The main trend moves towards early excision and skin grafting as treatment for the deep second degree burns and the third degree burns. The ability to excision & skin grafting. This study prospectively evaluated the ability of laser doppler flow measurements obtained within 72 hours after burn injury to predict the depth of burn wounds. A Periflux system 4001 laser doppler flowmetry had been used to measure cutaneous microflow circulation of 100 selected points of burn wounds in 44 admitted patients from March 1993 to February 1994. The mean value of superficial second degree burn checked by laser doppler was 194.6 perfusion unit(PU). The deep second degree burn was 59.7 PU and third degree burn was 5.1 PU. The blood flow of more than 100 PU reliably predicted the superficial second degree burn with 90.2 percents accuracy. The blood flow between 100 PU and 10 PU predict the deep second degree dermal burn with 96.2 percents accuracy. That of less than 10 PU predict the third degree burn with 100 percents accuracy. There was also a significant correlation between initial flow measurements and the depth of burn wounds. We conclude that laser doppler flow measurements performed early after burn injury are useful in predicting the depth of burn wounds. The laser doppler flowmetry has the advantage of being easy to use, noninvasive, provide immediate result for early determination of burn depth. The laser doppler flowmetry is useful in selecting patients for early excision and grafting of burn wounds.
Burns* ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Prospective Studies ; Skin Transplantation ; Transplants ; Wounds and Injuries

PURPOSE: The objective of this study was to evaluate and compare the accuracy of impression body taking by the closed and the open tray impression technique with 3 types of impression tray. Individual tray, metal stock tray and polycarbonate tray were used. MATERIALS AND METHODS: Nine closed tray impressions were taken by individual tray, metal stock tray and polycarbonate stock tray, respectively with polyether impression material. 9 open tray impressions were also acquired by same manner. Precision analysis on the master models was performed by attaching the reference frameworks with alternate single screws and measuring the vertical fit discrepancy of respective analogues in working cast with a stereo microscope. Data were analyzed by 1 way ANOVA and independent t-test. RESULTS: The average fit accuracy of impression bodies was calculated. With the closed tray impression technique, there were significant statistical differences in vertical fit discrepancy according to the types of tray. The individual tray group showed the lowest value and the polycarbonate stock tray group represented the highest. With the open tray impression technique, there was no significant difference in vertical fit discrepancy. Significant statistical difference in vertical fit discrepancy was found between the open and the closed impression technique with the polycarbonate stock tray. CONCLUSION: From the results above, more precise impressions could be acquired by the rigid individual tray compared with the polycarbonate stock tray. It was hard to get consistent accuracy impressions by the closed tray impression technique with polycarbonate stock trays.
Dental Impression Technique ; Polycarboxylate Cement

The juxtaglomerular cell tumor is a rare benign tumor which causes surgically correctable hypertension. We report a case of hypertension caused by juxtaglomerular cell tumor in a 17-year old man. He presented with hypokalemia, metabolic alkalosis and hyperreninemic hyperaldosteronism. Renal angiography showed no evidence of renal artery stenosis. Though no mass was suspected in renal angiography, CT scan showed a well demarcated mass, 3 cm in diameter, in the upper portion of left kidney, which was resected and diagnosed to be a juxtaglomerular cell tumor. After resection of the tumor, blood pressure was normalized with resolution of hypokalemia, metabolic alkalosis and hyperreninemic hyperaldosteronism.
Adolescent ; Alkalosis ; Angiography ; Blood Pressure ; Humans ; Hyperaldosteronism ; Hypertension ; Hypokalemia ; Kidney ; Renal Artery Obstruction ; Tomography, X-Ray Computed

STUDY DESIGN: A Case report. OBJECTIVES: We report 4 cases of transverse fracture of upper sacrum with good clinical results. SUMMARY OF LITERATURE REVIEW: There is no clear guideline for the treatment of transverse fracture of upper sacrum. MATERIALS AND METHODS: Four patients, who visited our institute for transverse fracture of upper sacrum, were reviewed from January 2006 to July 2009. RESULTS: All patients had good clinical results after treatment. CONCLUSIONS: In all cases, patients were managed conservatively without reduction or internal fixation. Only for Roy-Camille type 2 and 3 transverse fracture of the upper sacrum with neurologic deficit, decompression was performed, yielding good clinical results.
Decompression ; Humans ; Neurologic Manifestations ; Sacrum

This study aimed to assess the effects of different dialysate bicarbonate concentrations in correcting acid-base imbalance in 53 stable hemodialysis patients in a university-hemodialysis unit. Three different bicarbonate concentrations were assigned, i.e. 25 mEq/L in 10, 30 mEq/L in 30, and 35 mEq/L in 13 patients. Blood gas analyses from arterial line blood samples before and after dialysis in the mid-week were performed for the determination of pH and serum bicarbonate concentration ([HCO3-]). The mean values of predialysis arterial [HCO3-] were mildly acidotic in all 3 groups, but not significantly different among them, whereas those of post-dialysis arterial [HCO3-] were alkalotic, especially in the group of 35 mEq/L as compared with the other two groups. The mean blood pH was not significantly different among the 3 groups. As expected, there was a positive correlation between pre-dialysis pH and post-dialysis pH (r=0.45, p=0.001), and pre-dialysis [HCO3-] and post-dialysis [HCO3-] (r=0.58, p=0.000), but with a negative correlation between pre-dialysis [HCO3-] and the increment of intradialytic [HCO3-] following hemodialysis (r=-0.46, p=0.001). In conclusion, this study shows that the impact of conventional dialysate bicarbonate concentrations ranging from 25 to 35 mEq/L is not quite different on the mild degree of predialysis acidemia, but the degree of postdialysis alkalemia is more prominent in higher bicarbonate concentrations. Base supply by hemodialysis alone does not seem to be the main factor to determine the predialysis acidosis in end-stage renal disease patients on chronic maintenance hemodialysis.
Acid-Base Imbalance ; Acidosis* ; Alkalosis* ; Blood Gas Analysis ; Dialysis ; Humans ; Hydrogen-Ion Concentration ; Kidney Failure, Chronic ; Renal Dialysis* ; Vascular Access Devices

BACKGROUND: A ring implantation in the tricuspid annulus requires many interrupted mattress sutures for correction of tricuspid regurgitation (TR). In this study, tricuspid ring annuloplasty was performed by 2-0 polypropylene continuous suture instead of multiple interrupted 2-0 polyester mattress sutures, and the efficacy of the method was evaluated. MATERIALS AND METHODS: This study included 20 patients who underwent tricuspid ring annuloplasty by continuous suture between May 2009 and July 2010. Four of the patients had an isolated TR, and the rest had a left-sided cardiac lesion. The concomitant tricuspid annuloplasty was performed after the left-sided heart surgery was completed and a Duran flexible ring prosthesis was used. RESULTS: There was no perioperative mortality or conduction problem. More than a moderate degree of TR was improved to less than a mild degree after the procedure. After the ring annuloplasty, the right atrial volume decreased from 123.7+/-69.2 mL to 74.5+/-37.4 mL, and the mean right atrial pressure was lowered from 18.7+/-12.2 mmHg to 8.9+/-5.5 mmHg. CONCLUSION: The continuous "over and over" suture may be a useful procedure for fixing the ring to the annulus and making an intentional annular placation in performing tricuspid ring annuloplasty.
Atrial Pressure ; Humans ; Polyesters ; Polypropylenes ; Prostheses and Implants ; Sutures ; Thoracic Surgery ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Intracranial arachnoid cyst are becoming a more frequent finding as a result of the increased use of cranial computed tomography. But the best treatment of arachnoid cysts remains the subject of controversy. We report 46 cases of patients with arachnoid cyst. Thirty nine cases(84.7%) had supratentorial locations. The cases of 22 patients with mild symptoms and small cysts were treated with conservative management only. Surgical treatment was performed on 24 patients with severe or uncontrolled symptoms and large sized cysts. Surgery consisted of craniotomy and cyst excision with communication to basal cistern. Surgical results and long-term outcomes were good. However there was a one operative death due to acute subdural hematoma. It is, therefore conclued that surgical excision of arachnoid cyst with communication to basal cistern is one of the more effective methods of alternative treatment. And further studies of the natural history of conservative cases should be undertaken for a futher understanding.
Arachnoid Cysts ; Arachnoid* ; Craniotomy ; Hematoma, Subdural, Acute ; Humans ; Natural History

PURPOSE: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. MATERIALS AND METHODS: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. RESULTS: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20 (25.0%) for the BDI, 16 (20.0%) for the ZDS, 18 (22.5%) for the CDSS and 6 (7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. CONCLUSION: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.
Age of Onset ; Depression ; Depressive Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Prognosis ; Psychotic Disorders ; Schizophrenia* ; Suicide

A 65-year-old woman complained of a pedunculated, huge mass on the anterior chest associated with neurofibromatosis type 1. The clinical and histological data showed the possibility of a malignant peripheral nerve sheath tumor. On electron microscopy, we found the characteristic findings of a malignant peripheral nerve sheath tumor, such as the foci of en-tangled cytoplasmic processes, undifferentiated spindle cells having large pleomorphic nuclei with prominent nucleoli, distinct basal cell lamina, rudimentary cell junctions, intermediate filaments and clumps of glycogen in the tumor cells. We, herein, report a case of malignant peripheral nerve sheath tumor arising from neurofibromatosis, studied by electron microscopy.
Aged ; Cytoplasm ; Female ; Glycogen ; Humans ; Intercellular Junctions ; Intermediate Filaments ; Microscopy, Electron ; Neurofibromatoses* ; Neurofibromatosis 1 ; Peripheral Nerves* ; Thorax

BACKGROUND: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. METHODS: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. RESULTS: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. CONCLUSION: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.
Acute Kidney Injury ; Aged* ; Atrial Fibrillation ; Body Mass Index ; Carcinoma, Non-Small-Cell Lung* ; Delirium ; Hospital Mortality ; Humans ; Hypertension ; Life Style* ; Mortality ; Multivariate Analysis ; Myocardial Ischemia ; Pneumonia ; Postoperative Complications* ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Survival Rate