No abstract available.
Clavicle* ; Dislocations*

The main goal of spinal surgery using implant is a rigid fixation to provide the stability until solid fusion will occur. Recently, various implant fixation devices have been introduced and transpedicular screw fixation is the usual method. In the past, we obtained the implant-related complications like screw failure and rod breakage after using the modified Harrington rod. However, we obtained good results after follow up over one year using TSRH instrument. We experienced spinal surgery using TSRH instrument in 42 cases since 1991 and followed from one year to 28 months with average 16 months. We analyzed the 28 cases and evaluated the implant-related problems. The results were as follows: 1. Among 28 patients, 10 patients were operated due to fracture and 9 patients operated due to spinal stenosis. 2. The male patients were 16 cases and the female were 12 cases. 3. The TSRH instruments provided the rigid fixation with three points clamping mechanism. 4. The cross-linking plate of TSRH was found to increase stiffness and strength. 5. There were no case of screw breakage. 6. In functional results by Kirkaldy-Willis; foriteria the excellent cases were 15, and the good were 2 cases.
Constriction ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Spinal Stenosis

One hundred and thirty-eight strains of Mycobacterium tuberculosis isolated from the 7th nationwide tuberculosis prevalence survey in 1995 were subjected to the restriction fragment length polymorphism (RFLP) analysis using IS6110 probe to define the representative fingerprinting patterns of Korean strains of M. tuberculosis and to evaluate the usefulness of DNA fingerprinting in tracing the transmission link of M. tuberculosis. Among 138 strains, 129 different IS6l10 RFLP types were identified. The number of bands in IS6110 RFLP types diversed from 1 to 20, and the majority (75%) was 9 to 14 bands. The RFLP patterns of 8 out of 15 strains isolated from the follow-up survey of one and half year later after the 7th national TB prevalence survey were unchanged when compared with previous RFLP patterns. Fifteen (11%) out of 138 strains were grouped in 6 IS6110 clusters; 2 with 10 copies, 2 with 12 copies, 1 with 14 copies, and 1 with 17 copies. These clusters were unable to be subclassified by IS1081 or (GTG) probes except one cluster by pTBN12 probe. The transmission links of 2 clusters were deducible; one from household and another from neighborhood, but those of remaining clusters were unclear because they had no contact one another. The results suggest that vigorous transmissions in tuberculosis are still progressing in Korea.
Dermatoglyphics ; DNA Fingerprinting* ; DNA* ; Family Characteristics ; Follow-Up Studies ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Restriction Fragment Length ; Prevalence* ; Residence Characteristics ; Tuberculosis*

In correction of ptosis, symmetry of lid contour, lash position and lid height must be matched. Most of blepharoptosis patients want to perform both the double eyelid operation and ptosis repair at the same time to achieve the best cosmetic and functional result. Using a surgical technique directed at the levator aponeurosis or the frontalis muscle with double eyelid operation, we corrected 13 cases of unilateral and 10 cases of bilateral congenital blepharoptosis. In unilateral ptosis with good or fair levator function, levator resection was performed and the position of the lid margin was adjusted at 1~2 mm below the superior limbus. The height of the lid crease of the ptotic eye is determined 1~3 mm lower than that of normal side. The position of the lid margin is adjusted at the level of the superior limbus and the height of the lid crease of the ptotic eye is determined 2~4 mm lower than that of nonptotic side. The advantages of this approach are normal anatomic planes of the eyelid are maintained, to obtain symmetry of both eyelids relatively easily, entropion may be prevented, and to achieve aesthetically pleasing results.
Blepharoptosis* ; Entropion ; Eyelids* ; Humans

