No abstract available.
Arthralgia*

Cerebral vascular disease is not infrequent disorder in children. Recently, 66 case of cerebral vascular diseases were investigated at Ped. Depart of Yonsei Medical Center. And obtained following result. 1) Age incidence represented 30% was under 1yr. Of age. 40.9% was under 2 years of age. 2) Of 66 cases 1 schemic vascular disease was 54.5% hemorrage vascular disease was 42.4%. 3) Moya disease was 8(12.1%), cases and cases associated with congenital heart disease was 9 cases(13.6%) and A-V malformatin was 8 cases (12.1%). 4) Over all the survival rate was 80.3% from the accident, in ischemic type the survival rate was 91.7% hemorragic type, 64.3%. 5) The occurrence of sequele in ischemic type was 88%, while hemorragic type 67%.
Child* ; Heart Defects, Congenital ; Humans ; Incidence ; Survival Rate ; Vascular Diseases*

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

BACKGROUND: To evaluate the efficacy of intramedullary K-wire fixation and interosseous wiring in the arthrodesis of the distal interphalangeal (DIP) joint with description of surgical procedure. METHODS: We retrospectively analyzed 9 cases (7 women and 2 men) of DIP joint arthrodesis. The average age of patients was 44.2 years (range, 21 to 71 years) and the mean follow-up period was 19.6 months. Joint union was evaluated on the follow-up radiographs together with postoperative complications. RESULTS: All cases achieved radiologic union of the arthrodesis site. There was no surgical complication except for one case of skin irritation by the interosseous wire knot which was removed during the follow-up period. CONCLUSIONS: Intramedullary K-wire fixation and interosseous wiring could be an alternative procedure of arthrodesis in the DIP joint.
Adult ; Aged ; Arthritis/*surgery ; Arthrodesis/*methods ; Bone Wires ; Female ; Finger Joint/radiography/*surgery ; Hand Deformities, Acquired/*surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients* ; Pharynx*

Background: Lumbar epidural anesthesia is widely used regional blockade method. But postepidural back pain is most common cause that experienced patients refuse epidural anesthesia. We planned this study to evaluate the effect of epidural dexamethasone injection for postepidural back pain. Methods: Adult patients free of back pain were randomly allocated into two groups. In both group anesthesia was induced with 2% lidocaine 20~25 ml mixed with 1:200,00 epinephrine and fentanyl 0.1 mg. After surgery, epidural catheter was removed after epidural dexamethasone injection in one group (group 2). In other group (group 1), catheter was removed without treatment. We visited patients and asked existence of back pain, and the intensity of back pain was measured by visual analogue scale at 24, 48 and 72 hours after surgery. Statistical analysis was done by Student's t-test and Mann-Whitney test. Results: In group 2, there was significant decrease in number of patients suffering from back pain and intensity of back pain. Conclusion: Epidural dexamethasone injection results in decreased number of patients suffering from back pain and also less in intensity of back pain.
Adult ; Anesthesia ; Anesthesia, Epidural* ; Back Pain* ; Catheters ; Dexamethasone* ; Epinephrine ; Fentanyl ; Humans ; Lidocaine

The postnatal development of somatostatin [SOM]- and neuropeptide Y[NPY]- immunoreactive[ir] neurons were examined in rat cerebral cortex considering their coexistence in cortical neurons. Using double immunohistochemical staining for SOM and NPY with diaminobenzidine and benzidine dihydrochloride as chromogens, we subdivided immunoreactive cells into double-labeled SOM/NPY-, SOM only-, and NPY only-ir neurons. Interestingly, SOM/NPY- and SOM only-ir neurons were detectable even at the day of birth, in contrast to NPY only-ir cells which first appeared in most cortices from two weeks of age. The morphological features of double-labeled SOM/NPY neurons were not identical to those SOM only- and NPY only-ir neurons. No apparent changes in the shape and size of single-labeled neurone occurred with age ; throughout their postnatal life they were round and ovoid, had a thin rim of perinuclear cytoplasm, and short processes. In contrast, the features of SOM/NPY-ir neurons were not consistent during postnatal life. By day P7, these neurons showed immature features ; they began to show more advanced neuronal characteristics by week P2, when they had a larger and more intensely-stained cytoplasm. In addition, their processes were longer, thicker and more complex than at earlier ages. At this age, SOM/NPY-ir somata were close to their maximum size. From week P4, they became smaller and were lightly labeled. SOM/NPY-ir somata were larger than SOM only- and NPY only-ir somata at and after two weeks of age. The present results showing different postnatal maturation patterns such as time of appearance and morphological features suggest that double-labeled SOM/NPY and single-labeled neurons might be different populations regulated by different mechanisms in their development, and with different functional properties during development.
Animals ; Cerebral Cortex* ; Cytoplasm ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Parturition ; Rats* ; Somatostatin*

