No abstract available.
Spinal Fractures*

Brachycephaly is a kind of craniosynostosis. Because of premature closure of the coronal suture, the skull is shorter in the anteroposterior diameter but is widened with a high vault and the occiput and forehead are flattened. Diabetes insipidus had been reported in oxycephaly. We have experienced a case of central diabetes insipidus associated with brachycephaly. A brief review of related literatures is included in this report.
Craniosynostoses* ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Forehead ; Skull ; Sutures

No abstract available.
Spinal Cord Diseases*

No abstract available.
Humans ; Infant, Newborn* ; Osmolar Concentration* ; Specific Gravity*

PURPOSE: The cross-protection of 7-valent pneumococcal conjugate vaccine (PCV7) against vaccine-related serotypes has been controversial. We investigated the serological properties of cross-protective antibodies against vaccine-related serotypes 6A, 6C, and 19A induced in young children aged 12-23 months after booster immunization of PCV7. METHODS: IgG and IgM antibody concentrations and opsonic index (OI) against vaccine serotypes 6B and 19F and vaccine-related serotypes 6A, 6C, and 19A were measured by ELISA and opsonophagocytic killing assay (OPA) in 4 selected immunesera. The serological properties and antigenic specificity of protective antibodies were determined by IgM depletion of immunesera, OPA, and competitive OPA against serogroup 6 and 19 pneumococci. RESULTS: Compared to pre-IgM depleted immunesera, OI of IgM-depleted immunesera against 6B and 19F decreased and OI against 6A, 6C, and 19A decreased, too. In competition OPA, free 6B and 19F polysaccharide completely inhibited the immune protection against vaccine-related serotypes 6A, 6C, and 19A as well as vaccine types 6B and 19F. CONCLUSIONS: The booster immunization of PCV7 certainly induced cross-protective antibodies against vaccine-related serotypes 6A, 6C, and 19A with both IgG and IgM isotypes. Furthermore, IgM antibodies are more highly contributed to opsonophagocytic activity against vaccine-related serotypes as well as most of vaccine types than do IgG antibodies. Further studies are needed for the more immunized sera in the children as well as adults.
Adult ; Aged ; Antibodies ; Child ; Cross Protection ; Enzyme-Linked Immunosorbent Assay ; Epitopes ; Homicide ; Humans ; Immunization ; Immunization, Secondary ; Immunoglobulin G ; Immunoglobulin M ; Pneumococcal Vaccines ; Streptococcus pneumoniae ; Heptavalent Pneumococcal Conjugate Vaccine

BACKGROUND: The dipyridamole and dobutamine stress echocardiography have been studied as a non-invasive diagnostic test in coronary artery disease. Recently, some authors have extended the usefulness of these tests to predicting the prognosis of myocardial infarction patients. But as far as we know, there was no literature which tried boh tests to the same infarcted patients group. So, we performed both tests in the 23 infarcted patients to compare and evaluate both tests as predicting the prognosis in myocardial infarction. METHODS: Patients underwent (1) two-dimensional echocardiography under basal condition and after dipyridamole infusion for 4 minites at the dose of 0.14mg/kg/min, (2) another two dimensional echocardiography under basal and during dobutamine infusion at each dose of 5 to a maximum of 20microg/kg/min at 1 or 2 days after dipyridamole stress echocardiography, and (3) coronary and left ventricular angiography. Preinfusion and peak infusion images were analyzed independently by two different observers using Nova Micro Sonic soft were(DataVueII and ColorVue II analysis system). The segmental wall motions were scored as follows ; hyperkinetic : 1, normal : 2, hypokinetic : 3, akinetic : 4. THe test response was considered positive if abnormal wall motion and reduced myocardial thickening were observed during drug infusion at the vascular distributions except the akinetic infarcted segment identified during basal condition. The coronary angiography was analyzed by measuring the maximal luminal diameter stenosis with caliper and 50% or greater diameter narrowing was considered significant. The sensitivity and specificity were calculated by comparing echocardiographic prediction and angiographic findings. RESULTS: 1) Among 22 patients with sufficient image in dipyridamole stress echocardiography, 13 patients have myltivessel coronary disease without resting akinesia of non-infarcted segments. Only 5 patients showed positive findings in dipyridamole stress echocardiography(sensitivity, 38.4%). Among 9 patients who has single or minimal disease, 9 patients were negative finding(specificity, 100%). 2) Among 21 patients with sufficient image in dobutamine stress echocardiography, 12 patients have multivessel coronary disease without resting akinesia of non-infarcted segments. 7 patients showed positive finding in dobutamine stress echocardiography(sensitivity, 58.3%). Among 9 patients who has single or minimal disease, 8 patients showed negative finding(specificity, 88.8%). 3) In hemodynamic changes, dipyridamole stress echocardiography showed significant changes in heart rates and double products and dobutamine stress echocardiography showed significant changes in heart rates, systolic blood pressure and double products. 4) There was no significant side effect during both stress tests inacute and old myocardial infarction patients. CONCLUSION: 1) The dobutamine and dipyridamole stress echocardiography are safe and easy test for myocardial infarction patients. 2) The dobutamine stress echocardiography has higher sensitivity than dipyrdamole stress echocardiography for identifying multivessel coronary disease in myocardial infarction patients but the dose of both drugs were relatively small to get the adequate results. So the high dose of drugs must be tried in feature study.
Angiography ; Blood Pressure ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Diagnostic Tests, Routine ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Exercise Test ; Heart Rate ; Hemodynamics ; Humans ; Myocardial Infarction* ; Phenobarbital ; Prognosis ; Sensitivity and Specificity

No abstract available.
Emergencies* ; Humans ; Prospective Studies*

PURPOSE: The purpose of this study is to illustrate MR patterns of bone marrow of calvarium and vertebral body in normal subjects according the age distribution and to understand the course of the fatty replacement from red marrow. METHODS AND MATERIAL: We retrospectively evaluated MR examinations of the calvaria(n=71), cervical spine(n=71), thoracic spine(n=65), Imbar spine(n =68) in subjects without bone marrow abnormality whose age ranged 3 weeks to 74 years. Three distinctive patterns were categorized on Tl-weighted images of the skull. In pattern 1, uniformly low signal intensity with or without very small areas of high intensity in frontal and occipital bones is noted. In pattern 2, frontal and occipital bones have uniformly high signal intensity, and patchy area of high intensity appears in parietal bone. In pattern 3, the entire skull has uniformly high signal intensity. In the spine, four patterns were categorized on Tl-weighted MR images. In pattern 1, the vertebral body has uniformly low signal intensity except for linear areas of high intensity superior and inferior to basivertebral vein. In pattern 2, bandlike and triangular areas of high signal intensity are found in the periphery. Pattern 3 and 4 have diffusely distributed areas of high signal intensity; pattern 3 consist of numerous indistinct dots measuring a few millimeter or less, and pattern 4 consist of fairly well marginated areas ranging in size from 5 to 1.5cm. RESULT:In the calvaria, 73% of pattern 1 were younger than 20 years, pattern 2 were evenly distributed, and 86% of pattern 3 were older than 40 years. In the spine, 87% of pattern 1 were younger than 40 years, 72% of pattern 3 were in 40 to 50 years, and 87% of pattern 4 were older than 50 years. Pattern 2 were evenly distributed in the cervical and thoracic spine, but in the thoracic spine 62% were younger than 30 years. CONCLUSION:It is concluded that younger age group shows mainly pattern 1, whereas elderly group has pattern 3 or 4 in the calvarial and vertebral body marrow. This suggests that conversion to fatty marrow begin locally and progress diffusely with age.
Age Distribution* ; Aged ; Bone Marrow* ; Humans ; Occipital Bone ; Parietal Bone ; Retrospective Studies ; Skull* ; Spine ; Veins

No abstract available.
Glucose* ; Humans ; Infant, Newborn*

PURPOSE: The study investigated clinical features of patients who underwent thyroid surgery, with and without Hashimoto's thyroiditis. METHODS: We retrospectively reviewed the medical records of 150 patients who underwent thyroid surgery at the Department of Surgery, Wallace Memorial Baptist Hospital, between January 2007 and December 2008. Patients were divided into two groups according to occurrence or non-occurrence of Hashimoto's thyroiditis, and analyzed them for age, sex, day of hospitalization, duration of drain keeping, operation time, and post-operative complications, including recurrent laryngeal nerve injuries, hypoparathyroidism, hypocalcemia, and adjacent structure injury. There were 24 lobectomies and 126 total thyroidectomies. RESULTS: Operation time was longer for patients with Hashimoto's thyroiditis. There was little difference between the two groups with respect to day of hospitalization, duration of draining, or post-operative complications. Of the total thyroidectomy cases without Hashimoto's thyroiditis, 36 patients (37.5%) had transient hypocalcemia and four (4.2%) had permanent hypocalcemia. Of the cases with Hashimoto's thyroiditis, 13 patients (38.2%) had transient hypocalcemia and three (8.8%) had permanent hypocalcemia. Patients undergoing thyroid surgery with Hashimoto's thyroiditis had longer operation times due to increased angiogenesis and fibrosis. No difference was shown for other clinical features or post-operative complications. CONCLUSION: The data strongly indicate that meticulous hemostasis and careful surgical technique, along with an understanding of anatomic variation and surgical experience, leads to a low late of complications following thyroid surgery, even for patients with Hashimoto's thyroiditis.
Anatomic Variation ; Fibrosis ; Hemostasis ; Hospitalization ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Medical Records ; Postoperative Complications ; Protestantism ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Thyroid Gland* ; Thyroidectomy* ; Thyroiditis*