No abstract available.
Morphine*

Two avulsed ears attached by very narrow subcutaneous pedicles were repaired with only cutaneous sutures and showed complete survival. The results showed that the entire auricle could be fully vascularized by just a single small vascular branch. This clinical result is compatible with our previous findings in anatomical study concerning arterial supply of the auricle.
Ear ; Sutures

No abstract available.
Mitral Valve*

PURPOSE: This study was devised to evaluate the post-operative satisfaction and daily life behavior in the patient who underwent Jone tube intubation. METHODS: 60 patients who underwent Jones tube intubation replied to the questionaire consisted of twenty questions. The questionare consisted of six groups: Basic statistical informations, past medical history, post operative satisfaction, post operative complications, questions about anesthesia, patients compliance. RESULTS: 28 (46.7%) patients were satisfied with outcomes of Jones tube intubation. 9 (15.0%) patients replied acceptable, and 23 (38.3%) patients were dissatisfied. Age, sex were not significantly associated with the post operative satisfaction (P-value>0.05). Air blowing in the eye was the most frequent complications (41.6%) and other concerning ocular symptoms are regurgitation of nasal discharge (35.0%), persistent tearing (35.0%), fogging of eyeglasses (18.3%) and etc. 23 patients (46.0%) refused to receive bilateral surgery because of post operative complications, old age, economic problems. CONCLUSIONS: Post operative satisfaction after Jones tube intubation is not associated with its functional success rate due to numerous postoperative complications.
Anesthesia ; Compliance ; Eyeglasses ; Humans ; Intubation* ; Postoperative Complications ; Weather

No abstract available.
Anemia* ; Hypothyroidism*

PURPOSE: To determine changes in the degree of pseudomyopia and convergence in patients with spasm of the near reflex. METHODS: In 5 patients with spasm of the near reflex, we checked following: UCVA/BCVA, the degree of pseudomyopia revealed through manifest and cycloplegic refraction tests, pupil size, limitation of EOM, the amount of convergence defined by the alternate prism cover test, and slit lamp and funduscopic exams. RESULTS: Of the 5 patients with spasm of near reflex, 3 had accommodative spasm alone and 2 had accommodative spasm, convergence spasm and miosis. The patients' degrees of pseudomyopia and convergence were -8.0D and 14PD on the average. which disappeared after an average of 10.8 months but recurred in 1 of the 3 patients with accommodative spasm. As for spasm of the near reflex, 1 patient showed improvement in convergence but worsening pseudomyopia during the follow-up period, and another patient showed recurrence. CONCLUSIONS: The most common clinical feature of spasm of the near reflex is accommodative spasm. Patients with accommodative spasm alone showed better prognosis among all patients with spasm of the near reflex in terms of recurrence and the disease course.
Follow-Up Studies ; Humans ; Miosis ; Prognosis ; Pupil ; Recurrence ; Reflex* ; Spasm*

Sjogren's syndrome (SS) is an autoimmune disease characterized by a lymphocytic infiltration of the salivary and lacrimal glands leading to a progressive destruction of these glands due to the production of autoantibodies. This disorder is either isolated (primary SS) or associated with other systemic diseases (secondary SS). The occurrence of B-cell non-Hodgkin's lymphoma (NHL) represents the major complication in the evolution of SS patients. The risk of developing NHL, which is equivalent for both primary and secondary SS, was estimated to be 44 times greater than that observed in a comparable normal population. NHLs in SS patients occur preferentially in the salivary glands and in other mucosa-associated lymphoid tissues (MALT). However, it can also occur in the lymph nodes or bone marrow. We documented a case of low-grade B-cell lymphoma of MALT in the right eyelid and primary biliary cirrhosis (PBC) of a patient with SS. To the best of our knowledge, this is the first case reported in Korea.
Case Report ; Eyelid Neoplasms/pathology ; Eyelid Neoplasms/etiology* ; Female ; Human ; Liver Cirrhosis, Biliary/pathology ; Liver Cirrhosis, Biliary/complications* ; Lymphoma, Mucosa-Associated Lymphoid Tissue/pathology ; Lymphoma, Mucosa-Associated Lymphoid Tissue/etiology* ; Middle Age ; Sjogren's Syndrome/pathology ; Sjogren's Syndrome/complications*