This study presents data on the externally received doses for radiation workers who used the Korea Radioisotope Association's personal monitoring and dose record keeping service from 1984. Distributions of annual dose by age of worker and occupational category were given. The number of radiation workers registered was 23,257 in 1997. The trend of the number of radiation workers and their annual doses increased since 1984. The measured radiation dose were generally low. The collective annual dose and the mean annual dose were 33.45 Sv and 1.44 mSv, respectively. Very few workers(0.5%) exceeded 20 mSv(2 rem) and only 1 exceeded 50 mSv, the legal limit for dose.
Humans ; Korea*

BACKGROUND: Clinical trials have shown that b-adrenergic blocking drugs are effective and well tolerated in patients with mild to moderate congestive heart failure. Carvedilol is a mild b1-selective adrenergic blocking agent with vasodilating properties due to a blocker and antioxidant and anti-proliferative properties. This study assessed the efficacy and safety of carvedilol in patients with moderate to severe congestive heart failure caused by idiopathic dilated cardiomyopathy. METHODS: We enrolled 27 patients with moderate to severe congestive heart failure with a left ventricular ejection fraction of 35% by MUGA scan. Each patient was randomly assigned to either control (n-9) or carvedilol (n-18, target dose 25 mg bid) for 6 months while background therapy with digoxin, diuretics, and ACE inhibitor remained constant. RESULTS: Compared to the control group, patients in the carvedilol group showed significant increase of left ventricular ejection fraction (p<0.05). In addition, patients in the carvedilol group had a tendency to show a decrease in left ventricular end-diastolic dimension and heart rate. Also, the carvedilol group had a greater frequency of symptomatic improvement than the control group. There was neither serious side effects nor hospitalization. CONCLUSION: These finding indicate that carvedilol produces important clinical benefits in patients with moderate to severe heart failure treated with digoxin, diuretics, and ACE inhibitor without serious side effects.
Cardiomyopathy, Dilated ; Digoxin ; Diuretics ; Heart Failure* ; Heart Rate ; Hospitalization ; Humans ; Stroke Volume

Purpose: Eph receptors are differentially expressed in numerous malignant tumors. This study intended to analyze the roles of EphB receptors (EphB2, B3, and B4) in urinary bladder cancer. Materials and Methods: Tissue microarray-based immunohistochemical analysis was used to investigate the expression patterns of EphB2, EphB3, and EphB4 in 154 bladder cancer specimens. Immunohistochemical staining was conducted examining the extent of stained cells and staining intensity. EphB was considered to be highly expressed when the intensity of staining was more than moderate in >25% of cells in the tissue section. Small interfering RNA (siRNA) was used to knock down EphB expression in bladder cancer cell lines (T24, 5637) to determine the effects of EphB on tumor cell invasion, proliferation, and migration. Results: EphB receptors (B2, B3, and B4) were detected in 40.9% (EphB2, 63/154), 71.4% (EphB3, 110/154), and 53.2% (EphB4, 82/154) of bladder cancer specimens. Low expression of EphB2, B3, and B4 receptors were significantly associated with higher tumor grade (EphB2, p<0.001; EphB3, p=0.032; EphB4, p<0.001) and muscular invasion (EphB2, p=0.002; EphB3, p=0.009; EphB4, p<0.001). No obvious correlation was observed with other clinicopathological variables, such as age, sex, recurrence, lymph node involvement, metastasis, and overall survival. Inactivation of EphB receptors by siRNA transfection increased cell viability, tumor cell invasion, proliferation, and migration in comparison with untransfected cancer cells. Conclusion Low expression of EphB receptors (B2, B3, and B4) can be a predictive marker for muscular invasion of bladder cancer.