One hundred and fifteen thoracolumbar vertebrel fractures Out. of 85 patients were avaluated in this study. In 97 cases out of 65 patients, angular deformity and loss of height of the fractured vertebral bodies were measured, and for 6. 3 months in average follow up study was made in 23 cases out of 18 patients. The angular deformity became increased from 18.4 degrees to 21. 0 degrees wheroas loss of height has also increased from 38.6 to 40.8%, showing little statical value. Incidence was higher in male than in female without seasonal differences. Age incidence ranged from 16 to 78, and most frequent in third and fourth decades. Causes of injury were industrial accident, traffic accident, home accident and fall from height. Location of injury was mainly twelfth thoracic and first lumbar vertebrae. As associated injury, fracture of the rib, ulna, malleolus and calcaneus in order. Conservative treatment was a method of choice, while operstive treatment was performed in 7%.
Accidents, Home ; Accidents, Occupational ; Accidents, Traffic ; Calcaneus ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lumbar Vertebrae ; Male ; Methods ; Ribs ; Seasons ; Ulna

This is to present the clinical analysis of 197 (165 Patients) open fractures of long bones which were treated at Han Gang Sacred Heart Hospital from December 1971 June 1975. The results obtained as follows: 1. The causes of injury were traffic accident 91, industrial accident 63, home acident 8 and other 3. 2. In this study, there were 139 males and 26 females. The main age incidence ranged 11–40 years. 3. Among the 197 cases, Tibia and fibula were affected mostly(54.8%) 4. Associated injuries included closed fracture of long bone 35, cerebral contusion 15, skull fracture 10, maxillofascial inury 9, joint dislocation 6 and other 21. 5. The method of treatment was chiefly debridement and primary closure of open wound with 16 internal fixation, followed by cast immobilization 161, skeletal traction 15 and pin & plaster. 5. 6. Consequent incidence of infection was 10.7% (deep 5.1%, superficial 5.6%) 7. The causative strains were coliform bacillus 28, pseudomonas 16, staphylococcus 6, streptococcus 1, and bacillus subtilis 1, 8. Death occured in 3 cases: the causes were sepsis due to pseudomonas 2 and anuria due to renal shut down 1.
Accidents, Occupational ; Accidents, Traffic ; Anuria ; Bacillus ; Bacillus subtilis ; Contusions ; Debridement ; Dislocations ; Female ; Fibula ; Fractures, Closed ; Fractures, Open ; Heart ; Humans ; Immobilization ; Incidence ; Joints ; Male ; Methods ; Pseudomonas ; Sepsis ; Skull Fractures ; Staphylococcus ; Streptococcus ; Tibia ; Traction ; Wounds and Injuries

BACKGROUND: Adenocarcinoma of the esophagus has been reported to be increasing in incidence in a number of regions throughout the world, while the incidence of squamous cell carcinoma (SCCA) of the esophagus is mostly stable or decreasing. To evaluate the increasing tendency of adenocarcinoma of the esophagus. METHODS: we studied retrospectively the records of patients with histologically proven esophageal cancer between 1970 and 1999 at the Yonsei Medical Center. RESULTS: Total cases of esophageal cancer were 969 patients of which the cases of adenocarcinoma and SCCA were 27 patients and 918 patients, respectively. The ratio of esophageal adenocarcinoma to SCCA was 0.0375 in the 1970s, 0.0241 in the 1980s and 0.0292 in the 1990s. There was no statistical difference (p=0.811) in the ratios of adenocarcinoma of the esophagus between the three consecutive 10-year groups. CONCLUSION: In conclusion, unlike the US and other western countries, it seems that the ratio of esophageal adenocarcinoma compared to SCCA has not increased among patients with esophageal carcinoma at the Yonsei Medical Center.
Adenocarcinoma/*epidemiology ; Carcinoma, Squamous Cell/*epidemiology ; Chi-Square Distribution ; Esophageal Neoplasms/*epidemiology ; Human ; Korea/epidemiology ; Middle Age ; Prevalence ; Retrospective Studies

BACKGROUND: Vasodilatory shock has been implicated in life-threatening complications after open heart surgery, where the systemic inflammatory reaction is attributed to the cardiopulmonary bypass (CPB). The secretion of arginine vasopressin (AVP) has been found to be defective in a variety of vasodilatory shock states and administration of AVP markedly improves vasomotor tone and blood pressure. So we reviewed our experience of AVP therapy in patients with vasodilatory shock following heart surgery using CPB. MATERIAL AND METHOD: From January 2004 to July 2006, we reviewed the records of patients who received AVP therapy for vasodilatory shock following heart surgery using CPB. Vasodilatory shock was defined as a mean arterial pressure lower (MAP) than 70 mmHg, a cardiac index greater than 2.5 L/min/m2, peripheral vascular resistance lower than 800 dyn/s/cm5, and vasopressor requirements. The hemodynamic responses of patients who received AVP therapy for vasodilatory shock after cardiac surgery were analyzed retrospectively. RESULT: One hundred ninety nine open cardiac surgery patients were consecutively included in this study. Twenty two patients (11.1%) met criteria for vasodilatory shock. Despite the administration of high dose catecholamine vasopressor, all patients were hypotensive with a mean arterial pressure less than 70 mmHg. AVP therapy increased MAP from 53.3+/-7.4 to 82.0+/-12.0 mmHg at 1 hour (p <0.001) and decreased other vasopressor requirements from 25+/-7 to 18+/-6 at 1 hour (p <0.001) and individually maintained it for 12 hours. CONCLUSION: Our date suggest that AVP may be a safe and an effective vasopressor in patients with vasodilatory shock. In patients exhibiting vasodilatory shock after heart surgery, replacement of AVP increases blood pressure and reduces catecholamine vasopressor requirements.
Arginine Vasopressin* ; Arginine* ; Arterial Pressure ; Blood Pressure ; Cardiopulmonary Bypass ; Hemodynamics ; Humans ; Retrospective Studies ; Shock* ; Thoracic Surgery* ; Vascular Resistance ; Vasodilation ; Vasopressins

BACKGROUND: This study was performed to evaluate the safety and efficacy of performing additional tetracycline pleurodesis during the thoracoscopic treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: Between March 2004 and December 2007, 91 cases of primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The thoracoscopic procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. For 27 cases (Tetracycline group, group I), 20 mg/kg tetracycline was instilled into the pleural space through a trocar before closing the chest. The control group (group II) consisted of 64 cases of primary spontaneous pneumothorax for which the same thoracoscopic procedures alone were performed during the same study period. RESULT: There was no significant difference between the two groups in terms of the demographic data, the operative findings and the operation time. The percentage of cases that needed intravenous analgesics and the duration of intravenous analgesics were comparable in both groups. There was no significant difference in the duration of air leaks and complications between the two groups. The patients treated with tetracycline pleurodesis had a longer period of postoperative chest drainage (4.2 days vs 3.5 days, respectively, p=0.03) and hospitalization (5.0 days vs 4.0 days, respectively, p=0.006). During the follow up period, the ipsilateral recurrence rate was much lower for the patients who were treated with tetracycline pleurodesis (0% vs 10.9%, respectively, p=0.099), and freedom from recurrence tended to be more favorable for group I (p=0.077), although this was not statistically significant. CONCLUSION: Additional tetracycline pleurodesis during thoracoscopic treatment for primary spontaneous pneumothorax caused prolongation of chest drainage and a prolonged hospital stay. However, further investigations are needed because tetracycline pleurodesis can be performed safely without serious complications and it showed a distinct tendency to reduce the rate of recurrence.
Analgesics ; Blister ; Drainage ; Follow-Up Studies ; Freedom ; Hospitalization ; Humans ; Length of Stay ; Pleura ; Pleurodesis ; Pneumothorax ; Recurrence ; Surgical Instruments ; Tetracycline ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax

Even though the Cox-Maze III procedure is the gold standard in the therapy for atrial fibrillation (AF) and its outcome is excellent, the complexity of the operation, longer cardiopulmonary bypass time and the risk of bleeding have tended to dissuade cardiac surgeons from its application. The recent data of the pathogenesis of AF and the development of alternative energy sources have facilitated the development of the modified Cox-Maze procedure rapidly. We reported that atrial fibrillation was conversed to sinus rhythm by the epicardial microwave ablation without cardiopulmonary bypass and the normal sinus rhythm was observed during 33 months of follow-up period.
Atrial Fibrillation* ; Cardiopulmonary Bypass ; Follow-Up Studies ; Hemorrhage ; Microwaves*

PURPOSE: Acute aortic dissection is a rare and life-threatening disease, requiring an immediate evaluation and treatment. In 2010, the American College of Cardiology/American Heart Association suggested a new risk score system for the detection of an acute aortic dissection. This system was applied to our known patients with acute aortic dissection. METHODS: 155 patients with acute aortic dissection regardless of the types from January 2000 to June 2012 were examined. The known risk factors and 12 newly proposed risk factors were compared, based on the new guidelines, after dividing them into a delayed diagnosis group and early diagnosis group. The impact of the aortic dissection detection (ADD) risk score on the diagnostic process was assessed. RESULTS: The abrupt onset of pain was the most frequent symptom (65.2%) and only had an impact on an early diagnosis (p=0.021). 83 patients (53.5%) showed a widened mediastinum in the chest X-rays. The diagnosis was delayed in 21 patients (13.8%). According to the new guideline, 149(96.1%) were identified by 1 or more of the 12 clinical markers. 6(3.8%), 88(56.8%) and 61(39.3%) patients were classified as low, intermediate and high risk, respectively. Three of the 6 low risk patients showed mediastinal widening. CONCLUSION: The clinical risk markers and the ADD risk score system in the 2010 guidelines detected patients with high sensitivity. The new risk score system appears to be a valuable diagnostic index at the initial presentation.
American Heart Association ; Biomarkers ; Delayed Diagnosis ; Early Diagnosis ; Emergencies ; Heart ; Humans ; Mediastinum ; Risk Factors ; Thorax

BACKGROUND: One of the major morphologic characteristics of hepatitis B is a hepatocellular regeneration which is induced by massive hepatocyte necrosis and associated with proliferative activity of hepatocytes. The purpose of this study is to document the proliferative activity of hepatocytes in various types of hepatitis B by immunohistochemical staining for proliferative cell nuclear antigen-labelling index (PCNA-LI) and electron microscopy. METHODS: We studied 83 patients with hepatitis B; 11 cases of acute viral hepatitis, 24 cases of mild chronic hepatitis, 34 cases of severe chronic hepatitis with early cirrhosis and 14 cases of severe chronic hepatitis. The PCNA was tested by immunohistochemical staining using anti-PCNA antibody. Furthermore we evaluated the ultrastructure of acinus-forming hepatocytes (AFH) by electron microscopy. RESULTS: The expression rate and labelling index of PCNA were 27.3% and 5.3 +/- 0.9% in acute viral hepatitis, 62.5% and 22.9 +/- 31.7% in mild chronic hepatits, and then 47.1% and 14.1 +/- 24.2% in severe chronic hepatitis with early cirrhosis, respectively (Figure 1). By contrast, no detectable PCNA expression was noted in AFH. Electron microscopic findings showed that hepatocytes forming a rosette underwent marked degenerative changes with sinusoidal capillarization and increased fine strands of collagen fiber in portal area. CONCLUSION: The proliferative acitivity of hepatitis B was significantly decreased in severe chronic hepatitis containing AFH. This result suggested that differences in proliferative activity was associated with hepatic cell necrosis and AFH.
Adolescent ; Adult ; Aged ; Cell Division ; Female ; Hepatitis B, Chronic/*metabolism/*pathology ; Hepatocytes/*metabolism/*ultrastructure ; Human ; Immunohistochemistry ; Male ; Microscopy, Electron ; Middle Age ; Proliferating Cell Nuclear Antigen/*metabolism

BACKGROUND/AIMS: This study was designed to clarify the fine structures of the hepatocytes and mesencymal tissues in chronic hepatitis according to severity. METHOD: For the purpose of elucidating the ultrastructural characteristics of mesenchymal tissues, liver biopsy specimens were studied by light and electron microscopy in 20 patients with chronic hepatitis. RESULTS: 1) Hepatocytes in mesenchymal tissues were thought to be in the stage of regenerated or degenerated process. 2) Regenerating nodules were surrounded by a basement membrane-like materials in the space of Disse. 3) In the widened Disse space the deposition of collagen fiber bundles and increased numbers of hepatic stellate cells in necrotic area were observed. 4) In necrotic areas, hepatic mesenchymal cell response including an increase of collagen fibers and fibroblast, angiogenesis, and a proliferation of bile ductules were also observed. CONCLUSIONS: These observations suggest that the fibrosis in severe chronic hepatitis was accompanied by the mesenchymal response including the proliferation of hepatic stellate cells, fibroblasts, capillarization of Disse space, and mesenchymal proliferation. Finally, this fibrosis observed electron microscopically may be a cause of functional hepatic failure.
Adult ; English Abstract ; Female ; Hepatitis, Chronic/*pathology/virology ; Hepatitis, Viral, Human/*pathology ; Hepatocytes/ultrastructure ; Human ; Liver/*ultrasonography ; Male ; Mesoderm/ultrastructure ; Microscopy, Electron ; Middle Aged