It would be naive to assume that any operative procedure is the solution to the problem of sacral pressure sore in the field of the orthopaedic surgery. The procedures outlined here involve the creation of compound myocutaneous flaps of the gluteus maximus muscle, skin, and the subcutaneous tissue. The myocutaneous flap us- ing the gluteus maximus muscle is a vascular flap instead of a random flap, with better blood supply for healing and advantage of an increased amount of cushion effect. We present an alternative method which will provide satisfactory and substantial soft tissue coverage in sscral pressure sores.
Methods ; Myocutaneous Flap ; Pressure Ulcer ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Operative

Rhabdomyosarcoma which was first described by Weber has generally been considered asan uncommon tumor. Pack and Eberhart were of the opinion that rhabdomyosarcoma represented 13.9 percent of soft tissue sarcomata. Recently it was classified as four types such as pleomorphic, embryonal, botryoid and alveolar type by many authors. We have experienced two cases of embryonal rhabdomyosarcoma, one arised within left leg and the other within right foot. The former(3 months old, female) showed tumor mass at birth, the latter(13 months old, male) showed at 1 month after birth.
Chungcheongnam-do ; Foot ; Leg ; Parturition ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal

Primary malignant melanornn of the vagina is rare, with only about 130 reported cases worldwide. They presumably arise from melanocytes that are present in the vagina in 3% of normal wornen. Vaginal melanoma accounts for less than 1% of melanomas and less than 3% of primary malignant tumors of the vagina. Most of patients complain vaginal bleeding, vaginal discharge, foreign body sensation in order. The best treatment of vaginal melanoma rernains eni.gmatic, Many authors indicate that radical surgery may be the pcferred approach and the number of reported cases treated with radical surgery is increasing. But other author comment that no significant change in survival is apparent with radical surgery. Overall prognosis is poor as most patients have deeply penetrating lesions at the time of diagnosis. Recently, not only the effort to increase the survival rate but the quality of life including sexual function after treatment is becoming an important issue about treatment ot cancer patients. We experienced a case of primary malignant melanoma of the vagina treated with radical surgery and restored the sexual function by vulvovaginal reconstruction using gracilis myocutaneous flap. So we report this case with brief literature review.
Diagnosis ; Foreign Bodies ; Humans ; Melanocytes ; Melanoma* ; Myocutaneous Flap ; Prognosis ; Quality of Life ; Sensation ; Survival Rate ; Uterine Hemorrhage ; Vagina* ; Vaginal Discharge

No abstract available.
Bilirubin* ; Humans ; Infant, Newborn* ; Kernicterus*

Objectives: ：This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods: ：A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher’s exact test was used. Collected data was analyzed using R 4.03. Results: ：Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (χ2 =4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (χ2 =8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions ：The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

No abstract available.
Porphyria, Acute Intermittent* ; Pregnancy*

PURPOSE: To compare the prevalance and the amount of astigmatism between the epiblepharon patients who had been operated epiblepharon and normal school children. METHODS: The noncycloplegic refraction using autorefractor was performed in 120 epiblepharon patients from Jan. 1997 to June 2000. Astigmatism in excess of 0.5 D was studied. We compared the findings of epiblephron patients and 443 normal school children in Seoul. RESULTS: The prevalence of astigmatism was 72.9% in epiblephron group and 41.6% in normal children group, and the difference was statistically significant (P< 0.001). The amount of astigmatism was 1.52 D and 0.73 D in each group, and the difference was statistically significant (P< 0.001).The distribution of astigmatism showed 1.0 D or less in 22.5%, from above 1.0 D to 2.0 D or less in 26.3%, from above 2.0 D to 3.0 D or less in 10.8%, from above 3.0 D to 4.0 D or less in 9.6% and above 4.0 D in 3.8% in epiblepharon group and in normal children group 26.2%, 11.2%, 2.6%, 1.0%, and 0.7% respectively. The difference between both groups was statistically significant (P< 0.001). With-the-rule astigmaism was found in 77.9% and against-the-rule was 22.1% in epiblephron group and 72.8% and 27.2% respectively in normal children group. CONCLUSIONS: The prevalence and the amount of astigmatism were higher in epiblepharon group than in normal children group. It might be caused by the increase of orbicularis muscle tone and the effect of skin fold overriding lid margin in epiblepharon patients.
Astigmatism* ; Child* ; Humans ; Prevalence ; Seoul ; Skin

BACKGROUND: Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known as an effective neurosurgical procedure for the treatment of advanced Parkinson disease (PD). Although short- and long-term effects of STN stimulation in PD are relatively well known, an interim analysis of its efficacy is essential for us to continue with this procedure in the future. We present the clinical outcome of 6 month follow-up in patients who were assessed in our hospital after bilateral STN stimulation. METHODS: Twenty-nine patients with PD treated with bilateral STN DBS were included in this study. The effect of STN DBS was assessed at 6 months after surgery, which included the followings; motor disability in 'DBS- off/on, medication-off/on' states, activity of daily living (ADL) in 'medication-off/on' states, levodopa-induced motor complication, daily levodopa and levodopa-equivalent dosage, neuropsychological assessment and quality of life. RESULTS: Nineteen patients completed the follow-up assessment. STN stimulation produced significant improvements in the motor disability score both during 'medication-off' and 'medication-on' states. The ADL score was improved only in 'medication-off' states. The amount of levodopa-induced dyskinesia and response fluctuation also significantly decreased. Scores of Korean version of Mini-mental status examination (K-MMSE), Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) and Beck Depression Inventory (BDI) did not change. Daily levodopa and levodopa-equivalent dosages were significantly reduced. No serious side effect was encountered. CONCLUSIONS: Bilateral STN DBS is a relatively safe and beneficial treatment for PD patients with levodopa- induced motor complications. In order to obtain a better prognosis in the future, we should assess the long-term outcome and the clinical predictive factors of STN DBS.
Activities of Daily Living ; Alzheimer Disease ; Deep Brain Stimulation ; Depression ; Dyskinesias ; Follow-Up Studies ; Humans ; Levodopa ; Neurosurgical Procedures ; Parkinson Disease ; Prognosis ; Subthalamic Nucleus

BACKGROUND: When we make treatment plan of class III malocclusion children, it is difficult to determine whether we treat it with orthognathic surgery or without orthognathic surgery. To determine that, we must consider many factors, such as cephalometric analysis, growth pattern, family history, and skeletal age. A Harvold cephalometric analysis is useful in determining the amount of discrepancy by comparing the maxillary unit length with mandibular unit length. We tried this study to help the decision of treatment planning in class III malocclusion children by comparison in class III malocclusion and normal occlusion children using a Harvold analysis. MATERIALS AND METHODS: The materials for this study consisted of 20 class III malocclusion children. Cephalometric tracing and measurements were performed by one investigator. The control group consisted of 18 normal occlusion children and lateral cephalograms were obtained from 8.5 to 14.5 years old children biannually. The relationships between class III malocclusion group and normal occlusion group were evaluated statistically. RESULTS: The lower anterior facial heights between two groups were not significantly different, although the lower anterior facial heights of class III malocclusion group was higher than those of normal occlusion group in all age groups. The Maxillary-mandibular unit length differences of class III malocclusion group were significantly higher than those of normal occlusion group(p < 0.05). CONCLUSION: A Harvold analysis was useful to make treatment planning for class III malocclusion children.
Child* ; Humans ; Malocclusion* ; Orthognathic Surgery ; Research Personnel

BACKGROUND: Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of maxillofacial growth patterns in adult cleft lip and palate patients. MATERIALS AND METHODS: The material for this study consisted of 17 adult male patients with cleft lip and palate. Cephalometric tracing and measurements were done by one investigator. The relationship between 17 cleft lip and palate patients and Korean norms were evaluated statistically. RESULTS: There were statistically difference in Na, perpendicular to point A, SNA angle, effective maxillary length, maxillofacial differencial, Wit's appraisal and upper incisor to point A (p < 0.01). Pogonion to Na. perpendicular also statistically differed (p < 0.05). Other measurements didn't statistically differ. CONCLUSION: It was evident that in adult cleft lip and palate patients, maxilla was retruded and short. Careful cleft lip and palate repair and treatment are recommended for facilitating normal growth of maxilla.
Adult* ; Cleft Lip* ; Congenital Abnormalities ; Growth and Development ; Humans ; Incisor ; Male ; Maxilla ; Palate* ; Research Personnel