First branchial cleft anomalies constitute less than one percent of all branchial arch anomalies. First branchial clefi anomalies are classified into 2 digerent types with different embryologic, anatomical and histologic features by Work (1972)1. Among 2 types, type II anomaly is less common than type I and there has been no report of type II anomaly in the Korean literatures. We experienced a 5-year-old female who had a inflammed cystic mass over neck which was extended into parotid area After elevation of parotidectomy skin incision and superficial parotid gland, the cystic mass was observed to be extended upward into the parotid gland, medial to the facial nerve and ended at the external auditory canal. Microscopic examination shows that cyst wall is lined with squamous epithelium and contains some mesodermal tissue such as pilosebaceous gland and muscle. In conclusion, we can present this case as the first branchial cleft anomaly type II.
Branchial Region* ; Child, Preschool ; Ear Canal ; Epithelium ; Facial Nerve ; Female ; Humans ; Mesoderm ; Neck ; Parotid Gland ; Skin

Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

No abstract available.
Head* ; Neck*

No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1*

The ankle is a modified hinge joint consisting of tibial plafond, medial and lateral malleolus, talus and many soft tissue structures, which plays important role in weight bearing and walking. Hence, the ankle injuries include not only fractures of bone but often also the rupture of ligaments and soft tissues, so if the structures were not accurately repaired, many complications may develop. The authers analysed 98 cases (96 patients) of the ankle fractures which were admitted and treated in Orthopaedic Department, Soon Chun Hyang University Hospital from January 1979 to August 1983. The results obtained are as follows: 1. Of the 98 cases, male was 70 cases(71.9%), female was 28 cases and the average age of the patient was 31,1 years. 2. The most common cause of the fracture was traffic accident and the other causes were slip down, sports injury, fall down and industrial injuries in order. 3. 83 cases(84.7%) out of the 98 cases of ankle fractures were closed fracture and the rest was open fracture. 4. The most common type of the ankle fracture, according to the classification of Lauge-Hansen, was supination external rotation type. 5. 68 cases were treated with open reduction and internal fixation and 30 cases were treated with closed reduction, among the cases of closed reduction, the 14 cases were indicated to open redu- ction but it was impossible due to improper skin condition, severe comminution and anesthetic problem. 6. The average duration of the cast immobilization in closed treatment was 10.1 weeks and in operative treatment was 6.3 weeks. 7. The results of the treatment was better in those cases of the open reduction, the early reduction and the mildly displaced cases than the results of closed reduction, delayed reduction and severely displaced cases. 8. The incidence of complication, such as traumatic arthritis and nonunion occured higher in the cases treated with closed method.
Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Rupture ; Skin ; Supination ; Talus ; Walking ; Weight-Bearing

Whiplash injury in low-speed traffic accidents are not objectively verified by medical equipment, thereby creating scope for misuse, which has resulted in huge social losses worldwide. The aim of this study was to examine the influence of low-speed vehicular rear-impact collisions on middle-aged men, and to analyze the head and neck injury criteria for the symptomatic human volunteers. Data was examined from the results of 50 dynamic sled tests, originally performed by Hong et al. (2012). In the previous tests, 50 men aged 30~50 years were exposed to an impulse equivalent to a bumper-to-bumper rear collision under medical supervision, and no resulting whiplash injury was identified. In this study, for 6 subjects who experienced dull aches over their bodies, head injury criteria (HIC15) and neck injury criteria (N(km)) were calculated according to the accelerations, forces, and moments at the occipital condyle measured by motion capture system. Although there were no changes in magnetic resonance imaging findings in all subjects at the pre-/post-test orthopedic examination, 6 subjects revealed mild aches around the shoulder, back, or lumbar area, and their symptoms disappeared within 2 days. The head and neck injury criteria, HIC15 (3.086 +/- 2.942) and N(km) (0.077 +/- 0.064) were obtained, and the maximum HIC15 and N(km) were found to be significantly lower than the critical injury assessment reference values (HIC15: 700, N(km): 0.3). Moreover, even though 2 subjects were exposed to the same level of change of velocity (7.9 km/h), each N(km) was significantly different (0.179, 0.057). One can therefore conclude that N(km) can vary according to voluntary movements in the human subject.
Acceleration ; Accidents, Traffic ; Aged ; Automobiles ; Craniocerebral Trauma ; Head ; Human Experimentation ; Humans ; Magnetic Resonance Imaging ; Male ; Neck ; Neck Injuries ; Organization and Administration ; Orthopedics ; Reference Values ; Shoulder ; Whiplash Injuries

IMR is useful for assessing the microvascular dysfunction after primary percutaneous coronary intervention (PCI). It remains unknown whether index of microcirculatory resistance (IMR) reflects the functional outcome in patients with anterior myocardial infarction (AMI) with or without microvascular obstruction (MO).This study was performed to evaluate the clinical value of the IMR for assessing myocardial injury and predicting microvascular functional recovery in patients with AMI undergoing primary PCI. We enrolled 34 patients with first anterior AMI. After successful primary PCI, the mean distal coronary artery pressure (Pa), coronary wedge pressure (Pcw), mean aortic pressure (Pa), mean transit time (Tmn), and IMR (Pd * hyperemic Tmn) were measured. The presence and extent of MO were measured using cardiac magnetic resonance image (MRI). All patients underwent follow-up echocardiography after 6 months. We divided the patients into two groups according to the existence of MO (present; n = 16, absent; n = 18) on MRI. The extent of MO correlated with IMR (r = 0.754; P < 0.001), Pcw (r = 0.404; P = 0.031), and Pcw/Pd of infarct-related arteries (r = 0.502; P = 0.016). The IMR was significantly correlated with the DeltaRegional wall motion score index (r = -0.61, P < 0.01) and DeltaLeft ventricular ejection fraction (r = -0.52, P < 0.01), implying a higher IMR is associated with worse functional improvement. Therefore, Intracoronary wedge pressures and IMR, as parameters for specific and quantitative assessment of coronary microvascular dysfunction, are reliable on-site predictors of short-term myocardial viability and Left ventricle functional recovery in patients undergoing primary PCI for AMI.
Adult ; Aged ; Aged, 80 and over ; Anterior Wall Myocardial Infarction/*physiopathology ; Arterial Pressure/physiology ; Coronary Occlusion/pathology ; Echocardiography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microcirculation/*physiology ; Middle Aged ; Percutaneous Coronary Intervention ; *Predictive Value of Tests ; Prospective Studies ; Recovery of Function ; Risk Factors

No abstract available.
Emergencies* ; Emergency Service, Hospital*

BACKGROUND: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. MATERIALS AND METHODS: From January 1998 to December1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication, success rate and patient's satisfaction were evaluated. RESULTS: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication, bladder perforation occurred in one patient(2.4%), residual urine sensation developed in seven patients(16.7%). and suprapubic pain was complained in five patients(11.9%). which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instablility were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. CONCLUSION: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence. but a longer follow-up is necessary to determine long term effect.
Catheters ; Cholinergic Antagonists ; Drainage ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Sensation ; Urinary Bladder ; Urinary Incontinence*

BACKGROUND: The major risk factors such as hypercholesterolemia, hypertension, diabetes melitus and cigarrete smoking have not been studied in an attempt to provide a composition of major risk factors in Korea. Also we have met with some patients without major risk factors. METHODS: A Retrospective Study was done on 160 patients of acute myocardial infarction who had been admitted to National Medical Center within 48 hours from onset, from January 1948 to December 1992 and studied on major risk factors of acute myocardial infarction. RESULTS: 1) Among major risk factors, smoking was found in 50%, hypertension in 49%, diabetes in 25% and hypercholesterolemia in 21%. 2) The percentage of patients without major risk factors was 19%. 3) Among major risk factors, hypertension, hypercholesterolemia and diabetes were increasing tendencies, recentely. CONCLUSION: Some patients with acute myocardial infarction don't have any major risk factors. Also hypertension, hypercholesterolemia and diabetes were increasing tendencies. So further study for other risk factors is needed and preventive management should require a commitment to behavior modification and alteration in life-style.
Behavior Therapy ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking