Blunt chest trauma to the heart may produce instantaneous death or, more frequently, congestive heart failure due to myocardial injury or disruption of intracardiac structures. Cardiac injury following by blunt chest trauma is often unsuspected and can range from cardiac contusion to chamber rupture, or to valvular dysfunction. The rate of occurrence of acute traumatic valvular insufficiency is extremely rare. Especially, the tricuspid valve is very rarely injured. Although clinical diagnosis of acute traumatic valvular insufficiency can be difficult to make for trauma patients with multiple injuries, echocardiography can establish diagnosis quickly and accurately. This report describes a patient who developed tricuspid regurgitation and acute heart failure following by an MCV.
Contusions ; Diagnosis ; Echocardiography ; Heart ; Heart Failure ; Humans ; Multiple Trauma ; Rupture ; Thorax* ; Tricuspid Valve ; Tricuspid Valve Insufficiency*

BACKGROUND: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. METHODS: Forty-three patients (mean age, 75.0 ± 5.2 years) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. RESULTS: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. CONCLUSIONS: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.
Arthroplasty* ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Shoulder* ; Surgeons ; Tears

Glutathione S-Tanaferase (GST) is tripeptide, which plays a central role in the detoxification of electrophilic xenobioticas, including cytotoxic drugs and carcinogens, by conjugation with redueed glutathione. There are four major claases af human GST : pi, alpha, mu and rnicrosomal, They are propoaed as a marker for human and experimental neoplasia iincluding liver, kidney, lung,colon, uterine cervix, etc. Expression of pi, alphn, mu form of GST in control (15 cases), CIN (14 cases), invasive carcinoma (28 cases) of human uterine cervix was investigated immunohistochemically. They were selected fram September, 1992, to,June, 1992, in the department of Obstetrics and Gynecology, Yonsei university College of medicine. In nucleus, the expresaion of GST pi was increased statistically significant in case of CIN and invasive Ca. of Cx. compared to control(p=0.018, p=0.002). But expression of GST alpha, mu has no significant difference in each case. In cytoplasms, the expvession of GST pi was increased statistically significani, in case of CIN and invasive Ca. of Cx. (p=0.001, p<0.001). But expreasion of GST alpha, mu has no significant differenrce in each case. There was no statistically significant diHerence in expression of GST isoenzymes oC each nucleua and cytoplasm according to stage and cell type in Ca. oC Cx. The further evaluation of survival and expression of GST pi in Ca. of Cx. in order to establish new prognostic factor in Ca. of Cx.
Carcinogens ; Cervix Uteri* ; Cytoplasm ; Female ; Glutathione Transferase* ; Glutathione* ; Gynecology ; Humans ; Isoenzymes* ; Kidney ; Liver ; Obstetrics

Tetanus is a rare disease in the developed countries, including Korea, as a result of nearly universal active immunization. Because many physicians have little experience with its diagnosis and management, misdiagnosis and therapeutic delay may result in catastrophic consequences. We report one case of generalized tetanus. A previously healthy 35-year-old man was admitted to the emergency department because of stiffness on jaw and neck. board-like abdomen, extended and rigid both legs, chest tightness, and dyspnea. Seven days before admission, he was injured on the right thing at work. In the emergency department, he was given 5,000 units of human tetanus immunoglobulin intramuscularly, as well as diazepam 2 mg/hr intravenously. On the second hospital day, tracheostomy was performed. Ten days later, his condition was improved. Twenty eight days after admission, he was discharged without any complication.
Abdomen ; Adult ; Developed Countries ; Diagnosis ; Diagnostic Errors ; Diazepam ; Dyspnea ; Emergency Service, Hospital ; Humans ; Immunoglobulins ; Jaw ; Korea ; Leg ; Neck ; Rare Diseases ; Tetanus* ; Thorax ; Tracheostomy ; Vaccination

BACKGROUND: The improved technique for cardiopulmonary resuscitation(CPR) has resulted in the survival of many patient who experienced cardiac arrest. However, mortality in resuscitated patients is high, and the survival rate without brain damage is very low. Various neurological examination models, neuro-imaging techniques, electrophysiological procedures, and biochemical tests have been studied with respect to the detection of cerebral damage and outcome, but an early, reliable prediction of individual outcomes is still uncertain. METHODS: We studied twenty patient who had been in a coma for more than 24 hours after CPR, Somatosensory evoked potentials(SEP) were measured within the first three days after CPR. RESULTS: Of the twenty patients, seven patients(35%) had a good outcome, and thirteen patients(65%) had a bad outcome. Of the eleven patients with loss of the cortical evoked potential's N20 peak, all had a bad outcome. CONCLUSION: SEPs are of great benefit in prognostic evaluation after CPR.
Brain ; Cardiopulmonary Resuscitation* ; Coma* ; Evoked Potentials, Somatosensory* ; Heart Arrest ; Humans ; Mortality ; Neurologic Examination ; Survival Rate

PURPOSE: To evaluate the prevalence of the opacification of paranasal sinuses and to correlate the prevalence and severity of the sinus opacification with presence of upper respiratory infection (URI) in infants and children using CT. MATERIALS & METHODS: We analyzed CT scans of 162 children aged under 16 who have no signs and symptoms of paranasal sinusitis. Both sides of maxillary and ethmoidal sinuses were evaluated. We scored from 0 to 3 according to the degree of soft tissue opacification of each sinus and then summed up the scores of each sinus. We divided the children into 5 groups according to their age. We paid particular attention to the following respects: 1) the prevalence of the opacification of the paranasal sinuses in each group; 2) the difference in the prevalence between the children with and without URI ;3) the correlation between the severity of the sinus opacification and the presence of URI. RESULTS: Of 162 children, one or more paranasal sinus opacification was noted in 76(47 %):31(65%) less than 1 year old;11(52%) between 1 and 2 years old;16(53%) between 2 and 6 years old ;15(28%) between 6 and 12 years old;and 3(33%) above 12 years old. In children less than 1 year old, no significant difference in the prevalence of the sinus opacification was found between URI-positive(71%) and URI-negative(58%) subgroups. In chilren between 1 and 12 years old, although the prevalence of the sinus opacification in URI-positive subgroups was much greater than that in URI-negative subgroup, statistically significant difference was noted only in children between 2 and 6 years old. As to the correlation between the severity of the sinus opacification and the presence of URI, these was a statistically significant difference in children between 2 and 6 years old and between 6 and 12 years old. CONCLUSION: Although the exact pathophysiology is not fully understood, the opacification of the paranasal sinuses is not an uncommon finding at CT in children without the signs and symptoms of sinusitis. We think that the clinical correlation is essential in determining the diagnosis and treatment plan in cases that the sinus radiographs or CT scans show the abnormal findings.
Child* ; Diagnosis ; Humans ; Infant* ; Paranasal Sinuses ; Prevalence* ; Sinusitis* ; Tomography, X-Ray Computed

The resin : metal interface is at the basis of most bonding failures in resin-bonded prosthesis. Although debonding has been a problem with adhesive fixed partial dentures, various dentists classify them as long-term restorations. The advantages of resin-bonded fixed partial dentures include minimal tooth reduction and the possibility of rebonding . if resin-bonded protheses can be easily rebounded, it is of clinical importance to know if the lutingagents rebond as well the second time as they did originally. Several retentive systems for resin-to-metal bonding have recommended. Treatments such as electrolytic etching and silicone coating, despite the good result of bond strength, have proved to be time-consuming and technique-sensitive. Therefore a simple and more reliable method is desirable. This study evaluated the effect of metal surface treatments on the rebond strength of panavia 21cement to a nickel-chromium(Ni-Cr) alloy. The samples were received the following surface treatments : Group No.1(control or served as the control) treatment with sandblasting with 50um aluminum oxide and ultrasonically cleaned for 10minutes in double-deionized water, Group No.2 were no surface treatments. Group No.3 were treated with metal primer. Group No.4 were treated with sandblasting as previously described, and then metal priming. From the analysis of the results, the following conclusions were drawn: 1. Sandblasting and metal priming appears to be an effective method for treatment of metal after accidental debonding. 2. Group without surface treatment had significantly lower bond strengths compared with other groups. 3. The combination of sandblasting and metal priming may not develop superior bonding strengths compared with other techniques that used the Ni-Cr alloys. 4. Combination of cohesive and adhesive failures were the most common type observed. The results support the use of sandblasting as a viable procedure when rebonding accidentally lost adhesive partial denture. We concluded that sandblsting and metal priming of metal surface before bonding could provide the adequate bond strength during rebonding of resin-bonded fixed partial denture.
Adhesives ; Alloys ; Aluminum Oxide ; Dentists ; Denture, Partial ; Denture, Partial, Fixed ; Denture, Partial, Fixed, Resin-Bonded ; Humans ; Prostheses and Implants ; Silicones ; Tooth ; Water

In view of the sparsity of report on normal and abnormal pattern of the major arteries during fetal life, the authors undertook investigation of the aortas, coronary arteries, renal arteries, and the umbilical arteries of 76 korean fetuses, ranging from 21/2 months to full-term, A normal pattern and its evolution of the intima, media, and the adventitia was described. The P. A. S. positive substance was most abundantly found in the media of the umbilical arteries, medium amount in the media and intima of the renal arteries and the aortas, and lesser amount in the media of the coronary arteries. A surprisingly high incidence of the alteration of the internal elastic membrane of the aorta simulating to the early lesions of atherosclerosis in adult and neonatal life was observed. In e1even instances, microcystic degeneration of the inner media of the aorta was observed, and its relationship to the idiopathic cystic medial necrosis and dissecting aneurysm was discussed.
Arteries/*embryology ; Arteriosclerosis/*etiology ; Female ; Histocytochemistry ; Human ; Korea ; Pregnancy

No abstract available.
Broad Ligament* ; Female ; Leiomyosarcoma*

The reconstruction of soft tissue defects with open fracture around the knee joint is limited by its unique location. Free tissue transfer is hindered by the selection of the recipient vessel and problems of microsurgery. The arc of rotation, defect size, and location must be taken into consideration in the use of regional muscle transfer such as gastrocnemius. According to Mathes et al, the flap survival can be enhanced by selective division of the dominant segmental pedicles, only a part of which can normally be transposed safely on its minor segmental pedicle. Neovascularization, vascular proliferation, and dilatation have also been produced by the delay procedure using silicone sheets. The authors have used the delay procedures with wrapping of the gracilis or sartorius muscle which enabled distally-based transposition of these muscles. The method showed satisfactory outcome in resurfacing the wound around the knee joint. The indictions for this procedure were defects of moderate size and those difficult to reach with conventional muscle flaps. The flap could reach the upper one-third of the lower leg. Other merits are relative simplicity and reliability without significant extension of hospital stay. The drawbacks are the two operative procedures necessary and the risk of infection due to silicone sheets.
Dilatation ; Fractures, Open ; Knee Joint* ; Knee* ; Leg ; Length of Stay ; Microsurgery ; Muscles ; Silicones ; Surgical Procedures, Operative ; Wounds and Injuries*