Eleven cases of arthroscopic ankle arthrodesis were reviewed. Average age of patients was 59 years, 4 male and 7 female. Underlying diseases were osteoarthritis in 7 cases, rheumatoid arthritis in 3 cases and one post-traumatic arthritis. At the mean follow up of 15 months, fusion rate was 100%, mean time to complete union was 9.5 weeks. There were no complications such as nonunion, infection and skin problems. All patients stayed at the hospital just overnight after the surgery. Patients satisfaction was high and the functional clinical grade was excellent in 9 patients, good in 1 patient and fair in 1 patient. We concluded that arthroscopic technique was a simple and effective method for ankle arthrodesis in the selected patients and had significant advantages over the open technique.
Ankle* ; Arthritis ; Arthritis, Rheumatoid ; Arthrodesis* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Osteoarthritis ; Skin

Objective To explore the impact of maternal hepatitis B (HBV) virus infection status on the vaccination effect of the offspring. Methods Eighty-six pairs of HBV-infected mothers and newborns who were treated in Dalian Sixth People<sup>'sup>s Hospital from 2017 to 2019 were selected as the research subjects. According to the strength of the hepatitis B vaccine response, all patients were divided into two groups, the observation group (none or weak response) and the control group (strong response). Hepatitis B virus infection was compared between the mothers of the two groups, and multivariate logistic regression was used to analyze the influencing factors of vaccination effect of the offspring. Results The positive rate of HBV DNA in mothers of the observation group was higher than that in the control group. HBV DNA was mainly at high load and HBeAg was at low level. The HBV DNA of the control group was mainly at low load, while the distribution of HBeAg was close. The difference was statistically significant (P < 0.05). HBV infection pattern in the observation group was <sup>"sup>HBsAg(+), HBeAg(+), anti-HBc(+)<sup>"sup> in 14 cases (51.85%), <sup>"sup>HBsAg(+), anti-HBe(+), anti- HBc(+)<sup>"sup> in 11 cases (40.74%) , while there were 27 cases (45.76%), 25 cases (42.37%), and 7 cases (11.86%), respectively, in the control group. The difference was statistically significant (P<0.05). Multivariate logisitic regression analysis showed that HBV DNA positivity, HBV DNA high load, HBeAg positivity, and low HBeAg levels were risk factors for weak response of the offspring vaccination. Conclusion HBV DNA positivity, high HBV DNA load, HBeAg positivity, and low HBeAg levels in HBV-infected mothers were risk factors for weak response of the offspring to vaccines, which should be paid attention to in clinic.

PURPOSE: The efficacy of 20-gauge and 23-gauge vitrectomy system was investigated in primary vitrectomy for rhegmatogenous retinal detachment. METHODS: Eyes that underwent primary vitrectomy without scleral buckling for the treatment of rhegmatogenous retinal detachment were followed up at least 6 months and were reviewed retrospectively. Anatomic results, functional outcomes, operation time and complications were compared between 20-gauge and 23-gauge groups. RESULTS: Among 59 eyes of 59 patients, the 20-gauge group had 29 eyes of 29 patients and 23-gauge group had 30 eyes of 30 patients. Anatomic success after a single operation was obtained in 23 eyes (79.3%) of the 20-gauge group and 28 eyes (93.3%) of the 23-gauge group. Recurrence occurred in 6 eyes (20.7%) in the 20-gauge and in 2 eyes (6.6%) in the 23-gauge group. Retinal reattachment in all of these eyes was obtained through reoperation. Visual acuity improved logMAR 0.2 or more in 19 eyes (65.5%) of the 20-gauge group and 20 eyes (66.7%) of the 23 gauge group (p=0.153, 0.215). The average operation time of the 23-gauge group was 80.2 minutes, which was significantly shorter than the 94.8 minutes of the 20-gauge group (p=0.008). Transient ocular hypertension and progression of lens opacity were the most common complications in the both groups. CONCLUSIONS: Twenty-three-gauge transconjuctival sutureless vitrectomy achieved outcomes comparable with 20-gauge vitrectomy, with significantly shorter operation time in repair of rhegmatogenous retinal detachment. It is considered as a viable alternative to 20-gauge vitrectomy in selected cases.
Cataract ; Eye ; Humans ; Ocular Hypertension ; Recurrence ; Reoperation ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Scleral Buckling ; Visual Acuity ; Vitrectomy

PURPOSE: To compare the changes in corneal topography between 23 gauge (G) pars plana vitrectomy (PPV) and 20 G PPV. METHODS: Forty-three eyes of 42 patients who underwent PPV were divided into 2 groups: 20G PPV (Group I, n=18) and 23 G PPV (Group II, n=25). Both groups were followed up over 3 months postoperatively. ORBSCAN II was performed to compare the corneal topographic change of 20 G PPV and 23 G PPV. RESULTS: In a 5 mm zone, significant postoperative change in the mean corneal surface cylinder was found between the 1st day and the 1st month in Group I, while no significant change was found in Group II. Postoperatively, the increase in the mean corneal surface cylinder in Group I was significantly higher than in Group II between the 1st day and the 1st month. Clinically significant astigmatism, induced by surgery, was found only in Group I one week after the operation. In a 3 mm zone, there was no significant change in the mean corneal surface cylinder in both groups postoperatively. The difference in the mean corneal surface cylinder between the 2 groups at the postoperative periods showed no significant change. Surgically induced astigmatism was significantly higher in Group I than in Group II between the 1st day and the 1st month postoperatively. CONCLUSIONS: PPV with the 23 G system is a sutureless transconjunctival surgery, which appears to be more effective due to insignificant corneal surface and astigmatic changes in the early postoperative period.
Astigmatism ; Corneal Topography ; Eye ; Humans ; Postoperative Period ; Vitrectomy

OBJECTIVES: This study aims to investigate the effectiveness of an internet-based anger management program for school-aged children. METHODS: Forty-eight elementary school students took part in an anger management training program; subsequently, participants, their parents, and their teachers answered questionnaires assessing the participants' anger, aggressiveness, and other emotional/behavioral problems, pre- and post-training. RESULTS: At the post-training self-assessment, the participants showed significant reductions in their "anger-out" tendencies and physical aggressiveness. In addition, the effects of the program on "anger-out" tendencies, aggressiveness, anger and peer relational problem were found to be more significant in participants who reported depressive symptoms. Teachers rated the participants' peer-relational problems as having decreased after the training. CONCLUSION: The proposed internet-based anger management program had a significant effect on the school-aged children's abilities to control their anger.
Anger* ; Child* ; Depression ; Education ; Humans ; Parents ; Self-Assessment ; Violence* ; Surveys and Questionnaires

No abstract available.
Child* ; Humans ; Liver Diseases* ; Liver* ; Prospective Studies*

There are some controversies on the mechanism of the lumbar disc degeneration and disc prolapse. But,it is clear that many factors are related to the disc degeneration. Configurations of the lower lumbar and lumbosacral spine have long been proposed as one of the important factors of disc degeneration in these areas. To look for the configurational risk factors and the probability of disc degeneration by the combinations of these factors, we analyzed simple radiographs and MRI of 73 patients who complaints of low back pain and are between 20 years and 39 years of age. We performed chi-square test and multivariate logistic regression analysis: L4-5 disc degeneration and L5-Sl disc degeneration as dependent variables and lumbar lordosis, sacral inclination, height of intercrest line, transitional vertebra and facet joint asymmetry as independent variables. We could not find any of these variables significantly related to the L4-5 intervertebral disc degeneration. For L5-S1 disc degeneration, only the presence of transitional vertebra was signicantly related. When there is no transitional vertebra, the probability of disc degeneration is 9 times(8.889) as large as that of presence of transitional vertebra. The probability of L4-5 disc degeneration without the degeneration of L5-S1 is 3 times as large as that of degeneration of both of L4-5 and L5-S1 disc in case of the presence of transitional vertebra.
Animals ; Humans ; Intervertebral Disc Degeneration* ; Logistic Models ; Lordosis ; Low Back Pain ; Magnetic Resonance Imaging ; Prolapse ; Risk Factors ; Spine* ; Zygapophyseal Joint

PURPOSE: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. METHODS: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. RESULTS: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score (< or =3) was lower in the immediate group than the delayed group. CONCLUSION: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.
Apgar Score ; Emergencies ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Medical Records ; Parturition ; Pregnancy ; Prenatal Care ; Retrospective Studies

BACKGROUND: The literature on variations of rib is limited. Very little has been written in the radiological journal of this country on the subject. It seemed of interest to investigate the nature and incidence of congenital variations in a series of routine chest roentgenograms. The topic of rib variations has not been covered extensively in the radiological journals in Korea. This has presented an opportunity to investigate the nature, type, shape and incidences of congenital rib variations in normal Korean adults from a series of routine roentgenograms. METHODS: Chest radiographs of 5,000 adults (,) who visited our hospital for a routine check-up or for employment physical examinations from January 1996 to September 1998, were consecutively reviewed. The sex distribution consisted of 2,827 male males and 2,173 females (ratio of 1.3:1) with the age range between 19 and 65 years (mean age: 34.6 years). The chest PAs was were analyzed for the presence, type, location, and shape of the rib variations (.) From this data, and we the incidence of each type of variations was calculated. RESULTS: Seventy-six of the 5000 adults (1.52%), 63 male (2.23%) and 13 female (0.6%), showed 88 cases of rib variation (Table 1). Bifid rib (n=35) was the The most common variation was the bifid rib (n=35), followed by hypoplasia of the rib (n=22), flaring of the rib (n=18), bridging of the ribs (n=7), cervical ribs (n=3), and fusion of between ribs (n=3) (Table 2). (New paragraph)Bifid The bifid rib (Table 1) was found most frequent in the right fourth rib (12/35, 34.3%), followed by the left fifth rib (6/35, 17.1%) and right third rib (6/35, 17.1%). Hypoplasia of the rib was common in first rib (20/22, 90.9%). Flaring of the rib was common at fourth rib (8/18. 44.4%, right and left combined) (,) and bridging between ribs was common between first and second rib (3/7, 42.9%). CONCLUSION: The percentage of incidence of rib variations in adults was 1.52%. Bifid rib was the most common variation, followed by hypoplasia, flaring, bridging, cervical rib, and fusion of ribs(,) in decreasing order.
Adult ; Cervical Rib ; Employment ; Female ; Humans ; Incidence* ; Korea ; Male ; Physical Examination ; Radiography ; Radiography, Thoracic* ; Ribs* ; Sex Distribution ; Thorax*

This article presents specific examples of delayed diagnosis of acute coronary syndrome, acute aortic dissection, and pulmonary embolism resulting from evaluating patients with nonspecific acute chest pain who did not undergo immediate dedicated coronary CT angiography (CTA) or triple rule-out protocol (TRO). These concrete examples of delayed diagnosis may advance the concept of using cardiac CTA (i.e., dedicated coronary CTA versus TRO) to triage patients with nonspecific acute chest pain. This article also provides an overall understanding of how to choose the most appropriate examination based on the specific clinical situation in the emergency department (i.e., dedicated coronary CTA versus TRO versus dedicated pulmonary or aortic CTA), how to interpret the CTA results, and the pros and cons of biphasic versus triphasic administration of intravenous contrast material during TRO examination. A precise understanding of various cardiac CTA protocols will improve the diagnostic performance of radiologists while minimizing hazards related to radiation exposure and contrast use.
Acute Coronary Syndrome ; Angiography ; Chest Pain ; Delayed Diagnosis ; Emergencies ; Humans ; Pulmonary Embolism ; Thorax ; Tomography, X-Ray Computed ; Triage