No abstract available.
Female ; Pregnancy ; Pregnancy, Tubal*

Rigid posterior fixation of the atlas to the third and fourth cervical spine was achieved in a patient in whom axis pedicle fracture and dislocation of axis on the third cervical spine. Althouth there was no evidence of neurologic disorder, marked instability of axis on the third cervical spine should inevitably be fused in any procedures. An anatomically contoured loop was secured to the posterior arch of the atlas and the laminae of the third and the fourth cervical spine by sublaminar wirings. The technique has the advantage over bone graft, either alone or with cement, in that it affords rigid stabilization, allows early mobilization and some flexion movement of atlanto-occipital joint.
Atlanto-Occipital Joint ; Dislocations ; Early Ambulation ; Humans ; Nervous System Diseases ; Spine ; Spondylolisthesis ; Transplants

PURPOSE: The aim of this study was to investigate the incidence and contributing factors of failure to thrive (FTT) up to corrected 18 months of age in very low birth weight (VLBW) infants. METHODS: Medical records of 98 VLBW infants admitted to NICU of Samsung Medical Center from January 1996 to December 2000, were reviewed retrospectively whose follow-up's were possible up to corrected 18 months of age. We defined FTT as failure to achieve body weight below 10th percentile of standard Korean infant's growth curve for appropriate corrected age. We investigated maternal, neonatal risk factors for FTT and changing pattern of growth parameters. RESULTS: The risk factors of FTT in VLBW infants were birth weight, gestational age, RDS, BPD, durations of ventilator care, TPN and hospitalization. When corrected for birth weight and gestational age, only duration of hospitalization remained to be a significant risk factor. Unlike body weight, height attained 10th percentile at corrected 15 months for VLBW infants, 18 months for extremely low birth weight (ELBW) infants. Head circumference attained 10th percentile more earlier at corrected 5 months for VLBW infants, 12 months for ELBW infants, respectively. Catch up growth occurred in the order of head circumference followed by height. CONCLUSION: Risk factors for FTT in VLBW infants and ELBW infants is multifactorial. To enhance optimal growth and development of VLBW infants, further studies on nutritional management related to enteral feeding is needed.
Birth Weight ; Body Weight ; Enteral Nutrition ; Failure to Thrive* ; Gestational Age ; Growth and Development ; Head ; Hospitalization ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Medical Records ; Retrospective Studies ; Risk Factors ; Ventilators, Mechanical

OBJECTIVE: To analyse neonatal outcomes of the very low birthweight infants born to women who underwent an indicated preterm delivery and spontaneous preterm delivery. METHODS: We performed an observational study of 150 very low birthweight(<1500 grams) infants delivered at Samsung Medical Center. The study population was limited to singleton infants without major congenital anomalies. The primary reason for delivery was categorized as indicated preterm delivery or spontaneous preterm delivery. Selected neonatal outcomes were compared between infants born to women in each of these groups. RESULTS: Univariate analyses showed some survival benefits in infants born to women who underwent indicated preterm delivery. Selected neonatal outcomes, however, did not differ between the groups in the multiple logistic regression analysis. CONCLUSION: There was no survival advantage to the very low birthweight infants born to women who underwent an indicated preterm delivery compared to those born to women with spontaneous preterm delivery.
Female ; Humans ; Infant* ; Logistic Models ; Observational Study

The authors present a case of giant serpentine aneurysm (a partially thrombosed aneurysm containing tortuous vascular channels with a separate entrance and outflow pathway). Giant serpentine aneurysms form a subgroup of giant intracranial aneurysms, distinct from saccular and fusiform varieties, and in this case, too, the clinical presentation and radiographic features of CT, MR imaging and angiography were distinct.
Case Report ; Cerebral Angiography ; Female ; Human ; Intracranial Aneurysm/*diagnosis ; Magnetic Resonance Imaging ; Middle Age ; Tomography, X-Ray Computed

