For treatment of the pressure sore, varieties of methods have been developed such as skin graftings, local flap, myocutaneous or fasciocutaneous flap, etc.. Except mild cases, myocutaneous flaps have been used commonly for the best coverage and padding of the wound. But the gluteus maximus muscle is not an expendable muscle, so the myocutaneous flaps using gluteus maximus muscle result in significant functional loss in ambulatory patients. Various methods as fasciocutaneous flap to reserve a function of the gluteus maximus muscle have been developed. We especially designed a bilateral fasciocutaneous flap in the fashion of interdigitating extended V-Y advancement in sacral sore when the defect is fusiform transversely in shape. With this design, we obtained reduced tension in the midline suture with less dissection in medial portion of the fasciocutaneous flap and made the flap more rleliable by including more parasacral perforators within the flap. We have experienced the eight cases of gluteal fasciocutaneous V-Y advancement flap and obtained the excellent results without flap necrosis. We conclude that a bilateral fasciocutaneous flap in the fashion of interdigitating extended V-Y advancement is useful in sacral sore when the defect is fusiform transversely in shape.
Humans ; Myocutaneous Flap ; Necrosis ; Pressure Ulcer ; Skin Transplantation ; Sutures ; Wounds and Injuries

This retrospective study comprise 595 patients with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, the Chung Buk National University Hospital between September 1991 and December 1997. The medical records of these 595 patients were reviewed and analyzed in order to obtain the clinical pattern and understand the therapeutic modalities. The following results were obtained. 1. The most prevalent age group was the third decade(35.1%). 2. The monthly incidence was the highest in September and the most common accident time was between 6:00 p.m. and midnight. 3. The most common etiology was motor vehicle accidents(59.5%) followed by assault(26.2%), fall(11.4%), sports(2.7%). 4. The male predominated over female in 4.27:1 ratio. 5. The most common fracture site was nose(30.0%) followed by mandible(26.7%), zygoma(23.3%), orbit(8.6%), maxilla(8.1%), frontal sinus(3.2%). 6. The most common fracture site of mandible was parasymphsis(34.9%) followed by angle(27.1%), condyle(23.4%), symphysis(14.5%). 7. The soft tissue injury was the most common associated injury(51.1%). Fcial soft tissue injuries were sustained by 53.3% in the highest rate associated with the associated injuries. 8. Open reduction was used for 63.7% of total cases while 33.8% of total cases required closed reduction, and 2.5% of total cases treated conservatively. 9. The complication rate was 14.1% and the ophthalmologic complication rate comprise 44.9% of all complications.
Chungcheongbuk-do ; Facial Bones* ; Female ; Humans ; Incidence ; Male ; Mandible ; Medical Records ; Motor Vehicles ; Plastics ; Retrospective Studies ; Soft Tissue Injuries

The frontal sinus has importance from the aesthetic and functional points of view, so management of the frontal sinus should be conducted. The management may differ with the severity of displacement, the extent of displacement, as well as the involvement of the brain and nasofrontal duct. Fifteen patients with frontal sinus fracture were managed differently depending on the severity of their injuries for between 14 and 31 months, and then evaluated. During the follow-up period, encountered no complications and the overall result of the foreh ead contour was satisfactory.
Brain ; Follow-Up Studies ; Frontal Sinus* ; Humans

No abstract available.

Kimura's disease is a chronic inflammatory condition of unknown cause. It usually appears as a painless nodule in the head and neck region often associated with regional lymphadenopathy, but there have rarely been reports of penile involvement or clinical presentation as an ulcerative plaque. We present a case of Kimura's disease occurring on the penile shaft as an ulcerative plaque in a 44-year-old man. A vesicular eruption had occurred on his penile shaft followed by an ulcerative plaque for 2 months. He had suffered from recurrent regional lymphadenopathy for 15 years and he had also exhibited intermittent eosinophilia. Histopathologic findings revealed diffuse eosinophilic infiltration in the dermis of the skin and eosmophilic abscesses in the lymphoid follicles of the mguinal lymph node. After short-term systemic steroid therapy and local injection of triamcinolone acetonide, the ulcerative plaque was healed.
Abscess ; Adult ; Dermis ; Eosinophilia ; Eosinophils ; Head ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Skin ; Triamcinolone Acetonide ; Ulcer

The incidence of atherosclerosis in Korea seems to be much increased due to diet change after national development. The pathogenesis of atherosclerosis is not clarified and there are many hypothesis but the most recent and reliable hypothesis is the ratio of HDL-cholesterol per total cholesterol. Under the basis of this hypothesis there have been much trials to administer the agents which has effect on lipid metabolism, so we tried pantethine on 30 patients who visited Han-Yang University Hospital Internal medicine Department, and the result as follows; 1) The mean age of study population was 50.1 years of age, mean body weight was 62kg, and mean height was 160.8cm. male was 17, and female 10. 2) The associated disease of study population was <19 with> cardiovascular disease, in 19, gastrointestinal disease 3, obesity in 1 and others in 4. 3) The undesirable effect of the drug was found on 3 patients; that is, constipation on 1 patient, dizziness on 1 patient, and skin eruption on 1 patient. 4) The mean serum lipids before and after pantethine administration(levels) are as following table. In conclusion, it seems that the effect of the drug which decreases the serum lipids is mild at initial but more increasing as the time goes by and constant, and we experience little side reaction except mild dizziness, constipation and skin eruption.
Atherosclerosis ; Body Weight ; Cardiovascular Diseases ; Cholesterol* ; Constipation ; Diet ; Dizziness ; Female ; Gastrointestinal Diseases ; Humans ; Incidence ; Internal Medicine ; Korea ; Lipid Metabolism ; Male ; Obesity ; Skin ; Triglycerides*

The effect of ketanserin, serotonin antagonist, among 19 korean patients over 55 years with essential hypertension was assessed in an open clinical trial for three months. patients were given Ketanserin 20mg bid with monthly follow-up visits. Mean values of systolic/diastolic blood pressures fell from 169+/-17/104+/-10mmHg to 155+/-14/94+/-9mmHg at 2 weeks(p<0.01) and to 147+/-10/87+/-6mmHg at end of treatment 12 weeks after(p<0.001). There was no significant change in heart rate. Transient mild side effects were observed in 5 patients. We conclude that Ketanserin is an effective and safe drug for the treatment of elderly hypertensives.
Aged ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension* ; Ketanserin* ; Middle Aged* ; Serotonin

A retrospective clinical observation was done in 90 cases of acute myocadial infarction admitted to Hanyang University Hospital from July 1972 to Dec. 1980. The following results were obtained. 1) The ratio of male to female was 2.3:1. Most patients(63.2%) were in the age groups between the 6th and 7th decades. 2) The main symptoms of acute myocardial infarction were chest pain(76.6%), dyspnea (64.4%), radiating pain(27.7%), epigastric pain(18.8%) and palpitation(15.5%). The painless infarction accounted for 11.1% of all cases. 3) The most common preceding disease was hypertension(38.5%) and other associated diseases were diabetes mellitus(13.2%), C.V.A.(8.8%), angina pectoris(8.8%), previous myocardial infarction(6.6%) and drug intoxication(3.3%). No preceding diseases were found in 12.0% of cases. 4) The anterior wall infarction was 45.5% of 90 cases, inferior wall infarction 22.2%, antero-inferior wall infarction 11.2%, subendocardial infarction 7.7%, posterolateral infarction 2% on ECG. 5) The mortality rate of patients according to the Killip class was 4.2% in class I, 14.3% in class II, 50% in class III and 76.9% in class IV. Group of high Killip class was associated with high mortality. 6) In long term prognosis according to Norris' coronary prognostic index, the highest value was 11.72 with average value of 7.02+/-2.65 in survival group, whereas in death group, the lowest value was 5.08, the highest 16.88 and average value was 10.4+/-3.86. 7) High risk subgroup who complicated within the first 4 admission days, occupied 21.1% and low risk subgroup without complication occupied 46.7%. After the 5th admission days, 2.2% of high risk subgroup was expired, whereas there was no death cases in low risk subgroup. 8) Average duration of hospitalization was 22.4+/-9.5 days in high risk subgroup and 17.3+/-6.8 days in low risk subgroup. In low risk subgroup, 10 cases were discharged within the 7th day of admission and 30 cases after the 8th day of admission. 9) 89.5% of total death occured within the 4th hospitalized day, and 66.7% of cases under systolic BP of 84mmHg were expired. Definite cardiomegaly on chest X-ray and past history of myocardial infarction were associated with high mortality. Half of cases with pulmonary edema were died.
Cardiomegaly ; Dyspnea ; Electrocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Prognosis ; Pulmonary Edema ; Retrospective Studies ; Thorax

BACKGROUND: In order to investigate the efficacy and safety of cilazapril, a recently developed angiotensin converting enzyme inhibitor, a clinical study was performed in the patients with mild to moderate essential hypertension. METHODS: The study subject consisted of 31 patients with diastolic blood pressure of 95mmHg~115mmHg (mean age : 56.0+/-8.1 years, 16 males and 15 females). Cilazapril was administered orally in a daily dose of 2.5mg~5.0mg Q.D. for 8 weeks. During cilazapril medication, anti-hypertensive efficacy, side effects and laboratory changes were monitored. RESULTS: Cilazapril decreased blood pressure from baseline value of 162.2+/-4.7/98.4+/-2.8mmHg to 144.6+/-10.0/89.7+/-5.7mmHg after 4weeks of medication (p<0.05) and 138.2+/-4.5/87.8+/-4.0mmHg after 8 weeks of medication (p<0.05). Heart rate change was not significant (72.3+/-4.7/min vs 71.7+/-3.6/min). Body weight change was not significant (66.6+/-9.8 Kg vs 66.8+/-9.9 Kg). There were no significant change in blood chemistry and hematologic examination except mild elevation of alanine transaminase and serum creatinine values but these date were within normal ranges. The side effects were dry cough (4 case, 12.9%), headache (2 case, 6.4%), indigestion (1 case, 3.2%) and dry mouth (1 case, 3.2%). One patient dropped out due to severe dry cough but others were mostly mild in nature. CONCLUSIONS: Cliazapril 2.5mg~5.0mg once daily regimen was effective and well tolerated in patients with mild to moderate essential hypertension.
Alanine Transaminase ; Blood Pressure ; Body Weight Changes ; Chemistry ; Cilazapril* ; Cough ; Creatinine ; Dyspepsia ; Headache ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth ; Peptidyl-Dipeptidase A ; Reference Values

Left ventricular false tendon, also called moderator bands, anomalous cords, accessory bands or false chordae tendinae, has been known as simple anatomical without clinical importance. But the possible relationship with Still's type murmur and ventricular arrhythmia were reported recently. The incidence of false tendon was known as 0.5-6.1% variably. In Korea, there are no reports about left ventricular false tendon till now. The authors examined 2,052 patients' echocaediograms and clinical manifestations retrospectively to find the incidence and potent clinical significance of false tendons. The incidence in present study was 1.02% and there was no specific relationship between false tendon and cardiovascular diseases. The authors observed Still's type musical murmur in 5 patients out of 21 and ventricular premature beats in 2 patients out of 10 without other cardiovascular diseases. One of them showed nonsustained ventricular tachycaedia during Holter ECG monitoring. The most frequent echocardiographic site of attachment was from basal inter-ventricular septum to lelft ventricular free wall and false tendon attached to papillary muscle was least frequently observed.
Arrhythmias, Cardiac ; Cardiac Complexes, Premature ; Cardiovascular Diseases ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Korea ; Music ; Papillary Muscles ; Retrospective Studies ; Tendons*