No abstract available.
Esophageal Neoplasms*

No abstract available.
Heart Valves* ; Heart*

No abstract available.
Pneumothorax*

No abstract available.
Paragonimiasis*

A hemagglutination(HA)-typing system has been developed for the presumptive identification of enterotoxigenic Escherichia coli(ETEC) possessing the colonization factor antigens(CFA) Seventy-seven E. coli strains from pediatric patients with or without diarrhea were examined for the mannose-resistant(MR) HA or mannose-sensitive(MS) HA of human, bovine, chicken, and guinea pig erythrocytes and their antibiotic resestances. A significant proportion(68%) of the isolates exhibited the HA pattern of NNNN(experssed in the order human/bovin/chicken/guinea pig erythrocytes), and 10% of the isolates exhibited NNSS, known as the pattern about half of enteropathogenic E. coli serogroups produced. Sixty-nine strains(88%) were resistant to one or more antibiotics; 55(80%) were reristant to four or more antibiotics. The strains showed multiple drug resistance were more higher in HA-positive strains(92% of HA-positive strains) than in HA-negative strains(76% of HA-negative strains) and all of the HA-positive strains with human erythrocytes were resistant to 4 or more antibiotics. There were no significant differences between HA patterns and antibiotic resistance in both the strains from the patients with or without diarrhea. In summary, although the causative organisms in cases of diarrhea of this study have not been established, the date herein suggested that ETEC possessing CFA which produce RRRN or NRRN HA pattern was not participated in this diarrhea.
Animals ; Anti-Bacterial Agents ; Chickens ; Child* ; Colon ; Diarrhea ; Drug Resistance* ; Drug Resistance, Microbial ; Drug Resistance, Multiple ; Enteropathogenic Escherichia coli ; Enterotoxigenic Escherichia coli ; Erythrocytes ; Escherichia coli* ; Escherichia* ; Guinea Pigs ; Hemagglutination* ; Humans

Descending necrotizing mediastinitis is a life-threatening infection originating in the head or the neck and descends into the mediastinum. Even in the era of antibiotics, mortality rate has been reported to be 25~40%. Prompt diagnosis and treatment is mandatory for delayed diagnosis and inappropriate drainage of the mediastinum are the main causes of high mortality. Surgical management ranges from cervical drainage to routine thoracotomy: however, the optimal management still needs to be defined particularly in respect to effective mediastinal drainage. Although posterolateral thoracotomy incision has been considered as a standard approach, potential disadvantages including postoperative pain, risk of wound complication and delayed recovery remain to be concerned. Thoracoscopic approach is an attractive treatment modality as it can provide an excellent exposure with minimal incision and can complete drainage from the mediastinum and the neck in one-staged manner. We describe here two cases of descending necrotizing mediastinitis successfully managed by thoracoscopic drainage.
Anti-Bacterial Agents ; Delayed Diagnosis ; Diagnosis ; Drainage ; Head ; Mediastinitis* ; Mediastinum ; Mortality ; Neck ; Pain, Postoperative ; Thoracoscopy* ; Thoracotomy ; Wounds and Injuries

The authors retrospecitviely analyzed the MRI findings of the 8 head-injured patiens who had showed persistent unconsciousness and severe neurologic deficite after trauma. T2-weighted MR images disclosed high signal intensity lesions of various size and shape at lobar white matter and corpus callosum, subcortical gray matter, brain stem, and cerebral cortex, and assisted greatly in understanding the neurologic deficits of the corresponding patients. The lesions were mostly multiple and involved multiple structures. CT's revealed in those patients only small hemorrhages, suspicious low densities, such nonspecific findings as slit ventricles and diffuse brain atrophy, or no abnormality at all. Post-traumatic parenchymatous lesions detected by MR images were either missed or quite underestimated on CT's. MRI was very supeior to CT in the detection and anatomic localization of nonhemorrhagic intraaxial cerebral injuries. especially in the cases of small corical contusions, brainstem and white matter injuries. For the evaluation of the acute posttraumatic patients, CT ios indicated in order to fastly detect intracranial hemagomas which may need emergent surgical evacuation. If CT findings does not explain the neurologic degicits of the patients, especially in the late stage. MRI is indicated. MRI is expected to play a major role in the diagnosis of shear injuries involoving white matter and brainstem where CT has been of little contribution or misleading.
Atrophy ; Brain ; Brain Stem ; Cerebral Cortex ; Contusions ; Corpus Callosum ; Diagnosis ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Unconsciousness

