No abstract available.
Child* ; Down Syndrome* ; Humans

One of the most difficult problems confronting the orthopedic surgeon today is what to do when faced with a large defect in a peripheral nerve. Recent advances in engineering and neurophysiology have improved our technical ability to understand the consequences of severing a nerve. We have treated a large traumatic ulnar nerve defect with microsurgical nerve graft technique. In a follow-up study of twehre monthes post surgery, the results were satisfactory.
Follow-Up Studies ; Neurophysiology ; Orthopedics ; Peripheral Nerves ; Transplants ; Ulnar Nerve

OBJECT: In order to compare several Obstetric characteristics and outmmes of teenage pregnancy. METHODS: The 10 year clinical records of 11,583 women undergoing Cesarean section and delivery were reviewed in the department of Obstetrics and Gynecology, Incheon Christian Hospital from July 1, 1989 to June 30, 1999. There were seventy-eight pregnancies under age 20 and we compared them with two hundred pregnancies aged 20-29 who were randomly chosen during the same periods as the control group. RESULT: The following results were obtained. The proportion of birth by teenagers increased from 0.5% of all birth in 1989 to 2.61% in 1999. The most of cases were in high teen group, age 14- 19.The majority(50.5%) were in the age of 19. Seventy two cases(92.3%) had no previous pregnant history. Six cases had one previous pregnant history. The frequencies of prenatal care were significantly lower than that of the control group(p<0.05). The mean gestational period was 36+4weeks, and showed significant difference between the study group and the control group(39+3 weeks). The incidence of preterm labor was significantly different between the two proups(p<0.05). But the incidence of postterm delivery were not significantly different between the two groups. The mean weight gain of pregnant teenagers revealed 10.64kg, significantly less profound than the control group. The matemal weight gain of control group revealed 12.95kg, respectively. The mean birth weight(2.54kg) of infant was significantly less profound than the control group. The incidence of birth of small for gestational age(birth weight 1,500-2,499gm ; 14.5%) was significantly increased among study group than the control group(1%). The rate of abdominal delivery(21.8%) were not significantly decreased than the control group(47%). The incidence of cephalopelvic disproportion and malpresentation for cesarean section were somewhat higher than the control group, and were statistically significant(p<0.05). During the antepartun period, anemia, pyelonephritis, and preterm labor occurred more frequently in the teenage pregnancy than the control group, but not statistically significant. Among postpartum complications, incidence of anemia(51.3%) increased significantly. The perinatal mortality, intrauterine growth retardation, congenital anomaly occurred more frequently than the control group. CONCLUSION: These results show that pregnancy of teenage will be comeout high risk and complications. And then we will be more concern and study about teenage pregnancy.
Adolescent ; Anemia ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gynecology ; Humans ; Incheon ; Incidence ; Infant ; Obstetric Labor, Premature ; Obstetrics ; Parturition ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Pregnancy in Adolescence* ; Prenatal Care ; Pyelonephritis ; Weight Gain

Serial platelet counts performed at four day intervals on forty two healthy premature infants whose birth weights were less than 2200 grams. The forty two infants were divided into two groups: twelve premature infants weighing less than 1700 grams, and thirty prematures infants weighing over 1700 grams at birth. We evaluated the length of time for the platetet counts of the premature infants to equal that of the full-term infants. Platelet counts also were determined on ninety-nine healthy full-term infants during twenty one days of age. The platelet counts were repeated twice a day. The counts of the twenty-four healthy premature infants and the twenty-two healthy full term infants were compared using the Brecher-Cronkite method. 1) There was no significant differnce in platelet counts between twenty four healthy premature infants and twenty two healthy full-term infants obtained at birth and four hour of life by the method of Brecher-Cronkite and the error of platelet Counts was within 2.4 percent. 2) There was no significant difference in the mean platelet values between premature infants weighing less than 1700 grams(21200/mm3) and weighing over 1700 grams (21900/mm3)during first day of life. It was noted the mean platelet values of forty two premature infants were significantly lower than that of sixty eight full term infants which was 27500/mm3. 3) At nine days of life, the mean platelet values of the forty two premature infants equaled that of the sixty eight full term infants at leveles of 27500/mm3. The platelet values were increase continuously and reached peak level of 370000/mm3at the age of three weeks. Increase of platelet values in premature infants weighing less than 1700 grams at birth was delayed about one week compared with that of the infants over 1700 grams at birth.
Birth Weight ; Blood Platelets* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Parturition ; Platelet Count*

