Characteristic residual deformities are thought to be unavoidable in most bilateral complete cleft lip and palate patients. Newly-adopted designs and modified surgical strategies were applied to 40 consecutive patients of bilateral complete cleft lip and palate and some characteristic deformities could be overcome. The future midline on the lateral lip segment was marked on the white roll of thickest vermilion and the alar base was transposed medially without circumalar incision. The prolabial width was reduced to 4-5 mm in consideration of further widening. To evaluate the outcome of bilateral cleft lip repair, 15 patients with adequate photographic records were assessed separately and overall by a panel of judges. Gross facial attractiveness of the visual analog recording scale correlated well with the cleft impairment scale. Full-bodied vermilion with tubercle was achieved and upper lip tightening and tower lip pouting could be avoided. Adequate philtral width was maintained over a 3-year follow-up. Nasal tip projection and proper alar position could be accomplished without circumalar incision. Cleft impairment scale showed impaired characteristics os short columella, no nostril sill, transverse nostril axis, flat and undimpled philtrum, convex-profiled upper lip and a downward drawn nose. Columellar length and nostril axis were expected to improve with growth and development. Absence of the philtral dimple and convex-profilled upper lip still remain to be solved. A reliable, easy to perform, and inexpensive evaluation protocol was provided for bilateral cleft lip repair and selected surgical procedures and postoperative outcomes could be assessed with photographic records.
Axis, Cervical Vertebra ; Cleft Lip* ; Congenital Abnormalities ; Follow-Up Studies ; Growth and Development ; Humans ; Lip* ; Nose ; Palate*

Molluscum contagiosum is a common, benign, viral disease of the skin and mucous membrane that generally affects children. This disease is characterized by a 2 to 7 week incubation period; the involvement of the face, trunk, and extremities; spontaneous resolution within 2 to 4 months; and common autoinoculation. Individuals are susceptibile from the age of one. Herein, we report a case of molluscum contagiosum with an unusual manifestation. The skin lesions, which occured at ten days postpartum, showed two adjacent hard papules on the posterior scalp. They remained for 8 months in the same size and number.
Child ; Extremities ; Humans ; Infant, Newborn* ; Molluscum Contagiosum* ; Mucous Membrane ; Postpartum Period ; Scalp ; Skin ; Virus Diseases

This paper describes the incidence and some epidemiological features of drowning accident out of a series of our study on the epidemiology of various accidents in Korea. By the daily press it is apparent from the frequent reporting of swimming accidents that the incidence would be high. In the rural areas, there are, at present about 1,250 artificial lakes and farm ponds to be utilized for rice production. The reservoirs, irrigation ditches and riversides are also used for recreation. In most places facilities for aquatic activities is meager, and safety measures for the prevention of drowning is not sufficiently enforced. In the survey crude data on drowning were collected from the concerned governmental statistic books for the period 1955 to 1967 which were compiled not in a uniform way. Drowning were classified into two categories, one is accidental drowning, E929 and the other is due to cataclysm, E934, according to the WHO international classification of diseases. Epidemiological variables in relation to drowning accident were obtained through qualitative analysis of informations from the popular newspapers. The following summary may be drawn; 1. The average number of deaths due to accidental drowning totaled 1,088 annually and the mortality rate per 100,000 population was 3.4. The 42.0% of all drowning were rescued and the remaining were not saved. 2. The sex ration(M/F) of the victims for all ages was 5 to 1, which had a wide range of difference among the age groups. The young ages less than 20 years occupied 68.0% of all deaths. 3. The percentage distribution of the causes of accidents revealed 31.9% for careless swimming, 45.5% for unskilled, 16.6% for swimmer's cramp and 6.0% for drunken. The distribution of places where accidents occurred showed 88.0% for rivers, water reservoirs, irrigation ditches and 12.0% for regular swimming pools. The seasonal distribution of cases indicated 85.0% of the total were seen during the summer months, June-August, and 50.0% of them occurred on Sundays. 4. The average annual deaths due to cataclysm were 402 and mortality rate per 100,000 population was 1.6, but the number of victims due to cataclysm varied greatly each year. 5. The accident cases due to cataclysm were classified into 60.0% for injuries, 40.0% for deaths. The 26.8% of all deaths were missing cases. 6. The deaths due to either accidental drowning or cataclysm totaled 1,490, and the death rate per 100,000 for the whole country was 5.0.
Drowning* ; Epidemiology ; Humans ; Incidence* ; International Classification of Diseases ; Korea* ; Lakes ; Mortality ; Muscle Cramp ; Newspapers ; Ponds ; Recreation ; Rivers ; Seasons ; Swimming ; Swimming Pools ; Water ; Periodicals

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance

OBJECTIVE: Catechol-O-methyltransferase(COMT) is an important enzyme that inactivates biologically active or toxic catechols. Abnormal catecholamine transmission has been implicated in the pathogenesis of schizophrenia and bipolar disorder. Polymorphism(Val/Met) of the COMT gene was shown to determine high-and low-activity alleles of the enzyme. This study was designed to investigate the association between COMT gene polymorphism and schizophrenia and bipolar disorder in a Korean population. METHOD: COMT gene were genotyped with polymerase chain reaction and restriction enzyme NlaIII in 128 patients with schizophrenia, 110 with bipolar disorder, and 176 controls. RESULTS: 1) The distribution of the COMT genotype in schizophrenic patients with Val/Val, Val/Met, Met/Met were 76(59.4%), 43(33.6%), 9(7.0%), in bipolar disorder patients were 63(57.3%), 35(31.8%), 12(10.9%), and in the controls were 83(47.2%), 79(44.9%), 14(8.0%). The allele frequencies of the COMT gene in schizophrenic patients with Val and Met were 195(76.2%), 61(23.8%), in bipolar disoreder patients were 161(73.2%), 59(26.8%), and in the controls were 245(69.6%), 107(30.4%). 2) There were no differences in genotype distribution and allele frequencies of COMT gene polymorphism among the 3 groups. Neither patients with schizophrenia nor bipolar disorder differed in the genotype and allelic frequencies from the controls. CONCLUSION: These results suggest COMT gene polymorphism is not causally related to the development of schizophrenia and bipolar disorder in a Korean Population.
Alleles ; Bipolar Disorder* ; Catechol O-Methyltransferase* ; Catechols ; Gene Frequency ; Genotype ; Humans ; Polymerase Chain Reaction ; Schizophrenia*

OBJECTIVES: To examine the screening rate of cervical cancer in women and to find out the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. METHODS: The data was based on self-reported questionnaires from 1,613 women whose ages ranged from 26 to 60 years; this survey was performed between December 1999 and January 2000. This study analyzed the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. A logistic regression analysis was performed in order to derive the significant variables from the predisposing factors (demographic factor, health promotion behavior, reproductive factor), intervention factors (information channel, relation with medical staff), and proximal factors (attitude, social influence, self-efficacy). All analyses were performed by the PC-SAS 6.12. RESULTS: Our analyses showed that the screening rate for the women who received a cervical cancer screening (Pap smear) more than once within their life-time was 56.1% while those who had received one within the last two years was 34.5%. The significant factors for participation in cervical cancer screening program within their life-time were their income, married age, health promotion score, relation with medical staffs, social influence, and self-efficacy. On the other hand, age, number of pregnancies, menarche age, relation with medical staffs, social influences, and self-efficacy were significant factors for those being screened within the last two years. The predictive power of the logit model within their life-time was 68.8% and that within the last two years was 66.6%. CONCLUSION: The predictive factors for participation in cervical cancer screening program within their life-time are different from those for within the last two years, and that women's relations with medical staffs and social influences were the critical factors impacting on cervical cancer screening rates.
Causality ; Female ; Hand ; Health Promotion ; Humans ; Logistic Models ; Mass Screening* ; Medical Staff ; Menarche ; Pregnancy ; Questionnaires ; Reproductive Behavior ; Uterine Cervical Neoplasms*

OBJECTIVE: Effects of life style modifications on lipid profiles have been well established. However, data is scarce in Korean patients. We tried to quantify the effect of life style modifications on lipid profiles in relatively large number of Korean hyperlipidemic patients. METHODS: This study enrolled 1037 consecutive hyperlipidemic patients (total cholesterol or triglyceride levels ≥200 mg/dL) from 2003 to 2013. They were consisted of patients with hypercholesterolemia (n=308), borderline hypercholesterolemia (n=302), mixed hyperlipidemia (n=107), borderline mixed hyperlipidemia (n=156), and hypertriglyceridemia (n=164). Blood lipid levels were measured before and after life style modification for 2-4 months. RESULTS: Life style modification showed a small but significant reduction of body weight in all groups. It reduced low density lipoprotein (LDL) cholesterol by 9.1% (p=0.000), 5.9% (p=0.000), and 4.8% (p=0.003) in patients with hypercholesterolemia, borderline hypercholesterolemia, and mixed hyperlipidemia, respectively. LDL cholesterol was elevated in hypertriglyceridemic patients by 35% (p=0.000). Triglyceride levels decreased in patients with hypertriglyceridemia by 22% (p=0.000) and increased in hypercholesterolemic patients. There were no different effects of life style modification between men and women. CONCLUSION: Life style modification made significant improvement in lipid profiles in Korean patients. The degree of improvement from this study may provide useful data for the management of Korean hyperlipidemic patients.
Body Weight ; Cholesterol ; Cholesterol, LDL ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia ; Hyperlipidemias* ; Hypertriglyceridemia ; Life Style* ; Lipoproteins ; Male ; Triglycerides

Massive pulmonary embolism is a major cause of morbidity and death in hospital. Most episodes of acute pulmonary embolism occurred from multiple emboli. When pulmonary embolism is suspected, the definitive diagnosis is pulmonary arteriography, but high degree of certainty can also be achieved with ventilation-perfusion scanning. The therapeutic modalities available for patients with acute pulmonary embolism are prophylatic and definitive therapy. Prophylatic therapy including anticoagulant with heparin is used to prevent further emboli episodes that might be fatal. Definitive therapy for pulmonary embolism including thrombolytic agents and pulmonary embolectomy attempts to dissolve and remove the resolution of the pathophysiologic sequelae of pulmonary embolism. We experienced a case of acute massive pulmonary embolism which occupied the pulmonary arteries bilaterally. Patient with orthopedic surgery one month before developedd dyspnea and chest tightness. Eventhough continuing enough amount of anticoagulant therapy, rapid hemodynamic deterioration and severe hypoxia occurred progressively. Urgent pulmonary embolectomy was succeeded and he has been followed up at out patient department.
Angiography ; Anoxia ; Diagnosis ; Dyspnea ; Embolectomy ; Fibrinolytic Agents ; Hemodynamics ; Heparin ; Humans ; Orthopedics ; Pulmonary Artery* ; Pulmonary Embolism* ; Thorax

Seventeen cases of apical hypertrophic cardiomyopthy were reviewed to clarify whether there is any racial difference in phenotypic expression of apical hypertrophic cardiomopathy and to study whether there is any clinical or morphological difference between apical hypertrophic cardiomyopathy of Japanese type (J-APH) and apical hypertrophic cardiomyophthy of non-Japanese type (NJ-APH). The diagnosis was made by cardiac catheterization, left ventriculography and echocardiography. Seventeen patients were divided into 9 (53%) patients with J-APH and 8 (47%) patients with NJ-APH. Mean ages of patients with J-APH and NJ-APH were 55 years and 57 years, respectively. The most common clinical symptoms were chest pain(100%), dyspnea(59%) and palpitation(35%). Mean values of S1+R5 and T wave depth were 58+/-16mm and 16+/-6mm in J-APH and 42+/-11mm and 7+/-3mm in NJ-APH(p<0.05, respectively). Seven patients experienced transient or permanent atrial fibrillation without significant symptoms. Seven patients showed progression or regression of T wave depth greater than 5mm during the period of follow-ups. On echocardiography IVS/LVPW thickness(mm) at the base were 11+/-2/10+/-2 in J-APH and 17+/-7/11+/-2 in NJ-APH, and IVS/LVPW thickness(mm) at the apex were 25+/-7/24+/-5 in J-APH and 26+/-3/26+/-2 in NJ-APH. Three patients with NJ-APH showed asymmetrical septal hypertrophy, cardiac catheterization disclosed elevated left ventricular end diastolic pressure in 11 out of 19 patients. Dye entrapment at the apex during systole was noted in 5 out of 18 patients. In conclusion, our study showed high prevalence rate expression of J-APH in contrast to the Western countries, there may be racial difference in phenotype of apical hypertrophic cardiomyopathy. Considering progression or regression of T-wave depth, NJ-APH may be a forme fruste or regressed form of J-APH.
Asian Continental Ancestry Group ; Atrial Fibrillation ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic ; Classification* ; Diagnosis ; Echocardiography ; Echocardiography, Doppler* ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertrophy ; Phenotype ; Prevalence ; Systole ; Thorax