No abstract available.
Funnel Chest*

PURPOSE: Cerebral palsy or hearing disability of hyperbilirubinemic complication was reduced by blood exchange transfusion(BET) and phototherapy(PT). But in spite of these treatment, abnormal Auditory Brainstem evoked Response(ABR) finding after BET or PT and neurodevelopmental defect due to chronic bilirubin encephalopathy were observed. So we have studied risk factors and outcome of chronic bilirubin encephalopathy after BET, and treatment of hyperbilirubinemia. METHODS: We have analyzed clinical characteristics, the finding and change of ABR after BET in 17 hyperbilirubinemic neonates, and in 8 hyperbilirubinemic neonates who were treated by phototherapy and 15 normal control neonates. RESULTS: 1) Mean bilirubin concentraion were 27.5+/-4.1mg/dL in BET group and 22.1+/-2.3 mg/dL in PT group. There were no difference of clinical findings between BET and PT group. 2) Change of ABR (1) Wave I loss resulted in 4 neonates, wave III loss in 3 neonates, and wave V loss in 2 neonates in BET group(P<0.05). (2) Wave I peak latency and hearing threshold in BET group were significantly increased more than normal control group(P<0.01). 3) In 10 neonates(58.8%) among 17 BET group, 4 neonates(50%) in 8 PT group were observed abnormal initial ABR finding after jaundice treatment. Age at treatment and duration of jaundice(interval between onset of jaundice and treatment) in abnormal ABR group were significant prolongation compared with normal ABR group(P<0.05). 4) Chronic bilirubin encephalopathy(CBE) was observed in 3 neonates(17.6%) among 17 BET group and showed higher of bilirubin level than normalized group after BET (31.1mg/dL vs 26.6mg/dL), other clinical findings showed no significant differences. CONCLUSION: Bilirubin level was significantly elevated in CBE more than in BET group and duration of jaundice, age at treatment were longer in abnormal ABR group than in normal ABR group. So not only bilirubin level but also duration of jaundice shoud be considered at jaundice treatment, and ABR has a potential utility in detection of acute brain toxicity of bilirubin and follow up evaluation of bilirubin encephalopathy.
Bilirubin ; Brain ; Brain Stem ; Cerebral Palsy ; Follow-Up Studies* ; Hearing ; Humans ; Hyperbilirubinemia ; Infant, Newborn* ; Jaundice ; Kernicterus ; Phototherapy* ; Risk Factors

No abstract available.

No abstract available.
Humans ; Infant, Newborn*

In order to investigate the risk factors of retinopathy of prematurity, we retrospectively reviewed the medical records of 153 premature badies alive and born in our hospital between October 1994 and January 1997. We performed analysis on birth weight, gestational age, duration of oxygen therapy, duration of oxygen therapy more than 40 percent, maxinmum and mean value of oxygen pressute and mean value of carbon dioxide pressure from arterial blood gas analysis in the first 2 weeks, the presence of multiple birth, surfactant therapy, corticosteroid therapy, and intraventricular hemorrhage. In univatiate analysis, birth weight, duration of oxygen therapy, value of oxygen pressure and mean value of carbon dioxide pressure from arterial blood gas analysis in the first 2 weeks, surfactant therapy, and corticosteroid therapy were statistically significant(p<0.05). Howeverm, in stepwise logistic regression analysis to correct the correlations in multiple variables, only birth weight and duration of oxygen therapy were significant risk factors in 95% confidence interval( 0.05, p<0.05). Birth weight, duration of oxygen therapy, and maximum value of oxygen pressure from arterial blood gas analysis in the first 2 weeks were significant risk factors in 90% confidence interval( 0.1, p<0.1).
Birth Weight ; Blood Gas Analysis ; Carbon Dioxide ; Gestational Age ; Hemorrhage ; Humans ; Logistic Models ; Medical Records ; Multiple Birth Offspring ; Oxygen ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors*

There has been so much controversies about the position of upper and lower jaws, and their first permanent molars in normal occlusion and Angle's class I,II,III malocclusions. So, the purpose of this study is to compare the position of upper and lower jaws, and their first molars in normal occlusion and Angle's class IIIIII malocclusions by lateral cephalometric analysis. The sample consisted of one hundred and twenty girls(thirty in each group) who had completed growth. The findings of this study were as follows: 1. In class I malocclusion, both maxilla and mandible were slightly posterior position than normal occlusion, but they showed harmonious relationship. 2. In class II malocclusion, the mandible was greatly retruded, and the maxilla was also slightly retruded to the cranial base as compared with normal occlusion. 3. In class III malocclusion, the maxilla was significantly retruded to the cranial base, but no significant difference was found in mandibular position as compared with normal occlusion. 4. The maxillary first molar was located at posterior position in class II malocclusion, and anterior position in class III malocclusion to the cranium, so that the rotation of mandible was influenced by that. 5. The mandibular first molar showed constant relationship to the mandible in all four groups, but different position to the cranial base in direct proportion to the mandibular position. 6. On the treatment planning of class II malocclusion, it seems to be better to promote the mandibular horizontal growth by inhibiting the vertical growth of maxillary molar area, and on the treatment planning of class III malocclusion, it seems to be better to promote the antero-inferior growth of maxilla and to promote the mandibular vertical growth by inducing the vertical growth of maxillary molar area.
Jaw* ; Malocclusion* ; Mandible ; Maxilla ; Molar* ; Skull ; Skull Base

CHARGE syndrome, first described by Pagon, was named for its six major clinical features. They are: coloboma of the eye, heart defects, atresia of the choanae, retarded growth and development including CNS anomalies, genital hypoplasia and/or urinary tract anomalies, and ear anomalies and/or hearing loss. We experienced three cases of CHARGE syndrome who displayed ocular coloboma, heart defects, retarded growth and development, and external ear anomalies, and we also review the previously reported literature concerning CHARGE syndrome.
Abnormalities, Multiple*/genetics ; Abnormalities, Multiple*/diagnosis ; Brain/abnormalities* ; Case Report ; Child, Preschool ; Choroid/abnormalities* ; Coloboma/genetics ; Coloboma/diagnosis* ; Ear, External/abnormalities ; Entropion/genetics ; Entropion/diagnosis ; Exotropia/genetics ; Exotropia/diagnosis ; Exotropia/congenital ; Facial Paralysis/genetics ; Facial Paralysis/congenital ; Female ; Heart Defects, Congenital/genetics ; Heart Defects, Congenital/diagnosis* ; Human ; Infant ; Karyotyping ; Male ; Mandible/abnormalities* ; Retina/abnormalities* ; Syndrome

BACKGROUND: One of major weakness in medical education in Korea is clinical skills has not been uniformly well taught during undergraduate period. To reinforce the basic clinical skill education, we developed introduction to clinical medicine(ICM) course In this study, we described the ICM course development process and the experience. METHODS: We performed comprehensive literature review related to ICM and doctoring curriculum. ICM/OSCE sub-commitee members discussed several time to develop the course. To assess the level of accomplishment of this course, we got feedback from 115 third year medical students by questionnaires. RESULTS: ICM was composed of 9 topics which covers the basic clinical skills. For each topic, three hours per week was allocated, one hour for didactic session and the other 2 hours for practical exercise. Standardized patients were used to teach interview skill. Most of students revealed history taking, abdominal examination, musculo-skeletal system, and interview skill session were valuable learning experience. However, for Gynecology and Pediatric session which were taught by mainly lectures, students evaluated them negatively. INTERPRETATION: This year, we focused on teaching basic clinical skills at ICM. However, our ultimate goal is to develop the ICM course which can allow the students to learn both the art and the science of Medicine.
Clinical Competence* ; Clinical Medicine* ; Curriculum ; Education ; Education, Medical ; Gynecology ; Humans ; Korea ; Learning ; Lectures ; Students, Medical ; Surveys and Questionnaires

To evaluate the degree of fibrovascular ingrowth in hydroxyapatite orbital implant, we performed gadolinium-enhanced T1 weighted magnetic resonance imaging in 10 eyes elapsed 6 months after hydrovyapatite implantation and on 6 eyes at 1, 2, 3, 4, and 6 months after hydroxyapatite implantation, and calcualted the volume of enhanced area. In 10 eyes elapsed 6months after hydroxyapatite implantation, all showed enhancement over 90%(average, 93.6%). In 6 eyes examined at 1, 2, 3, 4, and 6 months after hydroxyapatite implantation, the average percentage of enhanced area was 73.2% at 1 month, 76.0% at 2 months, 80.0% at 3 months, 89.8% at 4 months, and 92.0% at 6 months. the enhanced volume was over 90% at 4 months after the implantation in almost all cases. In hydroxyapatite orbital implantation done by our modified procedures, we suggest that the drilling for peg placement is possible 4 months after the implantation.
Durapatite* ; Magnetic Resonance Imaging* ; Orbit* ; Orbital Implants*

To evaluate the effect of ascorbate on cell death induced by ultraviolet A, cultured human ciliary body epithelial cells were exposed the UV-A at energy level of 10 and 30J/cm2. Before and after UV-A exposure the experimental group was treated with 250 microgram/ml L-ascorbate while the control group was not. Cell viability was 87.3% in the control group and 97.1% in the experimental group at energy level of 10J/cm2UV-A. Cell viability was decreased to 38.8% in the control group and 73.5% in the experimental group at energy level of 30J/cm2 UV-A. The cells in the experimental group were less affected. This phenomenon was also observed by light microscope. The degree of apoptosis was 4.68% in the control group and 4.11% in the experimental group at the level of 10J/cm2 UV-A. The apoptosis was increased to 11.01% in the control group and 4.16% in the experimental group at the level of 30J/cm2 UV-A. On electron microscope necrosis and apoptosis induced by UV-A were observed in both groups but the degree of cell death was much less in the experimental group. In conclusion, L-ascorbate has a role of decreasing cell death induced by UV-A in ciliary body epithelial cells.
Apoptosis ; Cell Death* ; Cell Survival ; Ciliary Body* ; Epithelial Cells ; Epithelium* ; Humans ; Necrosis