal fusion or binocular suppression at distance in young strabismic children. The accuracy will be increased in the combination with 4 prism base-out test. Therefore the vectograph also can be used in the screening of small amount of deviation, monocular amblyopia and low vision in kindergarten and elementary school.
Amblyopia ; Child ; Diptera ; Humans ; Mass Screening ; Telescopes* ; Vision, Low

No abstract available.
Antibodies, Anticardiolipin* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

Despite significant advances in neurosurgical and neuroanesthetic techniques, certain lesions such as giant aneurysms still present significant challenge to neurosurgoens. The authors experienced a case of giant MCA bifurcation aneurysm surgery using a technique of deep hypothermia and circulatory arrest with excellent outcome. Cannulation for cardiopulmonary bypass can be done either centrally through a sternotomy(aortic-right atrial), or peripherally through a small inguinal incision(femoral-femoral). In our case, femoral-femoral cannulation was done which can eliminate many serious complications following the sternotomy. The rationale for the application of the deep hypothermia and circulatory arrest in the complex intaracranial aneurysm surgery and the benefits of the femoral cannulation are disccused.
Aneurysm* ; Cardiopulmonary Bypass ; Catheterization ; Hypothermia* ; Sternotomy

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*