The pathophysiology of pediatric encopresis has been incomprehensible. The current study was designed to assess its clinical and physiologic findings. Moreover, outcome of treatment was evaluated. METHODS: The clinical and functional findings of 18 patients (13 boys, 5 girls) were analyzed, retrospectively. Physiologic studies for cooperative child included anal manometry (n=12), cinedefecography (n=3), and PNTML (pudendal nerve terminal motor latency, n=1). For exclusion of the organic cause, barium contrast study was carried out in all case. Patients were categorized by leading symptom as constipation or incontinence. Physiologic findings and outcome of treatment were analyzed based on the categorized groups. Biofeedback therapy by using newly-developed anal sphincter control system (KONTINENCE CLINICAL(TM)) in my institute, was underwent a mean 4.1 (range, 2~12) sessions. The outcome was analyzed in the period of 5.4 (range, 1~33) months follow-up. RESULTS: Patients were categorized as having constipation (group I, n=12) or incontinence (group II, n=6) group. In the manometric parameters, there were no statistical differences between the values of the mean resting pressure (RP), the maximum RP, and the maximum voluntary contraction between group I and II. In the cinedefecography, 3 of group I patients revealed as having the pelvic floor dyssynergia. The findings of PNTML were not specific in group II (n=1). Regarding to the therapeutic outcome, 8 of 10 patients were cured or improved. CONCLUSIONS: There were no differences in the resting and squeeze profiles of manometric parameters between two groups. However, pelvic floor dyssynergia was identified in the cinedefecography of constipated group. Conventional and biofeedback treatment for encopretic children provides acceptable outcome.
Anal Canal ; Ataxia ; Barium ; Biofeedback, Psychology ; Child ; Constipation ; Defecography ; Encopresis* ; Follow-Up Studies ; Humans ; Manometry ; Pelvic Floor ; Retrospective Studies

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. This syndrome is most commonly seen with spinal trauma and extramedullary spinal neoplasm. A herniated cervical disc has been rarely reported as a cause of this syndrome. We present a case of a 28-year-old male patient diagnosed as large C3-C4 disc herniation with spinal cord compression. He presented with left hemiparesis and diminished sensation to pain and temperature in the right side below the C4 dermatome. Microdiscectomy and anterior cervical fusion with carbon fiber cage containing a core of granulated coralline hydroxyapatite was performed. After the surgery, rapid improvement of the neurologic deficits was noticed. We present a case of cervical disc herniation producing acute Brown-Sequard syndrome with review of pertinent literature.
Adult ; Brown-Sequard Syndrome ; Carbon ; Ceramics ; Durapatite ; Humans ; Hydroxyapatites ; Male ; Neurologic Manifestations ; Paresis ; Sensation ; Spinal Cord Compression ; Spinal Neoplasms ; Spine

Rotor syndrome is a rare disease of hereditary hyperbilirubinemia transmitted with autosomal recessive trait. In general, Rotor syndrome shows direct hyperbilirubinemia and there has been several reports since Sons's report in 1966, in Korea. A 34-year-old female was admitted with the chief complaint of intermittent icteric sclera for 24 years. There was no family history of jaundice. Rotor syndrome was diagnosed by oral cholecystogram, BSP retention test, 99mTc-DISIDA scan, liver biopsy and electron microscopy study of liver biopsy specimen. We report this case with brief review of the literature.
Adult ; Biopsy ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Hereditary* ; Jaundice ; Korea ; Liver ; Microscopy, Electron ; Rare Diseases ; Sclera ; Technetium Tc 99m Disofenin

Three beagle dogs aged over one and half years were used in this study. All mandibular premolars were carefully extracted. Two AVANA implants(Sumin, Korea) and two 3i implants(Implant Innovation, USA) were installed at each right and left side respectively. Each dog was sacrificed at 4, 8. 12 weeks. Non-decalcified specimens were made and stained for a light microscopic study. The results were as follows; 1. Inflammation was not observed in the area of bone tissue adjacent to the implant body. 2. With time, quantity of osseointegration increased in each type of dental implant. There was no difference between AVANA implant and 3i implant. 3. Maturation of the bone around each type of the dental implant increased with time. 12 weeks after implant installation, the bone around dental implant represented compact bone-like appreance. 4. In case implants were located adjacent to a root, newly-formed periodontal ligament tissue was observed around the implant. And the direction of the periodontal ligament fiber was parallel to the surface of the implant. Within the results of this study, AVANA implants represented similar osseointegration in comparision with 3i implants.
Dogs ; Animals

