There have been so many methods described for the correction of the deviated noses but it is difficult to get satisfactory results and recurrence rate is high. There is no exact explanation why the recurrences are so high and no estabished guides for techniques according to the surgical pathology. We found the classical swinging door technique effective in cases where the caudal septum deviated from the midline. However, where the caudal septum and the tip stay in the midline, scoring or submucosal resection do not work well enough to cortet them. We used the reverse swinging door technique of our own. After elevation of mucoperichonodrium, we did sagittal section in the posterior septum and moved the septum to the midline on the pivot point of the caudal septum and. The gap created in the posterior portion of the septum were filed with bone grafts, cartilage grafts or Medopor, which were sutured to the septum, We did this technique with or without osteotmies in 56 deviated noses for last 5 years. The results were very satisfactory and there was no complication.
Cartilage ; Nose* ; Pathology, Surgical ; Recurrence ; Transplants

OBJECTIVE: It has been thought that estrogen has neuroleptic like effect in women schizophrenic patients. This study aimed to investigate neuroleptic side-effects severity in women with schizohrenia and to investigate their putative association with variations in sex steroids over menstrual cycle. Based on the estrogen theory, The author hypothesized that parkinsonian side-effects would be exacerbated when estrogen levels were high. METHOD: 26 schizophrenic women were assessed using the ESRS(Extrapyramidal Symptom Rating Scale) and estrogen analysis. Tests were conducted twice, in the mid luteal and mid follicular phase. RESULT: It was hypothesized that high level of estrogen would lead to an exacerbation of parkisonian side-effects but the results indicated that parkinsonian side effects decreased overall when estrogen levels were high. This effects were more marked for the group taking typical neuroleptics than those taking atypical neuroleptics. CONCLUSION: The results of this study suggest that estrogen and progesteron may reduce the severity of neuroleptic indeced extrapyramidal side effects over menstrual cycle in women with schizophrenia. It was concluded that estrogen has different effects on dopamine dynamics in the mesolimbic and mesostriatal pathways according to estrogen, progesteron, catecol estrogen, prolactine.
Antipsychotic Agents ; Dopamine ; Estrogens* ; Female* ; Follicular Phase ; Humans ; Menstrual Cycle ; Prolactin ; Schizophrenia ; Steroids

Hemoglobin(Hb), zinc protoporphyrin(ZPP) and blood lead(PbB) levels were determined for 1,851 blood samples collected from healthy urban population to establish reliable baselines for Hb, ZPP and PbB levels by age and sex. ZPP values were analyzed with a Hmatofluorometer and PbB determinations were concurrently carried out using flameless atomic absorption spectrophotometry. The blood sampling period was about 6 months from May, 1991 and the summarized results were as follows; 1. The mean value of Hb in male female were 14.55+/-1.81 g/dl and 12.61+/-1.81 g/dl respectively and there was statistically significant difference(p<0.05). 2. The mean value of ZPP in pre-schoolchildren was 37.49+/-13.31 microgram/dl for male, 35.77+/-11.85 microgram/dl for female and that of ZPP in after 7 years groups was 31.91+/-8.23 microgram/dl for male, 30.11+/-9.11 microgram/dl for female and there was statistically significant difference(p<0.05). 3. The mean value of PbB in pre-schoolchildren was 25.10+/-5.21 microgram/dl for male, 24.45+/-4.18 microgram/dl for female and that of PbB in after 7 years groups was 24.28+/-3.00 microgram/dl for male, 21.99+/-5.05 microgram/dl for female and there was statistically significant difference(p<0.05).
Female ; Humans ; Korea* ; Male ; Spectrophotometry, Atomic ; Urban Population* ; Zinc*

No abstract available.
Adult* ; Humans

No abstract available.
Pregnancy*

Hidradenitis suppurativa (HS) is a chronic inflammatory condition with an unclear etiopathogenesis that is considered to be a follicular occlusive disease. We present a case of HS that was suspected to have developed as a complication of subdermal excision. A 19-year-old man who had undergone subdermal excision due to osmidrosis presented 7 months after surgery with a persistent painful mass in his left axilla. Despite medical treatment, incision, and drainage, a painful enlarged abscess recurred in the left axilla and was cured completely by deroofing surgery. However, 15 months after subdermal excision, he revisited the hospital because of a painful mass in the right axilla. The patient’s condition met the diagnostic criteria of HS. After several recurrences, a cure was achieved by radical wide excision. Mechanical stress like that associated with subdermal excision is considered to be a possible etiological factor of HS. In addition, pathological changes at the sebofollicular junction allow rupture and leakage of folliculopilosebaceous units upon exposure to mechanical stress, which may result in the aggressive subcutaneous extension of inflammation. We suggest that HS should be considered in patients with a recurrent abscess after subdermal excision, and recommend surgical treatment as a possible option if conservative treatment is clinically ineffective.

