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

No abstract available.
Arthritis, Juvenile*

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

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

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

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

"The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.
Adult ; Delivery, Obstetric/economics/*utilization ; Female ; Hospitals ; Humans ; Pregnancy ; Prenatal Care/economics ; *Program Evaluation ; Republic of Korea ; Rural Population

BACKGROUND: Desmopressin acetate (DDAVP) may improve hemostasis in congenital or acquired disorders of coagulation and reduce operative blood loss in patients undergoing surgical procedures. The effects of DDAVP on coagulation in hemorrhagic shock were studied in rabbits subjected to severe hemorrhage. METHODS: 20 rabbits were bled to shock and infused lactated Ringer's solution simultaneously so that the mean arterial pressure were maintained above 50 mmHg. Animals were randomly received DDAVP 0.3 ug/kg (group Dl), 3 ug/kg (group D10) or saline (group S) over 15 minutes. Bleeding time and factor VIII coagulant activity (FVIII:C) were measured before, after shock and 45 minutes after DDAVP or saline infusion. RESULTS: After shock, bleeding time was not changed but FVIII:C was decreased significantly in all groups. After saline or DDAVP infusion, bleeding time was not changed in group S and group Dl, whereas shortened in group D10 from 107.5+/-11.3 second to 87.5+/-17.5 second (P<0.05). After saline or DDAVP infusion, FVIII:C was decreased in group S and group Dl (P<0.05), but not changed in group D10. CONCLUSIONS: Infusion of DDAVP 3 ug/kg shortens bleeding time and causes an increase of FVIII:C than other groups in rabbits resuscitated from hemorrhagic shock.
Animals ; Arterial Pressure ; Bleeding Time ; Deamino Arginine Vasopressin* ; Factor VIII ; Hemorrhage ; Hemostasis ; Humans ; Pharmacology ; Rabbits* ; Shock ; Shock, Hemorrhagic*

The wrist joint is formed by the distal end of the radius and ulna proximally, and eight carpal bones distally. It has many ligaments to maintain stability of the complex bony structures. The incidence of ligament injuries of the wrist has increased due to sports activities. However, diagnosis and management of these injuries are sometimes difficult because of the anatomic complexity and variable injury patterns. Among them, scapholunate ligament injury and triangular fibrocartilage tears are the two most common injuries resulting in chronic disabling wrist pain. Thorough understanding of the wrist anatomy and physical and radiologic examination is mandatory for proper diagnosis and management of these conditions. This article will briefly discuss the wrist joint anatomy and biomechanics, and review the diagnosis and management of the scapholunate ligament injury and triangular fibrocartilage injury.
Carpal Bones ; Diagnosis* ; Incidence ; Ligaments* ; Radius ; Sports ; Tears ; Triangular Fibrocartilage ; Ulna ; Wrist Joint ; Wrist*