No abstract available.
Congenital Hypothyroidism*

Since Thomas et al reported the first instance of successful removal of a broken intravascular guidewire without surgical intervention by using a bronchoscopic forceps in 1964, there have been a number of nonsurgical removal of intravascular or intracardiac foreign bodies using the bronchoscopic forceps, loop snare or basket stone catchers. We experienced a successful retrieval of accidentally broken subclavian puncture catheter from right atrium in 76 year old male patient with cerebral infarction admitted to this hospital on May, 1989. By percutaneous catheterization via right basilic vein, using a loop snare which is modified manually by guidewire for PTCA(USIC(R) Teflon coated PTCA Guide wire : ".014"), we removed successfully foreign body from right atrium. Therefore, we report a case of nonsurgical retrieval of foreign body from right atrium with the review of the literature.
Aged ; Catheterization ; Catheters ; Cerebral Infarction ; Foreign Bodies* ; Heart Atria ; Humans ; Male ; Ocimum basilicum ; Polytetrafluoroethylene ; Punctures ; SNARE Proteins ; Surgical Instruments ; Veins

No abstract available.
Anus, Imperforate*

To investigate long term effects of CAPD on the left ventricular function in end-stage renal disease patients, M-mode echocardiographic studies and measurement o fsystolic time intervals were performed in 20 CAPD cases, 28 hemodialysis cases and 29 uremic controls. Compared to the uremic control grup, the patients on CAPD treatment revealed significant improvement of ventricular contractility and reduction of volume. On the other hand in hemodialysis group, even though there was improvement of ventricular contractility, volume control was not adequate. In the systolic time interval measurement, it is postulated that increase of PEP/LVET ratio in CAPD group probably results from reduction of volume(preload) rather than from deranged ventricular function.
Echocardiography ; Hand ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis* ; Systole ; Ventricular Function ; Ventricular Function, Left

No abstract available.
Biopsy* ; Child* ; Humans

PURPOSE: We performed a retrospective study to compare effects of Surfacten(R) with HFV administration and meticulous conventional ventilatory support for neonatal RDS by analyzing clinical effects, complication and mortality between two groups. METHODS: Of 107 cases admitted to the nursery in Taegu Fatima hospital from February 1990 to June 1996, 52 neonates (admitted from January 1993 till June 1996) with RDS on high frequency ventilation after Surfacten(R) replacement were included as study group while 57 neonates(admitted from January 1990 till December 1996) with RDS on only conventional ventilation as control group. Serial change of FiO2, MAP, PaO2 and PaCO2 within 48hours after Surfacten(R) replacement, chest X-ray, clinical course, complication and mortality rate were propectively analyzed between two groups. RESULT: 1) After 24 hours Surfacten(R) replacement FiO2 had gradually decreased to 40% in the treated group, while in the control group, decreased to 50% within 48 hours. 2) MAP was maintained at 5.2cmH2O in the treated group, while in the control group, at 6.9cmH2O. 3) Serial change of PaO2 during weaning period after Surfacten(R) replacement between two groups were not significantly different(in the treated group : 74.5mmHg, in the conrol group : 76.1mmHg). 4) Serial change of PaCO2 during weaning period after Surfacten(R) replacement in the treated group were maintained significantly below the level of PaCO2 in the control group(in the treated group : 42.3mmHg, in the control group : 46.6mmHg). 5) In the treated group, complications were a series of PDA, IVH and pneumothorax, while in the control group, of PDA, Sepsis and IVH, and there were no differences between two groups with respect to mortality. CONCLUSION: It was concluded that the combined treatment with Surfacten(R) replacement and high frequency ventilation for neonatal RDS improved short term clinical effects than in the control group, but there were no significant difference in terms of complications and mortality rate between two groups
Daegu ; High-Frequency Ventilation* ; Humans ; Infant, Newborn ; Mortality ; Nurseries ; Pneumothorax ; Respiratory Distress Syndrome, Newborn* ; Retrospective Studies ; Sepsis ; Thorax ; Ventilation* ; Weaning

Severe head injury results in the suppression of cellular immunity associated with dysfunctioning of effector lymphocytes, such as helper T cells(CD4) (and cytotoxic T cells(CD8). Despite progress in the management of increased intracranial pressure following head injury, infection remains the most common complication and the primary cause of prolonged hospitalization and death. This study attempts to assess the cellular immune function following head injury according to the degree of severity, and to establish the clinically available parameters of cell mediated immune(CMI) function, which can then be used for coherent prediction of infection risk. Eighteem head injury patients without severe systemic injury, who divided into three subgroups depending on the severity of head injury, were estimated with the use of CMI multitest kit(Merieux Institute, France) to test delayed-type hypersensitivity(DTH) and enumerated the circulating lymphocyte subpopulation(pan T-cell marker CD3, helper T cell marker CD4, cytotoxic T cell marker CD8 and B-cell marker CD19) on the 1st, 7th, and 21th day of injury. Patients were monitored for evidence of infection for this period. Fourteen patients had no reaction to any antigens of the DTH skin test(anergy) and the remaining four patients had also some degree of anergy. Seven patients became infected and all of them were anergic. There were significant decrease of circulating effector T lymphocytes, both CD4-positive and CD8-positive cells, within 24 hours of injury in the mild as well as the moderate and severe head injury group. CD4-positive cells were nearly completely recovered by the 7th day of injury. CD8-positive cells had sustained significant decrease even after 3 weeks of injury. There was no significant change in pan T-cells(CD3-positive cells) and B-cells(CD19-positive cells). The results suggest that DTH skin test and effector T cell enumeration are both relatively simple and highly sensitive parameters for monitoring CMI function. Especially, anergy of DTH skin test can be used for indicator to predict risk of infection. Mild as well as moderate and severe head injuries may result in the suppression of cellular immunity associated with the dysfunctioning of effector T cell.
B-Lymphocytes ; Craniocerebral Trauma* ; Head* ; Hospitalization ; Humans ; Immunity, Cellular* ; Intracranial Pressure ; Lymphocytes ; Skin ; Skin Tests ; T-Lymphocytes

