Surgical procedures necessitating the prolonged use of the lithotomy position can be associated with neuromuscular dysfunction. Compartment syndrome of the lower leg is a grave complication which, if unrecognized, can lead to either permanent neuromuscular dysfunction or limb loss. We report a case of compartment syndrome of lower leg that occurred in male patient aged 20 years after 380 minutes arthroscopic surgery in the lithotomy position.
Aged ; Arthroscopy ; Compartment Syndromes ; Extremities ; Humans ; Leg ; Male ; Orthopedics

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization

OBJECTIVE: The aim of this study is to analyze the perinatal courses, fetal treatment and postnatal outcomes of fetal gastroschisis. METHODS: A retrospective review of the medical records of 35 cases with a prenatal diagnosis of gastroschisis was conducted between March 1997 and April 2007. RESULTS: Twenty-eight fetuses were followed up and 17 fetuses of them were born alive. Chromosomal study was performed in 22 fetuses and no abnormality was detected in them. Associated anomalies except for gastrointestinal anomalies were found in 12 (34.2%) cases: amniotic band syndrome (n=8), scoliosis (n=6), cleft lip (n=1), hydrops (n=1), hydrocephalus (n=1), acrania (n=1). In 4 fetuses, amnioinfusion and amnioexchange were performed simultaneously for treatment. Four cases (23.5%) were delivered by cesarean section. All neonates received corrected operation immediately after birth and 8 (47.1%) of them had postoperative complications. Three of them were died and the overall survival rate was 82.4%. The average length of hospital stays for the survivors was 36 days (2~210days). CONCLUSION: Fetal gastroschisis diagnosed prenatally has a good prognosis and high survival rates. The result of this study was not different from that of preexisting studies and will be a useful guide in counseling parents with a prenatal diagnosis of gastroschisis.
Amniotic Band Syndrome ; Cesarean Section ; Cleft Lip ; Counseling ; Edema ; Female ; Fetal Therapies ; Fetus ; Gastroschisis ; Humans ; Hydrocephalus ; Infant, Newborn ; Length of Stay ; Medical Records ; Neural Tube Defects ; Parents ; Parturition ; Perinatal Care ; Postoperative Complications ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies ; Scoliosis ; Survival Rate ; Survivors

OBJECTIVE: The purpose of this study is to describe the clinical characteristics and perinatal outcomes of fetuses with omphalocele. METHODS: The study enrolled all fetuses diagnosed prenatally with omphalocele at a single institution, from August 1996 to April 2008. Data were collected retrospectively by reviewing the maternal and neonatal medical records. RESULTS: The study population consisted of 54 cases with prenatally diagnosed omphalocele. In all, 15 fetuses were live-born, 29 were terminated, four died in utero, and six were lost to follow-up. Associated anomalies were found in 72.9% (35/48). Abnormal karyotype was found in 33.3% (16/48). In the live births, associated major anomalies were present in 46.7% (7/15) and were associated with increased neonatal morbidity. The rate of severe neonatal morbidity was 53.3% (8/15). In one case, death followed prolonged hospitalization with complications related to associated anomalies. The neonatal mortality rate was 6.7% (1/15) with no postoperative deaths. CONCLUSION: In this study, the neonatal mortality rates were low in the absence of associated anomalies or genetic defects. The results emphasize the importance of identifying both those fetuses with a potentially positive prognosis and favorable outcome and those which are likely to have a fatal outcome.
Abnormal Karyotype ; Fatal Outcome ; Fetus ; Hernia, Umbilical ; Hospitalization ; Humans ; Infant ; Infant Mortality ; Live Birth ; Lost to Follow-Up ; Medical Records ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies

OBJECTIVE: To evaluate the relationship between the presence of apolipoprotein E (Apo E) 4 allele and bone mineral density (BMD) and severity of joint destruction in postmenopausal women with rheumatoid arthritis (RA). METHODS: Apo E genotypes were analyzed in 113 postmenopausal women who were first diagnosed with RA and had not receiving antiresorptive therapy for osteoporosis at the time of enrollment. BMD was measured using dual-energy X-ray absorptiometry (DEXA), and joint destruction was evaluated on plain radiographs according to 'Larsen score'. The differences in BMD and severity of joint destruction in groups with and without an Apo E4 allele were analyzed in 94 patients with clinical information available. RESULTS: BMD (g/cm2) of the lumbar spine in the Apo E4 (-) group was 0.94+/-0.16 (n=67), whereas that in the Apo E4 (+) group was 0.87+/-0.14 (n=27; p=0.049). BMD of the femoral neck and great trochanter in the Apo E4 (-) group was 0.74+/-0.12 and 0.63+/-0.11, while that in the Apo E4 (+) group was 0.68+/-0.11 (p=0.039) and 0.57+/-0.11 (p=0.008). However, there were no significant differences in Larsen scores and erosive disease (%) between the Apo E4 (+) and Apo E4 (-) groups. CONCLUSION: The Apo E4 allele is associated with a reduced bone mass in postmenopausal RA patients. Therefore, Apo E4 allele is considered to be an independent risk factor for generalized osteoporosis in postmenopausal RA patients.
Absorptiometry, Photon ; Alleles ; Apolipoprotein E4 ; Apolipoproteins E ; Apolipoproteins* ; Arthritis, Rheumatoid* ; Bone Density* ; Female ; Femur ; Femur Neck ; Genotype ; Humans ; Joints ; Osteoporosis ; Polymorphism, Genetic* ; Risk Factors ; Spine

PURPOSE: To report an epidemiologic study of keratoplasty in which we analyze basic data of corneal transplants and corneal donations in Korea. METHODS: From June 2004 through October 2004, questionnaires were distributed to 25 hospitals. The questionnaires were about the characteristics of patients registered in eye banks for keratoplasty from May 2001 to April 2003, and about the results of keratoplasties performed from May 2002 to April 2003. RESULTS: The leading corneal diseases in patients registered for keratoplasty were infectious keratitis (22.0%), trauma (21.0%), and pseudophakic and aphakic bullous keratopathy (13.8%), in that order. The leading indications in corneal recipients were: trauma (15.5%), pseudophakic and aphakic bullous keratopathy (13.7%), and infectious keratitis (10.7%), in that order. In 233 cases of keratoplasties, penetrating keratoplasty was performed in 229 cases (98.3%) and lamellar keratoplasty was performed in 4 cases (1.7%). The most common combined surgery was cataract extraction. Common causes of graft failure were rejection of donor cornea and infection. Imported donor corneas were used in sixty-one cases (26.2%) among the 233 total keratoplasties. CONCLUSIONS: We constructed an epidemiologic data base of patients registered for keratoplasty, corneal donation, and the results of keratoplasties throughout Korea.
Cataract Extraction ; Cornea ; Corneal Diseases ; Corneal Transplantation* ; Epidemiologic Studies* ; Eye Banks ; Humans ; Keratitis ; Keratoplasty, Penetrating ; Korea* ; Surveys and Questionnaires ; Tissue Donors ; Transplants

PURPOSE: To report an epidemiologic study of keratoplasty in which we analyze basic data of corneal transplants and corneal donations in Korea. METHODS: From June 2004 through October 2004, questionnaires were distributed to 25 hospitals. The questionnaires were about the characteristics of patients registered in eye banks for keratoplasty from May 2001 to April 2003, and about the results of keratoplasties performed from May 2002 to April 2003. RESULTS: The leading corneal diseases in patients registered for keratoplasty were infectious keratitis (22.0%), trauma (21.0%), and pseudophakic and aphakic bullous keratopathy (13.8%), in that order. The leading indications in corneal recipients were: trauma (15.5%), pseudophakic and aphakic bullous keratopathy (13.7%), and infectious keratitis (10.7%), in that order. In 233 cases of keratoplasties, penetrating keratoplasty was performed in 229 cases (98.3%) and lamellar keratoplasty was performed in 4 cases (1.7%). The most common combined surgery was cataract extraction. Common causes of graft failure were rejection of donor cornea and infection. Imported donor corneas were used in sixty-one cases (26.2%) among the 233 total keratoplasties. CONCLUSIONS: We constructed an epidemiologic data base of patients registered for keratoplasty, corneal donation, and the results of keratoplasties throughout Korea.
Cataract Extraction ; Cornea ; Corneal Diseases ; Corneal Transplantation* ; Epidemiologic Studies* ; Eye Banks ; Humans ; Keratitis ; Keratoplasty, Penetrating ; Korea* ; Surveys and Questionnaires ; Tissue Donors ; Transplants

Malignant mixed Mullerian tumor of the ovary is extremely rare. This is heterologous neoplasms which apparently arise from undifferentiated mullerian stroma and is composed of mixture of malignant epithelial and stromal elements. We report a case of malignant mixed mullerian tumor of the ovary with brief literature review.
Female ; Ovary*

A survey was conducted to determine the extent of intestinal parasite infection in Bat Dambang, Cambodia in March 2004. A total of 623 fecal specimens was collected from kindergarten and schoolchildren and examined using the formalin-ether sedimentation technique. The overall infection rate of intestinal parasites was 25.7% (boys, 26.2%; girls, 25.1%), and the infection rates of intestinal helminthes by species were as follows: Echinostoma sp. 4.8%, hookworm 3.4%, Hymenolepis nana 1.3%, and Rhabditis sp. 1.3%. The infection rates of intestinal protozoa were; Entamoeba coli 4.8%, Giardia lamblia 2.9%, Iodamoeba butschlii 1.4%, Entamoeba polecki 1.1%, and Entamoeba histolytica 0.8%. There were no egg positive cases of Ascaris lumbricoides or Trichuris trichiura. All children infected were treated with albendazole, praziquantel, or metronidazole according to parasite species. The results showed that intestinal parasites are highly endemic in Bat Dambang, Cambodia.
Adolescent ; Age Factors ; Animals ; Cambodia/epidemiology ; Child ; Feces/parasitology ; Female ; Helminthiasis/*epidemiology ; Helminths/isolation & purification ; Humans ; Intestinal Diseases, Parasitic/*epidemiology ; Male ; Protozoa/isolation & purification ; Protozoan Infections/*epidemiology

OBJECTIVES: Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.
Animals ; Cattle ; Diarrhea ; Enterohemorrhagic Escherichia coli* ; Family Characteristics ; Grandparents ; Hemolytic-Uremic Syndrome ; Humans ; Korea* ; Mothers ; Shiga Toxin 2 ; Zoonoses