We studied the incidence and morphological variation of the metopic suture in Korean. Ninety-six adult Korean dried skulls and 141 cases of antero-posterior skull roentgenograms from age of 1 month to 80years old. We divided metopic suture into complete and incomplete type. Incidence of complete type was 8.3% in dried skulls. In roentgenograms the incidence was decreased according to aging, especially around 6-8 years old, and over 20 years old age group the incidence was 4.0%. The incidence of incomplete type was 32.3%.
Adult ; Aging ; Humans ; Incidence ; Skull ; Sutures*

No abstract available.
Esophagus*

No abstract available.
Arteriovenous Fistula* ; Renal Dialysis*

Background/Objectives: Extracapsular dissection has the advantage of reducing complications by minimizing tissue loss of the parotid without intentionally exposing the facial nerve in patients with benign parotid tumor. However, there has been controversy over the surgical results. Thus, the surgical outcomes of extracapsular dissection for benign parotid tumor was compared to those of superficial parotidectomy.Materials & Methods: A retrospective chart review was conducted with 132 patients who received surgery for benign parotid tumor in our center from January 2014 to December 2018 retrospectively. Results: A total of 132 people were enrolled, with 62 people receiving extracapsular dissection, 38 people receiving partial superficial parotidectomy and 32 people receiving superficial parotidectomy. No significant difference was found between the three groups regarding complications such as facial nerve palsy, Frey's syndrome, or first bite syndrome. Operation time and hospital stay was significantly short in extracapsular dissection group. Conclusion For well-selected cases, extracapsular dissection can be considered as an option for surgery of benign parotid tumor.

PURPOSE: The aim of this study was to describe the experience of teaching emergency management and cardiopulmonary resuscitation to medical students in Busan. METHODS: Study participants were 59 medical students in Busan. An eight-day curriculum in the emergency management and cardiopulmonary resuscitation was developed. They completed all class sessions and two drill/practical examinations taught by our interdisciplinary team from July 21 through 30, 2003. Each class is approximately 2 hours and reading assignments are given at the end of each class. Also included are practical, table-top and team-building exercises. The participants completed self-reported questionnaires for the education. RESULTS: About establishment and environment of the education, respondents answered with `very good' were 14%. About overall theoretical lecture, respondents answered with `very helpful' were lower than 40%. Especially, favorable evaluation for the medical lectures was lower than that of other lectures. Students generally enjoyed their emergency medicine experience as it is often their first opportunity to assume primary responsibility for patient care. About overall practices, respondents answered with 'very helpful' were higher than 60%. CONCLUSION: The authors found that medical students prefer opportunities to hone procedural skills than to hear theoretical lectures. Also, medical students are welcome to hear theoretical lectures that consists of emergency management related contents, not academically medical contents. This curriculum should be tailored to fulfill learner's requirements.
Busan* ; Cardiopulmonary Resuscitation* ; Curriculum ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medicine ; Exercise ; Humans ; Lectures ; Patient Care ; Students, Medical*

PURPOSE: To assess long term results of excising benign masses using ultrasound (US)-guided, vacuum-assisted core biopsy (Mammotome). MATERIALS AND METHODS: We enrolled 163 patients (197 masses) receiving USguided excision using vacuum-assisted core biopsy and follow-up sonography in this retrospective study. The masses were category 3 as determined by ultrasound imaging according to the Breast Imaging Reporting and Data System (BI-RADS) (n=145) or pathologically confirmed as benign masses by a previous core-needle biopsy although category 4a and 4b (n = 52). Pathology, the presence of hematoma and residual tissue, as well as scar formation were assessed. RESULTS: We diagnosed 190 (96.5%) benign masses, 4 (2.0%) malignant masses, and 3 (1.5%) high-risk lesions. Most (176 masses, 91.2%) were excised completely as demonstrated by the follow-up ultrasound examination. Scar changes were minimal (68.7%) or moderate (31.3%), with regression in 53%. CONCLUSION: US-guided excision using vacuum-assisted core biopsy is effective for the removal of benign breast masses. The majority of scars are minimal, with good cosmetic effect. However, subsequent excision should be done for malignant masses or phyllodes tumor because radiologic absence does not guarantee complete removal.
Biopsy ; Breast ; Cicatrix ; Cosmetics ; Follow-Up Studies ; Hematoma ; Humans ; Information Systems ; Phyllodes Tumor ; Retrospective Studies

