No abstract available.
Rickettsia typhi* ; Rickettsia*

No abstract available.
Humans ; Infant* ; Intussusception*

No abstract available.
Leiomyoma* ; Scalp*

No abstract available.
Abscess*

From March 1985 to June 1997, 451 patients of spontaneous pneumothorax treated at Kangbuk Samsung Hospital were reviewed retrospectively. Most of the patients were male (male to female ratio, 8.2:1). The mean age of the primary spontaneous pneumothorax (PSP) was 26.8 years, and that of secondary spontaneous pneumothorax (SSP) was 53.1 years. 330 out of 451 patients (73%) were PSP. The causes of the SSP were mostly pulmonary tuberculosis and COPD: 87 patients (72%), and 24 patients (19.2%), respectively. All the patient were treated by one of the following modalities: 1)rest and oxygen therapy in 42 patients, 2) closed thoracostomy in 208 patients, 3) thoracotomy in 156 patients, 4) VATS bullectomy in 45 patients. The mean duration of postoperative chest tube drainage was as following: thoracotomy 8.3 days, VATS bullectomy 4.7 days. For recent 3 consecutive years, VATS bullectomy has become the more frequently applied operative procedure than thoracotomy in the treatment of surgically indicated PSP, from 33% in 1994 to 78% in 1996. With the minimally invasive thoracoscopic surgery being more prevalent, VATS bullectomy will be able to be the 1st choice of treatment not only for the recurrent pneumothoracies but also for the some selected cases of the 1st episode pneumothoracies. To verify this approach as clinically acceptable one in terms of cost-effectiveness, recurrence rate, etc, a large scale of multi-institutional clinical study will be needed in a sooner time.
Chest Tubes ; Drainage ; Female ; Humans ; Male ; Oxygen ; Pneumothorax* ; Pulmonary Disease, Chronic Obstructive ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracostomy ; Thoracotomy ; Tuberculosis, Pulmonary

BACKGROUND: Atrial septal defect (ASD) is the most common congenital cardiac anomaly, accounting for 30 percent of congenital heart disease detected in the adult. Many patients with ASD are well tolerated and reach adult without significant symptoms. The patients with ASD die 4th and 5th decades, but prolonged survival is not uncommon. In general, the survival depends on whether pulmonary hypertension develops during adulthood or not. The most common cause of death in the patients with ASD is right ventricular failure or arrhythmias. MATERIALS AND METHODS: From January 1988 to June 1997, 33 cases of ASD underwent open heart surgeries in our hospital. Among them, 31 cases were adult ASD, and 2 tricuspid regurgitation, 1 pulmonic stenosis, 1 mitral regurgitation, 1 tricuspid regurgitation, and 1 coronary artery disease were combinded. All of the patients underwent surgical repair using autologus pericardial patch or direct closure. RESULTS: The postoperative course was smooth and uneventful. Most of the patients showed significant improvement in ECG finding, hemodynamic profile, radiologic finding, and echocardiography, after surgery. CONCLUSIONS: Conclusively, most of the ASD should be closed even in patients over the age of 60 years, and early surgical repair must be done to prevent pulmonary hypertension, right ventricular failure, and arrythmias.
Adult* ; Arrhythmias, Cardiac ; Cause of Death ; Coronary Artery Disease ; Echocardiography ; Electrocardiography ; Heart ; Heart Defects, Congenital ; Heart Septal Defects ; Heart Septal Defects, Atrial* ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Mitral Valve Insufficiency ; Pulmonary Valve Stenosis ; Tricuspid Valve Insufficiency

PURPOSE: Conventional indomethacin therapy(0.2mg/kg every 12 hours for three doses) has been used for closure of PDA. The effect of prolonged low dose of indomethacin therapy(0.1mg/kg daily for six days)had been reported in foreign country but, nothing had been reported in our country. So we attempted this study to examine effects of these two methods. METHODS: Forty one infants with PDA of prematurity from January 1992 to July 1995 who were admitted in NICU of Il Sin Christian Hospital were included. 27 of these infants received conventional dose of indomethacin therapy and 14 received prolonged low dose of indomethacin therapy, and we examined with closure rate and complication etc. RESULTS: 1) Closure of PDA was observed in 15(55.6%) and relapse was 3(11.1%) in conventional dose therapy group. In prolonged low dose therapy group, closure was 8(57.1%) and relapse was none. 2) Intraventricular hemorrhage was observed in 20(74.1%), 6(42.9%) and gastrointestinal tract bleeding was 6(22.2%), 13(92.2%) in each group. There was statistically significant between the two groups(p<0.05). 3) The rise of serum BUN, creatinine was observed in 9(33.3%), 6(46.2%), bleeding tendency was 9(33.3%), 8(57.1%), necrotizing enterocolitis was 2(7.4%), 0 and retinopathy of prematurity was 8(29.6%), 3(21.4%) in each group.But there was not statistically significant correlation between the two groups. 4) The development of sepsis and broncopulmonary dysplasia was slightly more in prolonged low dose therapy group. 5) The reduction of urine output was observed in 11(40.7%), 2(14.3%) in each group but, absolute oliguria was not observed in both groups. CONCLUSIONS: Though the closure rate of PDA was similar in both groups, prolonged low dose indomethacin therapy can be recommanded with its effectiveness on preventing the relapse of PDA and the accurrence of necrotizing enterocolitis.
Creatinine ; Enterocolitis, Necrotizing ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Indomethacin* ; Infant ; Oliguria ; Recurrence ; Retinopathy of Prematurity ; Sepsis

No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

PURPOSE: A lateral thoracodorsal fasciocutaneous flap (LTFF) is a local fasciocutaneous flap that has been used in breast reconstructions since the 1980s. Although the LTFF is a wellstudied reconstruction procedure after radical surgery in Western countries, there is no report in Korea. By introducing the LTFF procedure, we suggest an easy reconstruction technique that can be performed by the breast surgeon directly. METHODS: Patients with lateral breast cancer and redundant lateral thoracic region might be candidates for this procedure. The flap consists of the lateral and dorsal extensions of the inframammarian fold as well as an extended line from the anterior axillary line. A quadrantectomy is performed through a planned skin incision, and an axillary lymph node dissection can be performed simultaneously if the sentinel lymph node is positive. The skin and subcutaneous fat with the fascia of the serratus anterior and latissimus dorsi muscle should be dissected carefully. A wedge-shaped flap can be acquired successfully. The lateral breast defect is then reconstructed by a rotation of the flap. The axis of the flap is drawn following the inframammarian fold so that the final scar would be under the brassiere line. RESULTS: Nineteen patients were treated with the LTFF after breast conserving surgery. All tumors were located in lateral breast regions. Seroma occurred in three and partial fat necrosis and partial flap necrosis were observed in each one. The cosmetic result based on four-point scoring system of breast cosmesis showed excellent in seventeen and good in two. CONCLUSION: Despite its long scar line, with appropriate patient selection, a LTFF might be a useful method for breast reconstructions.
Axis, Cervical Vertebra ; Breast Neoplasms ; Breast* ; Cicatrix ; Fascia ; Fat Necrosis ; Female ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Mammaplasty* ; Mastectomy, Segmental ; Necrosis ; Patient Selection ; Seroma ; Skin ; Subcutaneous Fat ; Superficial Back Muscles

This paper concerns professional socialization of medical students. Professional socialization, in the context of this paper, means the process through which a layperson becomes a doctor equipped with professional identity and values. While medical education does not include such process in the curriculum, medical students obtain certain values and identity informally. The dependent variables were professional values and professionalism. The former means the desirable attributes required to conducting professional works such as humane attitudes, science-oriented mind, capability for organizational management. The latter means socio-political reasoning with which doctors can rationalize their privileges such as autonomy. A specially designed questionnaire was developed. The data were collected from five medical schools for 1,318 students in 1994. A total of 1,070 cases were finally included in the statistical analysis. The students emphasized the human factor in the professional values. Their attitude did not change with the grade. Other independent variables such as motives for entering a medical school, socioeconomic status, satisfaction with medical education, etc. also did not influence professional values. It implies that professional values were not consolidated among the students. However, the factors of professionalism change significantly with the grade. It implies that the students paid more attention to socio-political issues related to doctor`s interests as the grade went up. And the factor scores for professionalism were higher for those students who had more positive attitude towards doing medical practice for profit, expected higher income, and were more conservative about social reform. Other independent variables did not influence professionalism. It seems that the students also give emphasis on professionalism, like current medical doctors, mainly because of their concern with recent unfavorable changes in economic conditions of medical care providers.
Curriculum ; Education, Medical ; Humans ; Surveys and Questionnaires ; Schools, Medical ; Social Class ; Socialization* ; Students, Medical*