No abstract available.
Anencephaly* ; Humans ; Pregnancy, Twin* ; Twins*

With the marked decrease in operative mortality in simple heart diseases there have been several reports on the minimally invasive and cosmetic techniques including submammary incision right parasternal approach right anterolateral thoracotomy partial sternotomy and subxiphoid approach. We report here subxiphoid approach without sternotomy for the repair of atrial septal defect as the procedure that has less invasive technique and more cosmetic effect.
Cosmetic Techniques ; Heart Diseases ; Heart Septal Defects, Atrial* ; Mortality ; Sternotomy ; Surgical Procedures, Minimally Invasive ; Thoracotomy

PURPOSE: To evaluate the effectiveness and complication rate of our modified continuous buried suture technique for the correction of the upper lid epiblepharon. METHODS: This retrospective study included 132 eyes of 66 patients, who were diagnosed with upper lid epiblepharon from March 2000 through April 2002 After the followup of over 6 months, we evaluated the improvement and recurrent rate of epiblepharon after the procedure. RESULTS: In 131 of 132 eyes with the mean followup period of 12.9 months, the epiblepharon was corrected successfully with cosmetically satisfactory Results. In 1 eye, we experienced the disappearance of a double fold without the recurrence of the epiblepharon. CONCLUSIONS: This modified continuous buried suture Method appears to be an effective treatment of lash inversion in upper lid epiblepharon with good aesthetic Results.
Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Suture Techniques* ; Sutures*

In recent days, cataract surgery has trend to reduce postoperative astig-matism and acquired early visual rehabilitation.Phacoemulsification with small incision and insertion of foldable intraocular lens has been used popularly, but its high cost and intraoperative or postoperative complication especially in old age with dense nucleosclerosis could be detrimental to patients. Postoperative corneal astigmatic changes and visual rehabilitation were evaluated after extracapsular cataract extraction with 7 mmscleral tunnel incision (Group I, 7 mm-ECCE, 28 eyes)by comparing with those after phacoemulsification with 3.5 mmscleral tunnel incision (Group II, 3.5 mm-Phaco, 41eyes).One piece PMMA intraocular lens was inserted in group I, while foldable intraocular lens in group II.Surgically induced corneal astigmatism was calculated by Cravy's vector analysis.There was no statistically signifi-cant difference between group I and group IIfor surgically induced corneal astigmatism (Kt)after postoperative one month (p>0.05).In group I and group II, corneal astigmatism was with-the-rule in early postoperative days, and changed to against-the-rule in postoperative 3 months.There was no statistically significant difference between group I and group IIincorneal astigmatism during all follow-up period (p>0.05). Therefore, 7 mm-ECCE could be an effective method for old patient with high grade nucleosclerosis or when phacoemulsification was unavailable.
Astigmatism* ; Cataract ; Cataract Extraction ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Postoperative Complications ; Rehabilitation

PURPOSE: Theophylline, an adenosine antagonist commonly used in premature infants to treat apnea, has been shown to decrease erythropoietin levels in adults. We studied the effect of theophylline on serum erythropoietin levels in premature infants with apnea. METHODS: Subject were 12 premature infants with apnea who were admitted to the NICU, Chosun University Hospital. The first dose of theophylline was 5mg/kg, given intravenously, followed by 1 to 2mg/kg per day. Serum levels were maintained between 5 and 12microgram/dl with dosage adjustments. Erythropoietin, hemoglobin, hematocrit, reticulocyte count, erythrocyte indices were obtained on the last day of theophylline treatment and again 1 week later. Erythropoietin levels were determined by radioimmunoassay. Blood transfusions were avoided a week before and during the study period. RESULTS: 1) Hemoglobin and hematocrit levels were decreased at 1 week after the discontinuation of theophylline treatment compared to the last day of theophylline treatment (P<0.05), but reticulocyte count (%) was increased (P<0.05). 2) There was a significant increase in serum erythropoietin levels from 3.31+/-1.53u/l to 6.68+/-2.41u/l (P<0.05). 3) No correlation was found between erythropoietin levels and the number of days on respirator, the number of days of O2 supply, the number of apneic episodes, the number of blood transfusion, the period of theophylline treatment and the theophylline blood levels. CONCLUSIONS: We suggest that prolonged treatment with theophylline might reduce erythropoietin production in premature infants.
Adenosine ; Adult ; Apnea ; Blood Transfusion ; Erythrocyte Indices ; Erythropoietin* ; Hematocrit ; Humans ; Infant, Newborn ; Infant, Premature* ; Radioimmunoassay ; Reticulocyte Count ; Theophylline* ; Ventilators, Mechanical

