No abstract available.
Family Practice* ; Humans ; Primary Health Care*

We report on a 28 years old female with recurred cardiac myxomas who presented with dizziness, headache, and blurred vision. She had an excision of biatrial atrial myxomas 10 years age. Varying sized multiple cerebral aneuysms and myxomas in left atrium and left ventricle were found on a cerebral angiogram and echocardiogram, respectively. After wide excision including interatrial septum and part of left ventricular septum, her symptoms were much improved.
Adult ; Dizziness ; Female ; Headache ; Heart Atria ; Heart Ventricles ; Humans ; Intracranial Aneurysm ; Myxoma* ; Ventricular Septum

The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2 % HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.
Double-Blind Method ; Facial Bones ; Hot Temperature ; Humans ; Hyaluronic Acid ; Mouth Neoplasms ; Sensation ; Surgery, Oral ; Sutures ; Wound Healing

The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2 % HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.
Double-Blind Method ; Facial Bones ; Hot Temperature ; Humans ; Hyaluronic Acid ; Mouth Neoplasms ; Sensation ; Surgery, Oral ; Sutures ; Wound Healing

A 67-year-old man, with a history of pontine hemorrhage, was admitted because of ocular tremors. Also, tremors in the right upper limb and palates were detected. Oculopalatine tremors showed synchronous vertical oscillations and the limb showed midbrain tremor. Brain MRI revealed high signal intensities of both inferior olivary nuclei and right superior cerebellar peduncle. Electromyogram showed different tremor frequencies in the oculopalate and limb. Clinical, MRI and electromyographic findings indicate that the origins of oculopalatine and limb tremors are different.
Aged ; Brain ; Extremities ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Mesencephalon* ; Palate ; Tremor* ; Upper Extremity*

The salt-sensitivity has been generally accepted as a mechnism of high blood pressure in elderly hypertensive patients, and so it may result in a difference of renal handling of sodium and potassium between normal healthy control and elderly hypertensive patient. So to evaluate an lbove difference, the amount of 24 hours' urinary excretion of Na+ & K+ were measured in healthy normotensive control (10 case) and elderly hypertensive group(10 case) according to normal diet (12-15gm of NaCl) for first 3 days and low salt diet (3~5)gm of NaCi) for next 3 days, also blood rewwure was mintored. The results were followed : 1) 24 hours' urinary excretion of NA+ was increased in hypertensive group more than control group at first day of normal diet and low salt diet significantly. 2) After a replacement of normal diet to low salt diet, a maximal decrement of 24 hours' urinary excretion of Na+ was 25% at first day in control but 40% at second day in hypertensive group only. 3) There was a similar pattern of urinary excretion of K+ as Na+ in hypertensive group, but it was not stastically significant. 4) There was no significant changes of blood pressure, serum electrolyte and BUN/creatinine according to salt intake in both group. From above findings. We can conclude that a urinary excretion of sodium is delayed in elderly hypertensive group, and it is suggested that a delayed excretion of sodium. is associated with retention of sodium in body. So a persistent restriction of sodium is recommended in elderly hypertensive patient.
Aged ; Blood Pressure ; Diet ; Humans ; Hypertension ; Potassium* ; Sodium*

Background: The medial canthal region features a complex three-dimensional and internal anatomical structure. When reconstructing a defect in this area, it is crucial to consider both functional and aesthetic aspects, which presents significant challenges. Generally, local flaps are preferred for reconstruction; however, skin grafts can be used when local flaps are not feasible. Therefore, we conducted a comparative analysis of surgical outcomes skin grafts when local flaps were not feasible, to determine which surgical method is more effective for medial canthal region reconstruction. Methods: Twenty-five patients who underwent medial canthal region reconstruction using skin grafts or local flaps from 2002 to 2021 were enrolled. Patient information was obtained from medical records. Five plastic surgeons evaluated the surgical outcomes based on general appearance, color, contour, and symmetry. Results: Skin grafts were used in eight patients and local flaps were used in 13. Combined reconstructions were employed in four cases. Minor complications arose in four cases but improved with conservative treatment. No major complications were reported. Recurrence of the skin cancer was noted in two cases. All categories showed higher scores for the local flap compared to both skin graft and combined reconstruction; however, the differences were not statistically significant respectively. Conclusion The choice of appropriate surgical methods for reconstructing defects in the medial canthal region depends on various factors, including the patient’s overall health, the size and depth of the defect, and the degree of involvement of surrounding structures. When a local flap is not feasible, a skin graft may provide favorable surgical outcomes. Therefore, a skin graft can serve as a viable alternative for reconstructing the medial canthal region.

BACKGROUND AND OBJECTIVES: Reverse redistribution pattern (RRP), that is defined as the worsening of the perfusion defect at rest image, can be observed in 99mTC-sestamibi (methoxy isobutyl isonitrile) myocardial scan with standard stress-rest protocol. This study was prepared to evaluate the prevalence and clinical characteristics of RRP in stress 99mTc-sestamibi myocardial scan. MATERIALS AND METHODS: We retrospectively reviewed 1304 images of 99mTC-sestamibi myocardial perfusion scan performed between January 1995 and June 1997, and scintigraphic findings were compared with clinical and angiographic data. RESULTS: The prevalence of RRP was 5.2%(68 of 1,304). RRP was noted in 6.0% (41 of 679) of the adenosine study and 4.3% (27 of 625) of the exercise study. The mean coronary artery stenosis at RRP territory was 51.5+/-38.9%. However, normal coronary artery at RRP territory was noted in 45.8% (11 of 24). There was no significant differences in luminal narrowing of coronary arteries, TIMI flow grade and LV wall motion between the patient with RRP positive and RRP negative at the infarct related artery territory. CONCLUSION: Reverse redistribution pattern on 99mTC-sestamibi myocardial SPECT does not seem to indicate the presence of significant coronary artery disease or patency of the infarct related arteries in the patients with acute MI.
Adenosine ; Arteries ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Perfusion* ; Phenobarbital ; Prevalence ; Retrospective Studies ; Technetium Tc 99m Sestamibi* ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: Although the National Committee for Clinical Laboratory Standards (NCCLS) defined a standard reference broth microdilution method for testing the susceptibility of Candida species to antifungal drugs, many clinical laboratories require easier but reliable alternatives for routine antifungal susceptibility testing. We evaluated ATB FUNGUS 2 (bioMerieux, France.; ATB) compared to the method recommended by the NCCLS (NCCLS). METHODS: A total of 28 strains of Candida species consecutively isolated from blood and CSF cultures at Asan Medical Center from April to June 2004 were tested. In addition, 12 strains comprising C. krusei (3), C. glabrata (7) and C. guilliermondii (2) from the collection of Chonnam National University Hospital were included in the study. These strains were tested for minimum inhibitory concentrations (MICs) against flucytosine (FC), fluconazole (FZ), itraconazole (IZ) and amphotericin B (AB) by both of ATB and NCCLS. In NCCLS, MICs were read using a spectrophotometer after 24 and 48 hour-incubation. RESULTS: The concordance rates of MICs between ATB and NCCLS after 24 hour-incubation were 100%, 75%, 89% and 96% within two-fold dilution and 100%, 97%, 97%, 100% within four-fold dilution for FC, FZ, IZ and AB, respectively. For C. krusei, all three FC and FZ-resistant strains were either intermediate or SDD and one IZ-resistant strain was SDD in ATB, respectively. One C. tropicalis strain resulted in AB MICs of 0.5 microgram/mL in NCCLS, but 2 microgram/mL in ATB. CONCLUSIONS: ATB showed good concordance rates with NCCLS after 24 hour-incubation. ATB appears to be a useful alternatives to NCCLS for routine antifungal susceptibility tests. However, ATB needs further evaluation with more clinical strains, especially those resistant to antifungal agents.
Amphotericin B ; Antifungal Agents ; Candida* ; Chungcheongnam-do ; Fluconazole ; Flucytosine ; France ; Fungi* ; Itraconazole ; Jeollanam-do ; Microbial Sensitivity Tests

BACKGROUND: Ventrlcular tachyarrhythmias are major cause of sudden cardiac death in patients after myocardial infarction and their accurate detection seems to be important in prevention of sudden cardiac death. Clinical findings, treasmill test, holter monitoring and coronary angiography have been used to search for high risk group in sudden cardiac death. Recently electrographysiologic stimulation has been to this, but it is not practical, because of high cost and invasiveness. Signal averaged electrocardiogram(SAECG) may be helpful in prediction of high risk group in sudden cardiac death. So we try to know the values of SAECG in Korean patients without heart disease. RESULTS: 1) The mean value and standard deviation of Time domain analysis is as follows ; fQRS : 106.8+/-12.3ms, RMS : 36.2+/-21.5(micro)V, LAS : 27.2+/-8.1ms. 2) The mean value and standard deviation of Spectral turbulence analysis is a follows ; LSCR : 58.6+/-3.9, ISCM : 95.2+/-0.8, ISCSD : 71.8+/-15.7, SE : 6.9+/-1.8. CONCLUSION: There was no significant difference between male and female. Time domain analysis shows significant differences among each hour but spectral turbulence analysis did not. Spectral turbulence analysis shows high specificity.
Coronary Angiography ; Death, Sudden, Cardiac ; Electrocardiography* ; Electrocardiography, Ambulatory ; Female ; Heart Diseases* ; Heart* ; Humans ; Male ; Myocardial Infarction ; Sensitivity and Specificity ; Tachycardia