As the traffic accidents and occupational accidents increase, the pure blow out fracture has been increased. If we could know the prognostic information of the pure blowout fracture according to the fracture sites, it would be of benefit in consulting the patients preoperatively and in planning the treatment. In this study we defined the posterior wall fracture as that extending 2 cm from orbital rim and the anterior wall fracture as that presenting within 2 cm from orbital rim. These fractures were individually classified into inferior wall fractures, medial wall fractures, and combined inferior and medial wall fractures, based on the operative finding and the preoperative CT scanning. We experienced 76 cases of pure blowout fracture patients underwent surgical correction and followed up the subsidence of diplopia and extraocular muscle limitation with ophthalmic Hess test. The results obtained are as following: 1. Posterior wall fractures were improved more slowly than anterior wall fractures. 2. Combined inferior and medial wall fractures were improved more slowly than isolate inferior wall or medial wall fractures. These results may be related to the difference of the traumatic forces and the anatomical structure of the fracture sites. These results inform the importance of accurate anatomical reconstruction of fracture sites and can be used as a prognostic information of the pure blow out fractures.
Accidents, Occupational ; Accidents, Traffic ; Diplopia ; Humans ; Orbit ; Orbital Fractures* ; Tomography, X-Ray Computed

Together, the cheek and neck can be considered as a single anatomic location because skin vascularity, texture and thickness are similar. The cervicofacial flap has been described as the treatment of choice for the cheek defect because of its good mobility and excellent cosmetic result. However, if the defects on the cheek are wider than the length of palpebral fissure of extended to the lower two thirds of the cheek, the conventional cervicofacial flaps would be inadequate in size without the benefit of expansion. Tissue expansion of the cheek and neck is distinguished by a particuarly high rate of complication. Prevention of various complications require careful planning and certain modifications in technique. We have used the following modifications and measures to prevent the complications and to maximize the expansion. 1) Whenever possible, expanders were placed over the rigid foundation such as mandible or posterior neck area after wide undermining. 2) Expanders were placed deep to platysma in the neck area. 3) Following optimal expansion, the further dissection extending to the clavicle and the posterior neck area was performed for optimal mobilization and draping of the expanded skin. 4) The expanded skin was advanced upward on the cervical portion and rotated forward on the cheek portion. 5) The flap should not be draped above the inferior orbital rim and postoperatively the pressure garments were applied to prevent drooping of the expanded skin. We experienced 21 cases of the expanded cervicofacial flaps with above surgical modifications and the expanded cervicofacial flaps can resurface the 95% of cheek defects with minimal complications and excellent cosmetic results.
Cheek* ; Clavicle ; Mandible ; Neck ; Orbit ; Skin ; Tissue Expansion

We experienced two cases of Hand, Foot and Mouth Disease with vesicular lesions in the oral cavity and maculopapular rash on hands and feet. The diagnosis was confirmed by clinical features and biopsy findings. Also we made a brief review of literatures.
Biopsy ; Diagnosis ; Exanthema ; Foot* ; Hand* ; Hand, Foot and Mouth Disease ; Mouth

Two rare cases of human infection with parvum (dwarf) type of Diphyllobothrium latum [syn. D parvum (Stephens,1908)], were discovered in Korea. The first case was a 46-year old houseife, from whom a kind of pseudophyllidean tapeworm eggs was detected in the feces. She was treated with praziquantel and purged, and a complete strobila with scolex, 120 cm in total length, was recovered. She recalled that she had eaten raw trouts at a raw-fish restaurant near the Chungju Lake. Another patient was a 22-year old medical student (male), who used to eat raw sea-foods. He discovered a chain of tapeworm proglottids, 15 cm in length, discharged spontaneously in his stool and brought it for identification. The worms from the two cases were compatible with D. parvum (Stephens, 1908) of which the taxonomic significance has long been questioned. After a detailed morphological study and review of literature, we designated the worms as D. latum parvum type. This is the first report on the occurrence of this rare type of D. latum infection in Korea.
parasitology-helminth-cestoda ; Diphyllobothrium latum parvum type ; sea-food ; human ; case report

A case of carotico-cavernous fistula was managed by intravascular occlusion using a Fogarty catheter and ligation of the carotid artery. The fistula was obliterated by the procedure and neurologic deficits improved progressively without further recurrence. The radiological feature, symptomatology and surgical management were discussed.
Carotid Arteries ; Catheters ; Fistula* ; Ligation ; Neurologic Manifestations ; Recurrence