PURPOSE: The objective of this study was to analyze the relationship between the electrophysiological studies(EEG and BAEP) and brain ultrasonography and the prognosis of the newborn infants with asphyxia. METHODS: Clinical records, including electrophysiological findings of EEG and BAEP and brain ultrasonography, of 29 term infants with neonatal asphyxia, who had been admitted to the Pediatric Department of Chosun University Hospital between January 1994 and June 1997 were reviewed retrospectively. RESULTS: Out of the 29 cases that returned for follow up, 23 cases were neurodevelopmentally normal, but 6 cases showed delayed development on the Korean Denver Developmental Scale Test(KDDST). Of 19 cases with abnormal EEG findings, 5 showed delayed developrnent on the KDDST(P>0.05). Follow up EEG was performed in 10 cases', 8 of them were normalized, and two remained abnormal without delayed development on the KDDST. Of 8 cases with abnormal brain ultrasonographic findings, 5 showed delayed development on the KDDST(P<0.05). Of 12 with abnormal BAEP findings, 3 showed delayed KDDST(P>0.05). Follow up BAEP was performed in 8 cases, and all cases were normal. CONCLUSION: These results suggest that abnormal findings of EEG and BAEP in the asphyxiated term newborn were reversible, but abnormal brain ultrasonographic findings, especially intracranial hemorrhage, were significantly correlated with delayed development.
Asphyxia ; Brain Stem* ; Brain* ; Electroencephalography* ; Evoked Potentials, Auditory, Brain Stem* ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Intracranial Hemorrhages ; Prognosis ; Retrospective Studies ; Ultrasonography

BACKGROUND: As the internal mammary artery is far superior to the vein in the patency rate recently there has been a tendency to use the arterial graft as much as possible in coronary artery bypass grafts with the expectation of better the short- and long-term patency rate. MATERIAL AND METHOD: We sequentially grafted the diagonal and the left anterior descending artery significantly influencing the cardiac function with the internal mammary artery. There were 32 cases of sequential grafts from July 1993 to December 1998: 21 men and 11 women. The age range was from 43 to 69 years with a mean age of 56.64+/-6.41 years. There were 22 unstable angina 7 stable angina and 3 acute myocardial infarction. 8 cases of them were accompanied by stenosis of the left main coronary artery. The grafts for coronary artery bypass surgery included the great saphenous vein at 60 the right gastroepiploci artery at 5 and the left internal mammary artery at 64 coronary arteries. RESULT: One patient died from sepsis and multiorgan failure. Complications included wound infections in two cases and gastrointestinal bleeding in one patient. All patients showed decrease or disappearance of angina after operation. The postoperative coronary angiogram performed in 9 patients showed neither occlusion nor stenosis of the grafts. CONCLUSIONS: This study suggests that sequential anastomosis of the internal mammary artery to the diagonal and the left anterior descending artery may result in excellent short-term patency diagonal and the left anterior descending artery may result in excellent short-term patency rate and be useful for the coronary artery bypass graft using only arterial grafts.
Angina, Stable ; Angina, Unstable ; Arteries ; Constriction, Pathologic ; Coronary Artery Bypass* ; Coronary Vessels* ; Female ; Hemorrhage ; Humans ; Male ; Mammary Arteries* ; Myocardial Infarction ; Saphenous Vein ; Sepsis ; Transplants ; Veins ; Wound Infection

PURPOSE: To evaluate the CT features of abdominal tuberculosis by the pattern anaylsis. MATERIALS AND METHODS: We retrosepctively reviewed the CT findings of confirmed abdominal tuberculosis in 16 patients. Of the 16 patients, 1 was man and the remaining 15 were women with an average age of 34.1 years and the highest incidence in the twenties of age. Intravenous and oral contrast agents were used in all patients. The amount and location of ascites and the changes in the omenturn, mesentery, bowel wall, and peritoneum were analyzed. The morphologic feature, size and main compartment of involvement were also evaluated in the cases with lymphadenopathy as well as other changes in intraabdominal organs. RESULTS: The abdominal tuberculosis was more common in the female(15/16, 93.8%) and could be classified into 3 patterns on their CT findings;Complex ascitic, lymphadenopathy, or abscess forms. The complex ascitic form(10/16, 62.5%) was most commonly seen and characterized by uneven distribution and Ioculation of intraperitoneal fluid collection and marked changes of the omenturn and mesentery. The lymphadenopathy form(3/16, 18.8%) was characterized by central low density and peripheral rim enhancement on postcontrast CT with common involvements of porta hepatis and upper abdominal and paraaortic lymph nodes. The abscess form(3/16, 18.8%) was mainly related to the pelvic abscesses. CONCLUSION: CT was valuable in analyzing the patterns of the lesions and making a diagnosis of abdominal tuberculosis.
Abscess ; Ascites ; Contrast Media ; Diagnosis ; Female ; Humans ; Incidence ; Lymph Nodes ; Lymphatic Diseases ; Mesentery ; Peritoneum ; Tuberculosis*

PURPOSE: The incidence of multiple trauma is increasing nowadays and is the leading cause of death among young adults. Initial treatment is well known to be crucial in multiple trauma victims. However, many indiscriminate transfers occur due to the lack of a well-organized trauma system in Korea. The objective of this study is to demonstrate the current serious state in which major trauma patients are transferred to the Emergency Medical Center of a university hospital from another medical center. METHODS: From November 2009 to October 2010, we performed a retrospective study to analyze the characteristics of patients who visited the Ajou University Medical Center located in Gyeonggi-do. We evaluated the ISS (injury severity score), and a score over 15 point was identified as major trauma. The major trauma patients were separated into two groups according to the visit route, and the characteristics of each group were analyzed. RESULTS: Among the 88,862 patients who visited to the Emergency Medical Center, trauma patients accounted for 19,950, and 343 of them were evaluated as major trauma patients. Among the 343 patients, 170 patients had been transferred from other medical centers. The proportion of males to females was 3.3:1, and the mean ISS was 22.7. The leading cause of trauma was motor vehicle accidents. Of the total 170 patients, 77.6% were admitted to the Intensive care unit and 36.3% underwent surgery. The 170 patients that had been transferred to our medical center, 78.8% were transferred from Gyeonggi-do, 15.3% were transferred from other regions, and 5.9% were miscellaneous. CONCLUSION: Almost half of the major trauma victims treat at our medical center had been transferred from other medical centers. Establishing a traumatic system, supported by well-organized trauma centers and emergency medical services, that can reduce inappropriate transfers among medical facilities is essential.
Academic Medical Centers ; Cause of Death ; Emergencies ; Emergency Medical Services ; Female ; Humans ; Incidence ; Injury Severity Score ; Intensive Care Units ; Korea ; Male ; Motor Vehicles ; Multiple Trauma ; Retrospective Studies ; Trauma Centers ; Young Adult

Primary tumors of the heart are uncommon among pediatric patients. Rhabdomyoma is the most frequent cardiac tumor in infants and children, which is commonly associated with tuberous sclerosis. Tuberous sclerosis is a neurocutaneous syndrome affecting the brain, heart, skin, and other organs. Cardiac rhadomyomas are reported in 50-64% of infants with tuberous sclerosis. Tuberous sclerosis involves multiple locations in the atrium, ventricle and septum, and may induce mechanical obstruction of the outflow tract and heart failure depending on the location, number, size, and degree of invasion of tumors. Arrhythmias may also develop in infants with cardiac rhadomyomas, but only a few of these patients require prolonged anti-arrhythmic therapy because arrhythmia often disappears with spontaneous regression of the tumors, and the ultimate prognosis may be decided by the cerebral manifestations.
Arrhythmias, Cardiac ; Brain ; Child ; Heart ; Heart Failure ; Heart Neoplasms ; Humans ; Infant ; Infant, Newborn ; Neurocutaneous Syndromes ; Prognosis ; Rhabdomyoma ; Skin ; Tachycardia, Supraventricular ; Tuberous Sclerosis