To evaluate the availability of n-butyl-2-cyanoacrylate as an adhesive in limbal wound repair, we used 15 rabbits(30 eyes). A limbal incision exactly 9mm long was made and the wound of one eye was tightly closed with seven equally apaced corneoscleral sutures of 10-0 nylon(nylon group), The wound of the other eye was closed by two(6.5mm spaced, 11 and 1 o'clock) corneoscleral sutures of 8-0 vicryl and the outer surface of this limbal wound was thinly coated with a small amount of Histoacryl(Histo-acryl group). The average disrupting pressure in nylon group was 0.87 +/- 0.11 kg/cm2 and that in Histoacryl group was 0.79 +/- 0.17 kg/cm2. The average refractive change in nylon group was 2.5 diopter with-the-rule astigmatism, and that in Histoacryl group was 0.9 diopter against-the-rule astigmatism. A moderate inflammatory reaction was noted at the histopathologic findings of the wounds closed with Histoacryl 14 days after operation. From the results, post-operative inflammatory changes indicated that the Histoacryl seemed to be rather unsuitable for clinical application.
Adhesives* ; Astigmatism ; Cyanoacrylates* ; Enbucrilate ; Nylons ; Polyglactin 910* ; Rabbits* ; Sutures ; Wounds and Injuries*

Twenty-five patients with spontaneous intracerebellar hematoma were analyzed, who had been admitted to Jeonju Jesus Hospital from 1982 to 1985. All cases were diagnosed by CT scan and the amount of the hematoma was assessed by the largest diameter and the height as large, moderated, and small. Three clinical types were defined to evaluate the method of treatment and the outcome. All twelve acute cases were operated and seven were dead-five from brainstem failure, one from rebleeding, and one from chest infection. All chronic cases were treated conservatively to yield good results. Of seven subacute cases, five were operated and two died. Overall mortality was 36% and surgical mortality was 53%. To avoid considerable loss of potential recovery, it is suggested that prompt confirmation of the intracerebellar hematoma by CT scan, emergency surgical management, proper pre-and post-operative care results in better prognosis in cases of this not-uncommon-not-incurable disease.
Brain Stem ; Emergencies ; Glasgow Outcome Scale ; Hematoma* ; Humans ; Jeollabuk-do ; Mortality ; Prognosis ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: Color Doppler echocardiography is sensitive in detecting mitral regurgitation and useful in quantitating its severity. The presence of an eccentric regurgitant jet suggests that regurgitation is caused by prolapsing or flail leaflet of mitral valve. Until recently the direction of regurgitant jet in mitral valve prolapse has been examined in a single(parasternal short axis view) or orthogonal plane using color Doppler echocardiography, and few in the apical rotation method of a transducer. The purpose of this study was to clarify the usefullness of the apical rotation method of a transducer in detection of the direction of mitral regurgitant jet and diagnosis of the sites of mitral valve prolapse. METHODS: Twenty four patients(8 men and 16 women, mean age:47.3+/-18.8 years) with mitral valve prolapse with eccentric regurgitant jet were examined by two-dimensional and color Doppler echocardiograply using conventional parasternal long and short axis views, and four apical longitudinal planes(four chamber, vertical, two chamber and transverse views) obtained by the apical retation method of a transducer. RESULTS: Thirty one regurgitant jets were detected in twenty four patients, eighteen patients had anterior, nine patints posterior, and three patients bi-leaflet(anterior and posterior) prolapse. In eighteen patients with anterior leaflet prolapse, ten had medial, eight had middle, three had lateral, and three had two portions(two, medial and middle; one, middle and lateral) prolapse. In nine patients with posterior leaflet prolapse, five had medial, three had middle, two had lateral, and one had two(medial and middle) scallop prolapse. CONCLUSION: Color Doppler echocardiography by the apical rotation method of transducer is useful in assessment of the site of prolapse in patients with mitral valve prolapse with eccentric regurgitation.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler, Color ; Female ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pectinidae ; Prolapse* ; Transducers*

