No abstract available.

Computerized tomography(CT) has proven to be far superior to other diagnostic studies in the detection of intracranial lesions after head injuries. The procedure is especially appropriate for early and accurate diagnosis because it can be done quickly with no discomfort and minimal risk. CT was utilized as a screening diagnostic procedures in 100 consecutive patients of head injuries who were alert and neurologically no deficits in a 8 months period. 11 abnormal CT Scans found at 10 patients:six epidural hematomas, two intracerebral hematomas, one sudural hygroma and one temporal contusion. The cases presented are discussed in light of pertinent literature.
Contusions ; Craniocerebral Trauma* ; Diagnosis ; Head* ; Hematoma ; Humans ; Lymphangioma, Cystic ; Mass Screening ; Tomography, X-Ray Computed

PURPOSE: Postoperative long-term follow-up studies after orchiopexy are rare as compared for other studies such as for histological changes and proper operative age. We analyzed the five-year long-term follow-up results after orchiopexy, expecting a proper prognosis of testicular growth. MATERIALS AND METHODS: A total of 57 patients were selected from a follow-up study in 211 boys who underwent orchiopexy between January 1999 and July 2001. Patients were divided in several categories(operation age, testis consistency, pre-operational position of the testis) and were analyzed by examination of the previous medical records, preoperative and postoperative testicular volume(measured by ultrasonography), follow- up history taking, and from a physical examination. RESULTS: For the 57 patients, 14 patients had bilateral and 43 patients had unilateral cryptorchidism. All of the cryptorchid testes were smaller than a normal testis in the unilateral group of patients as determined by testis ultrasonography. Sorting by operation age, only patients that received orchiopexy within two years from birth showed a significant recovery of testicular volume percentage(operated testis/normal testis x100%: in the unilateral group) at follow-up. Sorting by consistency, the patients with normal testicular consistency showed a significant recovery of testicular volume percentage(operated testis/normal testis x100%: in the unilateral group) at follow-up. Sorting by the preoperative position of the testis, the proximity of the testis to the scrotum was a significant factor for recovery of delayed cryptorchid testicular growth. CONCLUSIONS: Orchiopexy performed at less than two years from birth and the proximity of the testis to the scrotum were significant factors for recovery of delayed cryptorchid testicular growth. Consistency of a cryptorchid testis can be a meaningful factor for expectation of testicular growth by the establishment of an objective measurement for testicular consistency and studies for histological correlation.
Follow-Up Studies

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy

PURPOSE: Although neonatal pulmonary hemorrhage is rare, it is associated with high mortality. We aimed to evaluate the risk factors associated with pulmonary hemorrhage in preterm infants and to describe the clinical course, including neonatal morbidity, of infants who developed pulmonary hemorrhage. METHODS: We performed a retrospective case-control study of 117 newborn infants aged less than 37 gestational weeks admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 1995 and December 2008. Control group infants without pulmonary hemorrhage were matched according to the gestational age, duration of mechanical ventilation, and birth weight range (< or =100 g). Pulmonary hemorrhage was defined as the presence of hemorrhagic fluid in the trachea and severe respiratory decompensation. RESULTS: Pulmonary hemorrhage occurred in 17 cases of very low birth weight infants (VLBW; birth weight < 1,500 g; median age, 3 days) and 22 cases of low birth weight infants (LBW; 1,500 g < or = birth weight < 2,500 g; median age, 1 day). Antenatal maternal glucocorticoid treatment significantly reduced the incidence of pulmonary hemorrhage in VLBW infants. Low APGAR score (< or =3 at 1 min) and acidosis at birth were associated with significantly high incidence of pulmonary hemorrhage in LBW infants. CONCLUSION: Antecedent factors and timing of pulmonary hemorrhage of LBW infants were different from those of VLBW infants. The mortality rates of VLBW and LBW infants were 88.2% and 45.5%, respectively. Pulmonary hemorrhage was the principal cause of death in 66.6% VLBW infants and 40.0% LBW infants.
Acidosis ; Aged ; Apgar Score ; Birth Weight ; Case-Control Studies ; Cause of Death ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Parturition ; Prognosis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Trachea

Compression of the left renal vein (LRV) between the superior mesenteric artery and the aorta has been termed the nutcracker syndrome. The entrapment of the left renal vein is not easily detectable by ordinary diagnostic procedures. We report 2 cases of the nutcracker syndrome with symptoms ( / ) diagnosed by phlebography and pressure measurement. In both cases, no remarkable findings were obtained from medical history and physical examination. Profuse collaterals from a left renal vein in one case with no symptom were observed in venous phase of renal angiography. In the other case, recurrent left flank pain and microscopic hematuria developed. In both cases, the diagnosis of "nutcracker phenomenon" was presumed by renal venography with measurement of pressure gradient between left renal vein and inferior vena cava. Awareness of the pathophysiology of the nutcracker syndrome ensures an early diagnosis. New diagnostic modalities are demanded for atypical cases.
Angiography ; Aorta ; Diagnosis ; Early Diagnosis ; Flank Pain ; Hematuria ; Mesenteric Artery, Superior ; Phlebography ; Physical Examination ; Renal Veins ; Vena Cava, Inferior

