No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The changes of corneal curvatures were measured in 63 cataract cases before and 2 months after cataract extraction with the aid of ophthalmometer and photo keratoscope. The change of the cornea in the vertical curvature was shown to be greater than that of horizontal curvature, in cases of conventional large corneal incision(120-170 degrees) of cataract surgery. Vertical curvature of the cornea was decreased and horizontal curvature was increased. The corneal astigmatism before and 2 months after surgery were respectively 0.67D. and 1.56D. showing the difference of 0.89D.
Astigmatism ; Cataract Extraction* ; Cataract* ; Cornea

Since the rectangular rod had been used by Eduardo R. Luque in 1979, many authors reported good results by this technique in low back arthrodesis. The advantages of this device are that the technique is relatively easy, the cost is cheaper than the other devices, and no special instruments are needed for application of this device. On the other hand, it has the disadvantage of possible neurologic damage while passing sublaminar wires. The rectangular rod functions fundamentally as a tension band that although it is strong in flexion, it is relatively weak in lateral bending or axial loading on the spine. From June, 1984 to June, 1988, the authors experienced 41 cases of rectangular rod instrumentation with sublaminar wiring in various low back conditions. And 30 cases of spondylolisthesis which could be followed for more than one year were analyzed. And the results obtained were as follows. l. Of 30 patients of spondylolisthesis, 7 cases(23.3%) were male and 23 cases(76.7%) were female. 2. 21 cases(70.0%) were isthmic type and 9 cases(30.0%) degenerative type. 3. 23 cases(76.7%) were in Grade I, 6 cases(20.0%) in Grade II and 1 cases(3.3%) in Grade III, according to Meyerding's classification. 4. At follow up examination, 18 cases(60.0%) were in excellent group, 8 cases(26.6%) in good, 2 cases(6.7%) in fair, according to Gill's criteria. Two cases(6.7%) of pseudoarthrosis were noted and these cases were classified in unsatisfactory group. 5. Rectangular rod with sublaminar wiring was not a good device for reduction of spondylolisthesis
Arthrodesis ; Classification ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Pseudarthrosis ; Spine ; Spondylolisthesis

Closed interlocking nailing has become a common method of treatment of femoral fractures in adults. Interlocking nailing had a tendency toward rotational deformity and shortening. Therefore, we determined anteversion of the femoral neck after closed IM nailing of the femoral fractures. Femoral rotational deformity in both leg was determined by the construction of a line through the femoral neck and another through the transcondylar plane of the distal portion of the femur, using the CT scanning. We performed a retrospective study of 15 patients treated with closed IM nailing for femoral shaft fractures from 1989 to 1994. 1. The average differences in anteversion angle was 12.9 degree. 2. 3 cases(50%) in 6 cases that have difference more than 15° are accompanied with ispilateral injury of the knee joint and the lower leg. 3. Angle difference of the rotational deformity of proximal or distal femoral fractures is 15.5° which is 3.5° larger than that of fractures of femoral midshaft, 12.0°.
Adult ; Congenital Abnormalities ; Femoral Fractures ; Femur ; Femur Neck ; Humans ; Knee Joint ; Leg ; Methods ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.
Asia ; Asian Continental Ancestry Group* ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Financial Management ; Humans ; Internship and Residency ; Intubation ; Patient Care ; Patient Transfer ; Peer Review ; Triage ; Ultrasonography

OBJECTIVE: Interhemispheric subdural hematoma (IHSDH) is uncommon, because of their unusual location. However, it is a distinct lesion with its unique characteristics. We investigated clinical features and outcomes of consecutive 42 patients with IHSDH, retrospectively. METHODS: From 2006 to 2015, we treated 105 patients with IHSDH. All patients were diagnosed by computed tomography (CT) or magnetic resonance imaging. We selected 42 patients with thick (3 mm or more) IHSDH. We retrospectively reviewed the clinical and radiological findings, management and outcomes. RESULTS: The male to female ratio was 2:1. Two thirds of the patients were over 60 years old. Slip or fall was the most common cause of trauma. The level of consciousness on admission was Glasgow Coma Scale (GCS) 13 to 15 in 25 patients. The most common symptom was headache. All IHSDH was hyperdense in CT at the time of diagnosis. IHSDH frequently accompanied convexity subdural hematoma. The outcome was favorable in 27 patients, however, six patients were expired. Twenty-two patients were managed conservatively. Surgery was performed in ten patients to remove the concurrent lesion. The outcome was poor in spontaneous one, patients with low GCS, and patients with conservative treatment. CONCLUSION: IHSDH is rare especially the isolated one. The outcome was dependent to the severity of injury. Surgery may be helpful to remove the concurrent mass lesion, however, conservative treatment is generally preferred.
Consciousness ; Craniocerebral Trauma ; Diagnosis ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Headache ; Hematoma, Subdural* ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Symptom Assessment

Bone marrow contains mesenchymal stem cells capable of differentiating into osteoblastic lineage. To test the ability of purified bone marrow mesenchymal cell loaded onto xenograft with type I collagen gel to heal bone defect, mesenchymal stem cells were isolated from bone marrow of Lewis rat, and culture-expanded. Northern blot hybridization revealed that osteocalcin and osteopontin mRNA expression persisted for 8 weeks of in-vitro culture. When the bone marrow mesenchymal cells became 80-90% confluent in 2-3 weeks, they were loaded onto chips of xenograft (Lubboc(R) with type I collagen gel. The cell-gel-xenograft composite was transplanted subcutaneously into the dorsum of nude mice. It was also transplanted into tibial diaphyseal defect made in syngeneic Lewis rats, and compared with the control group where only the xenograft was planted. There was no ectopic bone formation at the dorsum of nude mice around the transplanted cell-gel-xenograft complex. In the long bone defect model, the cell-gel-xenograft group induced fibrosis around it and the bone healing was inferior to the control group. Type I collagen gel is not a suitable carrier of bone marrow mesenchymal cells to heal the long bone defect.
Animals ; Blotting, Northern ; Bone Marrow* ; Collagen Type I* ; Fibrosis ; Heterografts ; Mesenchymal Stromal Cells ; Mice ; Mice, Nude ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteopontin ; Plants ; Rats ; RNA, Messenger

We have surgically experienced a case with primary double cancer which metachronously occurred in the gall bladder and the distal portion of common bile duct. This 61-year-old male underwent cholecystectomy with en bloc wedge resection of liver due to the malignant tumor in the gall bladder about 30 months ago. The histopathological examination revealed that the lesion was adenocarcinoma, moderately to poorly differentiated, with partly neuroendocrine differentiation, in the neck portion of the gall bladder (Figure 1). The malignant potential invaded to the subserosal layer, and the resected margin of the cystic duct was free from the malignant invasion. During the post-operative period, he has periodically or sporadically visited the out-patient Department of Surgery and Internal Medicine at Taejeon St. Mary's Hospital for follow-up studies. He was admitted again because of the insiduous onset of painless jaundice along with generalized itching sensations. The studies, using the ultrasonogram and the CAT scan, showed that the intra- and extra-hepatic biliary trees were moderately dilated due to a mass effect at the distal portion of the common bile duct (Figure 2). The ERCP revealed the lesion was malignant(Figure 3), and histologically confirmed adenocarcinima, well differentiated. He underwent Whipple's pancreaticoduodenectomy with regional lymph node dissection(Figure 4). The histopathological examination revealed that the lesion was adenocarcinoma, moderately differentiated, with lymphatic and perineural invasion, in the distal portion of the common bile duct (Figure 5). The malignancy extended toward the submucosal layer of duodenum and the pancreatic parenchyme. The resected margin of common bile duct was free from malignant invasion. He recovered uneventfully from the second surgical intervention. He periodically visits the out-patient Department of Surgery nowadays.
Adenocarcinoma ; Animals ; Biliary Tract* ; Cats ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Common Bile Duct ; Cystic Duct ; Daejeon ; Duodenum ; Follow-Up Studies ; Humans ; Internal Medicine ; Jaundice ; Liver ; Lymph Nodes ; Male ; Middle Aged ; Neck ; Outpatients ; Pancreaticoduodenectomy ; Pruritus ; Sensation ; Ultrasonography ; Urinary Bladder