No abstract available.
Tissue Expansion*

No abstract available.
Glycogen Storage Disease Type II* ; Wolff-Parkinson-White Syndrome*

Spinal epidural hematoma results from various causes such as use of anticoagulants, hemorrhagic diathesis, pregnancy, labor, arteriovenous malformation and spinal anesthesia as well as idiopathic orgin. We report a 3-year-old boy who was found to have spinal epidural hematoma and presented with lower back pain and fever. He developed paraplegia of lower legs after two consecutive lumbar punctures during two days. The lesion of spinal epidural hematoma was not found with lumbar spinal MRI but with cervico-thorasic one, because the lesion was at the C7-T6 level. Laminectomy was done to evacuate the hematoma and some specimen was obtained, of which pathologic finding was arteriovenous malformation. The boy is receiving physical therapy continuously due to unsatisfactory results with hematoma aspiration procedure and laminectomy treatment.
Anesthesia, Spinal ; Anticoagulants ; Arteriovenous Malformations* ; Child, Preschool ; Fever ; Hematoma ; Hematoma, Epidural, Spinal* ; Hemorrhagic Disorders ; Humans ; Laminectomy ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Paraplegia ; Pregnancy ; Spinal Puncture

No abstract available.
Animals ; Evoked Potentials* ; Rats*

Previously, we constructed a humanized antibody (HuS10) that binds to the common a antigenic determinant on the S protein of HBV. In this study, we evaluated its HBV-neutralizing activity in chimpanzees. A study chimpanzee was intravenously administered with a single dose of HuS10, followed by intravenous challenge with the adr subtype of HBV, while a control chimpanzee was only challenged with the virus. The result showed that the control chimpanzee was infected by the virus, and thus serum HBV surface antigen (HBsAg) became positive from the 14th to 20th week and actively acquired serum anti-HBc and anti-HBs antibodies appeared from the 19th and 23rd week, respectively. However, in the case of the study chimpanzee, serum HBsAg became positive from the 34th to 37th week, while actively acquired serum anti-HBc and anti-HBs antibodies appeared from the 37th and 40th week, respectively, indicating that HuS10 neutralized the virus in vivo and thus delayed the HBV infection. This novel humanized antibody will be useful in the immunoprophylaxis of HBV infection.
Animals ; CHO Cells ; Cricetinae ; Cricetulus ; Hepatitis B/blood/immunology/virology ; Hepatitis B Antibodies/blood/*immunology ; Hepatitis B Surface Antigens/*immunology ; Hepatitis B virus/*immunology ; Neutralization Tests ; Pan troglodytes/blood/*immunology/*virology

OBJECTIVE: To describe factors associated with the severity of post-stroke dysphagia. METHODS: We reviewed retrospectively medical records of patients having dysphagia following stroke in Seoul National University hospital from April 2002 through Dec 2009. A total of 578 patients (male and female, 331 and 247) were included. The following parameters were recorded and analyzed: patient's sex, age, type of stroke, onset of dysphagia, location of lesion and the American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale (ASHA NOMS). Using Binary logistic regression and multiple regression analysis, the relationship between dysphagia severity and other factors were analyzed. RESULTS: Their average duration between onset of stroke and the date of videofluoroscopic swallowing study (VFSS) was 32.3 +/- 18.4 days. Patients with hemorrhagic stroke (172 patients, ASHA 4.06 +/- 1.98) showed poorer swallowing function than those with ischemic stroke (406 patients, ASHA 4.49 +/- 2.02, p=0.013). Binary logistic regression analysis showed that patients who had longer duration from onset to the first study, hemorrhagic stroke, bilateral lesion and older age were at higher risk for dysphagia requiring non-oral supplements (p=0.031, 0.039, 0.042, and 0.043, respectively). Multiple regression analysis revealed that longer duration from onset to study, older age and hemorrhagic stroke were associated with the lower ASHA NOMS (p=0.006, 0.009 and 0.021, respectively). Bilateral lesion, sex, history of previous stroke and involvement of the brainstem, however, were not significant factors. CONCLUSION: Hemorrhagic stroke, longer duration from stroke onset to the initial evaluation, and older age were identified as associated factors with the poorer swallowing function after stroke. Further prospective studies will be required to evaluate the prognostic value of these characteristics.
American Speech-Language-Hearing Association ; Brain Stem ; Deglutition ; Deglutition Disorders ; Female ; Humans ; Logistic Models ; Medical Records ; Regression Analysis ; Retrospective Studies ; Stroke

