Survival after acute myocardial infarction (AMI) is related to the number of diseased vessel, ejection fraction, extent of residual ischemic tissue, presence of ventricular arrhythmia. Because a variety of revascularization modalities are tried in recent years, the natural course after AMI seems to become difficult ot assess. From the experience of 129 cases of coronary angiography in AMI from Jan 1984 to Apr 1987, the factors related to invasive modality were analysed to evaluate the effect on the survival after AMI. The following results are obtained. 1) Single vessel disease and insignificant lesion were present in 60%, and multivessel disease comprised 40% in all group. 2) Patients were followed for a mean of 16.3 months and 2 cases(1.6%) expired suddenly and reinfarction developed in 6 cases(4.7%). 3) After exclusion of 4 cases taken CABG operation, the event free survival of all patients was 0.98, 0.90, 0.78, 0.78, 0.78 in double vessel disease, 0.94, 0.87, 0.87, 0.77, 0.51 in triple vessel disease. The survival was better in single vessel disease compared to multivessel disease (p<0.05), but no difference was present between double and triple vessel disease. 5) Event free survival in group with left ventricular end diastolic pressure(LVEDP) >16mm Hg was better than that of a group with LVEDP <16mm Hg. But no difference was present between group with ejection fraction <40% and group with ejection fraction >40%. From the above results, it can be concluded that the event free survival after mainly uncomplicated AMI in Koreans depends on the number of diseased vessel and LVEDP.
Arrhythmias, Cardiac ; Coronary Angiography ; Disease-Free Survival* ; Humans ; Myocardial Infarction*

A method for exact evaluation of ligament integrity of the knee joint would be of clinical importance from the diagnostic point of view as well as from the desire to introduce objective measurement of stability either pre-and postoperatively, or before and after conservative treatment. Assessment of the posterior cruciate injury has been considered by numerous authors over the past decades. Even stress machine, such as Gonylaxometer, knee ligament arthrometer(KT-l000) and Genucome, have many problems such as soft tissue error, expansiveness and low popularity. Generally, orthopedic surgeons use passive tests, in which the displacing force is applied externally, to evaluate the integrity of the ligaments of the knee. Posterior tibial displacement of knee was measured at quadriceps neutral angle using a specially designed frame which minimized the rotational error to negate the quadriceps pulling effect. Posterior displacement of both sides of knee was measured in 15 patients who had posterior cruciate ligament injury and 40 adults who had normal knee. The following results were obtained. l. In the normal knee, the mean score of posterior tibial displacement was 3.0875mm in left, 2.8125mm in right each other and there was a mean of 1.05mm posterior displacement of tibia compared to the contralateral knee(range: 0–2.5mm). 2. More than 6mm displacement of lateral femoral condyle compared to the uninjured knee suggested posterior cruciate ligament injury. 3. This radiological measurement seems very efficient in detecting the posterior cruciate ligament instability of knee because of its simplicity, inexpensiveness and easy reproducibility with minimal error.
Adult ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Orthopedics ; Posterior Cruciate Ligament ; Surgeons ; Tibia

We presented two cases of bullous dermatoses in childhood. The first case was a 13-year-old boy who had numerous tense bullae on the scalp, both forearms and dorsa of hands, trunk and both thighs in symmetrical distribution, but he had not any oral lesion. On histologic examination, subepidermal bullae containing many neutrophils and only a few eosinophils were demonstrated. The lesions began to subside prornptly since 2 days after ornl administration of prednisolone and there was no evidence of recurrence during the follow-up studies of 4 months. The second case was a 14-year-old boy who had erythematous macules, vesicles, bullae and crusts scattered irregularly on almost entire body surface and had some oral lesions. Histologically erythematous macular lesions revealed many microabscesses composed almost entirely oi neutrophils on the tip of dermal papillae but vesicular lesions showed intraepidermal bulla containing numerous eosinophils exclusively. His skin lesions were well suppressed by DDS but reappeared one or two days after cessation of DDS. We thought these two cases were not the typical cases of bullous pemphigoid or dermatitis herpetiforrnis. We did not perform immunologic studies, so we cannot assure that these two cases were belong to either bullous pemphigoid or dermatitis herpetiformis and the so-called benign chronic bullous dermatosis of childhood.
Adolescent ; Dermatitis ; Dermatitis Herpetiformis ; Eosinophils ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Male ; Neutrophils ; Pemphigoid, Bullous ; Prednisolone ; Recurrence ; Scalp ; Skin ; Skin Diseases ; Skin Diseases, Vesiculobullous* ; Thigh ; Transcutaneous Electric Nerve Stimulation

BACKGROUND: Spontaneous echo contrast(SEC) is known to predict the increased incidence of thromboembolism in a variety of heart diseases. Transesophageal echocardiography can be useful for the detection of SEC due to proximity of the probe to the left atrium. We performed this study (1) to evaluate the incidence of SEC in mitral stenosis and its relation to the past history of thromboembolism and (2) to characterize the echocardiographic and hemodynamic indices in patients with SEC compared with those without SEC. METHODS: Transesophageal and thransthoracic echocardiographies were done in 89 patients with mitral stenosis. Biplane probe was used in transesophageal echocardiography. In 47patients cardiac catheterization and angiography were performed. RESULTS: (1) SEC was found in 56 out of 89 patients(63%), and left atrial thrombus was found in 32 patients. (2) Left atrial dimension was larger in patients with SEC than in patients without SEC(57.3%+/-8.4mm vs 49.3+/-6.8mm, p<0.05) and mitrial valve area was smaller in patients with SEC than in patients without SEC(0.85+/-0.27cm2 vs 0.97+/-0.24cm2) (3) Association of SEC to thrombi or previous history of arterial embolism showed a high sensitivity and negative predictive value. CONCLUSION: SEC was an useful finding to predict the increased risk of thromboembolism in patients with mitral stenosis. Patients with SEC had severe mitral stenosis than patients without SEC.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Heart Atria ; Heart Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Stenosis ; Thromboembolism ; Thrombosis

BACKGROUND: The laparoscopy requires carbon dioxide (CO2) insufflation and Trendelenburg position for operational convenience. However, the above circumstances affect the cardiopulmonary systems significantly and intraocular pressure (IOP) may be also influenced. METHODS: In 27 non-glaucoma patients right and left intraocular pressure (RIOP, LIOP) were measured 5 minutes after induction of general anesthesia (control value), 15 and 30 minutes after CO2 insufflation and endelenburg-lithotomy position. RESULTS: The control values of RIOP and LIOP were 11.3 4.7 mmHg and 11.5 4.7 mmHg respectively. At 15 minutes after CO2 insufflation and Trendelenburg-lithotomy position, they increased to 16.6 5.3 mmHg and 17.0 5.9 mmHg (p<0.05). At 30 minutes, 18.4 3.5 mmHg and 18.2 4.1 mmHg (p<0.05). CONCLUSION: CO2 insufflation and Trendelenburg-lithotomy position increase IOP significantly in non-glaucoma patients during laparoscopy.
Anesthesia, General ; Carbon Dioxide ; Head-Down Tilt ; Humans ; Insufflation* ; Intraocular Pressure* ; Laparoscopy*

There is room for debate in appropriate diagnosis and treatment due to physiological and anatomical differences in pediatric facial bone fractures from that of adult's. The objectives of this article is to analyze for our clinical cases and to suggest the appropriate management of facial bone fracture in children. The study included 56 children who had treatment for the craniofacial fractures form March, 1990 to February, 1998. Their ages ranged from 3 to 15. There were 38 males and 18 females. Physical examination, simple x-rays, ultrasonograms and routine CT scans were used for diagnosis. Materials were classified into 28 nasal bone fractures, 4 nasoethmoidal fractures, 6 orbital fractures, 8 mandible fractures, and 10 zygoma fractures. Patients were treated with conservative treatment in 9 cases, with closed reduction in 28 cases and open reduction only, and 14 patients with open reduction and internal fixation using microplates and screws. 3 patients needed autogenous calvarial bone graft. Plates and screws were removed in postoperative 3-6 months. All patients had successful union of fractured bones without no specific complications, and normal bony growths were noticed during the 7 years follow up. We conclude that surgeons should be careful in diagnosis and management for the pediatric facial fracture due to anatomical variations and differences in fracture aspects. First, it is mandatory for surgeous to get accurate diagnosis and identify children's fracture and displacement through routine CT check up along with physical examination. Second, it is important to perform the minimally invasive technique or conservative treatment for the children with mild displacement so that it reduces the incidence of growth retardation which may be caused by extensive operation. However, application of rigid fixation is necessary in case of extensive bony displacement or bony defects because of poor coorporation in postoperative care. Third, plates and screws which were used for the internal fixation should be removed at 3-6 months after the surgery. Fourth, if bone graft is needed, it is better to use autogenous graft than allogeneous graft. Fifth, care for dentition and follow up for growth are necessary for growing children.
Child ; Dentition ; Diagnosis ; Facial Bones* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mandible ; Nasal Bone ; Orbital Fractures ; Physical Examination ; Postoperative Care ; Tomography, X-Ray Computed ; Transplants ; Ultrasonography ; Zygoma

A 42-year-old woman with systemic lupus erythematosus (SLE) has had wide-spread erythemas with some purpuric patches on her trunk and upper extremities during exacerbation of her disease. Biopsy findings from erythematous lesions and purpuric areas revealed the pathology of lupus erythematosus and leukocytoclastic vasculitis (LCV) with immune deposits, respectively. A feature of wide-spread symmetrical erythemas with foci of LCV occurring in this patient is considered to be an unusual presentation.
Adult ; Biopsy ; Erythema* ; Female ; Glycogen Storage Disease Type VI ; Humans ; Lupus Erythematosus, Systemic* ; Pathology ; Upper Extremity ; Vasculitis*

No abstract available.
Aloe*

No abstract available.
Animals ; Hantavirus* ; Korea* ; Murinae*

Management of bladder tumors depends upon early detection and adequate follow-up. Urine Cytology plays an increasingly important and prominent role in the multidisciplinary approach to this problem. Herein we review our experience with urine cytology in the diagnosis and follow-up of bladder cancer at Department of Urology, College of Medicine, Yonsei University from 1981 to 1985. 1. A total of 478 cytologic evaluations were performed in the 198 patients. 2. The overall incidence of positive cytology was 49.2%. 3. The incidence of positive cytology in the presence of biopsy proven bladder tumor was 71.1%. 4.The incidence of positive cytology after TUR followed by adriamycin instillation was 72.2% at diagnosis, 41.7% after 3 months, 31.0% after 6 months, 33.3% after 9 months and 36.8% after 12 months. 5. The Number of cases with negative cytology after TUR and adriamycin instillation was 11 cases after 3 months, 7 cases after 6 months, 2 cases after 9 months and 1 case after 12 months. 6. Of the 5 patients having recurred tumor, there was 4 patients who constantly class IV, and 1 patient who had conversion from class I or II to class IV.
Biopsy ; Diagnosis ; Doxorubicin ; Follow-Up Studies ; Humans ; Incidence ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology