Neurofibromatosis is an autosomal dominant abnormality that may affect multiple organ systems. The eyelids, the orbits, the adjacent tissues and bones may be involved with varying frequency and severity. The management of orbitotemporal neurofibromatosis depends very much on the type and severity of the orbital involvement and on the functional state of the eye. Experience with surgical management of orbitotemporal neurofibromatosis involved in the orbit, the temporal soft tissue and bone with blind eye is reported. The goal of surgery is tumor resection, reconstruction of the orbital socket, aesthetic eyelids, and insertion of the artificial prosthesis. A two stage approach is recommended. In the first stage, tumor is resected and the orbital socket is reconstructed with titanium mesh plate and cranial bone graft. After reconstruction of the orbital socket, galeal flap is rotated posteriorly to cover the mesh plate and canthopexy is accomplished. Mask lift is performed to enhance aesthetics. In the second stage, correction of the bulky eyelids is achieved and orbital space for insertion of the artificial prosthesis is reconstructed. Authors have managed a orbitotemporal neurofibromatosis with blind eye of a 41-year-old male using titanium mesh plate and bone graft with satisfactory results.
Adult ; Esthetics ; Eyelids ; Humans ; Male ; Masks ; Neurofibromatoses* ; Neurofibromatosis 1 ; Orbit ; Prostheses and Implants ; Titanium ; Transplants

No abstract available.
Anterior Cruciate Ligament* ; Autografts* ; Polyethylene*

PURPOSE: In addition to regulating calcium and phosphorus homeostasis and bone metabolism, vitamin D is known as an immune modulator. Recently, there has been increased worldwide interest in the association between low levels of vitamin D and allergic diseases. The purpose of this study was to assess the relationship between serum vitamin D levels and allergic/vasomotor rhinitis (AR/VR) in children. METHODS: This study included 164 patients. The sample included 59 patients with AR, 42 patients with VR, and 63 controls. Their ages ranged from 0 to 16 years. We examined the levels of 25-hydroxyvitamin D, Immunoglobulin E, specific IgE, and eosinophil cationic protein; peripheral blood eosinophil count; and the results of a skin prick test. RESULTS: Serum 25-hydroxyvitamin D levels were 19.0+/-8.5 ng/mL in the AR group, 25.5+/-10.9 ng/mL in the VR group, and 26.9+/-10.7 ng/mL in the control group. After adjustment for body mass index and season at the time of blood sampling, vitamin D levels in the AR group were lower than those of the VR group (P=0.003) and control group (P<0.001). Vitamin D levels were inversely correlated with Immunoglobulin E levels (r=-0.317, P<0.001). AR patients with food allergy or atopic dermatitis did not have lower levels of 25-hydroxyvitamin D than AR patients without these diseases. CONCLUSION: This study demonstrates a possible relationship between vitamin D levels and allergic rhinitis in Korean children.
Body Mass Index ; Calcium ; Child* ; Dermatitis, Atopic ; Eosinophil Cationic Protein ; Eosinophils ; Food Hypersensitivity ; Homeostasis ; Humans ; Immunoglobulin E ; Immunoglobulins ; Metabolism ; Phosphorus ; Rhinitis ; Rhinitis, Vasomotor* ; Seasons ; Skin ; Vitamin D* ; Vitamins*

A Comparative study was retrospectively performed with 374 infants in order to find protective effect of breast feeding for infection. This study shows that breast feeding protect infant against gastrointestinal and respiratory infection. Breast feeding offers advantage by reducing gastraintestinal and respiratory infection when they should maintain breast feeding for at least three months. 1) First year morbidity increased with extent of artificial feeding and was nearly two fold for babies not breast-fed. 2) Prescence of older sibling, low birth weight and male sex are associated with increased morbidity. 3) Infant illness from 0~3 months, 4~6 months, 7~10 months, 11~12 moths was analyzed. Compared with the 108 bottle fed babies, the babies who had been partially (40) or fully (136) breast fed had significantly lower rate of gastrointestinal illness at 7~10 month (p<0.05), 11~12 month (p<0.005) and respiratory illness at 7~10 month (p<0.05). 4) Between the early weaning group (90) and the bottle group (108) showed no siggnificant difference. 5) Among the babies observed throughout the first year of life, 35 (9%) and 46 (12) were admitted to hospital with gastrointestinal and respiratory infection. Babies who were breast fed for more than 3 month had significant lower rate for hospital admission due to gastrointestinal and respiratory infection when compared with bottle fed babies. Breast feeding durning more than 3 month of life confers protection against gastrointestinal and respiratory infection.
Breast Feeding* ; Breast* ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Moths ; Nutritional Support ; Retrospective Studies ; Siblings ; Weaning

PURPOSE: This study describes the experience of using multiple types of visual educational tools in the setting of problem-based learning (PBL). The author intends to demonstrate their roles in diverse and efficient ways of clinical reasoning and problem solving. METHODS: Visual educational tools were introduced in a lecture that included their various types, possible benefits, and some examples. Each group made one mechanistic case diagram per week, and each student designed one diagnostic schema or therapeutic algorithm per week, based on their learning issues. The students were also told to provide commentary, which was intended to give insights into their truthfulness. Subsequently, the author administered a questionnaire about the usefulness and weakness of visual educational tools and the difficulties with performing the work. Also, the qualities of the products were assessed by the author. RESULTS: There were many complaints about the adequacy of the introduction of visual educational tools, also revealed by the many initial inappropriate types of products. However, the exercise presentation in the first week improved the level of understanding regarding their purposes and the method of design. In general, students agreed on the benefits of their help in providing a deep understanding of the cases and the possibility of solving clinical problems efficiently. The commentary was helpful in evaluating the truthfulness of their efforts. Students gave suggestions for increasing the percentage of their scores, considering the efforts. CONCLUSION: Using multiple types of visual educational tools during PBL can be useful in understanding the diverse routes of clinical reasoning and clinical features.
Humans ; Learning ; Problem-Based Learning ; Surveys and Questionnaires

During mechanical ventilation in the intensive care unit, auto-positive end-expiratory pressure (auto-PEEP) has been reported to occur in obstructive airway conditions aggravated by inappropriate ventilator settings. In this paper, we report a case of auto-PEEP-like problem during anesthesia, mainly caused by excessive sputum. After being positioned prone for spine surgery, the patient received pressure controlled ventilation at a low fresh gas flow rate. One hour after the start of surgery, sudden decreases in pressure and flow occurred. The typical maneuvers which could be performed by the anesthesiologists in the situations suggesting leakage within the breathing circuit consist of pressing the oxygen flush valve and manual hyperventilation for the initial evaluation. But from our experience in this case, we have learned that such maneuvers could cause unacceptable aggravation in the event of auto-PEEP. Also in this report, we discuss the difficulties in prediction based on the present knowledge of preoperative evaluation and the presumably best management policy regarding this type of auto-PEEP.
Anesthesia* ; Humans ; Hyperventilation ; Intensive Care Units ; Oxygen ; Positive-Pressure Respiration, Intrinsic ; Respiration ; Respiration, Artificial ; Spine ; Sputum ; Ventilation* ; Ventilators, Mechanical

A case of foreign body (a piece of wood) in the bladder by penetrating perineal injury was presented in a 13 years old Korean boy and reported with review of literature.
Adolescent ; Foreign Bodies* ; Humans ; Male ; Urinary Bladder*

Cardiopulmonary resuscitation is frequently required for severely depressed congenital diaphragmatic hernia patients. If the exact condition of the patient is not diagnosed prior to delivery, fatal complications such as tension pneumothorax occur often during the resuscitation process. In this case we report the difficulties in diagnosing congenital diaphragmatic hernia and the unusual responses and complications during cardiopulmonary resuscitation. We should know the various methods of management developed over the recent 10 years for these highly stressed patients.
Cardiopulmonary Resuscitation ; Heart Arrest* ; Hernia, Diaphragmatic* ; Humans ; Pneumothorax ; Resuscitation

We examined the anatomical position of the mental foramina in mandibles foramen normal adult Koreans. 1. The percentages obtained from the study of the relationships between the mental foramen and the lower teeth showed that the most common location was type lv in which the mental foramen lay at the apex of the second promolar. The foramen between thr apices of ice two premolars (type lll) and the foramen between the second premolar and the first molar (type v) occured often and less often rspectively and find no foramen mesial to the first premolar or at the apex of the first premolar and posterior of the first molar (type l, ll, vl). 2. The study of relationship of the mental foramen to the bo of the mandible revealed that mental foramen was situated closer to the lowed border of the mandibular body. The distance ratio between the mental foramen and the alveolar crest to that between the mental foramen and the lower border was approximately 1.2 : 1. The height of the mandibular body was 31.09±2.80mm on the left side and 30.97±2.48mm on the right. 3. The distance from the mandibular symphysis to the anterior border of the mental foramen measured 29.52±2.01mm on the left, 30.82±2.04mm on the right side, and from the mandibular symphysis to the posterior border of the mandibular ramus was 104.20±4.74mm on the left, 105.44±4.49mm on the right side. It indicates that the mental foramen lies approximately at one-fourth of the distance from the mandibular symphysis to 2017-04-19 the posterior border of the ramus. 4. The distance from the superior border of the mental foramen to the bottom of the lower second premolar socket was found to be positive. It was 5.46±3.09mm on the left, 5.73±3.03mm on the right side. This indicates that the bottom of the lower second premolar socket is slightly higher than the superior border of the mental foramen.
Adult* ; Bicuspid ; Humans ; Ice ; Mandible* ; Molar ; Tooth

Amniotic embolism is a fatal disease with an abrupt onset and rapidly deteriorating clinical course. Its clinical features are various and the prediction of its occurrence is very difficult. Understanding its pathogenetic mechanisms has increased over the past two decades. We report on a case of amniotic embolism along with its full clinical manifestations after a normal delivery in the young primigravida.
Embolism*