We had experienced 2 cases of acute subdural hematoma due to vitaimin K(vit. K) deficiency. They were 44-and 42-day-old. After the adminstration of vit.K1, prolonged prothrombin time(PT) and activated partial thromboplastin time(APTT) were corrected, so the surgical treatment ws performed. We supposed the predisposing factors were breast feeding and unknown hepatic pathology. No complication remained to one infant but the other multiple cerebral infarctions. The etiology, pathogenesis, diagnosis, prevention are discussed. We insist on neonatal administration of vit. K1 for the prevention of bleeding tendency. If intracranial hemorrhage develops, we must keep in mind that the early neurosurgical intervention may be needed.
Breast Feeding ; Causality ; Cerebral Infarction ; Diagnosis ; Hematoma, Subdural, Acute* ; Hemorrhage ; Humans ; Infant* ; Intracranial Hemorrhages ; Partial Thromboplastin Time ; Pathology ; Prothrombin ; Prothrombin Time ; Thromboplastin ; Vitamin K Deficiency ; Vitamins*

A retrospective review was performed in 33 knees of 30 patients who had undergone arthroscopic debridement for degenerative osteoarthritis of the knee. The mean age of the patients at operation was 55 years and the mean follow-up after operation was 15 months. We divided the knec:s into 2 groups; meniscectomy group (23 knees) and non-meniscectomy group (10 knees). The preoperative radiographic findings were divided into 3 groups according to the classification systern by Lotke et al. The postoperative results were evaluated using the nine-point scale by Baumgaertner et al. Our study was conducted to: 1) assess the overall efficacy of arthroscopic debridement, 2) compare the results between the. Meniscectomy group and nonmeniscectomy group, and 3) identify the relationship between the preoperative radiographic findings and out- come at the final follow-up time. Overall excellent or good results were ac.hieved in 22 knees (67%) and the preoperative radiographic findings correlated with the outcome at the final follow-up time. But the results in the meniscectomy and non-meniscectomy poups showed no significant differences statistically. We believe that arthroscopic debridement is an effective option of treatments for mild I:o moderate degenerative arthritis of the knee after failure of conservative measures.
Classification ; Debridement* ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Retrospective Studies

No abstract available.
Diabetes Mellitus, Type 1* ; Hypothyroidism*

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

Benign lichenoid keratosis is an asyrnptomatic, isolated, plaque-like lesion frequently mistaken for basal cell carcinoma, Bowens disease, and actinic or seborrheic keratosis because of its variable clinical appearance. We present two cases of benign lichenoid keratosis. The first case was a 44-year-old female who had mild pruritic, ll x15rnrn sized, single, slightly elevated brownish plaque with fine scaling on the right zygornatic area of 5 years' duration. The second case was a 35-year-old female who had mild prutitic, single, pea- sized erythernatous patch on the left ala nasi of one month's duration. On histologic examination, these two cases showed same histologic findings, such as focal parakeratosis, moderate hyperkeratosis, irregular acanthosis and liquefaction degeneration of basal cells in the epidermis and band-like mononuclear infiltration and colloid bodies in the dermis.
Actins ; Adult ; Bowen's Disease ; Carcinoma, Basal Cell ; Colloids ; Dermis ; Epidermis ; Female ; Humans ; Keratosis* ; Keratosis, Seborrheic ; Parakeratosis

BACKGROUND: Social support is defined as interpersonal transaction ; the giving of symbolic or material aid to another. It has been shown to have both buffering effects and direct beneficial effects on diverse health related outcomes. But there has been the dearth of well-validated measurement instruments. This article describes the development of Korean version of the Duke-UNC functional social support questionnaire(DUFSS), focusing on the aspect of social support. METHODS: The 13-item, self-administered questionnaire was translated to Korean language. It was evaluated on 177 patients attending the family medicine clinic of Seoul National University Hospital during one month(November, 1996.) Comparisons to the family APGAR, COOP/ WONCA functional status chart are made to assess validity. Factor analyses are performed. Correlation of the questionnire score with the sum of family APGAR and each items of COOP/ WONCA functional chart are measured Internal consistency are evaluated. RESULTS: The questionnaire score are correlated with significantly correlated with social activity item. The total Cronbachs alpha is calculated as 0.89. The four content areas developed by factor analyses are donfidant support(items 8, 9, 10), af fective support(items 4, 5, 6, 7), instrumental support(items 3, 12) and quantity of support(item 1). These shows similarity to American study results. CONCLUSIONS: The Korean version of the Duke-UNC functional social support questionnaire has been documented as having high reliability and moderate validity. It covers two dimensions well(confidant support, affective support) with a small enough number of questions. Instrumental support may need further study.
Humans ; Seoul ; Surveys and Questionnaires

