The resection of levator aponeurosis and its muscle through the anterior approach had been performed on 50 ptotic lids of 40 patients from April, 1985 to January, 1988. Their age ranged from 28 months to 44 years old(mean, 7.5 years old). All but one of them were congenital origin. Thirty-four per cent of eyes were associated with ocular abnormalities such as strabismus, entropion, and blepharophimosis. Three patients had inguinal hernia, tongue tie, and ventricular septal defect respectively as systemic abonrmalities. The cycloplegic refraction revealed mild hyperopia in 74%, mild myopia in 18%, and moderate or severe hyperopia in 8%. Seventy per cent of eyes had with-the-rule astigmatism, while 8% had againgt-therule astigmatism. Twenty-two per cent had no astigmatism. Amblyopia was noted in 11 patients of 31 patients in whom we could check the visual acuity. The amount of levator muscle resected, which depended on the function of levator muscle and the degree of ptosis, ranged from 15mm to 24mm (mean, 20.2mm). We also applied this procedure to the patient whose levator function was less than 2mm. Good surgical results were obtained in 45 eyes(90%). Undercorrected one eye underwent reoperation using the frontalis sling.
Amblyopia ; Astigmatism ; Blepharophimosis ; Blepharoptosis* ; Entropion ; Heart Septal Defects, Ventricular ; Hernia, Inguinal ; Humans ; Hyperopia ; Myopia ; Reoperation ; Strabismus ; Tongue ; Visual Acuity

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*

BACKGROUND: National reference standards are essential to the quality assessment and regulatory approval of in vitro diagnostic medical devices. However, the long-term stability of national reference standards has not been comprehensively secured. This study was performed to assessment on the long-term stability of the hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus-1 (HIV-1) national reference standards intended to be used for the nucleic acid amplification test (NAT). METHODS: The viral loads of the MFDS (Korea Ministry of Food and Drug Safety) working standard and recombinant DNA for HBV, HCV, and HIV-1 were measured before and after storage at −70℃ for up to 72 months using Cobas Ampliprep/Cobas Taqman assays (Roche Molecular System, Inc., Branchburg, USA) at defined time points. RESULTS: The viral loads of national reference standards for in vitro diagnostic medical devices of HBV, HCV, and HIV-1 stored at −70℃ for up to 72 months did not differ significantly from the baseline viral load. The changes in viral load of national reference standards of HBV, HCV, and HIV-1 tested after storage at −70℃ for up to 72 months ranged from −0.36 to 0.16 log10 IU/mL and did not exceed 0.5 log10, which is the estimated intra-assay variation of molecular tests. CONCLUSION: The HBV, HCV, and HIV-1 national reference standards for in vitro diagnostic medical devices intended to be used for the NAT were relatively stable after long-term storage at −70℃ for up to 72 months, regardless of the initial titer.
DNA, Recombinant ; Hepacivirus ; Hepatitis B virus ; HIV-1* ; Humans ; In Vitro Techniques* ; Nucleic Acid Amplification Techniques* ; Reagent Kits, Diagnostic* ; Viral Load

PURPOSE: The purpose of this study was to investigate the influence of communication competence and burnout on nursing performance in intensive care units (ICU). METHOD: The participants were 209 nurses from four university hospitals. Measurements included a socio-demographic and job related survey, communication competence inventory, the Maslach burnout inventory and a nursing performance scale. Data were collected from February 6 to 24, 2012, with a self-report questionnaire. The statistical analyses were performed with SPSS 18.0 software. RESULTS: The mean scores for communication competence, burnout and nursing performance were 50.49, 84.72, and 62.18, respectively. Communication competence (r=.44, p<.001) and burn out (r=-.32, p<.001) were significantly correlated with nursing performance. In the multiple linear regression, factors influencing nursing performance were communication competence, age and burnout. These variables explained about 46% of the total variance of nursing performance. Communication competence (beta=.34, p%.001) was the most influential factor. CONCLUSION: Nurses' poor communication skills and burnout can influence the occurrences of medical errors in ICU nursing performance. The results suggest that good communication and burnout resolution skills programs should be implemented to improve nursing performance efficiency.
Burns ; Hospitals, University ; Critical Care ; Intensive Care Units ; Linear Models ; Medical Errors ; Mental Competency ; Surveys and Questionnaires

BACKGROUND: The use of a functionally closed system for the glycerolization and deglycerolization of red blood cells (RBCs) allows for prolonged post-thaw storage for more than 24 hours. The aim of this study was to assess glycerolization and deglycerolization processing for RBCs using a high glycerol method in the automated, closed system provided by Haemonetics ACP 215. METHODS: Thirty-five packed RBCs were glycerolized using the ACP 215 to a final concentration of 40% (wt/vol). The units were either frozen as such (n=30) or excess glycerol was removed (n=5) before freezing. After storage at −80℃, the units were thawed, deglycerolized and resuspended in SAG-M. The frozen-thawed RBCs were stored at 4℃, and analyzed for their stability and in vitro quality. RESULTS: No prefreeze excess glycerol removal units showed significantly less potassium leakage during post-thaw storage compared to the prefreeze excess glycerol removal units. All measurements of the stability and in vitro quality of thawed RBCs prepared from frozen RBCs without the prefreeze removal of excess glycerol during post-thaw storage at 4℃ for 7 days were acceptable to the American Blood Bank Association's standards and European standards. CONCLUSION: RBCs frozen without prefreeze removal of excess glycerol and the ACP 215 simplifies cryopreservation procedure and increases the stability of frozen-thawed RBCs. This increases the practical applicability of cryopreserved RBCs in blood transfusion practice.
Blood Banks ; Blood Transfusion ; Cryopreservation ; Erythrocytes* ; Freezing* ; Glycerol ; In Vitro Techniques ; Methods ; Potassium

The blood supply can become disrupted in situations of increased demand during unexpected national catastrophes and when a patient needs a rare blood transfusion, which depends on the blood inventory in peacetime. Cryopreservation of blood, which can be stored up to 10 years, represents a possible solution to this problem by avoiding storage lesions. This review describes frozen red cell technologies, quality control issues related to post-thaw red blood cells, and preconditions and practical considerations for implementation of a frozen blood banking system in Korea.
Blood Banks ; Blood Transfusion ; Cryopreservation ; Erythrocytes ; Humans ; Korea ; Quality Control ; Strategic Stockpile*

OBJECTIVES: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. METHOD: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education-matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools-including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). RESULTS: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression (GDS> or =10) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. CONCLUSIONS: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.
Aged ; Alzheimer Disease ; Anxiety ; Depression ; Humans ; Memory ; Restless Legs Syndrome ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Trail Making Test

No abstract available.
Blood Donors* ; Humans ; Phenotype*

No abstract available.
Dermatitis, Allergic Contact