The management of chronic empyema remains still disturbing. These patients always have chances to exposure septic conditions. We presents 4 patients of chronic empyema with sepsis who underwent E-flap and Myoplasty with extrathoracic skeletal muscles between December 1994 and March 1997. Two patients who had BPF were treated with intercostal muscle flap as co-procedures. Intervals between first E-flap and second Myoplasty ranged from 5 to 10 months. There was no morbidity or mortality. We think these stepwise procedure offers a chance to terminate these debilitating disease.
Empyema* ; Humans ; Intercostal Muscles ; Mortality ; Muscle, Skeletal ; Sepsis*

Patterns of branches and distribution of right coronary artery in Korean adult hearts were observed at the viewpoint of newly edited Nomina Anatomica, and the results were as follows. Generally the right aortic sinus had one orifice, but sometimes had two orifices which were related to conal branch. The right coronary artery had mural coronary in 17.5% of cases. In the most of the cases, right coronary artery was dominent, and type 4 was most frequent. Descending septal artery was observed in 17.5% of cases. The atrial branches can be grouped as anterior, posterior and left atrial, and each group was composed of one or two branches when present. In 97.5% of cases, intermediate atrial branch was observed. The sinuatrial nodal artery was originated mostly from right coronary artery. The atrioventriclar branch was observed in 7.5% of cases. The ventricular branches can be grouped as right anterior, right posterior and left posterior, and composed of 3-6, 0-2, and 0-4 branches respectively. Right marginal branch showed great variation, and other branch originated from superiorto to it was found to distribute the apex of the heart. Based on the results, the authors depicts typical arrangement of the rignt coronary artery in Korean.
Adult ; Arteries ; Coronary Vessels* ; Heart ; Humans ; Sinus of Valsalva

The clinical review was done on 17 cases with the foreign body in the upper gastrointestinal tract who underwent endoscopic removal of foreign body at Kang Nam Sacred Heart Hospital from Dec. 1981 to Dec. 1991. The results were as follows: 1) The age distribution varies from 3 months to 72 years of age, being most prevalent under 5 years of age. 2) The incidence of foreign body in the order of frequency was coin, fish bone, safety pinring, peanut, keyring, food bolus, artificial teeth and medal. Among 17 cases, 9 cases(53.0%) were lodged in the esophagus and 8 cases(47.0%) were lodged in the stomach. 3) Dysphagia or globus was the common symptom in 8 cases(47.2%), followed by absence of symptom in 7 cases(41.2%), upper abdominal discomfort in 1 case(5.8%) and vomiting in 1 case (5.8%). 4) l0 cases(58.8%) of foreign body were removed within 72 hours and 7 cases(41.2%) of foreign body were removed after 72 hours.
Age Distribution ; Deglutition Disorders ; Esophagus ; Foreign Bodies* ; Heart ; Incidence ; Numismatics ; Stomach ; Tooth, Artificial ; Upper Gastrointestinal Tract* ; Vomiting

STUDY DESIGN: The operative treatment methods of twenty-one patients with Denis type B burst fractures were evaluated according to the level of pedicle screw fixation. OBJECTIVE: To compare the results of short segment pedicle screw fixation with long segment pedicle screw fixation in Denis type B burst fractures treated anteriorly with short bone graft. SUMMARY OF BACK GROUND DATA: Relatively good results(Short fusion time, good union rate, less loss of lordosis postoperatively etc.) were obtained in long segment fixation group during follow-up period. METHODS: Twenty-one patients with Denis B type burst fractures of thoracolumbar and lumbar spine were divided into two groups depend on the level of pedicle screw fixation in operative treatment methods, one group consisted of 10 cases which were treated by posterior short segment pedicle screw fixation and anterior interbody fusion with short bone graft(Group I : one level above and below posteior pedicle screw fixation of the fracture site and upper end plate of fracture site was fused with autogenous iliac bone or rib to adjacent vertebral body anteriorly through involved disc space) and the other groups consisted of 11 cases which were treated by posterior long segment pedicle screw fixation and anterior interbody fusion with short bone graft (Group II : more than two level above and below posterior pedicle screw fixation of the fracture site and additionally, anterior interbody fusion with short bone graft performed same as Group I). Bony union rate, union period, changes of height of bone and disc, kyphotic angle loss, interscrew angle and complications were measured using pre-, post-operative and follow-up radiographs and chart review. RESULTS: Comparing the two groups, there were no significant postoperative and follow-up results in both groups, especially, change of body & disc height, change of kyphotic angle and change of interscrew angle. However, relatively short fusion time, good union rate, less kyphotic angle loss, and low complication rates were obtainecl and maintained during follow-up period in long segment fixation lion group(Group II). CONCLUSIONS: Long segment pedicle screw fixation and anterior interbody fusion with short bone graft group could effectiyely treat Denis B type burst fractures of thoracolumbar & lumbar spine and maintain their postoperative results during follow up peroid.
Animals ; Follow-Up Studies ; Humans ; Lions ; Lordosis ; Ribs ; Spine ; Transplants*

Behavioral symptoms are well-recognized concomitants of the progression of dementia. These symptoms include agitation, aggression, anxiety, depression, disinhibition, delusions, hallucination, and sleep disturbance. Because these symptoms are a major source of impaired quality of life for patients and their caregivers, appropriate pharmacological management of them may reduce the burden of caregivers and postpone institutionalization. Furthermore, behavioral symptoms may be more amenable to pharmacological intervention than cognitive symptoms. For that reason, detailed evaluation and appropriate treatment are the mainstay in the management of dementia patients. In this article, we reviewed symptomatology and psychopharmacology for behavioral symptoms of dementia.
Aggression ; Alzheimer Disease ; Anxiety ; Behavioral Symptoms* ; Caregivers ; Delusions ; Dementia* ; Depression ; Dihydroergotamine ; Hallucinations ; Humans ; Institutionalization ; Neurobehavioral Manifestations ; Psychopharmacology ; Quality of Life

Congenital pulmonary lymphangiectasis is a rare cause of severe respiratory distress in the newborn period and most of these patient die, usually within the first 24 hours of life. The light microscopic characteristics of the lungs are a network of partly tubular, partly cystically enlarged lymph vessels within large areas of connective tissue and they have thin wall lined by endothelium. Also congenital pulmonary lymphangiectasis is closely associated with cardiovascular malformation, and most frequently occurs in the clinical setting of congenital heart disease with or without pulmonary venous obstruction(total anomalous venous return, atresia of large pulmonary veins) The authors describe three typical cases of congenital pulmonary lymphangiectasis.
Connective Tissue ; Endothelium ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Lung ; Lymphangiectasis* ; Lymphangioleiomyomatosis

Calcipotriol, a synthetic analogue of calcitriol(1,25-dihydroxyvitamin D) is as active as calcitriol in inducing cell differentiation and inhibiting cell pralifiration but at least 100 times less active than calcitriol in its effect on calcium metabolism. We report a case of psoriasis in a 28 year old male who was treated with calcipotriol ointment on the right forearm. The therapeutic effect of calcinoipotriol ointment was compared with desoxymethason, cream applied on the left forearm. Both topical agents reduced equally the degrees of scale, erythema and thickness of the lesions. We observed that the calcipotriol ointment was effective in the treatment of psoriasis n this case.
Adult ; Calcitriol ; Calcium ; Cell Differentiation ; Erythema ; Forearm ; Humans ; Male ; Metabolism ; Psoriasis*

No abstract available.

BACKGROUND: Although treament with PUVA or etretinate is effective for psoriasis, both treatment regimens have limitation because of the risk of long-term toxicity. OBJECTIVE: The present study was performed to compare the clinical effects of PUVA and retinoid-PUVA. METHODS: Twenty five chronic plaque psoriasis patients with more than 20% involvement of the skin suface were included in this study. Sixteen patiens were treated with the PUVA therapy and nine patients were treated with retinoid-PUVA. RESULTS: the number of phototherapy and cumulative UVA doses of retinoid-PUVA were significantly smaller than those of PUVA therapy. CONCLUSION: Combining PUVA with etretinate in the tretment of psoriasis may lead to lowering of total number of PUVA treatments and the cumulative dosage and it may be possible to shorten the duration of using etretinate.
Acitretin ; Etretinate ; Humans ; Phototherapy ; Psoriasis* ; PUVA Therapy ; Skin

In treatment of Vitamin D-resistant rickets, the authors supplemented supramalleolar stepcut osteotomy for complex deformity of tibia consisted of varus, anterior bowing and intemal torsional supramalleolar level which accompanied severe waddling gait. The results of 10 tibia operations from 5 patients were generally satisfactory in terms of appearance and function.
Congenital Abnormalities ; Gait ; Humans ; Osteotomy ; Rickets ; Rickets, Hypophosphatemic ; Tibia ; Vitamin D ; Vitamins