No abstract available.
Cutaneous Fistula ; Fistula*

A clinical study was done on 42 cases of inpatients, who had been admitted for foreign body aspiration form January 1979 to June 1992. We obtained the following results by analysing the records of their treatment during that time. 1) 31(73.8%) of these cases were below the age of 3 years. 25(59.4%) were below the age of 2. The ratio of male to female was 2:1 2) In 23 cases(54.8%) onset of the symptoms and diagnosis was less than 24 hours after aspiration. 3) Most of the cases(83.3%) had a history of foreign body aspiration; 7 other cases did not. 4) The most common symptoms of bronchial foreign bodies were cough, dyspnea and fever, whereas those of laryngotracheal foreign bodies were dyspnea and cough, in that order. 5) Common complications were obstructive emphysema, pneumonia and atelectasis, in that order. These complications were observed more frequently in the cases of vegetable foreign bodies. 6) Chest X-ray at the time of admission showed obstructive emphysema (42.9%) and pneumonia(40.5%). 11 cases(26.2%) were normal. 7) The most comon site of foreign body enlodgement was the right main bronchus(38.1%), and 4 cases(9.5%) were discovered in other bronchial sites. 8) Vegetable foreign bodies occupied 54.8% of the cases, peanuts being the most common.
Arachis ; Child* ; Cough ; Diagnosis ; Dyspnea ; Emphysema ; Female ; Fever ; Foreign Bodies* ; Humans ; Infant* ; Inpatients ; Male ; Pneumonia ; Pulmonary Atelectasis ; Thorax ; Vegetables

To dtermine the optimal timing for Aortic Valve Replacement in patients of aortic insufficiency is very important, because irreversible myocardial damage can result before symtoms such as dyspnea, syncope and chest pain, appear for the first time. Henry suggested that the echocardiographic index of left ventricular end systolic dimension 55mm could be useful as an indicator of whether to operate or not. But Fioretti, et al., insisted that there was no significant difference postoperatively between those below 55mm and those over 55mm. To determine whether a left ventricular end systolic dimension greater than 55mm is one of the risk factors for AVR in patients with aortic insufficiency, we analyzed the serial echocardiographic examinations of 23 patients who underwent AVR for isolated AI. Group I patients (n=17) had a preoperative left ventricular end systolic dimension less than or equal to 55mm and Group II patients (n=6) had a preoperative left ventricular end systolic dimension greater than than 55mm. 1) left ventricular end systolic dimension decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 modths after operation. 2) Left ventricular end diastolic dimension also decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 months after operation. 3) Ejection Fraction was decreased markedly just postoperatively, but it was recovered soon in both groups, and there was no statistically significant differences of the ejection fractions between the two groups postoperatively. 4) SV1+/-RV6 in EKG, as an indicator of LV mass, was also analzed and it revealed significant reduction in both groups postoperatively, but we could not observe statistically significant differences between the two groups from 6 months after the operation. We concluded that the preoperative left ventricular end systolic dimension 55mm could be useful as an index to predict postoperative prognosis and to determine the timing of aortic valve replacement.
Aortic Valve* ; Chest Pain ; Dyspnea ; Echocardiography* ; Electrocardiography ; Humans ; Prognosis ; Risk Factors ; Syncope

The principles determining the primary localization of lesions in fixed drug eruption (FDE) are still unknown. Studies investigating the predilection areas in FDE have indicated drug-related, trauma-related, or inflammation-related specific site involvement, as well as visceracutaneous reflex-related specific site involvement. The importance of viscerocutaneous reflexes for the location of dermatoses was first recognized in the 1960s. Head's zones are viscerocutaneous reflex projection fields on the skin that extend over certain dermatomes and possess a reflex-associated maximal point. Recently, in a Turkish collective of patients, three women with the primary location of FDE lesions on the maximal points of Head's zones were presented. We also experienced 3 cases with FDE where the lesions were located at specific sites (buttocks), the so-called maximal points of Head's zones, which are known to be the most active dermatomal areas of an underlying visceral pathology. An underlying internal disturbance (ureter stone, pyelonephritis and chronic pelvic inflammatory disease) was found in all 3 patients, corresponding to the organ-related maximal point of Head's zones in each case. In conclusion, the primary location of FDE lesions on the maximal points of Head's zones revealed relevant organ disorders with corresponding projection fields.
Drug Eruptions ; Female ; Humans ; Pyelonephritis ; Reflex ; Skin ; Skin Diseases

A five-year-old boy received a blunt trauma on chest by a kindergarten bus on Feb. 29, 1996. Pulmonary hemorrhage and pericardiac effusion were developed, followed by multi-organ failure threatening his life. All symptoms were improving when pansystolic harsh murmur (III/IV) originating from a tiny ventricular rupture with a blood leak to the pericardial space was auscultated on the 12th day after the trauma. This murmur disappeared with the left ventricular healing and progressive aneurysmatic formation. Howeve, on the 61st day after the trauma a continuous murmur (II/III) of aortic dissecting aneurysm on the left upper sternal border and dorsum was newly auscultated. Two-dimensional color doppler echocardiogram and aortogram by femoral artery catheterization revealed aneurysmatic dilatations of both the left ventricular free wall and descending aorta immediately after the origin of the subclavian artery with mild mitral regugitation. The patient underwent successful corrective surgery.
Aneurysm* ; Aneurysm, Dissecting ; Aorta, Thoracic* ; Automobiles* ; Catheterization ; Catheters ; Dilatation ; Femoral Artery ; Heart Ventricles* ; Hemorrhage ; Humans ; Male ; Rupture ; Subclavian Artery ; Thorax

BACKGROUND: Although oxycodone has been known to be superior to other opioids in postoperative care, few studies have compared its analgesic potency with that of fentanyl. We therefore examined these two drugs in terms of their dose requirements, effects on pain intensity, time needed for relief of pain, and side effects after surgery. METHODS: We enrolled 56 healthy women scheduled for total abdominal hysterectomy and randomly allocated them to either oxycodone or fentanyl. The opioids were administered to the two groups 10 minutes before the end of the operation. In the post-anesthesia care unit (PACU) after surgery, a visual analog scale (VAS) was used to assess the patients' pain every 10 minutes Whenever pain control was required, a bolus of the same dose of the respective drugs was repeated at 10-minute intervals. Patient-controlled analgesia (PCA) was used to manage postoperative pain. After the patient arrived on the ward, pain scores were recorded at once and then 1, 2, 3, and 24 hours thereafter. RESULTS: During the hour spent in the PACU, fewer patients in the oxycodone group required the opioid, and the time needed to achieve pain relief was shorter with oxycodone than with fentanyl. Moreover, postoperative VAS levels were significantly lower in the oxycodone group both in the PACU and on the ward (over a 24-hours period). There were no significant differences in side effects between the patients given oxycodone and those given fentanyl. CONCLUSIONS: Oxycodone was more effective than fentanyl when administered on the basis of the recommended dose ratio (1 : 100). Although further evaluation is needed to investigate the optimal dose ratio, we would recommend a higher conversion factor (1 : 62).
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics, Opioid ; Female ; Fentanyl* ; Humans ; Hysterectomy* ; Oxycodone* ; Pain, Postoperative* ; Postoperative Care ; Visual Analog Scale

An apocrine hydrocystoma is a translucent cystic nodule that looks like adenomatous cystic proliferation of an apocrine gland, which originated from a hair germ. Dermoid cyst is a cystic teratoma that contains developmentally mature skin appendages, such as hair follicles, sweat glands, and other tissues derived from the ectoderm. Many investigators believe that dermoid cysts re originated from the ectoderm, specifically the hair germ cells. A 58-year-old woman was presented with a purple, asymptomatic, dome-shaped nodule on her right lower eyelid that had been slowly increasing in size for several years. Histopathological examination revealed two well-demarcated cysts: one was lined with stratified squamous epithelium with mature hair and sebaceous glands and the other contained large cystic spaces, which papillary projections extended. We report a rare case of a dermoid cyst, combined with an apocrine hydrocystoma, occurring in the right lower eyelid.
Apocrine Glands ; Dermoid Cyst ; Ectoderm ; Epithelium ; Eyelids ; Female ; Germ Cells ; Hair ; Hair Follicle ; Humans ; Middle Aged ; Research Personnel ; Sebaceous Glands ; Skin ; Sweat Glands ; Teratoma

To find out the different cognition of the members of medical school about the importance of graduate outcomes such as 'clinical performance, communication, supporting patients, professionalism, problem solving and research, self-development', a survey applied with self-report method was conducted with 110 faculties, 132 students (71 premedical 2nd graders and 61 medical 2nd graders), and 30 parents about graduate outcomes and sub-outcome competences. Parents usually thought highly of the importance of graduate outcomes, while medical second graders comparatively regarded them as less important. Among graduate outcomes, 'clinical performance' was definitely considered the most important and was followed by 'communication'. As for 'self-development', parents and premedical 2nd graders regarded it as important, while faculty and medical 2nd graders had lower awareness about its importance. As to the suboutcome competences, faculty generally had lower awareness about their importance compared to students and parents.
Cognition ; Humans ; Methods ; Parents* ; Problem Solving ; Professionalism ; Schools, Medical*

Ectopic ossification refers to the process of new bone formation in sites that normally do not ossify. The auricle is composed of elastic cartilage, and hence is a pliable structure. Auricular ossification is a rare condition that might be caused by injurious processes, including frostbite, physical trauma, and inflammation as well as processes related to metabolic or endocrine disorders. Here, we report a case of unilateral auricular ossification in a 53-year-old Korean man who had previously rubbed his ear repeatedly with his hand.
Cartilage ; Ear ; Elastic Cartilage ; Frostbite ; Hand ; Humans ; Inflammation ; Middle Aged ; Ossification, Heterotopic ; Osteogenesis

Cerebral Venous Sinus Thrombosis (CVST) in children is rare and its cause is multifactorial. The clinical manifestations of CVST vary and may cause long-term neurological sequelae and even death on rare occasion. In this case, a 15 year old boy presented with severe headache and vomiting for 1 day. Brain MRI with venography revealed multiple lesions of CVST in superior sagittal sinus and the left transverse sinus. Anticoagulation therapy was performed for 3 months, which led to the complete resolution in superior sagittal sinus and partial resolution in left transverse sinus.
Adolescent ; Brain ; Child ; Headache ; Humans ; Phlebography ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus ; Vomiting