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*

OBJECTS: Event related potential(ERF) has been recently applied to examine the neurophysiological disturbance in attention deficit hyperactivity disorder(ADHD), particularly with regard to N100 and P300 which are known as one of ERP components closely linked with cognitive function. On the basis of these aspects, this study was designed to evaluate electrophysiologic characteristics and its availability for diagnosis and treatment of ADHD children by comparison of ERP between normal controls and ADHD children before and after methylphenidate (MFD) administration. METHODS: We examined the topographic auditory ERF and T.O.V.A.(Test of variables of attention), a standardized computerized visual continuous performance test following administration of stimulant drug, MPD 10mg in 13 ADHD children and compared these results with those of 11 normal controls. RESULTS: The results were as follows: 1) Thought the difference was not spastically significant(P=0.0548), N100 latencies seemed to be longer in ADHD children than in normal controls. N100 amplitudes also seemed to be larger in ADHD children than in normal controls(P=0.0629). 2) The F300 latencies significantly shortened after MFD administration when compared with those before MPD administration in ADHD group(P<0.01). 3) ADHD group performed significantly less well than normal controls in T.O.V.A.(P<0.05). And T.O.V.A. scores significantly improved after MFD administration in ADHD group(P<0.01). 4) The N100 and P300 latencies and the T.O.V.A. scores were significantly correlated before MPD administration in ADHD group(P<0.05). 5) The F300 latencies before MFD administration were significantly correlated with the amplitudes of changes of T.O.V.A. scores after MFD administration(P<0.05). CONCLUSION: It seems that prolonged N100 latency of ADHD children can be regarded as a relatively enduring trait marker and that F300 latency may reflect attentional response ability along with therapeutic effect by stimulant.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Diagnosis ; Evoked Potentials* ; Humans ; Methylphenidate* ; Muscle Spasticity

PURPOSE: Endovenous laser treatment (EVLT) for varicose vein has been shown to be an effective method of treatment. But, after EVLT, recurrence due to recanalization of the great saphenous vein has been identified as a complication. This study was performed to evaluate the effectiveness of EVLT combined with high ligation and to assess the recurrence rate. METHODS: Between April 2004 and April 2009, medical records of 163 patients treated with EVLT combined with high ligation and stab phlebectomy were reviewed retrospectively. Duplex ultrasonography was performed before surgery. All patients were followed up with clinical evaluation at 1 week and 1, 3, and 6 months after operation. The mean follow up period was 5.9 months. RESULTS: In total, 178 limbs of 163 patients were reviewed. In our study, almost all (98.8%) patients had symptomatic and cosmetic improvement. We observed complications such as ecchymosis (22.1%), edema (12.9%), pain (5.5%), and in one case, hematoma. Ecchymosis, edema, and pain were controlled by conservative treatment. The patient with hematoma was hospitalized and improved with conservative therapy. There were no cases of recanalization during the follow up period. CONCLUSION: Compared to previous studies, EVLT combined with high ligation showed satisfactory results, with no recurrence. However, the longer operation time and higher cost were issues and further studies are necessary for objective comparison.
Cosmetics ; Ecchymosis ; Edema ; Extremities ; Follow-Up Studies ; Hematoma ; Humans ; Ligation ; Medical Records ; Recurrence ; Retrospective Studies ; Saphenous Vein ; Varicose Veins

No abstract available.
Uterine Prolapse*

PURPOSE: To report the clinical outcomes of percutaneous A1 pulley release for the surgical treatment of locked trigger thumb in children. MATERIALS AND METHODS: Twenty-six trigger thumbs in 24 patients with a average of 14.2 months follow-up after percutaneous release were enrolled. There were 15 females and 9 males with an average age of 39 months. The mean time from first presentation to surgery was 16 months. Procedures were performed under local anesthesia. Postoperative examinations at immediate, 3 months and 1-year recorded pain, triggering and range of motion and presence of complications. RESULTS: All thumbs had a satisfactory result without digital nerve injury. Eleven patients(46%) had a mean 14.3degrees extension loss of the interphalangeal joint and 12.0degrees hyperextension of the metacarpophalangeal joint of the thumb, compared to the contralateral thumb. At final follow-up, all but 1 patient were completely resolved. The duration of symptoms and age were higher in the group with thumb deformity (p<0.05). CONCLUSION: Temporary thumb deformity is possible after surgical treatment of trigger thumb in children with a long duration of symptoms. Percutaneous release can be a safe and satisfactory treatment option in pediatric trigger thumb.
Anesthesia, Local ; Child ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Hand Deformities ; Humans ; Joints ; Male ; Metacarpophalangeal Joint ; Range of Motion, Articular ; Thumb ; Trigger Finger Disorder

PURPOSE: Prostaglandin (PG) E2 is known to be closely related to cancer progression and is inactivated by 15-hydroxyprostaglandin dehydrogenase (PGDH). 15-PGDH is shown to have tumor suppressor activity and to be down-regulated in various cancers, including colorectal cancer (CRC). Therefore, we evaluated the expression of 15-PGDH and its prognostic effect in patients with CRC. METHODS: 15-PGDH expression was examined by using immunohistochemistry in 77 patients with CRC. Its prognostic significance was statistically evaluated. RESULTS: Negative 15-PGDH expression was noted in 55.8% of the 77 cases of CRC. 15-PGDH expression showed no correlation with any of the various clinicopathologic parameters. The status of lymph node metastasis, tumor-node-metastasis stages, and pre-operative carcinoembryonic antigen levels showed significant prognostic effect. However, univariate analysis revealed down-regulation of 15-PGDH not to be a predictor of poor survival. The 5-year overall survival rate was 71.7% in the group with positive expression of 15-PGDH and 67.1% in the group with negative expression of 15-PGDH, but this difference was not statistically significant (P = 0.751). CONCLUSION: 15-PGDH was down-regulated in 55.8% of the colorectal cancer patients. However, down-regulation of 15-PGDH showed no prognostic value in patients with CRC. Further larger scale or prospective studies are needed to clarify the prognostic effect of 15-PGDH down-regulation in patients with colorectal cancer.
Carcinoembryonic Antigen ; Colorectal Neoplasms ; Down-Regulation ; Humans ; Hydroxyprostaglandin Dehydrogenases ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Oxidoreductases ; Prognosis ; Survival Rate

