PURPOSE: The aim of this study was to determine clinical significance of dual-probe esophageal pH monitoring and to compare four pH monitoring parameters between proximal and distal esophagus in pathological gastroesophageal reflux disease with recurrent respiratory symptoms. METHODS: Among the thirty-four patients who were performed 24 hr pH monitoring, seventeen patients with pathological distal reflux were classified into two groups: Group I (n:12) had recurrent respiratory symptoms and Group II (n:5) hadn't recurrent respiratory symptoms. The ambulatory dual-probe esophageal pH monitoring was performed for 18~24 hr. A pathologic GER was defined when reflux index (percent of the investigation time a pH<4) exceeded the 95th percentile of normal value. RESULTS: Among the sixteen patients with recurrent respiratory symptoms, twelve patients (75%) have pathological distal reflux. Whereas among the eighteen patients without recurrent respiratory symptom, five patients (28%) have pathological distal reflux. In the Group I, the significant differences between proximal and distal esophageal pH recordings persisted for all parameters, but didn't persist in group II except for longest episode. Comparing esophageal pH four parameters between group I and group II at the proximal esophageal site, all parameters didn't show statistically significant differences. CONCLUSION: Regardless of respiratory symptoms, patients with pathological distal reflux didn't show statistically significant differences in the all parameters at the proximal esophageal site. Therefore we may reconsider usefulness of dual probe pH meter in patients with recurrent respiratory symptoms.
Esophageal pH Monitoring* ; Esophagus ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Reference Values

Leiomyomas of vagina and vulva are rare solid tumors, but most common mesenchymal tumors in adult woman. Most of the reported cases have been benign. The tumors were firm, well-defined submucosal masses in a majority of patients. We experienced two cases of vulvar and vaginal leiomyoma, thus it is presented with a brief review of the cases and its literatures.
Adult ; Female ; Humans ; Leiomyoma* ; Vagina* ; Vulva*

No abstract available.
Humans ; Spondylolisthesis*

No abstract available.
Hematoma* ; Orbit*

No abstract available.
Lymphangioma, Cystic*

Diaphragnatic hernia is one of the surgical emergencies of the childhood because of the life-threatening cardiorespiratory embarrassment frequently associated with it. This congenital condition is characterized by varying degrees of protrusion of the abdominal viscera into the thoracic cavity through an abnormal opening in the diaphragm this opening results from a defect in the complex embryologic developement of the diaphragm between the thoracic and abdominal cavities. We expenienced 16 cases of congenital diaphragmatic hernia which were diagnosed at Severance Hospital from May 1964 to April 1977, and obtained the following results. 1) In 16 cases, male were ten and female were six. They were eleven cases of bochdalek hernia, two cases of diaphragmntic eventration, one case of hiatal and two undetermined. 2) Onset of symptoms were within 24 hours in 7 cases and in the rest cases symptoms were occured up to 24 months. 3) Most common symptoms were dyspnea and cynosis. 4) Most common signs were decreased breathing sound on affected lung, PMI shifting, scaphoid abdomen and subcostal retraction. 5) Combined anomalies were band adhesion of intestinal loop, hypoplasia of left lung etc. 6) Small intestine were more frequently herniated as well as large intestine. 7) mortality rate between abdominal procedure and thoracic procedure was equal. 8) Cases whose symptoms were occured within 24 hours were 7, 5 of these 7 were expired, Expired cases were associated with marked respiratory difficulties and pulmonary hypoplasia.
Abdomen ; Abdominal Cavity ; Diaphragm ; Dyspnea ; Emergencies ; Female ; Hernia ; Hernia, Diaphragmatic* ; Humans ; Intestine, Large ; Intestine, Small ; Lung ; Male ; Mortality ; Respiratory Sounds ; Thoracic Cavity ; Viscera

