PURPOSE: To evaluate the efficacy and prognosis of graded inferior oblique recession in inferior oblique overaction. METHODS: We reviewed the records of 92 patients (184 eyes) who had been diagnosed with inferior oblique overaction and who had undergone an inferior oblique recession in both eyes. All were followed up for a minimum of 1 year postoperatively, and preoperative exclusion criteria included superior oblique palsy, history of vertical rectus muscle surgery, and previously performed inferior oblique muscle surgery. Inferior oblique overaction was graded from +1 (mild overaction) to +4 (severe overaction) and each group had 6 mm, 8 mm, 10 mm, and 14 mm inferior oblique recessions performed, respectively. Cases of postoperative inferior oblique overaction under +1 were considered successful. (In the group initially graded as +1, a postoperative grade of 0 was considered a success.) On the other hand, a grade over +1 was considered a failure. RESULTS: The average postoperative follow-up time was 43.7 months (12~159 months). On final examination, 6-mm inferior oblique recession (5 eyes) resulted in 100% success, 8-mm inferior oblique recession (76 eyes) resulted in a 94.7% success rate, 10-mm inferior oblique recession (97 eyes) resulted in an 87.5% success rate, and 14-mm inferior oblique recession (6 eyes) resulted in a 50% success rate. The overall success rate was 89.7% (165 eyes of the 184 eyes). CONCLUSIONS: Graded inferior oblique recession in patients diagnosed with inferior oblique overaction was an effective procedure with stable, long-term outcomes.
Follow-Up Studies ; Hand ; Humans ; Paralysis ; Prognosis

The purpose of this study was to evaluate the nutritional status and growth of Korean infants, who were atending peripheral community clinics in low income areas, by anthropometric measurements and estimating dietary intakes. Dietary intakes and growth were compared among different feeding patterns of 143 infants until age 9 months. The overall mean nutrient intakes of infants in this study were below the recommended allowances except the calcium intake from significant difference in each groups; however, calcium, zinc and iron intake of the formula fed infant(FF) was higher than the breast fed infant(BF) or the mixed fed infant(MF). Form ages 4-6 months, the nutrient intakes were shown to be higher in groups that were given supplementary foods than groups that were not. From ages 7-9 months, all nutrient intakes were higher in or the formula and supplementary foods fed(ESF) infants than in the breast and supplementary food(BSF) or the formula and supplementary food(FSF) groups, All subjets in this study showed a large Z-score. The growth of infants up to 6 months of age showed no significant difference in the feeding pattern, however, after 7 months of age the BSF group had significantly lower weight than the FSF or the ESF groups, There were significant positive relationships between infants weight gain at age 7-9 months from birth and the current protein or zinc intakes. As a result the average status of nutrient intakes of infants in this area was loser than the RDA, however, the growth pattern was fairly good. Although the breast milk is beneficial for infants, mothers should be educated for the importance of supplemental food and its practice to support good nutrition.
Breast ; Calcium ; Feeding Behavior ; Humans ; Infant ; Iron ; Milk, Human ; Mothers ; Nutritional Status ; Parturition ; Weight Gain ; Zinc

PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase

PURPOSE: Urinary excretion of N acetyl-beta-D glucosaminidase (NAG) and beta2-microglobulin (beta2-M) was increased in the presence of proximal tubular damage. Based on these urinary materials, we investigated the ability of expecting renal function in chronic glomerular diseases. In this study, we evaluated the relationship between glomerular filtration rate (GFR) urinary NAG, and urinary beta2-M. METHODS: We evaluated 52 children with chronic kidney disease at the Chung-Ang University Hospital between January 2003 and August 2009. We investigated the 24-hour urinalysis and hematologic values in all 52 patients. Serum creatinine, creatinine clearance (Ccr), serum cystatin C, urinary beta2-M and urinary NAG were measured. RESULTS: Out of 52 patients, there were 13 children with minimal change in disease, 3 children with focal segmental glomerulosclerosis, 17 children with immunoglobulin A nephropathy, 15 children with Henoch-Schonlein purpua nephritis, 3 children with poststreptococcal glomerulonephritis, and 1 child with thin glomerular basement membrane disease. In these patients, there were significant correlation between the Ccr and urinary NAG (r=-0.817; P<0.01), and between the GFR (as determined by Schwartz method) and urinary NAG (r=-0.821; P<0.01). In addition, there was a significant correlation between the GFR (as determined by Bokencamp method) and urinary NAG (r=-0.858; P<0.01). CONCLUSION: In our study, there was a significant correlation between the GFR and urinary NAG, but there was no correlation between the GFR and urinary beta2-M, suggesting that the GFR can be predicted by urinary NAG in patients with chronic glomerular disease.
Child ; Creatinine ; Cystatin C ; Glomerular Basement Membrane ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulosclerosis, Focal Segmental ; Hexosaminidases ; Humans ; Nephritis ; Proteinuria ; Renal Insufficiency, Chronic ; Urinalysis

The gray vibrissae of Korean males(n =189) between 15 and 75 years old and females(n =111) between-15 and 74 years old who visited the department of otorhinolaryngology, Konkuk university Chungju hospital during 1996 to 1998, were counted for the purpose of estimating approximate age range in individuals of unknown age . The lowest age appearing gray hairs in both sexes was 15-year-old. The Pearson's correlation coefficient in both sexes was 0.490 (p<0.01). The age appearing gray vibrissae in females was slightly earlier than that of males, however, the differences between right and left sides of nasal cavity were insignificant. This method of counting gray vibrissae would be useful to estimate age range in personal identification together with other methods available until now.
Adolescent ; Aged ; Chungcheongbuk-do ; Female ; Hair* ; Humans ; Male ; Nasal Cavity ; Otolaryngology ; Vibrissae*

No abstract available.
Head* ; Neck*

The ankle is a modified hinge joint consisting of tibial plafond, medial and lateral malleolus, talus and many soft tissue structures, which plays important role in weight bearing and walking. Hence, the ankle injuries include not only fractures of bone but often also the rupture of ligaments and soft tissues, so if the structures were not accurately repaired, many complications may develop. The authers analysed 98 cases (96 patients) of the ankle fractures which were admitted and treated in Orthopaedic Department, Soon Chun Hyang University Hospital from January 1979 to August 1983. The results obtained are as follows: 1. Of the 98 cases, male was 70 cases(71.9%), female was 28 cases and the average age of the patient was 31,1 years. 2. The most common cause of the fracture was traffic accident and the other causes were slip down, sports injury, fall down and industrial injuries in order. 3. 83 cases(84.7%) out of the 98 cases of ankle fractures were closed fracture and the rest was open fracture. 4. The most common type of the ankle fracture, according to the classification of Lauge-Hansen, was supination external rotation type. 5. 68 cases were treated with open reduction and internal fixation and 30 cases were treated with closed reduction, among the cases of closed reduction, the 14 cases were indicated to open redu- ction but it was impossible due to improper skin condition, severe comminution and anesthetic problem. 6. The average duration of the cast immobilization in closed treatment was 10.1 weeks and in operative treatment was 6.3 weeks. 7. The results of the treatment was better in those cases of the open reduction, the early reduction and the mildly displaced cases than the results of closed reduction, delayed reduction and severely displaced cases. 8. The incidence of complication, such as traumatic arthritis and nonunion occured higher in the cases treated with closed method.
Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Rupture ; Skin ; Supination ; Talus ; Walking ; Weight-Bearing

