PURPOSE: To evaluate the outcomes of juxtarenal aortic occlusion (JRAO), a review of 15 patients who underwent aortic bypass replacement following aortorenal thrombectomy, especially focusing on the safety of suprarenal aortic clamping or transient aortic compression, was undertaken. MATERIALS AND METHODS: During the period of June 2001 to November 2012, 15 patients with JRAO (chronic 10, acute 5) were analyzed retrospectively. JRAO with combined stenosis of the renal artery was found in 2 patients, renal artery thrombus in 8 patients, and normal in 5 patients. RESULTS: All patients were males. Mean age was 61.7+/-11.2 years. There were 14 aortobifemoral bypass grafting and 1 aortobiiliac bypass grafting. Six Dacron and 9 PTFE artificial Y-grafts were implanted to the aorta with end-to-end anastomosis in the proximal aorta. Suprarenal aortic clamping was performed in 7 patients, supraceliac clamping in 2 patients, and transient aortic compression in 6 patients. There were 13 cases with aortic clamping time <10 minutes and 2 cases with >10 minutes. Thrombectomy of the aorta and renal artery was performed in 10 (66.7%) patients. There were no operative mortality cases. The perioperative morbidity rate was 26.7% (4/15). Preoperative renal function was impaired in four patients. The renal functions of these cases were recovered postoperatively. CONCLUSION: Aortic bypass replacement following aortorenal thrombectomy with suprarenal aortic clamping or transient aortic compression for JRAO is the optimal treatment. It is important to focus on short renal ischemic time during suprarenal aortic clamping for prevention of renal damage. It provides unmatched perioperative and long-term results.
Aorta ; Constriction ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Polyethylene Terephthalates ; Polytetrafluoroethylene ; Renal Artery ; Retrospective Studies ; Thrombectomy ; Thrombosis ; Transplants

With a view to investigating the distribution of keratinophilic fungi in soil according to latitudes in south Korea, soil samples were collected at 81 sites in 17 areas in different latitudes across the country and keratinophilic fungi were isolated by means of Vanbreusegherns technique. The results are summarized as follows : 105 strains of keratinophilic fungi were recovered from 56(69.2%) out of 81 samples. Isolated fungi were composed of 41 strains of Trichophyton ajelloi, 24 stains of Chrysosporium species, 20 strains of Microsporum gypseum, and 20 strains of M. cookei. Frequency of isolation of keratinophilic fungi tended to decrease from higher latitudes down to lower latitudes. In areas of higher latutudes, T. ajelloi and M. cookei were isolated more frequently than in lower latitudes. M. gypseem was most frequent in Cheju City, and Chrysosporium species showed an even distribution, Among three areas under different conditions of moisture and shadedness(i.e., shaded wet, shaded dry, and sunny dry areas), frequency of isolation was highest in shaded dry areas(72.2%). T. ajelloi was the most frequent species in all the three areas, especially in shaded wet areas(53.1%). No M. gypsetcm was found in shaded dry areas. As regards distribution at various sites, roadsides and streamsides exhibited the highest frequency of isolation, and hills the lowest. Except for roadsides, T. ajelloi was the most frequent species at all sites, especially in forests. M. gypseum was frequent at sites beside streams M. cookei at streamsides, fields, and hills and Chrysosporim species in gardens, forests, and streets.
Chrysosporium ; Coloring Agents ; Fungi* ; Jeju-do ; Korea* ; Microsporum ; Rivers ; Soil* ; Trichophyton