PURPOSE: To determine the added value of dynamic subtraction magnetic resonance (MR) imaging for the localization of prostate cancer. MATERIALS AND METHODS: We examined 21 consecutive patients who underwent MR imaging in 3T unit with a phased-array body coil and then had radical prostatectomy. After T2-weighted fast spin-echo imaging, we performed a contrast-enhanced dynamic 3D gradient-echo imaging consisting of pre-contrast, 2 successive early-phased (first imaging was started just after the appearance of contrast material in the aortic bifurcation followed by second imaging 35 seconds after the initiation of first imaging) and one 5-minute delayed post-contrast series. Subtraction of pre-contrast images from corresponding post-contrast images of each phase was performed on the console. RESULTS: On ROC analysis, the overall accuracy (Az value) of dynamic imaging combined with subtraction imaging was higher than T2-weighted imaging (p = 0.001) or conventional dynamic imaging alone (p = 0.074) for localization of cancer foci regardless of their zonal locations. Among pathologically verified 81 lesions, the mean volume of detected lesions with the subtraction images (n = 49, 0.69cm3) was smaller than with T2-weighted images (n = 14, 1.05cm3) or conventional dynamic images (n = 43, 0.71cm(3)). CONCLUSION: For localization of small prostate cancer, additional subtraction for the dynamic imaging could be superior to both T2-weighted imaging and un-subtracted dynamic imaging.
Aged ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Prostate/pathology ; Prostatic Neoplasms/*diagnosis/pathology ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVE: To evaluate the causes, methods of delivery, and maternal complications in cases of fetal death in utero(FDIU) at Samsung Medical Center. METHODS: There were 92 cases of FDIU among 25,195 deliveries at Samsung Medical Center during 7 years from 1994 to 2001. In these cases, perinatal autopsy and placental biopsy was performed in 35 and 71 cases, respectively. All the clinical informations were obtained by reviewing medical records retrospectively. RESULTS: The overall incidence of FDIU was 0.37%. Most of FDIU occurred in 25 to 29 years old group(43.5%). Recurrence rate of FDIU was 3.3%. Most of FDIU were low birth weight(79.3%) and preterm(79.6%). The modes of delivery were induced labor(68.5%), laparotomy(18.5%), and the spontaneous delivery(13.0%). The causes of FDIU were chorioamnionitis(15.2%), placental abruption(14.1%), severe preeclampsia(11.9%), congenital and chromosomal anomaly(6.5%), but it was unexplained in 27.2%. There were 25 cases with maternal complications and the most common complications were intra-/postpartum fever(18.5%), postpartum hemorrhage(8.7%) and DIC(8.7%). CONCLUSION: The causes of FDIU could not be determined in only about 1/4 cases at Samsung Medical Center. Since FDIU recurred in 3.3%, thorough studies including perinatal autopsy and chromosomal study must be made on stillborn infants and placenta to determine the recurrent causes.
Adult ; Autopsy ; Biopsy ; Fetal Death* ; Humans ; Incidence ; Infant ; Medical Records ; Parturition ; Placenta ; Postpartum Period ; Recurrence ; Retrospective Studies

Tuberculosis remains one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. The diagnosis and treatment of extrapulmonary tuberculosis involving the abdomen is still complicated owing to vague or non-specific clinical features. Although rare, isolated splenic involvement is one of the important manifestations of extrapulmonary tuberculosis, and imaging suspicion of the disease is essential. We report a case of surgically confirmed mass-forming splenic tuberculosis showing a layered pattern consisting of caseous necrosis with profound restriction of water molecules surrounded by an irregular rind of granulation tissue with less diffusion restriction on diffusion-weighted magnetic resonance imaging (DWI). In the differential diagnosis of neoplastic or non-neoplastic mass-forming lesions involving the spleen, this unique DWI feature could be helpful in characterizing splenic tuberculosis. The patient has been in clinically disease free status for nearly 20 months after splenectomy.
Diffusion Magnetic Resonance Imaging/*methods ; Female ; Humans ; Middle Aged ; Necrosis ; Splenectomy ; Tuberculosis, Splenic/*pathology

