PURPOSE: Periventricular leukomalacia(PVL) is associated with the characteristic neurologic sequale of spastic diplegia or quadriplegia, and cortical blindness. So early diagnosis of PVL in the neonatal period is of importance because of the prognostic implications of this lesion. Novotny et al reported that Positive Rolandic Sharp waves(PRS) on the EEGs was a marker of PVL because most infants who had excessive PRS on their EEGs also had PVL on their neurosonography. PRS were present in most neonates at a time when neurosonography showed periventricular echodense lesions, prior to the appearance of cystic PVL. Therefore, the appearance of excessive PRS on the EEG is very useful for the early detection of PVL. The aim of this study is to assess the relationship between the PVL and PRS on the EEGs, to observe the appearance timing of PRS on the EEGs, and to evaluate the risk factors of later neurologic sequale. METHODS: Among the neonates admitted to the Sowha Childern's Hospital between 1989 and June 1993, 25 neonates with cystic PVL on neurosonography or CTscan were the study group. Control group were the age-matched 20 neonates who were admitted at the same time of study period. We reviewed the neurosonographic findings, EEG features, and charts retrospectively. RESULTS: 1) Excessive PRS were observed in 20 cases of study group(80%), whereas 1 case in control group(5%)(p<0.001). 2) The frequency of PRS was not affected by the abnormality of EEG background activity. 3) The frequency of PRS in a 10 minutes epoch was 14.5+11.1 in the study group, whereas 1.57+1.96 in the control group(p<0.001). 4) In most neonates, PRS were present at a time when the neurosonography showed periventricular echodense lesion or cystic PVL. 5) In a follow-up neurosonography, 12 among 17 neonates with localized PVL were normalized and only 5 cases had ventriculomegaly. Whereas, all of 5 extensive PVL had the sequale of ventriculomegaly or cerebral atrophy. 6) In a follow-up neurologic examination, the poorer sequale including spastic diplegia or quadriplegia was associated with the larger, the more extensive, and the subcortical PVL. CONCLUSIONS: 1) Excessive PRS were significantly more observed in the study group than in the control group(p<0.001). 2) The frequency of PRS was not affected by the abnormality of EEG background activity. 3) The prognosis of the neonates with PVL was depended on the size, extent, and location of the PVL rather than the presence or frequency of PRS.
Atrophy ; Blindness, Cortical ; Cerebral Palsy ; Early Diagnosis ; Electroencephalography ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular* ; Neurologic Examination ; Prognosis ; Quadriplegia ; Retrospective Studies ; Risk Factors

To clarify the mechanism of the protective effect of hemodialysis on lipid peroxidation in RBC membrane structures, the level of malondialdehyde (MDA) which is the lipid peroxidation product, and the activities of antioxidant enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) were determined before and after hemodialysis in the RBCs from 20 patients with end stage renal disease (ESRD), and from 14 healthy subjects. Before dialysis, MDA levels in the RBCs from the patients with ESRD were higher than those from healthy controls. SOD and catalase activities in the RBCs were lower. After hemodialysis, MDA, SOD, and catalase in the RBCs from the patients with ESRD were normalized. These results indicate that hemodialysis treatment is helpful to protect the peroxidative darnage through normalizing the activities of antioxidant enzymes.
Catalase ; Dialysis ; Erythrocytes* ; Glutathione Peroxidase ; Humans ; Kidney Failure, Chronic* ; Lipid Peroxidation ; Malondialdehyde* ; Membranes ; Renal Dialysis* ; Superoxide Dismutase