Purpose: This study was performed to analyze the predictors that might contribute to urinary retention following semiclosed hemorrhoidectomy under spinal anesthesia. Methods: This retrospective study enrolled 2,176 consecutive patients with symptomatic grade III to IV hemorrhoids who underwent semiclosed hemorrhoidectomy between September 2018 and September 2019. Results: Among the 2,176 patients, 1,878 (86.3%) had no postoperative urinary retention, whereas 298 (13.7%) developed urinary retention after hemorrhoidectomy. The percentage of males was significantly higher in the retention group than in the non-retention group (60.4% vs. 48.1%; P=0.001). The risk of urinary retention was 1.52-fold higher in males than in females (95% confidence interval [CI], 1.13–2.04; P=0.005), 1.62-fold higher in old age (95% CI, 1.14–2.28; P=0.006), and 1.37-fold higher with high body mass index (BMI) (95% CI, 1.04–1.81; P=0.025). Patients with ≥4 resected hemorrhoids had a higher odds ratio (OR) of 1.46 (95% CI, 1.12–1.89; P=0.005) than patients with <4 resected hemorrhoids. Among the supplementary medication, patients who used analgesics had a higher OR of 2.06 (95% CI, 1.57–2.68; P=0.001) than those who did not. Conclusion Male sex, age, high BMI, number of resected hemorrhoids, and supplementary analgesics are independent risk factors for urinary retention after semiclosed hemorrhoidectomy.

Objective: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is suggested as a prognostic biomarker for communityacquired pneumonia (CAP). However, its predictive value for an individual adult and elderly CAP patients has not been fully investigated. Methods: Patients with CAP aged 18 years and older, who visited the emergency department (ED) from March 1, 2016 to March 31, 2019, were included in this study. Patients were divided into the adult group and the elderly group (age ≥70 years). Data was collected from the ED-based registry, and medical charts were retrospectively reviewed. The registry data included sociodemographic and past medical characteristics, as well as laboratory findings including NT-proBNP and C-reactive protein (CRP), Pneumonia Severity Index (PSI), and CURB65 (confusion, urea, respiratory rate, blood pressure, and aged 65 or more). The independent potential of NT-proBNP to predict mortality was assessed in both groups using multivariable logistic regression, and its predictive ability was evaluated in terms of performance (using areas under the curve [AUCs]) and goodness-of-fit (using the Bayesian information criterion [BIC]). Results: Totally, 325 CAP patients were evaluated, of which 208 (64%) belonged to the elderly group. NT-proBNP was identified as an independent predictor of CAP mortality in elderly patients, but not in adult patients. Moreover, AUC of the NT-proBNP for mortality was comparable to AUC of the PSI, but was higher than that of the CURB65, in elderly CAP patients. Similarly, the NT-proBNP had a better overall fit (lower BIC value) compared to the CURB65, for mortality. Additionally, both AUC and overall fit of the NT-proBNP for mortality were significantly superior to values obtained for CRP. Conclusion For elderly CAP patients in the ED, the NT-proBNP is an independent and useful predictor of mortality.

Tuberculous arthritis on the sternoclavicular joint is an uncommon disease and a delayed diagnosis can be due to the obscure clinical symptoms. We should suspect tuberculous arthritis in patients with slowly progressive pain, swelling, mild fever and a previous history of tuberculosis. Early diagnosis is important through conducting a thorough physical examination and performing laboratory tests and radiologic study. Tuberculous arthritis on the sternoclavicular joint should be treated with a combination of systemic antituberculous agents and thorough surgical debridement in marked damaged joints. When performing this operation, it is important not only to minimized the injury of the costoclavicular ligament, but also to avoid injury to the surrounding the vital structures such as the mediastinum and pleura after aggressive resection or radical debridement. We describe here 2 cases of the tuberculous arthritis on the sternoclavicular joint: one case had a good result after surgical debridement with using an anti-tuberculous agent, and the other had fatal complications such as mediastinal abscess and pleural effusion after the operation.
Abscess ; Arthritis ; Debridement ; Delayed Diagnosis ; Early Diagnosis ; Fever ; Humans ; Joints ; Ligaments ; Mediastinum ; Physical Examination ; Pleura ; Pleural Effusion ; Sternoclavicular Joint ; Tuberculosis