No abstract available.

A case of 30 years old male with acne conglobata was reported. The skin lesions were characterized by numerous papules, pustules, abscesses, discharging sinuses and resultant hypertrophic scars on the buttocks, back, face, chest, abdomen, neck, and the both extremities. Physical examination shows chronic tonsillitis, caries, and missing of the teeth, and periodontitis. Pus culture shows only coagulase negative Staphylococcus. He was treated with tetracycline, predlnisolone and vitamin B-complex for four weeks with favorable effect.
Abdomen ; Abscess ; Acne Vulgaris* ; Adult ; Buttocks ; Cicatrix, Hypertrophic ; Coagulase ; Extremities ; Humans ; Male ; Neck ; Palatine Tonsil ; Periodontitis ; Physical Examination ; Skin ; Staphylococcus ; Suppuration ; Tetracycline ; Thorax ; Tonsillitis ; Tooth ; Vitamins

OBJECTIVES: To evaluate the effectiveness and the value of Laparoscopic Assisted Vaginal Hysterectomy, and to evaluate the possibility whether to replace abdominal hysterectomy to LAVH. METHOD: A retrospective study of the surgical procedure was performed by one team with one experienced laparoscopist. The operations were carried out in a private hospital, where operative laparoscopic set was available. All 500 patients underwent LAVH from March 1998 to March 1999 at the department of Obstetrics and Gynecology, Eun hospital. Patients were required hysterectomy for uterine fibroid, chronic pelvic pain and carcinoma in situ of cervix,. etc. RESULTS: The average operating time was 56.4+/-11.8 minutes, and the mean estimated postoperative hemoglobin loss was 0.62+/-1.0 g/dL. The mean uterine weight was 223.9+/-129.7 gram (range from 60gram to 800gram). The most common pathologic finding was adenomyosis(59.6%),and the second most pathologic findig was uterine fibroid(47%). No serious complications occured, but 3 vault hematoma cases occured. The combined procedures were salpingoophorectomy, adhesiolysis, and anterior or posterior colporrhaphy, etc. CONCLUSIONS: LAVH that has been possible to replace abdominal hysterectomy, may be valuable for gynecologic uterine diseases, but the experience is important for laparoscopic surgery. The learning curve influences the results of surgery and incidence of complications. Therefore the procedure may only be carried out by experienced laparoscopists, then the maximum value and advantages of laparoscopic surgery can be obtained. Our experience indicates that LAVH is to reduce almost all incidence of abdominal hysterectomy(0.4%)
Carcinoma in Situ ; Cervix Uteri ; Female ; Gynecology ; Hematoma ; Hospitals, Private ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Incidence ; Laparoscopy ; Learning Curve ; Leiomyoma ; Obstetrics ; Pelvic Pain ; Retrospective Studies ; Uterine Diseases

Unstable Colles' fractures have an inherent capacity for loss of reduction or shortening, or both. The istability can be recognized by the presence of much comminution, severe dorsal angulation(20 degrees or more), or extensive intra-articular involvement. It is difficult to align the fracture fragments and to maintain the reduction. In twenty-nine patients with unstable Colles' fracture from Jan. 1982 to Mar. 1984, several invasive methods were used. The results were as follows: 1. Among 147 patients with Colles' fractures 29 patients(19.7%) had unstable fractures. 2. Colles' fracture was occurred more frequently in women(77%) and in 6th and 7th decades(56%). Unstable fractures showed no significant age and sex related propencity. 3. Mechanism of injury caused unstable Colles' fractures were fall on the outstretched hand(25 patients), traffic accident(3 patients) and crushing injury(1 patient). Open fractures were shown in 4 patients among the unstable fractures. 4. Most of the unstable fractures were comprised of type VII and VIII(49%) but type I and II fractures with marked comminution or displacement also showed instability. 5. Complications were such as, redisplacement of the fractures, temporary neuropathy of the median nerve, compartment syndrome, Sudeck's atrophy, and shoulder-hand syndrome. 6. Overall assessments showed excellent in 4 patients, good in 16 patients, fair in 7 patients and poor in 2 patients. 7. Overall results were mainly correlated with initial severity of the injury and anatomical restoration of the fractures.
Atrophy ; Colles' Fracture ; Compartment Syndromes ; Fractures, Open ; Humans ; Median Nerve ; Radius ; Reflex Sympathetic Dystrophy

