There have been several reports that nasal bone fractures are inadequately managed. They are probably due to poor understanding of the pathophysiology of nasal bone fracture and absence of the accurate diagnostic method. And there has been little adequate comprehensive classification of nasal bone fracture and nasal septal fracture. We examed 132 patients sustaining nasal bone fracture using computerized tomography. Fracture line, deviation, depression, associated skeletal deformities and the nasal septum were clearly identified. We compared our results with Murray & Maran's classification of nasal bone fracture. We found that they revealed almost same results and computerized tomography was good method for diagnosis of nasal septal fracture. The computerized tomography will be helpful for accurate diagnosis and preperative planning of the correction of nasal bone and septal fracture.
Classification ; Congenital Abnormalities ; Depression ; Diagnosis ; Humans ; Nasal Bone* ; Nasal Septum

No abstract available.
Carcinoma, Renal Cell* ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Kidney*

BACKGROUND: Elecsys 2010 immunoassay system is based on the electrochemiluminescence immunoassay using a ruthenium (II) tris (bipyridyl) label. Since it was the first time to use the system in our laboratory, we would like to evaluate the analytical performances (precision, linearity and recovery rate) and correlation with radioimmunoassay (RIA) and microparticle enzyme immunoassay (MEIA) methods. METHODS: We used precicontrol tumor marker (TM1, TM2) for alpha-fetoprotein (AFP), prostatic specific antigen (PSA) and carcinoembryonic antigen (CEA), Precicontrol universal (Ul, U2) for triiodothyronine (T3) and thyroxine (T4), Precicontrol-TSH for thyrotropin (TSH) and pooled serum for the evaluation of precision and recovery rate. Patients' sera were used for the linearity and comparison study. RESULTS: The coefficients of variatron of Imprecision study were below; 4.0%, 8.7% and 10.2%, respectively in the within-run, within-day and between-day analysis. The recovery rates were 100.5%, 96.1% and 102.5%, respectively in T4, TSH, and AFP. The linearity were y=1.02x-0.182(r=0.99) for T4, y=1.01x+0.12 (r=0.99) for TSH and y=1.01x+0.54(r=1.00) for AFP. T3, T4, TSH, CEA and PSA results showed good correlation with RIA (r>0.90), but AFP showed r=0.88. Also, AFP, CEA and PSA results showed excellent correlation with AxSYM (r>0.99). CONCLUSION: Elecsys 2010 immunoassay system showed excellent precision, recovery rate, clinically acceptable linearity and good correlation with the results obtained by RIA and MEIA methods.
alpha-Fetoproteins ; Carcinoembryonic Antigen ; Immunoassay* ; Immunoenzyme Techniques ; Radioimmunoassay ; Ruthenium ; Thyrotropin ; Thyroxine ; Triiodothyronine

This study is aimed at providing the variables associated with adolescent compliance in orthodontic treatment, and identifies the salient predictors of cooperative behaviors over the course of treatment. Orthodontic attitude scale, orthodontic locus of control scale and demographics data were obtained for 60 adolescent orthodontic patients who had been in treatment a minimum of 10 months. This data was then analyzed in relation to their sex, school age and treatment compliance. The following results were obtained. 1. The scoring of external-powerful others-parents, subscale of the Orthodontic Locus of Control scale, found a statistically significant difference between sex differences (p<0.05). The score of boys was higher than that of girls. 2. The external-powerful others-parents score from the Orthodontic Locus of Control scale showed a significantly positive correlation (p<0.05) with the level of compliance. 3. The salient factors associated with compliance were the adolescent patients' own cognition and decisions. 4. There was a statistically significant correlation between the length of treatment and patient compliance (p<0.05). Thus, there was a substantial decrease in the cooperation of orthodontic patients over time. 5. Other independent variables including age, sex, family environment, religion, academic standing, parents' occupation and education, and brushing frequency were investigated and did not yield any significant relationships. Patient compliance is a critical factor in the efficacy of orthodontic treatment. Individuals vary greatly in their perceptions and attitudes of orthodontic treatment, sociodemographic environments and personality characteristics. In assessing the level of compliance attainable by each individual patient it is advisable to pay sufficient attention not only to the technical matters but also to the psychologic aspects of the treatment progress.
Adolescent* ; Cognition ; Compliance* ; Cooperative Behavior ; Demography ; Education ; Female ; Humans ; Internal-External Control ; Occupations ; Patient Compliance ; Sex Characteristics

The thalamus, located between the cerebrum and midbrain, is a nuclear complex connected to the cerebral cortex that influences motor skills, cognition, and mood. The thalamus is composed of 50-60 nuclei and can be divided into four areas according to vascular supply. In addition, it can be divided into five areas according to function. Many studies have reported on a thalamic infarction causing motor or sensory changes, but few have reported on behavioral and executive aspects of the ophthalmoplegia of the thalamus. This study reports a rare case of a paramedian thalamus infarction affecting the dorsomedial area of the thalamus, manifesting as oculomotor nerve palsy, an abnormal behavioral change, and executive dysfunction. This special case is presented with a review of the anatomical basis and function of the thalamus.
Cerebral Cortex ; Cerebrum ; Cognition ; Executive Function ; Infarction* ; Mesencephalon ; Motor Skills ; Oculomotor Nerve Diseases ; Ophthalmoplegia ; Thalamus

PURPOSE: Late-onset hypotension in preterm infants is not a rare condition. Late circulatory collapse due to adrenal insufficiency (AI) is one of the major causes of late-onset hypotension. We assessed the incidence and causes of late-onset hypotension. We also compared the clinical findings according to the presence of AI. METHODS: In total, 244 preterm infants with a gestational age < or =32 weeks and who were admitted to the neonatal intensive care unit (NICU) of Seoul National University Boramae Hospital and Seoul National University Hospital from January 2009 to April 2011 were included. Clinical findings were analyzed retrospectively. RESULTS: Forty-four infants (18%) suffered from late-onset hypotension. Hydrocortisone was administered to 30 infants (68.2%) and AI occurred in 16 infants (36.4%). Cesarean section, sepsis before hypotension, and gastrointestinal surgery were independently associated with late-onset hypotension. Intrauterine growth retardation (IUGR) was less frequent in the hydrocortisone-treated group than in infants not treated with hydrocortisone. The AI group had fewer IUGR infants, and the duration of hospitalization was shorter in the AI group than in infants who were not administered hydrocortisone. Blood pressure tended to normalize more quickly in the AI group, however, the difference was not significant. CONCLUSION: AI was a major cause of late-onset hypotension, and the use of hydrocortisone shortened the length of hospitalization.
Adrenal Insufficiency ; Blood Pressure ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Hydrocortisone ; Hypotension ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Pregnancy ; Sepsis ; Shock

PURPOSE: We tested the hypothesis that preterm infants who develop bronchopulmonary dysplasia (BPD) have higher concentration of serum tumor necrosis factor-alpha (TNF-alpha) within 8 hours after birth than those who do not. METHODS: Serum and tracheal aspirate (TA) TNF-alpha concentrations were measured by enzyme-linked immunosorbent assay in the thirty-four preterm infants born before 32 weeks of gestation. Multiple logistic regression analysis was done. RESULTS: Median concentrations of both serum and TA TNF-alpha were higher in BPD group than in non BPD group [serum TNF-alpha, 214.52 pg/mL (84.20-244.20) versus 100.07 pg/mL (78.43-225.52), P=0.037],[TA TNF-alpha, 13.12 pg/mL (10.43-64.67) versus 11.58 pg/ mL (9.76-58.53), P=0.038]. After making adjustments for the effects of gestational age at birth, 5 minute Apgar score less than 7 and histologic chorioamnionitis, only serum TNF-alpha concentration was independently significant [P=0.045 Odds ratio, 1.381 95% confidence interval, 1.007-1.895]. The diagnostic indices of TNF-alpha (cutoff, 97.1 pg/mL) as a predictor of development of BPD were: sensitivity of 85.7%, specificity of 38.5%, positive predictive value of 69.2%, negative predictive value of 62.5% (P=0.037). CONCLUSION: Increased serum TNF-alpha concentration within 8 hours after birth may be a significant risk factor of later development of BPD.
Apgar Score ; Bronchopulmonary Dysplasia* ; Chorioamnionitis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Logistic Models ; Odds Ratio ; Parturition ; Pregnancy ; Risk Factors ; Sensitivity and Specificity ; Tumor Necrosis Factor-alpha*

PURPOSE: Thymic size can be affected by glucocorticoids which promotes surfactant synthesis in preterm infants. We assessed the hypothesis that the fetal lung maturity in preterm infant correlates with the size of the thymus detected at birth on the routine chest radiograph. We also searched for a possible relationships between thymus size, respiratory distress syndrome (RDS), and the cord blood cortisol level. METHODS: The cardiothymic/thoracic ratios (CT/T) within 6 hours after birth and cord blood cortisol levels were measured in 42 preterm infants admitted to the neonatal intensive care unit of Seoul National University Children's Hospital from June 2002 to December 2003. Multiple linear regression analyses were done to assess the relationships between the CT/T, the perinatal events and the cord blood cortisol levels. The receiver operation characteristic curve analysis was done to evaluate the CT/T in the prediction of RDS. RESULTS: 8 infants (19.0%) developed RDS. The CT/T positively correlated with the birth weight, but not with the gestational age. The CT/T were significantly larger and the cord blood cortisol levels were significantly lower in the preterm infants with RDS than in those without RDS. The cord blood cortisol levels were negatively correlated with the CT/T. The birth weight and RDS were all independently associated with the CT/T. The CT/T less than 0.37 identified infants with RDS with 87.5% sensitivity and 61.8% specificity. CONCLUSION: The larger thymus at birth can be used to identify RDS. The lower cord blood cortisol level may be associated with the larger thymus in RDS.
Birth Weight ; Fetal Blood* ; Gestational Age ; Glucocorticoids ; Humans ; Hydrocortisone* ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Linear Models ; Lung ; Parturition ; Radiography, Thoracic ; Sensitivity and Specificity ; Seoul ; Thymus Gland*

OBJECTIVE: To determine whether gene expressions of VEGF and PlGF are different between the human placenta of normal and abnormal pregnancy. METHODS: Placenta was collected at each trimester of normal pregnancy, missed abortion, intrauterine growth retardation and pre-eclampsia. Total RNA was extracted from placenta. Reverse transcription-polymerase chain reaction(RT-PCR) was performed using VEGF and PlGF primer. RESULTS: VEGF121, VEGF165 and VEGF189 were identified in normal pregnancy and missed abortion. In two cases of four IUGR and one case of three pre-eclampsia, four of isoforms (VEGF121, VEGF145, VEGF165, and VEGF189) were identified. The intensity of signal was strongest for VEGF165 in all cases. PlGF131 and PlGF152 were identified in all cases. However, the signal intensities of VEGF121, VEGF165, VEGF189, PlGF131 and PlGF152 were not different according to the gestational age. They were also not different between normal pregnancy and abnormal pregnancy. CONCLUSION: VEGF and PlGF were not only expressed at placenta but also overexpressed in part of IUGR and pre-eclampsia. The results suggest that VEGF may play a role in the induction of angiogenesis of placenta in normal pregnancy and its production may be increased under the hypoxic condition.
Abortion, Missed ; Female ; Fetal Growth Retardation ; Gene Expression* ; Gestational Age ; Humans* ; Placenta* ; Pre-Eclampsia ; Pregnancy ; Protein Isoforms ; RNA ; Vascular Endothelial Growth Factor A