No abstract available.
Athletes* ; Female ; Humans

No abstract available.
Athletes* ; Dysmenorrhea* ; Female ; Humans

PURPOSE: Acute diverticulitis of the right colon is not rare in Korea and the clinical presentation is indistin guishable from acute appendicitis. Cecal diverticulitis has led to a controversy in the management of disease. METHODS: Thirty-one cases of acute cecal diverticulitis who underwent operation for suspected acute appendicitis were reviewed retrospectively from January 1995 to December 1998. RESULTS: There were 17 men & 14 women. Ages ranged from 9 to 69 (mean: 37.5) years. All patients presented with signs and symptoms as acute appendicitis. All patients were explored through a transverse incision in the right lower quadrant under the impression of acute appendicitis. An appendectomy and drainage was performed in 13 patients, and resection of the lesion was performed in 18 patients (12 ileocecal resection, one partial cecectomy including appendix, one partial cecectomy and an appendectomy, 4 diverticulectomy and appendectomy), depending on the location of diverticulitis, severity of inflammation, and surgeon. Staples (TA(R), GIA(R)) were used in all cecal resection cases except for diverticulectomy. Five complications were observed, 3 in cecal resection cases (one wound seroma, one wound infection and one bleeding), and 2 in appendectomy and drainage cases (two wound infections). There was no postoperative mortality. The average length of the postoperative stay was 10.2 days in the drainage group and 8.8 days in the cecal resection group. Two recurrences were observed. One was the patient who had diverticulectomy performed. The other was a patient who had had appendectomy and drainage. CONCLUSION: We concluded that the preferred surgical management of an acute cecal diverticulitis operated for a presumed acute appendicitis is cecectomy using staples depending on its location and severity of inflammation. It was safe, relatively easy to do through the same incision, and could be a definitive treatment.
Appendectomy* ; Appendicitis ; Appendix ; Colon ; Diverticulitis* ; Drainage ; Female ; Humans ; Inflammation ; Korea ; Male ; Mortality ; Recurrence ; Retrospective Studies ; Seroma ; Wound Infection ; Wounds and Injuries

Biliary complications after orthotopic liver transplants are a continuing cause of morbidity and mortality. Biliary stones and sludge are less well known complications of hepatic transplantation, although they have long been recognized. Recently we experienced two cases of biliary stones developed after liver transplantation. One 32-year-old male, who frequently admitted due to recurrent cholangitis, was treated with percutaneous transhepatic biliary drainage and choledochojejunostomy with cholecystectomy. The other 58-year-old male, who had stones in commone bile duct, was treated by endoscopic manipulation. They are in good condition without recurrent bile duct stones or its accompanying complications. Although stones and sludge are relatively infrequent after liver transplantation, surgical or interventional radiologic treatments are usually performed for treatment.
Adult ; Case Report ; Common Bile Duct Calculi/ultrasonography ; Common Bile Duct Calculi/radiography ; Common Bile Duct Calculi/etiology* ; Human ; Liver Transplantation/adverse effects* ; Male ; Middle Age ; Tomography, X-Ray Computed/methods

BACKGROUND: Paradoxical embolism through the patent foramen ovale (PFO) is a well-recognized mechanism for otherwise unexplained ischemic stroke. Although transthoracic contrast echocardiography (TCE) has been used frequently for noninvasive diagnosis of right to left shunt through PFO, its diagnostic accuracy appears limited, especially in patients with poor acoustic window. Since harmonic imaging (HI) can enhance the definition of contrast microbubbles, theoretical advantages of HI in the detection of right to left shunt through PFO using microbubbles can be considered. However, there are few data regarding the diagnostic efficacy of HI in the detection of right to left shunt through PFO. The purpose of this study was to compare the diagnostic value of transthoracic HI in the detection of right to left shunt through PFO in patients with stroke with that of fundamental imaging (FI). Methods: One hundred thirty-six consecutive patients with stroke (82 male, mean age:9) underwent TCE in both HI and FI and transesophageal echocardiography (TEE) during rest and Valsalva maneuver with intravenous administration of agitated saline. PFO was judged to be present if microbubbles appeared in the left atrium within 3 cardiac cycles of their appearance in the right atrium. TEE was regarded as the gold standard for assessing the diagnostic accuracy of TCE. Results: Right to left shunt through PFO was detected in 40 of 136 patients by TEE (29.4%). FI of TCE detected shunt through PFO in only 9 of 136 patients (6.6%). In contrast, HI detected shunt through PFO in 25 of 136 patients (18.4%). The overall sensitivity and specificity of FI and HI for detection of right to left shunt through PFO were 22.5%, 62.5% (p<0.05) and 100%, 100%, respectively. Valsalva maneuver during HI significantly increased the detection rate of shunt through PFO (during rest in 9 and during Valsalva maneuver in 25, p<0.05). CONCLUSION: HI with contrast microbubble injection significantly enhanced the detection of right to left shunt through PFO in patients with ischemic stroke compared with FI by transthoracic approach.
Acoustics ; Administration, Intravenous ; Diagnosis ; Dihydroergotamine ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Heart Atria ; Humans ; Male ; Microbubbles ; Sensitivity and Specificity ; Stroke ; Valsalva Maneuver

BACKGROUND: The efficacy of bisphosphonates for osteoporotic fracture has been consistently reported in recent randomized controlled trials (RCTs) enrolling hundreds of patients. The objective of this study was to update knowledge on the efficacy of available bisphosphonates in the prevention of vertebral and non-vertebral fractures. METHODS: An approach “using systematic reviews” on PubMed and Cochrane Library was taken. Twenty-four RCTs investigating the effects of bisphosphonates for the prevention of osteoporotic fracture were included in final analysis. A pairwise meta-analysis was conducted with a random effects model. Subgroup analysis was performed according to the type of bisphosphonate. RESULTS: The use of bisphosphonate decrease the risk of overall osteoporotic fracture (odds ratio [OR] 0.62; P<0.001), vertebral fracture (OR 0.55; P<0.001) and non-vertebral fracture (OR 0.73; P<0.001). Subgroup analysis indicated that zoledronic acid showed the lowest risk reduction (OR 0.61; P<0.001) for overall osteoporotic fractures but no significance was observed for etidronate (OR 0.34; P=0.127). CONCLUSIONS: This update meta-analysis re-confirmed that bisphosphonate use can effectively reduce the risk of osteoporotic fracture. However, there is a lack of evidence regarding etidronate for the prevention of osteoporotic fracture.
Diphosphonates* ; Etidronic Acid ; Humans ; Meta-Analysis as Topic ; Osteoporosis ; Osteoporotic Fractures* ; Risk Reduction Behavior

Adenomyosis of the uterus is a relatively common gynecologic disease characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Small cystic spaces (not larger than several mil-limeters) are invariably present, and these are filled with blood. Extensive hemorrhagic cystic adenomyosis,however, is rare, and there have been very few radiologic reports of this condition. We describe the CT and MRI features of three cases of histologically confirmed huge cystic adenomyosis.
Adenomyosis* ; Animals ; Female ; Genital Diseases, Female ; Magnetic Resonance Imaging* ; Mice ; Myometrium ; Uterus*

PURPOSE: Amblyopia is the commonest cause of defective vision in childhood. It develops during the sensitive period of visual maturation which continues until about 7-8 years of age. The authors investigated the effect of a polaroid photoscreening camera designed to detect amblyogenic factors, including asymmetric and abnormal refractive errors, strabismus, ptosis and media opacities. METHODS: Fifty-four children aged 3-24 months were evaluated for amblyogenic factors using the polaroid photoscreening carnera from March 1998 to March 1999 in Chungnam National University Children's Hospital. Then each child underwent medical examination by an ophthamologist. Results The mean age was 9.0+/-4.5 months. The results of photoscreening were normal findings of 74.1%, abnormal findings of 25.9%, and slight eccentric fixation in 18 cases, normal findings in 9 cases, peripheral crescents in 13 cases, strabismus in 4 cases, myopia in 5 cases, hyperopia in 2 cases, anisometropia in 2 cases, ptosis in 1 case and reexam in 14 cases. The photoscreener had a sensitivity rate of 81.8%, a specificity rate of 88.4%, a positive predictive value of 64.3% and a negative predictive value of 95.0%. CONCLUSION: Polaroid photoscreening method is an easy, noninvasive and reliable mass screening method of detecting amblyogenic factors in undilated children.
Amblyopia ; Anisometropia ; Child* ; Chungcheongnam-do ; Humans ; Hyperopia ; Infant* ; Mass Screening ; Myopia ; Refractive Errors ; Sensitivity and Specificity ; Strabismus

PURPOSE: Amblyopia is the commonest cause of defective vision in childhood. It develops during the sensitive period of visual maturation which continues until about 7-8 years of age. The authors investigated the effect of a polaroid photoscreening camera designed to detect amblyogenic factors, including asymmetric and abnormal refractive errors, strabismus, ptosis and media opacities. METHODS: Fifty-four children aged 3-24 months were evaluated for amblyogenic factors using the polaroid photoscreening carnera from March 1998 to March 1999 in Chungnam National University Children's Hospital. Then each child underwent medical examination by an ophthamologist. Results The mean age was 9.0+/-4.5 months. The results of photoscreening were normal findings of 74.1%, abnormal findings of 25.9%, and slight eccentric fixation in 18 cases, normal findings in 9 cases, peripheral crescents in 13 cases, strabismus in 4 cases, myopia in 5 cases, hyperopia in 2 cases, anisometropia in 2 cases, ptosis in 1 case and reexam in 14 cases. The photoscreener had a sensitivity rate of 81.8%, a specificity rate of 88.4%, a positive predictive value of 64.3% and a negative predictive value of 95.0%. CONCLUSION: Polaroid photoscreening method is an easy, noninvasive and reliable mass screening method of detecting amblyogenic factors in undilated children.
Amblyopia ; Anisometropia ; Child* ; Chungcheongnam-do ; Humans ; Hyperopia ; Infant* ; Mass Screening ; Myopia ; Refractive Errors ; Sensitivity and Specificity ; Strabismus

No abstract available.
Hematocrit ; Mucocutaneous Lymph Node Syndrome*