The presence of epicanthal folds in Asian eyelids is one of their unique features, in combination with the lack of supratarsal folds. Western culture has influenced many people to prefer to eliminate the prominent epicanthal fold. A number of surgical techniques have been suggested for their correction. However, difficulty with design, excessive and prominent scarring of medial canthal and nasal area, recurrence, and rigidity of application are potential problems associated with many procedures. This paper describes a epicanthoplasty with three-dimensional Z-plasty. Through epicanthal fold incision, the medial canthal tecdon is medially advanced and sutured to the periosteum of nasal bone. After the transposition of the flaps, trimming of the flap is usually required. Three-dimensional Z-plasty crates the attactive eyes. From March, 1995 to March, 1997, the technique was applied to 37 patients with epicanthal fold and was performed with or without double-fold operation. There were 34 females and 3 males with ages ranging from 17 to 30 years. Through 2 years follow-up, this techniques has delivered esthetically good results with minimal postoperative scar and could made the reduction of ICD from 40 +/- 2.13mm to 34 +/- 1.98mm. The advantages of epicanthoplasty procedure using three-dimensional Z-plasty(Yoon's method) are as follows; 1) simple in design 2) minimal postoperative scar in the medial canthal area 3) versatile in its application 4) no recurrence 5) no hypertrophic scar 6) preserving ethnic identity.
Asian Continental Ancestry Group ; Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Male ; Nasal Bone ; Periosteum ; Recurrence

PURPOSE: The incidence of shigellosis had been decreased due to the use of antibiotics and the improvement of environmental sanitation but recently increases again. Shigellosis occurrs in mass outbreak through unsanitized meal preperation refered from welfare facility and school. We observed epidemic aspect and clinical coarse of childhood shigellosis. METHODS: from December 2001 to January 2002, 22 inpatients with shigellosis in Dongbu Municipal Hospital were observed epidemiologically, clinically and microbiologically. RESULTS: 1. The sexual ratio was 1:1 and mean age was 5.5+/-1.4 years (14 months to 11 years). 2. The clinical manifestations were following: diarrhea (95.5%), high feve (10%) and asymptomatic (4.5%). The mean duration was 3.9+/-2.1 days (1 to 12 days). All patients had no complication and normal serologic test. 3. S. sonnei was cultured in rectal swab, and was resistant to TMP/SMX and ampicillin, but susceptible to ampicillin/sulbactam and the 3rd generation cephalosporins. 4. The patients were treated by antibiotics with conservative treatment including electrolytes and fluid therapy for 5 days, resulting in improvement confirmed by negative reaction on stool culture. 5. These cases were all occurred in mass outbreak in day care center and were suspected to be secondary infection by members of family. CONCLUSION: This shigellosis occurred in day care center was secondary infection due to S. sonnei and had mild clinical coarse and improvement after antibiotic treatment.
Ampicillin ; Anti-Bacterial Agents ; Cephalosporins ; Child ; Coinfection ; Day Care, Medical ; Diarrhea ; Dysentery, Bacillary* ; Electrolytes ; Fluid Therapy ; Hospitals, Municipal ; Humans ; Incidence ; Inpatients ; Meals ; Sanitation ; Serologic Tests

OBJECTIVE: Gout is one of the most common forms of inflammatory arthritides among men, which is caused primarily by chronic hyperuricemia. Although pharmacological therapy is the mainstay treatment to manage gout, limiting the consumption of dietary purine is also important. Several epidemiological studies have reported that alcohol consumption is closely related to hyperuricemia and gout. The objective of this study was to determine the purine content in common Korean alcoholic beverages using high performance liquid chromatography (HPLC) to provide a dietary guideline for those with hyperuricemia or gout. METHODS: Thirty-five alcoholic beverages were analyzed. Blindly labeled samples of each alcoholic beverage were degassed and frozen. The sample preparation prior to HPLC followed the methods of Japanese researchers. HPLC was performed to analyze adenine, guanine, hypoxanthine, and xanthine content in the alcoholic beverages. RESULTS: The standard curves were linear for all purines. Purine contents were as follows: beer (42.26~146.39 micromol/L, n=12), medicinal wine (8.2 and 40.41 micromol/L, n=2), rice wine (13.19 micromol/L), Makgeolri (11.71 and 24.72 micromol/L, n=2), red wine (0, 6.03, and 17.9 micromol/L, n=3). No purines were found in fruit wine (n=2), Kaoliang (n=1), white wine (n=1), or distilled alcoholic beverages, such as soju (n=10) or whiskey (n=1). CONCLUSION: Among popular Korean alcoholic beverages, beer contained a considerable amount of purines, whereas distilled alcoholic beverages did not. Patients with either gout or hyperuricemia should avoid alcoholic beverages, especially those containing large amounts of purines.
Adenine ; Alcohol Drinking ; Alcoholic Beverages ; Alcoholics ; Arthritis ; Asian Continental Ancestry Group ; Beer ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Fruit ; Gout ; Guanine ; Humans ; Hyperuricemia ; Hypoxanthine ; Male ; Purines ; Wine ; Xanthine

BACKGROUND: Causative bacterial agents of infectious diarrheal disease were traditionally diagnosed by stool cultures. Stool culture, however, has a problem because of relatively low sensitivity and long turnaround time. In this study, we evaluated multiplex PCR applied on stool specimens directly to diagnose enteropathogenic bacteria. METHODS: From June to September 2009, 173 diarrheal stools submitted for stool cultures were tested by Seeplex(R) Diarrhea ACE Detection kit (Seegene, Korea) to detect 10 enteropathogenic bacteria. Specimens were cultured for Salmonella, Shigella, Vibrio, and Yersinia. Late 50 specimens were also cultured for Campylobacter. The specimens positive for verotoxin-producing Escherichia coli (VTEC) were further subcultured for detecting enterohaemorrhagic Escherichia coli O157:H7. Electronic medical records were reviewed for clinical and laboratory findings. RESULTS: Of 173 specimens, multiplex PCR and cultures identified enteropathogens in 36 (20.8%) and 8 specimens (4.6%), respectively. While multiplex PCR detected 5 Salmonella, 15 Campylobacter, 1 Vibrio, 4 Clostridium difficiles toxin B, 5 Clostridium perfringens, 1 Yersinia enterocolitica, 5 Aeromonas, and 2 VTEC, cultures detected 5 Salmonella, 1 Vibrio, 1 Y. enterocolitica, 1 Aeromonas, and 2 E. coli O157:H7. CONCLUSION: Multiplex PCR would be useful to detect Campylobacter, VTEC and C. perfringens, as well as have equivalent sensitivity to conventional culture for ordinary enteropathogens such as Salmonella, Shigella, Vibrio, Y. enterocolitica. Direct application of multiplex PCR combined with conventional cultures on stool warrants remarkable improvement of sensitivity to diagnose enteropathogenic bacteria.
Aeromonas ; Bacteria ; Campylobacter ; Clostridium ; Clostridium perfringens ; Diarrhea ; Dysentery ; Electronic Health Records ; Escherichia coli ; Multiplex Polymerase Chain Reaction ; Salmonella ; Shiga-Toxigenic Escherichia coli ; Shigella ; Vibrio ; Yersinia ; Yersinia enterocolitica

BACKGROUND: The primary outcome of sugammadex reversal for rocuronium-induced neuromuscular block (NMB) is a train-of-four ratio (TOFR) of 0.9, not first twitch (T1) height. We investigated whether the recovery of TOFR or T1 differs based on the reversal of NMB with neostigmine or sugammadex. METHODS: The acceleromyographic responses from 0.6 mg/kg of rocuronium were monitored supramaximally in 80 patients after induction of anesthesia. The TOFR and T1 height were recorded, and saved in a personal computer using TOF-Watch SX Monitor software in all patients. Patients were randomly assigned to 2 groups to receive either neostigmine 50 µg/kg with glycopyrrolate 10 µg/kg (neostigmine group, n = 40) or sugammadex 2.0 mg/kg (sugammadex group, n = 40). The primary objective was to determine the difference of recovery time between TOFR to 0.9 and T1 to 0.9 after sugammadex or neostigmine administration during moderate rocuronium-induced NMB. RESULTS: The recovery pattern of the TOFR 2 min after sugammadex administration was 1.0 or more, but that of T1 was less than 90% (T1 / control value) up to 6 min after drug was injected. The recovery pattern of TOFR and T1 was similar during the 20 min after reversal with neostigmine. CONCLUSIONS: If you have not performed the T1 monitoring, both TOFR and T1 should be considered to confirm suitable recovery during the 6 min after reversal with sugammadex during rocuronium-induced moderate NMB.
Anesthesia ; Depression* ; Glycopyrrolate ; Humans ; Microcomputers ; Neostigmine ; Neuromuscular Blockade* ; Neuromuscular Monitoring

PURPOSE: The aim of this study was to investigate the potential effects of mild hypoxia in the mature and immature brain. METHODS: We prepared organotypic slice cultures of the hippocampus and used hippocampal tissue cultures at 7 and 14 days in vitro (DIV) to represent the immature and mature brain, respectively. Tissue cultures were exposed to 10% oxygen for 60 minutes. Twenty-four hours after this hypoxic insult, propidium iodide fluorescence images were obtained, and the damaged areas in the cornu ammonis 1 (CA1), CA3, and dentate gyrus (DG) were measured using image analysis. RESULTS: In the 7-DIV group compared to control tissue, hypoxia-exposed tissue showed decreased damage in two regions (CA1: 5.59%+/-2.99% vs. 4.80%+/-1.37%, P=0.900; DG: 33.88%+/-12.53% vs. 15.98%+/-2.37%, P=0.166), but this decrease was not statistically significant. In the 14-DIV group, hypoxia-exposed tissue showed decreased damage compared to control tissues; this decrease was not significant in the CA3 (24.51%+/-6.05% vs. 18.31%+/-3.28%, P=0.373) or DG (15.72%+/-3.47% vs. 9.91%+/-2.11%, P=0.134), but was significant in the CA1 (50.91%+/-5.90% vs. 32.30%+/-3.34%, P=0.004). CONCLUSION: Although only CA1 tissues cultured for 14 DIV showed significantly less damage after exposure to hypoxia, the other tissues examined in this study showed a tendency towards less damage after hypoxic exposure. Therefore, mild hypoxia might play a protective role in the brain.
Anoxia* ; Brain ; Dentate Gyrus ; Fluorescence ; Hippocampus ; Neuroprotective Agents* ; Oxygen ; Propidium

PURPOSE: Effective management of pediatric hand burn is a considerable challenge for clinicians. Traditional dressings may result in significant pain, wound dryness, weak adhesive strength, and increase necessity for dressing change. Versiva(R)XC is combined dressing materials of hydrocolloid, hydrofiber, a polyurethane foam. Authors have used Versiva(R)XC in treatment of pediatric hand burns, and we experienced that maintenance of dressing is comfortable and decrease patient's discomfort. METHODS: Study enrolled 9 patients of mean age 3.6 years with second degree pediatric hand burn, Versiva(R)XC dressing initially applied after bullae aspiration and saline gauze dressing. After admission, we daily changed the dressing in first two or three days and had an interval of two or three days depending on the degree of exudate from the wound. RESULTS: The mean day of application was 6.3 days. None of patients required surgery and healed with no other complication of scar contracture and hypertrophic scar formation. CONCLUSION: The dressing with Versiva(R)XC was effective method because of decreased pain, easy dressing change, more comfort, and decreased hospital day.
Adhesives ; Bandages ; Blister ; Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Colloids ; Contracture ; Exudates and Transudates ; Hand ; Humans ; Polyurethanes

The purpose of the present study was to examine the effects of water extracts from red pepper seeds powder on antioxidative enzyme activities and oxidative damage in groups of rrats fed high-fat and high-cholesterol diets group (HFC). The Rrats were divided into the following five experimental groups which are : composed ofa normal diet group, a high fat.high cholesterol diet group, and a high fat.high cholesterol diet group supplemented with different amounts contents (1%, 2% and 4%) of red pepper seeds powder water extracts supplemented groups (HFCW1, HFCW2 and HFCW4, respectively). Body weight gains and food intake were lower ofin the red pepper seed water extracts groups were lower than those inof the HFC group. Hepartic xanthine oxidase (XOD) activity was decreased in the HFCW2 and HFCW4 groups compared to the HFC group. Hepartic glutathione peroxidase (GSH-px) activitiyactivity was increased in the HFCW4 group compared to the HFC group. Hepatic superoxide radicals within the mitochondria and microsomes of cells were significantly reduced in the HFCW2 and HFCW4 groups compared to the HFC group. Hepartic hydrogen peroxide in the cytosol was significantly reduced in the HFCW3 and HFCW4 groups compared to the HFC group. Hepatic carbonyl values in the microsomes and mitochondria were significantly reduced in the HFCW4 group compared to the HFC group. Hepartic thiobarbituric acid reaction substance (TBARS) activity was decreased in the HFCW2 group compared to the HFC group. These results suggest that water extracts of red pepper seeds powder may reduce oxidative damage by activation of antioxidative defense systems in rats fed high fat.high cholesterol diets.
Animals ; Body Weight ; Capsicum ; Cholesterol ; Cytosol ; Diet ; Eating ; Glutathione Peroxidase ; Hydrogen Peroxide ; Microsomes ; Mitochondria ; Rats ; Seeds ; Superoxides ; Thiobarbiturates ; Water ; Xanthine Oxidase

Stress fractures of the acromion and scapular spine are well-known complications following reverse total shoulder arthroplasty. However, these fractures in patients with massive rotator cuff tear or cuff tear arthropathy are extremely rare, and the pathogenesis, clinical features, diagnosis, and treatment of these fractures are poorly understood. We report a case of bilateral stress fracture of the posterior angle of the acromion in a patient with massive rotator cuff tear and discuss the pathogenesis, clinical manifestation, and treatment with a review of the literature.

BACKGROUND: Nation-wide measles outbreaks occurred from 2000 to 2001 in Korea. Since, mass vaccination campaign for measles eradication among children and adolescents was implemented in May-August of 2001. Even in a highly vaccinated community, measles cases occur among vaccinees and there might be different serological responses among unvaccinees. In addition, the primary and secondary vaccine failures are not rare in the mass-vaccination era. Therefore, this study was undertaken to evaluate the effectiveness of serologic method for diagnosis of measles among the vaccinees and to estimate the vaccine failure rate among students with relatively high vaccination rate during the measles outbreak in a primary school. METHODS: In March 2000, the measles outbreak occurred in a primary school in Youngduk county, Kyung-sang-buk Do. Questionnaires about clinical manifestations of measles and history of measles vaccination were given out to in 209 3rd and 5th grade students among whom many measles cases occurred. The paired sera, which were taken from all students during March and May 2000, were tested for IgM and IgG measles antibody by using Enzygnost Anti-Measles IgG and IgM (Dade Behring, Germany). RESULTS: The questionnaires and serum samples were obtained from 145(69.4%) out of 209 cases. The immunization rate of measles vaccine was 80.7% (117/145). During the measles outbreak, 25 (17.2%) out of 145 cases with previous history of measles vaccination were diagnosed as measles, based on clinical definition. Among 17 cases (17/25, 68.0%) with paired samples out of 25 measles cases, 4 cases (4/17, 23.5%) were diagnosed by seroconversion of IgG, but negative IgM antibody, and they all had received measles vaccination previously. Among 117 cases with previous history of measles vaccination, 47 (40.2%) cases without measles symptoms showed four-fold increment of IgG titer. The primary and secondary failure rates of measles vaccine were 6.0% (7/117) and 1.7% (2/117), respectively. CONCLUSION: Among symptomatic measles cases with previous history of measles vaccination, 23.5% were diagnosed only by seroconversion of IgG measles antibody. In a highly vaccinated country, the accuracy of measles serodiagnosis can be increased with the IgG test of convalescent serum sample in addition to IgM antibody test. Among vaccinees, secondary immune response was 40.2%, suggesting that non-specific measles symptoms might occur among them. Therefore, further studies on the clinical definition of measles cases, vaccine failure rate and protective antibody titers should be continued in order to effectively conduct measles eradication campaign.
Adolescent ; Child ; Diagnosis ; Disease Outbreaks ; Humans ; Immunization ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Mass Vaccination ; Measles Vaccine ; Measles* ; Seroepidemiologic Studies* ; Serologic Tests ; Vaccination ; Surveys and Questionnaires