With the aging process, the senile lids are manifested by the excessive skin, decreased height of palpebral fissures with interference of the vision. Sometimes these patients often complained the blepharitis on the lateral canthal area and phtophobia. But there are many diseases to differentiate from senile lids such as dermatochalasia, blepharochalasia, hypertrophy of orbicularis oculi, herniation of orbital fat, myasthenia gravis, and blepharoptosis. Blepharospasm must also be differentiated because of sysmptoms similar to the above described senile lids. Essential blepharospam is an idiopathic progressively debilitating desease which involve bilateral spasm of the orbicularis oculi. So just only an conventional blepharoplasty could not get an improvement of symptoms and some times it makes the symptoms worsen. This case report is about blepharospasm patients visiting for blepharoplasty. And the patients got relatively the satisfied results with the injection of botulinum A toxin, aided by neurologist, instead of blepharoplasty. In conslutions, The blepharospasm in required to detect in preoperative evaluation for blepharoplasty. Once the blepharospasm is diagnosed, it is better to cooperate with neurologist and to do the blepharoplasty.
Aging ; Blepharitis ; Blepharoplasty* ; Blepharoptosis ; Blepharospasm* ; Botulinum Toxins ; Botulinum Toxins, Type A ; Humans ; Hypertrophy ; Myasthenia Gravis ; Orbit ; Skin ; Spasm

Injuries and pains of musculoskeletal joint in human body is common onset in industrialized world. However, muscle fatigue plays a very significant role in contributing causes of many pains associated with musculoskeletal joints. Based on this hypothesis, degree of muscle fatigue was investigated using electromyography measurement technique during isometric and concentric/eccentric muscle contractions. Different response of the muscle fatigue between two different muscle contractions (isometric and concentric/eccentric contractions) was examined by comparison of parameters which were median frequency, median power and RMS value. Healthy 16 young persons without previous musculoskeletal diesease history were tested with Noraxon Myosystem 2000 EMG measurement system. In this study, two different exercises were performed. First exercise was concentric/eccentric exercise. Second exercise was isometric muscle contraction. In the case of the isometric exercise, median frequency was decreased, but median power and RMS were increased. However, during the concentric/eccentric exercse, median frequency was increased, but median power and RMS were decreased. Both of those revealed that the pattern of the median frequency was W type, but median power and RMS were M type as time passed. In this study, the patterns of the muscle fatigue during concentric/eccentric exercise as well as isometric exercise were identified. It will be helpful to prevent musculoskeletal injury from over-working andexercising.
Electromyography* ; Exercise ; Human Body ; Humans ; Joints ; Muscle Contraction ; Muscle Fatigue*

No abstract available.
Dermoid Cyst*

Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their numerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fracture and the remaining 11 were open. The comminuted and segmental fractures were 18 (57.7%) in number and the most common fracture site was the middle one third (53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.
Accidents, Traffic ; Ankle ; Congenital Abnormalities ; Female ; Fractures, Bone ; Fractures, Closed ; Humans ; Male ; Orthopedics ; Soft Tissue Infections ; Tibia*

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

Tethered cord syndrome is a kind of spinal dysraphism with low-lying conus frequently associated with intraspinal lipoma, diastematomyelia, or fibrous band. The clinical manifestations include spine abnormality such as spina bifida and variable neurological symptoms involving lower extremities and sphincters. Here are two cases of tethered cord syndrome associated with intraspinal lipoma. Both are diagnoses with CTMM (computed tomographic metrizamide myelography) and one is operated.
Conus Snail ; Diagnosis ; Lipoma ; Lower Extremity ; Metrizamide ; Neural Tube Defects ; Spinal Dysraphism ; Spine

BACKGROUND: A lots of fires were happened every years. And then, the many peoples have died because of foe. It is important to plane for initial field emergency management that the major cause of death and injury type is analysed by large scaled fire. METHOD: We have analysed the fire victims by large scaled fire from Jan. 1995 to Dec. 1995 in Korea. We analysed systemic factors, environmental factors, patient factors which was acquired from medical records and interviews with victims, victim's famaly, rescuer. RESULT: The total number of victims are 130 and the mortality rate is 61.5% (80 patients). The major injury and cause of death were inhalation injury and trauma. The injury type of fire victims are 19 cases of inhalation injury, 13 cases of laceration,5 cases of burn,5 cases of contusion,4 cases of blephaloconjunctivitis. In fire deaths, the 78 victims (97.5%) were death associated with the gas inhalation, and the only 2 fire deaths were due to trauma. This result of the cause of death was higher inhalation injury than previously reported literature because most fires of our study was happened at the closed-maze area. CONCLUSION: When the fee was happened at closed-maze area, many victims foiled to escape the space because of smoke, toxic inhalants from combustible interior decoration, and then were death.
Cause of Death ; Emergencies* ; Emergency Treatment* ; Fees and Charges ; Fires* ; Humans ; Inhalation ; Korea ; Medical Records ; Mortality ; Smoke ; United Nations

BACKGROUND: The Sampung Collapse took place at 17:55 June 29, 1995. The rescue operation encountered 458 dead and 477 multiply traumatized patients and 464 non traumatized peoples. We wanted to present basic data for disaster planning for example of Sampung Collapse. METHODS: We made a survey of accident field immediately after accident and interviewed with victims, victim's famaly, and rescuer. We analysed the medical record and SCL-9 (Hopkins symptom check list 90R) which was checked several list with victims, victim's family and control group. RESULT: The mean RTS was 11.9 and the mean ISS was 4.3.96 long bone fractures occurred in 76 patients. 127 case of vertebral injury occurred in 63 patients. Total number of surgical operations were 237. There are also many crushing injury and acute post-traumatic stress diseases. CONCLUSION: There are many injury types which are crushing injury, vertebral injury, blunt trauma and acute PTSD(post traumatic stress diseases). Thus, The field management, especially field triage, is very important. And, the urgent patients were 72 patients, about 5% of total patients, witch needed intensive care in tirtiary hospital. Therefore, we need to plan out the expeditious proper management. and prevention of disaster propagation.
Disaster Planning ; Disasters ; Fractures, Bone ; Humans ; Critical Care ; Medical Records ; Triage ; Wounds, Nonpenetrating

A 46-year-old male patient developed jaundice after 23 days' treatment of propylthiouracil (PTU) for Graves' disease. Serum alkaline phosphatase was elevated markedly with moderate increase in serum aminotransferase, and the peak level of total bilirubin was 7.3 mg/dL. After withdrawal of PTU, serum aminotransferase and bilirubin began to decrease simultaneously, and completely normalized. One week after the discharge from hospital, he received radioiodine treatment for Graves' disease, but he showed aggravation of hyperthyroidism and ophthalmopathy. So we prescribed methimazole inevitably 16 days' after the radiodiodine treatment. He developed jaundice again after 69 days' treatment of methimazole, but the pattern of hepatotoxicity was slightly different from that of the previous PTU-nduced hepatotoxicity. Serum aminotransferase increased slightly and quickly normalized after discontinuance of methimazole, but serum total bilirubin increased continuously and reached to 24.6 mg/dL. Eosinophilia was prominent and the result of liver biopsy was compatible with cholestatic jaundice. The patient was treated with prednisolone and recovered from jaundice rapidly.
Alkaline Phosphatase ; Bilirubin ; Biopsy ; Eosinophilia ; Graves Disease ; Humans ; Hyperthyroidism ; Jaundice ; Jaundice, Obstructive ; Liver ; Male ; Methimazole* ; Middle Aged ; Prednisolone ; Propylthiouracil*

BACKGROUND: The survival rate of children with neuroblastoma has been improved over 20 years, excluding the metastatic disease, in which it does not exceed 20% so far. New treatment modalities have been developed to improve the outcome in metastatic disease. Preoperative chemotherapy reduce the size, the vascularity and the adhesiveness, so increase the resectability of the primary tumor. This retrospective clinical study was designed to review the survival rate in neuroblastoma and to analyze the effect of preoperative chemotherapy in the view point of neoadjuvant therapy on long-term survival in advanced disease. METHODS: One hundred and thirty-four cases were reviewed from 135 patients with neuroblastoma registered at the Department of Pediatrics in Seoul National University Children's Hospital from January, 1985 till December, 1995. The survival rate was reviewed according to the stage. The age, sex of the patients, the stage, anatomical site of the tumor, the level of serum ferritin and neuron-specific enolase were analyzed for the risk factors on survival. RESULTS: Ranges of age at diagnosis were from 1 month to 166 months with the median of 39 months. Five year survival rates and five year disease-free survival rates were 100%, 100% in stage 1(n=5), 90.9%, 90.9% in stage 2(n=13), 43.4%, 40.6% in stage 3(n=19), 27.1%, 19.8% in stage 4(n=95) and 100%, 100% in stage 4S(n=2), respectively. In stage 3, five year survival rate was 52.5% in group receiving neoadjuvant chemotherapy, 28.6% in control group(P=0.02). Five year disease-free survival rate was also noted as 48.6%, 28.6% in each group(P=0.02). In stage 4, five year and ten year survival rates were 27.6%, 23.6% in group receiving neoadjuvant chemotherapy, 26.9%, 0% in control group(P=0.02). Five year and ten year disease-free survival rates were 14.3%, 14.3% in group receiving neoadjuvant chemotherapy, 20%, 0% in control group (P=0.11). In univariate analysis, the age, the stage, and the site of primary tumor appeared to affect the long-term survival. CONCLUSION: Neoadjuvant chemotherapy and delayed primary surgery contribute for advance in survival in advanced neuroblastoma via increasing the resectability of the primary tumor.
Adhesiveness ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Ferritins ; Humans ; Neoadjuvant Therapy ; Neuroblastoma ; Pediatrics ; Phosphopyruvate Hydratase ; Retrospective Studies ; Risk Factors ; Seoul ; Survival Rate