PURPOSE: inhaled nitric oxide(iNO) is an excellent method for the postoperative pulmonary hypertension in congenital heart disease. But more detailed care is needed because of the development of rebound pulmonary hypertension after NO Withdrawal. We performed this study in order to discontinue the iNO successfully by way of presenting the adequate weaning and supplying methods. METHODS: Between January, 1998 and August, 1999 we sudied 10 patients who had rebound pulmonary hypertension(RPH) after iNO withdrawal. We completed the iNO in these patween the first the second trial of the weaning process. We tried to discover the differences between the first and second weaning process. We measured NO concentration at the start and just before NO withdrawal and during the period of weaning process. Moreover, to identify the iNO effects during the weaning of the iNO, we counted the degree of the change of PaO2/FiO2and mean PAP/SAP beween initial and at half of the initial NO concentration. RESULTS: Second weaning had a longer duration weaning process(11+/-0 cersus 5+/- hours, P<0.05), lower NO concentration just before NO withdrawal(2+/-.6 versus 4+/-ppm, P<0.05). In the change of the mean PAP/SAP and PaO2/FiO2as iNO was weaning from the initial iNO concentration to a half of the initial iNO concentration, the degree of increase in mean PAP/SAP(0.026+/-.07 versus 0.054+/-.07, P<0.05) and the degree of decrease in PaO2/FiO2(49+/-4 versus 65+/-2, P<0.05) were smaller in the second in the second weaning process than the first weaning process. CONCLUSION: A successful weaning of iNO can be performed with a low iNO concentration at the start and just before withdrawal and with the long duration iNO weaning process. Moreover, We speculate that the degree of change in the mean PAP/SAP and PaO2/FiO2at the half of the iNO weaning process are an indicator for the development of RPH.
Heart Defects, Congenital ; Humans ; Hypertension, Pulmonary ; Nitric Oxide* ; Weaning*

BACKGROUND: We hypothesized that the direction of the J-tip of the guidewire during insertion into the internal jugular vein (IJV) might determine its ultimate location. METHODS: In this study, 300 patients between the ages of 18 and 99 years who required central venous catheterization via IJV in the emergency department enrolled for randomization. IVJ catheterization was successful in 285 of 300 patients. An independent operator randomly prefixed the direction of the J-tip of the guidewire to one of three directions. Based on the direction of the J-tip, patients were allocated into three groups: the J-tip medial-directed group (Group A), the lateral-directed group (Group B), or the downward-directed group (Group C). Postoperative chest radiography was performed on all patients in order to visualize the location of the catheter tip. A catheter is considered malpositioned if it is not located in the superior vena cava or right atrium. RESULTS: Of the total malpositioned catheter tips (8 of 285; 2.8%), the majority (5 of 8; 62.5%) entered the contralateral subclavian vein, 2 (25.0%) were complicated by looping, and 1 (12.5%) entered the ipsilateral subclavian vein. According to the direction of the J-tip of the guidewire, the incidence of malpositioning of the catheter tip was 4 of 92 in Group A (4.3%), 4 of 96 in Group B (4.2%), and there were no malpositions in Group C. There were no significant differences among the three groups (p = 0.114). CONCLUSIONS: The direction of the J-tip of the guidewire had no statistically significant effect on incidence of malpositioned tips.
Catheterization ; Catheterization, Central Venous ; Catheters* ; Central Venous Catheters ; Emergency Service, Hospital ; Heart Atria ; Humans ; Incidence ; Jugular Veins* ; Radiography ; Random Allocation ; Subclavian Vein ; Thorax ; Vena Cava, Superior

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