The safety and efficacy of the CO2laser as a replacement for the steel scalpel is well documented in plastic surgery, but the use of the laser blepharoplasty has been controversy. This study compares and contrasts the use of the CO2 laser with conventional method in cosmetic upper eyelid blepharoplasty. Thirteen Patients underwent blepharoplasty in a paired comparison study. Four patients(Group A) underwent blepharoplasty by laser, another four patients (Group B) underwent blepharoplasty by conventional method, and the other five patients(Group C) underwent upper eyelid blepharoplasty using the laser on one eye and a conventional method on the other side. Preoperative factor(set up time, equipment), intraoperative factor(actual operation time, bleeding, visibility), postoperative factor(swelling, ecchymosis, immediate & short term result) were evaluated. The advantage of using the CO2 laser rather than the steel scalpel in blepharoplasty are less bleeding and superior intraoperative visibility. The disadvantage of using the laser compared with steel scalpel include the cost of purchasing and maintaining the laser equipment, the need for additional and extensive laser training for surgeons and assistants, and the need for two assistants rather than the one needed for scalpel surgery There were no complications with either the scalpel or the laser.
Bleeding Time ; Blepharoplasty* ; Carbon Dioxide* ; Carbon* ; Ecchymosis ; Eyelids* ; Hemorrhage ; Humans ; Lasers, Gas* ; Matched-Pair Analysis ; Steel ; Surgery, Plastic

For many years the standard surgical treatment for carpal tunnel syndrome has been division of the transverse carpal ligament under direct vision through a palm incision. Although the effectiveness and Patient acceptability of the conventional open carpal tunnel release are good, disability from a painful palm cutaneous neuroma, and prolonged swelling are reported Endoscopic carpal tunnel release seems to result in less postoperative morbidity, and minimal serious complications. Because endoscopic carpal tunnel release leaves the overlying skin, the subcutaneous fat and the palmer fascia and its attachments to the thenar and hypothenar musculature intact its proponents maintain that their patient have less scar tenderness, quicker recovery of grip strength, and earlier to return activities of daily living and work The endoscopic approach(Agee single portal technique), which includes specific localization of the hook of hamate, flexor retinaculum and the superficial palmar arch utilizing topographical landmarks, avoids entry into Guyon's canal and common digital nerves. We experienced four cases of carpal tunnel syndrome. In four cases, patients with carpal tunnel syndrome have been performed endoscopic carpal tunnel release with minor complication.
Activities of Daily Living ; Carpal Tunnel Syndrome ; Cicatrix ; Fascia ; Hand Strength ; Humans ; Ligaments ; Neuroma ; Skin ; Subcutaneous Fat

No abstract available.
Hemochromatosis* ; Spleen*

This study attempted to assess the risk factors for mortality of very-low-birth-weight (VLBW) infants in the neonatal intensive care unit (NICU, n=2,386). Using data from the Korean Neonatal Network, we investigated infants with birth weights <1,500 g and gestational ages (GAs) of 22-31 weeks born between January 2013 and June 2014. Cases were defined as death at NICU discharge. Controls were randomly selected from live VLBW infants and frequency matched to case subjects by GA. Relevant variables were compared between the cases (n=236) and controls (n=236) by Cox proportional hazards regression to determine their associations with cause-specific mortality (cardiorespiratory, neurologic, infection, gastrointestinal, and others). In a Cox regression analysis, cardiorespiratory death were associated with a foreign mother (hazard ratio, HR, 4.33; 95% confidence interval, CI, 2.08-9.02), multiple gestation (HR, 1.65; 95% CI, 1.07-2.54), small for gestational age (HR, 2.06; 95% CI, 1.25-3.41), male gender (HR, 1.69; 95% CI, 1.10-2.60), Apgar score < or =3 at 5 min (HR, 1.97; 95% CI, 1.18-3.31), and delivery room resuscitation (HR, 2.60; 95% CI, 1.53-4.40). An Apgar score < or =3 at 5 min was also associated with neurological death (HR, 2.95; 95% CI, 1.29-6.73). Death due to neonatal infection was associated with outborn delivery (HR, 5.09; 95% CI, 1.46-17.74). Antenatal steroid and preterm premature rupture of membranes reduced risk of cardiorespiratory death (HR, 0.43; 95% CI, 0.27-0.67) and gastrointestinal death (HR, 0.30; 95% CI, 0.13-0.70), respectively. In conclusion, foreign mother, multiple gestation, small gestation age, male gender, Apgar score < or =3 at 5 min, and resuscitation in the delivery room are associated with cardiorespiratory mortality of VLBW infants in NICU. An Apgar score < or =3 at 5 min and outborn status are associated with neurological and infection mortality, respectively.
Apgar Score ; Cohort Studies ; Databases, Factual ; Female ; Gestational Age ; Humans ; Infant ; *Infant Death ; *Infant Mortality/trends ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Kaplan-Meier Estimate ; Male ; Pregnancy ; Pregnancy, Multiple ; Proportional Hazards Models ; Republic of Korea ; Resuscitation ; Risk Factors ; Sex Factors

No Abstract available.
Arthritis, Rheumatoid* ; Humans ; Osteoclasts*

Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6+/-41.8 (Range: 1~148) months and 14.5+/-9.9 (Range: 3.0~40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection (cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I-or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. RESULT: A mean length of skin incision was 6.1+/-1.0 (range: 4.0~9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0+/-1.1 (range: 2.0~7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9+/-20.0 (range: 28~147), 29.8+/-12.8 (range: 11~79), and 161.1+/-34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0+/-68.1 (range: 0~267) cc. All patients were extubated mean 11.3+/-13.8 (range: 1~73) hours after operation. A mean total amount of analgesics used was 0.8+/-1.8 (range: 0~9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0+/-32.2 (range: 10~194) hours and 6.2+/-2.0 (range: 3~11) days. There were no wound complications and hospital deaths. CONCLUSION: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.
Analgesics ; Aorta ; Blood Transfusion ; Body Weight ; Cardiopulmonary Bypass ; Catheterization ; Child* ; Deception ; Foreign Bodies ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Morphine ; Seoul ; Skin ; Sternotomy ; Surgical Procedures, Minimally Invasive ; Tetralogy of Fallot ; Thoracic Surgery* ; Wounds and Injuries

BACKGROUND: The genicular arteries (GAs) can be utilized for genicular nerve block. We aimed to evaluate the ability to localize GAs under ultrasound in patients with chronic knee pain. METHODS: Twenty-four knees from 14 osteoarthritic patients were enrolled. The target GAs included the superomedial GA (SMGA), superolateral GA (SLGA), and inferomedial GA (IMGA). GAs were observed at the relevant adductor tubercle and epicondyle-shaft transition under ultrasound. Distribution of the SMGA at the adductor tubercle was evaluated using defined zones in transverse and longitudinal ultrasound images. SLGA and IMGA were also categorized using defined zones in longitudinal images. Distance from bony cortex to the relevant GA was then estimated. RESULTS: Among 24 knees, 91.7% of SMGAs were located at the upper part of the adductor tubercle. The distances between the SMGA and bony cortex on transverse view (dSMGAt) and on longitudinal view (dSMGAl) were directly correlated (rs = 0.6539, P = 0.0005). CONCLUSIONS: Under ultrasound guidance, the SMGA was found to be mainly localized to the upper part of the adductor tubercle. Likewise, the SLGA and IMGA were mainly localized at the distal and proximal parts of the epicondyle-shaft transition, respectively. Our results support the feasibility of ultrasound guidance for GA localization in patients with knee osteoarthritis.
Arteries* ; Humans ; Knee ; Nerve Block ; Osteoarthritis, Knee ; Ultrasonography*

Polyarteritis nodosa (PAN) is a systemic vasculitis involving small- and medium-sized arteries, which presents with necrotizing inflammation. PAN occurs as a systemic disease or as a limited form confined to a single organ. Few cases have been reported with single organ involvement, and even fewer have been reported with skeletal muscle involvement. Herein, we report the ultrasonography and magnetic resonance imaging findings in a rare case of PAN with limited muscle involvement in a 66-yearold man.

Polyarteritis nodosa (PAN) is a systemic vasculitis involving small- and medium-sized arteries, which presents with necrotizing inflammation. PAN occurs as a systemic disease or as a limited form confined to a single organ. Few cases have been reported with single organ involvement, and even fewer have been reported with skeletal muscle involvement. Herein, we report the ultrasonography and magnetic resonance imaging findings in a rare case of PAN with limited muscle involvement in a 66-yearold man.

PURPOSE: To determine the correlation and agreement between perpheral venous and arterial values in emergency department patients. METHODS: The study was conducted at an urban teaching hospital emergency department with an annual volume of 80,000 patient visits. Prospective comparison of paired peripheral venous and arterial values were evaluated from October, 2009 to February, 2010. Peripheral venous and arterial samples were taken as simultaneously as possible when patients who were deemed by the attending doctor to require an peripheral arterial sample presented in the emergency department. Collected information included age, sex, vital signs, emergency department initial diagnosis, lactate, pH, base excess, bicarbonate, pO2, and pCO2. Statistical methods were Shapiro-Wilk test, Spearman rho test, linear regression analysis, and Bland-Altman plots. RESULTS: Among the 546 patients, 50 were excluded and 496 were included. The majority (59.5%) of patients were male. Correlation constant (rho) of pH and lactate were 0.907 and 0.901, respectively. Mean difference and CI (confidence interval) of pH were -0.04 and -1.34~1.56, respectively. Mean difference and CI of lactate were 0.11 mmol/L and -0.15~0.07 mmol/L, respectively. CONCLUSION: Moderate correlation and agreement between perpheral venous and arterial pH, lactate, base excess, and CO2 was evident. Especially, peripheral venous pH, lactate correlated very well and had reasonable agreement with peripheral arterial values to serve as substitutes.
Blood Gas Analysis ; Emergencies ; Hospitals, Teaching ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid ; Linear Models ; Male ; Prospective Studies ; Statistics as Topic ; Vital Signs