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

Primary cancer of the female urethra is a relatively rare disease. During the past 10 years, we could collect 11 cases of the female urethral cancer which were confirmed by pathological examinations. The results of clinical investigation were as followed: 1. The age distribution was from 28 years old to 72 years old and the average was 57 years old. The most common age group was 50 to 69 years (73%). 2. The intervals from onset of symptoms to admission were distributed as follows: the most common group was within 1 year (64%), the second common group was within 3 year (27%) and the third was within 3 months (9%). 3. The common symptoms were as follows: urinary frequency in 9 cases (82%), dysuria in 7 cases (64%), urethral mass in 6 cases (55%), urinary retention in 5 cases (46%), urethral bleeding in 4 cases (36%), hematuria in 2 cases (18%) and urethral pain in 2 cases (18%). 4. Histopathological findings showed squamous cell carcinoma in 5 cases (45%), adenocarcinoma in 4 cases (36%) and transitional cell carcinoma in 2 cases (18%) in order of their frequency. All of the 5 cases of squamous cell carcinoma were vulvourethral types. Among the 4 cases of adenocarcinoma, 3 cases were urethral types and 1 case was vulvourethral type. The 2 cases of transitional cell carcinomas were urethral type and vulvourethral type. 5. Clinical stages were distributed as follows: 2 cases were stage A, 3 cases. stage B, 2 cases, stage C and 4 cases, stage D. In the 7 cases of vulvourethral type, 5 cases were stage A or stage B and 2 cases were stage C or stage D, but the 4 cases of urethral type were stage C or stage D. 6. Treatment of female urethral cancers consisted of surgery and irradiation in general. 1) Local excision was performed on the 2 cases of stage A, but tumor recurrence occurred in 1 case after 1 month postoperatively. 2) In stage B, local excision and interstitial irradiation were made on 1 case, external and interstitial irradiation on 1 case and external irradiation only on 1 case. In the 1st case, tumor recurred after 1 month postoperatively and urinary retention developed after 6 months postoperatively. so suprapubic cystostomy was performed. In the second case, we couldn`t follow up, and in the last case the treatment showed no beneficial effect. 3) In stage C, anterior pelvic exenteration and Bricker`s operation were made on 1 cases. And only suprapubic cystostomy was performed on 1 case but the patient died after 14 months postoperatively. 4) It stage D, suprapubic cystostomy was performed on 3 cases. Among which 1 case died after 6 months postoperatively and 2 cases couldn`t be followed up. The other 1 case was operated with cystourethrectomy and Bricker`s operation but the metastasis to retroperitoneal lymph nodes was found in operative field. This case also couldn`t be followed up.
Adenocarcinoma ; Adult ; Age Distribution ; Aged ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Cystostomy ; Dysuria ; Female* ; Hematuria ; Hemorrhage ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Pelvic Exenteration ; Rare Diseases ; Recurrence ; Urethra ; Urethral Neoplasms* ; Urinary Retention

No abstract available.
Leukemia, Monocytic, Acute* ; Leukemic Infiltration* ; Lymphatic Diseases* ; Skin*

BACKGROUND: We compared brachial-ankle pulse wave velocity (baPWV) measured by a simple oscillometric method with heart-carotid (hc) and heart-femoral (hf) PWVs measured by a conventional tonometic method. METHODS: Using an automatic waveform analyzer, we measured hcPWV, hfPWV and baPWV simultaneously. The subjects comprised 82 healthy subjects (normal group), 229 subjects without coronary artery disease (CAD) but with hypertension, diabetes, hypercholesterolemia, low HDL-cholesterol, smoking, or obesity (risk group), and 106 patients with coronary artery disease (CAD group). In 30 subjects, reproducibility of PWVs were determined. RESULTS: Pearson's correlation coefficients of intraobserver reproducibility of hcPWV, hfPWV and baPWV were r=0.855, r=0.912 and r=0.976, respectively (p<0.001 for all). The corresponding coefficients of variation (CV) were 4.5%, 4.5% and 2.6%. Pearson's correlation coefficients of interobserver reproducibility of hcPWV, hfPWV and baPWV were r=0.751, r=0.802 and r=0.972, respectively (p<0.001 for all). The corresponding CV were 7.8%, 5.8% and 3.3%. baPWV correlated well with hcPWV and hfPWV (r=0.457 and 0.640, respectively, p<0.001 for both). In normal and risk groups, age, sex and hypertension were major independent factors affecting hcPWV, hfPWV and baPWV. PWVs were increased according to the number of risk factors (p<0.001 for all). In CAD group, hfPWV was higher in patients with 3 vessel disease than those with 1+2 vessel disease (p=0.024). hcPWV, hfPWV and baPWV did not differ between risk and CAD groups in the age of 50 to 69 (p=NS for all). CONCLUSION: baPWV has good reproducibility and correlates acceptably with hcPWV and hfPWV. This simple measurement of baPWV is useful for screening of arterial stiffness.
Atherosclerosis ; Blood Flow Velocity ; Coronary Artery Disease ; Coronary Disease ; Humans ; Hypercholesterolemia ; Hypertension ; Mass Screening ; Obesity ; Pulse Wave Analysis* ; Risk Factors ; Smoke ; Smoking ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Even short-term treatment with angiotensin converting enzyme inhibitor in essential hypertension has been known to improve left ventricular (LV) diastolic function, LV hypertrophy (LVH), and aortic stiffness. The purpose of this study was to examine the effects of angiotensin II receptor antagonist (Losartan) on LV diastolic function, LVH, and aortic stiffness in essential hypertension. MATERIALS AND METHODS: Twenty-three hypertensive patients who were aged over 50 years, previously untreated, and without cardiac, renal, neurologic disease, or diabetes, were studied. Before and 12 weeks after monotherapy with Losartan 50 mg q.d., (1) supine arterial blood pressure by sphygmomanometry, (2) interventricular septum and LV posterior wall thickness, and LV end-diastolic dimension by M-mode echocardiography, (3) mitral peak E and A wave velocity by doppler echocardiography, (4) pulse wave velocity (PWV) in the descending aorta from aortic arch to the bifurcation by doppler echocardiography, were done. RESULTS: Twelve weeks after treatment, systolic blood pressure was lowered from 168.2+/-3.5 mmHg to 142.9+/-2.9 mmHg (p<0.05), diastolic blood pressure from 98.52.4 mmHg to 87.51.3 mmHg (p<0.05). Peak E/A ratio was increased from 0.75+/-0.04 to 0.82+/-0.04 (p<0.05). LV mass was decreased from 267.5+/-15.8 g to 235.6+/-12.6 g (p<0.05), and LV mass index from 166.8+/-8.0 g/m2 to 146.9+/-6.0 g/m2 (p<0.05). However, there were no significant change in PWV (from 7.18+/-0.10 m/sec to 7.23+/-0.30 m/sec, p>0.05), compliance (from 1.31+/-0.04 to 1.34+/-0.12, p>0.05), and compliance index (from 0.16+/-0.01 to 0.15+/-0.01, p>0.05). CONCLUSION: Short-term treatment with Losartan decreases blood pressure, improves LV diastolic function and LVH, but not aortic stiffness.
Angiotensin II* ; Angiotensins* ; Aorta, Thoracic ; Arterial Pressure ; Blood Pressure ; Compliance ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension ; Hypertrophy ; Losartan* ; Peptidyl-Dipeptidase A ; Pulse Wave Analysis ; Receptors, Angiotensin ; Vascular Stiffness* ; Ventricular Function, Left*

