Surgical effects were evaluated in 37 cases of mono-canalicular laceration following canaliculoplasty using Mini-Monoka from April, 1993 through SEptember, 1997 in the Department of Ophthalomology, Yeungnam University, College of Medicine. Lower canalicular laceration was included in 33 cases and upper canalicular laceration was found in 4 cases. Distance from the punctum to the lacerated canaliculus was noted to be 1 to 9mm(mean 4.6mm) and age ranged from 3 to 57 years(mean29.3 years). Thirty-four patients were men and three were women. Punctal portion of Mini-Monoka was fixated at the punctum with 6-0 black silk suture. End to end anastomosis was performed with 9-0 Ethylone(spatula needle) or 6-0 Vicryl(round needle). Steroid and antibiotics eye drops were used for 6 months after surgery. Mini-Monoka was removed 4 months postoperatively. After the follow-up period of 6-49 months(mean 11.3 months), 36 cases became recanalized well but 1 case showed obstruction because the laceration site was distant, 9mm from the punctum. Postoperative complications included loss of tube(3 cases), granuloma of the punctum(3 cases) and corneal abrasion(2 cases). Canaliculoplasty using Mini-Monoka is a procedure of choice for repair of mono-canalicular laceration with prevention of loss of the tube by punctal fixation suture without damage of the intact another canaliculi and the inferior meatus.
Anti-Bacterial Agents ; Female ; Follow-Up Studies ; Granuloma ; Humans ; Lacerations ; Male ; Ophthalmic Solutions ; Postoperative Complications ; Silk ; Sutures

No abstract available.
Child* ; Gangwon-do* ; Humans

The authors have examined 980 children with strabismus who were 6 years of age or under at the Eye Clinic of Yeungnam University Hospital. This study was conducted during the 4-year period between January 1990 and December 1994. The main objective of this study was to determine the incidence and clinical characteristics of fundus abnormality in children with strabismus. The total number of subjects in this study are 980 cases. Sixty subjects(6.1%) are found to have optic disc, chorioretinal and vitreous anomalies. Among them, 26 cases(43%) are diagnosed as having optic nervehypoplasia, in 7 cases (12%) coloboma, in 4 cases(7%) morning glory syndrome, in another 4 cases persistent hyperplastic primary vitreous, and in 3 cases retinoblastoma. In our study, 6.1% of the patients with strabismus are found to have disorders in optic disc and vitreoretina. These finding suggests that infants and young children with strabismus should have been examined to detect other related disorders of the eye.
Child* ; Coloboma ; Humans ; Incidence ; Infant ; Persistent Hyperplastic Primary Vitreous ; Retinoblastoma ; Strabismus*

No abstract available.
Collagen Type I* ; Skin* ; Wound Healing* ; Wounds and Injuries*

Etomidate and midazolam are the most popular drugs among the induction agents for emergent endotracheal intubation. The purpose of this study was to compare the incidence of adrenal insufficiency and mortality between the septic shock patients who received etomidate (ETM group) and those who received midazolam (MDZ group). Between November 2004 and September 2006, 65 patients were analyzed in this study. The hospital mortality rate was 36% in the ETM group (n=25) and 50% in the MDZ group (n=40), which was not statistically significant (p=0.269). The incidence of relative adrenal insufficiency was significantly higher in the ETM group than in the MDZ group (84% and 48%, respectively; p=0.003). On multivariate analysis, the use of etomidate was the only significant factor affecting the incidence of relative adrenal insufficiency (odds radio, 5.59; 95% confidence interval, 1.61- 19.4). In conclusion, we think that physicians who treat patients with septic shock should be aware that etomidate can cause adrenal insufficiency, and should start corticosteroids if etomidate is administered.
Adrenal Cortex Hormones/therapeutic use ; Adrenal Insufficiency/chemically induced/complications ; Aged ; Anesthetics, Intravenous/*adverse effects ; Etomidate/*adverse effects ; Female ; Humans ; *Intubation, Intratracheal ; Male ; Midazolam/*adverse effects ; Middle Aged ; Retrospective Studies ; Shock, Septic/complications/drug therapy/*mortality

No abstract available.
Flushing* ; Liver Transplantation* ; Liver*

Although trisomy 18 (Edwards' syndrome) or the terminal deletion syndromes of 18p and 18q have been occasionally detected, pseudoisodicentric chromosome 18 is a very rare constitutional chromosomal abnormality. We describe a case of pseudoisodicentric chromosome 18q without mosaicism, which was confirmed from fetal cells in the amniotic fluid used for prenatal diagnosis of multiple congenital anomalies. A 23-yr-old pregnant woman was suspected of having a fetal anomaly at 18(+3) weeks gestation. In sonography, the fetus showed multiple anomalies: bilateral overt ventriculomegaly in the brain, ventricular septal defect and valve anomaly in the heart, bilateral club foot, polydactyly, meningocele, and a single umbilical artery. The pregnancy was terminated and a conventional G-banded chromosome study was performed using amniotic fluid. Twenty metaphase cells among the cultured amniocytes showed a 46,XX,psu idic(18)(q22). Consequently, the fetus had partial trisomy (18pter-->q22) and partial monosomy (18q22-->qter). Both parents were confirmed to have a normal karyotype.
Abnormalities, Multiple/diagnosis/*genetics ; Centromere ; *Chromosomes, Human, Pair 18 ; Female ; Gestational Age ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis/*methods ; Trisomy ; Ultrasonography, Prenatal ; Young Adult

PURPOSE: Alcohol consumption is an important risk factor for injury. It is controversial, however, whether alcohol also has an effect on the severity of injury. We tried to evaluate the effect of alcohol on the severity of injury, especially on the severity of blunt injury due to traffic accidents, falls, collisions, and so on. METHODS: We used the ED-based injury registry in a regional emergency center. During two months, 831 victims were registered. We enrolled 397 patients who were over 15 years and had been injured by blunt trauma. We classified them into two groups by alcohol consumption. Positive alcohol consumption was defined as that positively confirmed by the victims or guardians, or that suspected on physical examination. The injury severity was measured by using the New Injury Severity Score, the Revised Trauma Score, the Trauma and Injury Severity Score (TRISS), the probability of survival of TRISS, and the International Classification of Disease 10th-version-based Injury Severity Score. RESULTS: Alcohol consumption was significantly larger in males than in females, in intentional injuries than in accidental injuries, in injury mechanisms other than traffic accident injuries, and in nighttime injuries than daytime injuries. However, the injury severity for the two groups was not significantly different. In the subgroup analysis, alcohol did not seem to affect the severity of injury due to any of the individual injury mechanisms. CONCLUSION: Alcohol consumption has no significant effect on the severity of blunt injuries.
Accidents, Traffic ; Alcohol Drinking* ; Classification ; Emergencies ; Female ; Humans ; Injury Severity Score ; Male ; Physical Examination ; Risk Factors ; Wounds and Injuries ; Wounds, Nonpenetrating*

PURPOSE: The use of rapid sequence intubation (RSI) by emergency physicians in emergency departments is increasing. Our aim was to evaluate the current practice of RSI, focusing particularly on the appropriateness of sedative dose. METHODS: We retrospectively investigated RSI cases in two urban emergency centers occurring between June 2005 and May 2006. We calculated the sedative dose used per patients' weight and divided into a low dose group (less than the minimum recommended dose) and a full dose group. We investigated the differences between these two groups, including hemodynamic changes, success rates and complication rates. RESULTS: Of 745 cases of endotracheal intubation performed, 211 cases were defined as RSI cases. The mean sedative dose was 0.29 mg/kg (+/-0.08 SD) for etomidate and 0.08 mg/kg (+/-0.03 SD) for midazolam. Sedatives were underdosed in 56.3% of etomidate cases and 82.1% of midazolam cases, for a mean underdose rate of 63.6%. Drops in SBP (systolic blood pressure) were significantly different between the etomidate and midazolam groups (-14.4 mmHg vs -22.43 mmHg, p=0.04), but there was no significant difference in SBP between low dose and full dose groups. The overall complication rate was 17.1%, was again with no significant difference between full dose and low dose groups. CONCLUSION: Overall, sedatives were underdosed in 63.6% of cases with midazolam more frequently underdosed than etomidate. However, the underdosing of sedatives was not significantly correlated with the first pass rate or the complication rate.
Emergencies* ; Emergency Service, Hospital ; Etomidate ; Hemodynamics ; Hypnotics and Sedatives* ; Intubation ; Intubation, Intratracheal ; Midazolam ; Observational Study* ; Retrospective Studies*

PURPOSE: The aim of this study was to evaluate the time delays in reperfusion of patients with ST elevation myocardial infarction (STEMI) according to the mode of transportation and patient arrival time. METHODS: An observational study of patients with STEMI treated with primary percutaneous coronary intervention (PCI) was performed from January 2004 to May 2009. The patients were classified into several subgroups according to the transportation method (self-transportation, EMS, and transfer) and patient arrival time (regular hours: weekdays, 7 AM~6 PM, off-hours: weekdays, 6 PM~7 AM, weekend and holiday). The symptom-to-door time (STDT), door-to-balloon time (DTBT), and the timeline to reperfusion were compared in each group. RESULTS: The median STDTs, DTBTs and the percent of the timeline to reperfusion (DTBT < or =90 min) differed significantly according to the transportation mode (p<0.001, respectively). Especially, the transfer group had longer median STDT (200 min, IQR 120~330), shorter median DTBT (80 min, IQR 66~102) and a significantly higher rate of achieving a timely DTBT (64.8%), compared to the other groups (self-transport and EMS use). Compared to the regular hour group, the offhour group had a shorter STDT (129 min vs. 180 min, p=0.016) and longer DTBT (99 min vs. 81 min, p<0.001). The percent of patients achieving a timely DTBT was much lower during off-hours (41.1% vs. 61.5%, p<0.001). CONCLUSION: The results of this study showed that the transfer group and regular hour group had a significantly shorter median DTBT, and the timeline for reperfusion was longer in the transfer group compared to the regular hour group in this study.
Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Reperfusion ; Sodium Fluoride ; Transportation ; Urethane