Intramuscular hemangiomas are uncommon tumors of the head and neck, consistituting of 0.8% of all hemangioma, but often occur in the trunk and extremities. In the head and neck area, the masseter and trapezius muscle occur frequently, in which diagnosis is often difficult even with accurate preoperative imaging. The definitive diagnosis is made by histological study of the surgical biopsy specimen. Treatment of choice is complete surgical excision. This is, to our knowledge, the first case of intramuscular hemangioma of the mentalis muscle to be reported in korea.
Biopsy ; Diagnosis ; Extremities ; Head ; Hemangioma* ; Korea ; Neck ; Superficial Back Muscles

The simultaneous occurrence of a renal cell carcinoma and a urothelial carcinoma in the same kidney is uncommon. Here we report the case of a 79-year-old woman with ipsilateral synchronous renal cell carcinoma and urothelial carcinoma. She was referred to our hospital for gross hematuria and right flank pain. A computed tomography scan showed a 15x20 mm enhanced lesion on the upper calyx and a 12x15 mm mass on the lateral aspect of the right kidney. We thus suspected a renal pelvis tumor and performed right hand assisted laparoscopic nephroureterectomy with bladder cuff excision (HALSNU). Gross findings were multiple, pale yellowish papillary masses on the upper and lower major calices, of which the largest one measured 16x20 mm. A separated solid mass measuring 12x16 mm was also noted on the anterior midportion of the kidney. The former was a urothelial carcinoma and the latter was a chromophobe renal cell carcinoma. We present a rare case of a chromophobe renal cell carcinoma and a urothelial carcinoma in the same kidney.
Aged ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Hand ; Hematuria ; Humans ; Kidney ; Kidney Pelvis ; Urinary Bladder

OBJECTIVES: The purpose of this study was to assess the difference of subjective daytime sleepiness level between primary insomnia patients and healthy control subjects. We also investigated the relationship between subjective daytime sleepiness level and variables of nocturnal polysomnograghic sleep architecture of insomnia patients. METHOD: Total subjects were 87 patients with primary insomnia diagnosed with polysomnography and 88 normal controls. The daytime sleepiness level in each group was measured by Korean version of Epworth Sleepiness Scale (ESS). The correlations of ESS score and nocturnal polysomnographic variables were calculated in the patient group. RESULTS: Patients with insomnia had the lower ESS scores than the control group. In patients group, the ESS score showed significant negative correlations with total sleep time, sleep efficiency%, and stage 2 sleep time%. The ESS score also showed significant positive correlations with number of awakenings, number of awakenings more than 2 minutes, and wake after sleep onset time. CONCLUSIONS: Insomnia patients showed lower level of subjective daytime sleepiness that may indicate their higher alertness comparing to control subjects. Daytime sleepiness of patients with insomnia was associated with polysomnographic variables including total sleep time, sleep efficiency%, stage 2 sleep time% and disrupted continuity of nocturnal sleep.
Humans ; Polysomnography ; Sleep Initiation and Maintenance Disorders*

PURPOSE:Carotid endarterectomy may benefit patients with bilateral carotid stenosis by improving cerebrovascular hemodynamics of ipsilateral as well as contralateral cerebral hemispheres. We investigated cerebrovascular hemodynamics after carotid endarterectomy in patients with contralateral carotid occlusion by acetazolamide stress brain SPECT. MATERIALS AND METHODS: Subjects were 14 symptomatic patients (all men, mean age 66 yrs) with carotid stenosis (> 50%) with contralateral carotid occlusion. Acetazolamide stress Tc-99m ECD brain SPECTs were performed within 2 weeks before and after carotid endarterectomy using one day protocol. Cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were assessed visually. In 12 patients, correlation between the patency of proximal anterior cerebral or anterior communicating arteries (A1/A-comm) and the improvement of CBF or CVR after endarterectomy was assessed. RESULTS: Preoperative SPECT showed reduced CBF in 2 ipsilateral and 10 contralateral hemispheres. CVR was reduced in 4 ipsilateral and 9 contralateral hemispheres. Of 12 hemispheres with reduced CBF, 2 hemispheres (16.7%) showed improvement of CBF after endarterectomy. However, reduced CVR was improved in all 4 ipsilateral and 7 of 9 (78%) of contralateral hemispheres after endarterectomy. Three of 4 with stenotic A1/A-comm and 4 of 8 with patent A1/A-comm had reduced contralateral CVR. Reduced contralateral CVR improved in all 3 patients with stenotic A1/A-comm and 3 of 4 with patent A1/A-comm. CONCLUSION: Acetazolamide stress brain SPECT demonstrated improvement of compromised cerebrovascular reserve in not only ipsilateral but also contralateral hemispheres of patients with contralateral carotid occlusion after carotid endarterectomy, and may, therefore, be useful for evaluating cerebral blood flow and cerebrovascular reserve after carotid endarterectomy.
Acetazolamide* ; Arteries ; Brain Ischemia ; Brain* ; Carotid Stenosis* ; Cerebrum ; Endarterectomy ; Endarterectomy, Carotid* ; Hemodynamics ; Humans ; Male ; Tomography, Emission-Computed, Single-Photon*