Massive pulmonary embolism is a major cause of morbidity and death in hospital. Most episodes of acute pulmonary embolism occurred from multiple emboli. When pulmonary embolism is suspected, the definitive diagnosis is pulmonary arteriography, but high degree of certainty can also be achieved with ventilation-perfusion scanning. The therapeutic modalities available for patients with acute pulmonary embolism are prophylatic and definitive therapy. Prophylatic therapy including anticoagulant with heparin is used to prevent further emboli episodes that might be fatal. Definitive therapy for pulmonary embolism including thrombolytic agents and pulmonary embolectomy attempts to dissolve and remove the resolution of the pathophysiologic sequelae of pulmonary embolism. We experienced a case of acute massive pulmonary embolism which occupied the pulmonary arteries bilaterally. Patient with orthopedic surgery one month before developedd dyspnea and chest tightness. Eventhough continuing enough amount of anticoagulant therapy, rapid hemodynamic deterioration and severe hypoxia occurred progressively. Urgent pulmonary embolectomy was succeeded and he has been followed up at out patient department.
Angiography ; Anoxia ; Diagnosis ; Dyspnea ; Embolectomy ; Fibrinolytic Agents ; Hemodynamics ; Heparin ; Humans ; Orthopedics ; Pulmonary Artery* ; Pulmonary Embolism* ; Thorax

No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis*

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumor that occurs among young women and typically presents as bilateral multiple nodules. In the present report, we describe an uncommon case of PEH presented as a single cavitary nodule in a 33-yr-old asymptomatic man. This is the first case of PEH presented as a single cavitary nodule in the English literature. Three years of the follow-up without treatment was performed. Overall histologic findings were accord with conventional PEH, but some atypical features such as, increased mitotic activity (mean; two per ten high power fields), necrosis, spindling, and pleural and vascular invasion were recognized. Immunohistochemically, the tumor cells were positive for CD34. This report may contribute to the data on clinical findings and natural history of this rare tumor.
Adult ; Antigens, CD34/biosynthesis ; Hemangioendothelioma, Epithelioid/*diagnosis/pathology ; Human ; Immunohistochemistry ; Lung Neoplasms/*diagnosis/pathology ; Male ; Mitosis ; Necrosis ; Time Factors ; Tomography, X-Ray Computed

No abstract available.
Bone Marrow* ; Humans

BACKGROUND: Recently some countries such as U.S.A. and Canada where human immunodeficiency virus(HIV) infection is rather prevalent, included HIV-1 p24 antigen test as a routine donor blood screening. This study was performed to evaluate the advantage of additional p24 antigen testing for the prevention of transfusion-associated AIDS infection in Korea. METHODS: Blood collected from 1726 volunteer blood donors, 16 HIV-positive patients, 39 sera from 4 commercial seroconversion panels, 15 sera included in low titer performance panel were tested with HIV-1 p24 Antigen ELISA Test System(Ortho Diagnostic Systems, U.S.A.). Anti-HIV antibody was also measured in parallel employing commercial kits produced by two world-famous companies. For some sera, western blot testing was additionally done. RESULTS: False-positive rate of p24 antigen testing was 0.06%. In 2 examples from 4 seroconversion panels, the p24 antigen test detected HIV infection 1-25 days and 11-47 days earlier than anti-HIV tests. CONCLUSION: Additional p24 antigen testing was found to have a potential to reduce transfusion-associated HIV infections. Including the p24 antigen testing as a routine donor screening should be considered if the number of transfusion-associated HIV infections continues to grow in Korea.
Blood Donors ; Blotting, Western ; Canada ; Donor Selection ; Enzyme-Linked Immunosorbent Assay ; HIV Infections ; HIV-1 ; Humans* ; Korea ; Mass Screening ; Tissue Donors ; Volunteers