An open trial was carried out to investigate the efficacy and tolerance of isosorbide 5-mononitrate(Elantan(R)) in 30 patients diagnosed as angina pectoris at Pusan national university hospital. Drugs were given 20mg two times daily for 2 to 3 weeks and the results were assessed in terms of effects on anginal pain and untoward side effects experienced during administration of medication. Treament resulted in an overall improvement in 25 patients(83.4%), complete abolition of anginal attacks in 17 patients(56.7%) and reduction in frequency of attacks in 8 patients(26.7%). So called "Nitrated headache" was observed in 5 patients(16.6%) but improved with proceeding of administration in 3 patients. This trial indicates that isosorbide 5-mononitrate should be efficacious as well as tolerated in patients with coronary heart disease.
Angina Pectoris* ; Busan ; Coronary Disease ; Humans ; Isosorbide*

Fracture of acetabular are relatively uncommon, but when they occur they seem to pose management difficulties for attending surgeon. They are, however, important injuries because they may give rise to disabling symptoms. Furthermore, they are increasing in frequency due to the increasing number of traffic accidents. Forty cases of acetabular fracture were treated in the National Medical Center during the period 1980 to 1987. The short summary of observation were as follows : 1) There was a preponderance of young patients, the majority being in the 31–40 age group(68%). The ratio between males and females was 2.6:1. 2) The most common cause of injury was traffic accident(68%). 3) The most common associated fracture was pelvic bone fracture(48%), and most common associated other injury was abdominal visceral injury(30%). 4) The most common fracture was posterior wall fracture(28%) following to Judet & Letournel's anatomocal clsssification. 5) Twenty-five fracture(63%) were treated by conservative measures, and 15 fractures (37%) were treated by open reduction and internal fixation. 6) The results were as follows : excellent in 13(33%), good in 19(47%), fair in 5(13%), and poor in 3(7%). 7) The complication of acetabular fracture were traumatic arthritis in 6 cases, sciatic nerve injury in 2 cases, avascular necrosis of femoral head in 2 cases. 8) Not only choice of treatment but also determination of surgical approch require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radiologic analysis.
Accidents, Traffic ; Acetabulum ; Arthritis ; Female ; Head ; Humans ; Male ; Necrosis ; Pelvic Bones ; Sciatic Nerve

Multiple fixation techniques for arthrodesis of the ankle and hindfoot have been introduced. The cannulated screw fixation provides excellent internal compression for arthrodesis. We used 5.0 and 6.5mm cannulated screws for seven ankle, seven subtalar, four tibiotalocalcaneal, three pantalar and two triple arthrodesis between January 1994 and September 1995. No iliac bone graft was utilized. The follow-up period was from 12 to 25 months. Ages of the patients ranged from 25 to 58 years. All fused except one who was preoperatively diagnosed as pyogenic arthritis of the ankle and hindfoot. One patient with diagnosis of Streeter's disease was complicated with partial necrosis of the forefoot. We think this procedure has several advantages; 1. The leg or foot length is largely preserved because minimal subchondral bone is removed. So, the leg and foot is aesthetically pleasing and the musculature around the ankle and foot can be maintained in the normal balanced position. 2. The rate of fusion is high, because the soft tissues are minimally stripped and cannulated screw compresses the subchondral bone surface. 3. The cannulated screws rarely requires removal. So, we believe that the cannulated screw fixation for the ankle and hindfoot arthrodesis is an excellent treatment method.
Ankle* ; Arthritis ; Arthrodesis* ; Diagnosis ; Follow-Up Studies ; Foot ; Humans ; Leg ; Necrosis ; Transplants

PURPOSE: To analyze high-resolution CT findings(HRCT) of pulmonary lymphangitic carcinomtosis(PLC) and to correlated the HRCT findings with the results of pulmonary function test(PFT). MATERIALS AND METHODS: In Twenty eight patients with radiologically and clinically proved PLC, we retrospectively reviewed HRCT scans and PFT(N=12). PLC was classified by extent and distribution of metastatic nodules and interstitial thickenings on HRCT and the findings were correlated with the results of PFT and impairment of PFT according to the degree of FEVl(forced expiratory volume in one second). RESULTS: On the basis of distribution of PLC, HRCT findings showed 20 cases of peripheral type, 3 cases of central type, and 5 cases of mixed type. In the patients with PFT diffuse type was 10 cases and localized type was 2 cases. In diffuse types, the restrictive pattern occurred in 7 cases (p<0.05) and in localized types, restrictive pattern occurred in 2 cases. Marked impairment of vital capacity was shown as restrictive pattern in 7 cases all of which were diffuse type and were consisted of peripheral type in 4 cases and mixed type in 3 cases. CONCLUSION: HRCT findings of lymphangitic carcinomatosis correlated well the type and degree of impairment of PFT. Especially in diffuse type of lymphangitic carcinomatosis, the result of pulmonary function test were prominent restrictive patterns. Marked impairment of pulmonary function occurred in patients with diffuse type and types with peripheral interstitial thickening(periphral and mixed types).
Carcinoma* ; Humans ; Respiratory Function Tests* ; Retrospective Studies ; Vital Capacity

PURPOSE: To assess the MR findings of Tolosa-Hunt syndrome and to evaluat differential point of cavernous sinus lesions. MATERIALS AND METHODS: Eleven cases of Tolosa-Hunt syndrome were evaluated by MRI with specific regard to the shape of cavernous sinus, signal intensity, and pattern of enhancement. Other associated findings were also anlaysed. RESULTS: Two patients had normal MR features of the cavernous sinus. When compared with the contralateral normal cavernous sinus, the involved cavernous sinus was enlarged in six of the nine patients. The outer dural margin was convex and bulged laterally in 6 cases, flat in 2 cases, and concave in 1 case. Of the nine patients, five had iso-signal intensity and four had low signal intensity relative to gray matter on short TR/short TE. Three had isosignal intensity and 6 were not detectale on long TR/short and long TE pulse sequence. Contrast enhancement was seen in 8 cases ;7 cases showed homogeneous enhancement, 1 case heterogeneous enhancement. CONCLUSION: In the appropriate clinical setting of painful ophthalmoplegia, MR findings of cavernous sinus abnormality that consist of iso to low signal intensity on short TR/short TE images and isointense or undetectale mass on long TR/short TE or long TR/Iong TE images may suggest the dignosis of Tolosa-Hunt syndrome.
Cavernous Sinus ; Humans ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Tolosa-Hunt Syndrome*

PURPOSE: Recently, allergic disorders in children have increased. The cause of allergic disorders made not clear. Therefore study in aspect of food and nutrition was required to prevent allergic disorders in children, show guide of dietary management. METHODS: This study was done in 78 children with allergy from July, 1997 to September, 1997, investigated family history of allergy and general environment with questionnaire, besides growth levels of children with allergic symptoms, nutrient intakes, eating behavior, and allergy-inducing foods. RESULTS: The results of this study are summarized as follows. 1) Allergic symptoms with a age 2-3 years old were asthma (46%), dermatitis (39%), hypersensitivity skin (7%), urticaria (5%) and rhinitis (5%). At age 4-6 years, asthma was 54%, dermatitis 44%, rhinitis 28%, hypersensitivity skin 10%, and urticaria 3%. Most of the dermatits was caused by unknown etiology, temperature change and house dust mite. Asthma was caused by house dust mite and temperature change. Urticaria was caused by foods and rhinitis was caused by house dust mite. 2) Tomato was the most common food as a cause of allergic disease and peach, mackerel, yoghurt, cheese, and egg were included. Urticaria was provoked mainly by tomato and peach, diarrhea was induced by milk, yoghurt and cheese, vomiting by quail eggs, and swelling lip was induced by tomato. 3) The average daily calory intake was 80% of the RDA at the age of 2-3 years old, 66% at the age of 4-6 year old. Protein and fat intake were similar as RDA. The other nutrients intake at the age of 2-3 and 4-6 years old were 106% and 71% for calcuim, 49% and 52% for iron, 30% and 31% for zinc, respectively. The amount of vitamin intake also lower than RDA for both age groups. CONCLUSION: The average calory intake and other nutrients intake for the children with allergic symptoms were lower than RDA. But they showed relatively normal growth pattern compared with the Korean growth standard. It is necessary to findout the food that provoke the allergic symptoms and make guideline for diet therapy for the children with a various allergic symptoms.
Asthma ; Cheese ; Child* ; Dermatitis ; Diarrhea ; Diet Therapy ; Eggs ; Feeding Behavior ; Humans ; Hypersensitivity ; Iron ; Lip ; Lycopersicon esculentum ; Milk ; Ovum ; Perciformes ; Prunus persica ; Pyroglyphidae ; Quail ; Surveys and Questionnaires ; Rhinitis ; Skin ; Urticaria ; Vitamins ; Vomiting ; Yogurt ; Zinc

Agenesis of trachea is a rare congenital anomaly. The main signs are respiratory distress, cyanosis, inability to vocalise and impossible tracheal intubation. There is no long-term surgical solution at present, therefore the condition is ultimately fatal. We report a case of tracheal agenesis. We anesthetized a 2.25 kg neonate for endoscopic examination, who was intubated successfully. Beyond 2.5 cm from the vocal cord, there was no trachea and we can only see esophageal lumen with fistula opening. After the endoscopic examination, exploratory thoracotomy was done, but surgical correction was impossible. After the surgery, she died from progressive ventilatory failure. Autopsy revealed a Floyd's type II tracheal agenesis with tracheo-esophageal fistula.
Autopsy ; Cyanosis ; Fistula ; Humans ; Infant, Newborn ; Intubation ; Thoracotomy ; Trachea ; Vocal Cords

Staphylococcus aureus continues to be the main cause of surgical site infections. Recently, methicillin-resistant S. aureus (MRSA) has been known to be resistant to many kinds of antibiotics and causes the problem of neonatal nosocomial infection. Antibiotic sensitivity tests which have been routinely used to detect MRSA in the laboratory depend on the culture conditions. Therefore it is necessary to develop a new method based on a molecular biological technique in order to overcome these problems. We report the development of a multiplex PCR protocol for the diagnosis of staphylococcal infection. The protocol was designed to i) detect any staphylococcal species to the exclusion of other bacterial pathogens (based on primers corresponding to staphylococcal-specific regions of the 16S rRNA genes), ii) provide an indication of the likelihood that the Staphylococci present in the specimen are resistant to oxacillin (based on the amplication of the mecA gene, encoding penicillin-binding protein 2'(PBP-2'), which is known to confer resistance to the bacteriostatic action of methicillin). In this study, 67 S. aureus strains were isolated from the neonatal intensive care unit and general neonatal nursery at Pusan National University Hospital, Busan, Korea, between January and July 2003. Methicillin resistance was tested by the oxacillin disk diffusion method and the MIC method. We performed the multiplex PCR to amplify the mecA gene, encoding PBP-2'. We tested it by multiplex PCR and compared the results with the antimicrobial susceptibilities. Different results were obtained from 2 MRSA (4.65%), suggesting that the PCR method should be performed at the same time for a more accurate clinical test of MRSA
Anti-Bacterial Agents ; Busan ; Cross Infection ; Diagnosis ; Diffusion ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Multiplex Polymerase Chain Reaction* ; Nurseries ; Oxacillin ; Penicillin-Binding Proteins ; Polymerase Chain Reaction ; Staphylococcal Infections ; Staphylococcus aureus ; Thiram

An open clinical trial was performed to test the efficacy and side effects of Pravastatin(Mevlotin(R)), HMG-CoA reductase inhibitor, administering 5mg twice daily for 12weeks in 30 patients of hypercholesterolemia in out patient clinics, Pusan National University Hospital. The total cholesterol, triglyceride and HDL-cholesterol were measured with enzyme methods and LDL-cholesterol was calculated indirectly by Friedewald formula. The result obtained were as follows: 1) The degree of change at the end points compared with baseline pretreatment levels were 26.1% fall in serum total cholesterol.36.6% fall in LDL-cholesterol, 20.8% fall in triglyceride and 14, 6% rise in HDL-cholesterol. And the rate of improvement more than moderate degree were 90.0% in total cholesterol(the fall of 10% or more), 53.3% in triglyceride (the fall 20% or more) and 33.3% in HDL-cholesterol(the rise of 7mg% or more). 2) The total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL cholesterol ratios were decreased significantly from 6, 4+/-0.7 to 4.2+/-0.5(34.4%) and from 4.5+/-0.7 to 2.5 +/-0.4(44.4%) respectively. 3) The greatest fall in serum total cholesterol and LDL-cholesterol were observed in 2 weeks after administrating drug and thereafter fell gradually and maintained until 12 weeks of endpoint, but HDL-cholesterol showed significant rise from the 4 weeks of administration. On the other hand triglyceride showed remarkable fall in the measured values from the 4 weeks but statistical significance was observed only in 10 and 12 weeks after administration owing to wide individual variation of values. 4) There observed the tendency that the higher the initial pretreatment levels the greater the degree of fall in total cholesterol and triglyceride. 5) Neither side effects nor abnormal laboratory findings were shown during the period of observation. The results suggest that Pravastatin will be a useful and safe drug in the treatment of hyperlipidemia.
Busan ; Cholesterol ; Hand ; Humans ; Hypercholesterolemia* ; Hyperlipidemias ; Oxidoreductases ; Pravastatin ; Triglycerides