No abstract available.
Asthma* ; Child* ; Humans ; Lymphadenitis*

Purpose: We used optical coherence tomography angiography to analyze the macular microvasculature of normal eyes of healthy Korean children; we derived normative data stratified by age. Methods: We retrospectively analyzed the medical records of 68 children (126 eyes) aged from 3 to 15 years. Optical coherence tomography angiography was performed on 3-mm2 regions centered on the fovea. The vascular densities of the superficial and deep capillary plexuses and the foveal avascular zone were determined, and analyzed by age. We sought correlations between age, gender, axial length, and the spherical equivalent. Results: The foveal, superficial capillary plexus vessel densities were 17.41 ± 5.41, 20.53 ± 4.76, 21.78 ± 5.73, and 22.95 ± 3.91% in children aged 3-5, 6-8, 9-11, and 12-15 years, respectively. The vessel densities of the foveal deep capillary plexus were 30.20 ± 6.59, 34.54 ± 7.16, 35.81 ± 6.02, and 37.38 ± 5.16% in those aged 3-5, 6-8, 9-11, and 12-15 years, respectively. Significant differences by age were apparent (p = 0.002, p < 0.001, respectively). The foveal vessel densities of the superficial and deep capillary plexuses were positively correlated with axial length (R2 = 0.153, p < 0.001; R2 = 0.158, p < 0.001, respectively) and the foveal avascular zone area was negatively correlated with axial length (R2 = 0.085, p < 0.001). Conclusions The vessel densities of the superficial and deep capillary plexuses measured via optical coherence tomography angiography in normal eyes of healthy Korean children differed by age, and correlated significantly with axial length.

BACKGROUND: The purpose of this study was to compare the cost-effectiveness of propofol using a target-controlled infusion (TCI) with two currently used anesthetic regimens during major operations. METHODS: Forty-two patients undergoing major gynecological surgery were divided into three groups according to the period during which the surgeries were performed. Group propofol/TCI (n = 16) received 1% propofol using TCI-50% N2O, Group isoflurane (n = 14) received thiopental 5 mg/kg-isoflurane-50% N2O, and Group enflurane (n = 12) received thiopental 5 mg/kg-enflurane-50% N2O. All patients also received 2 microgram/kg of fentanyl before induction. Concentrations of propofol and volatile anesthetics were varied according to the patient's hemodynamic responses. Consumption of volatile anesthetics was measured by weighing the vaporizers by a precision weighing machine. RESULTS: Biometric data, duration of surgery and of anesthesia were similar in the three groups. Recovery from anesthesia was significantly shorter in the propofol/TCI group. Episodes of postoperative nausea and vomiting in the recovery room were less common in propofol/TCI group. Patient satisfaction was similar in all three groups. Total (intra- and postoperative) costs were significantly higher in the propofol/TCI group. CONCLUSIONS: When compared with the standard anesthetic regimens, the use of propofol using TCI anesthesia during major operations was associated with higher costs, but did not offer any clinically significant advantages in cost-effectiveness over the standard anesthesia regimens.
Anesthesia* ; Anesthetics ; Enflurane ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Hemodynamics ; Humans ; Isoflurane ; Nebulizers and Vaporizers ; Patient Satisfaction ; Postoperative Nausea and Vomiting ; Propofol* ; Recovery Room ; Thiopental

PURPOSE: To present a new classification based on the CT and MR imaging findings of buccal space lesions, and to propose guidelines for their radiologic differentiation. MATERIALS AND METHODS: Sixty-two histopathologically confirmed or clinically diagnosed buccal space lesions were classified on the basis of their morphologic appearance and extension to adjacent space as either (1) a mass with a distinct margin, confined to the buccal space; (2) a mass with surrounding infiltration, confined to the buccal space; or (3) a multi-space occupying mass. RESULTS: Type 1 included pleomorphic adenoma, ex-pleomorphic adenoma, carcinoma, B-cell lymphoma, acinic cell carcinoma, rhabdomyosarcoma, glomus tumor and ameloblastoma, and differentiation between malignant and benign neoplasms was not possible. Type 2 included adenoid cystic carcinoma, abscess, complicated dermoid cyst, and Kimura disease. T-cell lymphoma, neurofibroma, vascular malformation, inflammation, and foreign body granuloma pertained to type 3, and each type-3 entity showed different imaging characteristics. CONCLUSION: This new classification based on CT and MR imaging characteristics may provide useful guidelines for predicting the differential diagnosis of buccal space lesions.
Abscess ; Adenoma ; Adenoma, Pleomorphic ; Ameloblastoma ; Angiolymphoid Hyperplasia with Eosinophilia ; Carcinoma, Acinar Cell ; Carcinoma, Adenoid Cystic ; Classification* ; Dermoid Cyst ; Diagnosis, Differential ; Glomus Tumor ; Granuloma, Foreign-Body ; Inflammation ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Magnetic Resonance Imaging* ; Neurofibroma ; Rhabdomyosarcoma ; Vascular Malformations

No abstract available.
Humans ; Pregnancy* ; Prognosis* ; Takayasu Arteritis*

Tracheoesophageal fistula is a rare disease of abnormal communication between esopha- gus and respiratory system. The common causes are the acquired origins in adult such as trauma, infection of the adjacent organs, malignant tumor, and foreign body. Among the traumatic origins, chemical drug, the procedure of the dilatation on the stenotic area, blunt trauma(fall, collisions), penetrating trauma(bullet, knife), and pressure injury are much more common than others. Recently, trauma and foreign body in the esophagus and bronchus are becoming the main cause of the tracheoesophageal fistula, however the frequency of the development of tracheoesophageal fistula caused by the infectious diseases is getting decreased. Fibrinogen-thrombin glue stimulates the healing process of the wound and the ulcer. We treated a 52-year-old male patient with nan-inalignant tracheoesophageal fistula, who had symtoms of pharyngolaryngeal and chest discomfort concomitant with a paroxysmal cough on swallowing food which were caused by fish bone. The diagnosis of tracheoesophageal fistula was made by the esophagogram, chest CT, and esop aecopy. By using the therapeutic endoscopy with an injection of the fibrinogen-glue, the tracheoesopeal fistula was obliterated completely with dramatic symptomatic improvement. Here we conqluded that this method would be the one of the best methods for the treatment of tracheoesophageal fistula.
Adhesives* ; Adult ; Bronchi ; Communicable Diseases ; Cough ; Deglutition ; Diagnosis ; Dilatation ; Endoscopy ; Esophagus* ; Fibrinogen* ; Fistula ; Foreign Bodies ; Humans ; Intestines* ; Male ; Middle Aged ; Rare Diseases ; Respiratory System ; Stomach* ; Thorax ; Thrombin* ; Tomography, X-Ray Computed ; Tracheoesophageal Fistula* ; Ulcer ; Wounds and Injuries

Sarcopenia-related falls and fractures are increasing worldwide due to the aging population. The purpose of this study was to 1) evaluate anthropometric characteristics related to hip fracture in Korean patients, 2) investigate sarcopenia prevalence in hip fracture (HF) and non-hip fracture (NF) groups, and 3) investigate the correlation between sarcopenia and osteoporosis. This case-control study examined 359 HF and 1,614 NF normal populations using Korea National Health and Nutrition Examination Survey data. We performed whole-body dual energy X-ray absorptiometry to analyze body composition using the skeletal muscle mass index (SMI: lean mass/height2) and bone mineral density (BMD). In the HF group, using the AWGS definition, the prevalence of sarcopenia in women and men was 44.3% and 68.2%, respectively; in the NF group, it was 7.1% and 16.1%, respectively. Lower appendicular SMI (P < 0.001), leg muscle mass (P < 0.001), and higher prevalence of sarcopenia (P < 0.001) were observed in the HF group after adjustment for age and gender. In multivariate analysis, sarcopenia (OR = 6.52; 95% CI = 4.67-9.09), age (OR = 1.15; 95% CI = 1.13-1.17), and osteoporosis (OR = 1.87; 95% CI = 1.35-2.58) were associated with the occurrence of a hip fracture. This study showed a higher prevalence of sarcopenia in patients with hip fractures compared with a normal population, and higher prevalence of sarcopenia in men.
Absorptiometry, Photon ; Accidental Falls ; Aging ; Body Composition ; Bone Density ; Case-Control Studies* ; Female ; Hip Fractures ; Hip* ; Humans ; Korea ; Leg ; Male ; Multivariate Analysis ; Muscle, Skeletal ; Nutrition Surveys ; Osteoporosis ; Prevalence* ; Sarcopenia*

The location of the sigmoid colon varies within the abdominal cavity, but its mesocolon is fixed to the left side. Right side fixation of the sigmoid colon is a very rare congenital positional anomaly. In addition, it has been reported that hepatocolic fistula is also a very rare disease that may present lower gastrointestinal bleeding. Here, the authors describe a case of a 71-year-old man who underwent surgery for hepato-sigmoidocolic fistula complicated by hepatocellular carcinoma and the right side fixation of the sigmoid colon.
Abdominal Cavity ; Carcinoma, Hepatocellular ; Colon, Sigmoid ; Fistula ; Hemorrhage ; Humans ; Mesocolon ; Rare Diseases

OBJECTIVES: We sought to examine the diverse factors associated with aneurysms of the posterior circulation. In addition, the results of conventional craniotomy were compared with those of endovascular treatment. METHODS: One hundred and one patients with posterior circulation aneurysms were selected for study inclusion. The factors that might affect the clinical outcomes were studied , such as the initial Hunt-Hess (H-H) grade, aneurysm location, size of the aneurysm, and therapeutic modalities. In addition, the morbidity and mortality rates were analyzed. The treatment outcomes were evaluated using the Glasgow Outcome Scale (GOS) 6 months after the initial insult. RESULTS: The patient population consisted of 67 women and 34 men, with a mean age of 52 (range 28-81 years). The overall morbidity and mortality rates at 6 months were 13.9% (14/101) and 17.8% (18/101), respectively. Sixty-one operations (60.3%) were performed, and 32 patients were treated with endovascular therapy. Forty-two (85.7%) of the 49 patients that had initial H-H grades of I and II had a better prognosis (GOS more than 4) than those with poor H-H grades (P<0.001). Patients that underwent endovascular treatment had better outcomes than those that had clipping (P=0.032). There was no significant difference in outcome according to the size of the aneurysm, location of the aneurysm, or the age of the patients. CONCLUSIONS: The results of this study showed that the factors affecting the prognosis were the initial HH grade and treatment modality. Considering the very high mortality rate in patients with rebleeding, early management may help improve the prognosis of patients with posterior circulation aneurysms. Endovascular therapy should be considered the primary treatment modality in patients with posterior circulation aneurysms.
Aneurysm ; Craniotomy ; Female ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm ; Male ; Prognosis

OBJECTIVE: Our purpose was to determine normal amniotic fluid alpha-fetoprotein level in midtrimester Korean pregnant women whose neonatal outcomes were normal. METHODS: Amniotic fluid alpha-fetoprotein(AFAFP) levels were measured by specific radioimmunoassay (RIA) in midtrimester pregnant women for various indications of amniocentesis from May 1992 to July 1999 at Seoul National University Hospital. Normal ranges were obtained from 640 singleton pregnancies in which neonatal outcomes were normal. RESULTS: Median values of AFAFP in Korean pregnant women were 13,250ng/mL, 12,900ng/mL, 11,150ng/mL, 9,430ng/mL, 8,019ng/mL, 6,800ng/mL, 5,850ng/mL, 5,750ng/mL, 5,210ng/mL, 3,420ng/mL at 15 week, 16 week, 17 week, 18 week, 19 week, 20 week, 21 week, 22 week, 23 week, 24 week, respectively. CONCLUSION: This determination of the median values and the normal range of AFAFP level by each gestational week in uncomplicated Korean women could be used reference values for prenatal diagnosis of various disorders like open neural tube defect.
alpha-Fetoproteins* ; Amniocentesis ; Amniotic Fluid* ; Female ; Humans ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women* ; Prenatal Diagnosis ; Radioimmunoassay ; Reference Values* ; Seoul