We report a mild variant of hypomelia-hypotrichosis-facial hemangioma syndrome in a 3 month-old female. The patient showed major features of the previously reported cases including flexion deformities of both upper extremities, sparse light colored hair, mid-facial hemangioma and a characteristic facial appearance. Roentgenogram showed radio-humeral synostosis at both elbow joints by which shortening of upper limbs could be anticipated. However, intra- and extrauterine growth retardation were not remarkable and the lower limbs were not affected.
Congenital Abnormalities ; Elbow Joint ; Female ; Hair ; Hemangioma* ; Humans ; Hypotrichosis ; Lower Extremity ; Synostosis ; Upper Extremity

With the development of spinal fusion and internal fixation, rehabilitation mediclne, urinary control and antibiotics, the outlook for patients with cervical spine injuries has brightened considerably, as compared with half a century ago. However, splnal cord injury still remains as one of the most devastating accidents that man can Incur and still survive. There is increasing tendency to stabllize unstable cervical spine injuries surglcally for the benefit of early mobilization,.early rehabilitation, easy nursing care, and rigid stability of the spine. A clinical study was performed on 72 patients with 76 fractures and fracture-dislocatlons of the cervical spine, who were hospitalized and treated at Severance Hospital during the period between January 1970 and December 1978 and the following results were obtained. 1. The prevalent age distribution was between 30 and 50 years of age (59.7%), and the ratio between males and females was 5:1. The most common cause of injury was falling from a height (51.4%). 2. In overall patients, neurologic damage was found at first examination in 69.4%, and among these, complete paralysis below the injured level In 41.7%, incomplete paralysis in 25%, and nerve root injury in 2.7%. 3. The mechanisms of injury included flexion-rotation (50%), extension-distraction (18%), flexion-compression (12.5%), pure flexion (5.5%), axial compression (5.5%), and unclassified (8.3%). 4. Among 72 patients, emergency decompressive laminectomy was performed on 10 patients, anterior interbody fusion on 15 patients, posterior fusion with wiring on 3 patients and the rest of patients were treated conservatively. 5. There was no significant difference in the recovery of neurologic loss between conservatively and surgically treated patients, but it was thought better to stabilize the unstable fracture-dislocations surgically for early mobilization and rehabllitatlon.
Accidental Falls ; Age Distribution ; Anti-Bacterial Agents ; Clinical Study ; Early Ambulation ; Emergencies ; Female ; Humans ; Laminectomy ; Male ; Nursing Care ; Paralysis ; Rehabilitation ; Spinal Fusion ; Spine

PURPOSE: To analyze and compare the clinical characteristics of patients with herpes zoster ophthalmicus (HZO) by age groups on the basis of the age of 60. METHODS: Medical records of patients with HZO who visited Chonbuk National University Hospital from February 1, 2002 to February 28, 2011 were reviewed. The patients with follow-up of three months or more were divided into two groups: patients under 60 and patients with 60 years old and over. The clinical characteristics between two groups were examined through the analysis of their medical records. RESULTS: Among a total of 63 patients, 29 patients (46%) were under 60 years old, and 34 patients (54%) were 60 years old and over. Incidence of HZO highest in the sixties. The sex and intrusion of each group showed no difference. Younger patients had a higher incidence of pseudodendrite by HZO (86.2% vs. 58.8%, p = 0.014) compared with older patients who showed a higher incidence of post herpetic neuralgia (13.8% vs. 35.3%, p = 0.046). As patients showed Hutchinson's sign, they often had more ocular complications such as pseudodendrite (100% vs. 64.7%, p < 0.05), uveitis (41.7% vs. 7.8%, p = 0.04), and conjunctivitis (100% vs. 90.2%, p = 0.02). CONCLUSIONS: Herpes zoster ophthalmicus shows different clinical characteristics according to patients' age and requires appropriate treatment. Especially elderly patients showing Hutchinson's sign should be treated early and aggressively enough.
Aged ; Conjunctivitis ; Follow-Up Studies ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Incidence ; Medical Records ; Neuralgia ; Neuralgia, Postherpetic ; Uveitis

