Though proper management of hand burns in children is provided, hypertrophic scars frequently cause various hand deformities or functional disturbances in growing hands. When correction principles have not been observed for the long term, contraction of the skin, tendon and joints has a serious influence on hand deformities and bone change occur in growing children and second, to determine when is the proper operative time to minimize hand deformities and recurrences. We reviewed 107 hands in 103 admitted pediatric patients who had postburn hands deformities by scar contracture. The analysis of severity of hand deformities was evaluated by assessment of our hospital scale. According to these data, we performed the operations and compared the final results. The results were as follows: The types of burn hand deformities among 107 involved hands of 103 patients included flexion contracture (39.3%), syndactyly (29.9%), extension contracture (10.3%), Boutonniere deformity (9.3%), claw hand deformity (5.6%), severe hypertrophic scar (3.7%), swan neck deformity (0.9%), and loss of digit (1.9%) etc. On 98 preoperative x-ray examinations, bone changes were common, including angular deformity (19.4%), epiphyseal plate loss(18.4%), osteoporosis (17.3%), bony erosion (17.3%), joint change (15.3%), and ankylosis (9.2%). Thus, early correction of postburn hand deformities is imperative in pediatric patients, even though there is a greater chance of secondary operation due to immature scars. All patients were operated on by our proposed protocol and postoperative results showed greatly improved finger joint motion than before. We concluded that early correction of Grade III to V postburn hand deformities is mandatory in rapidly growing pediatric patients.
Animals ; Ankylosis ; Burns* ; Child* ; Cicatrix* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Finger Joint ; Growth Plate ; Hand Deformities* ; Hand* ; Hoof and Claw ; Humans ; Joints ; Neck ; Operative Time ; Osteoporosis ; Recurrence ; Skin ; Syndactyly ; Tendons

The surgical correction of postburn nose and lips deformities still remains a difficult task domain to be done by plastic surgery. Consequently, the performance of autogenous cartilage graft and ear cartilage graft to maintain a better philtral form were found to raise the problem of a defect in the unnatural form due to consecutive tension in the region. Recently, focus had been placed on composite graft, including auricular cartilage, to obtain a unique dimple in the philtrum, and concurrently with this, part of its natural form has been acknowledged. However, composite graft on scar beds with poor circulation on the recipient site dose not represent safe survival, has increased risk allotment, which laeds to difficult application. From Jan. 1992 to Dec. 1998, the authors have experienced auricular composite graft in 15 patients who had a defect on the philtrum due to postburn scar contractures. As types of this operation, in method I, the subcutaneous pocket is made at the midline of the upper lip. The next step is cartilage insertion into subcutaneous tissue. The cartilage graft is fixed to be overlying skin by the bolus sutures. In Method II, the recipient site is excavated by some excision of the soft tissue in the central upper lip after scar tissue excision. The obtained auricular skin composite graft is placed and fixed to the philtral area. In Method III the auricular skin composite graft is harvested, and 2 or more 2mm-sized multiple holes are made along the midline of cartilage. Then composite graft is fixed to the defects of philtrum. The elongated portion of the distal tip of cartilage is embedded into the vermilion tubercle for sprouting and fullness. The most effective method was Method III, which enhanced the survival of auricular cartilage graft and its overlying skin, by trimming the margin of grafts, and enhancement of the connecting vessels through fenestrated holes of cartilage between the recipient site and composite graft. The authors hereby report the results of the present study along with study findings based on literature surveys.
Burns* ; Cartilage ; Cicatrix* ; Congenital Abnormalities ; Contracture ; Ear Cartilage ; Humans ; Lip ; Nose ; Skin ; Subcutaneous Tissue ; Surgery, Plastic ; Sutures ; Transplants*

PURPOSE: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-gamma release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON(R)-TB Gold In-Tube (QFT-GIT) and compared their results. METHODS: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. RESULTS: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the non-intrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFT-GIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. CONCLUSION: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.
Adolescent ; Child ; Follow-Up Studies ; Humans ; Interferon-gamma Release Tests ; Korea ; Latent Tuberculosis ; Outpatients ; Skin ; Skin Tests ; Tuberculin ; Tuberculosis

A survey was done on the participants of the previous education seminar. Eighty two endoscopists from 67 instituties had replied and 50 practitioners replied for a total of l32 that were surveyed and analyzed. (continue...)
Education* ; Endoscopy* ; Korea*

No abstract available.
Esophageal and Gastric Varices* ; Hemorrhage*

OBJECTIVE: This study was designed to evaluate whether maternal serum human chorionic gonadotropin(hCG) level measured during second trimester could be used as a predictor of pregnancy-induced hypertension. METHODS: Between March 1996 and November l997, 505 pregnant women undergoing second trimester(14-22 weeks of amenorrhea) triple marker screening for neural tube defect and Down syndrome who delivered at our institution were reviewed. All samples were assayed in the same laboratory and medical records were reviewed about medical and obstetrical history. RESULTS: Maternal serum human chorionic gonadotropin level(multiples of the median, MoM) was significantly higher in the pregnancy-induced hypertension group than in the control group. With the use of 2. l multiples of the median as a cutoff value, the sensitivity of human chorionic gonadotropin as a screening marker for development of pregnancy-induced hypertension was 38.7%, the specificity was 95.9%, positive predictive value was 38.7% and negative predictive value was 95.9%. Conlusion: We suggest that second trimester maternal serum human chorionic gonadotropin levels can be used clinically as an early predictive marker for pregnancy-induced hypertension.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Humans ; Humans* ; Hypertension* ; Hypertension, Pregnancy-Induced ; Mass Screening ; Medical Records ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Sensitivity and Specificity

BACKGROUND: Candida species are one ol the major pathogens causing opportunistic infection. The need for a standardized. and clinically relevant method for antifungal susceptibility testing has become more increased because resistance to antifungal agents is now being reported with increasing frequency. The purposes of this study were to measure the minimal inhibitory concentrations actions amphotericin B, flucytosine and fluconazole of clinical isolates of Candida species, and to evaluate broth microdilution method as a more efficient test method, compared with NCCLS standard broth macrodilution. METHODS: The minlmal Inhibitory concentrations of C. parapsilosis ATCC 90018, C, albicans ATCC 90028 and 32 Candida isolates from Korea University Hospital were evaluated against amphotericin B, flucytosine and fluconazole by broth macrodilution and microdilution methods. RESULTS: The minimal inhibitory concentrations of Candida species ranged 0.25 to 1.0 microgram/mL for amphotericin B, 0.125 to 2.0 microgram/mL for flucytosine and 0.125 to 64 microgram/mL for fluconazole. The percent of agreement between NCCLS standard broth macrodilution and microdilution was highest when inoculum size was 0.5-2.5x103 CFU/mL and incubation time was 48 hours, and one fold dilution agreement was 100% for amphotericin B, 100% for flucytosine and 88-96% for fluconazole. CONCLUSIONS: This study showed good agreement of results of broth microdilution test with those of macrodilution, and suggested that broth microdilution method is an accessible and useful method and can be substituted for broth macrodilutlon method with the expectation of good results.
Amphotericin B ; Antifungal Agents ; Candida* ; Fluconazole ; Flucytosine ; Korea ; Opportunistic Infections

OBJECTIVE: Base on clinical practice, the authors report a case of tardive dyskinesia arising during the course of treatment with resperidal. METHODS: This article was review and analysis of a case on risperidone-induced tardive dyskinea. RESULTS: Mrs K, a 51-year-old women with a 1-year history of schizophrenic disorder, gradually developed tardive dyskinetic movement of the mouth, lip, and tongue over a 4 month period(From July 1996 to June 1997) while taking risperidone. Initially she was treated with haloperidol and alprazolam. However, the haloperidol was subsequently discontinued because of EPS developed. From 11th March 1997, she was observed to have a severe form of tardive dyskinesia involving her tongue, lip, and mouth. After risperidone was withdrawn at 9th May 1997, her tardive dyskinetic movement was disappeared. CONCLUSIONS: This is, to our knowledge, the first report of the onset of tardive dyskinesia in a patient taking risperidone. However, additional controlled studies of specific questions are needed ; e.g., the dose-response curves for produce tardive dyskinesia and the mechanism of producing risperidone-induced tardive dyskinea and so on.
Alprazolam ; Female ; Haloperidol ; Humans ; Lip ; Middle Aged ; Mouth ; Movement Disorders* ; Risperidone ; Schizophrenia ; Tongue

The injection of paraffin for cosmetic purpose is an illegal method as it evokes late complications such as the development of grauuloma, migration of foreign body, inflammation, ulceration, embolic phenomenon, etc. However, paraffin has been used by some unauthorized people for the augmentation of the soft tissue, i.e. face, breasts, as they can easily reansform the body contour in a short time and paraffin is not expensive to do so. Paraffinoma has been reported frequently as a delayed or late complication of foreign body reaction in the field of plastic surgery. And various mehtods of its surgical treatment also has been a topic of plastic surgeon, as postoperative outcome is not satisfactory. As the nose is located at the center of face, the patients who are suffering from paraffinoma in nose could not conceal their deformed appearance by cosmetics. Therefore the only method of improvement is surgical removal of paraffinoma. Paraffinoma of nose has been removed by transcolumellar, infracartilaginous, intercartilaginous incision. However, complete removal of the foreign material does not seem to be possible, may leave complications such as hematoma and overlying skin necrosis, and the remaining foreign material does not permit symmetric appearance. We experienced excision of paraffinoma by direct incision on nasal dorsum. 3 patients with paraffinoma of nose were successfully treated without any complications by vertical elliptical excision on the dorsum of the nose, and scars on nasal dorsum were acceptable with satisfaction by patients. Therefore, the authors concluded that excision of paraffinoma by direct incision on nasal dorsum is a good method for symmetric resection of foreign material, low risk of complication.
Breast ; Cicatrix ; Foreign Bodies ; Foreign-Body Reaction ; Hematoma ; Humans ; Inflammation ; Necrosis ; Nose ; Paraffin ; Skin ; Surgery, Plastic ; Ulcer

Although the incidence of tuberculous arthritis of the hip is being decreased with improvement of hygiene and preventive measures and chemotheraphy, it remains as important disease in orthopedic surgery. In order to evaluate which treatment is best in the view of eradication of the tuberculosis and preservation of the function, seventy two patients of tuberculous arthritis of the hip who were treated at the Department of Orthopedic Surgery, Seoul University Hospital for periods of 14 years between January 1970 and August 1983 were analysed clinically. The results are as follows: 1. Age distribution showed that patients below 15 years were thirty (41.7%) and those above 16 years were forty two (58.3%). 2. Onset of the symptoms above 1 year occupied forty two patients (58.3%). 3. Duration of follow up is between 1 year and 14 years with average duration of 3.5 years. 4. Recurrence rate according to the modality of treatment was 12.9% as 4 cases among 31 cases of hip fusion group, 15,2% as 5 cases among 33 cases of synovectomy group, and 28.6% as 2 cases among 7 cases of conservative group. 5. Follow up of the functional evaluation of the hip was 92.9% of “above Fair” as 26 cases among 28 cases of synovectomy group, 60% of “above Fair” as 3 cases among 5 cases of conservetive treatment group, and 25.7% of “above Fair” as 9 cases among 35 cases of hip fusion group. 6. Although the recurrence rate of synovectomy group is a little higher than that of hip fusion group, synovectomy is a better treatment in the view of the preservation of the function of the hip considering Korean life style.
Age Distribution ; Arthritis ; Follow-Up Studies ; Hip ; Humans ; Hygiene ; Incidence ; Life Style ; Orthopedics ; Recurrence ; Seoul ; Tuberculosis