No abstract available.
Hand* ; Surgical Flaps*

No abstract available.

BACKGROUND: Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. The efficacy of flexible coil stent as a bail-out device has been reported. However, the restenosis after stenting still remained as a main limitation like other devices. This study reports on the angiographic follow-up after successful intracoronary stenting with flexible coil stent. METHOD: From April 1993 through July 1994, coronary stenting was tried in 21 patients by a single operator for various indications(acute or threatened closure, suboptimal result after balloon angioplasty). The nineteen(95%) out of 20 patients in whom stent was successfully deployed underwent follow-up coronary angiography 7.6+/-3.0 months after coronary stenting. RESULT: Mean age was 54.7+/-11.3(33-73) years and 16 parients were men. Clinical diagnosis of patients were as follows : stable angina 7, unstable angina 6, old myocardial infarction with stable angina 6 and acute myocardial infarction in 1 patient, respectively. Stents were implanted at left anterior descending artery in 9, left circumflex artery in 5 and right coronary artery in 8. Ten out of 21 stents(47.6%) were found to be renarrowed more than 50% at follow-up coronary angiography. There was no significant difference in clinical and angiographic variables between restenosis group and no-restenosis group. Coronary artery bypass graft surgery was performed in 1 patient for the treatment of restenosis after stenting. Repeat PTCA was performed in 3 patients and remaining 5 patients were followed medically. CONCLUSION: Flexible coil(Gianturco-Roubin) coronary stent is a useful adjunct percutaneous intervention to prevent or minimize complicatioms associated with dissections. Despite favorable initial angiographic and clinical results, 47.6% of stents were found to be renarrowed significantly at follow-up coronary angiography. New techniques or more optimal characters of stents would be desired.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Arteries ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Diagnosis ; Follow-Up Studies* ; Humans ; Male ; Myocardial Infarction ; Stents* ; Transplants

BACKGROUND: Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. The efficacy of flexible coil stent as a bail-out device has been reported. However, the restenosis after stenting still remained as a main limitation like other devices. This study reports on the angiographic follow-up after successful intracoronary stenting with flexible coil stent. METHOD: From April 1993 through July 1994, coronary stenting was tried in 21 patients by a single operator for various indications(acute or threatened closure, suboptimal result after balloon angioplasty). The nineteen(95%) out of 20 patients in whom stent was successfully deployed underwent follow-up coronary angiography 7.6+/-3.0 months after coronary stenting. RESULT: Mean age was 54.7+/-11.3(33-73) years and 16 parients were men. Clinical diagnosis of patients were as follows : stable angina 7, unstable angina 6, old myocardial infarction with stable angina 6 and acute myocardial infarction in 1 patient, respectively. Stents were implanted at left anterior descending artery in 9, left circumflex artery in 5 and right coronary artery in 8. Ten out of 21 stents(47.6%) were found to be renarrowed more than 50% at follow-up coronary angiography. There was no significant difference in clinical and angiographic variables between restenosis group and no-restenosis group. Coronary artery bypass graft surgery was performed in 1 patient for the treatment of restenosis after stenting. Repeat PTCA was performed in 3 patients and remaining 5 patients were followed medically. CONCLUSION: Flexible coil(Gianturco-Roubin) coronary stent is a useful adjunct percutaneous intervention to prevent or minimize complicatioms associated with dissections. Despite favorable initial angiographic and clinical results, 47.6% of stents were found to be renarrowed significantly at follow-up coronary angiography. New techniques or more optimal characters of stents would be desired.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Arteries ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Diagnosis ; Follow-Up Studies* ; Humans ; Male ; Myocardial Infarction ; Stents* ; Transplants

Authors observed the antihypertensive effect of debrisoquin sulfate in 35 cases of essential hypertension and following results were obtained. 1) Results of short term control of blood pressure with debrisquin in 35 hypertensive patients revealed good control in 74.3%, fair in 14.3%, poor in 5.7% and failure in 5.7% of cases. Significant reduction of blood pressure was achieved in 7 of 9 cases of hypertension with addition of hydrochlorthiazide to debrisoquin. 2) During long term therapy with debrisoquin (duration of average 3.9 months), good control cases were slightly reduced(good in 58.6%, fair in 24.1%, poor in 6.9%, failure in 10.3%). But average effective dose of debriioquin was not increased significantly. 3) Antihypertensive effect of debrisoquin was slightly reduced in the cases of severe hypertension, hypertension of over 10 years duration and complication of cerebrovascular accident. 4) The side effects during treatment with debrisoquin were dizziness in 31.4%, headache in 11.4%, dry mouth, blurred vision, general weakness, insomnia in 8.6% respectively. There were no side effects in 48.6% of cases.
Blood Pressure ; Debrisoquin* ; Dizziness ; Headache ; Humans ; Hypertension* ; Mouth ; Sleep Initiation and Maintenance Disorders ; Stroke

Symphyseal injury is increasing in number together with today's speed of development of car industry in Korea. However, this injury is not common in practice. Some authors reported that symphyseal injury is only 4 to 6% of all pelvic fractures. Symphysis pubis has characteristicsl anatomy to maintain mechanical integrity of the pe1vis with circumferential ligament. The pelvis is a ring structure with strong ligaments. This support include the symphysis pubis, the anterior and posterior sacroiliac ligaments, and the strong sacrotuberous ligaments. According to Peltier(1964), when symphysis is separated more than 1.0cm, pubic instability will be developed. However, Wild(1982) reported that pelvic instability develops when separation of the symphysis exceeds more than 2.5cm. Tile(1984) reported that anterior pubic rami acts as a strut to prevent anterior collapse of the pelvic ring during weight bearing. However, in the presence of intact posterior structures, it gives little effect on pelvic stability. In addition to trauma, pelvic instability develops congenitally or by pregnancy. During pregnancy, pregnancy-related hormones relsx the ligameritous stuctures of the pelvic girdle. In most instances, the major pelvic ring returns to normal when the effect of the relaxin hormones disappear. However, in rare instances, a major symphysis disruption may continuously persist. To evaluste the trauma-induced separation of the symphysis pubis, we analyzed the 19 cases with 15 months follow-up on an average, who were treated at the Orthopaedic Department, Kang-Nam St. Marys Hospital, from June 1981 to June 1986. The results were as follows 1. Among 19 cases, 9 cases(47.4%) were male, 10 cases(52.6%) were female. And average age of the patients was 30.2 years. 2. The main cause of the fracture was traffic accident in 18 out of 19 cases. 3. In cases of symphyseal separation more than 3.4cm, fracture-separation of both sacroiliac joint was certainly occured. However, in cases with separation more than 2.2cm, unilalateral fracture-dislocation of sacroiliac joint occurred. 4. Open reduction and interal fixatiopn including external fixation was performed in 9 og cases. As an indication of surgery, separation of the symphysis, which exceeds more than 2.2cm and which associated (1) with sacroiliac fracture-dislocation, (2) failed conservative treatment, and (3) when simultaneously emergency urological operation is indicated.
Accidents, Traffic ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Korea ; Ligaments ; Male ; Pelvis ; Pregnancy ; Pubic Bone ; Relaxin ; Sacroiliac Joint ; Weight-Bearing

Purpose: We used optical coherence tomography angiography to analyze the macular microvasculature of normal eyes of healthy Korean children; we derived normative data stratified by age. Methods: We retrospectively analyzed the medical records of 68 children (126 eyes) aged from 3 to 15 years. Optical coherence tomography angiography was performed on 3-mm2 regions centered on the fovea. The vascular densities of the superficial and deep capillary plexuses and the foveal avascular zone were determined, and analyzed by age. We sought correlations between age, gender, axial length, and the spherical equivalent. Results: The foveal, superficial capillary plexus vessel densities were 17.41 ± 5.41, 20.53 ± 4.76, 21.78 ± 5.73, and 22.95 ± 3.91% in children aged 3-5, 6-8, 9-11, and 12-15 years, respectively. The vessel densities of the foveal deep capillary plexus were 30.20 ± 6.59, 34.54 ± 7.16, 35.81 ± 6.02, and 37.38 ± 5.16% in those aged 3-5, 6-8, 9-11, and 12-15 years, respectively. Significant differences by age were apparent (p = 0.002, p < 0.001, respectively). The foveal vessel densities of the superficial and deep capillary plexuses were positively correlated with axial length (R2 = 0.153, p < 0.001; R2 = 0.158, p < 0.001, respectively) and the foveal avascular zone area was negatively correlated with axial length (R2 = 0.085, p < 0.001). Conclusions The vessel densities of the superficial and deep capillary plexuses measured via optical coherence tomography angiography in normal eyes of healthy Korean children differed by age, and correlated significantly with axial length.

Myotonic dystrophy is an autosomal-dominantly inherited neuromuscular disorder characterized by slowly progressive muscular dystrophy, muscle weakness and myotonia. The clinical features may vary from just cataracts to involvement of multiple organ systems such as various muscles, heart, lung and intestine. During pregnancy and delivery, serious maternal and obstetrical complications may occur. The myotonia is often aggravated during pregnancy and it leads to obstetrical complications such as fetal loss, preterm premature delivery, hydrops, in-utero fetal death, difficulties in fetal expulsion, postpartum hemorrhage and/or anesthetic accidents. The affected neonate may display severe hypotonia, facial displegia and respiratory distress. This report presents a woman with myotonic dystrophy complicated with congestive heart failure and preterm delivery during pregnancy.
Cataract ; Edema ; Estrogens, Conjugated (USP)* ; Female ; Fetal Death ; Heart Failure* ; Humans ; Infant, Newborn ; Intestines ; Lung ; Muscle Hypotonia ; Muscle Weakness ; Muscular Dystrophies ; Myocardium ; Myotonia ; Myotonic Dystrophy* ; Obstetric Labor, Premature* ; Postpartum Hemorrhage ; Pregnancy*

BACKGROUND: Efficacy of percutaneous transluminal angioplasty(PTA) in the treatment of Peripheral arterial disease has been established. Complications such ans PTA-induced dissections or residual stenosis with occasional mural thrombi have been reported, which compromise the results. New procedures can be used in combination with PTA to improve the immediate and long term results, such ans prolonged balloon inflation, atherectomy, or implantation of endovascular prosthesis. In addition, the occurrence of other lesions, such as spontaneous or post-catheterization dissection or post-PTA restenosis, has prompted the insertion of a vascular stent. But there was few reports on stenting for peripheral arterial disease in Korea. METHODS: To evaluate the safety, efficacy and stability of stent in peripheral arterial disease, twenty-six consecutive symptomatic patients with 37 peripheral lesions were treated with 39 balloon expandable(33 Strecker and 6 Palmaz)stents with or without prior balloon angioplasty in the period of March 1991 and February 1994. RESULTS: The major cause of disease was arteriosclerosis(22 out of 26). The implantation sites for our study include 22 in common iliac artery, 11 in external iliac artery 2 in aorta, subclavian artery, superficial femoral artery each other. Indication for stent deployment were primarily suboptimal results(19 lesions), insufficient PTA such as dissections(4), restenosis after previous PTA(2), and primary stenting was performed without preceding therapeutic PTA(10). Stent deployment was technically successful in 24 of the 26 patients(92%) and clinical success rate was in 25 of the 26 patients treated(96%). Hemodynamic change revealed markedly improvement before and after stenting(peak pressure difference from 66.329.0mmHg to 9.1+/-7.1mmHg; Mean pressure difference from 33.0+/-22.5mmHg to 4.7+/-4.3mmHg). There were two procedural complications which included one stent migration and one artery perforation. During the 7 months of follow-up(1-18 momths), two restenosis occurred. One patient died due to cerebral hemorrhage during thrombolysis with urokinase. CONCLUSION: The stent deployment is relatively safe and very effective primary therapeutic modality and may abolish the limitation of PTA such as suboptimal result, dissection with sudden occlusion and restenosis in peripheral vascular disease and highly recommended in selected cases.
Angioplasty, Balloon ; Aorta ; Arteries ; Atherectomy ; Cerebral Hemorrhage ; Constriction, Pathologic ; Femoral Artery ; Hemodynamics ; Humans ; Iliac Artery ; Inflation, Economic ; Korea ; Peripheral Arterial Disease* ; Peripheral Vascular Diseases ; Prostheses and Implants ; Stents* ; Subclavian Artery ; Urokinase-Type Plasminogen Activator

In the unconscious patient with general muscle rigidity, the natural teeth can be luxated and then bite wounds may be occurred around lip, owing to the pathologic involuntary self-biting habit. If the forceful biting is generated continuously, the teeth may be avulsed and aspirated into the aerodigestive tract with the infection of biting wound. For the prevention of pulmonary aspiration of the teeth and wound infection, the biting teeth should be cared before the fact. The authors treated the teeth as endodontic drainage with removal of the crown or iodoform gauze drainage into the socket with extraction of the teeth. The prognosis was more favorable without biting wounds.
Crowns ; Dental Pulp Cavity* ; Drainage* ; Humans ; Lip ; Muscle Rigidity ; Prognosis ; Tooth ; Wound Infection ; Wounds and Injuries*