Eleven patients underwent posterior sagittal anorectoplasty(PSARP) as a secondary procedure. Two of them had rectovaginal fistula and another two had rectocutaneous fistula. Six of the rest complained of frequent fecal soiling and the last one had severe anorectal stricture after perineal anoplasty. Five patients had lived with colostomy until the second operations were carried out. The ages at the time of the secondary PSARP were between 7 months and 29 years. Distal colostogram and MRI were taken to evaluate distal colon, position of the rectum and voluntary muscle. All patients had normal sacrum except one who had anorectal stricture. Seven patients, six with fecal incontinence and the other one with rectovaginal fistula had mislocated anorectums. Three patients, two with rectocutaneous fistula, the other one with anorectal stricture, had abdominal approach to obtain enough length of colon for pull-through procedure. With the posterior midsagittal approach, we could manage all the problems, rectovaginal fistulas, rectocutaneous fistulas, strictures and malpositioned rectums, without difficulty. No patients had serious complications except wound infection in one. All patients were satisfied with the results after redo-PSARPs even though normal continence has been achieved in only one patient. Seven patients who had continuous soiling or rectocutaneous fistula, needed no more diapers even though four of them showed fecal staining under stressful condition and the other three showed intermittent fecal leaking less than once a day. The rest three of the patients maintained their continence with support of drugs and/or enemas because of constipation. The PSARP is a popular procedure as a primary operation; however, our results suggested that this procedure also gave us a good opportunity for management of serious complication developed after primary anoplasties.
Colon ; Colostomy ; Constipation ; Constriction, Pathologic ; Enema ; Fecal Incontinence ; Fistula ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Rectovaginal Fistula ; Rectum ; Sacrum ; Soil ; Wound Infection

BACKGROUND: Dizziness is a common complaint in patients presenting at emergency departments. Dizziness is difficult to assess because it is a subjective complaint that cannot be measured. We report a clinical analysis of patients with acute dizziness: type, duration, symptom, incidence, etc. METHODS: We reviewed the clinical details and the results of vestibular function tests for 106 acutely dizzy patients who visited the Emergency Department of Wonkwang University Hospital during the period of Jul. 1999 through Dec. 1999. RESULTS: The most common etiology of acute dizziness was the peripheral vestibular system(66%). The most common disease of the peripheral vestibular system was benign paroxysmal positional vertigo(52.9%), and the second most one was vestibular neuronitis(42.9%). In the central nervous system, cerebrovascular accident(63.6%) was the most common cause. All of the patients had experienced a previous vertigo attack, and 42.4% of them had frequent attacks. Dizziness of the cochlear systems were usual in peripheral vertigo. The usual underlying diseases related with vertigo were hypertension, cerebral infarction and diabetes mellitus. CONCLUSION: Dizziness is a complex and frustrating symptom with numerous possible causes. In case with suspected central disorders, CT and MRI have a great diagnostic significance.
Central Nervous System ; Cerebral Infarction ; Diabetes Mellitus ; Dizziness* ; Emergencies* ; Emergency Service, Hospital ; Humans ; Hypertension ; Incidence ; Magnetic Resonance Imaging ; Vertigo ; Vestibular Function Tests

Aneurysm of the splenic artery are the third most common intra-abdominal aneurysm, following aneurysms of the infrarenal aorta and iliac arteries. Splenic artery aneurysms (SAA) are the most frequent visceral artery aneurysms and account for more than two thirds of all lesions. Incidence of SAA are rare clinical entities(0.01-0.2%) that carry risk of rupture and fatal hemorrhage(35-100%). Fibroblastic dysplasia and atherosclerosis is fecund in the majority, and the fact that these aneurysms developes more commonly in female. Most patients are asymptomatic and the diagnosis is generally made incidentally. The treatment of patient with known SAA is dictated by several factors, including location, age, sex, present of symptom, size, pregnancy. We report ruptured splenic artery aneurysm with hemoperitoneum and review of the literature.
Aneurysm* ; Aorta ; Arteries ; Atherosclerosis ; Diagnosis ; Female ; Fibroblasts ; Hemoperitoneum ; Humans ; Iliac Artery ; Incidence ; Pregnancy ; Rupture ; Splenic Artery*

Leiomyoma is one of the rarest solid tumor of the ovary. Approximately 50 cases have been published to date. However, most reported leiomyoma of the ovaries were small and rarely induced serious symptoms. We report a case of ovarian leiomyoma in 57-year-old woman which has been experienced in our haspital with brief review of literature.
Female ; Humans ; Leiomyoma* ; Middle Aged ; Ovary*

BACKGROUND: Stress is found to have influence on physical and mental disorders, and also to healthy life habits related to physical health mental stress. Job holders are groups that have suffered from chronic stressful condition. Consider medical people of job holders to received exess stress. So, we tested this investigation to know the relationship between health habits and stress amounts about nurse. METHODS: This study was performed on nurses who worked on one hosptal in Pusan Metropolitan city for one months(from April, 1, to April, 30, 2000). We used 128 results. Health habits were investigated about 5 articles out of "Breslow's 7 health habits" and stress amounts were measured by Korean translated BEPSI(Brief Encounter Psychosocial Instrument) and Bae Jong Myun's 30 items SRRQ(Social Readjustment Rating Questionnaire). RESULTS: There were differences in amounts of stress of subjects according to marital state(P<0.05), job department(P<0.05), BMI(Body Mass Index)(P<0.05), sleeping time(P<0.05). CONCLUSION: This investigation has showed that having excess stress in nurses. Body Mass Index, sleeping time appeared to be health habits related to amounts of stress.
Body Mass Index ; Busan ; Mental Disorders

No abstract available.
Humans ; Sexual Behavior* ; Uterine Cervical Neoplasms*

No abstract available.
Diabetes Mellitus

BACKGROUND : The recent studies shows that Helicobacter pylori (H. pylori) related chronic gastritis leads to dysplasia, intestinal metaplasia and gastric cancer. The aim of this study was to determine the association between precancerous lesion of stomach (dysplasia, intestinal metaplasia) and H.pylori infection in the elderly. METHODS : 469 patients were enrolled this study, Patients with intestinal metaplasia or dysplasia (case, n=148) were compared with controls (without intestinal metaplasia and dysplasia, n=321) about H. pylori positive rates H. pylori positivity was confirmed by histologic determination of endoscopic biopsy specimens. Results : 1) Among study populations H. pylori positive rates were 51.8% (55.8% in male, 40.7% in female). It was significantly higher in male (p=0.001). 2) There were no significant differences in sex distribution between cases and controls, but in old age, the cases were more frequent than in young age (p<0.001). 3) Age distribution of H. pylori positive rates were not significant between cases and controls. 47.5% in intestinal metaplasia, 43.4% in dysplasia, 21.3% in dysplasia+intestinal metaplasia were H. pylori positive. H. pylori positive rates were more higher in controls than cases, followed by in decreasing order by the intestinal metaplasia group, the dysplasia group, and those having both (p=0.003). 4) Age and sex adjusted H. pylori positive rates were more higher in controls (42.7%) than in cases (25.0%)(p<0.009). CONCLUSION : The prevalence of intestinal metaplasia and dysplasia was age dependent. But we couldn't explain the carcinogenic effect of H. pylori, because H. pylori positive rates were lower in cases than in controls
Age Distribution ; Aged ; Aging* ; Biopsy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Metaplasia* ; Prevalence* ; Sex Distribution ; Stomach ; Stomach Neoplasms

Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.
Botulinum Toxins ; Botulinum Toxins, Type A ; Frustration ; Ganglion Cysts ; Humans ; Muscle Relaxation ; Nerve Block ; Neurotransmitter Agents ; Pain Perception ; Urinary Bladder

The muscle glycogen is an important energy source for muscle contraction especially in prolonged exercise. One of the important factors for improvement of physical performance in athletes is the storage of extra-amount of glycogen (supercompensation) in liver and muscles. During 120 minutes treadmill exercise (intensity of exercise was approximatly 80% VO2max), the glycogen concentration was significantly decreased to 36% in liver and 46% in muscles after 60 minutes exercise. At 90 and 120 minutes of exercise, the level of glycogen concentration of liver and muscles statistically were not different from the levels of the 60 minutes exercise. The repletions of glycogen in the liver and muscles in overnight fasted control(C) and 120 minutes treadmill exercise(E) groups during l80minutes after glucose ingestion were investigatect. ln the liver, the concentration of glycogen in C and E groups were markdly increased till 120 minutes after zlucose ingestion, hut the levels of concentration at 180 minutes were decreased comparing to the levels of 120 minutes in both groups. In the muscles, the repletion of glycogen at 60, 120 and 180 minutes of C and E groups were significantly increased comparing to 0 minute of respective groups in the soleus and plantaris muscles. In soleus(SOL), the repletion of glycogen in all of the E groups was significantly higher than that of the respective C groups. However, the repletion of glycogen in all of the E groups of plantaris was revealed higher tendency comparing to respective C groups. Mean repletion rates of glycogen in liver and muscles after glucose ingestion were highest during the first 60 minutes in all groups and the rates of E groups were 2-3 times than those of respective C groups. These results suggest that the glycogen supercompensation in the muscle be provided with decrement of glycogen concentration by exercise, increment of glucose uptake by muscuiar contraction itself and increased insuJin level, and the activation of glycogen synthetase by insulin.
Animals ; Athletes ; Eating* ; Glucose* ; Glycogen Synthase ; Glycogen* ; Humans ; Insulin ; Liver* ; Muscle Contraction ; Muscles ; Rats*