No abstract available.
Enterococcus*

No abstract available.
Enterococcus*

No abstract available.

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

The supranuclear control of eye movement invo l ves the pathway extending from the cerebral cortex to theocular motor nuclei located in the brain stem. This paper de-scribes the normal supranuclear pathway, whichcontrols eye movement. We also include magnetic resonance imaging findings of the typical ocular manifestationscaused by disorders involving the supranuclear pathway, providing the anatomic ex-planations for certain clinicalsigns.
Brain Stem ; Cerebral Cortex ; Eye Movements ; Magnetic Resonance Imaging ; Ocular Motility Disorders*

BACKGROUND: Serum eosinophil cationic protein(ECP) level has been proposed as a indirect marker of eosinophilic inflammation of the airway in bronchial asthma. OBJECTIVE: To evaluate serum ECP against indirect clinical markers of disease, we compared bronchial obstruction, bronchial hyperresponsiveness and peripheral blood eosinophil counts, total IgE with serum ECP levels in patients with bronchial asthma and normal controls. METHOD: Fourty-two patients with bronchial asthma and twenty-six normal controls were enrolled. Measurement were made by spirometry, inhalation challenge with methacholine, peripheral blood eosinophil counts, total IgE and FEIA(fluoroenzymatic immunoassay) of serum ECP RESULT: Serum ECP levels were significantly higher in asthmatic patients than normal controls(p<0.0,5). Serum ECP levels were correlated with peripheral blood eosinophil counts(p<0.01, r=0.544) and bronchial hyperresponsiveness(PC,)(p<0.01, r=-0.456) in patients with bronchial asthma. Serum ECP levels were correlated with degree of bronchial obstruction(FEV, % to predicted value, FEV1/FVC%) in total subjects, but not in asthmatic patients. CONCLUSION: Serum ECP level may be used as indicator of disease activity in bronchial asthma and be helpful in differentiation between normal person and asthmatic patients on simple serological method. Further studies on the changes of serum ECP levels according to disease course and therapeutic responses are needed.
Asthma* ; Biomarkers ; Eosinophil Cationic Protein* ; Eosinophils ; Humans ; Immunoglobulin E ; Inflammation ; Inhalation ; Methacholine Chloride ; Spirometry

PURPOSE: To evaluate the effects of converted intermittent exotropia type with part-time occlusion therapy on final postoperative outcomes. METHODS: The present study included 140 consecutive intermittent exotropia patients. On the patient's first visit, the type of intermittent exotropia was determined according to the deviation angle. After preoperative part-time occlusion therapy, the type of intermittent exotropia was reevaluated. The surgical success rates of each group was compared retrospectively according to the converted type. RESULTS: At the first visit, the basic type was the most prevalent (n = 112), followed by convergence insufficiency type (n = 18) and pseudo-divergence excess type (n = 10). Mean deviation angle on the first visit was 25.42 +/- 6.05 PD at distance and 26.19 +/- 8.20 PD at near. There were significant changes in near deviation angle after part-time occlusion in patients with the basic and convergence insufficiency types (p = 0.045, 0.03, respectively). Twenty-seven patients who had converted from basic type to pseudo-divergence excess type and from convergence insufficiency type to basic type showed better surgical success rate (89%) than other patients (69%) (p = 0.033). CONCLUSIONS: Part-time occlusion therapy converts the type of intermittent exotropia by reducing near deviation angle and is related to a better surgical success rate.
Exotropia ; Humans ; Ocular Motility Disorders ; Retrospective Studies

Percutaneous transhepatico-biliary duodenal drainage(PTBDD) (n=2) and percutaneous transhepatic duodenaldrainage(PTDD) (n=1) were performed as palliative treatment of obstructed afferent loop in patients in whomobstructive jaundice had occurred after surgery for malignant tumors. All three patients experienced septic shockafter PTBDD or PTDD. We describe these cases and review the literature.
Duodenum ; Humans ; Jaundice ; Jaundice, Obstructive* ; Palliative Care ; Sepsis ; Shock, Septic*

We report the first case of an angiomyomatous hamartoma (AH) of the popliteal lymph nodes (LNs) occurring in association with diffuse pigmented villonodular synovitis (PVNS) of the knee. AH is a rare benign vascular disease with a predisposition for the LNs of the inguinal region. Twenty-five cases of AH have been reported to date; however, the precise pathogenesis is still undetermined. In the present case, an open synovectomy revealed two of three popliteal LNs in close proximity to the extra-articular component of diffuse PVNS. These LNs demonstrated irregularly distributed thick-walled blood vessels in the hilum. These vessels extended into the medulla and cortex and were associated with haphazardly arranged smooth muscle cells in the sclerotic stroma. These findings are compatible with an AH. Our observations raise the possibility that AH of the popliteal LNs may represent an abnormal proliferative reaction against the inflammatory process caused by PVNS of the knee.
Angiomyoma ; Blood Vessels ; Hamartoma ; Knee ; Lymph Nodes ; Myocytes, Smooth Muscle ; Synovitis, Pigmented Villonodular ; Vascular Diseases

No abstract available.
Adenoma* ; Kidney*