No abstract available.
Addison Disease*

No abstract available.
Gynecology* ; Laparoscopy*

Down syndrome is the most common autosomal syndrome in man. The incidence of trisomy 21 due to translocation is about 3.5-5%. Translocations are usually centric fusions between a 21 and a D group (54.2%) or a G group (40.9%) chromosome. Since the short arm of 21 carries no phenotypically active genes, even if the short arm of 21 is lost, usually there is no imbalance with clinical significance. Rare translocations in Down syndrome may also occur between a 21 and other chromosomes (4.9%). We experienced a case of unusual (1q;21q) translocation Down syndrome inherited from a t (1q;21q) balanced carrier mother. The segmental trisomy was confirmed by FISH analysis. This is the first case of a familial Down syndrome with t (1q;21q) in Korea.
Arm ; Down Syndrome* ; Humans ; Incidence ; Korea ; Mothers* ; Trisomy

Although listeria monocytogenes is widely distributed in nature, it rarely causes clinical infection in previously healthy people. However, this microorganism may cause severe infectious disease in pregnant women and newborns due to impaired cell-mediated immunity. Various clinical symptoms have been described such as sepsis, central nervous system infections, endocarditis, gastroenteritis and localized infections. A clinical presentation of listeriosis in an early third trimester pregnant woman and in a preterm infant is emphasized in addition to taking a careful patient history, early empirical administration of antibiotics, aggressive ventilation therapy and also pharmacological support.
Anti-Bacterial Agents ; Central Nervous System Infections ; Communicable Diseases ; Endocarditis ; Female ; Gastroenteritis ; Humans ; Immunity, Cellular ; Infant, Newborn ; Infant, Premature ; Listeria monocytogenes ; Listeriosis* ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnant Women* ; Sepsis ; Ventilation

PURPOSE: To demonstrate the effectiveness of the conservative treatment which was introduced to the extraarticular triplane fractures of the distal tibia. MATERIALS AND METHODS: We reviewed radiographs and medical records of eight patients with extraarticular triplane fractures of the tibia. Four patients were treated with closed reduction and internal fixation and the others with closed reduction and plaster. RESULTS: In all patients, the union of fractures was obtained. Although the physes were closed early, there was no angular deformity or leg length discrepancy. CONCLUSION: In case of extraarticular triplane fracture, except for open fracture or failure of closed reduction, conservative treatment yield good result.
Child* ; Congenital Abnormalities ; Fractures, Open ; Humans ; Leg ; Medical Records ; Tibia*

BACKGROUND: Intravenous thrombolysis with alteplase is the most effective therapy for acute ischemic stroke, but hemorrhagic transformation (HT) is a potentially dangerous complication of such thrombolysis. Few studies have investigated the predictors of HT after thrombolysis in Korean stroke patients. METHODS: From 2003 to 2009, acute ischemic stroke patients who received intravenous alteplase were included from the prospective stroke registry of Kyung Hee University Hospital. Patients submitted to CT or MRI scans with gradient echo sequences within 12-36 hours of thrombolysis. The Hemorrhage After Thrombolysis (HAT) score [ranging from 0 (minimum risk) to 5 (maximum risk)] was calculated retrospectively for each patient. The predictive ability of the HAT score for HT and symptomatic intracranial hemorrhage (sICH) was calculated using C statistics. RESULTS: Among 151 consecutive patients, HT was confirmed in 35 on follow-up brain imaging. Atrial fibrillation (OR=2.709, 95%CI=1.118-6.567) and low one-third CT scan (OR=3.419, 95%CI=1.281-9.121) increased the risk of HT after intravenous thrombolysis in multivariate logistic regression analysis. HT, sICH (based on the National Institute of Neurological Disorders and Stroke and the Safe Implementation of Treatment in Stroke-Monitoring Study definitions), unfavorable [modified Rankin Scale (mRS) score of 2-6] and poor (mRS score of 3-6) outcomes at 3 months, and mortality at 3 months were increased with higher HAT scores (C statistic=0.632, 0.637, 0.843, 0.670, 0.689, and 0.659, respectively; p=0.018, 0.036, 0.042, 0.002, 0.015, and <0.001). CONCLUSIONS: The HAT score can be used to predict the risk of sICH following intravenous thrombolysis and the long-term clinical outcome.
Atrial Fibrillation ; Follow-Up Studies ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Logistic Models ; Magnetic Resonance Imaging ; National Institute of Neurological Disorders and Stroke ; Neuroimaging ; Prospective Studies ; Retrospective Studies ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator

BACKGROUND: To evaluate the role of emergency debridement performed in conjunction with an empirical antibiotic therapy in clinically diagnosed, full-blown Vibrio vulnificus sepsis. METHODS: Immediate surgical debridement was performed on 13 out of 15 patients who were clinically diagnosed as having Vibrio vulnificus sepsis. RESULTS: Among 15 patients Vibrio vulnificus was isolated in 8 patients. Underlying diseases were liver cirrhosis (2), chronic alcohol ingestion or chronic liver disease (10), diabetes mellitus (3), gastrectomy (1) and in 4 cases no underlying condition was identified. All patients had skin lesions such as erythema, bulla, vesicle and gangrene. All but one initially showed variable degree of hypotension, thrombocytopenia, hepatic dysfunction, renal failure and mental confusion. Their mean APACHE III score was 84. Immediate survival (within 48hrs) in clinically diagnosed Vibrio sepsis was 80% (12/15) and long term survival rate among them was 66.6%. Forty-eight hour survival rate in bacteriologically confirmed cases of Vibrio vulnificus sepsis was 75%, where their long-term survival was 62.5%. CONCLUSION: In treating full-blown Vibrio vulnificus sepsis, immediate emergency surgical debridement performed in conjunction with the empirical antibiotics gives a possibility to improve both immediate and long term prognosis of the disease.
Anti-Bacterial Agents* ; APACHE ; Debridement* ; Diabetes Mellitus ; Eating ; Emergencies* ; Erythema ; Gangrene ; Gastrectomy ; Humans ; Hypotension ; Liver Cirrhosis ; Liver Diseases ; Prognosis ; Renal Insufficiency ; Sepsis* ; Skin ; Survival Rate ; Thrombocytopenia ; Vibrio vulnificus ; Vibrio*

PURPOSE: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) and pulsed-spraypharmacomechanical thrombolysis (PSPMT) using urokinase for the management of insufficient hemodialysis access. MATERIALS AND METHODS: Between September 1996 and May 1998, 21 insufficient hemodialysis accesses were treated in 16 patients (3 artificial arteriovenous fistulae, AVF ; and 13 arteriovenous graft, AVG). PTA and PSPMT were performed in 6 and 15 and 15 cases, respectively, and success and long-term patency rates were evaluated. RESULTS: The overall success rate of PTA and PSPMT for insufficient hemodialysis access was 76.2%(16/21). The success rates of PTA and PSPMT were 83.3%(5/6) and 73.3%(11/15), respectively. the primary patency rates of PSPMT were 69+/-12.8% at 6 months and 38+/-18.6% at 12 months. One of the two initially successful PTAs had been patent for 7months, and the second PTA was performed at that time due to venous stenosis. The other was patent for 15 months throughout the follow-up period. CONCLUSION: PTA and PSPMT are effective primary methods for the treatment of insufficient hemodialysis access ; success and patency rates were high, and the procedures can be performed repeatedly.
Angioplasty ; Arteriovenous Fistula ; Constriction, Pathologic ; Endometriosis* ; Female ; Follow-Up Studies ; Humans ; Renal Dialysis ; Transplants ; Urokinase-Type Plasminogen Activator

PURPOSE: A structural equation model was analysed to explore the determinants of health behaviors of university students in Korea. METNOD: Nine hundred sixty nine university students were selected by random cluster sampling from five universities located in the central area of Korea. DATA COLLECTION: The data was collected by questionnaires about demographic characteristics, stressful life events, perceived social support, perceived health status and health behaviors. RESULTS: 1. Gender showed indirect effect on health behaviors. 2. Living together with(out) family had a direct effecton health behaviors: students living with family showed more positive health behaviors. 3. Stressful life events had an indirect effect on health behaviors via perceived health status;a higher score of stressful life events was the predictor for negative health behaviors. 4. A higher score of perceived health status predicted positive health behaviors. RECOMMENDATION: Each university should be encouraged to develop a health behavior control program and health promotion program for their own university students. It would be more effective to develop health programs separately according to the demographic or social characteristics of the students. It is also necessary for the Ministry of Education to reform the School Health Act and school health policy to strengthen a health promotion program for university students. In conclusion, following studies should identify and promote the validity and reliability of perceived health status and health behaviors measurements.
Adult ; Attitude to Health ; Female ; *Health Behavior ; Health Status ; Humans ; Korea ; Life Change Events ; Male ; Social Support ; *Students/psychology ; Universities

Tracheal bronchus is an uncommon anomaly in which an ectopic bronchus originates directly from the supracarinal trachea. It is usually an asymptomatic anatomical variant incidentally found on computed tomography or bronchoscopy. However, it can present with symptoms, such as chronic cough, wheezing, atelectasis, and recurrent pneumonia. We report a case of tracheal bronchus diagnosed in the neonatal period, in which the term baby presented with respiratory distress and persistent pulmonary hypertension of the newborn after birth, but no other congenital anomaly was found on further evaluation.
Bronchi* ; Bronchoscopy ; Cough ; Female ; Humans ; Hypertension, Pulmonary* ; Infant ; Infant, Newborn* ; Parturition ; Persistent Fetal Circulation Syndrome ; Pneumonia ; Pulmonary Atelectasis ; Respiratory Sounds ; Trachea