BACKGROUND: The cases of Methicillin-Resistant Staphylococcus aureus(MRSA) infection after middle ear surgery, most of which are thought to be hospital acquired infection, are increasing recently in our hospital. MRSA infection is apt to be long lasting and to bring many complications because MRSA is resistant to aminoglycosides and cephalosporin as well as methicillin. There are many reports that medical personnel have a role to transmit that organisms to other patients. OBJECTIVES: To find and eradicate infection source and transmission route are both essential because medical personnel who contact MRSA infected patients can be a continuing transmission route. MATERIALS AND METHODS: Bacterial cultures from the noses and hands of medical personnel working in the department of Otolaryngology of Korea University Hospital were done and ribotyping through Southern blot technique was used to compare and prove an identical strain of MRSA organism between medical personnel and patients. RESULTS: As a result of ribotyping with EcoRI and HindIII, one distinct subtype(type I) was identified to be shared between medical personnel and patients. Among 30 medical personnel, 10 were carriers of MRSA. Seven MRSA isolates from these 10 medical carriers and 18 from 30 isolates of otorrhea shared the same type I ribotype. CONCLUSION: This finding reveals that MRSA transmission could occur between medical personnel and patients. Medical personnel should be aware of their possible role as a relay-stay of transmission of pathogenic organisms and should give efforts to prevent it.
Aminoglycosides ; Blotting, Southern ; Ear, Middle* ; Hand ; Humans ; Korea ; Methicillin ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Nose ; Otolaryngology ; Ribotyping ; Staphylococcus

Methyl gallate (meGAL) is known as one of major antioxidants. To investigate whether meGAL protects human cells from oxidative stress, meGAL extracted from Korean medicinal plant, Cercis chinensis leaves, was primarily screened using cell viability assay against oxidative stress. Human umbilical vein endothelial cells (HUVECs) were treated with three different concentrations of meGAL for indicated time. After or during meGAL treatment, H2O2 was added and incubated. meGAL showed free radical scavenging effect at low concentration (0.02 mM) and cell protective effect against H2O2-mediated oxidative stress. meGAL recovered viability of HUVECs damaged by H2O2-treatment, reduced the lipid peroxidation (LPO) and decreased the internal reactive oxygen species (ROS) level elevated by H2O2-treatment. Free radical scavenging effect of meGAL was proven to be very high. Differential display reverse transcription-PCR analysis showed that meGAL upregulated the levels of regulator of chromatin condensation 1, type 1 sigma receptor and phosphate carrier protein expressions, respectively. Based on structural similarity compared with meGAL, 14 chemicals were chosen and viability assay was performed. Four chemicals, haematommic acid (56.2% enhancement of viability), gallic acid (35.0%), methylorsellinic acid (23.7%), and syringic acid (20.8%), enhanced more potent cell viability than meGAL, which showed only 18.1% enhancement of cell viability. These results suggest that meGAL and four meGAL-related chemicals protect HUVECs from oxidative stress.
Antioxidants/*chemistry/*pharmacology ; Biological Assay ; Catalase/analysis ; Endothelial Cells/*drug effects/enzymology ; Fabaceae/*metabolism ; Free Radical Scavengers/chemistry/pharmacology ; Gallic Acid/*analogs & derivatives/chemistry/pharmacology ; Gene Expression/drug effects ; Humans ; Molecular Structure ; Oxidative Stress/*drug effects/genetics ; Plant Extracts/chemistry/pharmacology ; Plant Leaves/metabolism ; Research Support, Non-U.S. Gov't ; Superoxide Dismutase/analysis ; Umbilical Veins/cytology ; Water/pharmacology