It is the purpose of this study to compare the postoperative results of 168 patients with exotropia of basic and simulated divergence excess type over 40 prism diopters; 86 patients had bilateral rectus muscle recessions and 82 patients underwent lateral rectus muscle recession and medial rectus muscle resection. The patients in the former group had averaged 13.7 years of age and 8.2 months of postoperative follow-up period. Those in the latter group averaged 22.9 years and had been followed up for 7.1 months. The postoperative success rates are as follows: 66.7%(57/86) in the bilateral rectus muscle recession group and 68.1%(58/82) in the lateral rectus muscle recession and medial rectus muscle resection group(P>0.05). And the success rates of those older than 16 years without amblyopia are 60.0%(18/30) in the former group and 75.0%(24/32) in the latter group(P>0.05). The lateral rectus muscle recession and medial rectus muscle resection group showed somewhat higher rates of success even though it proved statistically insignificant.
Amblyopia ; Exotropia* ; Follow-Up Studies ; Humans

We reviewed 92 eyes(65 patients) of diffuse diabetic macular edema which were treated with grid laser photocoagulation and followed up for more than 4 months from March 1992 to March 1997. There were improvements of visual acuity in 24 eyes(26.1%)and non changes in 50 eyes(54.3%), and 18 eyes(19.6%) showed worsened visual acuity. Initial visual acuity, presence of clinically significant macular edema and severity of retinopathy had not significant effects on visual outcome(P>0.05). Patients with grid photocoahulation without panretinal photocoagulation showed significantly good results than panretinal photocoagulation before or after grid photocoagulation(p<0.05).
Humans ; Light Coagulation* ; Macular Edema* ; Visual Acuity

No abstract available.
Animals ; Burns* ; Lymphocyte Subsets* ; Lymphocytes* ; Mice* ; Spleen* ; Thymus Gland*

No abstract available.
Silicones* ; Transplants*

Purpose: To proceed effectively with clinical research requires an understanding of the fundamental principles of study design and biostatistical methods. In this article, we identified and summarized basic clinical research designs and some of the key biostatistical methods that have been commonly used in clinical research. Materials and Methods: In an observational study, cross-sectional, case- control and Cohort designs were illustrated and compared. In a clinical trial study, parallel group design and cross-over designs were described according to their characteristics. Also, the biostatistical methods for their usages classified and summarized. Results: Understanding and evaluating research design are part of the process researchers must use to determine both the quality and usefulness of their research. Adequate applications to biostatistical methods are need; i.e., descriptive statistics, Student's t-test, ANOVA, nonparametrics, categorical data analysis, correlation and regression, and survival analysis. Conclusions: Research findings are used by clinical researcher to guide their practice and reduce their uncertainty in clinical decision making. However, to understand how to interpret research results, it is important to be able to understand basic statistical concepts and types of study design. Clinicians should also appropriately choose the biostatistical methods to suit their purposes.
Biostatistics ; Cohort Studies ; Cross-Over Studies ; Decision Making ; Observational Study ; Research Design* ; Statistics as Topic ; Uncertainty

BACKGROUND: The cryopreservation of Red Blood Cells have been proved to have many advantages in western countries. However, in Korea, clinical application of frozen-thawed blood is still in its early stage. We tried autologous frozen-thawed blood transfusion and evaluated the effects and complications. METHODS: Nine units of whole blood were collected from the autologous (n=1) and allogeneic bone marrow donors (n=3) and made packed RBCs by a centrifugation method. We made frozen RBCs using high glycerol method and stored them in -80degrees C freezer for 1 month. Eight units of frozen RBCs were thawed and washed by Cobe spectra (Cobe, USA). Autologous transfusions were done to the patient and donors while the bone marrow collection procedures were in process for bone marrow transplantation and we carefully observed its effects and complications. RESULTS: The mean RBC recovery rate were 89.8% and the supernatant plasma hemoglobin, K+, LD, osmolality, and simulation test were satisfactory to the allowable limit. After transfusion, the hemoglobin value was significantly elevated being comparable to that of the fresh blood. A case showed mild hematuria related to this transfusion but soon it disappeared in a day. CONCLUSION: The autologous frozen-thawed blood transfusions were safe and as much effective as the fresh blood. It would be essential to have skillful techniques in post-thaw washing process.
Blood Transfusion* ; Bone Marrow Transplantation ; Bone Marrow* ; Centrifugation ; Cryopreservation ; Erythrocytes ; Glycerol ; Hematuria ; Humans ; Korea ; Osmolar Concentration ; Plasma ; Tissue Donors*

OBJECTIVES: Patient's behavior features are important factors which influences the clinical judgement including diagnosis. However, most psychiatrists build up a picture of patients' behavior from an amalgamation of their own brief observations and nurses' reports, which often lack in the objectiveness. Several behavioral scales have been developed to alleviate this difficulty, but the poor efficiency and reliability of these scales have made them less useful. The recently developed Ward Daily Behavior Scale is an objective tool for evaluating all the daily noteworthy behaviors of patients, and is easily applicable to wide ranges of diagnoses and ages. This study tried to prove the reliability and validity of the Ward Daily Behavior Scale-Korean version. METHODS: The 112 patients, 63 males and 49 females, at a chronic psychiatric inpatient ward were selected as subjects. Experienced and unexperienced nurses rated patients' behaviors independently with the Ward Daily Behavior Scale-Korean version, after observing behaviors of subjects for 8 hours during day duty time. And then we tested the inter-rater reliability, internal consistency, and concurrent validity of this scale. RESULTS: The Ward Daily Behavior Scale-Korean version proved to be both reliable and valid for measuring of behaviors of psychiatric inpatients. CONCLUSIONS: The Ward Daily Behavior Scale-Korean version will be a valuable tool to observe and quantify patients' behavior in psychiatric wards.
Diagnosis ; Female ; Humans ; Inpatients ; Male ; Mianserin* ; Psychiatry ; Reproducibility of Results ; Schizophrenia* ; Weights and Measures

OBJECTIVE: The aim of this study is to evaluate the effectiveness of the syringo-subarachnoid shunt for the syringomyelia, according to the clinical outcome and radiological changes. METHODS: Ten patients who underwent syringo-subarachnoid shunt during last 5 years were included in this analysis. The average age at the presentation was 32.6(range 7 to 51) years. Chiari I malformation was found in four patients, Post-infectious syringomyelia was in three patients, and posttraumatic syringomyelia in two patients. The most common presenting symptoms were motor weakness and pain. Radiological diagnosis was made by magnetic resonance image in all patients. All patients underwent syringo-subarachnoid shunt, and in five patients with Chiari I malformation or achondroplasia, foramen magnum decompression was done as well. RESULTS: Eight showed the significant clinical improvement. Remaining two patients showed stabilization of the symptom. The postoperative magnetic resonance image, performed in seven cases, showed the reduction of the syrinx size in all case. There was no shunt malfunction or infection in our series. The transient cerebospinal fluid leakage was noted in three cases. CONCLUSION: It appears that the syringo-subarachnoid shunt is beneficial surgical method for the syringomyelia of various etiologies.
Achondroplasia ; Decompression ; Diagnosis ; Foramen Magnum ; Humans ; Syringomyelia*

OBJECTIVES: The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. MATERIAL AND METHOD: A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. RESULTS: In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. CONCLUSION: It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.
Age Distribution ; Basal Ganglia ; Cerebral Hemorrhage* ; Coma ; Geriatrics ; Hematoma ; Hemorrhage ; Humans ; Mortality ; Prognosis* ; Retrospective Studies ; Vascular Diseases

BACKGROUND AND OBJECTIVES: This was a multicenter study to evaluate the usefulness of the tumor necrosis factor-alpha (TNF-alpha) blocker infliximab for treatment of Korean pediatric patients with refractory Kawasaki disease (KD). SUBJECTS AND METHODS: Data from 16 patients throughout Korea who were diagnosed with refractory KD and received infliximab were collected retrospectively. RESULTS: Complete response to therapy with cessation of fever occurred in 13 of 16 patients. C-reactive protein (CRP) concentrations decreased following infliximab infusion in all 14 patients in whom it was measured before and after treatment. There were no infusion reactions or complications associated with infliximab except in 1 case with acute hepatitis occurring during treatment followed by calculous cholecystitis 4 months later. Fifteen patients had coronary artery (CA) abnormalities before infliximab therapy. Three had transient mild dilatation and 9 had CA aneurysms, with subsequent normalization in 4 patients, persistent mild dilatation in 3, persistent aneurysm in 2, and there were 3 cases (2 with CA aneurysm, 1 with mild CA dilatation) without follow-up echocardiography. CONCLUSION: The results of this study suggest that infliximab may be useful in the treatment of refractory KD, and it appears that there is no significant further progression of CA lesions developing after infliximab treatment. Multicenter trials with larger numbers of patients and long-term follow-up are necessary to assess the clinical efficacy and safety of infliximab in refractory KD.
Aneurysm ; Antibodies, Monoclonal ; C-Reactive Protein ; Child ; Cholecystitis ; Coronary Vessels ; Dilatation ; Echocardiography ; Fever ; Follow-Up Studies ; Hepatitis ; Humans ; Korea ; Mucocutaneous Lymph Node Syndrome ; Retrospective Studies ; Tumor Necrosis Factor-alpha ; Infliximab