OBJECTIVES: Many studies showed that risperidone and olanzapine in the treatment of delirium were similar to haloperidol, in side effects were superior to that. Quetiapine is frequently used in delirious patients. However, the studies of quetiapine in the treatment of delirium are very few. This study was designed to compare the efficacy of risperidone and quetiapine in elderly patients with delirium. METHODS: We divided 2 groups (risperidone and quetiapine) of elderly patients with delirium. We compared the two groups of elderly patients with delirium by Korean Version of Delirium Rating Scale (K-DRS) and Korean Mini-Mental State Examination (K-MMSE) at baseline and 1 week later. RESULTS: Our results showed that risperidone and quetiapine were efficacious in the treatment of elderly patients with delirium according to using K-DRS and K-MMSE. There were no significant differences in the degree of effects in both drugs. CONCLUSION: We compared the efficacy of risperidone and quetiapine in the treatment of delirium. Quetiapine was as efficacious as risperidone in the treatment of the elderly patients with delirium. In future, the sample size need to be increased in the studies of delirium. And the evaluation of long-term side effects related to quetiapine need to be performed.
Aged* ; Delirium* ; Haloperidol ; Humans ; Risperidone* ; Sample Size ; Quetiapine Fumarate

STATEMENT OF PROBLEM: Various double crown systems have been used with removable partial dentures in the clinical field. Although retentive force between inner and outer crown are affected by several factors, differences between the retentive forces of different double crown system types are expected. PURPOSE: The purpose of this study was to evaluate the initial retentive force of outer crowns fabricated by the conventional casting technique in conus and hybrid double crowns. MATERIAL AND METHODS: Ten double crowns were fabricated. The groups were as follows. Group 1, double crowns of hybrid inner and outer crowns using the conventional casting method; Group 2, double crowns of conus inner and outer crowns using the conventional casting method. Tensile strengths of double crowns when the inner and outer crowns were separated on a universal testing machine were measured. These values of retentive force were then statistically analyzed using the Kruskal-Wallis test. RESULTS: Retentive force in group 2 was significantly higher than that in group 1 (p<.05). CONCLUSION: The initial retentive forces of double crowns were affected by the types of the double crown system.
Conus Snail ; Crowns* ; Denture, Partial, Removable ; Tensile Strength

This is a case of a 30-year-old man who was referred to our hospital for evaluation of a rapidly growing tumor in the left thyroid gland. It was palpated 2 weeks ago. But it was growing fast. A 4x3 cm mass was palpated in the left thyroid gland. Our impression was anaplastic thyroid carcinoma. Computed tomography finding indicated a thyroid malignant tumor and cytology result suggested spindle cell neoplasm. A lower anterior neck mass was resected and final histopathological result turns out to be a rhabdomyosarcoma (RMS). Although cervical RMS is very rare in adults, it has to be included for the differential diagnosis for the rapidly growing mass at thyroid gland.
Adult ; Diagnosis, Differential ; Humans ; Neck ; Rhabdomyosarcoma* ; Thyroid Gland* ; Thyroid Neoplasms*

The upper and lower lateral cartilages provide the key to the lower cartilaginous portion of the nose. Lifting the cartilages is essential procedure for correction of unilateral cleft lip nose deformity. After correction of cleft lip nose deformity, authors used acoustic rhinometry (AR) to compare the lower nasal cavity of cleft side with non-cleft side. AR is a well known new, non-invasive diagnostic technique in which nasal geometry is assessed by means of acoustic reflection. From June 1996 to January 2004, we performed acoustic rhinometric analysis after correction of unilateral cleft lip nose deformity. This study involved 40 children of age ranged from 3 months to 8 years. Subjects were divided into the group of incomplete unilateral cleft lip nose deformity(20 subjects), and the group of complete unilateral cleft lip nose deformity(20 subjects). Results show that lower nasal cavity volume between non-cleft side and cleft side has no difference, and better results were obtained when nasal molding prong was applied at cleft side nostril. The results between incomplete type and complete type have no significant difference. In conclusion, AR is an effective method to calibrate cross sectional area and nasal cavity volume of unilateral cleft lip nose deformity, and furthermore effective in comparing the volume of cleft side with non-cleft side after unilateral cleft lip nose deformity correction with lifting the lower lateral cartilages to the upper lateral cartilages.
Acoustics* ; Cartilage ; Child ; Cleft Lip* ; Congenital Abnormalities* ; Fungi ; Humans ; Lifting ; Nasal Cavity ; Nose* ; Rhinometry, Acoustic

PURPOSE: Direct anthropometry is an ideal method for preoperative planning and postoperative evaluation in plastic surgery, but it requires highly skilled specialty. Indirect anthropometry, especially photogrammetry, is an alternative method. In photogrammetry, standardized clinical photography is essential. Photogrammetry-based standardized clinical photography has several advantages over direct anthropometry. It is easier to measure and has less chance to make errors during measurement. Furthermore, it is possible to repeat measurements, and available for follow up study based on permanent custody. But, it is still different from actual measurement, and inherently less accurate than anthropometry. METHODS: The authors revised the standardized clinical photography and then, carried out photogrammetry using Photoshop(Adobe, U.S.A.), and compared each data with those of anthropometry. The subjects were 50 males and 50 females, undergraduate medical students in twenties. Standard head position was obtained from the wire, fixed to cephalostat which indicates the Frankfort horizontal plane. All photographs were taken at the same situation such as fixed position of light, subject and camera, etc. RESULTS: Total 96 measurements, based on 40 landmarks, consist of linear measurements, angular measurements and inclinations include 3 measurements in head, 22 in face, 15 in orbit, 28 in nose, 16 in lip and mouth, and 12 in ear. CONCLUSION: Normal photogrammetric data of face of Korean in twenties was obtained. Reliable photogrammetric measurements, not significantly different from anthropometric measurement statistically, accounted for 44 in 96 measurements(45.8%). Anthropometric values different from those of photogrammetric values were obtained by multiplying coefficient by photogrammetric value.
Anthropometry ; Ear ; Female ; Follow-Up Studies ; Head ; Humans ; Lip ; Male ; Mouth ; Nose ; Orbit ; Photogrammetry* ; Photography* ; Students, Medical ; Surgery, Plastic

PURPOSE: Direct anthropometry is an ideal method for preoperative planning and postoperative evaluation in plastic surgery, but it requires highly skilled specialty. Indirect anthropometry, especially photogrammetry, is an alternative method. In photogrammetry, standardized clinical photography is essential. Photogrammetry-based standardized clinical photography has several advantages over direct anthropometry. It is easier to measure and has less chance to make errors during measurement. Furthermore, it is possible to repeat measurements, and available for follow up study based on permanent custody. But, it is still different from actual measurement, and inherently less accurate than anthropometry. METHODS: The authors revised the standardized clinical photography and then, carried out photogrammetry using Photoshop(Adobe, U.S.A.), and compared each data with those of anthropometry. The subjects were 50 males and 50 females, undergraduate medical students in twenties. Standard head position was obtained from the wire, fixed to cephalostat which indicates the Frankfort horizontal plane. All photographs were taken at the same situation such as fixed position of light, subject and camera, etc. RESULTS: Total 96 measurements, based on 40 landmarks, consist of linear measurements, angular measurements and inclinations include 3 measurements in head, 22 in face, 15 in orbit, 28 in nose, 16 in lip and mouth, and 12 in ear. CONCLUSION: Normal photogrammetric data of face of Korean in twenties was obtained. Reliable photogrammetric measurements, not significantly different from anthropometric measurement statistically, accounted for 44 in 96 measurements(45.8%). Anthropometric values different from those of photogrammetric values were obtained by multiplying coefficient by photogrammetric value.
Anthropometry ; Ear ; Female ; Follow-Up Studies ; Head ; Humans ; Lip ; Male ; Mouth ; Nose ; Orbit ; Photogrammetry* ; Photography* ; Students, Medical ; Surgery, Plastic

OBJECTIVES: Patients with organic brain lesion can produce unique slow waves (delta and theta) in the EEG. Basic assumption of this study was that the low resolution electro magnetic tomography (LORETA), an inverse source localization program, can provide functional images representing increased slow wave activity in these patients compared to normal subjects. METHODS: The current study was performed by 18 channels digital EEG for 10 patients whose organic deficit have been visually confirmed by CT or MRI. The source images of slow wave (1-7 Hz) frequency were produced by LORETA-key program. RESULTS: We found that in eight out of ten subjects, LORETA successfully found out the source regions which were very closely matched to their original brain lesions. However in two subjects whose organic brain lesions were too small (<1 cm) and located out of gray matter, we failed to find any increased slow wave activity compared with normal control. CONCLUSION: We can conclude that LORETA could be a useful method to provide functional imaging in patients with gray matter deficits in their brain. Its usefulness and limitations were discussed.
Brain* ; Electroencephalography ; Functional Neuroimaging ; Humans ; Magnetic Resonance Imaging ; Magnets* ; Neuroimaging*

