The treatment of extensive soft tissue injury is a chsllenge to Orthopedidic Surgeon especially in young children and at present reconstructive surgery with free flap is being employed under microscopy actively. The author present 27 cases of free flaps in young children below 6 years old, which were performed from March 1983 to December 1986. The results are as followes ; 1. The mean age was 4.9 years old. 2. The mechanism of injuries were all pedestrian injury. 3. We performed 27 cases of free flaps, among them 24 cases of flap were survived(88.9 %) with good functional and cosmetic result. 4. The vessels were larger in these young children than we expected. It is apparent that in a healthy child even though below 6 years old, the careful application of microsurgical principle is an excellent method for salvaging devascularized parts that are vital for function or appearance.
Child ; Clinical Study ; Free Tissue Flaps ; Humans ; Methods ; Microscopy ; Soft Tissue Injuries

No abstract available.
Extremities* ; Ilizarov Technique*

The anthelminthic effect of phenylene-diisothiocyanate-(1,4)(=Jonit) was studied on the eighty three cases infected with Ancylostoma duodenale. For the evalution, the number of eggs per gram of feces on all these cases was calculated before treatment. The follow-up for the egg reduction was carried out over a period of four weeks. The sixty-seven cases were treated in dosage schedule of 3 x 100 mg every 12 hours. The cure rates - the rate of negative conversion of eggs - was 74.6 percent and the total egg reduction rate of 94.2% was obtained. The ten out of 14 cases treated in the dosage schedule of 2 x 100 mg every 12 hours showed 100% egg reduction and the cure rate was 71.4%. In this group. the total egg reduction rate of 78.6% was noted. In the dosage schedule of 2 x 50 mg every 12 hours the remainder, two out of total 83 cases showed 100% egg reduction. Side effects were observed as being mild, 51 cases (56.6%) were free of side reactions and the most frequently noted side effects were vertigo and diarrhea. From the above results, it is concluded that Jonit is an effective antheminthic against Ancylostoma duodenale and its effectiveness is quite equivalent to that of a known recommended anti-hookworm products.
parasitology-helminth-nematoda ; Ancylostoma duodenale ; chemotherapy ; phenylene-diisothiocyanate ; Jonit

PURPOSE: We investigated the effect of 100-year-old mountain ginseng(Panax ginseng C.A. Meyer, PG-CAM) extract on patients with erectile dysfunction(ED). MATERIALS AND METHODS: A total of 35 patients with ED(23 patients in PG-CAM administration group, 12 in placebo group) were enrolled in this double-blind study. The drug was administered for 12 weeks. Before and after administration, patients took the self-administered IIEF-5 questionnaire and were tested for serum hormone levels(testosterone, LH, FSH, estradiol), complete blood count, liver and renal function test, and urinalysis. RESULTS: The IIEF-5 scores for the placebo group were 19.7+/-2.3 and 19.9+/-3.6 before and after treatment, respectively. For all patients taking PG-CAM, IIEF-5 scores increased 18.1+/-5.6 to 20.2+/-4.5. For those patients with initial scores below 17, IIEF-5 scores increased from 12.4+/-6.2 to 19.7+/-6.7. These results indicate that PG-CAM may increase erectile function in ED patients, particularly those with poor erection. No changes were detected in hormonal levels or blood tests. No toxic side effect were reported. CONCLUSIONS: IIEF-5 score improved significantly in ED patients treated with PG-CAM, suggesting that PG-CAM extract could be a treatment candidates for ED.
Blood Cell Count ; Double-Blind Method ; Erectile Dysfunction* ; Hematologic Tests ; Humans ; Liver ; Male ; Panax* ; Penis ; Surveys and Questionnaires ; Urinalysis

PURPOSE: We investigated the effect of 100-year-old mountain ginseng(Panax ginseng C.A. Meyer, PG-CAM) extract on patients with erectile dysfunction(ED). MATERIALS AND METHODS: A total of 35 patients with ED(23 patients in PG-CAM administration group, 12 in placebo group) were enrolled in this double-blind study. The drug was administered for 12 weeks. Before and after administration, patients took the self-administered IIEF-5 questionnaire and were tested for serum hormone levels(testosterone, LH, FSH, estradiol), complete blood count, liver and renal function test, and urinalysis. RESULTS: The IIEF-5 scores for the placebo group were 19.7+/-2.3 and 19.9+/-3.6 before and after treatment, respectively. For all patients taking PG-CAM, IIEF-5 scores increased 18.1+/-5.6 to 20.2+/-4.5. For those patients with initial scores below 17, IIEF-5 scores increased from 12.4+/-6.2 to 19.7+/-6.7. These results indicate that PG-CAM may increase erectile function in ED patients, particularly those with poor erection. No changes were detected in hormonal levels or blood tests. No toxic side effect were reported. CONCLUSIONS: IIEF-5 score improved significantly in ED patients treated with PG-CAM, suggesting that PG-CAM extract could be a treatment candidates for ED.
Blood Cell Count ; Double-Blind Method ; Erectile Dysfunction* ; Hematologic Tests ; Humans ; Liver ; Male ; Panax* ; Penis ; Surveys and Questionnaires ; Urinalysis