Congenital biliary atresia is the commonest cause of prolonged obstructive jaundice in the neonatal period, and is due to the pathologic closure of a major portion or segment of the biliary tree. The neonate with prolonged obstructive jaundice poses a diagnostic dilemma that may be insoluble by routine clinical and laboratory studies. This applies particularly to the most common entities, neonatal hepatitis and biliary atresia. We esperienced one case of congenital biliary atresia associated with ectopic pancreatic tissue in 23 day-old female which was confirmed by autospy. Literature about congenital biliary atresia were reviewed.
Biliary Atresia* ; Biliary Tract ; Female ; Hepatitis ; Humans ; Infant, Newborn ; Jaundice, Obstructive

A daily count of air borne pollen was done within the city limits of Seoul, Korea for a period of two years (1984-1985) using Durham's Gravity Sampling Device. Two major pollen seasons, March through May, and the month of September, were easily distinguishable. The concentration of the different types of pollen as well as all of the pollens combined varied similarly both years to a significant degree. The pollen types found in the greatest numbers were Alnus (March), Populus (April), Quercus (April-May), Pinus(May), grasses (September), and weeds (September). The main weed pollens detected in September, sagebrush, ragweed and Japanese hop would also be considered to be important allergenic pollens of respiratory allergy in Korea. The results of the survey are discussed in the light of especially relevant published literature.
Air Pollution/analysis* ; Comparative Study ; Human ; Korea ; Pollen/analysis* ; Seasons

The dorsolateral medullary syndrome (Wallenberg's syndrome) is produced by infarction of a wedge of lateral medulla posterior to the inferior olivary nucleus, and is usually caused by vertebral artery occlusion. Ipsilateral axial lateropulsion as an initial symptom of vertebral artery occlusion is rare, and the responsible anatomical structure is still uncertain. Here we describe a patient presenting with ipsilateral axial lateropulsion as an initial symptom of vertebral artery occlusion.
Humans ; Infarction* ; Lateral Medullary Syndrome ; Magnetic Resonance Imaging ; Olivary Nucleus ; Vertebral Artery

Intracranial metastasis of hepatocellular carcinoma have been rarely reported, even in the Orient and Africa where this carcinoma is one of the relatively common malignancies. Hepatocellular carcinomas usually spread to regional lymph nodes around the porta hepatis via lymphatics. But venous metastasis of this cacinoma can occur via intrahepatic vein. The lungs are the most common distant metastatic sites followed by stomach, bones, and adrenals. Recently, we experienced a case of intracranial metastasis of hepatocellular carcinoma associated with epidural hematoma. Although the epidural hematoma and the metastatic tumor mass were totally removed, the patient died of liver complications on the 9th day of postoperative care. The clinical and radiological details of this case are presented here with a brief review of the literature.
Africa ; Carcinoma, Hepatocellular* ; Hematoma* ; Humans ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis* ; Postoperative Care ; Stomach ; Veins

This is the report of 98 cases in renal allograft, which were treated at Yeungnam University Hospital from January 1994 to July 1996 and compared the significance of changes of TNF alpha, IL-2R, IL-6 in blood and urine as an early diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF alpha, IL-2R, IL-6 in patients with renal allografts. Renal allografts patients were divided into four groups (control, acute rejection, acute tubular necrosis, systemic infection) according to their postoperative diagnostic methods. Blood and urine samples in four groups were obtained: control group (2 days before transplantation, at the day of transplantation and every other day after transplantation), acute rejection group (everyday sampling from 2 days before therapy to the end of therapy), acute tubular necrosis and systemic infection group (everyday sampling from the day of diagnosis to the end of therapy). In acute rejection group, there were significant elevation of cytokines; plasma TNF alpha (68.4%, p<0.01), IL-2R (73.6%, p<0.01), and IL-6 (89.5%, p<0.01), urinary TNF-alpha (42.1%, p<0.01), IL-2R (89.5%, p<0.01) and IL-6 (94.7%, p<0.01). In systemic infection group, all cytokines except urinary TNF-alpha were significantly elevated. The results suggested that plasma and urinary TNF-alpha, IL-2R, and IL-6 may play a complementary early diagnostic tool of acute rejection in renal allograft patients although the differential diagnosis is difficult with systemic infection. Urinary TNF-alpha was not elevated in systemic infection group, so it may be used in differential diagnosis between acute rejection and systemic infection.
Allografts* ; Cytokines ; Diagnosis ; Diagnosis, Differential ; Humans ; Interleukin-6* ; Necrosis ; Plasma* ; Tumor Necrosis Factor-alpha*