No abstract available.
Transplants*

We report 22 patients with benign prostatic hyperplasia treated with transurethral balloon dilation and followed for six months thereafter. Of these 22 patients, 15 patients(68.2%) demonstrated significant improvement in modified Boyarsky symptom score and/or corrected peak flow rate on six months follow-up.
Follow-Up Studies ; Humans ; Prostatic Hyperplasia

PURPOSE: This study was undertaken to determine the amount of ptosis correction in congenital unilateral ptosis patients who had been performed frontalis suspension with autologous fascia lata under general anesthesia. METHODS: The subjects consisted of 27 patients with unilateral ptosis who had been performed frontalis suspension with autologous fascia lata under general anesthesia. At 1,4,8,and 12 weeks, the width of interpalpebral fissure was measured with videocamera. RESULTS: The mean preoperative interpalpebral fissure was 3.9+/-1.2 mm. At intraoperation, the mean interpalpebral fissure was 4.5+/-0.4 mm. The mean postoperative interpalpebral fissures were 6.8+/-0.6 mm, 7.8+/-0.8 mm, 6.8+/-0.8 mm, and 6.7+/-0.8 mm at 7+/-1, 29+/-3, 57+/-4, and 96+/-9 days. In preoperative severe ptosis group (ptosis amount 4 mm), the mean postoperative interpalpebral fissure was smaller than the other group. CONCLUSIONS: The postoperative interpalpebral fissure was stabilized after the 2-month follow-up. The results of this study suggest that the amount of ptosis correction should be modified in consultation with preoperative ptosis amount.
Anesthesia, General ; Fascia Lata* ; Fascia* ; Follow-Up Studies ; Humans

BACKGROUND: Laryngoscopy and tracheal intubation are associated with hemodynamic pressor responses, which lead to adverse effect. Opioids have been used to reduce the hemodynamic change. The purpose of this study was to investigate an optimal dosage of remifentanil for attenuating hemodynamic change. METHODS: 120 ASA class 1-2 patients, scheduled for elective surgery, were divided randomly into 4 groups. Anesthesia was induced with vecuronium priming dose (0.01 mg/kg) and TCI of propofol target concentration 8 microgram/ml. This was reduced to 4 microgram/ml when the effect-site concentration had been 3 microgram/ml. After the effect-site concentration had reached 4 microgram/ml, vecuronium (0.09 mg/kg) was given. At the same time, control group received normal saline, group R0.25 received remifentanil 0.25 microgram/kg, group R0.5 received remifentanil 0.5 microgram/kg, group R1 received remifentanil 1 microgram/kg over 60s and an infusion 0.2 microgram/kg/min. Intubation was performed after maximum depression of the single twitch was shown by single twitch stimulation test. Sytolic blood pressure, mean arterial pressure, diastolic blood pressure, heart rate and BIS value were measured preinduction, after propofol induction, immediately before and after intubation and 1, 2, 3, 4 minutes after intubation, respectively. RESULTS: Post-intubation mean arterial pressure decreased significantly from pre-intubation value in group R0.5 and R1 (P < 0.05). In group R0.5 and R1, hypotension and bradycardia occurred but there were no significant differences in their incidence between two groups. CONCLUSIONS: We suggest that remifentanil 0.5 microgram/kg bolus and an infusion of 0.2 microgram/kg/min attenuate the pressor response to tracheal intubation in patients anesthetized with propofol TCI.
Analgesics, Opioid ; Anesthesia ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Depression ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Intubation* ; Laryngoscopy ; Propofol* ; Vecuronium Bromide

OBJECTIVE: After classifing the twin-twin transfusion syndrome (TTTS) according to clinical stage by Quintero, we reviewed effectiveness and usefulness of clinical stage by Quintero in diagnosis and treatment of TTTS. METHODS: Twelve cases (16%) were diagnosed as TTTS among 75 examples (31.3%) of monochorionic twin pregnancy out of 240 cases of twin pregnancy born in our hospital between Mach 2000 and June 2004. For TTTS, the clinical stage was decided at the time of initial diagnosis, and any changes of it were observed according to the developments of pregnancy. Neonate was regarded as alive when 5 minutes Apgar score was above 7 after birth. Also we observed the vascular anastomosis of placenta, and classified the method of treatments and its results according to each clinical stage. RESULTS: Two cases were classified into the clinical stage 1 through 4 each, and 4 cases in the clinical stage 5. The higher the clinical stage, the shorter the duration between diagnosis and delivery (p<0.05). In cases of both survivors, compared to no survivors, the interval between diagnosis and delivery were long (p<0.05). In the clinical stage 4 and 5, we found many cases that didn't have placental vascular anastomosis between artery and artery, and in this case, there revealed poor perinatal outcomes. For 4 cases that fell in the clinical stage 1 and 2 and 4, we performed amnioreduction and for one case in the clinical stage 2, we did amnioseptostomy at the same time. In 4 cases with amnioreduction or amnioseptostomy, survival rate was 38%. CONCLUSION: The clinical classification system of TTTS by ultrasound would be helpful for planning treatments and also for predicting the outcomes.
Apgar Score ; Arteries ; Classification ; Diagnosis ; Humans ; Infant, Newborn ; Parturition ; Placenta ; Pregnancy ; Pregnancy, Twin ; Survival Rate ; Survivors ; Ultrasonography*

OBJECTIVES: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. METHODS: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. RESULTS: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. CONCLUSION: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.
Academies and Institutes ; Autism Spectrum Disorder* ; Autistic Disorder* ; Child ; Diagnosis ; Education ; Education, Special ; Humans ; Korea* ; Running ; Seoul ; Specialization

No abstract available.
Uterine Cervical Neoplasms*

Uterine leiomyosarcoma is a rare malignant tumor, and distant metastasis to skull bone is very uncommon. We experienced a case of parietal skull bone metastasis from uterine leiomyosarcoma in a 52-year-old woman who had undergone simple total hysterectomy and bilateral salpingoophorectomy with the diagnosis of uterine myoma. We treated this patient with combination chemotherapy using cisplatin and adriamycin and radiotherapy after craniectomy. She is alive now without particular symptoms. We report this case with a brief review of some literatures.
Cisplatin ; Diagnosis ; Doxorubicin ; Drug Therapy, Combination ; Female ; Humans ; Hysterectomy ; Leiomyoma ; Leiomyosarcoma* ; Middle Aged ; Neoplasm Metastasis* ; Rabeprazole ; Radiotherapy ; Skull*

PURPOSE: To evaluate the merit of umbilical artery Doppler study as a predictive marker of perinatal outcome in preterm small for gestational age (SGA) infants. MATERIALS AND METHODS: A total of 218 patients at 27 - 36 weeks of gestational age (GA) who received antenatal umbilical artery Doppler velocimetry and delivered singleton infants with SGA. The ratio of peak-systolic to end-diastolic blood flow velocities (S/D) in the umbilical artery was measured in each patient. The patients were divided into 3 groups: the normal group with S/D ratios of less than 95th percentile (n = 134), elevated S/D ratio group of 95th or more percentile (n = 41), and those with absent/reversed end diastolic flow (n = 43). Maternal characteristics and neonatal outcomes of these groups were comparatively analyzed. RESULTS: The gestational age (GA) at the time of diagnosis of SGA, the mean GA at delivery, and the mean birth weight showed statistically significant difference among three groups (p < 0.001). Also, poor perinatal outcome was significantly increased in infants with abnormal S/D ratio (13.4% vs. 31.7% vs. 67.4%, p < 0.001). Multivariate logistic regression analysis revealed umbilical artery Doppler study as a significant independent factor for prediction of poor perinatal outcome (odds ratio: 3.7, 95% confidence interval 1.4 - 9.5, p = 0.007). CONCLUSION: Antenatal umbilical artery Doppler velocimetry is shown as a significantly efficient marker in predicting perinatal outcome in preterm SGA infants.
Blood Flow Velocity ; Female ; Humans ; Infant, Newborn ; *Infant, Small for Gestational Age ; Multivariate Analysis ; Predictive Value of Tests ; Pregnancy ; *Pregnancy Outcome ; Retrospective Studies ; Ultrasonography, Doppler/*methods ; Ultrasonography, Prenatal/*methods ; Umbilical Arteries/*ultrasonography

Nowadays breast reconstruction with autologous tissues after radical mastectomy is commonly performed, and a natural inframammary fold in the reconstructed breast is considered to be an essential aspect of symmetrical breast shape and location. Total of 104 patients underwent breast reconstruction with free TRAM flap and formation of inframammary fold with free TRAM breast reconstruction was done in 79 patients. No suture fixation for inframammary fold were done in 19 patients. 27 patients(24.0%) were made of inframammary fold with absorbable suture, 52 patients (50.0%) underwent inframammary fold creation with nonabsorbable suture. There were 4 cases(16.0%) of displacement of reconstructed breast and 2 cases(8.0%) of partial disruption of inframammary fold in the group of no suture. There were 2 cases(7.4%) of displacement of reconstructed breast and 3 cases(11.1%) of partial disruption of inframmamary fold in the fixed group with absorbable suture. There was only 1 case(1.9%) of partial disruption of inframammary fold fixed with nonabsorbable suture group. Therefore, we could speculate that the reinforcement of ligamentous structure for making the definite inframammary fold is necessary, and the area of the inframammary fold should not be undermined in immediate breast reconstruction as much as possible in order to preserve the zone of adherence. If the fold is disrupted during the mastectomy, it should be re-created with the non-absorbable sutures. Nonabsorbable suture fixation seemed to be more stable than absorbable suture. Preoperative marking and design are very important to make the symmetrical shape and location of inframammary fold in both of immediate and delayed reconstruction of breasts.
Breast* ; Female ; Humans ; Ligaments ; Mammaplasty* ; Mastectomy ; Mastectomy, Radical ; Sutures