Injury of the ankle ligaments is one of the most common sports-related injuries. Although there are some debates as to the best initial treatment for an acute tear of a lateral ligament, persistent functional instability of the ankle develops in approximately 20% of patients regardless of the type of initial treatment. In these patients, late reconstruction of the lateral ankle ligaments may become necessary. Among 13 cases which have been operated with Larsen procedure using peroneus brevis tendon from March 1991 to February 1993, the 11 cases followed up over 1 year were examined clinically and radiologically. We introduced the clinical analysis and results with the brief review of the literatures. 1. The indication of surgical treatment was the ankle instability which had differences over 10° in talar tilting angle or over 3mm in anterior displacement compared wit the uninjured site. 2. The postoperative results were 5 cases in excellent and 4 in good. 3. The Larsen procedure was considered a good method to anatomically and simply stabilize both the ankle and subtalar joint and to fix tendon depending on the type of instability.
Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Methods ; Subtalar Joint ; Tears ; Tendons

In the paget's disease involving the vertebra, the symptom and sign of compression come from encroachment on the spinal cord due to the enlarging vertebral bodies, pedicles and laminae. The cord compression appears to be preceded by a long insidious period of noncharacteristic clinical symptoms with minor neurologic dysfunction. The lumbar syndrome of Paget's disease is classified according to its severity, clinical findings, biochemical factors and radiologic patterns. The severity of neurologic complication in Paget's disease involving the vertebra varies according to the level involved. The outcome depends on the suddeness of symptom onset and the effectiveness of decompression. We have experienced a case of Paget's disease involving long bones and lumbar spine in 56 year old male patient, in which surgical decompression produced improvement. We report a case of spinal stenosis in paget's disease with brief review of literature.
Decompression ; Decompression, Surgical ; Humans ; Male ; Neurologic Manifestations ; Spinal Cord ; Spinal Stenosis ; Spine

PURPOSE: As one of the new chemotherapeutic agents, gemcitabine is widely used as a four-week schedule in combination with cisplatin in the treatment of advanced non-small-cell lung cancer (NSCLC). In this study, we evaluated the efficacy, tolerance, and survival effect of this combination in a three-week schedule in patients with locally advanced inoperable or metastatic NSCLC. MATERIALS AND METHODS: Between January 2000 and September 2002, previously untreated 124 NSCLC patients were enrolled and 118 patients, who completed at least two cycles of chemotherapy, were evaluated. Patients received gemcitabine 1200 mg/m2 on days 1 and 8, cisplatin 75 mg/m2 on day 1 of a 21-day cycle, for a maximum of 6 cycles. RESULTS: They were 81 men and 37 women. Clinical stage IIIB was present in 56 (47.5%), and stage IV in 62 (52.4%) patients. Sixty-seven patients (56.8%) had a performance status of ECOG grade 0 or 1 and fifty-one patients (43.2%) of grade 2. During the period of chemotherapy, grade 3/4 leukopenia and neutropenia were observed in 19.5% and 31.4%, respectively and grade 3/4 thrombocytopenia in 7.6%. The overall response rate was 52.5% among the 118 patients. Overall median survival time was 12.2 months, and one-year and two-year survival rates were 50.2% and 20.4% respectively. The presence of response to chemotherapy, ECOG performance status of grade 0~1, and women showed better survival by the univariate analysis (p=0.010, 0.001 and 0.015, respectively). CONCLUSION: A three weekly gemcitabine/cisplatin doublet was relatively well tolerated, with an acceptable response rate and a reasonable median survival in locally advanced inoperable or metastatic NSCLC.
Appointments and Schedules ; Cisplatin* ; Drug Therapy* ; Female ; Humans ; Leukopenia ; Lung Neoplasms* ; Lung* ; Male ; Neutropenia ; Survival Rate ; Thrombocytopenia