BACKGROUND AND OBJECTIVES: Though the surgical intervention of subclavian artery stenosis has been effective, its high morbidity and mortality have limited its clinical application. In 1980 percutaneous balloon angioplasty of stenotic artery was introduced as a substitute for surgical intervention and subsequent reports have supported its efficacy noting that it is more effective when combined with stent. The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous intervention as an alternative or primary therapy for symptomatic subclavian artery stenosis. METHODS: Between September 1993 and October 1998, 17 lesions in 16 patients of symptomatic subclavian artery stenosis were enrolled as candidates for nonsurgical intervention. We performed percutaneous balloon angioplasty with stenting to the subclavian artery stenosis and evaluated the early results. RESULTS: 1)The patients had a mean age of 55+/-14 years and 13 of 16 patients were male. 2)Subclavian artery stenting was successful in 94% (16/17) of the lesion without significant complications. The cause of failure was suboptimal result after deployment of stent. 3)The types of stents deployed were Strecker stents in 4, Palmaz stents in 8, Wall stents in 3 and Jo stents in 2 cases. 4)The peak and mean pressure gradient reduced from 58.5+/-17.0 to 8.5+/-7.4 and 31.4+/-13.0 to 4.7+/-5.5 mmHg respectively (p<0.01) and the degree of luminal stenosis decreased from 92.5+/-8.5% to 10.0+/-14.3%. (p<0.01) CONCLUSION: Subclavian artery stenosis can be managed safely and effectively through percutaneous balloon angioplasty with stenting, with an excellent technical success rate and less morbidity and mortality particularly in patients coexisting other vascular and systemic diseases. However, the long-term patency and clinical effects should be warranted.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Phenobarbital ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome

During the past 2 years : June, 1985 to May, 1987, 564 cases with dermatophytosis who visited the Dermatology Clinic of Wonju Christian Hospital were studied for Microeporam(M,) canis infection by mycologieal examination. The incidence of M.canis infection found to be 16.3%. The monthly distribotion was the highest in January and lowest in August. The ratio of male to female patient was 1: 1. Most of the cases (80.0%) were found in children under the age of 10. Tinea capitis was the most common clinical type of dermatophytosis caused by M. canis. Patients who had a history of contact with domestic cats (27.5%) or dogs (6.3%) were observed in 27 cases and family infections were observed in 22 cases. The incidence of patients with the noninflammatory and inflammatory lesions in tinea cspitis was similar. Most of patients with tinea corporis exhibited multiple, smaller than 2 cm in diameter, annular patches having pustules or papules.
Animals ; Cats ; Child ; Dermatology ; Dogs ; Female ; Gangwon-do* ; Humans ; Incidence ; Male ; Microsporum* ; Tinea ; Tinea Capitis

There is much controversy concerning the method of treatment on the tibial fracture because of frequent complications, such as non-union, delayed union and infection. Authors reviewed and analyzed 110 tibial fractures which had been treated at the Department of Orthopedic Surgery, Sung Ae General Hospital from June 1983 to March 1987 by the groups, conservative treatment, open reduction and internal fixation with compression plate and closed flexible intramedullary nailing. The results were as follows :1. In regard to the fracture location, there was no difference in the healing time among the treatment methods. The I.M. nailing group healed 1.5 weeks earlier than other groups in each location. 2. In minor and moderate severity by Ellis, the I.M. nailing group revealed better result, and in major one, the compression plate group showed better result. More complications occured in major severity. 3. Union time among the trestment methods was not affected by the fibular fractures, but most of the complications occured in the concomitant fibular fracture case. 4. In open fracture, the healing time showed no difference among the groups, and was prolonged about 2 weeks than closed fracture. In closed case, the I.M. nailing group showed good result. 5. The cases, which were reduced earlier in the conservative group, and treated within 3 days in the I.M. nailing group revesled better result. 6. The radiological union time from the definite treatment was 15.80 weeks in the conservative treatment group, 15.18 weeks in the compression plate group and 13.92 weeks in the I.M. nailing group.
Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hospitals, General ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

BACKGROUND: Left atrial thrombus(LAT) has long been recognized as a complication of mitral stenosis(MS).The transesophageal echocardiographic approach readily visualize LAT. We evaluated the risk factors for left atrial thrombus in patients with MS using transthoracic(TTE) and transesophageal echocardiography(TEE). METHODS AND RESULTS: One hundred and forty-three(patients) who had moderate to severe MS were consecutively studied with TTE and TEE. They were 43 males(30%) and 100 females(70%).The mean age was 44+/-11 years(range 21-70). Twenty-five patients had at least one episode of embolic events. Ninety-six patients were in atrial fibrillation(AF). LAT was detected in 30 pts(21%) : 16 had thrombus confined to the LA appenge(LAA), 14 to true LA cavity and/or LAA. TTE variables were compared between LAT group and non-LAT group. Univariate predictors of LAT were mitral valve area(MVA)(0.78+/-0.22cm2 vs 1.05+/-0.32cm2, p=0.001), pressure half time(353+/-88ms vs 258+/-118ms, p=0.002). LV ejection fraction(EF)(55+/-11% vs 62+/-8%,p=0.008), LA size (58+/-11mm vs 52+/-7mm, p=0.033) and AF(p=0.001). Stepwise logistic regression analysis revealed significant independent predictors of LAT to be AF(p=0.02), MVA(p=0.02) and EF(p=0.03). CONCLUSION: Left atrial thrombus was not uncommon in patients with rheumatic mitral stenosis. Small mitral valve area and reduced ejection fraction of left ventricle appear to be significant predictors of LAT in mitral stenosis with atrial fibrillation.
Atrial Fibrillation ; Echocardiography* ; Heart Ventricles ; Humans ; Logistic Models ; Mitral Valve ; Mitral Valve Stenosis* ; Risk Factors ; Thrombosis*

BACKGROUND: Since the nonsurgical treatment of mitral stenosis using a single balloon has been introduced by Inoue et al. in 1984. percutaneous mitral valvuloplasty has became an accepted therapeutic modality for selected patients with mitral stenosis. Zeibag et al. demonstrated the double balloon technique showed a better outcome than the single balloon in obtainning the optimal mitral valve area. On the other hand, there are several reports that single balloon technique was comparable with the double balloon technique. Therefore, there are still controversies in efficacy, benefit and complications between balloon techniques. METHOD: To compare the efficacy and complications of percutaneous mitral valvuloplasty with the double balloon or the Inoue balloon technique, 40 patients were studied consecutively by random method in selecting the balloon technique. RESULTS: In all cases, percutaneous mitral valvulopasty was performed successfully. Optimal outcome defined as mitral valve area larger than 1.5cm2 was obtained in 12 cases out of 16(75%) in double balloon group and 15 out of 24(63%) in Inoue balloon group(p=NS). Mitral valve area was significantly increased after valvulopasty in both technique but there was no different between both groups(Mean+/-SD ; 0.9+/-0.3 to 1.7+/-0.2 vs 0.9+/-0.2 to 1.9+/-0.2cm2). There were also hemodynamic improvement significantly in mean mitral gradient(MG). pulmonary artery pressure (PAP) and left atrial pressure(LAP) after PMV but there were no difference between groups (18+/-8 to 7+/-2 vs 21+/-13 to 9+/-4 mmHg for MG. 29+/-12 to 22+/-9 vs 28+/-9 to 18+/-5mmHg for PAP and 22+/-8 to 11+/-5 vs 21+/-6 to 11+/-4 for LAP respectively). Mitral requrgitation greater than grade 2 occurred in 2 cases of the double balloon group and one case of the Inoue balloon group(p=NS). New development of atrial shunt was found in 3 cases in both groups. CONCLUSIONS: The double and Inoue balloon techniques were quite comparable in immediate outcome and complications.
Hand ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Prospective Studies* ; Pulmonary Artery

We evaluated the hypolipidemic effect and adverse reaction of Lovastatin, HMG-CoA reductase inhibitor 20 to 40mg once-daily in the evening, in 20 patients with primary hypercholesterolemia for 12 weeks and the following results were obtained. 1) Lovastatin significantly reduced the total cholesterol(from 264.8+/-12.9mg/dl to 195.3+/-31.3mg/dl) by 26.3%, TG(from 191.1+/-41.5mg/dl to 156.2+/-52.9mg/dl) by 18.3%, LDL-C(from 177.0+/-12.4mg/dl to 121.3+/-19.6mg/dl) by 31.5% and increased th HDL-C (from 39.8+/-4.2mg/dl to 41.6+/-5.0mg/dl) by 4.5% at the end of 12th week. 2) The adverse reaction during the period of study were limited to diarrhea and nausea in one patient, dryness of skin and itching in one patient, and no patients was withdrawn form therapy. In this study, Lovastatin was well toterated and effective agent for the treatment of hypercholesterolemia without serious side effects.
Diarrhea ; Humans ; Hypercholesterolemia* ; Lovastatin ; Nausea ; Oxidoreductases ; Pruritus ; Skin

A pancreatic pseudocyst is the most common cystic lesion in the pancreas encountered in the clinical practice. The management of pancreatic pseudocyst is a complex and prolonged problem for the general surgeon. Especially, considerable ambiguity exists regarding both the incidence for surgery and the timing of operative intervention in patients with pancreatic pseudocysts. The clinical courses of 50 patients with pancreatic pseudocysts were retrospectively reviewed in the Department of Surgery at Young Dong Severance Hospital during the period of 10 years from March 1985 to February 1995. The results were as follows: 1) The pancreatic pseudocysts were most prevalent in the 3rd and the 4th decade (58%) of age, and the male to female ratio was 3.5:1. 2) Alcoholic pancreatitis was the disease most frequently associated with pancreatic pseudocysts (44%). 3) The frequent symptoms or signs of patients of pancreatic pseudocyst were abdominal pain (84%), abdominal masses (24%), and nausea and vomiting (20%). 4) Valuable diagnostic radiologic methods were abdominal sonography (82%), abdominal CT (96%), and ERCP (80%). 5) The applied surgical methods were Roux-en-Y cystojejunostomy (37% of all surgical cases), pseudocyst resection or distal pancreatectomy (50%), and external drainage (13%).Surgical indications for the conservative management group were persistent symptoms and/ or increase in size in eleven patients (33%) and natural complications in six patients (18%). As the size of the pseudocyst increase, resolution rate tended to decrease and the complication rate tended to increase, but complete resolution occurred in 26% of the pseudocysts sized from 5 cm to 10 cm. Two pseudocysts greater than 10 cm in size were treated successfully with conservative management. We conclude that the cyst size and the cyst age are not absolute criteria for determining surgical indications.
Abdominal Pain ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Female ; Humans ; Incidence ; Male ; Nausea ; Pancreas ; Pancreatectomy ; Pancreatic Pseudocyst* ; Pancreatitis, Alcoholic ; Retrospective Studies ; Tomography, X-Ray Computed ; Vomiting

BACKGROUND: Susceptible health care workers are at risk of acquiring and transmitting measles, rubella, and varicella. This study was performed to assess the immune status and to determine the prevention strategy for aforementioned diseases. METHODS: A total of 182 subjects were tested for immunoglobulin G of measles, rubella, and varicella. The results were evaluated with histories of the three diseases, vaccination or contact histories to determine which historical information can predict the immunity. RESULTS: We found that 94.5% of the subjects were serologically immune to measles, 85.2% to rubella, and 82.4% to varicella. The historical information did not predict immunity for measles, rubella, and varicella. CONCLUSION: We recommend that all health care workers involved in the clinical care of patients should be screened for their antibody against varicella, and those who are susceptible to varicella, measles or rubella should be vaccinated.
Chickenpox* ; Delivery of Health Care* ; Humans ; Immunoglobulin G ; Measles* ; Rubella* ; Vaccination

BACKGROUND: Susceptible health care workers are at risk of acquiring and transmitting measles, rubella, and varicella. This study was performed to assess the immune status and to determine the prevention strategy for aforementioned diseases. METHODS: A total of 182 subjects were tested for immunoglobulin G of measles, rubella, and varicella. The results were evaluated with histories of the three diseases, vaccination or contact histories to determine which historical information can predict the immunity. RESULTS: We found that 94.5% of the subjects were serologically immune to measles, 85.2% to rubella, and 82.4% to varicella. The historical information did not predict immunity for measles, rubella, and varicella. CONCLUSION: We recommend that all health care workers involved in the clinical care of patients should be screened for their antibody against varicella, and those who are susceptible to varicella, measles or rubella should be vaccinated.
Chickenpox* ; Delivery of Health Care* ; Humans ; Immunoglobulin G ; Measles* ; Rubella* ; Vaccination

PURPOSE: Bone bruises of patients with acute traumatic knee injuries, that are not found on simple radiograph, can be found on magnetic resonance imaging (MRI). The purpose of this study is to evaluate the frequency and locations of bone bruises on MRI in acute traumatic anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) injury. MATERIALS AND METHODS: 25 and 19 MRls, in which acute traumatic ACL and PCL injury was pre sent and there was no abnormality in simple radiograph, were reviewed. MRI was taken within 51 days of injury. A bone bruise was determined as a geographic and nonlinear area of signal loss on T1 images and increased signal intensity on T2 images involving the subcortical bone. RESULTS: In 16 patients with bone bruises and acute ACL injury, bone bruises were found in the lateral compartment of the knee in 15 (93.8%) patients. The most common area was the lateral tibial plateau (11 cases, 68.8%) and the second was lateral femoral condyle (9 cases, 56.3%). In 5 patients with bone bruises and acute PCL injury, bone bruises were found in the lateral compartment of the knee in all 5 (100%) patients. The most common area was lateral tibial plateau (4 cases, 80%) and the second was lateral femoral condyle (2 cases, 40%). CONCLUSIONS: In patients with acute traumatic ACL or PCL injuries the bone bruises are often found on the lateral compartment of the knee, especially lateral tibial plateau and lateral femoral condyle on MRI.
Anterior Cruciate Ligament ; Contusions* ; Humans ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament