No abstract available.

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

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

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.