This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

Bone grafts are used in the repair of segmental bone loss caused by severe trauma, bone tumors and infection, and to enhance bone healing in ununited fractures. Autograft is the most frequently used and the most effective method, but because of inadquate supply and additional operative morbidity, allograft or heterograft could be used. Heterograft has been shown to be poorly tolerated by the host and ineffective in providing an osteogenic system. The objective of this study is to observe healing process of a segmental defect of long bone following to heterograft, and to compare the difference of histologic process between autograft and hetero graft. Twenty-four white rabbits weighing 1,000 to 2,000 grams were used for the experiment. A segment measuring three times the diameter of the ulna shaft (1.5 to 2cm) of rabbit was resected with its periosteum. Twenty-four white rabbit were divided into three groups (control, autograft, heterograft group) according to graft methods, each group comprising of eight rabbits. The animals were sacrificed at 2, 4, 8 and 12 weeks after the experimental procedures and were periodically evaluated by radiographs and histology. The obtained results were as follows: 1. The results of the radiological evaluation showed that no ungrafted ulnar defects (control group) healed. In the heterograft group, partial union was observed from 8 weeks and complete union was obtained on 12 weeks. In the autograft group, partial union was observed on 2 weeks and complete union was obtained on 4 weeks. 2. The results from histological examination showed that the ungrafted ulnae did not heal across the defect but some immature trabeculae were founded on the edges of the defect. In the heterograft group, immature trabeculae were appeared from 4 weeks and defects were substituted with mature trabeculae on 12 weeks. In autograft group, defects were substituted with immature trabeculae on 2 weeks and with mature trabeculae on 4 weeks. As seen in the results of the experiment, union could be obtained with the heterograft, but needed more long time than autograft. Though the autograft is the most effective graft method in bone defect or non-union, above results suggest the heterograft as the alternative method in the treatment of large bone defect, in a multioperated patient, or in the children or the elderly, combined with autograft or alone.
Aged ; Allografts ; Animals ; Autografts ; Child ; Fractures, Ununited ; Heterografts* ; Humans ; Periosteum ; Rabbits* ; Transplants ; Ulna

In general. femoral neck fracture in young adult presents poor prognosis due to the high velocity injury, high angle shear fracture, and poor candidate for arthroplasty. In addition to the relative rarity of the injury, the high incidence of aseptic necrosis and nonunion have been reported in the management of these fractures. 25 cases of femoral neck fracture in young adult were treated with multiple pinning and analyzed at Sung-Ae general hospital from 1987 to 1994 after 28 months follow up in average with review of charts, X-ray and clinical result. There were 18 male and 7 female, 5 cases of them had significant polytrauma to other organs or skeletal system, authors tried to treat them as soon as possible to decrease the interval time between fracture and fixation (the average time was 39.7 hours.) Union occurred in all of Garden stage I (4 cases) and II (4 cases), but in Garden stage III (7 among 8 cases) and IV (7 among 9 cases) the union rate was lower. Average union time was 16.5 weeks. The incidence of complications (12%, 3 among 25 cases) was higher in displaced fractures group (Garden stage III, IV) and also in poorly reduced group of Garden’s alignment index. In conclusion, the prognosis of femoral neck fractures in young adult was related with mainly initial reduction and rigid fixation than the initial injury.
Agriculture ; Arthroplasty ; Female ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Male ; Multiple Trauma ; Necrosis ; Prognosis ; Young Adult

No abstract available.
Appendicitis* ; Child* ; Humans

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilator techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilator techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of PaCO₂ during the manually controlled ventilation, 29.9±2.0 mmHg was decreased statistically comparing with that of PaCO₂ before the anesthesia, 39.8±2.8 mmHg. 2) Mean values of pH and HCO₃⁻ during the manually controlled ventilation were 7.48±0.03, 22.2±2.4 mEq/1, respectively and values before the anesthesia were 7.41±0.02, 25.2±1.8 mEq/1, respectively. 3) Mean value of PaO₂ and O₂ saturation during the manually controlled ventilation were 270.0±28.8 mmHg, 99.6±0.2%, respectively and values before the anesthesia were 92.5±4.0 mmHg, 96.9±1.0%, respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.
Anesthesia ; Anesthesia, General* ; Anesthesiology ; Cerebrovascular Circulation ; Hydrogen-Ion Concentration ; Pulmonary Gas Exchange ; Ventilation* ; Ventilators, Mechanical