Blunt chest trauma to the heart may produce instantaneous death or, more frequently, congestive heart failure due to myocardial injury or disruption of intracardiac structures. Cardiac injury following by blunt chest trauma is often unsuspected and can range from cardiac contusion to chamber rupture, or to valvular dysfunction. The rate of occurrence of acute traumatic valvular insufficiency is extremely rare. Especially, the tricuspid valve is very rarely injured. Although clinical diagnosis of acute traumatic valvular insufficiency can be difficult to make for trauma patients with multiple injuries, echocardiography can establish diagnosis quickly and accurately. This report describes a patient who developed tricuspid regurgitation and acute heart failure following by an MCV.
Contusions ; Diagnosis ; Echocardiography ; Heart ; Heart Failure ; Humans ; Multiple Trauma ; Rupture ; Thorax* ; Tricuspid Valve ; Tricuspid Valve Insufficiency*

Torsion of a mucocele of the vermiform appendix is an extremely rare condition and also a rare cause of an acute abdomen with a clinical presentation that is indistinguishable from acute appendicitis, and thus, the condition is diagnosed during operation. Here, the authors describe the case of a 78-year-old female, who presented with intermittent abdominal pain. The appendix had a pelvic position and the torsion was counterclockwise. In addition, the torsion was associated with mucocele of the appendix, which was considered a secondary factor of torsion. Appendectomy and drainage were performed.
Abdomen, Acute ; Abdominal Pain ; Aged ; Appendectomy ; Appendicitis ; Appendix ; Drainage ; Female ; Humans ; Mucocele ; Torsion Abnormality

The purpose of this study is to evaluate the short-term results of the reconstruction of acetabular bone defect radiographically. Twenty three reconstruction with bone graft and non-cemented porous hemispherical cup and one reconstruction with bone graft and cemented polyethylene cup that had been performed in 24 patients from 1991 at Wonkwang University Hospital and had followed more than one year were included in this study. Osseous union, resorption of the graft, the amount of the migration and angle change of the acetabular components and radiolucency were checked on plain X-ray. 9 morselized grafts for contained defect showed 100% union within 6 months, without severe resorption and loosening. Of the 15 structural grafts, 11 minor column or shelf grafts showed 100% union and remodeling, and one case of radiolucency around the cup. There were two collapses of the structural graft and one migration of the cup which suggest the failure among the 4 major column grafts. For the above 3 failed cases, non-cemented porous hemispherical cups were used. In conclusion, bone graft for reconstruction of the deficient acetabular bone stock seems to be suc- cessful, but the use of cement and the delay of weight bearing should be considered for the major column graft.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Humans ; Polyethylene ; Transplants* ; Weight-Bearing

Tibial nonunion is often associated with the soft tissue atrophy and the local circulatory disturbance, so it is important to minimize the soft tissue injury and maintain the stability at fracture site for bone union. We reviewed 29 cases of subcortical onlay bone grafts and plate fixations for the nonunion and delayed union of tibial shafts, from Jan. 1988 through Jan. 1994. The results were as follows. 1. Twenty-nine patients who had nonunion of the tibia underwent subcortical cancellous onlay bone graft and plating, and 28 fractures(96.6%) went on to union. 2. Subcortical elevation or shingling of cortical bone fragments of the tibial cortex, is advocated to provide sound biological condition in atrophic soft tissue envelope. 3. Narrow DCP encouraged early motion and reliably promoted obtaining anatomical alignment. So, in treatment of protracted tibial nonunion, especially in an area with deficient soft tissue or unyielding scar tissue, subcortical onlay bone graft and plate fixation is very useful method, result in good union and no skin problem.
Atrophy ; Cicatrix ; Humans ; Inlays ; Methods ; Skin ; Soft Tissue Injuries ; Tibia ; Transplants

No abstract available.
Neurilemmoma* ; Trachea*

Intradural extramedullary (IDEM) tuberculoma of the spinal cord is uncommon entity and moreover, few reports have been documented on concurrent IDEM and intracranial tuberculomas. Authors report a case of IDEM spinal tuberculoma having intracranial lesion simultaneously. A 49-year-old woman suffered from paraparesis and urinary incontinence while being given medical treatment for tuberculous meningitis. Magnetic resonance imaging (MRI) revealed an IDEM mass lesion between the T1 and T2 spinal levels, and multiple intracranial tuberculous granulomas. Surgical resection of the IDEM tuberculoma followed by anti-tuberculous medication resulted in good outcome.
Brain/radiography ; Case Report ; Female ; Follow-Up Studies ; Human ; Magnetic Resonance Imaging ; Middle Age ; Mycobacterium tuberculosis/isolation & purification ; Spinal Cord Diseases/radiography* ; Tuberculoma/surgery ; Tuberculoma/radiography ; Tuberculoma/drug therapy ; Tuberculoma/complications* ; Tuberculosis, Meningeal/surgery ; Tuberculosis, Meningeal/radiography ; Tuberculosis, Meningeal/drug therapy ; Tuberculosis, Meningeal/complications*

Most currently available statins are associated with an increase with risk of myositis, including rhabdomyolysis. Myopathy is believed to be caused by interference in the cytochrome P450 3A4 enzyme system, which results in a marked increase in reductase activity. Cerivastatin, a new synthetic HMG-CoA reductase inhibitor, is a safe, well-tolerated effective drug for the treatment of patients with dyslipidemia. The drug is metabolized by the cytochrome P450 3A4 and cytochrome P450 2C8 hepatic isoenzymes. Because of this dual metabolic pathway, it has been suggested that cerivastatin is less subject to drug-todrug interactions. We describe a 60-year-old woman with rhabdomyolysis and localized myositis, after she had taken cerivastatin(lipobay, 0.3 mg/day) and gemfibrozil(lopid, 500 mg/day) for 1month.
Cytochrome P-450 Enzyme System ; Dyslipidemias ; Female ; Gemfibrozil ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Isoenzymes ; Metabolic Networks and Pathways ; Middle Aged ; Muscular Diseases ; Myositis ; Oxidoreductases ; Rhabdomyolysis*

No abstract available.
Rhinitis*

BACKGROUND AND OBJECTIVES: Attic cholesteatoma which develops from the papillary or retracted from progresses through various anatomic sites such as the mesotympanium, the mastoid process and the epitympanium. Although the most common site for attic cholesteatoma is the lateral attic space, it has also been found frequently in the medial attic space. We hoped to understand the pathogenesis of attic cholesteatoma through clinical analyses in order to contribute to the cholesteatoma treatment. MATERIALS AND METHODS: We chose 60 attic cholesteatoma patients showing attic retraction or perforation. These cases of attic cholesteatomas were classified into either the lateral or the medial types depedning on the main site of occurence. They were further classified into anterior, posterior and inferior types according to the direction of cholesteatomatic progression. CONCLUSION: The accurate assessment and clear understanding of the pathogenesis of different forms of cholesteatoma enabled a successful operation and helped to minimize the operative field.
Cholesteatoma* ; Hope ; Humans ; Mastoid

BACKGROUND: The quick and accurate radiologic evaluation is essential to minimize the sequelae of temporal bone trauma. High resolution computed tomography(HRCT) is regarded as a method of choice in the evaluation of the head trauma including temporal bone fractures. Although the diagnosis of ossicular dislocation with HRCT has been described, we could find only one report on the usefulness of coronal sections in the diagnosis of lateral displacement of the incus. OBJECTIVES: The purpose of this study is to evaluate the usefulness of a recently reported radiologic sign, named the "Y" sign, for the diagnosis of lateral dislocation of the incus on the coronal HRCT sections of the temporal bones. MATERIALS AND METHODS: We retrospectively reviewed the axial and coronal HRCT sections of 13 cases who the laterally dislocated incus was confirmed operatively. RESULTS: In the axial HRCT sections, abnormal ice cream cone was shown in only 3 cases, but normal ice cream cone was shown in 10 cases. In the coronal HRCT sections, the Y-sign was shown in 11 cases-open Y-sign: 3 cases, closed Y-sign: 8 cases, in contrast, only 2 cases did not shown Y-sign. CONCLUSION: The Y-sign in the coronal sections is more correlated with the dislocated incus than with abnormal ice cream cone configuration in the axial sections. So, the Y-sign seems to be very useful in the diagnosis of the dislocated incus.
Craniocerebral Trauma ; Diagnosis* ; Dislocations* ; Ice Cream ; Incus* ; Retrospective Studies ; Temporal Bone