Epilepsy surgery has been demonstrated to be an effective alternative treatment for intractable partial or localization related epilepsy. Primary intracranial neoplasms and other structural lesions of the brain are important etiological factors in patients with partial seizure disorders. A neuroimaging identified lesion in patients with seizures, not necessarily medically refractory, may also be an indication for surgery in selected patients. Twelve patients operated on under local or general anesthesia for resection surgery underwent intraoperative recording(electrocorticogram) and/or functional mapping by electrical stimulation or somatosensory evoked potentials-(SSEPs) for identification of the secondary epileptogenic area and/or functional area; 2 meningiomas, 5 astrocytomas, 1 gangliocytoma, 1 abscess, 1 small AVM, 1 cysticercosis and one gliosis by previous intracerebral hemorrhage with middle cerebral artery(MCA) aneurysm. Among these, additional corticectomy or anterior temporal lobectomy was performed in eleven patients. All the patients did well after surgery with good outcomes as seizure free in nine(75%) out of 12 patients with 11.9 months of follow-up period, without any neurological deficits. Intraoperative recording and functional mapping of adjacent areas of the structural lesions of the brain are useful in surgery and can guide the extent of further resection.
Adolescent ; Adult ; *Brain Mapping ; Brain Neoplasms/physiopathology/*surgery ; Electroencephalography ; Evoked Potentials, Somatosensory ; Female ; Human ; Intraoperative Period ; Male ; Middle Age ; Seizures/physiopathology/*surgery ; Support, Non-U.S. Gov't

The incidence of spine trauma has been increasing. To investigate the incidence, characteristics, and difficulty in management of the acute spine-injuried patients in suburban area we analyzed 50 cases treated conservatively or by operative fusion over a recent one-year period. This study comprised of 26 females and 24 males, between 23 and 83 years old patients with injury of whole column of spine. The most frequent cause of injury was traffic accident. The most common lesion was the compression fracture of the first lumbar spine. Most patients complained neck or back pain on admission. In 3 cases, neurological deficits were noted. For six patients, surgical treatment were performed and 44 patients has been conservatively managed with halo brace, neck collars, and thoracolumbar orthoses. The average period of admi-ssion and immobilzation for the conservatively treated patients was 6 weeks. During which time a few complications such as progressive kyphosis, hypoalbuminemia, thrombophlebitis, urinary tract infection, paralytic ileus, bed sore, and alcohol withdrawal syndrome were aroused. In most cases, good outcomes were achieved. Most of geriatric patients, concomitant systemic diseases with cardiovascular and pulmonary dysfunction were usually present and absence of the insight on spine injury made difficulties in managment. On the basis of these results we concluded that most elderly patients with spine fracture coulde be effectively treated by conservative methods, and also careful and systemic management with adequate education for patients and their families were required.
Accidents, Traffic ; Aged ; Aged, 80 and over ; Back Pain ; Braces ; Education ; Female ; Fractures, Compression ; Humans ; Hypoalbuminemia ; Incidence ; Intestinal Pseudo-Obstruction ; Kyphosis ; Male ; Neck ; Orthotic Devices ; Pressure Ulcer ; Spine ; Thrombophlebitis ; Urinary Tract Infections

Arotinolol, a new alpha and beta receptor antagonist, was administered in 27 essential hypertensive patients for 8 weeks in order to evaluate the antihypertensive effect and side effects. The dose were 10mg to 15mg given twice a day. The results are as follows : 1) Before medication, systolic and diastolic blood pressure in sitting, supine and erect position were 173.1+/-3.2/105.8+/-1.8, 171.1+/-3.6/86.7+/-2.0 and 169.3+/-2.6/97.2+/-2.1mmHg. 2) After 8 weeks treatment moderated to marked antihypertensive effect was observed in 74.0%(in systolic blood pressure) and 81.4%(in diastolic blood pressure) respectively in sitting position. 3) There was a significant reduction of pulse rate from 73.0+/-2.5 beats per minute on the beginning of the treatment to 63.4+/-5.2 beats per minute after 8 weeks of medication. 4) There was no significant change in hematocrit, WBC, serum lipid, GOT, GPT, BUN and creatinine. But fasting blood sugar was reduced from 95.3mg% to 81.5mg% with treatment. 5) The side effects of arotinolol were gastrointestinal symptoms(15%), fatigue(11%), dizziness(7%) and insomnia(3%). But these side effects were not severe enough to discontinue medication. In summary, arotinolol seemed to be an effective antihypertensive drug in treating mild to moderate hypertension without significant side effects.
Blood Glucose ; Blood Pressure ; Creatinine ; Fasting ; Heart Rate ; Hematocrit ; Humans ; Hypertension