The surgical reconstruction of complex facial injuries have focused on the following; early one-stage repair, exposure of all fracture fragments, precise anatomic rigid fixation, immediate bone grafting, and definite soft tissue management were the main surgical procedures, as in other facial bone injuries. Complex facial bone fractures involving dentition should be managed by the same principles. However, conventional methods can not achieve accurate preinjury occlusion when there are unstable fracture segments, edentulous state, or complex palatal/maxillary and mandibular fractures. Seventeen patients were surgically reconstructed in conjunction with dental impression, model surgery, and fabrication of dental splints to establish better occlusion. Among the facial fractures that had the occlusal problem, maxillary/palatal fractures and complex mandibular fractures, were the major indications for fabrication of acrylic splints. During operation, fracture segments were reduced and repositioned according to dental wear facets of the prefabricated occlusal splint and then temporary intermaxillary fixations were performed. This allowed us to accomplish precise anatomical reduction and rigid intrenal fixations. The postoperative occlusions were acceptible and no complication occurred as direct effects of dental splint. We suggest that fabrication of an acrylic occlusal splint is necessary for the management of complex facial injuries involving dentition.
Bone Transplantation ; Dentition ; Facial Bones ; Facial Injuries* ; Humans ; Mandibular Fractures ; Occlusal Splints ; Splints* ; Tooth Wear

PURPOSE: Streptococcus pyogenes is an important cause of invasive diseases in children. We aimed to describe the clinical characteristics of invasive infections due to S. pyogenes in children in Korea. METHODS: A retrospective study of children under 18 years of age with invasive infections due to S. pyogenes at Seoul National University Children's Hospital between March 1992 and December 2012, and Seoul National University Bundang Hospital between March 2003 and December 2012 was conducted. Demographic factors, clinical characteristics, laboratory findings, treatment, mortality and morbidity of all patients were reviewed. RESULTS: A total of 30 among 36 cases identified as invasive disease due to S. pyogenes were available for review. There was a predominance for male subjects (male:female=2.75:1). The median age was 50 months (range 12 days to 15 years) and 53.3% were under 5 years of age. Skin and soft tissue infections (9/30, 30.0%), bacteremia without identified focus (4/30, 13.3%) and bone and joint infections (6/30, 20.0%) were the most frequent clinical presentations. Streptococcal toxic shock syndrome (3/30, 10.0%) pulmonary, abdomen and central nervous system infections (2/30, 6.7%) were also seen. There was a peak in number of patients in year 2012 (9/30, 30.0%). There were no cases of mortality. Erythromycin and clindamycin resistance rates were low by 3.8% and 7.5%, respectively. CONCLUSION: We studied the clinical presentations of invasive infections due to S. pyogenes during the past 20 years in Korean children. The findings of this study help us understand the characteristics of the disease, enhancing early recognition and prompting adequate antibiotic therapy which is important in reducing morbidity and mortality.
Abdomen ; Bacteremia ; Bacterial Infections ; Central Nervous System Infections ; Child* ; Clindamycin ; Demography ; Erythromycin ; Humans ; Joints ; Korea ; Male ; Mortality ; Retrospective Studies ; Seoul ; Shock, Septic ; Skin ; Soft Tissue Infections ; Streptococcus pyogenes*

Malignant tumor is found in 1-2% of ovarian benign cystic teratomas. Among these malignant neoplasms, squamous cell carcinoma is by far the most common malignancy, whereas the incidence of struma ovarii is less than 5% in mature teratoma. As far as concerned the struma ovarii, a very small percentage is associated with carcinoid, mucinous or serous cystadenoma, or Brenner tumor. However, any reports of struma ovarii associated with squamous cell carcinoma in the same ovary could not be found in English literature. Recently we have experienced a case of squamous cell carcinoma and struma ovarii arising in an ovarian benign cystic teratoma in 72 year old female patient.
Female ; Humans ; Incidence

No abstract available.
Diazepam* ; Seizures, Febrile*

No abstract available.
Hydrocephalus*

BACKGROUND: Zinc which is widely used to treat Behcet's disease, is known to be an important modulator in various aspects of immunity including cell mediated immunity (CMI). CMI is suspected of playing a major role in the pathogenesis of Behçet's disease. OBJECTIVE: This study was done to clarify the relationship of CMI and zinc in Behçet's disease. METHODS: Serum zinc level, NK cell activity, and ADCC were measured in 83 patients with Behçet's diseade. The results were analyzed using multiple regression analysis. RESULTS: ADCC and serum zinc level were found to be two significant variables that affect NK cell activity positively and negatively, respectively. CONCLUSION: Serum zinc is presumed to exert inhibitory effect on NK cell activity but does not affect ADCC in Behçet's disease patients.
Antibody-Dependent Cell Cytotoxicity ; Humans ; Immunity, Cellular ; Killer Cells, Natural ; Zinc*

PURPOSE: The purpose of this study was to identify factors in the clinical learning environment that affect clinical practice stress and anxiety in nursing students. METHODS: Participants were 210 senior nursing students from two universities who had completed their clinical experience. Data were collected from self-report questionnaires and analyzed using t-test, ANOVA, and hierarchical multiple regression analysis with the SPSS/WIN 21.0 Program. RESULTS: The mean scores for the clinical learning environment, the clinical practice stress, and anxiety were 3.16+/-0.68, 2.98+/-0.66, and 43.74+/-10.18 points, respectively. The regression analysis showed that the clinical learning environment contributed to 13% of the stress and 20% of the anxiety in the nursing students with the conditions controlled for general characteristics, department satisfaction and social support. CONCLUSION: The results of this study suggest that the clinical learning environment should be carefully assessed to reduce nursing students' stress and anxiety from clinical practice. Therefore, collaboration between nursing universities and teaching hospitals is necessary to optimize clinical learning environment.
Anxiety* ; Cooperative Behavior ; Education, Nursing ; Hospitals, Teaching ; Humans ; Learning* ; Nursing* ; Students, Nursing*

59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures

PURPOSE: To investigate the effects of 0.15% brimonidine tartrate ophthalmic solution spray on the luminal changes in the nasolacrimal excretory system. METHODS: A prospective study was performed on 52 eyes in 26 patients complaining of epiphora in both eyes. The randomly-assigned 26 test eyes (cases) received spray of the solution through the nasal cavity, and the other 26 eyes (controls) were irrigated with the same drug through the inferior calnaliculus. Dacryocystography was then performed to observe the luminal changes jn the nasolacrimal excretory system, patient symptoms and physiologic drainage functions. RESULTS: The changes in lumen width of the nasolacrimal duct (NLD) were noted, and the changes in lumen width of the lacrimal sac were not significant in either mode. The upper and middle parts of the NLD were widened more in the irrigation group, and the lower part of the NLD was widened more in the spray group. Though there was no significant difference in the physiologic drainage functions, the patients in both groups reported reduced symptoms. CONCLUSIONS: Brimonidine tartrate spray altered the width of the NLD and improved the subjective symptoms of patients. Therefore, the spray can be applied in functional NLD obstruction patients before the surgical procedure.
Drainage ; Eye ; Humans ; Lacrimal Apparatus Diseases ; Nasal Cavity ; Nasolacrimal Duct ; Phenobarbital ; Prospective Studies ; Quinoxalines ; Brimonidine Tartrate

PURPOSE: This study was conducted to understand the meaning of mind control as it is understood by elderly persons in Korea. METHOD: This study was conducted by engaging three elderly persons who are over the age of sixty five and presently residing in Seoul. Several in depth interviews were conducted with these individuals from March 2003 until November 2003. The contents of the interviews were analyzed using the Giorgi Method (1985), which places the emphasis on discovering meaning within the phenomenological context of an individual's experience. RESULTS: The analysis of the contents revealed the following four components with regard to the meaning of mind control for elderly persons (1) Settling the mind (2) Gradual lowering of expectations and hope for the success of offspring, (3) Having good thoughts and acting accordingly, and (4) Making up one's mind to follow the 'natural flow of life'. CONCLUSION: By allowing a wider and deeper understanding of the meaning of mind control for elderly persons the results of this study provide a basis for improving the care of elderly with a holistic perspective.
Aged* ; Hope ; Humans ; Korea* ; Life Change Events ; Seoul