Author analyzed 117 patients with traumatic lesions in posterior cranial fossa who had been treated at the Department of Neurosurgery in Jeonju Presbyterian Medical Center from January 1982 to December 1985. Results are summarized as follows: 1) The traumatic lesions in posterior cranial fossa were 4.97% of all head injuries. 2) 73 out of 117 patients were male and female were 44 cases. 75.2% of cases were found below age of 40. 3) The most common cause of injuries was traffic accident with motor vehicle(50%). 4) Occipital skull fractures were found in 69 cases(50.4%). Most of them were linear type. There were 15 epidural hematoma(12.8%), 6 cerebellar hematoma, 4 pontine hematoma, 1 subdural hematoma. 5) 67 cases of all patients were on Grady coma scale grade 1 and 2. 48 cases were on Grady coma scale grade 3 and 4. 2 cases were on Grady coma scale grade 4 and 5 on admission. 6) 13 cases with traumatic hematomas in posterior cranial fossa were treated surgically and 13 cases conservatively. 3 of them were expired. 7) There were 61 cases associated injuries(52.1%). Commonly associated injuries were the fracture of rib, clavicle and femur. 8) 50 out of 117 cases showed sequelae:Motor weakness and cranial nerve palsies were main deficits. 9) The total mortality of traumatic posterior fossa lesions was 12.8%(15 cases) and the operative mortality was 15.4%(2 cases).
Accidents, Traffic ; Clavicle ; Coma ; Cranial Fossa, Posterior* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Female ; Femur ; Hematoma ; Hematoma, Subdural ; Humans ; Jeollabuk-do ; Male ; Mortality ; Neurosurgery ; Protestantism ; Ribs ; Skull Fractures

Author analyzed 117 patients with traumatic lesions in posterior cranial fossa who had been treated at the Department of Neurosurgery in Jeonju Presbyterian Medical Center from January 1982 to December 1985. Results are summarized as follows: 1) The traumatic lesions in posterior cranial fossa were 4.97% of all head injuries. 2) 73 out of 117 patients were male and female were 44 cases. 75.2% of cases were found below age of 40. 3) The most common cause of injuries was traffic accident with motor vehicle(50%). 4) Occipital skull fractures were found in 69 cases(50.4%). Most of them were linear type. There were 15 epidural hematoma(12.8%), 6 cerebellar hematoma, 4 pontine hematoma, 1 subdural hematoma. 5) 67 cases of all patients were on Grady coma scale grade 1 and 2. 48 cases were on Grady coma scale grade 3 and 4. 2 cases were on Grady coma scale grade 4 and 5 on admission. 6) 13 cases with traumatic hematomas in posterior cranial fossa were treated surgically and 13 cases conservatively. 3 of them were expired. 7) There were 61 cases associated injuries(52.1%). Commonly associated injuries were the fracture of rib, clavicle and femur. 8) 50 out of 117 cases showed sequelae:Motor weakness and cranial nerve palsies were main deficits. 9) The total mortality of traumatic posterior fossa lesions was 12.8%(15 cases) and the operative mortality was 15.4%(2 cases).
Accidents, Traffic ; Clavicle ; Coma ; Cranial Fossa, Posterior* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Female ; Femur ; Hematoma ; Hematoma, Subdural ; Humans ; Jeollabuk-do ; Male ; Mortality ; Neurosurgery ; Protestantism ; Ribs ; Skull Fractures

PURPOSE: To determine the MR imaging findings of synovial sarcoma, with emphasis on the signal characteristicsof pathologically correlated T2-weighted images. MATERIALS AND METHODS: MR images of 14 cases ofpathologically-proven synovial sarcomas were retrospectively reviewed and correlated with the histopathologicfindings. We analyzed the signal intensity of T1- and T2-weighted images and the incidence of triple signalintensity, and evaluated the frequency of fluid-fluid levels, internal fibrous septa, calcification, the invasionof bone or neurovascular bundles and the involvement of joint capsules, as well as the size, location and marginof the tumors and pattern of contrast enhancement. RESULTS: Necrosis, cystic change or hemorrhage was suggested in11 cases, ten of which showed triple signal intensity, and in all cases, was pathologically confirmed. Fluid-fluidlevels were found in three cases and internal septa in ten. In four cases, maximum diameter was less than 5cm, andin nine, was greater than this. No mass was detected in one case. The tumor was located in the low extremity(n=9),pelvic girdle and hip joint area(n=2), scapular(n=1), shoulder joint area(n=1), and scalp(n=1). Eleven casesshowed a relatively well-defined margin and nine showed lobulation. Except in the area of necrosis and cysticchange, the pattern of contrast enhancement was diffuse and inhomogenous. Bony invasion was detected in two cases,neurovascular encasement in four, calcification in four, and joint capsule invasion in four. CONCLUSION: OnT2-weighted images, synovial sarcoma frequently showed triple signal intensity and internal septa with fluid-fluidlevels ; this was induced by cystic changes due to necrosis and hemorrhage.
Hemorrhage ; Hip Joint ; Incidence ; Joint Capsule ; Magnetic Resonance Imaging* ; Necrosis ; Retrospective Studies ; Sarcoma, Synovial* ; Shoulder Joint

PURPOSE: To evaluate the clinical and radiological results of patients that underwent total knee replacement arthroplasty (TKRA) using a NexGen(R). implant, and who were followed up for at least 2 years. MATERIALS AND METHODS: Between July 1996 and June 2002, 100 knees in 67 patients, and followed up for at least 2 years following TKRA using a NexGen(R). implant were retrospectively assessed for clinical and radiological results using the assessment standards of the Knee and Functional Score of the American Knee Society. RESULTS: The average preoperative range of motion in patients with osteoarthritis and rheumatoid arthritis were 107.4degrees (50-140degrees) and 105.8degrees (70-120degrees), respectively, which had improved to 127.2degrees (85-140degrees) and 125.6degrees (90-140degrees), respectively, at the final follow up. In addition, the preoperative flexion contracture improved from 11.3degrees (0-30degrees) and 10.6degrees (0-30degrees) to 1.3degrees (0-15degrees) and 3degrees (0-15degrees) postoperatively. The results using the assessment standards of the Knee and Functional Score of the American Knee Society were improved from 62 (35-82) and 40 (0-70) to 95.8 (87-100) and 97 (70-100) in patients with osteoarthritis, whereas the patients with rheumatoid arthritis were improved from 53.8 (32-73) and 36 (0-50) to 95.1 (89-98) and 79 (55-95). As a complication, infection occurred in 2 cases; they were given a reimplantation. CONCLUSION: TKRA using a NexGen(R). implant showed satisfactory improvement in pain relief and function, such as range of motion, as well as a lower occurrence rate of complications.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies* ; Humans ; Knee* ; Osteoarthritis ; Range of Motion, Articular ; Replantation ; Retrospective Studies

When a bullet hits the body, it generally follows a straight path, and there may or may not be an exit wound. Sometimes the bullet loses its kinetic energy within a blood vessel and thus it embolizes into the cardiovascular system, either in the systemic circulation or the pulmonary circulation and we call this phenomenon a "Bullet" embolism. A thirty-five years old man with a gun shot injury on his abdomen came to hospital. There was an entry site, but no exit site. According to his plain X-ray, there was no bullet in his abdomen. Instead, the bullet was located on the right ventricle of the heart. Because there was no injury on his diaphragm and heart, we concluded that the bullet got into a blood vessel and it ran through the venous system into the heart.
Abdomen ; Blood Vessels ; Cardiovascular System ; Diaphragm ; Embolism ; Glycosaminoglycans ; Heart ; Heart Ventricles ; Porphyrins ; Pulmonary Circulation

PURPOSE: Laparoscopic surgery has been considered to be contraindicated for obstructive colorectal cancer. However, endoscopic stent insertion for obstructive colorectal cancer has recently allowed elective laparoscopic surgery. The aim of this study is to evaluate the feasibility and the short-term clinical outcomes of laparoscopic surgery following endoscopic stent insertion for management of malignant colorectal obstruction at a single center. METHODS: The medical records of patients who had undergone endoscopic stent insertion for colorectal cancer obstruction, followed by laparoscopic colorectal resections, from August 2004 to August 2008 were reviewed. To evaluate the surgical and clinical outcomes, we analyzed the clinical and pathologic data. RESULTS: Thirty-six endoscopic stent insertions were successfully performed during the study period. Of those 36, the 28 treated by laparoscopic surgery were enrolled in this study. The mean interval between stent insertion and surgery was 7.4+/-2.3 days. Two cases were converted to open surgery. The mean operative time was 185.5+/-53.1 min, and the mean blood loss was 77.0+/-72.9 mL. Flatus was passed on the mean 2nd postoperative day, and patients started to eat on the mean 4th postoperative day. The mean postoperative hospital stay was 11.2+/-4.4 days. Anastomosis leakages occurred in two cases and were treated by a secondary operation with a transient ileostomy. There were morbidities in five cases, but no mortalities. CONCLUSION: A combined endoscopic stent insertion and laparoscopic surgery is an effective and safe, minimally invasive operation for malignant colorectal obstruction.
Colorectal Neoplasms ; Flatulence ; Humans ; Ileostomy ; Laparoscopy ; Length of Stay ; Medical Records ; Operative Time ; Stents

Sixty-eight clinical isolates of Stenotrophomonas maltophilia from inpatients of 2 university hospitals in Taegu were epidemiologically analyzed by using the minimum inhibitory concentrations of 25 antimicrobial drugs, biochemical reaction, pulsed-field gel elctropgoresis (PFGE), and PCR with enterobacterial repetitive intergenic consensus sequences as primer (ERIC-PCR). 1. All the strains were susceptible to minocycline. More than 57% were susceptible to sulfisomidine (Su), ciprofloxacin (Ci), Ofloploxacin (Of), nalidixic acid (Na), and chloramphenicol (Cm), and 19apprx35% to ceftazidime (Cd), trimethoprim (Tp), Ticacillin-clavulanic acid, and cefoperazone-sulbactam. Most isolates were resistant to beta-lactam antibiotics such as ampicillin (Ap), carbenicillin (Cb), cefotaxim (Ct), cefoxitin (Cx), and aminoglycosides including gentamicin (Gm), tobramycin (Tb), amikacin (Ak). 2. All the isolates were multiply resistant of 5 to 17 drugs and showed 40 different resistance pattern types. 3. All the strains showed very similar biochemical reactions except beta-galactosidase and nitrate reduction test. Fourteen strains selected randomly were classified 10 different pattern type by PFGE and ERIC-PCR. These two methods showed identical result. Four strains isolated from wound in 1994 showed similar MIC pattern and identical API 20NE profile, PFGE, and ERIC-PCR pattern indicating episodes of cross-infection among patients. These results indicate that PFGE or ERIC-PCR profile has comparable discriminatory power for epidemiological typing of S. maltophilia.
Amikacin ; Aminoglycosides ; Ampicillin ; Anti-Bacterial Agents ; beta-Galactosidase ; Carbenicillin ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Chloramphenicol ; Ciprofloxacin ; Consensus Sequence ; Daegu ; Gentamicins ; Hospitals, University ; Humans ; Inpatients ; Microbial Sensitivity Tests ; Minocycline ; Nalidixic Acid ; Polymerase Chain Reaction ; Stenotrophomonas maltophilia* ; Stenotrophomonas* ; Sulfisomidine ; Tobramycin ; Trimethoprim ; Wounds and Injuries