PURPOSE: To evaluate the effects of preoperative and postoperative parameters, particularly anterior chamber depth, on corneal endothelial cell loss during cataract surgery. METHODS: Eighty-two eyes of 82 patients who underwent cataract surgery by the same surgeon using the same technique were selected for the present study. Various preoperative and postoperative parameters including age, anterior chamber depth, duration and power of phacoemulsification, preoperative endothelial cell density, coefficient of variation, hexagonality, and grade of nucleosclerosis were evaluated. Endothelial cell densities were recorded preoperatively and at two months postoperatively using a noncontact specular microscope. RESULTS: After two months, the mean central endothelial cell loss in all eyes was 8.77%. Among the pre- and post-operative parameters, patient' age, anterior chamber depth, duration, power, and energy of phacoemulsification and grade of nucleosclerosis showed significant correlation with endothelial cell loss. Stepwise multiple linear regression analysis identified age, nucleosclerosis, anterior chamber depth, and phacoemulsification time as independent predictors for endothelial cell loss. CONCLUSIONS: The risk of endothelial cell loss increased with increases in patient' age, nucleosclerosis, and phacoemulsification time. However, eyes with a deep anterior chamber showed a significantly lower risk of endothelial cell loss.
Anterior Chamber ; Cataract ; Cornea ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Eye ; Humans ; Linear Models ; Phacoemulsification

BACKGROUND: Pneumonia is a common medical complication after acute stroke, and makes a considerable influence on the prognosis. It is potentially preventable or treatable if early recognized. Thus, the identification of which patients are at risk for the development of pneumonia is clinically significant. METHODS: A total of 240 patients with an acute stroke who were consecutively admitted to a Seoul National University Hospital were studied. The following prognostic factors were accounted for in the statistical analyses: age, sex, hypertension, diabetes, cardiac disease, smoking, recurrent stroke, NIHSS, modified Rankin scale (mRS), the presence of dysphagia, blood pressure, body temperature, white blood cell count, blood sugar, fibrinogen, Levin tube insertion, Foley catheter insertion, and subtype of stroke. RESULTS: Pneumonia was diagnosed in 36 (17.0%) patients during the acute stage of stroke, particularly within 2 weeks. Average admission stay of patients with pneumonia was 38.7 days, whereas it was 19.3 days for those without pneumonia. By multivariate analysis, Levin tube insertion, body temperature, recurrent stroke, and mRS were significant predictor of pneumonia development. Forty percent of patients with four or five points of mRS developed pneumonia, compared to 6% in less than four points. CONCLUSIONS: Our results show that the patients who have Levin tube, high mRS, or recurrent stroke tend to develop pneumonia after acute stroke. It is important for early detection and prevention of pneumonia in patients with high mRS.
Blood Glucose ; Blood Pressure ; Body Temperature ; Catheters ; Deglutition Disorders ; Fibrinogen ; Heart Diseases ; Humans ; Hypertension ; Leukocyte Count ; Multivariate Analysis ; Pneumonia* ; Prognosis ; Seoul ; Smoke ; Smoking ; Stroke*

Total hip arthroplasty in patients with chronically dislocated hips poses many challenging technical problems. Abnormal relationship of bones and soft tissues occurs in chronic complete dislocation of the hip (grade IV, Crowe's classification). Problems in placing the acetabular component in the true acetabulum include, first how to cover the acetabular component sufficiently, second how to fix it securely and last how to avoid excessive stretching of the neurovascular structures such as the sciatic nerve. The authors have introduced a technique of one stage distal femoral shortening in order to avoid excessive stretching of the neurovascular structures. From December 1988 to May 1996, the total hip arthroplasties combined with one stage distal femoral shortening were carried out in chronic complete dislocation of 44 hips (grade IV, Crowe's classification) and followed-up more than two years. This method has several advantages: It preserves wide and healthy proximal metaphysis of the femur, does not need greater trochanteric osteotomy, and provides many chances to choose the appropriate stem size and shape, especially in cementless total hip arthroplasty.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Femur ; Hip Dislocation* ; Hip* ; Humans ; Osteotomy ; Sciatic Nerve