Post-traumatic tricuspid insufficiency is a rare condition and may be clinically silent and imprecise. The diagnosis may be difficult when it progreses slowly and other acute lesions exist concomittantly. Two-dimenstional Doppler echocardiography appears to be an essential procedure in diagnosting the rupture of chordae tendineae or papillary muscle following traumatic injury. We report a case of tricuspid insufficiency of which symptom developed 8 years later following a blunt chest trauma. The patient was operated by tricuspid vlave repair with chordal replacement and ring annuloplasty successfully. We would like to emphasize that patients sustaining major thoracic trauma should be carefully examine for possible blunt chest trauma including cardiac valve rupture or tear.
Chordae Tendineae ; Diagnosis ; Echocardiography, Doppler ; Heart Valves ; Humans ; Papillary Muscles ; Rupture ; Thorax*

No abstract available.
Blood Platelets* ; Platelet Activating Factor* ; Progesterone*

In spite of the many improvements in arthroscopic surgical techniques for the treatment of mild to moderate degree degenerative joint diseases which were resistant to conservative treatment, the results are variable, showing a tendency to decline in therapeutically following the passage of time. Using a 2.1 un holmium: YAG laser we operated on patients with mild to moderate degenerative joint diseases which had not improved through conservative treatment. We evaluated the results of arthroscopic laser surgery for degenerative joint disease and investigated the proper indication and complications of laser surgery. We operated on 28 knees of 28 patients between July 1995 and June 1996. There were 16 females and 12 males. The average follow-up period was 16.3 months and the average age was 54.5 years. Under epidural or general anesthesia, we used arthroscopic tools, including laser, and the laser power was modified according to the type of operation (chondroplasty: 1.0Jx20pulse/sec, meniscectomy: 2.0Jx15pulse/sec, bone drilling: 2.5Jx10 pulse/sec). We used Bauer & Jackson's classification of articular cartilage change, and performed 12 laser chondroplasties in grade II, III, V lesions, 16 chondroplasties and laser bone drilling in grade IV, VI lesions, 16 laser meniscectomies, 6 laser synovectomies and 2 lateral retinacular releases. Medial femorotibial arthritis was the most common site. Postoperative results by Orgilvis-Harris & Fitsialos's methods indicated that 82% of treated patients were satisfied and only two patients (7%) did not improve. As a postoperative complication, eight patients complained of postoperative effusion which was subsided by medication and physical therapy. We performed second-look arthroscopic examinations in four knees that had been treated with laser chondroplasy and drilling. Regenerated tissues at the operated site were observed in three cases, but denuded articular cartilage and naked subchondral bone at the operated site were found in one case as a sign of osteonecrosis. Concluding this short-term study, 2.1 holmium: YAG laser in arthroscopic surgery seems to be effective in mild to moderate degenerative joint disease but care should be taken to avoid thermal injuries to the adjacent normal cartilages.
Anesthesia, General ; Arthritis ; Arthroscopy ; Cartilage ; Cartilage, Articular ; Classification ; Female ; Follow-Up Studies ; Holmium* ; Humans ; Joint Diseases ; Knee Joint* ; Knee* ; Laser Therapy ; Lasers, Solid-State* ; Male ; Osteoarthritis* ; Osteonecrosis ; Postoperative Complications ; United Nations

PURPOSE: To evaluate the accuracy of ultrasonography(USG) and abdominal computerized tomography(CT) and the possibility of reducing unnecessary appendectomy rate with improvement of diagnostic accuracy using optional CT with USG. METHODS: From January 1999 to May 2003, 496 patients younger than 14 years received surgical intervention with preoperative impression of acute appendicitis. They were devided into three groups no preoperative imaging study; preoperative abdominal USG only; and USG with optional abdominal CT. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated in each group, and percentage of unnecessary appendectomy was also obtained. RESULTS: Sensitivity and unnecessary appendectomy rate of group was 78.4% and 21% respectively. Sensitivity, specificity, positive predictive value, negative predictive value and unnecessary appendectomy rates of group were 96.5%, 42.8%, 85.4%, 78% and 12.2%. Sensitivity and positive predictive value of group was 100% and 98%, and no unnecessary appendectomy was performed in this group. CONCLUSION: With consideration of radiation exposure, cost, and in-hospital delay time, using optional CT with USG under optimal indication can decrease the frequency of complications and unnecessary appendectomy rates.
Appendectomy ; Appendicitis* ; Diagnosis* ; Diagnostic Errors ; Humans ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography

In the originally published version of this article, complete anonymity was not achieved.

Hemophilia, a genetically determined disorder, can be divided into hemophilia A and hemophilia B. Hemophilia A, defined as a sex-linked recessive trait hemorrhagic disease of males characterized by a deficiency of factor VIII occurs about seven times more frequently than hemophilia B which is characterized by a deficiency of factor IX. The complications resulting from hemophilia occurs in virtually every system. This paper is concerned with a rare complication of hemophilia, iliacus hematoma with femoral neuropathy. On case of spontaneous hemorrhage of iliacus muscle with femoral neuropathy in hemophilia was decompressed through a small incision with sump drainage under cover of AHF(Anti-hemophilic factor) concentrated plasma cryoperecipitate followed AHF replacement therapy.
Drainage ; Factor IX ; Factor VIII ; Femoral Neuropathy ; Hematoma ; Hemophilia A ; Hemophilia B ; Hemorrhage ; Humans ; Male ; Plasma

No abstract available.

PURPOSE: This study was designed to compare the amount of polymerization shrinkage of dual-cure resin cements according to different polymerization modes and to determine the effect of light activation on the degree of polymerization. MATERIALS AND METHODS: Four kinds of dual-cure resin cements were investigated: Smartcem 2, Panavia F 2.0, Clearfil SA Luting and Zirconite. Each material was tested in three different polymerization modes: self-polymerization only, immediate light polymerization and 5 minutes-delayed light polymerization. The time-dependent polymerization shrinkage-strain was evaluated for 30 minutes by Bonded-disk method at 37degrees C. Five recordings of each material with three different modes were taken. Data were analyzed using one-way ANOVA and multiple comparison Scheffe'test (alpha=.05). RESULTS: All materials, except Panavia F 2.0, exhibited the highest polymerization shrinkage-strain through delayed light-activated polymerization. No significant difference between light activation modes was found with Panavia F 2.0. All materials exhibited more than 90% of polymerization rate in the immediate or delayed light activated group within 10 minutes. CONCLUSION: As a clinical implication of this study, the application of delayed light activation mode to dual-cure resin cements is advantageous in terms of degree of polymerization.
Polymerization* ; Polymers* ; Resin Cements*

The purpose of this study was to evaluate the relation between ocular discomfort and ocular Demodex infestation, and therapeutic effects of tea tree oil (TTO) in Demodex blepharitis patients. Three hundred and thirty-five patients with ocular discomfort were evaluated for ocular Demodex infestation and subjective symptoms with ocular surface discomfort index (OSDI) score. Among them, Demodex-infested patients were randomized to receive either eyelid scrubbing with TTO (TTO group,106 patients) or without TTO (Control group, 54 patients) for 1 month. Demodex were found in 84% of patients with ocular discomfort. The number of Demodex was significantly correlated with age (P = 0.04) and OSDI score (P = 0.024). After eyelid scrub treatment, Demodex count was reduced from 4.0 +/- 2.5 to 3.2 +/- 2.3 in the TTO group (P = 0.004) and from 4.3 +/- 2.7 to 4.2 +/- 2.5 in the control group (P = 0.27). Also, OSDI score was reduced from 34.5 +/- 10.7 to 24.1 +/- 11.9 in the TTO group (P = 0.001) and from 35.3 +/- 11.6 to 27.5 +/- 12.8 in the control group (P = 0.04). In conclusion, Demodex number showed a significant positive correlation with age and subjective ocular discomfort. The tea tree oil eyelid scrub treatment is effective for eliminating ocular Demodex and improving subjective ocular symptoms.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Animals ; Anti-Infective Agents, Local/pharmacology/therapeutic use ; Blepharitis/*drug therapy/pathology ; Eye Infections, Parasitic/*drug therapy/parasitology/pathology ; Eyelids/parasitology/pathology ; Female ; Humans ; Male ; Middle Aged ; Mite Infestations/*drug therapy/parasitology/pathology ; Mites/drug effects ; Phytotherapy ; Tea Tree Oil/pharmacology/*therapeutic use ; Young Adult

Lichen planus and vitiligo are common skin disorders, which rarely coexist. We report a case of colocalization of lichen planus and vitiligo in a 42-year-old woman. Furthermore, herein, we discuss the possible mechanism of colocalization of lichen planus and vitiligo, including the role of actinic damage in the initiation of lymphocytic infiltrates of lichen planus in vitiliginous skin.
Actins ; Adult ; Female ; Humans ; Lichen Planus* ; Lichens* ; Skin ; Vitiligo*