No abstract available.
Bone Density* ; Child* ; Humans

PURPOSE: Antiepileptic drug (AED) therapy has been reported to induce immunological alterations in epileptic patients. However, despite extensive studies, the accumulated data are not consistent and there is still confusion and controversy over the effects of AEDs on the immune system. This study tries to elucidate the effects of anticonvulsant on some immune parameters, and serum concentration of IgA, IgG, IgM. METHODS: Thirty pediatric epileptic patients[Group A (n=12) : patients on carbamazepine, Group B (n=10) : patients on valproic acid and Group C (n=8) : patients on carbamazepine and valproic acid] were enrolled in this study and the levels of IgA, IgG, and IgM were determined before treatment and after 10 months of anticonvulsant therapy. Paired t-test was used to evaluate the data. p values<0.05 were considered significant. RESULTS: The mean serum concentratrions of IgG was elevated in patients receiving anticonvulsants (p<0.05) but mean concentrations of IgA and IgM were not different significantly. CONCLUSION: Our results demonstrate that anticonvulsants elevate the serum concentrations of IgG level, suggesting that anticonvulsants may increase humoral immunity and decrease the opportunity of infectious disease, thus decreasing the convulsion.
Anticonvulsants ; Carbamazepine* ; Child* ; Communicable Diseases ; Humans ; Immune System ; Immunity, Humoral ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Seizures ; Valproic Acid*

We examined 60 eyes of 60 patients after excimer photorefractive keratectomy(PRK) for myopia and analyzed the changes of central island on corneal topography for 6 months prospectively. These patients were divided into two groups according to the degree of myopia, group 1(26 eyes, 6 diopters or below by spherical equivalent) and group 2 (34 eyes, over 6 diopters). The occurrence rate of central island was 76.4% collectively, 87.5% in group 1, 67.7% in group 2 at 2 weeks after PRK. It decreased to 30.4%, 43.5%, and 21.1% respectively at 6 months after PRK and was lower in group 2 than group 1. However there was no statistically significant correlation between the reduction of central island size and improvement of corrected visual acuity in both groups. In conclusion, the central island disappeared and decreased the amount for six months follow-up period after PRK and seems to be no effect on the corrected visual acuity.
Corneal Topography ; Follow-Up Studies ; Humans ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Visual Acuity*

No abstract available.

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

The Taylor's approach is a special paramedian approach to enter the L5-S1 interspace. The L5-S1 interspace is the largest in vertebral column. This approach is particularly useful when the interspace has been narrowed by pathologic bone destruction such as rheumatoid arthritis or osteoarthritis. Surgery in geriatric patients is associated with a markedly higher incidence of perioperative complication or mortality rate. Optimal anesthetic management of geriatric patients depends on understanding of the normal anatomy and physiologic changes in response to drug in aging. We studied of 3-geriatric patients with Taylor's approach. These patients had problems with respiratory dysfunction and anatomic constraints, which make other approaches unfeasible.
Aging ; Arthritis, Rheumatoid ; Humans ; Incidence ; Mortality ; Osteoarthritis ; Spine

Korean hemorrhagic fever is an acute febrile illness which causes hemorrhagic nerrosis of multiple internal organs. Some orular symptoms are described by physicians without ophthalmic examination. The authors evaluated early ocular manifestations in 21 patients (42 eyes) with Korean hemorrhagic fever, who were admitted from Oct. to Nov. in 1984. The results are summarized as follows: 1. In eleven patients (22 eyes, 52.4%), visual disturbances caused by transitory myopia were observed. 2. During the period of transitory myopic change, the intraocular pressure in the group of refrartive change was significantly raised compared to that in the group of non-refrartive change. 3. In the group of refractive change, increasing intraocular pressure and a shallowing of the anterior chamber were observed accompanied by transitory myopic change. 4. During the earIy phase of the illness, lid edema, chemosis, conjunctival injection, subconjunctival hemorrhage, and macular edema were observed.
Eye Diseases/etiology ; Eyelid Diseases/etiology ; Hemorrhagic Fever with Renal Syndrome/*complications ; Humans ; *Intraocular Pressure ; Myopia/*etiology

No abstract available.

No abstract available.

Since the first report of completely amputated thumb replantation by Tamai in 1965, replantation surgery has been popularized with increasing success rate and improving functional regain. Recently, difficult replantation such as traction avulsion amputation has been challenged and good success rate and function have been reported. We have analized 34 cases of upper extremity and finger replantation in 23 patients, which were performed at the Dept. of Orthopedic surgery. Hyun Dai Hae Seong Hospital, Ulsan, Korea, from June 1982 to January 1986. The results were as follows: 1. Male patients were 22, female was 1, left upper limbs and digits injuries were more prevalent(16: 7), and average age was 25 years old. 2. The most common injury was done by cutting machine. 3. The number of amputations of fingers were almost same in all fingers and most prevalent in zone III(26 cases, Danial classification). 4. Success rate of replantation was 82.4% In cases of less than 6 hrs ischemic time, the rate was 93.4%, and more than 6 hrs ischemic time, rate was 33.3% 5. Performing arterial anastomosis prior to venous anastomosis, can find out main draining vein, and with one vein and one artery anastomosis, can get good results distal to zone IV. 6. Functional results were satisfactory, evaluating by modified. Tamai score, average 87.5. 7. 6 cases of digital replantations distal to sublimis tendon insertion have good results functionally, cosmetically and technically easy (Tamai score 98). 8. 5 cases of traction avulsion amputations needed many additional surgery to restore function, but end results were relatively satisfactory.
Amputation ; Arteries ; Clinical Study ; Female ; Fingers ; Humans ; Korea ; Male ; Orthopedics ; Replantation ; Tendons ; Thumb ; Traction ; Ulsan ; Upper Extremity ; Veins