BACKGROUND: The APACHE scoring system of the Health Care Financing Administration (HCFA) has been being used for serious patients. The scoring system is composed of acute physiologic variables and chronic disease. METHODS: Among patients who underwent emergency operations from 1992 to 1997 because of gastrointestinal perforation, we analyzed 110 cases with five kinds of diseases: duodenal ulcer perforation, small bowel perforation, perforated appendicitis, gastric ulcer perforation and colon perforation. RESULTS: The results were as follows: 1) The preoperative APACHE II scores ranged from 0 to 21. The scores of 64 cases (60.9%) were from 0 to 5. 2) There were no death in case for which pre-peration APACHE II score was from 0 to 10, 25% of the mortality occurred in cases with scores from 11 to 15, 50% in those with scores from 16 to 20, and 100% in those with scores above 21. 3) The APACHE II score decreased continuously from the 3rd to the 7th postoperative day. 4) The preoperative APACHE II scores in gastric ulcer perforation patients were significantly higher than those in duodenal ulcer perforation patients. In the cases of gastric and duodenal ulcer perforations, the APACHE II scores in patients who underwent primary closure were higher than the scores in those who underwent a more definitive operation. 5) In death cases, all of their APACHE II scores were higher at the 3rd postoperative than at the 7th postoperative day, but their APACHE III scores continuously increased postoperatively. CONCLUSIONS: It is thought that the APACHE scoring system is more reliable than clinical experience in the classification of patients by operative risk and in estinating the result and giving a prognosis. Thus, the principle of treatment should be established by estinating patient's score before the operation. Careful preoperative management is necessary for patients with scores more than 10. Because patientswith scores more than 21 have very a high mortality, operative time and method must be carefully decided. The APACHE III scoring system seems to be more sensitive than the APACHE II scoring system in predicting deaths and further investigations and clinical applications should be performed.
APACHE* ; Appendicitis ; Centers for Medicare and Medicaid Services (U.S.) ; Chronic Disease ; Classification ; Colon ; Duodenal Ulcer ; Emergencies ; Humans ; Mortality ; Operative Time ; Prognosis ; Stomach Ulcer

No abstract available.
Polychondritis, Relapsing*

No abstract available.
Polychondritis, Relapsing*

Cardiovascular changes has been reported eating and digestion. Experimental studies showed an early rise in cardiac output during eating which was attributable to an increased heart rate. This changes reverted to baseline valuse at the end of eating. To investigate postprandial cardiac functional change, we studied 20 healthy young men(average age 27 years) nonivasively with BP measurement, electrocardiography and M-mode echocardiohrapy before, 30 minutes and 3 hours after a lunch(600 Kcal). There was no significant changes in mean blood pressure after eating. On echocardiography, diastolic and systolic left ventricular internal dimensions were 4.9+/-0.4 and 3.1+/-0.4cm before meal and 4.9+/-0.4 and 2.9+/-0.3cm 30 minutes after eating. There was an average increase of 9% in cardiac output 30 minutes after meal. Fractional shortening was 36.4+/-6.4% before meal and 40.4+/-6.1(p<0.05) 30 minutes after eating. Ejection fraction changed from 73.5+/-7.9% to 78.2+/-6.3%(p<0.05) at postprandial 30 minutes. Myocardial contractility index assessed by the ratio of systolic BP to end-systolic volume was 4.3+/-1.6mgHg/ml before and 5.3+/-2.2mmHg/ml 30 minutes after eating. Peripheral resistance index as the ratio of mean blood pressure divided by cardiac index changed from 2,536+/-1,120dynesdSdcm-5/m2 to 2,048+/-472dynesdSdcm-5/m2 at postprandial 30 minutes. Electorcardiographic study revealed no changes in ST SE segment, T wave and heart rate after a meal. In conclusion, the increase of cardiac output after a moderate meal in healthy young men was associated with an increase in myocardial contractility and a decrease in peripheral vascular resistance.
Blood Pressure ; Cardiac Output ; Digestion ; Eating ; Echocardiography* ; Electrocardiography ; Heart Rate ; Humans ; Male ; Meals* ; Vascular Resistance