STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine

Juvenile spring eruption(JSE) of the ears is an unusual type of photodermatosis, which develops on the light exposed areas of the ears of boys and young male adults in the early spring months. JSE has received little attention in the literature, and to our knowledge no cases have been reported in Korea until now. Herein we report a case of JSE occurring in a 17-year-old man who has suffered from a recurrent pruritic erythematous papulovesicular eruption of both helix, followed by crusting and healing without scarring within one to two months early each spring for six years.
Adolescent ; Adult ; Cicatrix ; Ear* ; Humans ; Korea ; Male

BACKGROUND: To access the accuracy and clinical usefulness of microplate identification (ID) system for the identification of Enterobacteriaceae, we compared microplate ID system with API 20E(bioMerieux, Etoile, France). METHODS: Ninety-two cultures of Enterobacteriaceae and one isolate of Aeromonas species were simultaneously identified by microplate ID system and the API 20E. Twenty biochemical tests used in microplate ID system were lactose, sucrose, and H2S in Kligler's iron agar media; indole, sucrose, raffinose, arabinose, trehalose, adonitol, dulcitol, sorbitol, cellibiose, methy-red, phenylalanine deaminase, ornithine decarboxylase, lysine decarboxylase, arginine dihydrolase, urease, and citrate in microplate; and oxidase test. The identification was obtained by considering percent likelihood(% ID), modal frequency and ID score method. RESULTS: Among the 92 cultures of Enterobacteriaceae and one isolate of Aeromonas species, agreement rate of identification according to the % ID between microplate ID system and API 20E were 90.3% to the species level and 97.8% to the genus level. CONCLUSIONS: For the identification of clinical Enterobacteriaceae isolates, the microplate ID system compares favorably with API 20E in identification accuracy and have the advantage of costsaving and easy to use.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Galactitol ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Oxidoreductases ; Phenylalanine ; Raffinose ; Ribitol ; Sorbitol ; Sucrose ; Trehalose ; Urease

It is the most important to select optimal culture conditions to promote safe embryo growth in the technique of human in vitro fertilization and embryo transfer. It has been shown that the addition of biologic fluids, such as blood serum, of various origins, improved fertilization and early cleavage rates in numerous species. The purpose- of this study is to attempt to measure developmental potential of mouse eggs fertilized and cleaved in Ham's F10 culture medium containing a chelating agent, EDTA and fetal cord serum. hi this study, we selected 40 female mice and 20 male mice, and investigated optimal serum concentration' for mouse embryo growth. Two cell stage mouse embryos were cultured in Ham's F-10 medium, Ham's F-10 medium with various concentrations of EDTA, or Ham's F-10 medium with EDTA and 10% human cord serum. Developmental ratios to morula in Ham's F-10 medium containing various concentrations of EDTA and/or 10% fetal cord serum were significantly higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to blastocyst in Ham's F-10 containing 10% fetal cord serum and 5011M or 100pM EDTA were significanldy higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to morula in Ham's F-10 containing 10% fetal cord serum and 100,uM EDTA were significanitly higher than in Ham's F-10 with 10% fetal cord serum used commonly in many human IVF centers(p<0.05). Developmental ratio to blastocyst in Ham's F-10 containing 10% fetal cord serum and 100pM EDTA was significanity higher than in Ham's F-10 with 200pM EDTA(p<0.05).
Animals ; Blastocyst ; Edetic Acid* ; Eggs ; Embryo Transfer ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Male ; Mice* ; Morula ; Ovum ; Serum

No abstract available.
Dislocations* ; Tendons*

PURPOSE: The purpose of this study was to evaluate the accuracy of contrast enhanced magnetic resonance angiography (CE-MRA) in the visualization of the renovascular anatomy for the preoperative evaluation of living renal donors. MATERIALS AND METHODS: Thirty-one consecutive potential living renal donors were investigated. Ten patients underwent both digital subtraction angiography (DSA) and CE-MRA, and twenty-one underwent CE-MRA alone before the donor nephrectomy. The intraoperative findings on the number of renal vessels were compared with those of the DSA and CE-MRA. RESULTS: DSA and CE-MRA showed 100% agreement in identifying the main renal arteries, accessory renal artery, and renal veins before surgery. In the DSA and CE-MRA group (n=10), the accuracy relative to the intraoperative findings was 92.3% (12/13) for the renal artery and 100% (10/10) for the renal vein. In the CE-MRA alone group (n=21), 93.3% (28/30) accuracy was shown for the renal artery and 91.3% (21/23) for the renal vein compared with the intraoperative findings. CONCLUSIONS: CE-MRA showed similar agreement and accuracy to DSA. As a minimally invasive technique, CE-MRA has the potential to replace DSA.
Angiography, Digital Subtraction ; Humans ; Magnetic Resonance Angiography* ; Nephrectomy ; Renal Artery ; Renal Veins ; Tissue Donors* ; Transplantation

The survey was undertaken among the 105 ostomates who attended the 2nd Workshop for Stoma Rehabilitation on Aug. 30th, 1997 by the Department of Surgery, Kyung-Hee University Hospital to assess the physical, psychosocial and sexual problems with a stoma. The 97% of ostomates had permanent colostomies following abdominoperineal resection. The 67% of ostomates had one or more physical problems caused by stoma. Frequent bowel movement (94.3%), impairment of irrigation (64.6%), unpleasant odor (27.3%), and urinary frequency (21.3%) were common problems encountered by ostomates. Concerning the psychosocial problems, 3.8% of them suffered from profound restriction of social activities and 1.9% of them had psychologic problems such as depression. 42 of 58 ostomates (72.4%) who were employed before operation returned to their work. Among 71 men, 44 (62%) were impaired by sexual function. Most ostomates suffered physical, social, psychologic and sexual problems in their daily life and needed helps of experts such colorectal surgeons, enterostomal therapists, and ostomy association. Attention is needed more to improve the quality of life for the ostomates.
Colostomy ; Depression ; Education ; Humans ; Male ; Odors ; Ostomy ; Quality of Life ; Rehabilitation

Over the physiologic range of heart rate, the duration of electrical systole(QT) is shorter than that of electromechanical systole(QS2), which reflects direct physiologic link between electrical repolarization and mechanical events of the cardiac cycle. The present study designed to test usefulness of systolic time intervals and QT-QS2(QT minus QS2) value as complication predictors, which may predict prognostic status of myocardial infarction. The studied subjects were consisted of 33 healthy adults as control(22 men, 11 women) and 35 patients with myocardial infarction. And studied patients were divided into 3 groups; group I of 14 patients with or without complication in acute stage, group II of 11 uncomplicated patients under recovery of chronic status, group III of 10 complicated patients under recovery or chronic status. The observation periods were 3 to 13 days in group I, 5 to 96 weeks in group II and III after their onset. The results were follows; 1) The normal ranges were defined as mean+/-2 standard deviations of the measured values of control, that of QTc were shorter than 431ms of man and 458ms of woman, that of QS2 I were longer than 503ms of man and 514ms of woman, that of PEP/LVET ratio was less than 0.40, that of QT-QS2 value was less than 0 ms respectively. 2) QTc of all patient groups were significantly prolonged compared with that of control, and that of group III was significantly longer than that of group II(481+/-25 vs 432+/-32, p<0.005). 3) The changes of QS2 I were not significant in all patient groups compared with QS2 I of control. 4) QT-QS2 value showed QT>QS2 in group I and III. and QTQS2 had positive predictive value of 82% for predicting probability of previous complicated status. We concluded that QT-QS2 value, including PEP/LVET ratio and QTc, could be used as complication predictors. But it is necessary to examine these indicators prospectively to confirm its clinical applicability.
Adult ; Female ; Heart Rate ; Humans ; Male ; Myocardial Infarction* ; Reference Values ; Sensitivity and Specificity ; Systole*

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel