No abstract available.
Maxillary Sinus* ; Maxillary Sinusitis*

For the establishment of the basis of treatment and study in the patients of facial bone fracture, we performed a clinico-statistical study about 28 papers and 9564 cases reported as facial bone fractures in the journal of Korean association of oral and maxillofacial surgeons, the journal of the Korean academy of maxillofacial plastic and reconstructive surgery, and related journals. The results were as follows: 1. The ratio of men to women was 4.50:1. 2. The age frequency was highest in the third decade(37.6%), and fourth(21.5%), second(15.5%), fifth(10.3%) decade in orders. 3. The most common location of facial bone fractures was the mandible(62.7%), and zygoma complex (22.6%), nasal bone(15.0%), and maxilla(13.0%) were next in order of frequency. 4. The major etiologic factors were traffic accident(37.9% ), fisticuffs(26.4%), and falldown and slip down(23.4%). 5. The frequent fracture site of mandible is symphysis(39.3%), angle(24,4% ), and condyle(22.5%). The ratio of left to right was 1.31:1. Open reduction(69.1%) was the more frequently using method of treatment in mandibular fracture than colsed reduction (28.6%). 6. The sites of zygoinatic fractures were zygoma complex(48.0%), zygornatic arch(35.7%), and combined(16.3%). The left to right ratio was 1.37:1. 7. The most frequent maxillary fracture was Le Fort I (31.4% ), and Le Fort II (27.1%), unilateral(14.3%), Le Fort III (7.6%) were next in order of frequency.
Facial Bones* ; Female ; Humans ; Male ; Mandible ; Mandibular Fractures ; Maxillary Fractures ; Plastics ; Statistics as Topic* ; Zygoma

Although the incidence of tuberculous arthritis of the hip is being decreased with improvement of hygiene, preventive measures and chemotherapy, it remains as important disease in orthopedic surgery. In the tuberculous arthritis of the hip, eradication of the disease with improvement of joint function is ideal treatment. But classical treatment of anti-tuberculous chemotherapy, synovectomy, and especially hip fusion which was done in most cases in adults, have their own limitation in functional results. Recently the methods of total hip replacement arthroplasty done in tuberculous arthritis with treatment of infection by antituberculous chemotherapy reported good results. During the period from January 1970 to December 1984, total hip replacement arthroplasty were done in 55 patients of tuberculous arthritis of the hip in Seoul National University Hospital. The average follow-up period was 3 years and 1 months. And, the following results were obtained. l. of the 55 cases, 50 cases(90.9%) were resulted in success without reactivation of tuberculosis, and 5 cases(9.1%) were resulted in failure. In those cases, the follow-up period were more than 1 year. 2 . The average period of immediate preoperative anti-tuberculous chemotherapy was higher in the success cases with 10.0 weeks than in the failure cases with 4.5 weeks. 3 . The average preoperative ESR was lower in the success case with 12.4mm/ hr than in the failure cases with 28mm/hr. 4 . Failure cases were restricted to active cold abscess in operative finding. 5. The positive bacteriology was fewer in the success cases with 4% than in the failure cases with 60%. 6. Follow-up functional results of the success cases were superior to any other methods of treatment. It is our conclusion that preoperative anti-tuberculous chemotherapy is important to reduce inflammatous reaction, and although granulation or caseation necrosis is found in operation field, total hip replacement can be successful if there is no active cold abscess.
Abscess ; Adult ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bacteriology ; Drug Therapy ; Follow-Up Studies ; Hip ; Humans ; Hygiene ; Incidence ; Joints ; Necrosis ; Orthopedics ; Seoul ; Tuberculosis

BACKGROUND: Since percutaneous mitral valvuloplasty(PMV) using balloon was introduced by Inoue in 1984, this procedure has been accepted as a new non-surgical therapeutic modality for the treatment of selected patients with mitral stenosis. Pregnant women with mitral stenosis has suffered from life threatening complication due to altered hemodynamic changes and heart failure. Surgical valvotomy has been performed after failure of medical therapy with high risk of fetal mortality and teratogenicity. PMV can be an adequate alternative to surgical valvotomy in pregnant women. METHODS: After precise echocardiographic examination of mitral valve and its surrounding structures including thrombi in left artrium was performed, antegrade transseptal procedure was done in all 3 cases with abdominal shield using Inoue balloon technique. RESULTS: Mitral valve area increased over 1.5cm2 and hemodynamic variables improved immediately after PMV. Symptoms subsided soon after PMV in all 3 cases. Healthy normal babies were delivered transvaginally without difficulties in all 3 patients. CONCLUSIONS: Percutaneous mitral valvuloplasty is a safe and effective therapeuteic alternative to surgical valvotomy in a pregnant women with mitral stenosis who failed medical therapy, in a high risk or symptomatic pregnant women.
Echocardiography ; Female ; Fetal Mortality ; Heart Failure ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Pregnancy* ; Pregnant Women

The aortic dissection is an acute aortic syndrome, caused by an intimal tear and subsequent splitting of the media by the pulsatile blood flow. Though there would be differences in the origin of aortic dissection and therapeutic modalities, the intermediate and long-term prognoses are poor. Endovascular Stent-graft implantation is a revolutionary technique in the treatment of aortic dissection. The endovascular stent grafting in aortic dissection is less invasive and feasible method and is an effective tool for closing the entry site and promoting clot formation, reducing the size of the false lumen. Therefore, endovascular Stent-graft implantation makes possible the desirable remodelling of aorta. We report 33 year-old male with aortic dissection in the thoracic aorta, which was treated with endovascular Stent-graft implantation. Over the favorable remodelling, his dissection was healed completely by the endovascular treatment using Stent-graft.
Adult ; Aorta ; Aorta, Thoracic* ; Blood Vessel Prosthesis ; Humans ; Male ; Prognosis

Although the carotid endarterectomy presently represents the standard therapeutic approach for most patients with significant carotid artery stenosis, a percutaneous transluminal angioplasty (PTA) with stenting has become an alternative method for treating patients with co-mobid conditions, particulary coronary artery disease. A PTA with stenting has the potential for being safer, less traumatic, more cost-effective, and useful in patients at high surgical risk. As well, they are not limited to the cervical carotid artery. But it is reported that carotid angioplasty by femoral approach is difficult to do in 1 - 2% of patients with carotid stenosis due to abnormal origin of carotid artery or occlusion of femoral arteries. We succeeded in PTA with stenting of tight stenosis of right internal carotid artery through the transseptal approach in case of a sharply angled right brachiocephalic artery take-off from the aorta. The transseptal approach can be used for PTA with stenting in case of problems with femoral approach.
Angioplasty ; Aorta ; Arteries ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Constriction, Pathologic ; Coronary Artery Disease ; Endarterectomy, Carotid ; Femoral Artery ; Humans ; Stents*

BACKGROUND: Previous reports have suggested that alleles at the plasminogen activator inhibitor-1 (PAI-1) gene are associated with increased risk of developing coronary artery disease, including myocardial infarction and stroke through their effect on PAI-1 levels. Method: We attempted to search English literatures for all reports of possible effects of PAI-1 gene on cardiovascular disease in human published prior to November 1998. We used a Mantel-Haenszel method (fixed effect model) and random effect model, respectively, to perform a meta-analysis of 7 case-control studies that provided information related to the effects of PAI-1 gene on risk of cardiovascular disease. RESULTS: From 7 studies for diagnosed cardiovascular disease, the relative frequencies of the three genotypes among controls was (5G/5G) (homozygous normal), 24.5%; (4G/5G) (heterozygous), 48.2%, and (4G/4G) (homozygous for the mutant, 675 GGGG), 27.3%. These relative frequencies in cases were 21.7% for 5G/5G, 48.0% for 4G/5G, and 30.3% for 4G/4G. In fixed effect model, compared with those with genotype (5G/5G), the overall odds ratio (OR) for cardiovascular disease among those with (4G/5G) was 1.12 (95% CI, 0.93 to 1.34), and it was 1.20 (1.01 to 1.44) for the (4G/4G) genotype. For five studies with myocardial infarction as the outcome, the overall OR of myocardial infarction was 1.20 (0.99 to 1.47) for those with (4G/5G) and 1.24 (1.00, 1.54) for those with (4G/4G) genotypes, respectively. CONCLUSION: Our findings provide support for the weak association between PAI-1 gene and cardiovascular disease, in particular, myocardial infarction.
Alleles ; Cardiovascular Diseases* ; Case-Control Studies* ; Coronary Artery Disease ; Genotype ; Humans ; Myocardial Infarction ; Odds Ratio ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Polymorphism, Genetic* ; Stroke

24-hour ambulatory ECG monitoring has been examined for the evaluation of heart rate and longest pause in 34 patients with chronic atrial fibrillation (20 patients treated with digoxin and 14 patients without treatment). Following results were obtained: 1. In 34 patients, the mean of average heart rates was 75.7±13.8/minute, fastest heart rates 148.0±32.4/minute, slowest heart rates 48.1±8.4/minute, difference between fastest and slowest heart rates in individual patients 99.9±29.0/minute and longest pauses 2.95±1.06seconds. The longest pauses of more than 4.0 seconds occurred in 4 of the 34 patients and made an exception of comparison groups. 2. In 27 of the 34 patients, ventricular premature contractures were developed and in 11 of 27, mainly occurred less than 100/24 hours and aberrant conduction occurred in all patients. 3. In 20 patients treated with digoxin (0.25 mg/day), the mean of average heart rates was 78.4±13.7/minute, fastest heart rates 152.5±33.1/minute, slowest heart rates 48.9±8.5/minute, difference between fastest and slowest heart rates in individual patients 103.6±31.7/minute and longest pauses 2.55±0.50 seconds. 4. In 10 patients without treatment, the mean of average heart rates was 78.0±10.7/minute, fastest heart rates 154.5±26.8/minute, slowest heart rates 50.6±7.1/minute, difference between fastest and slowest heart rates in individual patients 103.9±22.2/minute and longest pauses 2.66±0.39 seconds. 5. The difference of heart rates and longest pauses between patients with treatment and without treatment were statistically not significant (P>0.05). In summary, authors seemed to consider that 24-hour ambulatory ECG was useful and safe method for clinical evaluation of patients with chronic atrial fibrillation.
Atrial Fibrillation* ; Contracture ; Digoxin ; Electrocardiography* ; Heart Rate ; Humans ; Methods

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

BACKGROUND AND OBJECTIVES: Percutaneuous transvenous mitral commissurotomy(PTMC) has been performed as an effective non-surgical treatment modality of rheumatic mitral stenosis. Mitral regurgitation(MR) as a complication of the procedure occur in 20-53% of the patients. The moderate to severe mitral reguargitation, created by the PTMC, sometimes leads to the requirement for mitral valve replacement, but most of the MR limits the optimal dilation of mitral commissure due to the worry about the progression of the MR. This study was designed to evaluate the occurrence of mitral regurgitation and predictive factors for the moderate to severe mitral regurgitation(grade> or =2) induced by PTMC. METHODS: This study enrolled 46 patients(female 42, mean age 45 years) who have performed PTMC in Yeungnam University Hospital from May 1996 to May 1999. We analyzed the occurrence rate of mitral regurgitation(MR) and predictive factors for MR grade> or =2 after procedure. RESULTS: MR was detected in 35% of the patients prior PTMC, and in 56% after the procedure(grade 1, 30%; grade 2, 15%; grade 3, 11%). 21 cases of the MR was commissure MR as a grade< or =2. MR grade 3, occured in 5 patients, was non-commissure MR caused by the unilateral rupture of the lateral commissure in 4 patients and tearing of the annulus in one patient. On the univariate analysis, patients with MR grade> or =2 showed more frequent atrial fibrillation, mitral regurgitation and fluoroscopic calcification, and had more severe symptoms than patients with MR grade<2 before the procedure. On the analysis of the calcification, there was no significant difference of the leaflet calcification score, but the commissure calcification score was significantly higher in MR> or =2 group than MR<2 group(1.5+/-0.54 vs 2.5+/-0.96, p=.02). On the multivariate logistic regression analysis, independent predictor of MR grade> or =2 was fluoroscopic mitral calcification(OR 6.38, p=.048). CONCLUSION: Mild to moderate commissure MR was observed in most of the patients after PTMC. Commissure calcification have more influence on the development of MR grade> or =2 than valvular calcification, and the fluoroscopic mitral calcification can predict the occurrence of MR grade> or =2 mitral regurgitation after PTMC.
Atrial Fibrillation ; Humans ; Logistic Models ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis ; Rupture