Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

Data pools and their integration are fueling the big data revolution in health care with the recent advances in information technology. Korea has shown tremendous promise in the utilization of big data for its advanced technology, computerized health data, and unique identifiers. However, the Personal Information Protection Act (PIPA) severely limits access to personal identifiers, which has discouraged the use of health data even for the public good. In contrast, western countries have focused on research without the use of identifiers, which has augmented the use of the available data while maintaining and respecting privacy; they have allowed some exemptions of informed consent and utilized limited data sets, which have the identifiers removed. The amount of research output has increased rapidly and an in-depth understanding of cancer has been made possible based on the linkage of Surveillance, Epidemiology, and End Results (SEER) and Medicare in the US. More than 700 projects covering a wide range of medical areas have been conducted, which has led to changes in clinical practice based on the Western Australian Data Linkage System. Although rare, evidence-driven decisions based on data linkage have been found in some cases in Korea; the adoption of prostate cancer screening as a national screening program was suspended as its cost-effectiveness has not been verified on the basis of data linkage by the National Evidence-Based Healthcare Collaboration Agency. For the active use of health data, there is an urgent need to amend PIPA, prepare regulations for data analysis, and foster collaboration among data-related institutions. Great projects based on data linkage will guarantee the world's leading research output and will be major sources for moving forward to success.
Computer Security ; Cooperative Behavior ; Dataset ; Delivery of Health Care* ; Epidemiology ; Evidence-Based Practice ; Humans ; Information Storage and Retrieval ; Informed Consent ; Korea ; Mass Screening ; Medicare ; Privacy ; Prostatic Neoplasms ; Social Control, Formal ; Statistics as Topic

Intermittent exotropia shows higher incidence in Oriental than in Caucassian. The results of surgical treatment is variable and the factors related to that have been a matter of some dispute. The authors retrospectively reviewed the relationships between the factors and the results of surgical treatment on the 186 children who had intermittent exot ropia and who were treated with bilateral lateral recti recessions. The 162 cases(86.5%) of 187 cases showed satisfactory surgical results, which was less than 5 prism diopters of exotropia and esotropia at far and near, with good stereopsis. The age at onset and initial surgery, the time interval from onset to initial surgery, the preoperative deviation angle, the types of intermittent exotropia, the inferior oblique overaction and dissociated vertical deviation did not significantly influence the surgical results(p>0.05). But, early postoperative overcorrection of 6~9 prism diopters lead to successful result(95.6%). This study revealed initial postoperative overcorrection influence the surgical results of bilateral lateral recti recessions in intermittent exotropia(p=0.03).
Child ; Depth Perception ; Dissent and Disputes ; Esotropia ; Exotropia* ; Humans ; Incidence ; Retrospective Studies

To search for the more effective amblyopia treatment, we prospectively compared the results of initial group and alternative group with use of Min's glasses. Initial and alternative groups consisted of 18 and 64 patients. 15 patients (83.3%) of initial group were compliant with the treatment while 50 patients(78.1%) of alternative group were. No significant differences existed between them based on age, sex, causes of amblyopia and initial visual acuity (P>0.05). Average visual acuity improvements were 2.13 +/- 1.81 lines in initial group, compared to 2.51 +/- 1.50 lines in alternative group and no significant differences existed between them according to age, causes of amblyopia and initial visual acuity (P>0.05), However, in cases of female, there was significant visual acuity improvement in alternative group in comparision with initial group (P=0.034). In conclusion, Min's glasses were effective not only in initial treatment group but also in alternative treatment group, and in female patients who previously failed with conventional occlusion therapy the effect was more pronounced than male patients.
Amblyopia ; Child* ; Compliance ; Eyeglasses* ; Female ; Glass* ; Humans ; Male ; Prospective Studies ; Visual Acuity

Townes-Brocks syndrome (TBS) is a rare genetic disorder characterized by the classic triad of congenital anomalies of the anus, thumbs, and ears, with variable expressivity. Additionally, renal malformations, cardiac anomalies, and endocrine and eye abnormalities can accompany TBS, although less frequently. TBS is inherited in an autosomal dominant fashion; however, about 50% of patients have a family history of TBS and the remaining 50% have de novo mutations. SALL1, located on chromosome 16q12.1, is the only causative gene of TBS. SALL1 acts as a transcription factor and may play an important role in inducing the anomalies during embryogenesis. Clinical features of TBS overlap with those of other multiple anomaly syndromes, such as VACTERL syndrome, Baller-Gerold syndrome, Goldenhar syndrome, cat eye syndrome, and Holt-Oram syndrome. Consequently, there are some difficulties in differential diagnosis based on clinical manifestations. Herein, we report a Korean family with two generations of TBS that was diagnosed based on physical examination findings and medical history. Although the same mutation in SALL1 was identified in both the mother and the son, they displayed different clinical manifestations, suggesting a phenotypic diversity of TBS.
Anal Canal ; Animals ; Anus, Imperforate ; Cats ; Diagnosis, Differential ; Ear ; Embryonic Development ; Eye Abnormalities ; Family Characteristics ; Female ; Goldenhar Syndrome ; Hearing Loss, Sensorineural ; Humans ; Mothers ; Physical Examination ; Polydactyly ; Pregnancy ; Thumb ; Transcription Factors

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

BACKGROUND: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. METHODS: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. RESULTS: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 +/- 7.9 mm versus 7.3 +/- 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. CONCLUSIONS: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Arm ; Clavicle* ; Consensus ; Elbow ; Extremities ; Hand ; Humans ; Ligaments* ; Prospective Studies ; Seoul ; Shoulder ; Shoulder Fractures ; Skin ; Suture Anchors ; Sutures*

To evaluate the progression of the cataract, we examined the retroillumination and the slit image of the lens by using EAS-1000 Scheimpflug photography in 50 individuals(91 eyes) with senile cataract from September 1990 to January 1996. We analyzed the cataract progression periodically by retroillumination for opacity area(%) change and Scheimpflug photography for density change of at each eyes at the same time. And we examined cataract type progression by aging and medication effect. In the retroillumination image, the monthly increment of opacity areas were 1.24%. In the Scheimpflug photography(slit image), the monthly incerement was 4.23 CCT. Both the opacity area(%) changes and the density changes at each cataract type were faster in the young age group than other age group. Both the opacity area changes and the density changes were slower in the anticataract medication group than non-medication group, but it was statistically insignificant.
Aging ; Cataract* ; Humans ; Photography

The present study has been conducted to assess the possible mechanism of cultured rabbit lens epithelial cell(LEC) damage and generation of oxygen free radicals after UVB exposure as well as to investigate the role of antioxidants to the survival rate of epithelial cells. Cultured rabbit LECs were exposed to various fluences of UVB radiation. The release of oxygen radicals(superoxide radical and hydrogen peroxide) and the activity of antioxidants(SOD, catalase) were also measured. The protective effects of various antioxidants on LECs damage after UVB exposure were measured. UVB radiation brought about a decrease in the survival fraction of cultured rabbit LECs. Exposure of the cells to fluences of 400 mJ/cm2, 1,600 mJ/cm2 and above 2,400 mJ/cm2 of UVB radiation resulted in 50%, 10%, nearly 0% in cell survival fraction, respectively. Cultured rabbit LECs exposed to UVB and hydrogen peroxide. The activity of intracellular SOD(esp. Cu, Zn-SOD) was significantly increased, but the activity of intracellular catalase was not changed. Antioxidants pretreatment(SOD, catalase, purpurogillin and allopurinol) ameliorated the cytoxoxic effect of UVB on the cultured rabbit LECs. These rusults indicate that the release of oxygen radicals are enhenced by exposure of LECs to UVB radiation. The oxygen radicals seem to play a specific role in the cytotoxic effect of LECs after UVB exposure.
Antioxidants ; Catalase ; Cataract ; Cell Survival ; Epithelial Cells* ; Free Radicals ; Hydrogen ; Hydrogen Peroxide ; Oxygen ; Reactive Oxygen Species ; Survival Rate