No abstract available.
Sleep Disorders, Circadian Rhythm*

No abstract available.
Animals ; Mice*

BACKGROUND: Fear of dental treatment is a very real problem for many people. Very young patients or children that are mentally or physically handicapped have various problems that preclude routine dental treatment in the office and require general anesthesia for extensive dental restoration. In America, outpatient operations are performed in thousands of dental offices annually, but there is no report about outpatient general anesthesia in Korea. METHOD: A review of forty children treated under outpatient general anesthesia for extensive dental treatment between 1994 and 1996 inclusive was carried out to assess the patient selection, anesthetic method, recovery time and complication. RESULTS: The mean age was 8.4 years, and twenty-five percent of the patients were autism. The length of the postoperative observation period before discharge was 3.2 hours, and postoperative fever was major complication. CONCLUSION: For extensive dental treatment in handicapped children, we suggest that outpatient general anesthesia can provide reasonably safe treatment, while reducing its expense and requiring less hospital bed space.
Americas ; Anesthesia, General* ; Autistic Disorder ; Child* ; Dental Offices ; Disabled Children ; Disabled Persons* ; Fever ; Humans ; Korea ; Outpatients* ; Patient Selection

This study is based on 155 patients of congenital me colon. For the diagnosis, 93 cases were histologically proven and the remaining 63 cases were diagnosed on clinical basis including barium enema or surgical gross findings. On histologic examination, 80 cases(86%) showed typical features of absence of ganglion cell in the myenteric plexus and the 13 cases(14%) had atypical features which were segmental absence Of ganglion cell in one case. There we 127 males(82%) and 28 females(18%). The age at diagnosis was younger than 30 days in 87 cases(56%), I month to 1 year in 39 cases(25%) and older than I year in 29 cases(18%). The levels of aganglionosis were variable: short segment (rectosigmoid) in 134 cases(86%), intermediate segment (more proximal colon) in 14 cases(100%). and 6 cases(4%) had total aganglionosis. Common clinical presentations were abdominal distention, delayed meconium passage or bilious vomiting in neonate, and chronic constipation in infancy or childhood. Following initial colostomy or ileostomy, a definitive procedure was performed in 151 cases(Duhamel type in 150 cases; Soave type in 2 cases; Swenson type in 3 cases). Frequently associated problems after definitive procedure were persistent constipation(ll%) due to septum formation, fecaloma, remnant aganglionic segment and rectal stenosis. Overall mortality rate was 4%, and increased mortality was associated with enterocolitis(14%) which was the most frequent cause of death. The follow-up study longer than 3 months was available in 138 patients who underwent a definitive procedure(mean 2 year 11 months). Seventy-three cases(53%) had normal bowel function, 38cases(27.5%) had occasionally used enema or stool softners, and 27 cases(19.5%) had severe constipation or soiling. The bowel habit improved with time, and were considered normal in 60% of patients after follow-up more than 3 years. The results of definitive procedures for congenital megacolon including Duhamel operation was satisfactory, and long-term follow-up appeared an important and critical component of patients'care.
Child ; Male ; Female ; Infant, Newborn ; Humans ; Mortality ; Follow-Up Studies

The authors evaluated ultrasonographic findings of 12 cases in thirty lymphangiomas which were provenpathologically or surgically at Wonju christian hospital fram Aug. 1978 to Apr. 1985. The results were as follows:1. The age distribution was 16 cases in first decade, 7 cases in 2nd decade, 2 cases in 3rd decade, 3 cases in 4thdecade, 2 cases in 7th decade. 2. The male to female ratio was 14:16. 3. The location of lymphangiomas were 14cases in head & neck, 8 cases in extrimity, 4 cases in back & chest, 4 cases in abdomen, and 1 case in scrotum. 4.The size of lymphangioma were variable, (2-20cm). 5. Ultrasonographic findings in 12 cases of lymphangioma werehypoechoic (12), eliptical(11), internal septation (8), and internal hyperechoic component(3).
Abdomen ; Age Distribution ; Female ; Gangwon-do ; Head ; Humans ; Lymphangioma ; Male ; Neck ; Scrotum ; Thorax

PURPOSE: To compare central keratometric values (K-values) measured at the pupillary center by Orbscan II (R) topography (Orbtek, Bausch & Lomb, USA) with preexisting methods for K-values in patients who have been treated with laser in situ keratomileusis (LASIK). METHODS: A total of 36 consecutive eyes of 25 patients who were treated with LASIK for myopia have been followed up for more than 1 year. Central K-values measured by Orbscan II(R) topography, K-values measured with autorefractokeratometer, and refraction-derived K-values were compared . RESULTS: The mean central keratometric K-value measured by Orbscan II (R) topography was 39.65+/-1.94 (35.82 to 43.45) diopter (D), and was not statistically significantly different from the mean refraction derived K-value which was 39.63+/-1.95 D (35.95 to 43.41) (p>0.05), but was statistically lower than the mean K-value measured with autorefractokeratometer which was 40.23+/-1.76 D (36.56 to 43.69) (P<0.05). CONCLUSIONS: In patients who have been treated with LASIK for myopia, central keratometric K-value measured with Orbscan II R topography is not statistically significantly different from refraction derived K-value, but is lower than K-value measured with autorefractokeratometer.
Humans ; Keratomileusis, Laser In Situ* ; Myopia

PURPOSE: To report a previously unreported secondary Mooren's ulcer associated with simultaneous sur-gery for cataract and pterygium. METHODS: Case report. Five days after simultaneous surgery for cataract and pterygium, an 86-year-old woman developed severe pain and a superior and inferior peripheral corneal ulcer that had the characteristic clinical appearance of Mooren's ulcer. RESULTS: Peripheral corneal ulcer is rapidly progressive, painful, beginning at the limbus with a gray, overhanging, infiltrated edge at its central border. She had no history of collagen-vascular disease, negative serologic test result, and negative culture for pathogen. Surgical trauma may have been the inciting factor in development of the ulcer. She was treated with topical and systemic steroids. After complete control of the inflammation, the patient remained in remission.
Aged, 80 and over ; Cataract* ; Corneal Ulcer* ; Female ; Humans ; Inflammation ; Pterygium* ; Serologic Tests ; Steroids ; Ulcer*

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

Intussusception which is the mot frequent cause of intestinal obstrucsion in childhood, is the invagination of a segment of the gastrointestinal tract into an adjacent segment. Since 1927, barium enema under fluoscopic guidance has been used widely as a therapeutic method. In 1953, Fiorito and Cuestas reported the use of controlled insufflation of air for diagnosis and treatment of intussusception. This method has several advantages than barium enema for diagnosis and treatment, with its simplisity, fast diffusion of air, clear-cut visualization of intussusception, no contraindications, and no interference with the normal physiology of bowel. We compared the results of treatment with barium enema in 117 cases with that of controlled air insu-fflation in 50 cases from January, 1976 to Octover, 1981. The results were summarized as follows 1) Age and sex distribution of the overall cases: 82% of the patients were under 1 year of age(the peak incidence was 4~8 months of age) with the predominence of male(2.2:1). 2) Growth percentile comparing with Korean standard data: 67% of the patient were above 50 porcentile. 3) Seasonal incidence: slight prevalence was noted during spring, but not significant. 4) Etiologic factors: 97% of the patient were idiopathic and only 3% of the cases had organic causes. 5) Cardinal symptoms and signs: abdominal pain and irritability 82%, vomiting 76%, bloody mucous stool 64%, and abdominal mass 50.3%. 6) The most common type of intussusception is ileo-colic. 7) Reduction rate: 68.4% for barium enema and 92% for controlled air insufflation(p<0.01). 8) Recurrence rate: 12.5% for barium enema and 8% for controlled air insufflation. 9) Recurrence interval of overall cases is the most frequently from one month to 6 months after reduction. 10) Perforation: One case with barium enema and 2 cases with controlled air insufflation. 11) Duration and pressure requiring to reduce by controlled air insufflation: 84.8% of cases reduced within 30 min. and the pressure required to reduce was about 61 mmHg to 100 mmHg in 73.9% of cases.
Abdominal Pain ; Barium* ; Child* ; Diagnosis ; Diffusion ; Enema* ; Gastrointestinal Tract ; Humans ; Incidence ; Infant* ; Insufflation* ; Intussusception* ; Physiology ; Prevalence ; Recurrence ; Seasons ; Sex Distribution ; Vomiting

Moyamoya is a chronic cerebrovascular disease characterized by progressive stenosis or occlusion of the terminal parts of both intermal carotid arteries with telangiectatic vascular network of collateral circulation at the base of the brain and leptomeningeal arteries. The etiology and pathophysiology of this disease are still unknown. Although the idiopathic presentattion is the commonest, moyamoya disease has also been reported in several hereditary or acquired clinical conditions including neurofibromatosis, sickle cell anemia, tuberculous meningitis, atherosclerosis, and following radiation therapy to the head. The term moyamoya disease should be reserved for those cases in which the characteristic angiogrphic pattern is idiopathic; moyamoya syndrome is used when the underlying condition is known. We have experienced a case of coexistence of moyamoya syndrome and hereditary spherocytosis in a 6-year-8-month-old girl who presented with right-sided hemiparesis and pallor. A cerebral angiogram revealed occlusion of proximal portion of left middle cerebral artery and abnormal collateral network. The peripheral blood smear and osmotic fragility test disclosed hereditary spherocytosis. To our knowledge, the coexistence of moyamoya syndrome and hereditary spherocytosis has not been documented. We report here the case and the brief review of related literatures. Further studies are needed to clarify the intimate relationship between the two diseases.
Anemia, Sickle Cell ; Arteries ; Atherosclerosis ; Brain ; Carotid Arteries ; Collateral Circulation ; Constriction, Pathologic ; Female ; Head ; Humans ; Middle Cerebral Artery ; Moyamoya Disease* ; Neurofibromatoses ; Osmotic Fragility ; Pallor ; Paresis ; Tuberculosis, Meningeal