No abstract available.
Nasal Bone*

No abstract available.
Allografts*

No abstract available.

Four-part displaced fractures, four-part fracture-dislocations, impression fractures of the articular surface involving greater than 50% of the head, and head-splitting fractures are to be best treated by primary prosthetic replacement. 3 primary prosthetic replacements were performed for the treatment of the proximal humeral fractures(l case of four-part displaced fracture, 2 cases of fracture-dislocation) and all cases were followe( up at least 3 years. Case II had excellent result, case I was satisfactory, and case III failure by Neers numerical ratin method. There were proximal subluxation roentgenologically in case I and III.
Head ; Methods ; Prostheses and Implants ; Shoulder Fractures

BACKGROUND AND OBJECTIVES: The objectives were to analyze the results of the laryngeal framework surgery (LFS) in one institute during 12 years. We reviewed the present position of LFS in the phonosurgery field and discussed the prospects for this type of surgery in the future. SUBJECTS AND METHOD: One hundred seventy nine charts of patients who underwent LFS in Yongdong Severance hospital from 1992 to 2003 were reviewed. Types of procedures were made according to the classification/ nomenclature of European Laryngological Society. RESULTS: One hundred ninty seven operations had been performed during 12 years in 179 patients. Type I thyroplasty was the most common procedure (28.9%). Type I thyroplasty+Arytenoid adduction (26.4%), Type III thyroplasty (16.8%), Arytenoid adduction (15.2%), Injection medialization (11.2%), Type IV thryroplasty (1.5%) followed in the order of most commonly operated choices. Of 197 cases, 18 cases were revision. There was only one major complication (dyspnea). A variety of dysphonias, which include vocal fold paralysis (71.5%), various pitch problems (mutational dysphonia (14%), androphonia (1.1%)), glottal insufficiency (12.8%), and some cases of spasmodic dysphonia (0.6%), had been treated with LFS. CONCLUSION: Laryngeal framework surgery is a new type of surgery that aims to improve the voice by restructuring the laryngeal framework. This type of surgery has become increasingly popular, because it has been found to be safe and effective.
Dysphonia ; Humans ; Laryngoplasty ; Paralysis ; Treatment Outcome ; Vocal Cords ; Voice ; Voice Disorders

17 cases of acute myocardial infarction with no or insignificant narrowing of major coronary arteries on angiogram and without any-other types of heart disease were found in a series of 133 consecutively studied patients with acute myocardial infarction(12,7%). There were no differences in risk factors between groups. Although the infarction site were similar in both groups, the patients with normal coronary arteries had fewer complications during hospitalization(p<0.05) and lesser ST segment change during the exercise test before discharge(p<0.05). In the hemodynamic fingings, cardiac index, left ventricualr and diastolic pressure and resional wall motion were similar in both groups of the patients, but ejection fraction was higher(p<0.05) in the patients with the normal coronary arteries. In conclusion, it could be predicted that the acute myocardial infarction with the normal coronary arteries would have the better prognosis. And a transient coronary occlusion, as the most likely pathogenic mechanism of the acute mtocardial infarction with normal coronary arteries, might be studied in the aspect of the thrombosis following lysis, the coronary artery spasm and the platelet aggregation.
Angiography* ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels ; Exercise Test ; Heart Diseases ; Hemodynamics ; Humans ; Infarction ; Myocardial Infarction* ; Platelet Aggregation ; Prognosis ; Risk Factors ; Spasm ; Thrombosis

In various autopsy series, overdiagnosis as well as underdiagnosis of pulmonary embolism has been reported. During the past decade, mortality rate has not declined despite advances in diagnostic methods. To evaluate the hypothesis that changes of hemodynamic parameters responded by mean pulmonary arterial pressure differences are of paramount importance to guide prognosis, experimental model of anesthetized dogs was used. Six dogs were anesthetized with 15 milligrams per kilogram of pentobarbital sodium, given intravenously and paralyzed with 2 milligrams of pancuronium bromide. 0.3 to 0.8 gram per kilogram of autologous blood clot was infused into the right atrium through a left external jugular vein. The dogs after embolization were divided into group A(mean pulmonary arterial pressure 33mmHg) and group B(mean pulmonary arterial pressure 43 mmHg). Each group of three dogs was monitored for a total of 4.5 hours. A 7F Swan-Ganz catheter was positioned and used to measure with fluid-filled transducer pulmonary capillary wedge pressure, mean pulmonary arterial pressure and mean right atrial pressure. Cardiac ouput was measured in triplicate by thermodilution and divided by weight to obtain the cardiac index. Blood gases, pH and saturation of arterial blood were measured. White blood cell and platerlets were counted in arterial blood. The results are as follows : 1) Changes in mean arterial pressure showed no significant differences between group A and group B following embolization. 2) Changes in mean pulmonary arterial pressure showed significant differences between group A and group B(p<0.05). 3) Changes in cardiac index showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 4) Changes in total pulmonary resistance showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 5) PaO2 showed significant differences between group A and group B after one hour following embolization(p<0.05), but arterial pH showed no significant difference. 6) Changes in mean pulmonary capillary wedge pressure, mean right atrial pressure and heart rates showed no significant differences between group A and group B following embolization. In conclusion, changes in mean pulmonary arterial pressure, cardiac index, total pulmonary resistance and PaO2 showed significant differences between group A and group B following embolization.
Animals ; Arterial Pressure ; Atrial Pressure ; Autopsy ; Catheters ; Dogs* ; Gases ; Heart Atria ; Heart Rate ; Hemodynamics ; Hydrogen-Ion Concentration ; Jugular Veins ; Leukocytes ; Models, Theoretical ; Mortality ; Pancuronium ; Pentobarbital ; Prognosis ; Pulmonary Artery* ; Pulmonary Embolism* ; Pulmonary Wedge Pressure ; Thermodilution ; Transducers

From march, 1983 to May, 1987, we experienced 17 patients of Marfan syndrome. The clinical profile and course of 17 patients of Marfan syndrome were reviewed. 1) Their ages ranged from 13 to 50 years with a mean age of 30 years and 16 patients were male and 1 patient was female. 2) musculoskeletal features were present in 14(88%) of the 16 examined. Ocular features were found in 5(42%) of 12 examined. Familial features were present in 7(47%) of 15 examined. 3) Among cardiovascular manifestations dissecting aneurysm was present in 10(59%) patients, aortic annuloectasia in 15(94%), MR in 4(24%) and MVP in 1(6%). 4) Modified Bentall operation was performed to 8 patients. Two of them died. The other 8 patients took a conservative medical therapy. Four of them died.
Aneurysm, Dissecting ; Female ; Humans ; Male ; Marfan Syndrome*

From May, 1975 to August, 1986, we experienced 21 patients with ruptured aneurysm of the sinus of Valsalva. 1) Their ages ranged from 15 to 52 years with a mean age of 26.7 years, and 14 patients were male and 7 patients were female. Among 18 cases of which aneurysms occurred on the right sinus of Valsalva, 15 cases (83%) ruptured into the right ventricle, 1 case (6%) ruptured into the right atrium and 2 cases (11%) ruptured into the pulmonary artery. All 3 cases of which aneurysms occurred on the noncoronary sinus ruptured into the right atrium. 2) Clinical symptoms consisted of dyspnea (95%), palpitation (81%), chest pain (43%), orthopnea (33%), cough (14%), hemoptysis (5%), oliguria (5%), and fever (5%). In all patients continuous heart murmur was audible. Hepatomegaly (48%), pulmonary basal rale (14%), and pretibial pitting edema (19%) were also observed. 3) In all patients diagnosis was made with cardiac catheterization and angiography, and confirmed by operation excetpt one case. 4) Among 20 patients who had been performed corrective surgery, ventricular septal defect was observed in 16 patients (85%), aortic insufficiency in 5 patients (25%), pulmonary infundibular stenosis in 1 patient (5%), patent foramen ovale in 1 patient (5%), and tricuspid insufficiency in 1 patient (5%). Ventricular septal defect was observed in all 16 patients whose aneurysms of the right coronary sinus of Valsalva ruptured into the right ventricle and the pulmonary artery. 5) All patients survived operation, and no postoperative complication was found except 1 patient to whom reoperation was performed because of postoperative aortic insufficiency and detachment of the patch closure for ventricular septal defect. There was symptomatic improvement in all patients.
Aneurysm ; Aneurysm, Ruptured* ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Sinus ; Cough ; Diagnosis ; Dyspnea ; Edema ; Female ; Fever ; Foramen Ovale, Patent ; Heart Atria ; Heart Murmurs ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Hemoptysis ; Hepatomegaly ; Humans ; Male ; Oliguria ; Postoperative Complications ; Pulmonary Artery ; Pulmonary Subvalvular Stenosis ; Reoperation ; Respiratory Sounds ; Sinus of Valsalva*

BACKGROUND: Platelet plays an important role in the pathogenesis of acute coronary syndrome. Platelet glycoprotein IIb III a is the receptor for fibrinogen, and it plays an important role in the platelet aggregation. It was reported that polymorphism of the platelet glycoprotein III a (PlA1/A2) is related to acute coronary syndrome, especially in young patients. The aims of this study is to evaluate the relationship between platelet glycoprotein III a polymorphism and acute coronary syndrome in Koreans. METHOD: We studied total 208 patients (M: F=131 : 77, mean ages : 57.2+/-9.7). Acute coronary group comprised 110 patients, who underwent coronary angiography with the impression of acute myocardial infarction or unstable angina. Normal group comprised 98 patients who had no significant angiographic lesion. Genomic DNA was extracted from peripheral blood. To determine the frequency of PlA1/A2 genotype, polymerase chain reaction (PCR) was done and the product was restricted with Msp I. 3% gel electrophoresis showed Restriction Fragment Length Polymorphism (RFLP). Clinical profile and risk factor were also reviewed. RESULT: One patient in the acute coronary group is PlA1/A2 heterozygote and all the other are PlA1 homozygote. In normal group, all patients are PlA1 homozygote. The genotypic frequency of PlA1/A2 is consistent with the previous study. CONCLUSION: The genotype frequency of platelet glycoprotein III a gene polymorphism in Koreans is different from that of Caucasian. The allele frequencies of platelet glycoprotein III a is not different between acute coronary syndrome patient and normal control group. Platelet glycoprotein III a polymorphism may not be an hereditary risk factor in Koreans.
Acute Coronary Syndrome* ; Angina, Unstable ; Blood Platelets* ; Coronary Angiography ; DNA ; Electrophoresis ; Fibrinogen ; Gene Frequency ; Genes, vif ; Genotype ; Glycoproteins* ; Heterozygote ; Homozygote ; Humans ; Integrin beta3 ; Myocardial Infarction ; Platelet Aggregation ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Risk Factors