PURPOSE: Neonatal hyperbilirubinemia has benign courses in most cases, but the possibility of toxicity of hyperbilirubinemia required courses examination of every newborn infant to identify the severity of hyperbilirubinemia progress. This study aims to see how the body surface area of newborns influences the decline rate of serum bilirubin level in conventional phototherapy. METHODS: Based on the charts of the Pediatrics Department, Dae-Dong Hospital from January 2003 to December 2006, we analyzed 168 neonates diagnosed as neonatal hyperbilirubinemia (serum bilirubin > or =15 mg/dL) in retrospective way. We excluded newborn infants under 37 weeks of gestation and under 2,500 g birth weight and classified neonates into four groups by the calculation results of body surface area:males above 75 percentile (group A), males below 25 (group B), females above 75 (group C), and females below 25 (group D). RESULTS: Out of 168 samples, the number of group A, B, C, D was 30, 20, 20, 15 respectively. In conventional phototherapy, the mean decline rates of serum bilirubin of group B and D recording 2.09 mg/dL/day and 1.77 mg/dL/day, were significantly faster than those of group A and C recording 1.63 mg/dL/day and 1.41 mg/dL/day (P<0.01). No significant differences were found in different duration of phototherapy between groups below 25 percentile and those above 75 in both genders. CONCLUSION: In conclusion, body surface area influences of infants the decline rate of serum bilirubin level in conventional phototherapy.
Bilirubin* ; Birth Weight ; Body Surface Area* ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn ; Male ; Pediatrics ; Phototherapy* ; Pregnancy ; Retrospective Studies

p53 gene alterations in the ovarian cancers are regarded as early events in the whole process of carcinogenesis. This study is intended to compare p53 protein expression rate in the ovarian surface epithelial tumors according to histologic types, degree of malignancy and differentiation. 134 cases of ovarian epithelial tumors including 26 cases of serous cystadenoma, 7 cases of serous borderline malignancy, 15 cases of serous cystadenocarcinoma, 40 cases of mucinous cystadenoma, 21 cases of mucinous borderline malignancy, 20 cases of mucinous cystadenocarcinoma, 4 cases of endometrioid carcinoma, and 1 case of clear cell carcinoma were studied. Immunohistochemistry using monoclonal p53 antibody(DO-7) was applied to the routine formalin-fixed paraffin embedded tissue. The results were as follows; 1. No immunohistochemical positivity of p53 protein was found in all 66 cases of benign serous and mucinous tumors studied. 2. There was no significant difference of p53 protein expression between serous and mucinous malignant tumors. 3. The expression rate of p53 protein exhibited a statistically significant difference between borderline(42%) and malignant(74%) ovarian surface epithelial tumors (p<0.05). 4. The expression rate of p53 protein of poorly differentiated carcinomas(100%) was higher than those of moderately (88%) and well differentiated carcinomas(60%), but there was no statistical significance. In summary, p53 protein expression might be a good indicator of malignant transformation of the ovarian surface epithelial tumors.
Ovarian Neoplasms ; Genes, p53

The chondrogenic potential of free autogenous periosteal grafts for osteochondral defects was investigated at the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine. Five millimeter diameter of circular full-thickness defects were made in patellar groove of both femur in 64 adolescent rabbits and the rectangular periostei, prepared from the proximal tibiae, were placed over the defects of patellar groove and sutured(cambium layer, facing joint surface) and the rabbits were allowed to move actively. A serial gross and histologic examinations of neochondrogenesis were done during 8 weeks. The results were as follows. l. At 2 weeks after operation, neochondrogenesis was hardly seen either in the graft group or in the control group. The defects were partially filled with some fibrous tissue. 2. After 6 weeks of operation, all defects in the graft group(postop 6 weeks and 8 weeks) were filled with hyaline cartilage cells but only 38% (postop 6 weeks) and 44% (postop 8 weeks) of the control group were filled with hyaline cartilage cells. 3. The cartilages, formed at 6 and 8 weeks, were more mature and better than those formed at 4 weeks. 4. The newly formed hyaline cartilage of the graft group filled the defect earlier and were better than those of the control group. 5. The chondrocytes in the newly formed tissue were originated from the cambium layer of periosteal grafts. 6. Free autogenous periosteal grafts can repair a full-thickness defect in a joint surface by producing tissue that resembles articular cartilage grossly and histologically.
Adolescent ; Cambium ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Femur ; Gangwon-do ; Humans ; Hyaline Cartilage ; Joints ; Rabbits ; Tibia ; Transplants

PURPOSE: The purpose of this study was to determine an increase in the number of younger and middle-aged people who have a stroke and the differences in their recovery experience compared with older people. METHODS: The research question for this study was "What is the recovery experience of young adults and middle-aged people who suffer a stroke?". In order to answer the question, the grounded theory method was utilized. The data was collected through individual in-depth interviews of six participants, their age ranged from 36 to 45 years old. RESULTS: After comparative analysis, the core category was "standing up for oneself with limit". The experience process were categorized into four stages: 'Facing Reality stage', 'Motivation stage', 'Desire Recovery stage', 'Self-Overcoming stage'. CONCLUSION: Most of the research for the recovery process was prognostic in nature and the results. This study was demonstrated certain indicators which can be useful in further research.
Humans ; Middle Aged ; Recovery of Function ; Stroke ; Young Adult

STUDY DESIGN: In this study, 18 patients undergoing posterior lumbar interbody fusion for multilevel lumbar spinal stenosis associated with degenerative scoliosis were reviewed retrospectively. OBJECTIVES: To assess the effectiveness of the cage-instrumented posterior lumbar interbody fusion in multilevel lumbar spinal stenosis associated with degenerative scoliosis. SUMMARY OF LITERATURE REVIEW: Degenerative lumbar scoliosis with the problems of neurogenic claudication, mechanical back pain and spinal deformity present a challenge for treatment. MATERIALS AND METHODS: We reviewed 18 surgical cases of multilevel lumbar spinal stenosis with degenerative scoliosis from March 1995 to April 2000 with an average follow up period of 2.9 years. We assessed the radiographic results of scoliotic angle correction and sagittal angle correction of the maximum curve and fused segment and disc height restoration. Clinical results were evaluated according to the Kirkaldy-Willis criteria. RESULTS: Mean scoliotic angle at preoperative, postoperative and final follow-up (maximum curve/fused segment) was 17.7-6.1-7.3degree /15.0-5.8-6.1degree respectively. Mean sagittal angle corresponding to each period was 12.1-34.1-32.7degree /8.3-27.0-26.0degree respectively. Mean disc height corresponding to each period was 22.9-42.4-40.5% respectively. The clinical result was analyzed as 15 satisfactory (83.3%), 3 fair (16.7%) and no poor. Fusion success was achieved in all patients. There were no serious complications except one case of fusion extension distally and no significant curve progression within follow-up period. CONCLUSIONS: The cage-posterior lumbar interbody fusion in multilevel lumbar spinal stenosis with degenerative scoliosis was effective for correction of scoliotic and sagittal deformity and restoration of disc height with resultant foraminal patency, provided relatively high clinical success and in situ fusion success in all cases even over multiple fusion levels, and can be an alternative among surgical treatments of this complex disease.
Back Pain ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Retrospective Studies ; Scoliosis* ; Spinal Stenosis*

