PURPOSE: To evaluate the progress and outcome of consecutive esotropia after surgery for intermittent exotropia. METHODS: The authors investigated the risk factors, changes in the angle of esodeviation and treatment outcome in consecutive esotropia after lateral rectus muscle recession for intermittent exotropia in 196 patients. RESULTS: Consecutive esotropia occurred in 25 patients (12.8%). The patients underwent more frequent combined muscle surgeries on vertical and oblique muscles (p = 0.001) and had a greater amount of immediate postoperative overcorrection than subjects without consecutive esotropia. There was no significant difference with the incidence of overcorrection greater than 17 PD between the 2 groups with and without consecutive esotropia. There was no difference with the immediate postoperative overcorrection between the 6 cases that required surgery for their consecutive esotropia and the cases that recovered from their consecutive esotropia with conservative treatment. The former showed increasing esodeviation and maximum angle at average postoperative month 29.5. In the latter, esodeviation tended to decrease and showed maximum angle at average postoperative month 4.3. Finally, esotropia disappeared and good stereoacuity was obtained in both cases. CONCLUSIONS: Although subjects with consecutive esotropia had a greater immediate postoperative overcorrection than subjects without consecutive esotropia, the progress and outcome of consecutive esotropia following the initial overcorrection were not predictable. Consecutive esotropia after surgery for intermittent exotropia showed good overall outcome and well-preserved stereoacuity after treatment.
Esotropia ; Exotropia ; Humans ; Incidence ; Muscles ; Risk Factors ; Treatment Outcome

PURPOSE: This study was done to identify the factors affecting the perception of patient-safety-culture and the level of safety-care-activity among nurses in small-medium sized general hospitals. METHOD: Data were collected during April and May 2011, from 241 nurses of five hospitals. A hospital survey questionnaire on patient-safety-culture and safety-care-activity was used. Collected data were analyzed using descriptive statistics, Pearson correlation, t-test, ANOVA, Scheffe test and multiple-regression. RESULTS: There were significant differences in the level of perception of patient-safety-culture according to the nurses' age, type of hospital, position, work department, and knowing whether there was a Patient-Safety committee in their hospitals. Nurses with higher perceived level of the patient-safety-culture performed more safety-care-activities. Factors influencing on the safety-care-activities were general patient safety, having had safety-education, patient-to-nurse ratio, employment status, and the level of reporting medical errors. These factors explained 22.9% of the safety-care-activity. CONCLUSIONS: The study findings suggest that in order to improve the nurses' perceived level of patient-safety-culture and safety-care-activity, the hospitals need to establish patient-safety committees and communication systems, and openness to reporting medical errors are needed. Better work conditions to ensure appropriate work time, regulate patient-to-nurse ratio, and nursing education standards and criteria, are also required.
Dietary Sucrose ; Education, Nursing ; Employment ; Hospitals, General ; Humans ; Medical Errors ; Patient Safety ; Surveys and Questionnaires

No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.
Airway Obstruction ; Asphyxia* ; Atmosphere ; Autopsy* ; Classification* ; Confined Spaces ; Drowning ; Homicide ; Humans ; Korea* ; Ligation ; Male ; Suicide

No abstract available.
Arthritis, Juvenile*

PURPOSE: Thyroid disease is the most common endocrine disease in childhood. Thyroid hormone has critical effects on growth and development, especially in childhood. We survey the prevalence, sex and age distribution, symptoms and thyroid function states of thyroid diseases in childhood. METHODS: Three hundred ninety one children who were diagnosed as having thyroid disease at department of pediatrics, St. Mary's hospital from Jan. 1987 to Dec. 1998 enrolled in this study. RESULTS: 1) The ratio between male and female patients was 1: 5.3. Age distribution was puberty, school age and infancy in their order of frequency. 2) The results of thyroid function tests showed normal function in 210 cases (53.7%), increased function in 95 cases(24.3%), and decreased function in 86 cases (22%). 3) Simple goiter, Graves disease, and chronic lymphocytic thyroiditis were the most common diseases in euthyroid, hyperthyroid, and acquired hypothyroid state, respectively. 4) The most common sign and symptom was goiter in euthyroid(100%), hyperthyroid(98.8%) and acquired hypothyroid state(96.2%). Forty of 68 cases(58.8%) with congenital hypothyroidism were detected by neonatal screening. CONCLUSION: Simple goiter, chronic lymphocytic thyroiditis and Graves disease were common acquired thyroid diseases in childhood, and goiter is the most common clinical manifestation in acquired thyroid disease. Recently, increasing number of congenital hypothyroidism was detected by neonatal screening test.
Adolescent ; Age Distribution ; Child ; Congenital Hypothyroidism ; Endocrine System Diseases ; Female ; Goiter ; Graves Disease ; Growth and Development ; Hashimoto Disease ; Humans ; Infant, Newborn ; Male ; Neonatal Screening ; Pediatrics ; Prevalence ; Puberty ; Thyroid Diseases* ; Thyroid Function Tests ; Thyroid Gland*

