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*

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

BACKGROUND/AIMS: This study was performed to investigate the clinical and serological characteristics of toxocariasis in the Pohang region. METHODS: A total of 145 patients with peripheral eosinophilia (> 450 cells/microL) were enrolled and divided into two groups based on Toxocara excretory-secretory IgG enzyme-linked immunosorbent assay (ELISA) positivity, and the clinical features and serologic markers were compared between the two groups. RESULTS: The seropositive rate of Toxocara was 62.1%. The serum total eosinophils (p = 0.038), total IgE level (p < 0.01), Dermatophagoides farinae (Df) seropositivity rate (p < 0.01), frequency of eosinophilic tissue infiltration in the lung or liver (p < 0.01), and ingestion of raw cow meat or liver (p < 0.01) were higher in seropositive patients than in seronegative patients. However, the presence of asthma and rhinitis (p < 0.01) were more frequent in seronegative patients. Among seropositive patients, positive correlations were observed between serum total IgE, total eosinophils, and the optical density value of the Toxocara IgG ELISA (p < 0.01; p = 0.015, respectively). The specific IgE to Df was significantly higher (p < 0.01) than that to Dermatophagoides pteronyssinus (Dp), suggesting a cross reaction between the Df antigen and the Toxocara antigen. CONCLUSIONS: Patients who have elevated serum total IgE and have eosinophilia without allergic disease might have toxocariasis. The lower frequency of asthma or rhinitis and a tendency for higher specific IgE to Df than that to Dp could be useful findings for the diagnosis of toxocariasis in patients with eosinophilia.
Asthma ; Cross Reactions ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Eating ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Liver ; Lung ; Meat ; Pyroglyphidae ; Rhinitis ; Toxocara ; Toxocara canis ; Toxocariasis

As jaws of children differ from those of adults in the aspects of architectural and mechanical properties, site, form and treatment modality of pediatric fractured jaws are somewhat different from those of adults. This study takes stastics of 33 pediatric patients with mandibular fractures (55 fracture sites) who were admitted to the department of oral and maxillofacial surgery. Kyung-hee university from May 1986 to March 1995, aged up to 15years with primary or mixed dentition, by age, cause, site and treatment modality. The results are as follows. 1. The mandibular fracture has sexual predilection for male, 0 to 3 years group. 2. The main cause of mandibular fracture is falling from various position, followed by traffic accident. 3. The highest incidence of fracture site is symphysis and/or condyle area. 4. Circumferential wiring is widely used for pediatric mandibular fracture.
Accidents, Traffic ; Adult ; Child ; Dentition, Mixed ; Humans ; Incidence ; Jaw ; Male ; Mandibular Fractures* ; Surgery, Oral

PURPOSE: To call on health authorities to construct an organized surveillance and investigation system with national financial support for sudden unexpected infant death (SUID) in Korea. METHODS: A single-center retrospective study was conducted on 19 SUID cases, including an analysis of vital statistics for Korean infants, estimation of costs, and suggestion of plans. RESULTS: SUID is the second most common cause of infant deaths in the ER. Most of the deceased infants in this study were discovered in a prone position and bystanders had not in any of the cases started cardiopulmonary resuscitation (CPR) at the scene. Immediate intraosseous (IO) access was not performed in the ER. All cases were categorized as "unclassified sudden infant death" according to the San Diego definition because autopsies and various screening tests were not performed. The assumed rate of incidence of SUID in Korea is 0.3~0.56 per 1000 live births per year. The cost for a response per SUID case was estimated to be over one million won. CONCLUSION: 1) Immediate launching of nation-wide "back-to-sleep campaign" is urgent. 2) Certification in infant resuscitation and prevention of sudden infant death syndrome (SIDS) should be required for workers in day care centers, orphanages or caregivers companies. 3) IO access should be performed immediately for infant cardiac arrest cases in the ER. 4) A nation-wide campaign would also be helpful to change irrational ideas about dead bodies, get public agreement on performing autopsies and raising the autopsy rate. 5) Legislation should be promoted to mandate autopsies and to organize and maintain a surveillance and investigation system with multi-agency support.
Autopsy ; Cardiopulmonary Resuscitation ; Caregivers ; Certification ; Day Care, Medical ; Financial Support ; Heart Arrest ; Humans ; Incidence ; Infant ; Infusions, Intraosseous ; Korea* ; Live Birth ; Mass Screening ; Orphanages ; Prone Position ; Resuscitation ; Retrospective Studies ; Sudden Infant Death* ; Vital Statistics