BACKGROUND: It is not yet clear whether the abnormal cytokine production in relation to serum IgE levels in atopic dermatitis (AD) is associated with the amount of mRNA of cytokine gene. OBJECTIVE: Our purpose was to delineate the effect of reciprocal correlation in the level of mRNA between interleukin-4 (I") and interferon-gamma (IFN-γ) in severe AD. METHODS: We examined 15 cases including 5 AD patients with high serum IgE (>2,000 kU/liter), 5 AD patients with low serum IgE (<100 kU/liter), and 5 healthy controls. Using semi quantitative reverse transcription-polymerase chain reaction, IL-4 and IFN-γ gene expressions in peripheral mononuclear cells (PBMC) were examined. RESULTS: 1) IL-4 gene expression in spontaneous PBMC was higher in AD patient groups than in control group, significantly higher only in AD patient group with high serum IgE level (p < 0.05). 2) IFN-γ gene expression in spontaneous PBMC showed increased tendency in AD patient groups than in control group without statistical significance. 3) IL-4 and IFN-γ gene expressions in stimulated PBMC were not different among all three groups. CONCLUSION: In light of our results, high and low IgE subgroups in AD can exist and AD may not be R characterized by the shift in the reciprocal relationship between IL-4 and IFN-γ when T cells are stimulated under antigen presenting cell-independent conditions.
Dermatitis, Atopic ; Gene Expression ; Humans ; Immunoglobulin E* ; Interferon-gamma* ; Interleukin-4* ; RNA, Messenger ; T-Lymphocytes

BACKGROUND/AIMS: The caudal anesthsia is most commonly used for benign anorectal surgery, The combination of long-acting anesthetics and opiates has been used for longer duration and successful control of postoperative pain. But the side effects of peridural anesthesics and morphine have commonly occured in caudal anesthesia. This study was performed to assess the difference in clinical effects between peridural mepivacaine and bupivacaine with morphine. METHODS: We evaluated the clinical effects in 60 patients who had anal operation with Jack-Knife position under caudal anesthesia. We divided randomly these 60 patients into two groups, M and B groups (in each group, 30 patients included). Group M (n=30) was given 2% mepivacaine 20 ml with morphine 2 mg caudally, and Group B (n=30) was given 0.5% bupivacaine 20 ml with morphine 2 mg in the same manner. We measured the onset time, duration, postoperative analgesia, and side effects including urinary retention. RESULTS: The onset time for analgesia was significantly shorter in group M than in group B. The duration of postoperative pain complaints was significantly longer in group M than in group B. The postoperative analgesic effects and side effects were not significantly different between two groups. CONCLUSIONS: Caudal mepivacaine and morphine mixture is effective for control of postoperative pain without significant side effects.
Analgesia ; Anesthesia, Caudal* ; Anesthetics ; Bupivacaine* ; Humans ; Mepivacaine* ; Morphine* ; Pain, Postoperative ; Urinary Retention

PURPOSE: When the patients with both recurrent and primary pterygia, We performed conjunctival autograft transplantation for recurrent pterygium and bare sclera technique for primary pteygium. We then compared the recurrence of each case in order to find out the usefulness of each surgery and effective mothod of surgery. METHODS: We performed follow-up on 26 eyes of 13 patients for 14 months (mean); 8 patients (16 eyes) were female, and 5 patients (10 eyes) male. The mean age of the patients was 49.5 years ranging from 37 to 63. In the operation, all patients received with 0.02% Mitomycin C for 1 minute. RESULTS: Pterygium recurred in 3 of 13 eyes which underwent bare sclera technigue, and did not recur in 13 eyes undergoing conjunctival autograft transplantation, but there was no significant difference because of a small number of study cases (P=0.07). We found postoperative complications such as corneal fila-ment and conjunctival granuloma in the case of bare sclera technique; but none in conjunctival autograft transplantation. CONCLUSIONS: We recommend a conjunctival autograft transplantation with application of low concen-tration of Mitomycin C as a safe and effective method for recurrent pterygium or pterygium with high recurrence rate.
Autografts* ; Female ; Follow-Up Studies ; Granuloma ; Humans ; Male ; Mitomycin ; Postoperative Complications ; Pterygium* ; Recurrence* ; Sclera