PURPOSE: This study were to understand the caregiving situation of families with the demented elderly and to develop a self-help program for them. METHODS: A self-help program was designed to increase caregivers' confidence and skills in problem solving. In addition, it was designed to provide information about the demented elderly. The self-help program of this study was composed of nine sessions. RESULTS: Family caregivers of elderly patients with dementia obviously experience high level of stress. which often leads the caregivers to negative outcomes such as depression, interference with social activities and health difficulties. That is, caring is stressful for caregivers because the demands of the caregiving situation tend to overwhelm the caregivers' coping resources. Therefore, families with demented elderly persons need assistances in order to be relieved from their care burden. CONCLUSION: The self-help program includes the understanding of dementia, the family caregiving experiences of the demented elderly persons, the time for self-care, the search for helping, the improving of interpersonal relations and communications.
Aged* ; Caregivers ; Dementia ; Depression ; Humans ; Interpersonal Relations ; Problem Solving ; Self Care

PURPOSE: To evaluate the degree of Group B streptococcal colonization in Korean pregnant women of gestational age 35-37 weeks. METHODS: From May 1, 2002 to April 30, 2003, the medical records of 53 pregnant(gestational age from 35 to 37 weeks) women who visited the department of Ob & Gyn, Pusan National Hospital for antenatal care, were reviewed. By use of CDC recommendations, specimens were obtained from lower vagina, cervix and rectum, and inoculated on Lim Broth(selective media, Becton Dikinson Co., Cokeysville, MD, USA) to isolate group B streptococci. RESULTS: The prevalence of group B streptococci in pregnant women was 3.44%(2/58). Two specimens were obtained from cervicovagina; there were no GBS infection signs in their neonate. CONCLUSION: This study reported a 3.44% prevalence rate. GBS colonization in pregnant women (gestational age 35-37weeks) was lower than other countries. By use of CDC recommendation, we reported that our results were meaning. To resolve the reason for low the GBS infection of Korean pregnant women, further studies will be needed.
Busan ; Centers for Disease Control and Prevention (U.S.) ; Cervix Uteri ; Colon ; Culture Media ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Medical Records ; Pregnancy ; Pregnant Women* ; Prevalence ; Rectum ; Streptococcal Infections* ; Streptococcus agalactiae ; Vagina

PURPOSE: To compare clinical outcome after Ahmed valve implantation and Molteno implantation with tube ligature and releasable internal stent insertion METHODS: The medical records of 56 eyes, which were followed up more than 6 months, after either Ahmed valve implantation (20 eyes, group A) or Molteno implantation (36 eyes, group M) were reviewed retrospectively. Preoperative and postoperative intraocular pressure (IOP) at 1 day, 1 week, and 1, 2 and 6 months and the number of glaucoma medication were measured. Comprehensive success was defined at IOP less than 22 mmHg or when there was a 30 % reduction of preoperative IOP regardless of glaucoma medication. Qualified success was defined at IOP less than 22 mmHg regardless of glaucoma medication. Complete success was defined at IOP less than 22 mmHg without glaucoma medication. RESULTS: There is no statistical significance in postoperative IOP at all the times between groups A and M (p>0.05). Comprehensive success rate between groups A (75.0 %) and M (91.7 %) was not statistically significant (p>0.05). Qualified success rate between groups A (65.0 %) and M (86.1 %) was not statistically significant (p>0.05). Complete success rate between groups A (10.0 %) and M (30.6 %) was not statistically significant (p>0.05). CONCLUSIONS: There was no statistically significant difference in the success rate at postoperative 6 months between Ahmed valve implantation and Molteno implantation with tube ligature and releasable internal stent insertion.
Glaucoma ; Intraocular Pressure ; Ligation ; Medical Records ; Retrospective Studies ; Stents

BACKGROUND: The selection of anesthetic agents is important in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome patient because serious and unexpected complications can occur after anesthetic exposure.CASE: A 30-year-old man with MELAS syndrome and sepsis underwent colectomy. Propofol was administered by step-wise until target effect-site concentration (Ce) 1.0 µg/ml and stopped for the loss of consciousness and to avoid hemodynamic instability. After the loss of consciousness, total intravenous anesthesia (TIVA) using dexmedetomidine (1.0 µg/ml/h) and remifentanil (1–4 ng/ml of Ce) was performed for the maintenance of anesthesia to avoid malignant hyperthermia and mitochondrial dysfunction. During the surgery, the bispectral index score stayed between 26 and 44, and increased to 97 after the end of anesthesia.CONCLUSIONS: TIVA with dexmedetomidine and remifentanil as non-triggering anesthetic agents in patients with MELAS syndrome and systemic sepsis may have advantages to decrease damages associated with mitochondrial stress and metabolic burden.
Adult ; Anesthesia ; Anesthesia, Intravenous ; Anesthetics ; Colectomy ; Dexmedetomidine ; Hemodynamics ; Humans ; Malignant Hyperthermia ; MELAS Syndrome ; Propofol ; Sepsis ; Unconsciousness