Using Littmann's method for correcting the magnification of central fundus photographs, we evaluated the color photographs of 195 optic discs to measure the diameter and area of the optic disc. Minimal disc diameter ranged from 1.30mm to 2.53mm(mean 1.81mm) and maximal diameter from 1.53mm to 3.08mm(mean 2.04mm). Mean optic disc area measured 2.93mm2(minimum 1.63mm2, maximum 5.53mm2). The correlation coefficients between the refractive diopter of right eye and the disc diameter of right eye were 0.34 and between the refractive diopter of left eye and the disc diameter were 0.42. The correlation coefficients between the disc area and the refractive diopter were 0.43. There was no statistically significant difference in each optic disc diameter. Regarding the Gaussian distribution curve based on these preliminary data, microdiscs can be defined as being smaller than 1.57mm2(mean minus two standard deviations) and macrodiscs as being larger than 429mm2(mean plus two standard deviations).

BACKGROUND: Abdominal pain is one of the most common complaints in the emergency department and the evaluation presents an extraordinary challenge to the emergency physician's skill. C-reactive protein, an acute phase protein which is increased in the presence of inflammation in various clinical conditions, has been proven useful in assessing disease severity, in monitoring the development of complications, and in evaluating the response to specific treatments. So we tried to determine whether CRP offers an advantage over other clinical or laboratory variables for decision-making in the management of acute abdominal pain in the emergency department. METHOD: Patients who came to a University Hospital ED with acute abdominal pain, between september 1, 1998 and November 30, 1998, were included in this study, Data collection included age, sex, duration of symptom, location of pain, and laboratory dta(white blood cell count, portion of neutrophils, ESR, CRP, amylase). RESULT: This study included 85 patients, 34 of whom were men. The mean age was 36.9+/-19.1 years. CRP might be useful to detect the serious condition, sensitivity 81%, but more useful to differentiate normal condition from serious condition in acute abdominal pain patients, specificity 83%. CONCLUSION: CRP is an useful indicator of decision-making to abdominal patients in the emergency department. Hospitalization or operation is very unlikely when CRP value is normal.
Abdominal Pain* ; Acute-Phase Proteins ; Blood Cell Count ; C-Reactive Protein* ; Data Collection ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Hospitals ; Humans ; Inflammation ; Male ; Neutrophils ; Sensitivity and Specificity

A 9-year-old Korean boy with lissencephaly was found dead at home. He had previously been diagnosed with lissencephaly that presented with infantile spasm on the basis of magnetic resonance imaging and electroencephalogram results. Antemortem chromosomal banding revealed a normal karyotype. A legal autopsy was requested to eliminate the possibility of neglect or abuse by his parents. The autopsy findings revealed type I lissencephaly with the associated microcephaly. No external wounds or decubitus ulcers were noted. Postmortem fluorescence in situ hybridization for the LIS1 locus and nucleotide sequence analysis of the whole coding regions of the LIS1 gene did not reveal any deletions. The antemortem and postmortem findings revealed that lissencephaly syndrome was associated with isolated lissencephaly sequence. External causes of death were excluded by the full autopsy and toxicology test results. Because patients with mental retardation are frequently victimized and suffer neglect or abuse, thorough external and internal examinations should be conducted at the time of autopsy.
Autopsy ; Base Sequence ; Cause of Death ; Child ; Child Abuse ; Classical Lissencephalies and Subcortical Band Heterotopias ; Clinical Coding ; Electroencephalography ; Fluorescence ; Forensic Pathology ; Humans ; In Situ Hybridization ; Infant ; Infant, Newborn ; Intellectual Disability ; Karyotype ; Lissencephaly ; Magnetic Resonance Imaging ; Microcephaly ; Parents ; Pressure Ulcer ; Spasms, Infantile ; Toxicology

Squamous cell carcinoma (SCC) is a common head and neck cancer that is usually restricted to the mucosal surfaces and skin, so sometimes it is very difficult to diagnose a primary lesion. We report a case of a 73-year-old man who presented as a small skin ulcer and parotid mass. The pathologic diagnosis was a squamous cell carcinoma, although it was very difficult to distinguish between skin cancer invading the parotid gland and a primary SCC of the arotid gland extending to the skin. The patient was treated with surgical resection and radiation therapy.
Aged ; Carcinoma, Squamous Cell ; Head and Neck Neoplasms ; Humans ; Parotid Gland ; Skin ; Skin Neoplasms ; Skin Ulcer

Mucinous adenocarcinomas of the anal region constitute only 2% of anal cancer and adenocarcinoma developing in a chronic tuberculous anal fistula is extremely rare. In most cases, its origin is difficult to ascertain because the primary sites have already been destroyed before any diagnosis of malignancy is made. We experienced a case of perianal adcnocarcinoma developing in chronic tuberculous anal fistula, which was treated by abdominoperineal resection with preoperative chemo-irradiation. We reported a case and reviewed the related literatures.
Adenocarcinoma* ; Adenocarcinoma, Mucinous ; Anus Neoplasms ; Diagnosis ; Rectal Fistula*

PURPOSE: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. MATERIALS AND METHODS: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. RESULTS: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. CONCLUSION: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.
Female ; Follow-Up Studies ; Foot ; Humans ; Knee ; Male ; Osteotomy ; Talus* ; Transplants*

No abstract available.
Typhlitis*

PURPOSE: Laparoscopic cholecystectomy (LC) has become the standard procedure for gallbladder disease. LC is associated with bile duct injury, which can cause serious complications. We evaluate the treatment, results and the relation with cholangiopancreatography for bile duct injury during LC. METHODS: 860 cases of LC were performed from April 2000 to August 2005. Among them, 7 cases of bile duct injury were reviewed for the diagnosis, management and operation findings. RESULTS: According to the Strasberg classification, there were 5 cases of type E, 1 case of type C and 1 case of type D. All of them were identified at operation and they were immediately managed. Among the type E cases, the type E1 was managed by CBD end-to-end anastomosis with internal drainage, type the E2 and type E3 were managed by Roux-en-Y hepaticojejunostomy, the type C were managed by primary repair with T-tube drainage and the type D were managed by primary repair. Although all of cases were visible at the cystic duct on preoperative cholangiopancreatography, we could not identify the type E on the operation findings. CONCLUSION: In this study, although the cystic duct was identified on cholangiopancreatography preoperatively, the possibility of bile duct injury increases if there was severe inflammation and adhesion. For the management of bile duct injury, we recommend CBD end-to-end anastomosis for type E1, Roux-en-Y hepaticojejunostomy for type E2 and E3, and primary repair and/or drainage for type C and D.
Bile Ducts* ; Bile* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Classification ; Cystic Duct ; Diagnosis ; Drainage ; Gallbladder Diseases ; Inflammation ; Laparoscopy

Intussusception is the most common cause of intestinal obstruction in early childhood and characterized by periodic colicky abdominal pain or irritability, vomiting, current jelly stool, and sausage-like abdominal mass. Meckel's diverticulum is common intestinal anomaly presenting with painless rectal bleeding during first 2 year of age. It is recognized as a common leading point of intussusception in childhood. Hematemesis is the rare clinical manifestation of both intussusception and Meckel's diverticulum. A 7-year-old girl presented with hematemesis was diagnosed as having intussusception by abdominal ultrasonography. Meckel's diverticulum was the leading point of intussusception in this case.
Abdominal Pain ; Child ; Female ; Hematemesis* ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception* ; Meckel Diverticulum* ; Ultrasonography ; Vomiting

No abstract available.
Coronary Sinus ; Coronary Vessels