This study was conducted to evaluate the relationship between change in obesity indices and change in serum lipids in adult male workers. Two-hundred-eight adult male workers of an industry in Taegu city were followed-up from 1991 to 1995. Height, weight, circumferences of hip and waist, blood pressure were measured and serum lipids were analysed. Data on life style were obtained using self-administered questionnaires. Mean differences of anthropometric measurements between 1991 and 1995 were as follows; 1.63kg in weight, 3.61cm in waist circumferences, 4.23cm in hip circumferences, 0.52kg/m2 in BMI and -0.021 in WHR. Those of lipids were as follows; 15.09mg/dl in total cholesterol, 20.43mg/dl in triglyceride, 9.40mg/dl in HDL-cholesterol, 2.87 in MI-index(p<0.01) and 350mg/dl in LDL-cholesterol. The changed value of BMI and Katsura index were strongly correlated with that of total cholesterol(r=0.174, p<0.05), the changed value of BMI correlated with that of triglyceride(r=0.374, p<0.01) and the changed value of weight correlated with that of MI index(r=-0.173, p<0.05). The changed value of WHR was significantly correlated with that of total cholesterol(r=0.162, p<0.05), however, was not significantly correlated with HDL-cholesterol, LDL-cholesterol, triglyceride and MI index. The changed value of weight, BMI and Katsura index were correlated with that of triglyceride(r=0.262, p<0.01; r=0.267, p<0.01; r=0.258, p<0.01) and the changed value of MI index(r=-0.143, p<0.05; r=-0.158; r=-0.144, p<0.01), adjusting the pattern of change in life style. The changed values of HDL-cholesterol and MI index between 1991 and 1995 in low WHR group were significantly higher than those in high WHR group(p<0.05, p<0.01), adjusting the baseline value of them. Similar pattern was observed when considering Katsura index. When stratifying by BMI value of 1991, in low BMI group, the changed value of HDL-cholesterol and MI index showed the same pattern as above, however the of triglyceride was statistically higher in obese group than in non obese group(p<0.05). In conclusion BMI might be a better indicator to predict serum lipids change than other obesity indices.
Adult* ; Blood Pressure ; Cholesterol ; Daegu ; Hip ; Humans ; Life Style ; Male* ; Obesity* ; Surveys and Questionnaires ; Triglycerides ; Waist Circumference

As a new concept of resistive exercise, isokinetic exercise was developed during the early 1950's. In isokinetic exercise, the subject works at a fixed speed against variable and totally accommodating resistance. The isokinetic equipment has been used widely as a therapeutic modality in clinical setting, as a training and testing device for sports practicians, and as a method for scientific examination of postoperative status of muscles and joint function for orthopedists. In order to acquire the isokinetic normative data of the knee for clinical use, we examined the flexor and extensor muscle force of the knee joint in 160 subjects with Cybex II. The results were as follows; 1. Mean values of extensor strength were 76.04 ft.-1bs in right knee 75.45 ft.-lbs in left knee, 78.42 ft.-1bs in dominent hand side leg 73.84 ft.-1bs in non-dominent hand side leg, and 82.52 ft.-1bs in dominent leg 71.93 ft.-lbs in non-dominent leg. 2. Sex difference of extensor strength were 95.13 ft.-lbs in male 55.98 ft.-1bs in female, and that of flexor strength were 54.90 ft.-1bs in male 33.68 ft.-1bs in female. 3. Mean of position angle of maximal torque were between 58° and 65° for extensors, 35° and 45° for flexors. 4. Mean of total range of motion at working isokinetically with 60°/sec speed was 99°. 5. Mean values of extensor power were 54.43 ft.-1bs in male 30.63 ft.-lbs in female, and that of flexor power were 35.99 ft.-1bs in male 22.42 ft.-1bs in female. 6. Strength and power decreased as ages getting old, and there was significant diminish between 4th decade and 5th decade. 7. Power endurance had more difference when it was compared with occupation. Mean value of power endurance was between 12 times and 18 times.
Female ; Hand ; Humans ; Joints ; Knee Joint ; Knee ; Leg ; Male ; Methods ; Muscles ; Occupations ; Range of Motion, Articular ; Sex Characteristics ; Sports ; Torque

The presence of epicanthal folds in Asian eyelids is one of their unique features, in combination with the lack of supratarsal folds. Western culture has influenced many people to prefer to eliminate the prominent epicanthal fold. A number of surgical techniques have been suggested for their correction. However, difficulty with design, excessive and prominent scarring of medial canthal and nasal area, recurrence, and rigidity of application are potential problems associated with many procedures. This paper describes a epicanthoplasty with three-dimensional Z-plasty. Through epicanthal fold incision, the medial canthal tecdon is medially advanced and sutured to the periosteum of nasal bone. After the transposition of the flaps, trimming of the flap is usually required. Three-dimensional Z-plasty crates the attactive eyes. From March, 1995 to March, 1997, the technique was applied to 37 patients with epicanthal fold and was performed with or without double-fold operation. There were 34 females and 3 males with ages ranging from 17 to 30 years. Through 2 years follow-up, this techniques has delivered esthetically good results with minimal postoperative scar and could made the reduction of ICD from 40 +/- 2.13mm to 34 +/- 1.98mm. The advantages of epicanthoplasty procedure using three-dimensional Z-plasty(Yoon's method) are as follows; 1) simple in design 2) minimal postoperative scar in the medial canthal area 3) versatile in its application 4) no recurrence 5) no hypertrophic scar 6) preserving ethnic identity.
Asian Continental Ancestry Group ; Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Male ; Nasal Bone ; Periosteum ; Recurrence