Aging changes on the upper third of the face include brow ptosis, glabellar furrowing and forehead transverse wrinkle caused by an imbalance of the forehead muscles. Surgical methods to correct these phenomena include forehead lift with a coronal incision, endoscopic access, and direct forehead skin excision. In response to a common need for cosmetic improvement in the brow-upper eyelid and a desire for minimal incisions for forehead rejuvenation, an approach through blepharoplasty incision had been developed. This approach has many advantages, such as fewer skin incision, less tissue mobilization and direct excision of the hyperactive depressor muscles. However, this approach is not suitable for those who have significant forehead wrinkle and ptosis. We used a combined subperiosteal approach for forehead lift and transection of the hyperactive corrugator and procerus muscles through blepharoplasty incision. This combined surgical technique is simple and effective to correct aging of the upper third of the face without the usual complication. We performed 10 cases of the transpalpebral approach for the correction of the upper third of the face from January 1997 to September 1998, following them up for from 3 to 6 months and obtained satisfactory results. We report our experiences with a review of the literature.
Aging* ; Blepharoplasty ; Eyelids ; Forehead ; Muscles ; Rejuvenation ; Skin

There were 26 children with urolithiasis evaluated clinically who were admitted in Chonnnam University Medical School Hospital between l975 and 1984. Male patients predominated l2 to l. Age ranged from lO months to 14 years with a mean age of 7.3 years. Most of the stones (80.8 per cent) were found in the lower urinary tract. Abnormalities of the urinary tract were presented in 4 patients (l5.4 per cent) but no causative factor was demonstrable in 22 (84.6 per cent). Idiopathic hypercalciuria and hyperuricosuria were found in 3 and 2, respectively, of ll patients with idiopathic urolithiasis. The recurrences of urinary stone were observed in 5 of 26 patients (19.2 per cent).
Child* ; Humans ; Hypercalciuria ; Male ; Recurrence ; Schools, Medical ; Urinary Calculi ; Urinary Tract ; Urolithiasis*

No abstract available.

Spontaneous fistula formation between the kidney and the colon is uncommon. The underlying cause is usually a pyonephrotic kidney which becomes adherent to a portion of the colon and then ruptures spontaneously, thus creating a fistula. Herein we present a case of renocolonic fistula which occurred in a 36-year old man with review of the literature.
Adult ; Colon ; Fistula* ; Humans ; Kidney ; Rupture

BACKGROUND: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. METHODS: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. RESULTS: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 +/- 7.9 mm versus 7.3 +/- 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. CONCLUSIONS: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Arm ; Clavicle* ; Consensus ; Elbow ; Extremities ; Hand ; Humans ; Ligaments* ; Prospective Studies ; Seoul ; Shoulder ; Shoulder Fractures ; Skin ; Suture Anchors ; Sutures*

OBJECTIVES: This study aimed to identify the effects of anti-smoking public service announcements on the attitudes of Korean college students toward smoking. METHODS: This study involved students via convenience sampling from seven universities who were randomly assigned to four groups. All groups completed a preliminary questionnaire, before being shown a public service announcement twice, and then completed a post viewing questionnaire. RESULTS: For announcements with positive messages, the proportion of changes in beliefs and attitudes were 39.1% and 19.8%, respectively, whereas those with negative messages showed a greater proportion of changes in the beliefs (59.7%) and attitudes (40.3%). After adjusting for sex and change in belief, the message types and smoking status were identified as factors affecting the change in the participants attitudes. A negative message resulted in a greater change in attitudes (odds ratio [OR], 3.047; 95% confidence interval [CI], 1.847–5.053). Ever-smokers including current smokers showed a greater positive change in attitude than never-smokers (OR, 6.965; 95% CI, 4.107–11.812). CONCLUSION: This study found that positive anti-smoking public service announcements were more effective on attitude change than negative messages. Additionally these announcements were more effective among viewers who were current smokers or had a prior smoking experience.
Humans ; Public Service Announcements* ; Smoke* ; Smoking*

BACKGROUND: Reusable Proseal(TM) laryngeal mask airways (PLMAs) can act as a vector for the transmission of prion diseases such as variant Creutzfeldt-Jacob disease. This study tested the hypothesis that supplementary ultrasonic cleaning facilitates the removal of protein deposits on PLMAs after anesthesia. METHODS: After clinical use, 40 PLMAs were randomly allocated into two groups. In the first group, the PLMAs were washed by hand and were then subsequently placed in an autoclave at 134degrees C for 40 min (Group 1, n = 20). In the second group, the PLMAs were washed by hand and ultrasonic cleaning using an enzymatic solution for 5 min, and were then subsequently placed in an autoclave (Group 2, n = 20). In both groups, protein deposits were detected on PLMAs by erythrosin staining. A staining score designated as none (0%), mild (0-20%), moderate (20-80%) and severe (80-100%), was assigned to each site (outer surface, inner surface and edges of the cuff, airway and drain tube, finger strap) according to the percentage of the stained surface area. RESULTS: Despite the cleaning of the masks, residual protein was found on the outer surface, inner surface and edge of the cuff, airway and drain tube, and finger strap of the PLMAs in both groups. Similar scores were observed for each part of the cleaned PLMAs in both groups, except for the outer surface of the PLMAs in Group 2 (P < 0.05). CONCLUSIONS: We conclude that the use of an ultrasonic cleaner with an enzymatic solution may be effective to cleanse the outer surface of the PLMAs, but there were no differences in the total scores for both groups.
Erythrosine ; Fingers ; Hand ; Laryngeal Masks ; Masks ; Prion Diseases ; Proteins ; Ultrasonics

PURPOSE: Investigations of in-hospital pediatric cardiopulmonary resuscitation (CPR) have been of limited value because of the retrospective nature of the studies, the small sample sizes, and inconsistent definitions of cardiac arrest and CPR. The purpose of this study was to prospectively describe in-hospital pediatric CPR by using the Utstein guidelines and to confirm prognosis predictors. METHODS: All 168 in-hospital pediatric CPRs involving 115 patients, at Asan Medical Center from January 1, 2002, to December 31, 2003 were prospectively described and evaluated by using Utstein reporting guidelines. Uniform reports were made out after the CPRs and were supplemented with chart reviews. The outcome variables included sustained return of spontaneous circulation (ROSC), the survival rate at 24 hrs, the survival discharge rate, and the pediatric overall performance category scale (POPC) after CPR. RESULTS: All of the 115 patients who received CPRs, 65 (56.5%) patients had sustained ROSC, 54 (47.0%) patients were alive at 24 hrs, and 33 (28.7%) patients were discharged alive. The most common underlying disease was cardiovascular disease (45.2%), and the most common precipitating cause of CPR was shock (48.7%). The most common initial cardiac rhythm was bradycardia with poor perfusion (41.7%). A multiple logistic regression analysis revealed that death at discharge was independently associated with a higher POPC score before CPR, a longer duration of CPR, and repeated CPR. CONCLUSION: Independent prognosis predictors of in-hospital pediatric CPR were the POPC score before CPR, the duration of CPR, and repeated CPR.
Bradycardia ; Cardiopulmonary Resuscitation* ; Cardiovascular Diseases ; Chungcheongnam-do ; Heart Arrest ; Humans ; Logistic Models ; Pediatrics ; Perfusion ; Prognosis* ; Prospective Studies ; Sample Size ; Shock ; Survival Rate

Vertebrobasilar insufficiency (VBI) in rotatory vertebral artery occlusion syndrome can be caused by voluntary head turning in the yaw plane. We report a case of VBI for head tilting in the roll plane. Transcranial Doppler on left head tilting resulted in decreased blood flow in both vertebral arteries. A CT angiogram revealed that the stenotic left vertebral artery was very close to an enlarged thyroid gland, suggesting mechanical compression of the vertebral artery during head tilt.
Head ; Thyroid Gland ; Vertebral Artery ; Vertebrobasilar Insufficiency ; Vertigo

PURPOSE: Emergency physicians are often asked to predict a patient's functional outcome after an acute stroke. However, very little information is usually available to a physician to help predict the likelihood of severe permanent disability. The purpose of this study was to determine useful Initial prognostic predictors in patients with an acute stroke presenting to the emergency department. METHODS: Between March 1, 2004 and May 31, 2004, we analyzed 74 patients diagnosed to have an acute stroke by diffusion weighted magnetic resonance imaging obtained within 24 hours from symptom onset at the emergency department. Seven factors were evaluated as prospective variables including The National Institutes of Health Stroke Scale (NIHSS) measured by emergency physician (NIHSSEM) and neurologist (NIHSS-NR) at the time of presentation to the emergency department. The outcome variables were Barthel Index (BI), modified Rankin Scale (mRS), and the NIHSS measured at the time of discharge from hospital. RESULTS: The intraclass correlation coefficient between NIHSS-EM and NIHSS-NR was 0.94 (p < 0.001). History of stroke, gender, NIHSS-EM, large vessel disease and lacuna infarctions were statistically significant outcome predictors. In a multivariate logistic regression analyses, NIHSSEM was the only independent variable that correlated with NIHSS, mRS, and BI at hospital discharge. CONCLUSION: Among the many prognostic predictors studied, the NIHSS appeared to be the only independent variable showing a correlation with the patients's prognosis. The NIHSS perfomed in the emergency department may help emergency physicians provide more accurate initial prognosis in an acute stroke patient.
Diffusion ; Emergencies ; Emergency Service, Hospital ; Humans ; Infarction ; Logistic Models ; Magnetic Resonance Imaging ; National Institutes of Health (U.S.) ; Prognosis* ; Prospective Studies ; Stroke*