325 patients underwent emergency evacuation of traumatic intracranial hematomas over a 5-year period. Ten(3%) developed delayed contralateral epidural hematomas. These hematomas were not present on initial computed tomography(CT) scan, but repeat CT scan after craniectomy showed sizable hemorrhage. The authors analyzed 10 cases with delayed post-traumatic contralateral epidural hematoma according to their etiology, hematoma types on computerized tomography, initial Glasgow Coma Scale(GCS) & follow up Glasgow Outcome Scale(GOS). 1) Delayed development of post-traumatic contralateral epidural hematoma after evacuation of initial hematoma occurred in 10 of the 325 head injured patients, an incidence rate of 3%. 2) The important factors affecting patients outcome were the initial GCS & the time interval after surgery. 3) Eight patients were found to have a skull fracture at the site of delayed epidural hematoma formation(80%). 4) The results of delayed contralateral epidural hematoma was 50% good, 50% bad and had a mortality rate of 30%.
Coma ; Craniocerebral Trauma ; Emergencies ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Traumatic ; Mortality ; Skull Fractures ; Tomography, X-Ray Computed

PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina

Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).
Blood Pressure ; Consciousness ; Emergency Service, Hospital ; Female ; Glycosuria ; Herbicides ; Humans ; Hypnotics and Sedatives ; Incidence ; Intention ; Leukocytosis ; Male ; Miosis ; Mortality ; Nausea ; Pesticides ; Physical Examination ; Pneumonia ; Pulmonary Edema ; Pupil ; Respiratory Insufficiency ; Rodenticides ; Seasons ; Seizures ; Suicide ; Sweat ; Sweating ; Vomiting

Intraorbital or intracranial mucoceles usually arise from paranasal sinus and enlaarge sufficiently to compress orbital or intracranial structures: primary intraorbitocranial mucocele developing from optic canal or anterior clinoid process is extrmely rare. We experienced a case of 48-year-old female patient presenting headache and diplopia with 5 days` duration, whose primary mucocele had arisen from anterior clinoid process near the optic canal unassociated with paranasal sinus. We report the case herein with a review of the literature.
Diplopia ; Female ; Headache ; Humans ; Middle Aged ; Mucocele* ; Orbit

BACKGROUND: Recently, a lower incidence of late potentials has been reported in patients with acute myocardial infarction after successful thrombolysis when compared with conventionally treated patients. In another recent study, however, no significant effect of thrombolytic therapy on any abnormal signal average electrocardiography was found at 13 days after acute myocardial infarction. The present study was designed to determine the prognostic significance of the signal average electrocardiography and to evaluate the possible value of this technique as a noninvasive tool for monitoring of coronary occlusion and reperfusion. METHODS: Signal averaging was performed by using a signal average electrocardiography with bidirectional filterings before coronary artery occlusion, at 5 minutes after coronary occlusion and on reperfusion in 20 cats. Three of them died due to malignant ventricular arrhythmia during reperfusion. In all cats, approximately 250 beats were averaged. All data were analysed at filter frequency 25 to 250Hz, 40 to 250Hz and 80 to 250Hz. The following quantitative high resolutional electrocardiographic variables were calculated by computer : 1) filtered total QRS duration, 2) duration of HFLA(high frequency low amplitude) signals under 40uV, 3) RMS voltage of terminal 40ms, 4) mean Voltage of terminal 40ms, 5) average noise voltage. RESULTS: At the filter frequency of 40 to 250Hz and 80 to 250Hz, the filtered QRS duration and duration of HFLA signals 40uV were significantly prolonged at 5 minutes after coronary artery occlusion than before coronary occlusion(p<0.01). At the filter frequency of 40 to 250Hz and 80 to 250Hz, the RMS voltage(terminal 40ms) and mean voltage(terminal 40ms) were significantly prolonged at 5 minutes after coronary artery occlusion than before coronary occlusion(p<0.01, p<0.01 respectively). At the filter frequency of 80 to 250Hz, the filtered QRS duration and at the filter frequency of 25-250Hz, the duration of HFLA signals at 40uV were significantly shortened during reperfusion than at 5 minutes after coronary artery occlusion(p<0.01, p<0.05 respectively). At the filter frequency of 40 to 250Hz and 80 to 250Hz, the RMS voltage(terminal 40ms) and mean Voltage(terminal 40ms) were significantly shortened during reperfusion than at 5 minutes after coronary artery occlusion(p<0.01, p<0.01 respectively). There was no significant change of the filtered QRS duration, duration of HFLA signals 40uV,RMS voltage(terminal 40ms) and mean Voltage(terminal 40ms) after reperfusion compared with those of control at the filter frequency of 25 to 250Hz, 40 to 250Hz and 80 to 250Hz respectively. CONCLUSION: These results suggest that the signal average electrocardiography could be a valuable tool for monitoring the state of coronary artery occlusion and reperfusion.
Animals ; Arrhythmias, Cardiac ; Cats* ; Coronary Occlusion ; Coronary Vessels* ; Electrocardiography* ; Humans ; Incidence ; Myocardial Infarction ; Noise ; Reperfusion* ; Thrombolytic Therapy