Differential diagnosis between physiologic bow legs and nonphysiologic bow legs is difficult and still not fixed in diagnosis, especially under 5 years old age. Recently the problem exist in differential diagnosis and treatment method of rickets because of non-specific laberatory finding in rickets. Metaphyseal-Diaphyseal angle in distal femur, Diaphyseal-Diaphyseal angle between femur and tibia, and Metaphyseal-Diaphyseal angle in proximal and distal tibia, and Metaphyseal-Metaphyseal angle in tibia are measured and compared for 30 bow legs children. And divided into rickets group and physiologic bow legs group by clinical and laboratory findings. The results are as following 1. Mean age was 1.91 years old at initail examination, 2.08 years old in rickets group, 1.73 years old in phisiologic bow legs group. 2. Diaphyseal-Disphyseal angle between femur and tibia was 18.12 ±6.80 in rickets group. And 10.17±5.36 in phisiologic bow legs group. Metaphyseal-Diaphyseal angle in distal femur was 10.88±3.62 in rickets group. And 8.42±4.42 in physiologic bow group. 3. Metaphyseal-Diaphyseal angle in proximal tibia was 11.50±2.56 in rickets group. And 7.17±2.01 in phisiologic bow legs group. It's angle in distal tibia was 10.50±3.86 in the former and 9.50 ±3.09 in the later group. Metaphyseal-Metaphyseal angle in tibia was 20.68±3.91 in rickets group and 16.78±4.11 in phisiologic bow legs group. According to the above mentioned results. Metaphyseal-Metaphyseal angle and Metaphyseal- Diaphyseal angle in tibia are comparable to gross appearance of bow legs deformed children rater than Diaphyseal-Diaphysealangle between femur and tibia, and Metaphyseal-Diaphyseal angle in distal femur. All values are high in rchekts, statistically. Therfore measurement of above mentioned angle in simple X-ray is valuable in differential diagnosis between phisiologic bow legs and Rickets.
Child ; Diagnosis ; Diagnosis, Differential ; Femur ; Genu Varum ; Humans ; Methods ; Rickets ; Tibia

Most of cataract surgeons have made a great effort to minimize or nullify corneal 'astigmatism resulted from the incision and closure, but a completely ideal wound system still eludes us. The scleral pocket incision and continuous single knotted shoelace suture of it has been known as one of the technique for reducing postoperative astigmatism. Recently, horizontal suture closure of scleral pocket incisior has been introduced because it doesn't cause suture induced wound compression. We implanted standard PMMA intraocular lenses in the bag of 400 patients through 7mm scleral pocket incision following CCC (continuous circular capsulorhexis) and bimanual phacoemulsification. The incision was closed with either the shoelace or horizontal suture. The keratometric measurement was maded at postoperative 1 day, 1 week, 1 month, 2 month, 3 month and 6 month. In shoelace suture group, the preoperative corneal astigmatism appeared -0.14 +/- 0.15D of with the rule astigmatism (WTR); at one day postoperatively -2.75 +/- 1.61 of WTR, at 3 month 0.18 +/- 1.14D of against the rule astigmatism (ATR), 6 month 0.3 +/- 1.22D of ATR. In horizontal suture group, the preoperative corneal astigmatism appeared -0.22 +/- 1.22D of WTR; at one day postoperatively -1.05 +/- 1.28 of WTR, at 2 month 0.57 +/- 1.0 of ATR, at 6 month 0.72 +/- 1.91 of ATR. The difference between two suture methods was statistically significant (p<0.01 until 3 month, p<0.05 until 3-6 month).
Astigmatism* ; Cataract ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Sutures* ; Wounds and Injuries

Cubitus varus deformity is the late complication of the supracondylar fracture of humerus which is common in growing children. If the deformity is severe it causes tunctional problems as well as cosmetic ones necessitating conective osteotomy. Though many authors devised different methods of corrective osteotomy, the cosmetic results are not always satisfactory because of the development of the lazy S deformity hy the lateral prominence. Technically. the initial stahility of the osteotomy is also poor due to the poor contact of the osteotomy site. So we have devised a new quadrilateral displacement osteotomy to increase the initial stability of the osteotomy by creating a wedge on the osteotomy site & also to prevent the development of the lazy S deformity hy elimination of the Interal prominence. We treated 9 cases of cubitus varus deformity with the new quadrilateral displacement osteotomy. The correction technique was not difficult & the initial stahility of the osteotomy is rather good & the osteotomy is fixed by the conventional methods, & all of the cases were healed uneventfully. There developed no the lazy & deformity after osteotomy. We would like to report the details ot the supracondylnrquadrilateral displacemenl osteotomy.
Child ; Congenital Abnormalities* ; Humans ; Humerus ; Osteotomy*

This is a case report of correction of malunioned maxilla after traffic accident by Le Fort I osteotomy and posterior segmental osteotomy. By this procedure, authors obtained the following results. 1. The malunioned maxilla after traffic accident which had anterior crossbite, posterior open bite and scissor's bite were corrected by Le Fort 1 osteotomy and posterior segmental osteotomy. 2. No postoperative infection and specific complication were seen in this case. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. And then, the patient could open his mouth in normal range after a week of intermaxillary fixation removal. 4. For rigid fixation and reducing relapse, the osteotomized maxilla was fixed with miniplates.
Accidents, Traffic ; Humans ; Malocclusion ; Maxilla* ; Mouth ; Open Bite ; Osteotomy* ; Recurrence ; Reference Values

Two patients, sought treatment for chief complaints of protruding frontal tooth and desired treatment to reduce the prominence of lips, were diagnosed as bimaxillary protrusion via clinical and cephalometric analysis. The authors corrected them by combined surgical and orthodontic treatment. As pre-surgical survey, paper and cast surgery were performed and wafer and resin sprint were constructed. We performed anterior maxillary and mandibular osteotomies in first premolar site to retract the maxillary and mandibular dentoalveolar segment in order to; 1) Decrease prominence of upper and lower lips. 2) Create proper lower incisor intrusion. By use of intramaxillary fixation, prompt oral intake was possible. We made good result of esthetic improvement and there was no evidence of relapse and any complication.
Adult* ; Bicuspid ; Humans ; Incisor ; Lip ; Mandibular Osteotomy ; Recurrence ; Tooth

OBJECTIVES: This study examined the selective deficits of executive function in patients with mild traumatic brain injury that in normal range of general intelligence level and aimed to analysis of the correlation between K-WAIS result and executive function. METHODS: 59 subjects were included in this study, who were diagnosed as mild traumatic brain injury(MTBI) and they have visited in neuropsychiatric department of Wonkwang University Hospital during from March, 2005 to September, 2010. For measurement of general intelligence quotient, the Korean-Wechsler Adults Intelligence Scale(K-WAIS) was administered and for measurement of executive intelligence quotient(EIQ), Executive Intelligence Test(EXIT) was administered. RESULTS: Of patients, 50.8% included at abnormal EIQ group. The patients of abnormal EIQ showed poorer full scale IQ(FIQ), performance IQ(PIQ) and in subscale that picture arrangement, digit symbol, digit span, block design, object assembly and comprehension were significantly different. In terms of relationships between K-WAIS and EIQ, FIQ and PIQ have positive correlation with EIQ. And in subscale, picture arrangement, digit symbol, digit span, block design, object assembly and comprehension show positive correlation with EIQ. CONCLUSION: This study suggest that MTBI patients with have normal range of general intelligence level may have deficit of executive function is common. The decline of FIQ, PIQ and some subscales of K-WAIS may suggest executive dysfunction in MTBI patients.
Adult ; Brain ; Brain Injuries ; Comprehension ; Executive Function ; Humans ; Intelligence ; Reference Values ; Wechsler Scales

PURPOSE: The value of extracorporeal extraction in treating paraquat poisoning was questioned; some saved their patients by applying hemoperfusion, but others failed. This study was designed to investigate the efficacy of extracorporeal extraction treatment for patients suffering from paraquat poisoning. METHOD: The serum concentrations after ingestion of paraquat by 52 patients were serially checked. Of those 52, 42 were treated with hemoperfusion, and 34 of 42 patients were treated with continuous veno-venous hemodialysis (CVVH) after hemoperfusion. We evaluated the mortality, the survival time, and the hourly elimination rate of paraquat to investigate the efficacy of extracorporeal extraction. Also, we evaluated factors which affected the efficacy of the extracorporeal extraction. RESULT: There was no difference between the hemoperfusion group and the non-hemoperfusion group in mortality, time of survival, and elimination rate of paraquat (p>0.1). The total mortality was 50.0% (26/52) with no difference between the hemoperfusion group and the hemoperfusion +CVVH group. The mortality was closely related with the development of acute renal failure. Hemoperfusion, when applied before the collapse of the renal function, is effective in reducing mortality even in severe poisoning. Hemoperfusion had value in enhancing the hourly elimination rate of circulating paraquat in cases with renal collapse, but had little value in reducing mortality. CONCLUSION: The efficacy of extracorporeal extraction in treating patients with paraqaut poisoning was not proven in this study. However we suggest that early extracorporeal extraction may be effective in treating paraquat poisoning, even in severe cases, due to its possible detoxicating effect and toxin removal.
Acute Kidney Injury ; Eating ; Hemoperfusion ; Humans ; Mortality ; Paraquat* ; Poisoning* ; Renal Dialysis

Nineteen patients with benign pancreatic disease were managed with surgical treatment in Pusan Medical Center during three years from September 1993 to September 1995 and the results were reviewed retrospectively. The results were as follows; 1) This report includes five cases of severe(hemorrhagic in one case and necrotizing in four cases) acute pancreatitis,eight cases of pancreatic inury,three cases of pancreatic pseudocyst and three cases of chronic pancreatitis. 2)The most common etiology of benign pancreatic disease, excluding pancreatic injury, was alcohol ingestion. 3)Five cases of severe acute pancreatitis were represented with more than 4 of Ranson's prognostic factors and the surgical methods refered were external drainage with debridment or necrosectomy. All were effectively managed surgically except one case of death which had more than 6 of Ranson's prognostic factors. 4)The etiology of pancreatic injury was blunt abdominal trauma in seven cases and surgical complications in one case. The sites of injury were head in three cases,body in three cases and tail in one case. The operative methods used were drainage(all cases),distal pancreatectomy(3 cases),triple ostomy(1 case) and pancreaticoduodenectomy(1 case). 5)The sites of pancreatic pseudocysts were the body in two cases, head in one case. The operative method used was as follows; excision in one case, external drainage in one case and cystojejunostomy in one case. 6)Three cases of the chronic pancreatitis were diagnosed by intraoperative findings. 7)In conclusion, the most reliable treatment for benign pancreatic disease is early surgical intervention, in order to reduce the mortality rate and complications induced by pancreatic inflammation.
Busan ; Drainage ; Eating ; Head ; Humans ; Inflammation ; Mortality ; Pancreatic Diseases* ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic ; Retrospective Studies

PURPOSE: To report our experience of extracorporeal shock wave lithotripsy (ESWL), with the Dornier Compact Delta(R). MATERIALS AND METHODS: A total of 361 cases underwent EWSL using Dornier Compact Delta(R). The location and sizes of stones, session, success rate, and causes of failure and complications of ESWL, were retrospectively reviewed. The mean diameter of the stones was 8.7mm, ranging from 5 to 37mm. RESULTS: Of the 361 cases, there were 71 (19.7%) and 290 (80.3%) cases of renal stones and ureteral stones, respectively. The overall success rate was 92.5%, with success rates of 98.2, 86.2, 62.5 and 100% for stone sizes Kidney ; Lithotripsy* ; Retrospective Studies ; Shock* ; Ureter ; Urinary Calculi

PURPOSE: Despite the increased number of patients visiting emergency rooms on weekends, the level of staffing is often lower than it is on weekdays. It is uncertain whether in-hospital mortality rates among patients depend on when they visited the hospital on a weekend or on a weekday. METHODS: We analyzed 21,645 patients who visited our emergency department in 2003. We compared death within 48 hours after a visit to the emergency room between patients who visited on weekends and those with visited on weekdays. The odds of death within 48 hours for patients who visited on a weekend were analyzed by using a multivariate logistic regression. The severity of illness was adjusted by using triage and the Charlson comorbidity score. RESULTS: Compared with patients who visited on weekdays, the number of patients who visited on weekends was increased in 30%. The mortality rates were not statistically different for patients who visited on weekends and patients who visited on weekdays (3.1% vs 2.8%, p=0.399). However, two diagnoses (pneumonia and spontaneous subarachnoid hemorrhage) were associated significantly with a weekend effect. CONCLUSION: Visiting the emergency department on weekends was not associated with a higher mortality than visiting the emergency department on weekdays.
Comorbidity ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Hospital Mortality ; Humans ; Logistic Models ; Mortality ; Prognosis* ; Triage