Medial orbital wall fracture was described by Converse and Smith in the first time in 1957. These fractures which comprise more than 30% of all the orbital wall fracture are may easily be overlooked in routine orbital radiology. Accordingly, examination with orbital CT is essential for accurate diagnosis and appropriate treatment. These type of fracture are followed frequently by post-oprative complication such as diplopia and enophthalmos because it is very difficult to approach to orbital medial was in these operations. The mechanism of the orbital wall fractures are abruptly increased hydraulic pressure by sudden impact on orbital rim or soft tissue of orbital region. So patients who show the signs of subcutaneous emphysema, edema on the orbital region or diplopia need to get through examination with orbital CT for accurate diagnosis and immediate reconstruction of the fractured orbital wall. Conventional approaches in the operations of the orbital medial wall fractures are that with bicoronal incision, subciliary incision, transconjunctival incision and infra-orbital rim incision. But, approach with bicoronary incision, needs broader dissection and longer time for operation. Operations with transconjunctival incision and that with subciliary incision have difficulty to approach to fractured sites. Operations with other conventional methods may be also followed by scar problem. The authors performed reduction and reconstruction of the fractured orbital medial wall fractures successfully without any complications and difficulties by intra-eyebrow approach with which they made incision of 2 - 2.5 cm on mid-area of eyebrow to expose fractured medial wall with good operative field.
Cicatrix ; Diagnosis ; Diplopia ; Edema ; Enophthalmos ; Eyebrows ; Humans ; Orbit* ; Subcutaneous Emphysema

OBJECTIVES: Insomnia is significantly influenced by the pre-sleep arousal, self efficacy, sleep hygiene, depression and anxiety. The authors tried to explore how these factors are related with the clinical features of sleep. METHODS: Fifty three patients diagnosed as insomnia by DSM-IV criteria were studied. They filled up the pre-sleep arousal scale(PSAS), sleep efficacy scale(SES), sleep hygiene awareness and practice scale, BDI, and state and trait anxiety scales. RESULTS: 1) The mean values of sleep-related variables were as follows : Sleep latency,136.89 minutes ; frequences of awakening during a night, 2.28 ; minutes to get back to sleep, 42.70 ; total sleep time, 180.19 minutes ; duration of illness, 72.00 months. 2) The mean scores of scales were as follows : PSAS(cognitive), 22.40 ; PSAS (somatic), 17.32 ; SES, 20.16 ; sleep hygiene knowledge, 25.96 ; caffeine knowledge, 59.78 ; sleep hygiene practice, 42.12 ; BDI 18.2 ; state anxiety, 41.24 ; trait anxiety ; 44.50. 3) In the subjects with superimposed depression, the mean frequency of awakening during a night and the mean pre-sleep arousal scale score were higher than in those without depression. 4) Frequency of awakening were correlated positively with a PSAS(a tight tense feeling in your muscle) and sleep hygiene awareness. PSAS(cognitive) were correlated positively with a PSAS(somatic). BDI correlated positively with a PSAS item(a jittery, nervous feeling in your body)and a SES item(not allow a poor night's sleep to interfere with daily activities). Anxiety scales were correlated positively with sleep hygiene practice scale sleep and PSAS were correlated negatively with SES. CONCLUSIONS: The mean scores of PSAS, SES, sleep hygiene awareness and practice scale, BDI, state and trait anxiety scales of insomniacs were correlated either positively or negatively in insomnia patients. These factors seem to contribute to the development and maintenance of insomnia.
Anxiety* ; Arousal* ; Caffeine ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Hygiene* ; Self Efficacy* ; Sleep Initiation and Maintenance Disorders* ; Transcutaneous Electric Nerve Stimulation ; Weights and Measures

No abstract available.

Fifty-one consecutive 186 patients with aneurysmal subarachnoid hemorrhage were treated from the day of admission with nimodipine which was given first as an IV infusion at 30ug/kg/hr for 1 week and then orally in a dose of 360mg/day for 2 weeks and compared with 135 patients which were treated without nimodipine for the past 2 years. A comparision based on clinical and radiological variables influencing both the coruse and the outcome of the disease showed no significant difference between the nimodipine treated group and the control group except the delayed timing of surgery in the control group. There was no significant difference in the outcome between the nimodipine treated patients and the patients treated without nimodipine, however in Hung & Hess grade IV patients nimodipine treatment was associated with a significantly better outcome. Nimodipine treatment reduced the occurrence of delayed ischemic deficts(DID) in grade III, IV patients. Significant improvement in the outcome occurred in the nimodipine treated patients with subarachnoid hemorrhage of large amount(Fisher classification III).
Aneurysm* ; Classification ; Humans ; Intracranial Aneurysm ; Nimodipine* ; Subarachnoid Hemorrhage*

BACKGROUND: Otitis media with effusion(OME) is a very common disease in pediatric age. However, a few literatures on epidemiologic study of otitis media with effusion are available in Korea due to the great variability of its diagnostic criteria and clinical features. The aim of this study is to provide the estimate of silent otitis media prevalence for preschool age. METHODS: The study population includes 329 children enrolled in 6 kindergartens in Kunsan city from April 1 to 10, 1995. Silent otitis media was diagnosed with otoscopy, pneumatic otoscopy and impedance audiometry by DANAC 40 model impedance audiometer from DANA JAPAN Co. RESULTS: The prevalence of silent otitis media with effusion was 14.5% and peak at 6 years of age(17.8%).The prevalence of silent otitis media with effusion according to sex were 11.8% in boys group, 17.9% in girls group. Nine cases(11.8%) involved bilaterally. Forty three cases(89.6 %) were asymptomatic cases. CONCLUSIONS: Among 329 preschool children, the prevalence of silent otitis media with effusion was 14.5%. The prevalence by sex showed slightly higher in girls group than boys group. OME involved unilateral site mostly and subjective symptoms were rare.
Acoustic Impedance Tests ; Child ; Child, Preschool* ; Electric Impedance ; Epidemiologic Studies ; Female ; Humans ; Japan ; Jeollabuk-do* ; Korea ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Otoscopy ; Prevalence*

This study was conducted to investigate the vibrio flora in edible shellfish (Ruditapes philippinarum, Scapharca broughtonii, Batillus cornutus and Mytilus coruscus) which were purchased from seafood-market or collected from shellfish culture bed in Pusan and Masan Bay from May to October 1997. Sixty-three vibrio strains were identified among 438 collected strains. Five species of vibrios [V. alginolyticus (22 strains), V. parahaemolyticus (35 strains), V. costicola (2 strains), L. damsela (V. damsela 2 strains), and V. cholerae non-Ol (2 strains)] were identified by their phenotyfic and biochemical characteristics. Four groups (142 strains) were identified as genus Vibrio by their biological characteristics, but they could not be identified to the species level.
Bays ; Busan ; Cholera ; Mytilus ; Population Characteristics ; Scapharca ; Shellfish* ; Vibrio*

The purpose of this study was to evaluate the effects of surface conditioning with 10% polyacrylic acid, etching with 38% phosphoric acid, and polishing with a slurry of pumice on shear bond strengths of light-cured glass ionomer cement, chemically cured glass ionomer cement, and a composite resin to enamel, and to observe the failure patterns of bracket bondings. Shear bond strengths of glass ionomer cements were compared with that of a composite resin. Metal brackets were bonded on the extracted human bicuspids after enamel surface treatments, and samples were immersed in the 37degrees C distilled water bath, and shear bond strengths of glass ionomer cements and a composite resin were measured on the Instron machine after 24hrs passed, and the deboned samples were measured in respect of adhesive remnant index. Scanning electron micrographs were taken of enamel surfaces after various treatments. The data were evaluated and tested by ANOVA and Duncan's multiple range test, and those results were as follows. 1. Shear bond strength of light-cured glass ionomer cement showed statistically higher than that of chemically cured glass ionomer cement. 2. Shear bond strengths of light-cured and chemically cured glass ionomer cements to enamel treated with 10% polyacrylic acid and 38% phosphoric acid showed statistically higher than those with a slurry of pumice. 3. According to scanning electron micrographs, enamel surface conditioned with 10% polyacrylic acid is slightly etched and cleaned, that etched with 38% phosphoric acid is severely etched, and that polished with a slurry of pumice is irregulary scretched and not completely cleaned. 4. After debonding, light-cured glass ionomer cement to enamel treated with 10% polyacrylic acid showed less residual materials on the enamel surface than composite resin to enamel etched with 38% phosphoric acid. 5. There was no significant difference in the shear bond strength of light-cured glass ionomer cement to enamel treated with 10% polyacrylic acid and that of composite resin to enamel etched with 38% phosphoric acid.
Adhesives ; Baths ; Bicuspid ; Dental Enamel* ; Glass Ionomer Cements* ; Glass* ; Humans ; Water

PURPOSE: To report a case of unilateral mydriasis after accidental exposure to an Angel's trumpet leaf. CASE SUMMARY: A 53-year-old woman visited the Eye Department complaining of blurred vision and difficulty in light adaptation in the left eye of 1-week duration. The best corrected visual acuity was 20/20 in both eyes and other ophthalmological findings were considered normal except for dilation of the left pupil and a decrease in light reflex. The patient was initially unaware of any cause of her eye problems, but when asked specifically, the patient remembered an Angel's trumpet leaf brushing against her left eye when she carried the plants. There were no other previous medical or drug histories, thus the Angel's trumpet was considered as the cause for the unilateral mydriasis. The patient's progress was followed for a week, her symptoms improved and the pupil size and reflex returned to normal. CONCLUSIONS: The cultivation of Angel's trumpet has become increasingly popular in Korea in recent years. The present case emphasizes the importance of an accurate and detailed history regarding specific contact history with plants like Angel's trumpet in otherwise healthy patients affected by unilateral mydriasis.
Adaptation, Ocular ; Eye ; Female ; Humans ; Korea ; Light ; Middle Aged ; Mydriasis ; Pupil ; Reflex ; Vision, Ocular ; Visual Acuity

The study was undertaken to evaluate the effect of major blood components on the CT number. The CT numbers according to the various levels of hematocrit, total protein and cholesterol were checked and analysed by the dilution of pack cell, plasma and 184 complete blood cell count samples under same scanning conditions. In case of normal protein and cholesterol level(33 samples), the CT number was increased about 5.5 hounsfield unit according to 10% increase of hematocrit level: and In case of normal hematocrit and cholesterol level(39 samles), the CT number was increased about 3.5 hounsfield unit according to 1gm% increase of protein level. CT number changes were not predictable according to the changes of cholesterol level(34 samples). From these results, we concluded that major blood components should be considered in the CT number analysis of tissue.
Blood Cell Count ; Cholesterol ; Hematocrit ; Plasma Cells

Metaplastic breast carcinoma is very rare, and metaplastic carcinoma with chondroid differentiation is even rarer. Here, we report a case of metaplastic carcinoma with extensive chondroid differentiation mimicking chondrosarcoma that was challenging to diagnose. The tumor was characterized by an abundant chondromyxoid matrix. The definitive area of classic invasive ductal carcinoma was minimal. The peripheral portion of the tumor showed increased cellularity with pleomorphism and definitive invasive growth. Tumor cells in the chondrosarcomatous areas were diffusely immunoreactive for S-100 protein, patchy positive for cytokeratin, but negative for epithelial membrane antigen (EMA). Tumor cells in carcinomatous areas were diffusely positive for cytokeratin, S-100 protein, and patchy positive for EMA. In both areas, tumor cells were negative for smooth muscle actin (SMA) and CD34, while oncoprotein p53 was overexpressed. When pathologists encounter breast tumors with chondroid differentiation, careful sampling and immunohistochemistry for cytokeratin and SMA are most helpful to differentiate metaplastic carcinoma from malignant phyllodes tumor and malignant adenomyoepithelioma.
S100 Proteins/chemistry ; Neoplasm Metastasis ; Muscle, Smooth/pathology ; Middle Aged ; Metaplasia ; Keratins/metabolism ; Immunohistochemistry ; Humans ; Female ; Cell Differentiation ; Carcinoma/*complications/metabolism/pathology ; CA-15-3 Antigen/metabolism ; Breast Neoplasms/complications/metabolism/*pathology ; Antigens, CD34/biosynthesis ; Actins/metabolism