The fine structure of cells in the trigeminal mesencephalic (Me5) nucleus in the rat was studied by transmission electron microscopy. This nucleus located in the mid-brain and the rostral portion of the pons, most neurons in the caudal part of Me5 nucleus were sufficiently large (40~50micrometer) and appeared as round-shaped unipolar cells. The Me5 neurons had a large, round, centrally located nucleus, and their cytoplasm contained numerous mitochondria, dense granular endoplasmic reticulum, abundant Golgi apparatus, groups of free ribosomes, some heterogeneous particles and neurofilaments. Cell surfaces were studded irregularly with small spinouts processes, and they contained a few fine irregularly arranged neurofilaments and some granular endoplasmic reticulum. Boutons contacting the soma of Me5 neurons were defined as axosomatic synapses and bostons contacting dendrites located between the Me5 neurons were defined as axodendritic synapses. Based on differences in bouton and vesicle morphology, the four synaptic bouton types were identified. 1. Asymmetrical as well as symmetrical synapses with small round vesicles. 2. Asymmetrical synapses with pleomorphic admixture contained predominantlyspherical vesicles. 3. Symmetrical synapses with pleomorphic vesicles of flattened, spherical and dense-core vesicles. 4. Asymmetrical as well as symmetrical synapses with heterogeneous and large dense-core vesicles. Synaptic boutons containing round vesicles and large dense-core vesicles were most frequently observed.
Animals ; Carisoprodol ; Cytoplasm ; Dendrites ; Endoplasmic Reticulum, Rough ; Golgi Apparatus ; Microscopy, Electron, Transmission ; Mitochondria ; Neurons ; Pons ; Presynaptic Terminals ; Rats* ; Ribosomes ; Synapses

Ultrasonograms of proven liver abscesses in 44 patients were analysed. In ulltrasonography prior to otherdiagnostic approach, 38 patients(86.4%) were accurately diagnosed as liver abscess with correlation of clinicalsymptoms. The outline of abscess is smoothly defined. oval and round in 19 patients, irregularly and ill-definedin 25 patients. Only in 5 patients echogenic capsules are demonstrated. The internal echogenecity is variable;they are predominantly echo-free in 14, predominantly low-echo in 25 and predominantly echogenic, similar to solidtumor in 2 patients . 36 patients who were treated by medication only and combined needle aspiration had follow-up ultrasonography within 3 weeks since initial treatment. 33 patients were ultrasonically and clinically improved.Only one patients died of sepsis after needle aspiration and 2 patients were discharged without any sign ofimprovement.
Abscess ; Capsules ; Follow-Up Studies ; Humans ; Liver Abscess ; Liver ; Needles ; Sepsis ; Ultrasonography

PURPOSE: The standard treatment for aortic aneurysms is surgical replacement with a prosthetic graft. Currently there is great interest in endoluminal intervention for treatment of aortic aneurysm. The purpose of this study was to evaluate the safety and effectiveness of endoluminally placed Stent-graft for the treatment of aortic aneurysms. MATERIALS AND METHODS: Transluminal endovascular Stent-graft placements were attempted in 9 patients with infra-renal aortic aneurysms(n=6), thoracic aortic aneurysm(n=l), and aortic dissection(n=2). The endovascular Stent-grafts were custom-designed for each patient and were constructed of self-expandable modified Gianturco Stents covered with polytetrafluroethylene. The Stent-grafts were introduced through a 16-18 french sheath and expanded to 17-30mm in diameter. The endovascular therapy was performed using a common femoral artery cutdown with local anesthesia. RESULTS: The endovascular Stent-graft deployment was achieved in 7 of 9 patients. Two cases failed deployment of the Stent-graft due to lilac artery stenosis and tortousity. There were complete thrombosis of the thoracic and infra-renal aortic aneurysm surround the Stent-graft in 3 patients, and persistent leak with partial thrombosis in 2. Two patients with aortic dissection were successfully treated by obliteration of entry tears. There were no major complication associated with Stent-graft placement. CONCLUSION: These preliminary results show that transluminal endovascular Stent-grafts offer great promise and good results. Further investigation is needed to establish its long-term safety and efficacy.
Anesthesia, Local ; Aortic Aneurysm ; Arteries ; Constriction, Pathologic ; Femoral Artery ; Humans ; Stents ; Thrombosis ; Transplants

Short-bowel syndrome is functionally defined as a state of malabsorption following loss of small bowel, which comprises the sequelae of nutrient, fluid, and weight loss. The proximal segment of the bowel of a patient with intestinal atresia is usually grossly distended and atonic. In contrast, distal segment is smaller. For this reason, anastomosis of the proximal and the distal segment is technically difficult and may cause no propulsion even when they are anastomosed. We experienced that continuous drip ileostomy feeding with the secretions from the proximal stoma stimulated the distal bowel to accommodate and resolved many sequelae following loss of small bowel in a patient with short-bowel syndrome due to IIIa ileal atresia.
Humans ; Ileostomy* ; Infant, Newborn* ; Intestinal Atresia ; Weight Loss