No abstract available.
Genetic Therapy* ; Oligonucleotides*

No abstract available.
Gastroenteritis* ; Humans*

The effects of muscle relaxants and intravenous anesthetics on intraocular pressure(IOP) were studied in 40 patients ranging in age from 12~63 years and undergoning elective non-ophthalmic surgery. IOP was measured with the PErkins Applanation Tonometer before induction, 1 minute and 2 minutes after intravenous anesthesia, 1 minute after succinylcholine and 1 minute after intubation. The patients were divided into 4 groups: thiopental+succinylcholine+intubation (group A, control group) : pnacuronium pretreatment+thiopental+succinylcholine+intubation (group B): ketamine+succinylcholine+intubation (group C): and, pancuronium+ketamine+succinylcholine+intubation(group D). The results were as follows: 1) In group A, IOP changes following thiopental (5mg/kg) administration showed a highly significant decrease (p<0.01) after 1 minute and significant decrease(p<0.05) after 2 minutes compared with the control value. In group B, IOP changes following thiopental admistration decreased significantly(p<0.05) after 1 minute and 2 minutes compared with the control value. 2) The IOP changes following ketamine(2mg/kg) administration in group C and D showed mild increases or decreases and were not statiscally significant(p>0.05). 3)IOP changes after 1 minute following succinylcholine(1mg/kg) administration showed significant increases(p<0.05) in group A, C and highly significant increases(p<0.01) in group D. IOP changes after 1 minute of endotracheal intubation showed highly significant increases (p<0.01) compared with the control value in group A, C and D. 4) Pretreatment with a mondepolarizing muscle reaxant could not prevent the increase in IOP following succinylcholine administration.
Anesthesia, Intravenous ; Anesthetics, Intravenous* ; Humans ; Intraocular Pressure* ; Intubation ; Intubation, Intratracheal ; Succinylcholine ; Thiopental

No abstract available.
Child* ; Humans

Objective: To investigate and compare the slot sizes and parallelism of metal injection molding (MIM) and computerized numerical control (CNC) brackets. Methods: The following four MIM bracket series with 0.022-inch (in) slots were selected for investigation: Di MIM mini Twin (Ortho Organizers), Mini Diamond Roth (Ormco), Gemini MBT (3M Unitek), and Formula R Roth (Tomy).The following four CNC bracket series with 0.022-in slots were selected for investigation: Econoline MBT (Adenta), Legend mini MBT (GC Orthodontics), Crown mini MBT (Adenta), and Evolve MBT (DB Orthodontics). The slot dimensions were measured using an optical microscope (XTCam-D310M;Mitutoyo) with a resolution of 1 μm. The results were statistically analyzed using one-way analysis of variance and the Tukey post-hoc test with a significance level of 0.05. Results: The results indicated that all the investigated slot sizes were oversized with respect to the manufacturers’ specifications (0.022 in). Among the eight bracket series, the Di MIM bracket (MIM) was the most oversized by 10.4%, whereas the Evolve bracket (CNC) was the least oversized by 2.6%. The slots in seven of the bracket series had divergent walls instead of parallel ones. The Evolve bracket alone had parallel slot walls. Conclusions Regardless of the manufacturing method, all the slot sizes of the brackets investigated in this study were significantly oversized; most of the slot walls were nonparallel, except for those of the Evolve bracket. This study could not establish that the CNC method was more accurate than the MIM method in manufacturing bracket slots.

BACKGROUND/AIMS: Acute calculous suppurative cholangitis(ACSC) is the most severe complication of bile duct stone(s) and carries 100% mortality if left untreated, and emergent decompression is a life-saving procedure. Endoscopic therapy such as endoscopic sphincterotomy(EST) or endoscopic nasobiliary drainage(ENBD) are well-mtablished treatment of choice instead of emergent surgieal or percutaneous drainages which have a high mortality or morbity, respectively. However, EST and subsequent stone removal is operator-dependent, time consuming, associated with complication rate of 6~12%, and may be inadequeate in many critically ill patients. Recently, endoscopic retrograde biliary drainage(ERBD) is suggested to be as effective in temporary biliary drainage for retained common duct stone and acute cholangitis as ENBD is, and preferred to ENBD in some reports, because ENBD can be pulled out occasionally by confused patient, more time consuming, unpleasant, a hindrance for the patient, and does not seem to be any more effective than ERBD. So, we performed this study to evaluate the role of ERBD in patient with ACSC. METHODS: In Gil Hospital from March 1995 to April 1997, 35 patients were diagnosed as ACSC among the 289 patients with common bile duct stone(s). Of those with ACSC, "the emergent group" were 19 patients with common bile duct stone(s) in which polyethylene biliary stent was placed with the proximal end above the stone and the distal end in the duodenum within 1 days after admission, and "the delayed group" were 9 patients with common bile duct(CBD) stone(s) in which biliary stenting was delayed for 1 days or longer after admission. In both groups, diagnosis rate according to the endoscopic retrograde cholangiopancreatography(ERCP) timing, clinical manifestations at admission, clinical and laboratory effectiveness of ERBD, and mortalities were analyzed and compared by the unpaired t-test. RESULTS: 1. The mean ages and male to female ratio in the emergent group were 65.1, 11:8, respectively and 61.4, 5:4 in the delayed group. On admission, hypotension and confused mentality were more frequent in the emergent group than in the delayed group, but there were no difference in the frequency of medical disease, cholecystectomy history between the two groups. 2. In laboratory findings, anemia, leukocytosis, and thrombocytopenia were more severe in the emergent group than in the delayed group, but there were no difference in the liver function test between the two groups. 3. The diagnosis rate of ACSC according to the ERCP timing was 90.9% by the emergent ERCP, whereas 1.9% by delayed ERCP, and among the 33 procedures of emergent ERCPs, 5 ERCPs were performed without aid of fluoroscopy. 4. In endoscopic findings of papilla, the incidence of gross pus, impacted stone, choledochoduodenal fistula, and papillary hyperemia was 100%, 53.6%, 46.4%, and 21.4%, respectively. In ERCP findings, single CBD stone was most common(53.6%), followed by multiple CBD stone(46.4%), IHD stone(s)(21.4%), and GB stone(14.2%). There were no differences in endoscopic and ERCP findings between the two groups. 5. After ERBD, abdominal pain and fever, and the level of total bilirubin and GOT were subsided or normalized more rapidly in the emergent group than in the delayed group, but there were no differences in the duration of hypotension and the level of GPT, ALP, and creatinine between the two groups. 6. The success rate of ERBD were 100% in the emergent group and 77.8% in the delayed group, so overal l success rate was 92.3%. After ERBD, the effectiveness determined by clinical and laboratory findings were 94.7% in the emergent group and 100% in the delayed group, so overall effectiveness was 96.2%. 7. Definite treatment consisted of endoscopic management in 23 patients(82.1%), elective operation for gallbladder or IHD stone(s) in 3(10.7%) after endoscopic removal of CBD stone(s), permanent biliary stenting due to the patient's refusal of further endoscopic or surgical management after recovery from sepsis in 3 patients(10.7%), and urgent operation in 1 patient(3.6%) in the emergent group. One patient in the delayed group died of sepsis in spite of successful biliary drainage, so overall mortality rate was 3.6%. CONCLUSIONS: ERBD is an effective alternative method of decompressing the bile duct in patient with ACSC due to CBD stone(s), and high index of suspicion of the diagnosis is necessary because failure of diagnosis can result in delaye ddrainage and may be associated corresponding increase in mortality.
Abdominal Pain ; Anemia ; Bile ; Bile Ducts ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Cholecystectomy ; Common Bile Duct ; Creatinine ; Critical Illness ; Decompression ; Diagnosis ; Disulfiram ; Drainage* ; Duodenum ; Female ; Fever ; Fistula ; Fluoroscopy ; Gallbladder ; Humans ; Hyperemia ; Hypotension ; Incidence ; Leukocytosis ; Liver Function Tests ; Male ; Mortality ; Polyethylene ; Sepsis ; Stents* ; Suppuration ; Thrombocytopenia