Defecography evaluates in real time the morphology of rectum and anal canal in a physiologic setting by injection of a thick barium paste into the rectum and its subsequent evacuation. Because of its ability of structural and functional evaluation, defecography is primarily performed for work up of patients with longstanding constipation, unexplained anal or rectal pain, residual sensation after defecation or suspected prolapse. Technique and interpretation of this examination are outlined in this review.
Anal Canal ; Barium ; Constipation ; Defecation ; Defecography ; Humans ; Pelvic Floor ; Prolapse ; Rectum ; Sensation

OBJECTIVE: To examine the relationship of the amniotic, and maternal infiammatory responses and decreased amniotic fluid in patients with preterm PROM. METHODS: Fifty three patients with preterm PROM in singleton pregnancy who delivered preterm neonates (gestational age<35 weeks) within 3 days of amniocentesis were included. Amniotic fluid index(AFI) was measured by transabdominal ultrasonography at amniocentesis. Amniotic fluid was cultured far aerobic and anaerobic bacteria and mycoplasma. The intensity of the inflammatory response was evaluated by clinical and histologic chorioamnionitis. The intensity of fetal hypoxia was evaluated by 1 min Apgar score, 5 min Apgar score, and pH of cord blood at birth. RESULTS: The prevalence of oligohydramnios, which was defined when measured AFI was equal or less than 5.0, was 34% (18/53). The prevalence of positive amniotic fluid culture was 45% (24/53) and that of patients with was significantly higher than that of patients without oligohydramnios (78% [14/l8] vs 29% [10/35], p<0.01). Intrauterine inflammatory response was significantly stronger in patients with oligohydratnnios than in patients with adequate amniotic fluid (pathologic chorioamnionitis 100% [l6/16] vs 63% [19/30], clinical chorioamnionitis 39% [7/18] vs 6% [2/35]; p<0.01 for each). However, no significant difference was found in the intensity of fetal hypoxia (I min Apgar score <7 67% [12/18] vs 66% [23/35], 5 min Apgar score <7 39% [7/l8] vs 26% [9/35], pH of cord artery blood at birth 7.27+0.13 vs 7.22+0.13; p>O.I, for each). CONCLUSION: Oligohydramnios in patients with preterm PROM is strongly pedictive for positive amniotic fluid culture, and is associated with a robust host response in amniotic, and maternal cornpartments, but not with fetal hypoxia.
Amniocentesis ; Amniotic Fluid ; Apgar Score ; Arteries ; Bacteria, Anaerobic ; Chorioamnionitis ; Female ; Fetal Blood ; Fetal Hypoxia* ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Mycoplasma ; Oligohydramnios* ; Parturition ; Pregnancy ; Prevalence ; Ultrasonography

No abstract available.
Mass Screening* ; Stomach Neoplasms* ; Stomach*

No abstract available.
Dermatitis* ; Streptococcus pyogenes

Acute infectious myocarditis in children can be caused by many pathogens, including bacteria, viruses, fungi and protozoa. Patients may be asymptomatic or may have 'flu-like symptoms' to life-theratening arrhythmias or sudden death. We herein report a case of acute myocarditis complicated by complets and permanent AV block, associated with Salmonella group B gastroenteritis in a previously healthy 5-year-old boy. Presenting symptoms were dyspnea, cyanosis, vomiting, and diarrhea. Electrocardiography on admission showed very slow ventricular escape rhythm at 37 beats/minute. He was treated with antibiotics, inotropic agents, ventilatory support, and transvenous temporary pacemaker. Ten days later, permanent dual chamber pacemaker was implanted. All three consecutive stool cultures done after admission grew Salmonella group B. His ventricular function recovered rapidly and completely and he became fully active 2 months after the onset. However, his conduction system was totally destroyed and at last follw up evaluation 2 years after the onset, he is still totally dependent on the pacemaker without any escape rhythm.
Anti-Bacterial Agents ; Arrhythmias, Cardiac ; Atrioventricular Block* ; Bacteria ; Child ; Child, Preschool ; Cyanosis ; Death, Sudden ; Diarrhea ; Dyspnea ; Electrocardiography ; Fungi ; Gastroenteritis* ; Humans ; Male ; Myocarditis* ; Salmonella* ; United Nations ; Ventricular Function ; Vomiting

This study was conducted to determine the correlation between weighted needle pinprick sensory threshold(PPT) and sensory nerve conduction tests. The subjects were 53 healthy controls, 31 diabetic patients without peripheral neuropathic symptoms(DM) and 36 diabetic patients with peripheral neuropathic symptoms(DN). PPT was measured on the index and little fingers, bilaterally, as well as under the lateral malleolus, bilaterally. In electrophysiologic assessment the left and right median, ulnar and sural nerves were studied. Each mean PPTs was high in order of controls, DM and DN. Age adjusted PPT was significantly different among three groups on right little finger(p<0.05) and left malleolus(p<(0.05), but not significantly different between DN and DM on other sites. Each sensory nerve conduction velocity and amplitude was statistically significantly different among three groups(p<0.05). Correlations of PPT with sensory nerve conduction velocity and amplitude were statistically significant on each site and ranged from -0.4203(left malleolus) to -0.5649(right index finger) and from -0.3897(left index finger) to -0.6200(right index finger), respectively. When electrophysiological study is not feasible, measurement of PPT may be helpful for the assessment of peripheral sensory neurological function.
Fingers ; Humans ; Needles* ; Neural Conduction* ; Sensory Thresholds* ; Sural Nerve

The cytochrome P450 (CYP) 3A subfamily is estimated to participate in the biotransformation of 50% of the currently prescribed drugs. Four members of the CYP3A subfamily have been identified in humans: CYP3A4, CYP3A5, CYP3A7, and CYP3A43. Initial data suggested that CYP3A5 accounts for only a small proportion of the total hepatic CYP3A in about 20% of samples, but it was later revealed that CYP3A5 represents more than 50% of the total CYP3A amount in some individuals. Several genetic variants have been described for the CYP3A5 gene, of which the CYP3A5*3 allele (gA6986G), the most common form and leading to the loss of CYP3A5 activity, has been extensively investigated in the aspect of pharmacokinetics and disease risk. This review summarized the molecular characteristics of the CYP3A5 gene, and discusses the association of the CYP3A5*3 polymorphism with disease risks such as cancer and hypertension, along with its role in the pharmacokinetics of CYP3A substrates.
Alleles ; Biotransformation ; Cytochrome P-450 CYP3A ; Cytochrome P-450 Enzyme System ; Humans ; Hypertension ; Pharmacogenetics ; Pharmacokinetics

OBJECTIVES: To examine emotional and psychological characteristics associated with suicide attempts in depressed patients. METHODS: A sample of 37 inpatients diagnosed with major depressive disorder or depressive disorder NOS was divided into two groups : lifetime suicide attempters(N=15 ; 40.54%), non-attempters(N=22 ; 59.46%). Beck Depression Scale(BDI), Beck Anxiety Scale(BAI), Hamilton Depression Rating Scale(HDRS), Hamilton Anxiety Rating Scale(HARS), and MMPI-2 were used to evaluate symptoms severity and psychological characteristics. RESULTS: Suicide attempters scored higher on the BDI though there were no group differences on the HDRS and on the both anxiety scales. Also they showed higher scores on the F, Fb, Pa, RC1, DEP, HEA, PK, AAS among MMPI-2 subscales. Our findings suggest that suicide attempters among depressed patients undergo more severe subjective distress and difficulties in adjustment than non-attempters. Also they were more hostile to others and showed lower trust. Lastly, they showed more somatic complaints and substance related problems. CONCLUSION: The present study showed that suicide attempters among depressed patients have distinct emotional and psychological characteristics. MMPI-2 would be helpful to assess suicidal risk of depressed patients.
Anxiety ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Humans ; Inpatients ; Pyrrolidines ; Suicide ; Weights and Measures

The subjects were 349 high school boys and girls who were 10th and 11th graders in Seoul, Korea. Statistical analysis included percentages, means, Pearson correlation coefficient, ANOVA, t-test, and stepwise multiple regression analysis. As a result, there were positive correlations between social support, stress reduction and increases in health behavior. Stepwise multiple regression analysis of social support, stress, and adolescents health behavior showed that social support explained 26.3% of the variance in health behavior, The more social support subjects experienced more health behavior level and the less the correlated stress level. In the area of demographic attributes, gender, height, weight, grade level, socioeconomic level of the parents, and stress were significantly correlated, grade levels, religion, socioeconomic level of parents and social support. sibling order, religion, socioeconomic level of the parents, parents education, occupation of father. and health behavior were statistically significant The findings indicated stress was a negative factor in health behavior, and social support was a positive factor in reducing stress and promoting health behavior. To reduce adolescents stress and to promote health behavior, we should endeavor to develop realistic social support programs.
Adolescent* ; Education ; Fathers ; Female ; Health Behavior* ; Humans ; Korea ; Occupations ; Parents ; Seoul ; Siblings ; Child Health

Abdominal actinomycosis is very rare infectious disease and seldom reported as a cause of abdominal mass. This disease is diagnosed by pathologic findings and culture result but it is very difficult to differentiate with other granulomatous illammatory disease, diverticular disease, malignancy, etc. The radiologic findings were non-specific and CT scan revealed the inflammatory mass with multiple small abscesses and fibrous change. The treatment of choice for actinomycosis is medical treatment with penicillin but surgical intervention may be needed when complication such as obstruction, fistula formation, abscess formation develop. We report a patient with abdominal actinomycosis that presented with transverse colonic obstruction and severe abdominal wall inflammation. This patient had no past operative history but got intrauterine contraceptive devices during last 10 years. We treated this patient by surgical resection and antibiotic therapy.
Abdominal Wall ; Abscess ; Actinomycosis* ; Colon* ; Colon, Transverse ; Communicable Diseases ; Fistula ; Humans ; Inflammation ; Intrauterine Devices ; Penicillins ; Tomography, X-Ray Computed