STUDY DESIGN: The preoperative and postoperative lateral radiograms and clinical results were analyzed in 22 cases of lumbar spinal stenosis with osteoporosis treated by posterior decompression and posterior lumbar interbody fusion. OBJECTIVES: To assess the efficiency of the cage-instrumented posterior lumbar interbody fusion in lumbar spinal stenosis with osteoporosis. SUMMARY OF LITERATURE REVIEW: Problems in surgical treatment of osteoporotic spinal stenosis were early screw loosening and early reversal to the original deformity because of insufficient mechanical stability in the bone-screw interface, and special strategy is essential for transpedicle screwing to sustain axial and screw cut-up load applied by flexion-extension motion in vivo. MATERIALS AND METHODS: We reviewed 22 cases of lumbar spinal stenosis with osteoporosis(Jikei grade I, II/III) from June 1996 to July 1998 with an average follow up period of 1.4 years. Inclusion criteria was combined segmental instability, deformity, spondylolisthesis and herniated nucleus pulposus with significant disc space narrowing. We asssessed the radiographic results of sagittal angle correction(SAC) of the instrumented segment and disc height restoration(DHR) on the preoperative, postoperative and last follow up lumbar lateral views, and clinical results according to the Kirkaldy-Willis criteria. RESULTS: Postoperative mean SAC gain was 10degree(p<0.05) and mean SAC loss at last follow up was 1.1degree(p>0.05). Postoperative mean DHR gain was 21.3%(p<0.05) and mean SAC loss at last follow up was 3.9%(p>0.05). The clinical result was analyzed as 2 excellent(9.1%), 16 good(72.7%), 4 fair(18.2%) and no poor. There were 2 intraoperative complications of a dural tear and a nerve root injury and 2 postoperative complications of a transient radiculopathy and a pseudoarthrosis. CONCLUSIONS: Cage-instrumented posterior lumbar interbody fusion can be an option for the lumbar spinal stenosis with osteoporosis requiring instrumentation because of instability, deformity or postdiscectomy anterior column deficiency.
Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Intraoperative Complications ; Osteoporosis* ; Postoperative Complications ; Pseudarthrosis ; Radiculopathy ; Spinal Stenosis* ; Spondylolisthesis ; Tears

PURPOSE: The proximal femoral fractures in children are rare but the complications are grave. The importance of this fracture is related to the frequency of complications. So authors evaluated the result of early surgical treatment of proximal femoral fracture. MATERIALS AND METHODS: From February 1993 to June 1997, authors have treated 8 cases of displaced proximal femoral fractures in children follow up, more than a year. We classified fracture type by Delbet's, and functional results by Ratcliff's. Internal fixation was done with smooth steinmann pins or small caliber cannulated screws. RESULTS: According to the Delbet's classification, the cases of type II, III, IV were 2, 5, 1. The average age was 7.3 years and boys were predominant (7 cases). Seven cases were treated by immediate anatomical reduction and internal fixation and one was delayed. The mean operation time was 52.7 minutes, duration of hip spica cast was 5.8 weeks and the time of union was 10.9 weeks in average. The mean time to partial weight bearing and full weight bearing were 10.3 and 13.9 weeks. The fixation devices were removed at 24.3 weeks in average. All cases were excellent. CONCLUSION: We suggest that immediate anatomical reduction and internal fixation is the one of the best way to reduce the frequency and severity of the complication of proximal femoral fractures and can expect good functional results in children.
Child ; Classification ; Femoral Fractures* ; Follow-Up Studies ; Hip ; Humans ; Pediatrics* ; Weight-Bearing

The lack of familiarity with vertebral actinomycosis by both clinicians and radiologists, may contribute to its frequent omission from the differential diagnosis of suspicious lesions, therefore the condition can be difficult to diagnose. We now present the first report of two cases of thoracic and lumbar vertebral actinomycosis resulting in a paraparesis due to epidural abscess which necessifated surgery.
Actinomycosis* ; Diagnosis, Differential ; Epidural Abscess ; Paraparesis ; Recognition (Psychology) ; Spine

BACKGROUND: The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO. METHODS: From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST. RESULTS: Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 ×109/L (range, 46 to 434 ×109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST. CONCLUSIONS: The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.
Anticoagulants ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Hemostasis, Surgical ; Heparin ; Humans ; International Normalized Ratio ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Retrospective Studies ; Tracheostomy*

No abstract available.
Female ; Meigs Syndrome*