BACKGROUND: Although stress-induced cardiomyopathy (SCMP) is reported to be more common in women, little is known about gender differences in patients with SCMP. The aim of the study was to describe clinical features of patients with SCMP according to gender. METHODS: One hundred and three patients diagnosed with definite SCMP at a single tertiary institute from January 1997 to August 2014 were enrolled. SCMP was more common in women than in men. RESULTS: Age at presentation was not significantly different between the two groups (p = 0.758). Preceding physical stress, especially acute medical illness, was more common in male patients (p = 0.014), whereas emotional stress was more common in female patients (p = 0.016). Severity of medical illness classified by the Acute Physiology and Chronic Health Evaluation (APACHE) II score at the time of SCMP diagnosis was not significantly different between men and women (p = 0.752). Clinical characteristics, including symptoms, laboratory and electrocardiographic findings, were similar. However, pump failure was more severe in men (p = 0.024). Clinical outcomes were not statistically different (p = 0.220). Preceding physical stress and lower left ventricular systolic function after 2 months were independent risk factors for all-cause mortality for both genders. Women with an APACHE II score ≥ 15 and men with reduced left ventricular ejection fraction after 2 months had a greater risk of poor prognosis. CONCLUSION: SCMP was more common in female patients. Female patients more commonly experienced preceding emotional stress, whereas physical stress was more common in male patients. Systolic dysfunction was more severe in men. Long-term clinical outcomes appeared to be similar between men and women.
APACHE ; Cardiomyopathies* ; Diagnosis ; Electrocardiography ; Female ; Humans ; Male ; Mortality ; Prognosis ; Risk Factors ; Stress, Psychological ; Stroke Volume

PURPOSE: It is very important to differentiate breast cancer from benign mass. There are many reports to evaluate the differential diagnosis under the several diagnostic tools. We evaluated the usefulness of mammography and Tc-99m MIBI scintimammography in the differential diagnosis of breast mass and correlated with pathologic findings. MATERIALS AND METHODS: This study included 80 patients (age: 24-72, mean: 48.4) who underwent mammography and Tc-99m MIBI scintimammography for breast masses. Scintimammographies (anterior-posterior and lateral projections) were acquired in 10 minutes and 2 hours after intravenous injection of Tc-99m MIBI. Four specialists in diagnostic radiology and nuclear medicine evaluated the findings of breast masses under the mammography and Tc-99m MIBI scintimammography, and calculated the tumor to background (T/B) ratio. The pathologic results were obtained and we statistically analyzed the correlations between pathologic results and imaging findings under the mammography and Tc-99m MIBI scintimammography by chi-square and correlation test. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of mammography for detection of breast cancer were 87.5%, 56.3%, 75.0%, and 75.0% respectively. 45 cases of 80 patients were suspicious for breast cancer under the Tc-99m MIBI scintimammography. 41 cases of 45 patients were confirmed as breast cancer and the remaining 4 cases were confirmed as benign masses. The sensitivity, specificity, positive predictive value and negative predictive value of Tc-99m MIBI scintimammography for detection of breast cancer were 85.4%, 87.5%, 91.1%, and 80.8% respectively. The sensitivity of scintimammography was lower than that of mammography for detection of breast cancer, however the specificity, positive predictive value, and negative predictive value were higher. In the benign mass, the mean T/B ratio in 10 minutes was 1.409 +/- 0.30, and that in 2 hours was 1.267 +/- 0.42. The maximal T/B ratio of benign mass in 10 minutes was 1.604 +/- 0.42, and that in 2 hours was 1.476 +/- 0.50. In the malignant mass, the mean T/B ratio in 10 minutes was 2.220 +/- 1.07, and that in 2 hours was 1.842 +/- 0.75. The maximal T/B ratio of malignant mass was 2.993 +/- 1.94, and that in 2 hours was 2.480 +/- 1.34. And the T/B ratio under the early and delayed images were meaningful. CONCLUSION: The scintimammography is useful diagnostic tool to differentiate breast cancer from benign mass, although the sensitivity of mammography for detection of breast mass is high. Especially, the use of the T/B ratio is helpful to diagnose breast cancer.
Breast Neoplasms* ; Breast* ; Diagnosis, Differential* ; Humans ; Injections, Intravenous ; Mammography* ; Nuclear Medicine ; Sensitivity and Specificity ; Specialization

The impact of treatment delays to reperfusion on patient mortality after primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) is controversial. We analyzed 5,069 patients included in the Korea Acute Myocardial Infarction Registry (KAMIR) between November 2005 and January 2007. We selected 1,416 patients who presented within 12 hr of symptom onset and who were treated with primary PCI. The overall mortality at one month was 4.4%. The medians of door-to-balloon time, symptom onset-to-balloon time, and symptom onset-to-door time were 90 (interquartile range, 65-136), 274 (185-442), and 163 min (90-285), respectively. One-month mortality was not increased significantly with any increasing delay in door-to-balloon time (4.3% for < or =90 min, 4.4% for >90 min; p=0.94), symptom onset-to-balloon time (3.9% for < or =240 min, 4.8% for >240 min; p=0.41), and symptom onset-to-door time (3.3% for < or =120 min, 5.0% for >120 min; p=0.13). These time variables had no impact on one-month mortality in any subgroup. Thus, this first nationwide registry data in Korea showed a good result of primary PCI, and the patient prognosis may not depend on the initial treatment delay using the current protocols.
Aged ; Angioplasty, Transluminal, Percutaneous Coronary/*mortality ; Cohort Studies ; Female ; Humans ; Kaplan-Meiers Estimate ; Korea/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/*mortality/*therapy ; Predictive Value of Tests ; Registries/statistics & numerical data ; Time Factors

OBJECTIVES: The coagulation and fibrinolytic system appears to be activated by the septic process independently, leading to the syndrome of disseminated intravascular coagulation (DIC). In this study, we investigated the changes within the hemostatic system related to the severity of the illness and the prognosis in patients with sepsis. METHODS: Plasma thrombin-antithrombin III (TAT) and plasmin-alpha 2-antiplasmin (PAP) complexes were measured using ELISA methods in 32 patients with sepsis and 20 controls and were analyzed according to the APACHE III scores and survival of the patients. RESULTS: Plasma TAT and PAP in patients with sepsis were significantly higher than controls. Nonsurvivors showed greater levels of TAT (21.7 +/- 22.3 ng/mL) and lower levels of PAP (628.4 +/- 378.1 ng/mL) than survivors (TAT: 11.1 +/- 11.2 ng/mL; PAP: 857.1 +/- 364.1 ng/mL). The imbalance between coagulation and fibrinolysis described as TAT/PAP ratio was closely related with APACHE III scores in patients with sepsis (r = 0.47) and the TAT/PAP ratio in nonsurvivors was significantly higher compared with survivors (34.4 +/- 21.4 vs. 14.4 +/- 13.8). CONCLUSION: In sepsis, both coagulation and the fibrinolysis system are activated and the imbalance between coagulation and fibrinolysis predisposes to the hypercoagulation state and is closely related to the severity of the disease and the prognosis.
Adult ; Aged ; Antiplasmin/metabolism ; Antithrombin III/metabolism ; Blood Coagulation* ; Case-Control Studies ; Female ; Fibrinolysis* ; Human ; Male ; Middle Age ; Plasmin/metabolism ; Prognosis ; Sepsis/blood* ; Thrombin/metabolism

Korean ginseng and mountain ginseng (Panax ginseng CA Meyer) are important traditional herbal plants whose ginsenosides are generally accepted as serving to improve sexual functions, such as penile erection. We investigated the effects of tissue-cultured mountain ginseng extract (TMGE) on male patients with erectile dysfunction (ED). A double-blind, placebo-controlled study was conducted with 143 patients experiencing ED. Over the course of 8 weeks, one group took 1 000 mg of TMGE twice a day, and the other group took 1,000 mg of placebo twice a day. The effects of the TMGE and the placebo were analyzed using the Korean version of the International Index of Erectile Function (IIEF) questionnaire. A total of 86 patients completed 8 weeks of treatment. The scores on the five domains of the IIEF after medication were significantly higher than the baseline scores in the group treated with TMGE (P<0.05), whereas no significant improvement was observed in the placebo group (P>0.05). Erectile function and overall satisfaction scores after medication were significantly higher in the TMGE group than in the placebo group (P<0.05). Erectile function of patients in the TMGE-treated group significantly improved, suggesting that TMGE could be utilized for improving erectile function in male patients.
Adult ; Aged ; Bioreactors ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Panax ; growth & development ; Patient Dropouts ; Patient Satisfaction ; Phytotherapy ; methods ; Plant Extracts ; therapeutic use ; Plant Roots ; cytology ; growth & development ; Treatment Outcome