Episcleral osseous choristoma is a rare isolated bony nodule occurring in the conjunctival or episcleral connective tissue in eyes which are otherwise normal. They are present at birth. This congenital lesion is usually about the size of a pea and typically located in the superotemporal quadrant, some 5 to 10mm from the limbus. Of the 40 reported cases in the literature, none had associated ocular abnormalities. The diagnosis has seldom been suspected preoperatively. Our patient was 3-month-old healthy male baby. For the cosmetic purpose, we had done excisional biopsy. In the histopathologic study, the mass was a dermoid covered with skin and contained fat, hair follicle and osseous tissue at its center. The mass was confirmed to be a complex choristoma, especially osseous choristoma. We report this case because of the rarity of osseous chroistomas combined with complex choristoma.
Biopsy ; Choristoma* ; Connective Tissue ; Dermoid Cyst ; Diagnosis ; Hair Follicle ; Humans ; Infant ; Male ; Parturition ; Peas ; Skin

For evaluating the change of strength of extraocular muscle after strabismus surgery, ten rabbits had been performed resection of lateral rectus muscle in right eye and recession of lateral rectus muscle in left eye, and then performed EMG(electromyography). We performed EMG before surgery, at immediate post-op,after 1 day,1,2,3,4,6,8 weeks. In case of resection of lateral rectus muscle, EMG value increased at immediate post-op then stabilized after 6 weeks. In case of recession of lateral rectus muscle, EMG value decreased at immediate post-op, then stabo; ozed after 6 weeks. Therefore, EMG is the useful method in evaluating the change of strength of EOM. Especially, during 6 weeks after surgery is the important peeriod for follow-up.
Electromyography ; Follow-Up Studies ; Rabbits ; Strabismus

PURPOSE: To assess the difference in the change of postoperative ocular alignment in intermittent exotropia corrected by horizontal muscle transposition or inferior oblique muscle recession together with lateral rectus muscle recession. METHODS: A total of 110 patients with intermittent exotropia with a follow-up period of more than 6 months after lateral rectus muscle recession were enrolled in the present study. The patients who received lateral rectus muscle recession only were classified as group 1, patients who received both lateral rectus muscle recession and horizontal muscle vertical transposition in both eyes were classified as group 2, and patients who underwent lateral rectus muscle and inferior oblique muscle recession were classified as group 3. The differences in postoperative ocular alignment among the patient groups were compared. RESULTS: Among the 3 groups, group 2 demonstrated the smallest amount of esotropic deviation in mean postoperative ocular alignment measured 1 day and 1 month after surgery. There was no significant difference among the groups in the mean postoperative ocular alignment and mean amount of exotropic drift at 6 months. The difference in the amount of postoperative exotropic drift 1 year after surgery among the 3 groups was statistically significant. The largest amount of postoperative exotropic drift was observed in group 1. CONCLUSIONS: In correcting intermittent exotropia, the largest amount of postoperative exotropic drift was observed in patients who received only lateral rectus muscle recession. By contrast, the smallest amount of postoperative exotropic drift was observed in patients who received lateral rectus muscle recession with vertical transposition of the horizontal muscle.
Exotropia ; Eye ; Follow-Up Studies ; Humans ; Muscles

Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. the findings presented in this report are useful measures of the major health problems an even more important, as a guide to planning for improves medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural area. -to assess the rural population's needs in terms of health and medial care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group , the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample: Sample size was one fourth of total population: 1,438. The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination. Examination sessions usually were held in the morning every Tuesday, Wednesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior hgh school in Taegu city so the time was not convenient for them to receive examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Public health problems. Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years of older was 201 needed more health care and 65 of them had disabilities (table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health. Average number of pregnancies of eligible women was 4 times. There was almost no pre-and post-natal care. Pregnancy wastage. Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery Condition. More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimate about 35 per 10,000 live births. Child health. Consultation rate for child health was almost non existent. In general, vaccination rate of children was low; vaccination rates for children but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16). Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eight of estimate number of tuberculosis in the area. Number of discharged cases in the pat accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge on the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental Problems: More than 50% of the total population have lest one or more dental problems. (Table 19) B. Medical care Problems. Incidence rate: 1. In one month. Incidence rate of medical care problems during one month was 19.6% percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-n the order. The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years of over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old th rate of health problems increases gradually with aging. Eighty-three percent of health problems that occurred during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at those because of illness during one month were 1.7days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year. The incidence rate of medical care problems during a year was 7.8%, among them health problems which required rest at those was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occurred most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10) ,diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3)-in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were 16 days per interviewee and 4 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequency were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as follows:(previous page). Utilization of medical care (treatment) by various medical for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82% while the rate of those who have health problems which did not required rest was 61percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitated used were as follows: Hospital and clinics: 32-35%. Herb clinics: 9-10%. Drugstore: 53-58%. Hospitalization. Rate of hospitalization was 1.7% and the estimate number of hospitalization among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,1109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27).Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation. 2. MCH except medical care problems. 3. Family planning except surgical intervention. 4. Tuberculosis control except diagnosis and prescription. 5. Dental care except operational intervention. 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. b. Medical care problems. 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost. Considering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is need government to solve health and medical care problems for rural people.
Abortion, Induced ; Abortion, Spontaneous ; Adult ; Aging ; Anemia ; Bias (Epidemiology) ; Child ; Child Health ; Communicable Diseases ; Contraception ; Daegu ; Delivery of Health Care ; Dental Care ; Developed Countries ; Diagnosis ; Diarrhea ; Drinking ; Early Diagnosis ; Economic Development ; Family Characteristics ; Family Planning Services ; Female ; Follow-Up Studies ; General Practitioners ; Headache ; Health Education ; Health Services ; Hope ; Hospitalization ; Humans ; Incidence ; Infant ; Korea* ; Live Birth ; Male ; Maternal Death ; Maternal Health ; Midwifery ; Mortality ; Neuralgia ; Parasites ; Parturition ; Philosophy ; Pregnancy ; Prescriptions ; Primary Health Care ; Public Health ; Pulmonary Disease, Chronic Obstructive ; Rural Health ; Rural Population ; Sample Size ; Sanitation ; Secondary Care ; Skin ; Skin Diseases ; Specialization ; Spouses ; Students, Medical ; Toilet Facilities ; Tuberculosis ; Urban Health ; Vaccination ; Young Adult

OBJECTIVE: To investigate the effect of intravenous infusion of peripheral blood mononuclear cells (mPBMC) mobilized by granulocyte-colony stimulating factor (G-CSF) on upper extremity function in children with cerebral palsy (CP). METHODS: Fifty-seven children with CP were enrolled. Ten patients were excluded due to follow-up loss. In total, 47 patients (30 males and 17 females) were analyzed. All patients' parents provided signed consent before the start of the study. After administration of G-CSF for 5 days, mPBMC was collected and cryopreserved. Patients were randomized into two groups 1 month later. Twenty-two patients were administered mPBMC and 25 patients received normal saline as placebo. Six months later, the two groups were switched, and administered mPBMC and placebo, respectively. Quality of Upper Extremity Skills Test (QUEST) and the Manual Ability Classification System (MACS) were used to evaluate upper motor function. RESULTS: All subdomain and total scores of QUEST were significantly improved after mPBMC and placebo infusion, without significant differences between mPBMC and placebo groups. A month after G-CSF, all subdomain and total scores of QUEST were improved. The level of MACS remained unchanged in both mPBMC and placebo groups. CONCLUSION: In this study, intravenously infused mPBMC showed no significant effect on upper extremity function in children with CP, as compared to placebo. The effect of mPBMC was likely masked by the effect of G-CSF, which was used in both groups and/or G-CSF itself might have other neurotrophic potentials in children with CP.
Cerebral Palsy* ; Child* ; Classification ; Follow-Up Studies ; Granulocyte Colony-Stimulating Factor ; Humans ; Infusions, Intravenous* ; Male ; Masks ; Parents ; Peripheral Blood Stem Cell Transplantation ; Upper Extremity*

Among the bronchogenic carcinomas, especially squamous cell carcinoma and large cell carcinoma frequently present with cavitation, which may result from tumor necrosis. Cavitary lesions of the tumor are occasionally associated with infection and misdiagnosed as benign lung abscess owing to the partial responsiveness to antibiotics. It is very difficult to distinguish the carcinomatous abscess from the benign lung abscess, because of their similar clinical and radiologic features. Delay in diagnosis of underlying lung cancer may result in poor outcome. Therefore, clinicians should remember that the patients with highly suspicious carcinoma of the lung should undergo further precise examinations to find out malignant cells.
Abscess ; Anti-Bacterial Agents ; Carcinoma, Bronchogenic ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Humans ; Liver Abscess ; Lung ; Lung Abscess ; Lung Neoplasms ; Necrosis

“Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” is the 3rd edition of clinical practice guideline (CPG) for stroke rehabilitation in Korea, which updates the 2nd edition published in 2014. Forty-two specialists in stroke rehabilitation from 21 universities and 4 rehabilitation hospitals and 4 consultants participated in this update. The purpose of this CPG is to provide optimum practical guidelines for stroke rehabilitation teams to make a decision when they manage stroke patients and ultimately, to help stroke patients obtain maximal functional recovery and return to the society. The recent two CPGs from Canada (2015) and USA (2016) and articles that were published following the 2nd edition were used to develop this 3rd edition of CPG for stroke rehabilitation in Korea. The chosen articles' level of evidence and grade of recommendation were decided by the criteria of Scotland (2010) and the formal consensus was derived by the nominal group technique. The levels of evidence range from 1++ to 4 and the grades of recommendation range from A to D. Good Practice Point was recommended as best practice based on the clinical experience of the guideline developmental group. The draft of the developed CPG was reviewed by the experts group in the public hearings and then revised. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” consists of ‘Chapter 1; Introduction of Stroke Rehabilitation’, ‘Chapter 2; Rehabilitation for Stroke Syndrome, ‘Chapter 3; Rehabilitation for Returning to the Society’, and ‘Chapter 4; Advanced Technique for Stroke Rehabilitation’. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” will provide direction and standardization for acute, subacute and chronic stroke rehabilitation in Korea.
Canada ; Consensus ; Consultants ; Humans ; Korea* ; Practice Guidelines as Topic ; Rehabilitation* ; Scotland ; Specialization ; Stroke*