OBJECTIVE: This study was aimed to identify the incidence and risk factors of vancomycin-resistant enterococcus (VRE) colonization in neurosurgical practice of field, with particular attention to intensive care unit (ICU). METHODS: This retrospective study was carried out on the Neurosurgical ICU (NICU), during the period from January. 2005 to December. 2007, in 414 consecutive patients who had been admitted to the NICU. Demographics and known risk factors were retrieved and assessed by statistical methods. RESULTS: A total of 52 patients had VRE colonization among 414 patients enrolled, with an overall prevalence rate of 6.1%. E. faecium was the most frequently isolated pathogen, and 92.3% of all VRE were isolated from urine specimen. Active infection was noticed only in 2 patients with bacteremia and meningitis. Relative antibiotic agents were third-generation cephalosporin in 40%, and vancomycin in 23%, and multiple antibiotic usages were also identified in 13% of all cases. Multivariate analyses showed Glasgow coma scale (GCS) score less than 8, placement of Foley catheter longer than 2 weeks, ICU stay over 2 weeks and presence of nearby VRE-positive patients had a significantly independent association with VRE infection. CONCLUSION: When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. Because prevention and outbreak control is of ultimate importance, clinicians should be alert the possibility of impending colonization and infection by all means available. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.
Bacteremia ; Catheters ; Colon ; Demography ; Enterococcus ; Glasgow Coma Scale ; Hand Disinfection ; Handling (Psychology) ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Mass Screening ; Meningitis ; Multivariate Analysis ; Neurosurgery ; Prevalence ; Retrospective Studies ; Risk Factors ; Vancomycin

The incidence of tuberculoma of the brain in different countries varies reatly. They form a high percentage of intracrnial lesions dealt with in countries of Asia, Eastern Europe, Italy, Spain and South America. The recent introduction of the potent antituberculosis remedies, far from diminishing the incidence of tuberculoma of the brain, is more likely to increase it. This case was a 18 year old male who had increased intracranial pressure signs and characteristic signs which was suggestive lesion in posterior fossa. Conray ventriculography revealed nearly total obstruction of distal portion of aqueduct of Sylvius with displacement to the right side. Intensive antituberclous treatment then was started after removal of tuberculoma in cerebellar vermis and then discharged with fully recovery. References were reviewed as will.
Adolescent ; Asia ; Brain ; Cerebral Aqueduct ; Europe, Eastern ; Humans ; Incidence ; Intracranial Pressure ; Italy ; Male ; South America ; Spain ; Tuberculoma*

The incidence of tuberculoma of the brain in different countries varies reatly. They form a high percentage of intracrnial lesions dealt with in countries of Asia, Eastern Europe, Italy, Spain and South America. The recent introduction of the potent antituberculosis remedies, far from diminishing the incidence of tuberculoma of the brain, is more likely to increase it. This case was a 18 year old male who had increased intracranial pressure signs and characteristic signs which was suggestive lesion in posterior fossa. Conray ventriculography revealed nearly total obstruction of distal portion of aqueduct of Sylvius with displacement to the right side. Intensive antituberclous treatment then was started after removal of tuberculoma in cerebellar vermis and then discharged with fully recovery. References were reviewed as will.
Adolescent ; Asia ; Brain ; Cerebral Aqueduct ; Europe, Eastern ; Humans ; Incidence ; Intracranial Pressure ; Italy ; Male ; South America ; Spain ; Tuberculoma*

PURPOSE: Although has become increasingly acceptable to perform total thyroidectomy for bilateral and multiple benign nodules, diffuse toxic goiter, and thyroid cancers, surgeons continue to debate whether the potential benefits outweigh the potential complications of this procedure. The aim of this study was to evaluate the safety, effectiveness and complications of total thyroidectomy for malignant and benign thyroid diseases. METHODS: The medical records from 332 patients who had undergone total thyroidectomy for malignant and benign diseases between January 1990 and December 1999 at St. Mary's Hospital and St. Vincent's Hospital were reviewed retrospectively. RESULTS: Of the 332 patients, 121 had had benign disease and 211 had had carcinomas. Female patients were predominate, being 6.4 times the number of males. The incidence rate by age peaked in the 4th decade for patients. Masses of below 2 cm in diameter were the second most common size (30.8%) and 2 to 5 cm occupied more than half (51%). Of the 211 thyroid carcinomas, histologic types were papillary in 185 patients (87.7%), follicular in 21 (10%), anaplastic in 3 (1.5%), medullary in 1 (0.5%) and lymphoma in 1 (0.5%). Of the 121 benign disease, 71 (58.7%) were benign multiple nodular goiters, 23 (19%) toxic diffuse goiter, and there were 18 cases (14.9%) of Hashimoto thyroiditis and 9 (7.4%) of adenomatous goiter. Among the 211 patients who underwent total thyroidectomy for thyroid malignancy, anterior compartment lymph node dissection was performed in 53 patients (25.1%). Modified radical neck dissection was done in 31 cases, due to suspicions of local lymph node invasion during the operation. Radical neck dissection was done in 10 cases with palpable cervical nodes. The most common complication was early postoperative hypocalcemia 108 (32.5%), most of which was transient and sixty-three percent of which was symptomatic. It usually persisted less than 7 days, and the difference in incidence of post-operative hypocalcemia between benign disease and malignancy was not significant. The other complications were hoarseness (13%), bleeding (3%) and the recurrent laryngeal nerve injury (1.5%). CONCLUSION: Total thyroidectomy can be performed without additional risk compared with subtotal thyroidectomy for bilateral benign and malignant thyroid diseases, if done meticulously.
Female ; Goiter ; Goiter, Nodular ; Hashimoto Disease ; Hemorrhage ; Hoarseness ; Humans ; Hypocalcemia ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Lymphoma ; Male ; Medical Records ; Neck Dissection ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Surgeons ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*