Orbital blowout fractures are common consequence to blunt periorbital trauma. Pure orbital blowout fractures first occur at the weakest point of the orbital wall. Computed tomography(CT) is recognized to be the best imaging technique to evaluate orbital fractures. The extent and location of a blowout fractures in the CT scan were noted to have an effect on the clinical outcome. In the early posttraumatic period, the presence of significant enophthalmos is difficult to detect because of orbital edema. Early surgical intervention may improve the ultimate outcome because open reconstruction becomes more difficult if surgery is delayed. In this study, we evaluated isolated blowout fractures of the orbital floor by region-of-interest measurements from CT scans and their relationship to ophthalmologic findings. Six patients of the medial orbital wall fractures, eleven patients of the inferior orbital wall fractures, nineteen of the medial and the inferior orbital wall fractures confirmed by CT scan, were evaluated. The area of fracture and the volume of the displaced orbital tissue were determined from CT scan using linear measurements. Each of the calculated values for the area and the volume were compared with the degree of the enophthalmos, the diplopia, and the eyeball movement limitation to determine whether there was any significant relationship between them. The fracture area and the volume of the herniated orbital tissue were significantly positively correlated with the enophthalmos and the ocular motility limitation and not correlated with the diplopia. For the enophthalmos of 2mm or greater, the mean fracture area was 3.55+/-1.25cm2 and the volume of the herniated orbital tissue was 1.74+/-0.97cm3 for less than 2mm enophthalmos, 1.43+/-0.99cm3 and 0.52+/-0.49cm3, respectively. The enophthalmos of 2mm can be expected with 2.92cm2 of the fracture area and 1.40cm3 of the herniated orbital tissue. In conclusion, the enophthalmos of 2mm or more, which is a frequent indication for surgery. It can be expected when area of fracture is 2.92cm2 or more, or the volume of herniated orbital tissue is 1.40cm3 or more. And the CT scan using linear measurements has an application in the assessment of patients with blowout fractures and provides useful information in the posttraumatic evaluation of orbital fractures.
Diplopia* ; Edema ; Enophthalmos* ; Humans ; Orbit ; Orbital Fractures ; Tomography, X-Ray Computed

A weanling Thoroughbred foal was admitted to Equine Hospital, Korea Racing Association with signs of colic. On admission the foal was sweating profusely, appeared anxious and exhibiting signs suggestive of abdominal pain. Clinical examination revealed: tachycardia (90 beats/min), tachypnea (50 breaths/min) and congested and slightly cyanotic mucous membranes. No intestinal sounds were auscultated in all 4 abdominal quadrants. Rectal palpation identified concurrent cecum and large colon impactions. Treatment consisted of intravenous administration of a balanced electrolyte solution, nasogastric siphonage and administration of analgesics. Nasogastric reflux contained ascarids. This treatment failed to alleviate the signs of colic. The foal died 3 hours later following discharge because the owner didn't want laparatomy because of economic constraints. Prior to admission this foal had not received any prophylactic anthelmintic treatment. In necropsy, there were masses of ascarids accumulation in the stomach, small intestine and large intestine. The outcome of this report is to describe the first diagnosed case of gastrointestinal impaction by P. equorum in a Thoroughbred foal in South Korea and indicates the importance of regular anthelmintic treatment.
Animals ; Ascaridida Infections/diagnosis/parasitology/*veterinary ; Ascaridoidea/*isolation&purification ; Fatal Outcome ; Fecal Impaction/diagnosis/parasitology/*veterinary ; Horse Diseases/diagnosis/*parasitology ; Horses ; Intestinal Diseases, Parasitic/diagnosis/parasitology/*veterinary ; Korea

No abstract available.
Animals ; Dogs ; Mandible

Treacher Collins syndrome is inherited as an autosomal dominant trait with variable penetrance. It shows a marked variability even in the same family. This syndrome is developmental defect affecting the branchial arches. It is not usually associated with acute respiratory distress, but has symptoms of microtia, hypoplastic zygomatic bones, hypoplastic mandibular rami, and bilateral coloboma. It usually requires an emergency operation immediately after the birth. We experienced an infant with Treacher Collins syndrome who showed retrognathia, glossoptosis, microtia, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty associated with airway obstruction, and swallowing difficulty were also observed. To relieve severe upper airway obstruction caused by retrognathia and glossoptosis, we simultaneously performed tongue-lip adhesion and subperiosteal release of the floor of the mouth. The respiratory and swallowing difficulties were relieved and the tongue repositioned anteriorly. We report the present case with a review of the literature.
Airway Obstruction* ; Branchial Region ; Cleft Palate ; Coloboma ; Cyanosis ; Deglutition ; Depression ; Emergencies ; Humans ; Infant* ; Mandibulofacial Dysostosis* ; Mouth ; Parturition ; Penetrance ; Retrognathia ; Thorax ; Tongue

Ants ; Cicatrix ; Cleft Lip ; Compensation and Redress ; Dentures ; Humans ; Lip ; Malocclusion ; Mandible ; Maxilla ; Palate ; Skull Base ; Tooth

PURPOSE: The introduction of the mumps vaccine has dramatically reduced the number of mumps cases, but outbreaks have recently occurred among highly vaccinated populations in developed countries. Epidemiological and clinical characteristics of patients with mumps admitted between 1989 and 2012 in a single hospital in Korea are described in the present study. METHODS: We retrospectively evaluated inpatients with mumps between 1989 and 2012 and outpatients and inpatients with mumps in 2011-2012. RESULTS: A total of 152 patients with mumps were admitted between 1989 and 2012, and 163 patients were recorded in 2011-2012. The highest number of admitted cases occurred in 1998 and 2012 (35 and 34 cases, respectively). Among the patients admitted in 2011-2012, the highest frequency was observed among people aged 15-19 years, and low frequency was observed in those aged <4 years and >20 years, compatible to the city data and national data. In patients admitted to our department in 1998 (35 cases) and in 2010-2012 (27 cases), there were significant differences in the mean age and the rate of secondary measles-mumps-rubella (MMR) vaccination, but had similar clinical features, including complications, except aseptic meningitis. Antimumps immunoglobulin (Ig) G was positive in 83% and 100%, and IgM was positive in 67% and 41%, respectively, in the two periods. CONCLUSION: In Korea, recent mumps outbreaks have occurred mainly among secondary school students who received two doses of the MMR vaccine. The vaccinees might have a modified immune reaction to viral insults, manifesting modified epidemiological and clinical features.
Antibodies ; Developed Countries ; Disease Outbreaks* ; Humans ; Immunoglobulin M ; Immunoglobulins ; Inpatients ; Korea ; Measles-Mumps-Rubella Vaccine ; Meningitis, Aseptic ; Mumps Vaccine ; Mumps* ; Observational Study* ; Outpatients ; Retrospective Studies ; Vaccination

PURPOSE: Acute appendicitis is one of the most common surgical diseases and the accuracy of diagnosis has been reported to be between 71% and 85%. In this study we tried to determine whether abdominal sonographic examination is critical to the decision to operate and whether its use is essential before surgery of patients with clinically diagnosed or suspected acute appendicitis. METHODS: A total of 552 patients with clinically diagnosed acute appendicitis from January 2000 to December 2001 were enrolled in this study. All patients underwent an abdominal graded compression sonography performed by a staff radiologist. RESULTS: A total of 535 patients (96.9%) with positive findings of appendicitis proceeded to surgery. 17 patients (3.1%) were found to have other diseases. Of the 535 patients undergoing operation, 531 (99.3%) were proved to have appendicitis by pathologic reports. The 17 patients with negative findings in sonography underwent operation or CT examination; 12 (70.6%) were proved to have appendicitis. Abdominal sonography for detecting acute appendicitis had a sensitivity of 97.8%, a specificity of 55.6%, an accuracy of 97.1%, a positive predictive value of 99.3%, and a negative predictive value of 29.4%. CONCLUSION: Abdominal sonography is therefore one of the most useful examinations in diagnosing acute appendicitis before surgery and our experience suggests that patients with clinically suspected acute appendicitis should routinely undergo abdominal sonographic examination.
Appendicitis* ; Diagnosis ; Humans ; Sensitivity and Specificity ; Ultrasonography

The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for 7-14 days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative 1.3 months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.
Ankylosis ; Child* ; Humans ; Malocclusion ; Mandible ; Mouth ; Temporomandibular Joint

A 13-year-old Thoroughbred mare, retired from race, was admitted to Equine Hospital, Korea Racing Association with signs of colic. One and a half months following the previous treatment (second time) and 11 days following her previous discharge (third time), the mare repeatedly exhibited signs of colic and finally along with icteric eyes. Routine medical treatment with intravenous fluids, analgesics resulted in resolution of signs of colic in the first and second admission. The condition of the mare did not improve in the third admission despite over one month supportive treatment and she was subject to euthanasia at the request of the owner on the thirtyeighth day of hospitalization (95 days from her first admission). The clinical signs (fever, icterus, mild intermittent colic) in conjunction with clinical laboratory findings (leukocytosis, elevations of serum total bilirubin, direct bilirubin, alkaline phosphatase, aspartate aminotransferase, gamma glutamyl transferase, creatine phosphokinase, lactic dehydrogenase and blood fibrinogen indicative of obstructive biliary disease) in this mare suggested possible chlolelithiasis. However, liver enzymes and bilirubin estimations are often not part of routine screening in emergency colic cases. At necropsy, multiple dark brown choleliths of various sizes obstructing hepatopancreatic ampulla were found in the hepatic duct. The choleliths were found as large as 3-5 cm in diameter, faceted to each other, dark brown in color and showed soap consistency. Histopathologic findings revealed: biliary fibrosis, plugging of the bile canaliculi with bile pigments, cholangiohepatitis and pigmentation of the hepatic lymph node with bile pigment laden macrophages. Although definitive diagnosis of cholelithiasis might be challenging, clinicians should consider this condition in the differential diagnosis of recurrent colic.
Animals ; Cholelithiasis/complications/pathology/*veterinary ; Colic/complications/pathology/therapy/*veterinary ; Fatal Outcome ; Female ; Horse Diseases/*pathology ; Horses

A 7-year-old Thoroughbred gelding was admitted to Equine Hospital, Korea Racing Association for evaluation and treatment of colic. Based on the size and duration of the large colonic and cecal impaction, a routine ventral midline celiotomy and large colon enterotomy were performed to relieve the impaction. Six days following surgery the gelding exhibited signs of lethargy, fever, inappetence and diarrhea. Eleven days following surgery, the jugular veins showed a marked thrombophlebitis. On the sixteenth day of hospitalization the gelding died suddenly. Upon physical examination, the horse was febrile, tachycardic and tachypnoeic. Thoracic excursion appeared to be increased; however, no abnormal lung sounds were detected. No cough or nasal discharge was present. Hematology revealed neutrophilic leukocytosis. Serum biochemistry was normal but plasma fibrinogen increased. In necropsy, fibrinopurulent fluid was present in the thoracic cavity. There were firm adhesions between visceral pleura and thoracic wall. White, mixed and red thrombi were formed in both jugular veins from the insertion point of IV catheter. Histopathological examination showed fibrinopurulent inflammation and vascular thrombosis in the lung. The pleura showed edematous thickening and severe congestion. The clinicopathological and pathological findings suggest that septic thrombi associated with septic thrombophlebitis metastasized into the pulmonary circulation and were entrapped in the pulmonary parenchyma and provoked pleuropneumonia.
Animals ; Colic/*surgery ; Fatal Outcome ; Histocytochemistry ; Horse Diseases/*pathology ; Horses ; Male ; Pleuropneumonia/complications/pathology/*veterinary ; Postoperative Complications/pathology/*veterinary ; Sepsis/complications/pathology/veterinary ; Thrombophlebitis/complications/pathology/*veterinary