The purpose of this study was to analyze the growth and development of tooth germ and dental arch related to the bone growth during the fetal period. From 70 maxillae and 61 mandibles of the fetus aged 5, 6, 7, 8, 9 and 10 months, X-ray films were taken and measured. The results were as follows; 1. There was remarkable bone growth in the anterior and posterior area of palatum osseum, that were the interior portion of both deciduous canines anteriorly and the intero-posterior portion of both deciduous second molars posteriorly, where there was active bone growth and radiate formation of bony trabecylae was found. 2. The Growth of anterior tooth germ was greater than that of posterior germ, so anterior tooth germs were crowded. Especially in maxilla, the tooth germa of deciduous lateral incisors were located inside of dental arch and the tooth gerka of decoduous canines were located outside of dental arch. 3. Crowding amount increased with the fetal age because the growth of tooth germs was grdater than that of jow bone. 4. In the growth of upper dental arch, the increase of width was greater than that of length. 5. There was proportional relationship beween the arce of Palatal Trapezoid and the fetal age.
Bone Development ; Crowding ; Dental Arch* ; Fetus* ; Gestational Age ; Growth and Development* ; Humans* ; Incisor ; Mandible ; Maxilla ; Molar ; Tooth Germ* ; Tooth* ; X-Ray Film

No abstract available.

Epidural hematoma (EDH) is relatively rare in newborn infants and frequently associated with instrumental deliveries or other complications during labor and delivery. Although surgical evacuation has been the most common therapy, many other procedures have been suggested. Although many epidural hematomas require surgical evacuation rather than non-surgical management, the conservatiob or aspiration of hematoma have been attempted. In the case of EDH associated with cephalhematoma, aspiration of cephalhematoma could be attempted because frequent features of these combination were communication between these hematoma. We report a case of successful nonsurgical management for epidural hematoma through the aspiration of accompanying cephalhematoma in a five-day-old newborn infant.
Hematoma ; Humans ; Infant, Newborn ; Mucocutaneous Lymph Node Syndrome ; Retropharyngeal Abscess

Anomalous left pulmonary artery(pulmonary artery sling) is a congenital anomaly in which the vascular structure arises either from the posterior surface of the right pulmonary artery, or from the main pulmonary artery and courses to the left lung between the posterior surface of the trachea and the anterior surface of the esophagus. It may compress on the tracheobronchial tree causing significant symptoms on the part of the respiratory system such as dyspnea, stridor, or cyanosis. It is a rare condition leading to death in the first months of life, if it is not corrected. We present a case of pulmonary sling who was suffering from recurrent lower respiratory tract diseases, expiratory wheezing, and intermittent dyspnea since birth, thus she was treated for bronchial asthma. We confirmed the diagnosis with computerized tomography, especially with three dimensional reconstruction, which provided information regarding the spatial relationship between the anomalous pulmonary artery branch and the trachea and bronchi.
Arteries ; Asthma* ; Bronchi ; Cyanosis ; Diagnosis ; Dyspnea ; Esophagus ; Lung ; Parturition ; Pulmonary Artery* ; Respiratory Sounds ; Respiratory System ; Respiratory Tract Diseases ; Trachea

OBJECTIVE: to describe our experience and examine the frequency of gynecologic laparoscopy complication performed in a secondary care hospital. METHODS: We retrospectively studied 262 patients were treated by gynecologic laparoscopy (mean age 43 yrs). Period of study were from March 2003 through March 2005 in one teaching hospital. Data were analyzed using SPSS for windows software. Frequency and descriptive statistics were calculated. RESULTS: The overall number of complication in 262 laparoscopies was 16 (6.1%). 5 ureter injuries, 3 stump disruption, 2 troca site hematoma, 1 bladder injury, 1 small bowel injury, 1 post operative bowel obstruction, 1 leg neuropathy, 1 leg weakness, 1 massive bleeding. The complication rates were analysed by type of surgery. We evaluated correlation with variable factors. Our complication rates were higher to those reported in the literature and were significantly different by type of surgery. Complications were related to variable factors of blood transfusion and anesthetic time. CONCLUSION: The complication rate occurred at higher rates in our institution. All patients complications developed were treated and none sustained long-term morbidity. However, operative laparoscopy should be performed carefully. Early recognition of injuries, preferably intraoperatively, with immediate appropriate treatment is crucial. It is also important to be alert to early manifestations of complications in the postoperative observation period.
Blood Transfusion ; Hematoma ; Hemorrhage ; Hospitals, Teaching ; Humans ; Laparoscopy* ; Leg ; Retrospective Studies ; Secondary Care ; Ureter ; Urinary Bladder

Congenital muscle fiber type disproportion (CFTD) has been described as a form of congenital myopathy characterized by the smallness and marked predominance of type 1 fibers in a muscle biopsy. Clinical manifestations include hypotonia, nonprogressive muscle weakness, joint contractures, and skeletal deformities. However, it has also been noted that the same pathologic alterations appeared in clinically diverse conditions. Recently, we experienced a family, a mother and two children, in which a muscle biopsy showed the mother to have muscle fiber type disproportion. This case was unusual in that there was a significant progression of weakness, an absence of neonatal hypotonia, and other commonly associated musculo-skeletal deformities. In this report, we describe the clinicopathologic features of the family with a brief review about muscle fiber type disproportion.
Adult ; Biopsy ; Child, Preschool ; Female ; Human ; Male ; Muscle Fibers/pathology* ; Muscular Diseases/pathology ; Muscular Diseases/genetics*

PURPOSE: Among the many factors associated with acute intestinal mucosal infection, numerous studies have proposed the usefulness of fecal calprotectin. The aim of this study was to evaluate the usefulness of fecal calprotectin in the diagnosis of necrotizing enterocolitis (NEC). METHODS: We collected 154 stool samples from 16 very low birth weight and premature newborns at the Konyang University Hospital neonatal intensive care unit or neonatal nursery. The stool samples were collected using the Calprest device, and the fecal calprotectin level was measured with the BUHLMANN Calprotectin enzyme-linked immunosorbent assay kit. RESULTS: Fecal calprotectin levels were significantly higher in the NEC group than in the non-NEC group (P=0.02). There was a significant positive linear relationship between the fecal calprotectin level and number of days after birth (P=0.00) in the gestational age <26 weeks group. There was a significant negative linear relationship between the calprotectin level and number of days after birth (P=0.03) in the gestational age > or =26 weeks and <30 weeks group. There was no difference in the calprotectin levels according to the type and method of feeding between the NEC and non-NEC groups. CONCLUSION: Fecal calprotectin levels were significantly increased in premature infants with NEC. The fecal calprotectin test is a noninvasive, easy, and useful tool for the diagnosis of NEC.
Diagnosis ; Enterocolitis, Necrotizing* ; Enzyme-Linked Immunosorbent Assay ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Leukocyte L1 Antigen Complex* ; Nurseries ; Parturition

PURPOSE: We have evaluated type of medical errors and severity of results in the emergency department (ED). We also analyze the contributory factors of medical errors for the patient's safety and the quality improvement. METHODS: This study the was prospectively performed from May to August 2005. Medical errors that occurred in the ED were reported anonymously by emergency physicians. The type of medical errors and contributory factors were reported. The severity levels of errors were categorized into 5 levels: level 1- life threatening consequences; level 2- potentially life or limbs threatening consequences; level 3- serious failure or delay of diagnosis or treatment; level 4- inappropriate or unnecessary delay or treatment; level 5- no harm. RESULTS: The total number of patients admitted in the ED during the study period was 16,513, and 177 errors (1.5 errors/day) reported in 160 patients (9.7/1,000 patients). The most frequently occurring medical error was order omission (18.0%), but interpretation errors (11.3%) resulted in the most serious consequences (3.6+/-1.2). More than half of medical errors were no harm (51.4%). Educational and environmental (61 errors) factors were the most frequent causes of medical errors. CONCLUSION: Medical errors frequently occur in the ED. Reducing ED errors will require the improvement of ED environments, better communication, and reinforcement of education by supervising faculty members.
Anonyms and Pseudonyms ; Diagnosis ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Extremities ; Humans ; Medical Errors* ; Prospective Studies ; Quality Improvement

BACKGROUND: In recent years, there has been increasing interest in the use of capnometry, the noninvasive, continuous measurement of end-tidal carbon dioxide(ETCO2) in expired air during CPR. The purpose of this study is to determine the significance of ETCO2 monitoring according to immediate cause of arrest during CPR as a prognostic indicator of successful resuscitation and survival. METHODS: A prospective, clinical study was performed from May 1997 to December 2000 at the Department of Emergency Medicine, Ewha Womans University Mokdong Hospital. The study included 220 patients(231cases). All patients were immediately connected to a mainstream capnometer sensor between the tube and the bag after endotracheal intubation using an infrared capnometer. RESULTS: The 107 patients(46.3%) with return of spontaneous circulation(ROSC) had higher maximal ETCO2 during CPR than the 113 patients without ROSC(31.0+/-19.4 vs 11.7+/-9.4 mmHg, P=0.000). The ETCO2 was not significantly different in relation to age, initial rhythm, and survival time after ROSC, but there was a significant difference in the immediate cause of arrest in the ROSC group(respiratory arrest: 4 0 . 2+/-23.5 mmHg, P=0.000). In case of cardiac arrest due to trauma, maximal ETCO2 was not significant in the ROSC group compared with the non-ROSC group(18.2+/-16.6 vs 10.8+/-7.5 mmHg, P=0.208). When maximal ETCO2 was less than 10 mmHg, we observed a sensitivity of 94.4% and a specificity of 39.5% in predicting ROSC. There were 6 patients with ROSC even though the maximal ETCO2 was less than 10 mmHg. CONCLUSION: Continuous ETCO2 monitoring during CPR may be noninvasive and valuable predictor of successful resuscitation and survival from cardiac arrest. However, ETCO2 should not be used as a single indicator for either cardiac arrest due to trauma or withdrawal of CPR.
Carbon ; Cardiopulmonary Resuscitation* ; Emergency Medicine ; Female ; Heart Arrest ; Humans ; Intubation, Intratracheal ; Prospective Studies ; Resuscitation* ; Sensitivity and Specificity

PURPOSE: Our society is becoming more interested in domestic violence and proper care of those victims is required. This study was designed to develop a model of countermeasure against domestic violence that can be used in emergency department. METHODS: This prospective, clinical study was performed from Dec. 2000 to Aug. 2001 at the emergency department, Ewha Womans University Mokdong Hospital. Fifty-five patients of the 1665 female trauma patients were found to be victims of domestic violence during study period. We investigated the frequency of domestic violence in the patient's past, whether a weapon had been used, whether the assailant was an alcohol abuser, and whether he assaulted the victim in a drunken state or not. We analyzed correlation between these factors and severity injury of the patients. RESULTS: The average ISS of patients was 2.90+/-2.82, and 14 patients(25.8%) were admitted to hospital for treatment. Eighteen victims were reported to the police. Fourteen patients were injured with weapons, and in those cases, ISS and the hospital admission rates were marginallly higher than those not involving weapons(p=0.099). Police report rates in the weapon-using cases were 64.3%(9 people), which was considerably higher than those of nonweapons cases, 22.0%(p=0.007). No significant correlations exsisted between severity of patient's injury and frequency of domestic violence experienced in her past, assailant's alcohol history, and drunken assaulter. CONCLUSION: When weapons were involved, the police report rates were considerably higher. The medical personnel should immediately evaluate the patients's condition and provide a plan for her safety.
Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Police ; Prospective Studies ; Weapons