Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

Two hundreds fifty seven cases of normal mammogram were analysis for classification of types of breasts.Ranging from 20 to 79 years of age, mean age was 45 years. Two projections, craniocaudal & mediolateral, were used. Age, nutrient condition, familial tendency and hormonal factors influence to breats hisologically. Normalbreats were classified into the standard (9.75%), ductal (71.7%), glandular (6.2%) and atrophic (12.4%) types.Ductal type was further subclassified into intraductal, periductal and mixed types. Atrophic type was susbdividedinto fibrous and fatty, Standard type was observed in younger women, instead of atrophic type was seen in olderage group, especially after menopause. Periductal type was most common (65.4%), Glandular type was mostly intwenty to thirty year group. According to increase of age, gladular or ductal type transformed into atrophic type.
Classification ; Female ; Humans ; Menopause

OBJECTIVES: Considering large diversity of clinical presentation of schizophrenia, it is important to identify valid clinical subtypes or dimensions that might have homogeneous biological underpinning. The current study aimed to explore lifetime symptom-based dimensional phenotypes in patients with chronic schizophrenia, and to investigate their correlation with cognitive functions and other clinical characteristics. METHODS: Lifetime-based symptoms and additional clinical variables were measured using the Diagnostic Interview for Genetic Studies and the Schedule for the Deficit Syndrome in 315 clinically stable patients with chronic schizophrenia. Through principal components factor analysis, eight dimensional phenotypes were obtained. Comprehensive neuropsychological tests were administered for 103 out of 315 patients, and domain scores were calculated for cognitive domains defined in the MATRICS consensus battery. RESULTS: 'Non-paranoid delusion factor' including delusions of grandiose or religious nature, showed significant negative correlation with processing speed, working memory, attention/vigilance, and general cognitive ability, and positive correlation with intra-individual variability. 'Negative symptom factor' showed significant negative correlation only with general cognitive ability. Those two factors were also negatively correlated with function levels measured by Global Assessment Scale (GAS), and associated with poor treatment responses. CONCLUSION: Symptom-based dimensional phenotypes of schizophrenia measured on a lifetime basis showed discriminative correlation with cognitive function domains, global functioning level, and overall treatment responses, indicating their possibility as valid phenotype axes of schizophrenia having homogeneous biologic basis.
Appointments and Schedules ; Cognition ; Consensus ; Delusions ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Phenotype ; Schizophrenia*

No abstract available.
Head and Neck Neoplasms* ; Head* ; Neck Dissection* ; Neck*

The author reviewed 148 cases of phalangeal and metacarpal fractures of the hand, excluding distal phalangeal and carpal bones, in 75 patients treated at the Department of Orthopaedic Surgery, Dong-Kang Hospital, from January, 1984 to December, 1987. We obtained the following results ; 1. Better results were obtained in younger patients, transveres or spiral fractures, and cases immobilized in MP joint flexion. 2. Factors that led to worse results included older age, comminuted fracture, wide displacement, intra articular fracture, associated tendon injury, intraarticular pin placement. 3.In case of K-wire fixation, dorsal placement of the wire revealed better result than volar one.
Carpal Bones ; Clinical Study ; Fractures, Comminuted ; Hand ; Humans ; Joints ; Tendon Injuries

Tarsometatarsal injury has not been paid much attention due to it is unusual frequency. But the cases of tarsometatarsal injuries are on the increase in proportion to the increasing "high energy trauma injury" resulted from the traffic and industrial accidents. The purpose of this study is both assessing the relative effects among clinical results, final radiologic findings, treatment results and symtoms. In view of the results so far achieved from 20 cases of tarsometatarsal fracture dislocation which had been treated at Sung-Ae general hospital from January 1990 to December 1993, the results were as follows: 1. Thirteen cases were treated by open reduction and 3 cases were treated by closed reduction with smooth pins but no reduction loss were experienced. 2. Traumatic arthrosis could be observed in 14 cases but there were no influences on the functional end results. 3. Anatomical results correlated with pain. 4. Anatomical or neraly anatomical reduction was considered as most important factor of prognosis.
Accidents, Occupational ; Dislocations ; Hospitals, General ; Prognosis

Due to the instability of intertrochanteric fractures in elderly patients, various methods of reduction and fixation were introduced to obtain stable reduction and solid union, But there have been many controversies regarding advantages between anatomical reduction group and non-anatomical reduction group. The authors analyzed the 68 unstable intertrochanteric fractures out of total 94 cases of intertrochanteric fractures treated from Jan. 1988 to Jan. 1994 with mean follow-up 17 months and evaluated the radiologic and clinical results between those two groups. The results were obtained as follows: 1. The most common cause was low energy injury and according to the Tronzo classification, the type III was most common in 54 cases (79.4%). 2. The average union time was 14.0wks (84%), the union rate was low in the medialized reduction group(A-P) and anterior displaced reduction group(A-P), anterior displaced and anatomical reduction groups(Lateral). 3. The compression length more than 10mm of lag screw was deep in medialized reduction group(A-P), another displaced and anatomical reduction groups(Lateral). 4. The average length of lag screw sliding was 9.2mm and depth sliding of 6.8mm (74%) was occurred within immediate postoperative 1 month.
Aged ; Classification ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans

Fractures involving both tibial plataeus result form high energy trauma such as a traffic accidents or falls, and it is frequently accompanied by soft tissue injuries. Thus it is very difficult to treat these fractures satisfactorily and severe complications can be caused. The purpose of study is to analyze the clinical results, complication and factors influencing the results after open reduction and internal fixation of tibial bicondylar fractures. Twenty cases(19 patients) of tibial bicondylar fractures which had been treated by open reduction and internal fixation from January 1989 to December 1994 were analyzed after 1 to 5 years follow-up. The results were as follows. 1. By AO classification, the most common type was C3(13 cases). 2. According to Blokker's criteria, 5 cases was unsatisfactory and all of these cases were C3. 3. Unsatisfactory results were 3 cases of reduction loss(angular deformity), one case of deep infection and one case of unresolved peroneal nerve palsy. 4. Tibial tubercle osteotomy, bone graft and medial buttress plate were important for anatomical reduction and maintenance.
Accidental Falls ; Accidents, Traffic ; Classification ; Follow-Up Studies ; Osteotomy ; Paralysis ; Peroneal Nerve ; Soft Tissue Injuries ; Tibia ; Transplants

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Salivary Glands*

PURPOSE: To evaluate the therapeutic effect and difficulty of embolization of pseudaneurysm of the splanchnic artery. MATERIALS AND METHODS: Between February 1988 and June 1996, we employed transcatheter embolization to treat a total of eleven patients with splanchnic artery pseudoaneurysm by transcatheter embolization. Eight were males and three were females ; their ages ranged from four to 70 years (mean 44). Three patients had previously been operated on, three had undergone biopsy, and on three, percutaneous transhepatic biliary drainage had been performed ; one had been involved in a traffic accident and one had suffered a gun-shot wound. All patients underwent diagnostic angiography and superselective embolization using a 3F microcatheter. We used Gelfoam with microcoil four times, microcoil twice, Gelfoam once, Gelfoam with ethanol once, a detachable balloon once, and Ivalon once. RESULTS: Arteries in which pseudoaneurysm had occurred were as follows: renal, four, hepatic, three; gastroduodenal, two ; superior mesenteric, one. Nine patients underwent one session of procedure and two underwent two session. Nine patients (82%) were treated successfully and without complication by embolization. Two patients failed to embolize due to vascular spasm and tortuosity in one and a wide aneurysmal neck in the other ; one of these died six days later and the other was operated on. CONCLUSION: Although there are therapeutic difficulties in cases of vascular spasm, tortuosity, or a wide aneurysmal neck, embolization of pseudoaneurysm of the splanchnic artery is a safe and effective life-saving procedure.
Accidents, Traffic ; Aneurysm ; Aneurysm, False* ; Angiography ; Arteries* ; Biopsy ; Drainage ; Ethanol ; Female ; Gelatin Sponge, Absorbable ; Humans ; Male ; Neck ; Spasm ; Wounds and Injuries