BACKGROUND: Anterior cerebellar artery (AICA) occlusion results in vestibular dysfunctions because the AICA supplies the vestibular nuclei (VN) in the brain stem as well as the peripheral vestibular organs in the inner ear. The purpose of this study was to evaluate the expression of immediate-early gene products, a metabolic marker of neural excitation in neurons, by AICA occlusion in the VN of Sprague-Dawley rats. METHODS: After chloral hydrate anesthesia all animals were subjected to unilateral AICA occlusion by using a microsurgical clamp for 30 min to induce a transient ischemia. Unilateral labyrinthectomy was chemically undertaken to eliminate vestibular afferent activity. Immunohistochemical staining and image analysis for cFos, FosB, Krox-24, and JunB proteins were performed 2 hours after AICA occlusion. RESULTS: There was a high expression of cFos protein in the bilateral medial and inferior VN 2 hours after AICA occlusion. AICA occlusion induced minimal changes in cFos protein expression in the lateral and superior VN. Mild to moderate expressions of FosB and JunB protein in VN was observed 2 hours after ischemic injury of the brain stem and inner ear. On the contrary, the number of cFos and FosB immunoreactive neurons significantly decreased in the medial vestibular nucleus ipsilateral to the injured labyrinth 2 hours after AICA occlusion in the UL group. CONCLUSIONS: These results suggest that ischemic afferent activity from the peripheral vestibular apparatus is essential for the expression of immediate-early gene products in the medial and inferior VN of rats following AICA occlusion.
Anesthesia ; Animals ; Arteries* ; Brain Stem ; Chloral Hydrate ; Ear, Inner ; Equipment and Supplies ; Genes, Immediate-Early* ; Ischemia ; Neurons ; Rats ; Rats, Sprague-Dawley* ; Vestibular Nuclei* ; Vestibule, Labyrinth

Background and Objectives: Surgical resection is the basic treatment for benign laryngeal tumors and transoral laser microsurgery (TLM) has been used effectively. Transoral videolaryngoscopic surgery (TOVS) is another method of surgical resection that has been introduced. However, there have not been any studies related to the usefulness of TOVS in benign laryngeal tumors. The purpose of this study was to compare the efficacy and surgical outcomes of TLM and TOVS.Subjects and Method A retrospective chart review of 85 patients were conducted. This review included two groups (TLM group, n=44 versus TOVS group, n=41) of patients who underwent transoral surgery for benign laryngeal tumors. Clinicopathologic factors of the patients and surgical outcomes such as the operation time, amount of intraoperative bleeding, hospital stay, and complications were compared between two groups. Results: There were no significant differences between two groups regarding the clinicopathologic factors and surgical outcomes. The TOVS group presented relatively larger tumor size (p=0.067) and showed a tendency of shorter operation time (36.8±34.5 min) compared to that of TLM (45.6±27.9 min), but with no statistical significance (p=0.199). Conclusion TOVS may be considered as an alternative surgical method for benign laryngeal tumors.

BACKGROUND: We studied the differences in airway assessment factors among old, middle, and young age groups, and evaluated the frequency and causes of difficult intubation among these groups. METHODS: Patients were divided into young (< 40 yr, n = 75 ), middle (40-59 yr, n = 83), and old (> or = 60 yr, n = 89) group. Airway assessment factors such as head and neck movement, thyromental distance, interincisor gap, dentition, Mallampati score, and Arne score were assessed. After muscle relaxation, cervical joint rigidity and Cormack-Lehane (C-L) grade were assessed. The differences in airway assessment factors between difficult (C-L grade 3, 4) and easy (C-L grade 1, 2) intubation were then examined. Logistic regression analysis was also carried out to identify the extent to which airway assessment factors reflected difficult intubation. RESULTS: As aging, head and neck movement, thyromental distance, and interincisor gap decreased, the grade of dentition, Mallampati score, cervical joint rigidity and the ratio of Arne score > 11 increased. In the old and middle group, the incidence of difficult intubation was increased compared with the young group. Dentition in the young group, Mallampati score and interinsisor gap in the middle group and Mallampati score, cervical joint rigidity in the old group respectively predicted difficult intubation. CONCLUSIONS: Compared to young individuals, middle-aged or elderly adults are likely to experience more difficulty in endotracheal intubation and its predictive factors could vary by age group.
Adult ; Aged ; Aging ; Dentition ; Head ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Joints ; Laryngoscopy ; Logistic Models ; Muscle Relaxation ; Neck

PURPOSE: Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients. MATERIALS AND METHODS: Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected. RESULTS: Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis. CONCLUSION: Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.
Anthracyclines ; Cardiotoxicity ; Dexrazoxane ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Multivariate Analysis ; Neoplasms, Second Primary ; Risk Factors* ; Stem Cell Transplantation