OBJECTIVE: This study is aimed to compare the efficacy of GnRH agonist and intravenous iron therapy in women who need correction of anemia prior to hysterectomy for uterine myoma and adenomyosis. METHODS: We reviewed retrospectively the data of 105 patients with initial hemoglobin level under 10g/dl, who had undergone total abdominal hysterectomy after correction of anemia with GnRH agonist (Group 1) or intravenous iron therapy (Group 2) from January 2004 to April 2006. RESULTS: Initial hemogloblin level was not different between the two groups. After administration, hemoglobin level increased by 3.9+/-2.3 g/dl and 2.6+/-1.7 g/dl, respectively. Therefore, group 1 was superior in anemia correction (p<0.01). On postoperative 1st day, hemoglobin level was 10.3+/-1.6 g/dl and 9.0+/-1.0 g/dl. Correction duration was 7.8+/-4.7weeks (1-18weeks) in group 1 and 4.0+/-4.8weeks (1-30 weeks) in group 2. Shorter duration was needed for correction in group 2 (p<0.01). Surgically removed uterine weight was 391.4+/-195.1 gm and 630.6+/-648.9 gm, respectively. Uterine weight was heavier in Group 2 (p<0.01). CONCLUSION: In comparison of efficacy of GnRH agonist with intravenous iron therapy for the correction of preoperative anemia, corrected hemoglobin level was higher and removed uterine weight was smaller in group 1. But duration of therapy for the correction of anemia was shorter and cost-effectiveness was superior in group 2. Clinicians should consider the patients' condition prior to the selection of drug for preoperative anemia correction.
Adenomyosis ; Anemia* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Hysterectomy ; Iron* ; Leiomyoma ; Retrospective Studies

PURPOSE: A minimally invasive surgical technique has been introduced to treat carpal tunnel syndrome that causes less pain, minimal scaring, and a rapid recovery. This study was designed to evaluate the safety and effectiveness of the double minimal incision release compared with the open surgery technique. METHODS: A study was performed on 175 cases in 111 patients who were operated on for carpal tunnel syndrome from January 2010 to December 2014. The patients were classified into 2 groups according to the type of surgical technique: 82 cases underwent standard open surgery in group A and 93 cases underwent double minimal incision release in group B. Grip strength and postoperative pain were evaluated 4 and 8 weeks and 6 and 12 months after surgery, and the period of numbness and time needed to resume normal activities were investigated. RESULTS: Group B patients showed better outcomes during the 2 first months after surgery than those of group A patients in numbness, pain, stiffness (p<0.05), less scar pain and tenderness (p<0.001), and shorter time needed to resume normal activities. However, no differences in these parameters were observed between the 2 groups after 6 months (p>0.05). CONCLUSION: Double minimal incision release offered better clinical outcomes until 2 months after surgery compared to the standard open surgery technique and reduced incipient postoperative pain and allowed for earlier resumption of normal activities.
Carpal Tunnel Syndrome* ; Cicatrix ; Hand Strength ; Humans ; Hypesthesia ; Minimally Invasive Surgical Procedures ; Pain, Postoperative

No abstract available.
Echocardiography* ; Humans ; Infant, Newborn*

Anti-idiotype antibody (anti-id Ab) which recognizes idiotope in the variable region of immunoglobulin (Ig) can regulate Ab production by B cells in vivo and in vitro. Although it has been reported that anti-id Ab can suppress IgM production by lymphocytes or hybridoma cells without suppression of cell proliferation, the regulatory mechanism of anti-id Ab is not completely understood. We studied the effects of anti-id Ab on the production of IgG class anti-DNA Ab by hybridoma cells, on the proliferation of cells, and on the transcription levels of Ig genes. In contrast to suppressive effect of anti-id Ab on the production of IgM previously reported by others, stimulatory effects of anti-id Ab on the production of IgG by hybridoma cells as well as the proliferation of these .cells were observed. However, little effect of anti-id Ab on the transcription levels of Ig genes was observed. These results suggest that anti-id Ab can increase Ab production by stimulation of cell proliferation. Furthermore, these results suggest that the effect of anti-id Ab on the production of Ab may be determined by the difference in class of Ab produced by hybridoma cells following the treatment with anti-id Ab.
Antibody Formation* ; B-Lymphocytes ; Cell Proliferation ; DNA* ; Genes, Immunoglobulin ; Hybridomas* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Lymphocytes

This statistical analysis of 4,709 legal autopsies performed in Korea in 2012 was conducted to obtain primary data about and related variables. The analysis revealed the following: 1. Of the total number of deaths, men accounted for and women, 26.8%. Evidently, the number of deaths among men was more than twice that among women. 2. With respect to mode of death, 54.8% were recorded as unnatural deaths, 39.2% were natural deaths, and 6.0% had unknown causes. Of the 2,581 unnatural deaths, 44.8% were accidental deaths; 27.2%, suicidal; 17.5%, homicidal; and 10.3%, undetermined. 3. Of the total number of unnatural deaths, 43.0% were trauma-related deaths, for which falling down was the leading cause, accounting for 33.5% cases. Asphyxiation was accounted for 17.2%, among which the predominant cause was hanging (55.3%). Moreover, 12.5% of deaths were due to drowning; 11.5%, poisoning; 11.2%, thermal injuries; 2.7%, complications in medical procedures; and 0.3%, electrocution, starvation, or neglect. 4. Among 1,847 natural deaths, heart diseases accounted for 50.2% and vascular diseases accounted for 16.7%. 5. There were 207 cases of deaths among children under the age of 10, of which 94 were unnatural and 49 were homicidal deaths. Of all cases, 9.2% had an unknown cause of death, and of these 67.6%, were putrefied or skeletonized bodies.
Autopsy* ; Cause of Death ; Child ; Drowning ; Female ; Heart Diseases ; Humans ; Korea* ; Male ; Poisoning ; Skeleton ; Starvation ; Vascular Diseases