PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

C1q nephropathy is a distinct clinicopathologic entity, characterized by mesangial immunoglobulin and complement deposits, predominantly C1q, with no evidence for systemic lupus erythematosus. Clinically it may present as nephrotic syndrome and non-nephrotic proteinuria per se or associated with microscopic hematuria, gross hematuria, hypertension, or renal insufficiency. So far there is only one report about a familial case of C1q nephropathy (in two sisters). We present two cases of familial C1q nephropathy with nephrotic syndrome which was steroid resistant, but partially remitted with cyclosporine.
Complement System Proteins ; Cyclosporine ; Hematuria ; Humans ; Hypertension ; Immunoglobulins ; Lupus Erythematosus, Systemic ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Siblings

A clinical review of 34 cases of aortic dissection which were admitted to Yeungnam University hospital between March 1983 and April 1992. The results are as follows: 1. The peak incidence was in 5th, 6th decade and male to female ratio was 1.83:1. 2. The most common cause of aortic dissection was atherosclerosis and hypertension (79%). 3. The most common presenting symptom was pain (73%). but dyspnea, palpable mass, murmur, shock were also observed. 4. Abnormal electrocardiographic finding was myocardial ischemia in 6 cases, arrhythmia in 5 cases, LVH in 5 cases. 5. The X-ray findings showed abnormal aortic contour in 10 cases but normal X-ray finding was observed in 63% of DeBaKey Type III. 6. The most common diagnostic procedure was echocardiogram and abdominal Ultrasonography. 7. The mortality of all cases was 20%, operation mortality was 18% but no death of medically treatment in medical indication.
Arrhythmias, Cardiac ; Atherosclerosis ; Dyspnea ; Electrocardiography ; Female ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Myocardial Ischemia ; Shock ; Ultrasonography

PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that causes nosocomial infection in NICU. It contributes to neonatal morbidity and mortality with variable complications. This study was conducted to identify the risk factors associated with complicated MRSA bacteremia in neonates. METHODS: We reviewed the medical records of 44 neonates with positive blood culture for MRSA who were admitted to the NICU of Pusan National University Hospital from January 2002 to December 2007. We compared various factors of the complicated and uncomplicated MRSA bacteremia cases. RESULTS: Of the 44 neonates, 31 were male and 13, female. The mean gestational age and birth weight were 33.2+/-4.9 weeks and 1,859.9+/-962.2 g, respectively. Twenty-one of infants were treated with a mechanical ventilator during a mean of 8.8+/-13.8 days. There were 13 cases of complicated and 31 cases of uncomplicated MRSA bacteremia. Between the 2 groups, we compared the following variables: gestational age, birth weight, ventilator use, umbilical catheter use and central catheter insertion, O2 inhalation, first oral feeding day after birth, underlying disease, transfusion, and initial vancomycin use. The underlying disease and transfusion were the risk factors related to complicated MRSA bacteremia. CONCLUSION: Complicated MRSA bacteremia is related to underlying disease and transfusion. Since this was a retrospective study with a small sample size, it offered limited capacity to compare complicated and uncomplicated MRSA bacteremia. A prospective study with a larger population is needed to determine the exact characteristics of MRSA bacteremia in NICU.
Bacteremia ; Birth Weight ; Catheters ; Cross Infection ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Inhalation ; Male ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Parturition ; Retrospective Studies ; Risk Factors ; Sample Size ; Vancomycin ; Ventilators, Mechanical

Chronic recurrent multifocal osteomyelitis(CRMO) is an unusual inflammatory process involving multiple osseous sites. No causative agent can be consistently isolated from these lesions despite multiple biopsies and the affected child purses a clinical course of chronic remissions and exacerbations independent of antibiotic therapy. Biopsy of the lesions did not reveal any pathogens. Immunologic investigation revealed no abnormality common to the patient and there was no indication of a genetic etiology. The natural history of chronic recurrent multifocal osteomyelitis appears to be slow, spontaneous resolution of the osseous lesions without specific treatment. We experienced a case of CRMO in an 11-year-old girl who had complained of fever, pain on knee and wrist joints for several weeks. We studied the clinical, radiographic, histological findings in this patient and we report a case of CRMO with brief review of related literature.
Biopsy ; Child ; Female ; Fever ; Humans ; Knee ; Natural History ; Osteomyelitis* ; Wrist Joint

Urachal anomalies are very rare. The umbilicus and the structures which lead to its formation rarely cause trouble except in patients with an error. Embryologically, the urachus represents the vestigial remnant of the allantois which, in the fetus, communicates with the cloaca. The patent urachus results from failure of luminal closure of the urachus Herein a case of congenital patent urachus reported with a brief review of literatures.
Allantois ; Cloaca ; Fetus ; Humans ; Phenobarbital ; Umbilicus ; Urachus*

BACKGROUND: Propofol has been the most widely used IV adjuvant during Monitored anesthesia care (MAC), even though it lacksanalgesic properties. This study was designed to compare sedation quality, side effects, and recovery profiles of propofol alone (group P), propofol-fentanyl (group PF) and propofol-ketamine (group PK) using PCS for breast biopsy procedures using local anesthesia. METHODS: Anxiety VAS, pain VAS and digit symbol substitution test (DSST) were measured in 60 excision breast biopsy patients with local anesthesia. Vital signs, respiratory (SpO2, RR, and ETCO2) variables, BIS, and OAA/S scores were recorded. Perioperative side effects (e. g., pain on injection, excessive sedation [OAA/S < 4], hypoventilation [ventilatory frequency 8 bpm], hypotension, dizziness, unpleasant feeling, Nausea) were also noted. RESULTS: There were no differences among the three PCS groups with respect to demographic data (Table 1). A/D ratio in PK group had a significant increase over P group. The incidence of excessive sedation and dizziness were significantly more frequent in the PK group patients (P < 0.05)(Table 1, 2). OAA/S scores were significantly decreased in the PK group during near the end of surgery, whereas BIS scores were only at the end of surgery (P < 0.05)(Fig. 1, 2). During 15 min after arrival at recovery room, significantly less patients in the PK group gave correct responses on the DSST than other groups (P < 0.05)(Fig. 2, 3). CONCLUSIONS: In contrast to past studies of ketamine as an alternative to opioid adjuncts during propofol PCS, it has no more advantage than supplemental fentanyl in terms of sedation level and side effects.
Anesthesia ; Anesthesia, Local ; Anxiety ; Biopsy ; Breast ; Dizziness ; Fentanyl ; Humans ; Hypotension ; Hypoventilation ; Incidence ; Ketamine ; Propofol* ; Recovery Room ; Vital Signs

PURPOSE: Syncope appears to be common. However, the mechanism of syncope is not clear. Increased vagal activity and withdrawal of sympathetic stimulation cause hypotension, bradycardia and finally loss of consciousness. The purpose of this study was to evaluate changes of cerebral blood flow velocity, blood pressure, and heart rate during tilt test in children with vasovagal syncope. METHODS: Sixty four children with a past history of syncope were evaluated. The stand up test was performed for 15 minutes after a rest at supine position for 10 minutes, followed by an 80 degrees tilt test lasting 45 minutes. If presyncope(lightheadedness, nausea, blurred vision, or sweating) or syncope occurred, the study was discontinued. 12-lead electrocardiography, echocardiography, and electroencephalography were performed. Transcranial Doppler study was performed at the middle cerebral artery with 2 MHz continuous Doppler probe in 10 children with positive tilt test. Systolic, diastolic, mean cerebral blood flow velocity, integral, and pulsatility index were measured with blood pressure, heart rate, and O2 saturation. RESULTS: The positive rate of tilt test was 31.3%(20/64). Systolic, diastolic, and mean cerebral blood flow velocity decreased significantly in absence of hypotension or bradycardia during presyncope. Time velocity integral of cerebral artery also decreased significantly. CONCLUSION: Decreased cerebral blood flow velocity can predict the presyncope manifestation. Impairment of autoregulation of cerebral blood flow might play an important role in the pathophysiology of vasovagal syncope.
Blood Flow Velocity ; Blood Pressure ; Bradycardia ; Cerebral Arteries ; Child* ; Echocardiography ; Electrocardiography ; Electroencephalography ; Heart Rate ; Homeostasis ; Humans ; Hypotension ; Middle Cerebral Artery ; Nausea ; Supine Position ; Syncope ; Syncope, Vasovagal* ; Unconsciousness

OBJECTIVE: Idiopathic thrombocytopenic purpura (ITP) frequently occurs in young women. Consequently, clinicians often give medical treatment to pregnant women who are diagnosed with ITP. This study might help to make a clinical guidelines for obstetrical ITP patients and their infants. METHODS: We retrospectively investigated the medical charts of 19 cases of deliveries and 22 neonates which from mothers with the diagnosis of ITP during pregnancy from March 1998 to March 2007. RESULT: Corticosteroid treatment was administrated in 13 cases, high-dose immunoglobulin therapy in 3 cases, and concentrated platelet transfusion in 17 cases during their antenatal care. Ten (45%) vaginal deliveries and twelve (55%) cesarean sections were performed. There were no obstetrical complications associated with their ITP and only four infants with platelet counts below the 150,000/micronLiter were reported after birth. However there were not any signs and symptoms of neonatal complications resulting from their maternal ITP. CONCLUSION : Our results demonstrate that mothers with ITP can successfully deliver healthy infants in most case. Although maternal and fetal bleeding may occur, such a fatal complication is uncommon.
Blood Platelets ; Cesarean Section ; Diagnosis ; Female ; Hemorrhage ; Humans ; Immunization, Passive ; Infant ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Transfusion ; Pregnancy* ; Pregnant Women ; Purpura, Thrombocytopenic, Idiopathic* ; Retrospective Studies

Arteries ; Behcet Syndrome ; Central Nervous System ; Gastrointestinal Tract ; Glycosaminoglycans ; Humans ; Inflammation ; Joints ; Oral Ulcer ; Skin ; Skin Ulcer ; Superior Vena Cava Syndrome ; Thrombosis ; Veins ; Vena Cava, Superior ; Wound Healing