BACKGROUND: There has been a lot of changes in prehospital medical environment with development of EMSS(emergency medical service systems). Especially in out-of-hospital cardiac arrest, the patients could survive when they are moved to the hospitals earlier. The purpose of this research is to know the status of EMSS in Korea by analyzing CPR(cardiopulmonary resuscitation) outcomes of out-of-hospital cardiac arrest patients at 3 hospital in the western area of Seoul and Incheon. METHODS: From July 1997 to June 1998, we collected data about out-of-hospital cardiac arrest victims at Ewha Womens University Mokdong Hospital, Catholic University Medical College St. Mary Hospital, and Kachon University Chung Ang Gil Hospital. We used same record form based on the 'Utstein Style'. RESULTS: CPR were performed in 265 out-of-hospital cardiac arrest patients at 3 hospitals. One hundred twelve(42.3%) patients recovered the spontaneous circulation at least once and eight(3.0%) patients discharged alive. One hundred ninety four(73.2%) patients died of medical causes, one hundred two(38.5%) cardiogenic and ninety two(34.7%) non-cardiogenic, and seventy(26.4%) patients died of traumatic causes. Initial EKG showed VT/VF(ventricular tachycardia/ventricular fibrillation) in thirty one(11.7%) patients, asystole in one hundred fifty one(57.0%) patients and other rhythms in eighty three(31.3%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. CONCLUSION: Overall survival rate of out-of-hospital cardiac angst patients was 3% which was poorer than that of the western country. The proportion of the cardiogenic cause was 3% which was only hart of the western country. VT/VF is relatively not common as a initial EKG rhythm. These differences might be due to difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS.
Cardiopulmonary Resuscitation ; Electrocardiography ; Female ; Heart Arrest ; Humans ; Incheon ; Korea ; Out-of-Hospital Cardiac Arrest* ; Prevalence ; Seoul ; Survival Rate

PURPOSE: To develop a Critical Thinking Skill Test for Nursing Students. METHODS: The construct concepts were drawn from a literature review and in-depth interviews with hospital nurses and surveys were conducted among students (n=607) from nursing colleges. The data were collected from September 13 to November 23, 2012 and analyzed using the SAS program, 9.2 version. The KR 20 coefficient for reliability, difficulty index, discrimination index, item-total correlation and known group technique for validity were performed. RESULTS: Four domains and 27 skills were identified and 35 multiple choice items were developed. Thirty multiple choice items which had scores higher than .80 on the content validity index were selected for the pre test. From the analysis of the pre test data, a modified 30 items were selected for the main test. In the main test, the KR 20 coefficient was .70 and Corrected Item-Total Correlations range was .11-.38. There was a statistically significant difference between two academic systems (p=.001). CONCLUSION: The developed instrument is the first critical thinking skill test reflecting nursing perspectives in hospital settings and is expected to be utilized as a tool which contributes to improvement of the critical thinking ability of nursing students.
Education, Nursing/*methods ; Female ; Humans ; Interviews as Topic ; Male ; *Program Development ; Questionnaires ; Students, Nursing/*psychology ; *Thinking ; Young Adult

Verrucous carcinoma is a slow growing, low grade squamous cell carcinoma, which usually occurs on oropharynx, genitalia and soles. When it occurs on feet, it is known as epithelioma cuniculatum. Epithelioma cuniculatum is characterized by its histologic sinuses and cystic formations in a cuniculate(rabbit burrow-like) pattern. A 59-year-old man was consulted to our department for a well circumscribed, 5 × 5 cm sized, round, hyperkeratotic, verrucous plaque on the right great toe. He suffered from diabetes mellitus for 16 years and was managed by peritoneal dialysis three times a week due to chronic renal failure for last two years. The plaque had gradually increased in size. The biopsy specimen taken from the tumor mass showed chronic ulcerative inflammation with atypical squamous cell proliferation. We herein report a case of verrucous carcinoma occurring in a patient with diabetes melli-t tus and chronic renal failure.
Biopsy ; Carcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Cell Proliferation ; Diabetes Mellitus* ; Foot ; Genitalia ; Humans ; Inflammation ; Kidney Failure, Chronic* ; Middle Aged ; Oropharynx ; Peritoneal Dialysis ; Toes ; Ulcer