BACKGROUND: Although the number of high-risk neonates has increased in Korea, hospitals were reluctant to open or maintain neonatal intensive care unit (NICU) due to the low medical cost. Consequently, there were regional disparities in facilities, equipment, and neonatal health outcomes. For these reasons, the Korean government began to invest in neonatal care during the last decade. We identified the status of NICUs in Korea and assessed changes after the government-driven policies. METHODS: We surveyed 87 of 89 hospitals that operated NICUs in 2015. The questionnaire assessed the number of NICU beds, admission and mortality rates of very low birthweight infants (VLBWIs), personnel status, equipment and facilities, and available multidisciplinary approach. Current data was compared with the previous studies and changes in the status and function of the nationwide NICU from 2009 and 2011. RESULTS: During the last 7 years, there was an increase of 462 NICU beds, which met the required number estimated by the number of births and covered about 90% of regional VLBWI births. Status of facilities and equipment improved in all regions in Korea but there were still regional differences in multidisciplinary approach and human resources. The difference in odds ratios for mortality of VLBWI between regions decreased compared to 2009. CONCLUSION: There was improvement in regional disparities of neonatal care and mortality of premature babies with the government investment in Korea. Further supports are required for human resources and referral system.
Humans ; Infant ; Infant Health ; Infant, Newborn ; Intensive Care, Neonatal ; Investments ; Korea ; Mortality ; Odds Ratio ; Parturition ; Referral and Consultation

OBJECTIVE: The bystander effect, the phenomenon that non-transduced tumor cells can be killed along with the transduced cells, enables suicidal gene therapy feasible in spite of low efficiency of gene transfer at present time. Increment of thymidine kinase activity in the cells through double copy insertion of HSVtk gene may lead to increased bystander effect in vitro and in vivo, therefore enhancing the therapeutic potential of suicidal gene therapy. To examnine this hypothesis, we did an experiment to improve bystander effect by using double transfer of HSVtk gene into 9L tuomr cells. METHODS: We transduced 9L glioblastoma cells which had one copy or two copies of HSVtk gene using retroviral vector. Two different retroviral vector plasmids containing HSVtk gene were made employing pBabePuro or LXSN plasmid whose selection markers were puromycin and G418, respectively(LtkSP and LtkSN). Recombinant retrovirus was produced from ecotrophic PA317 packaging cells. Infection of the 9L cells with LtkSP recombinant retrovirus and selection with puromycin was done in vitro to make 9L/LtkSP(9LtkS). These cells were infected again with LtkSN recombinant retrovirus and selected under G418 to establish cells containing two copies of HSVtk gene, 9L/LtkSP/ LtkSN(9LtkD). RESULTS: By measuring the intracellular amount of phosphorylated 3H-GCV, 9LtkD cell lines showed significantly increased HSVtk activity, being 70% higher than that of 9LtkS cell lines. The sensitivity to GCV was also markedly increased. In vitro bystander effect, examined by coculturing with HSVtk gene transduced cells and 9L cells, was significantly increased on 9LtkD cell lines. To evaluate the in vivo bystander effect, 9LtkD/9L(20%:80%) cells or 9LtkS/9L (20%:80%) cells were implanted into the brains of Fisher 344 inbred rats, followed by administration of ganciclovir. Rats implanted with 9LtkD/9L cells showed better tumor regression and longer survival than those of 9LtkS/9L after treatment with ganciclovir. CONCLUSION: These results suggest that increasing herpes simplex virus thymidine kinase activity by introducing double copy of HSVtk gene into tumor cells would improve in vitro and in vivo bystander effect, and lead to enhanced efficacy of suicidal gene therapy.
Animals ; Brain ; Bystander Effect* ; Cell Line ; Ganciclovir ; Genetic Therapy ; Glioblastoma ; Glioma ; Herpes Simplex* ; Phosphotransferases* ; Plasmids ; Product Packaging ; Puromycin ; Rats ; Retroviridae ; Simplexvirus* ; Thymidine Kinase ; Zidovudine

PURPOSE: In this retrospective study, we aimed to compare the clinical characteristics of inguinal hernia developed after radical retropubic surgery for prostate cancer to the hernia without previous radical prostatectomy. METHODS: Twenty-three patients (group A) who had radical retropubic surgery for prostate cancer underwent laparoscopic or open tension-free inguinal hernia repair from March 2007 to February 2011. Nine hundred and forty patients (group B) without previous radical retropubic surgery received laparoscopic or tension-free open hernia operation. RESULTS: Group A was older than group B (mean +/- standard deviation, 69.6 +/- 7.2 vs. 54.1 +/- 16.1; P < 0.001). Right side (73.9%) and indirect type (91.3%) in group A were more prevalent than in group B (51.5% and 69.4%, respectively) with statistic significance (P = 0.020 and P = 0.023). The rate of laparoscopic surgery in group B (n = 862, 91.7%) was higher than in group A (n = 14, 64.3%, P < 0.001). In comparing perioperative variables between the two groups, operative time (49.4 +/- 23.5 minutes) and hospital stay (1.9 +/- 0.7 days) in group A were longer than in group B (38.9 +/- 16.9, 1.1 +/- 0.2; P = 0.046 and P < 0.001, respectively) and pain score at 7 days in group A was higher than in group B (3.1 +/- 0.7 vs. 2.3 +/- 1.0, P < 0.001). Postoperative recurrence rate was not significantly different between the two groups. CONCLUSION: Inguinal hernia following radical retropubic surgery for prostate cancer was predominantly right side and indirect type with statistic significance compared to hernias without previous radical prostatectomy.
Hernia ; Hernia, Inguinal ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies

The posterolateral approaches to the spine is an effective method for the neural decompression and the spinal stabilization. This procedure has an advantages of an one-stage posterolateral decompression-stabilization. We have experienced 8 patients with burst fracture in the thoracolumbar junction. A three-quater prone position was used for patient positioning. No patient showed neurologic deterioration after surgery. Patient positioning and the operative approach are described and illustrated.
Decompression* ; Humans ; Patient Positioning ; Prone Position ; Spine*

PURPOSE: The purpose of this study is to correlate the MR findings with clinical stage and clinical outcome, and to describe the evolutional changes of abnormal MR findings of transverse myelitis. MATERIALS AND METHODS: Medical records and spinal MR images of 23 patients with both clinical and radiological diagnosis of transverse myelitis were retrospectively reviewed. MR findings were correlated with clinical stages including interval between MR imaging and full development of clinical symptoms, and compared with the clinical outcome. RESULTS: Diffuse high signal intensity of the spinal cord on T2-weighted image with mild cord bulging (67%) and focal contrast enhancement of the cord (75%) were observed within the first four weeks after full development of clinical symptoms. The findings decreased in extent or vanished later than four weeks on either initial or follow-up MR images. Most patients with either cord atrophy or focal hemorrhagewithin the cord lesion had poor clinical outcome. CONCLUSION: The MR findings of transverse myelitis are nonspecific, which may be seen in a variety of diseases. Serial MRIs, especially follow up examination over at least one month after full development of clinical symptoms are useful in the diagnosis of transverse myelitis and predicting its prognosis.
Atrophy ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Myelitis, Transverse* ; Prognosis ; Retrospective Studies ; Spinal Cord

No abstract available.
Fascia* ; Foot* ; Free Tissue Flaps* ; Hand* ; Rabeprazole*

BACKGROUND AND SIGNIFICANCE: Because of the diverse clinical and radiologic manifestations of Neuro-Behcet disease, it is sometimes difficult to differentiate with multiple sclerosis or tumorous condition. We report two cases of Neuro-Behcet disease underwent by stereotaxic biopsy showing vasculitis without any evidence of malignancy, initially misdiagnosed as solitary tumor and metastatic tumor, respectively. CASE: A 35-year-old male admitted due to right hemiparesis. Brain CT showed low density mass shadow in left thalamus. Under the impression of low grade astrocytoma, stereotaxic biopsy was performed. Dense perivascular lymphocytic infiltration with petechial microhemorrhage mixed with hemosiderin pigment was noted in thalamic region. The other patient (male, 44yrs old) admitted due to seizure. On MRI, there are multiple inhomogenous signals on right occipital and left frontal lobe and left thalamus. Under the impression of metastatic tumor, work-up about the primary tumor was done without any positive findings. To determine the primary focus, stereotaxic biopsy was performed. Only reactive gliosis and mild perivascular lymphocytic infiltration was noted in pathologic specimen. With the retrospective careful history taking and follow-up image study, two patients were confirmed as having a Behcet's disease.
Adult ; Astrocytoma ; Biopsy ; Brain ; Follow-Up Studies ; Frontal Lobe ; Gliosis ; Hemosiderin ; Humans ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis ; Paresis ; Retrospective Studies ; Seizures ; Thalamus ; Vasculitis

Mirror writing is script that runs in the direction opposite to normal, with individual letters also reversed. A Right handed woman suddenly developed mirror-writing. After traumatic brain injury without definitive lesions on MRI, she could not discriminate between right and left by herself. Several theories, including motor, visual dominance, spatial disorientation and supplementary motor hypotheses, have been proposed to explain such. We believe that availability of mirror engrams induce reversal of normal left-to-right writing pattern including mirror-writings.
Brain Injuries ; Female ; Functional Laterality ; Hand ; Humans ; Magnetic Resonance Imaging* ; Writing

Two cases of skull metastasis from thyroid carcinoma are presented. The one case shows multiple involvement inthe skull base with sphenoid sinus, frontal bone, and rib. The other case is solitary extensive involvement to theright parietal bone. The follicular caroinoma of the thyroid shows a strong tendency toward vascualr invasion and dissemination through blood stream to the lungs, bones, liver, brain, and other distant sites. The sternum, thevetebrae, and the pelvis are the most common sites in bone metastasis of thyroid carcinoma, followed by the femur,shoulder girdle, skull, and rib. Metastatic caroinoma to the skull base, including sphenoid sinus s extremelyrare. Authors experienced recently 2 cases of metastatic carcinoma of the thyroid to the skull and report withreview of literature.
Brain ; Frontal Bone ; Liver ; Lung ; Neoplasm Metastasis ; Parietal Bone ; Pelvis ; Ribs ; Rivers ; Skull Base ; Skull ; Sphenoid Sinus ; Sternum ; Thyroid Gland ; Thyroid Neoplasms

No abstract available.
Carcinoma, Hepatocellular*