Antiseptics are substances that kill or prevent the growth of microorganisms when applied to living tissue. They must be effective against microorganisms but must also retain their activity in presence of body fluids without being harmful locally or systemically. Among many antiseptics, Betadine(R) has been widely used because of its low toxicity and high germicidal efficacy. We reported 2 cases of allergic contact dermatitis to Betadine(R) in surgical patients. They had eczematous eruption along the Betadine(R) applying sites. Path tests Betadine(R) confirmed the diagnosis.
Anti-Infective Agents, Local ; Body Fluids ; Dermatitis, Allergic Contact* ; Diagnosis ; Humans

Spontaneous spinal epidural hematoma is a rare entity. Various definitions for spontaneous epidural hematoma have been reported in the literature. The expression of nontraumatic spinal epidural hematoma seems to be less ambiguous and includes idiopathic hematomas and hematomas secondary to coagulopathy, vascular malformations, and tumors. We report three cases of nontraumatic spinal epidural hematomas observed from 1991 to 2000. The causes of the spinal epidural hematomas were not clear in two cases among them, but in the another one case, the cause was determined to be an acquired coagulopathy. We reviewed 24 cases reported in the Korean Journal of Neurosurgery and our three cases with particular emphasis on the various causes such as coagulopathy, vascular malformations and tumors. Among the 27 cases, numerous causes were detected such as three cases of vascular malformation, one case of anticoagulant treatment, five cases of combined lumbar disc herniation, two cases associated with pregnancy and postpartum, one case associated with hypertension, and one case associated with ossification of ligamentum flavum. No causes were detected in the ten cases. The authors reviewed the literature.
Hematoma ; Hematoma, Epidural, Spinal* ; Hypertension ; Ligamentum Flavum ; Neurosurgery ; Postpartum Period ; Pregnancy ; Vascular Malformations

No Abstract Available.
Blepharoptosis*

The spine is the most common site of metastatic cancer in the skeletal system. Managment of the lesion site due to the relation of the spinal cord or nerve root and post-operative treatment present coplicated and difficult problems. One hundred and ninety-three cases of metastatic cancer of the spine were seen and treated during the 5 year period from January 1981 to December 1985 in the Department of Orthopedic Surgery, Severance Hospital Yonsei University, College of Medicine in Seoul, Korea. This study was based on the clinical symtoms, radiological studies, laboratory studies, and tissue pathology of selected cases. Most of cases were treated by chemotherapy, radiation therapy, and hormonal therapy in selected terminal cases. In cases of intractable pain and neurological deficit, surgical intervention is advocated for relief of pain and to improve nursing care and daily activity. Unfortunately in Korea most patients and families refuse surgical intervention, the main reason being that surgery can not cure the disease itself. The results of the study lead us to conclude that; The incidende of spinal metastasis was 31.8% of the metastatic lesions of all skeletal systems, and was almost equally distributed in males and females l. 14: l. The primary site of the tumor was in decreasing order lung (25.9%), breast(9.8%), cervix of the uterus(6.7%), stomach(5.7%), liver(5.3%), kidney(3.7%), thyroid(3.7%), prostate(2.6%), bladder(2.6%), rectum(2.0%), ovary(1.0%), pancreas(1.0%), skin(1.0%), colon(0.5%), larynx(0.5%), and unknown origins (27.5 %). The peak age of the patient was the 7th decade in males and the 6th decade in females. The prominent clinical symtom was diffuse back pain (79.0%) which was characteristically worse in a resting position especially at night. The most significant laboratory finding was an elevated serum alkaline phosphatase in 28% of the cases. The predilection site of metastasis was the thoraco-lumbar junction. Diagnostically a whole body bone scan was more sensitive than a plain film.
Alkaline Phosphatase ; Back Pain ; Cervix Uteri ; Drug Therapy ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis ; Nursing Care ; Orthopedics ; Pain, Intractable ; Pathology ; Seoul ; Spinal Cord ; Spine

No abstract available.
Adenocarcinoma* ; Carcinoma, Squamous Cell*