In recent years there has been an increase in the number of outpatient surgical procedures performed using local anesthesia with intravenous sedation. However, many patients are reluctant to undergo surgery because of their concerns about pain and pain-awareness during the operation. We performed a study to evaluate the effectiveness and safety of midazolam during outpatient surgical procedures. Between March 1997 and December 1998, 50 patients were anesthetized with bolus intravenous injection of 0.1mg/kg of midazolam, followed by local anesthesia. The blood pressure, pulse and oximeter values were monitored. There was no significant change of arterial oxygen saturation. Midazolam induced antegrade amnesia in most cases. All patients except three (94%) said they would willingly choose this anesthetic technique again. Major complications were not noted. We concluded that midazolam is a good sedative agent in providing favorable antegrade amnesia, as well as reduced anxiety and fear of pain during surgical procedures. This suggests that midazolam may be used routinely in outpatient surgical procedures. Monitoring of oxygen saturation, however is essential in preventing severe hypoxia during procedures.
Amnesia ; Anesthesia, Local* ; Anoxia ; Anxiety ; Blood Pressure ; Humans ; Injections, Intravenous ; Methods ; Midazolam* ; Outpatients ; Oxygen

In the present study, tap water iontophoresis as a method of treatment of palmoplantar hyperhidrosis was evaluated. Eighteen patients, twelve males and six females, with singnificant palmoplantar hyperhidrosis were treated on every weekday for 2 weeks. The hand and foot of the same side were randomly selected for the treatment by tap water iontophoresis according to the the method described by Levit. The selected hand and foot were immersed in a pair of pans containing tap water and exposed to 30V and 3 to 14mA of direct current for 20 minutes. The results obtained were as follows . Among 18 patients treated, 14(77.8%) accomplishei3 sufficient control of hyperhidrosis after 6 12(average 9.1) treatments. Two patients showed a moderate response and one weak response. One patient showed no response. Several patients experienced untoward effects such as mild itching, erythema, tingling sensation, exfoliation, compensatory hyperhidrosis, but the discomfort was not so severe as to stop the treatment
Erythema ; Female ; Foot ; Hand ; Humans ; Hyperhidrosis* ; Iontophoresis* ; Male ; Pruritus ; Sensation ; Water

Changes of histopathological findings with time were studied after scratching the skin of 37 patients with dermographism. Biopsies were also done in 13 normal healthy controls for comparison with unstroked skin of the patients. 1. Biopsies of unscratched skin of the patients showed no histologic difference from those of the skin from controls. 2. Neutrophils increased in number with time after scratching and maximum neutrophil count (mean 16.08+/-24.17/HPF) was observed at 90 minutes after scratching 3. Eosinophilic infiltration was also similar to that of neutrophils. Maximum eosinophil count (mean 324+/-4.76/HPF) was found at 60 minutes after scratching. 4. L ymphohistiocytic infiltration showed a similar tendency to that of neutrophils, but the degree of change was not so prorninent. 5. Before scratching, mast cell count in patients with dermographism showed no difference in number when compared with norrnal controls. In patients with dermographism, mast; cell count inclined to decrease after scratching. 6. Edema and lymphatic dilatation in the upper dermis were most prominent at 5 minutes after scratching and disappeared slowly thereafter.
Biopsy ; Cell Count ; Dermis ; Dilatation ; Edema ; Eosinophils ; Humans ; Mast Cells ; Neutrophils ; Skin

Radiofrequency neurotomy of the lumbar medial branch, via a caudal approach, is a representative interventional procedure for lumbar zygapophysial joint pain, which can be performed more accurately and easily using a guide needle technique. We experienced a case of burn wound formation along the guide needle trajectory, where heat conduction through the guide needle was suggested to have resulted in the burn wound.
Arthralgia ; Burns* ; Hot Temperature ; Needles* ; Wounds and Injuries*

Clinical observations were made on 63 cases on nevus sebaceus of Jadasshon. 52 of 63 cases were diagnosed on the basis of clinical and histopathologic findings during a period of 19 years from January 1969 to July 1987 at the Department of Dermatology, Kyungpook National University Hospital, with the remaining 11 cases diagnosed at other skin clinics in Taegu. Histopathologic examinations were made on 51 selected cases of the 63. The results were as follows : Clinical observations 1) The percentage of patients with nevus sebaceus of Jadasshon of total new outpatients was 0.12%. Of the 63 cases, males numbered 38 and females, 25, with a sex r atio of 1.5: 1. 2) Patients when first seen were most commonly in the age group of 10~19. 3) The most favorate sites were the scalp(83.3%) and face(13.3%). 4) The average size of the lesions was 2.23cm * 3.24cm with no difference among the age groups. Histopathological observations 1) The apparent proliferation of sebaceous glands was observed in 32 of 51 cases(62.7%). The degree of proliferation markedly increased in the age group of l0~19 and slightly decreased beyond this age group. Apocrine glands were present. in 17(33.3%), with a higher number of glands seen in the age group of 10~19. Immature hair follicles were found in 38(74.5%), with no changes according to aging. 2) The epidermal changes such as acanthosis(86.3%), papillomatosis(70.6%), hyperkeratosis(78.2%) and hypergranulosis(78.2%) predominated in the age group of 10-19, and severe but more gradual changes were noted 20 years of age on. 3) Inflammatory cell infiltration of moderate to marked degree was noticeable in 27(53%). The older the patients were, the more pronounced dermal infiltration was. 4) Six of 51 cases were complicated with basal cell carcinoma(3) and syringocystadenoma papilliferum(4). The tumors, which occurred beyond 30 years of age, showed a marked inflammatory cell infiltration.
Aging ; Apocrine Glands ; Daegu ; Dermatology ; Female ; Gyeongsangbuk-do ; Hair Follicle ; Humans ; Male ; Nevus* ; Outpatients ; Sebaceous Glands ; Skin

No abstract available.

The fracture of femoral neck, the unsolved fracture, is a msjor periphersl fracture of our skeleton, and for more than century its treatment and the results hsve been a matter of controversy and inquiry among surgeons, and although the results obtained today show improvement, they are not at all comparsble to those of other fractures. This study was performed to find the characteristics of femoral neck fractures in Korea and to give the direction of further treatment. Through the review of 30 articles reported on Journal of K.O.A., we suggest the followings are essential for further study. l. Epidemiologic study of femorsl neck fractures based on statistical data needs to be performed. 2. The study should be directed not only the frscture itself but also the prevention of the fracture via the study of osteoporosis. 3. The relationship of severity of fracture, time frorn trauma to treatment, and the result of treatment established by our own data is to be established.
Epidemiologic Studies ; Femoral Neck Fractures ; Femur Neck ; Korea ; Neck ; Osteoporosis ; Skeleton ; Statistics as Topic ; Surgeons

BACKGROUND: It is known that 20% of childhood epilepsy is refractory to anticonvulsants therapy, Recently, a few new anticonvulsants has been introduced. One of these, gabapentin is known to effective in such refractory cases. This study has been done to estimate the effectiveness of gabapentin in refractory childhood as well as adult epilepsies. SUBJECTS AND METHODS: 43 patients(male 25, female 18) has been selected among refractory epilepsies during the period of March, 1981 to Feb, 1996 diagnosed and treated at pediatric neurologic clinic School of Medicine, Yonsei University Those were already treated with various anticonvulsants and gabapentin was added to previous medication, and effectiveness of seizure frequency and the degree has been investigated over more than 3 month period as well as the side effect. RESULTS: 30 patients out of 43, showed seizure free or decreased frequency of seizure, those patients whose the seizure frequency was decreased over 50% was 11 cases, partial seizure 10 cases, generalized seizure 1 cases. 15 case out of 43 showed no changes or increased frequencies of seizure in 4 out of 27 in partial epilepsies, 1 out of 16 in generalized seizure, and 6 cases out of 43 manifested side effects such as behaviour change, abdominal pain and headache. CONCLUSION: Gabapentin was effective by add on therapy in refractory epilepsies and reducing the frequency of seizure over 50% was 25.6%. Most of these patients was partial seizure. We concluded that gabapentin as add on therapy is effective at least in 1/4 cases of refractory partial seizures.
Abdominal Pain ; Adult ; Anticonvulsants ; Epilepsies, Partial ; Epilepsy ; Female ; Headache ; Humans ; Seizures*