Optic ataxia is characterized by an impaired visual control of the direction of arm reaching to a visual target, accompanied by defective hand orientation and grip formation. In humans, optic ataxia is associated with lesions of the superior parietal lobule, which also affect visually guided saccades and other forms of eye-hand coordination. A 67-year-old woman presented with sudden, unilateral, direct optic ataxia in the right homonymous half field and saccadic abnormalities which consisted of prolonged latency, undershoot dysmetria, and decreased velocity. Brain MRI showed a left parieto-occipital watershed infarction. It is suggested that lesions of the superior parietal lobule and the adjacent parietal eye field are responsible for optic ataxia and saccadic abnormalities, respectively.
Aged ; Arm ; Ataxia* ; Brain ; Cerebellar Ataxia ; Female ; Hand ; Hand Strength ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Rabeprazole ; Saccades

Heterotopic pregnancy is named when an extrauterine (ectopic) pregnancy coexists with an intrauterine pregnancy simultaneously by many causes such as PID (pelvic inflammatory disease), endometriosis, IUD (intrauterine device), previous pelvic surgery and others. This is very rare in general population, with a range of occurrence estimated between 1:7963 and 1:30000. But recently the incidence has increased as the uses of ARTs (assisted reproductive technologies) including ovulation induction, IVF-ET (in-vitro fertilization and embryo transfer) and GIFT (gamete intrafallopian transfer) increase. Because this has high maternal morbidity, mortality and fetal loss, early diagnosis and proper management is very important. We report a case of heterotopic pregnancy following IVF-ET with a brief review.
Early Diagnosis ; Embryonic Structures ; Endometriosis ; Female ; Fertilization ; Incidence ; Mortality ; Ovulation Induction ; Pregnancy ; Pregnancy, Heterotopic*

No abstract available.
Osteoma, Osteoid* ; Spine*

No abstract available.
Chungcheongnam-do* ; Gallstones*

Twelve neglected congenital dislocations of the hip in ten patients over the age of eight years were treated by open reduction and chiari osteotomy. Reduction was aided by preoperative traction only in two hips, by femoral shortening with preoperative traction in three and by femoral shortening only in seven. The average follow up period in our series is 3 years, ranging from 1 year and 2 moths to 4 years and 5 months. The overall results were good but one case of avascular necrcsis and one case of redislocation were seen. By our experience it is thought that all old and congenitally dislocated hip in the growing age can be reduced by femoral shortening with soft tissue release, and preoperative traction for its reduction is not undispensable. The most problem in the treatment of the old congenital dislocation of the hip is the postoperative partial ankylosis in the affected hip and this problem would be overcome by delicate operative technique and meticulous hemostasis.
Ankylosis ; Dislocations ; Follow-Up Studies ; Hemostasis ; Hip ; Humans ; Moths ; Osteotomy ; Traction

We performed ERCP manometry of Sphincter of Oddi(SO) before and after endoscopic sphincterotomy(EST) for evaluation of the effect af EST on the SO. The subjects were postcholecystectomized common bile duct stone patients(n=l2) and EST was performed by major incision. The pressure gradient between common bile duct and duodenum before EST (8.6 + 3.9 mmHg) decreased significantly after EST(2.4 +1.7 mmHg). The length of SO before EST(8.8 + 0.8mmHg) decreased significantly after EST(2.5 + 0.8mm). But in each patient, the pressure gradient between common bile duct and duodenum remained in spite of the major incision. In conclusion, EST alters the function of the sphincter of the Oddi, but does not destroy its all protective function. The positive pressure in the bile duct is preserved in contrast to the absolute loss of pressure following surgical transduodenal sphincteroplasty.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Duodenum ; Humans ; Manometry* ; Sphincter of Oddi* ; Sphincterotomy, Endoscopic* ; Sphincterotomy, Transhepatic

From July 1989 to August 1991, we performed 146 cases of endoscopic sphincterotomy(EST). In our series, 9 early complications occurred in 146 cases(morbidity rate: 6.2%), and no fatalities were recognized(mortality rate:0). Four cases with late complications consisted of 2 cases of acute cholecystitis, one case of chalaagitis and restenosis. There were 36 with the gallbladder with stone(11 cases) or without stone(25 cases). Two cases with chalecystitis after EST occurred in the patients with gallbladder stones. EST gives the sufficient result in diagnosis and treatment for various disease of biliary tract. Furthermore, EST was found to be a safe procedure from low rates of complications and fatalities.
Biliary Tract ; Cholecystitis, Acute ; Diagnosis ; Gallbladder ; Humans ; Sphincterotomy, Endoscopic*

Subacute osteomylitis is far less common than acute osteomyelitis, characterized by insidious onset of the symptoms of mild local pain or discomfort without any acute systemic illness. Radiographic findings are not infrequently confused with benign or malignant bone tumors. From Jan, 1983 to Dec. 1991, we experienced twelve patients with subacute osteomylitis of long bones. Our clinical observations were as follows. 1. There were 11 boys and one girl with an average age of 9.7 years(range, 30months-16years). 2. The involved sites were proximal in 1, distal radius in 3, midshaft of femur in 3, distal femur in 2, proximal tibia in 1, and distal tibia in 2 cases. 3. All patients had insidious onset of mild to moderate pain. ESR was increased in 9 cases(75%) with a mean value of 44 mm/hr, but leukocytosis was not found. 4. According to the Green and Edwards' classification, there were type 1 in 1, type 2 in 3, type 3 in 3, and type 6 in 5 cases. 5. Eleven patients had operative treatment. The remaining one patient was treated by antibiotic treatment. 6. Primary treatment was successful in 11 patients who were followed for and average 9.5 months. One patients was lost to follow-up.
Child ; Classification ; Clinical Study ; Female ; Femur ; Humans ; Leukocytosis ; Lost to Follow-Up ; Osteomyelitis ; Radius ; Tibia

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers