There have been so many methods described for the correction of the deviated noses but it is difficult to get satisfactory results and recurrence rate is high. There is no exact explanation why the recurrences are so high and no estabished guides for techniques according to the surgical pathology. We found the classical swinging door technique effective in cases where the caudal septum deviated from the midline. However, where the caudal septum and the tip stay in the midline, scoring or submucosal resection do not work well enough to cortet them. We used the reverse swinging door technique of our own. After elevation of mucoperichonodrium, we did sagittal section in the posterior septum and moved the septum to the midline on the pivot point of the caudal septum and. The gap created in the posterior portion of the septum were filed with bone grafts, cartilage grafts or Medopor, which were sutured to the septum, We did this technique with or without osteotmies in 56 deviated noses for last 5 years. The results were very satisfactory and there was no complication.
Cartilage ; Nose* ; Pathology, Surgical ; Recurrence ; Transplants

PURPOSE: To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. MATERIALS AND METHODS: Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39months. RESULTS: Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. CONCLUSION: Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.
Catheters* ; Deglutition Disorders ; Dilatation* ; Esophageal Achalasia* ; Esophageal Perforation ; Follow-Up Studies* ; Humans ; Male ; Recurrence

Authors treated 86 cases of patella fracture during 3 year period from June 1989 to March 1992 at the Dept. of Orthopaedic surgery, Soonchunhyang University. Forty cases of patella fracture showed hypertrophy of longitudinal and transverse diameter of patella during follow-up which were checked by simple radiographs. Completely documented cases were only forty-six, which were followed more than a year and preop. and postop. and final follow-up radiographs were reviewed. Authors measured longitudinal and transverse diameter of patella using preop. and postop and final simple radiographs to observe the morphological changes of patella after treatemnt. The purpose of this paper is to observe. 1. How much the patella was hypertrophied. 2. What kind of factors influence the hypertrophy of the patella, 3. What is the clinical correlation between the hypertrophy of patella and the clinical outcome. The results were as follows 1. Average hypertrophy of longitudinal and transverse diameter were 1.0±2.3mm and 2.5±1.2mm respectively. 2. Only fracture type(simple. vs comminuted.) was significantly related with the changes of longitudinal and transverse diameter of patella(p < 0.1), Other factors(cast immobilization period, operation method and age) show no significant relationship statistically(p>0. 5). And there is no relationship between longitudinal and transverse diameter statistically(p>0.4). 3. Those who showed change of longitudinal diameter between 0-10mm had good knee joint motion(99°±2). But those who showed shortening or lengthening over 10mm of longitudinal diameter had poor knee joint motion(37°±3, 60°±8 respectively). And change of transverse diameter was not related with the clinical result (p>0. 7).
Clinical Study ; Follow-Up Studies ; Hypertrophy ; Immobilization ; Knee Joint ; Methods ; Patella

No abstract available.

No abstract available.
Knee* ; Magnetic Resonance Imaging*

Acute febrile neutrophilic dermatosis, which was introduced to the dermatologic literature by Sweet in 1964, is characterized by persistent high fever and preceding upper respiratory infection like symptoms, polymorphonuclear leukocytosis in the peripheral blood, raised painful plaques on the limbs, face and neck, histologically a dense dermal infiltration with polymorphonuclear leukocyte, dramatic response to corticosteroids, and the absence of scarring. Case 1 was a 35 year-old female who had suffered from malaise, sore throat, and fever 3 to 7 days before the each episode of the cutaneous manifestation. Painful, red, raised, well-demarcated plaques appeared on the face with tendency of recurrences, and was accompanied by a few, small, shallow ulcerations on the lower Iip and tongue, and conjunctivitis. Polymorphonuclear leukocytosis (10400 with 65%, 11600 with 75%) and elevated ESR(23mm/hr, 19mm/hr) were found on two occasions. Histologically a dense inflammatory cell infiltration composed predominantly of polymorphonuclear neutrophils, small round cells, and a few eosinophils were seen in the dermis and subcutis, especially around the dermal capillaries. Alao there were many nuclear debris and marked endothelial cell proliferations. (countinued...)
Adrenal Cortex Hormones ; Adult ; Capillaries ; Cicatrix ; Conjunctivitis ; Dermis ; Endothelial Cells ; Eosinophils ; Extremities ; Female ; Fever ; Humans ; Leukocytosis ; Neck ; Neutrophils ; Pharyngitis ; Recurrence ; Sweet Syndrome* ; Tongue ; Ulcer

PURPOSE: To evaluate the diagnostic accuracy of T-tube cholangiography(TTC), selective cholangiography (SC) and noncontrast CT(NCT) in the evaluation of intrahepatic stone disease. MATERIALS AND METHODS: We retrospectively analyzed the radiological findings of these methods in thirty patients with intrahepatic stones proved by percutaneous removal. Findings of each procedure were reviewed and correlated with findings of stone removal procedure. RESULTS: Detection of stones was possible in 87. 0% for TTC, 90. 0% for SC, 96. 7% for NCT(p > 0.05). Selective cholangiography was as good as or superior to 1-I'C in determining the presence and extent of the stones in all patients(p < 0. 01). NCT was better than SC in 9;as good as SC in 18;inferior to SC in 3 patients in determining the extent and location of the stones(p > 0.05). Of 12 patients who had additional findings such as biliary cirrhosis or accompanied cholangiocarcinomas, only NCT could detect the lesions in 11 patients. CONCLUSION: Although there was no statistically significant difference between NCT and SC, one procedure sometimes gave valuable informations for interventional procedure which the other could not. Thus we conclude that both procedures are complementary studies and should be done in all patients who are subjected to biliary intervention.
Cholangiocarcinoma ; Cholangiography* ; Humans ; Liver Cirrhosis, Biliary ; Retrospective Studies

To measure the mutagenic activity of micro-organic pollutants in drinking water, mutagenic test was conducted using Salmnella typhimurium TA 98 strain on the water sample taken from three water supply station and six tap water in Seoul in July and November 1987. The results were as follows : 1. The average amounts of organic matters in raw, treated, and tap water sampled in July were 0.38mg/l, 0.28mg/l, and 0.45mg/l, respectively, and sampled in November were 0.34mg/l, 0.24mg/l, and 0.22mg/l, respectively. The amount of organic matters of tap water sampled in November did not increase while that of tap water sampled in July increased compare to those of raw or treated water. 2. The amount of organic matters is the highest in neutral fraction compare to acidic and basic fractions. 3. In the five out of six tap water and raw water of Paldang and Kuui station sampled in July, the mutagenic ratios were greater than two (both direct and indirect mutagenicity). 4. In the three out six tap water and raw and treated water of Kuui station sampled in November, the mutagenic ratios were greater than two. 5. While mutagenic were low in acidic and basic fraction, they were high in neutral fraction. The samples which had high mutagenic activity in the total amount also showed high mutagenic activity in neutral fraction. 6. While mutagenic activity was decreased after the treatment of water, it was increased in tap water as the distance from the water supply station increases.
Drinking Water* ; Drinking* ; Seoul* ; Water ; Water Supply

OBJECTIVES: This study was conducted in order to evaluate the prevalence of posttraumatic stress disorder (PTSD) and related factors in male firefighters in Daegu, Korea. METHODS: A total of 1,261 firefighters from fire stations in Daegu were the subjects of this study. Each firefighter completed a questionnaire on general and occupational matters, experience of traumatic events, and impact of event scale (IES). The IES questionnaire was administered to subjects in order to determine the high risk group for PTSD. We calculated the IES score and determined that an individual was abnormal if the IES score was over 26. RESULTS: The average IES score of the firefighters was 11.0+/-14.3, and the prevalence of high risk firefighters with PTSD was 15.1%. It was found that 40 years of age, fire sergeant, and emergency medical service personnel showed higher prevalence of PTSD than other groups. The most experienced event among traumatic events was 'witness death of victims or patients'. The results of multiple logistic regression analysis for the high risk PTSD group showed that fire sergeant (OR=2.28, 95% CI: 1.28~4.06), fire lieutenant (OR=2.47, 95% CI: 1.14~5.37), fire captain (OR=2.88, 95% CI: 1.11~7.45), firefighting department (OR=2.04, 95% CI: 1.00~4.17), emergency medical service personnel (OR=3.68, 95% CI: 1.47~9.23), total frequency of traumatic events experienced (OR=1.01, 95% CI: 1.00~1.02), and total type of traumatic event experienced (OR=1.35, 95% CI: 1.25~1.46) were significant variables with regards to the reference group (fire fighter and administration department). CONCLUSIONS: These findings indicate that the prevalence of PTSD in firefighters is higher than that in the general population, and fire sergeant, fire lieutenant, fire captain, emergency medical service personnel, firefighting department, total frequency of traumatic events experienced, and total type of traumatic event experienced were significant variables for the PTSD high risk group.
Emergency Medical Services ; Firefighters ; Fires ; Humans ; Logistic Models ; Male ; Prevalence ; Questionnaires ; Stress Disorders, Post-Traumatic

Favre-Racouchot syndrome(nodular elastosis with cysts and comedones) is a peculiar complication of solar elastosis in which comedones, follicular cysts, and nodules of altered elastic tissue occur mainly sround the orbits, on the cheeks, on snd around the nose, and oceasionally in other exposed areas, but sornetimes on the neck or behind the ears. We present a typical case of the Favre-Racouchot syndrome in a 66 year old man with maxillary cancer. The patient had numerous yellowish cysts and black topped comedones located on the forehead, around the orbits and the nose, on the neck, and also behind the ears of 5 years duration. The histopathology of the lesion showed dilated pilosebaceous openings and epitheliaI lined cysts filled with layered keratin in addition to pronounced solar elastosis.
Aged ; Cheek ; Ear ; Elastic Tissue ; Facial Dermatoses* ; Follicular Cyst ; Forehead ; Humans ; Neck ; Nose ; Orbit