No abstract available.
Delivery of Health Care* ; Family Practice* ; Humans ; Inpatients* ; Insurance* ; Korea*

OBJECTIVE: To investigate the frequency, type and severity of cardiac abnormalities in the patients with ankylosing spondylitis and undifferentiated spondyloarthopathy. METHODS: A history, clinical examination, standard 12 lead electrocardiography, two dimensional, M mode, and Doppler echocardiographies were performed on 19 patients with ankylosing spondylitis, 15 patients with undifferentiated spondyloarthropathy and 21 normal controls. RESULTS: 1) Cardiac abnormalities were detected in 8 patients(42.1%) with ankylosing spondylitis. 2) Cardiac abnormalities were detected in 8 patients(53.3%) with undifferentiated spondyloarthropathy including 2 patients with aortic valve abnormalities(mild aortic insufficiency, aortic valve thickening. 3) Cardiac abnormalities were detected in one (4. 8%) among normal controls (mild tricuspid regurgitation). 4) There were sinus bradycardias on electrocardiography in 2 patients among patients witn anl;ylosing spond!litis and in 1 patient among undifferentiated spondyloarthropathy. But there was no conduction disturbance in both groups. 5) The frequency of cardiac abnormality was higher in patients with ankylosing spondylitis and undifferentiated spondyloarthropathy than in normal controls. 6) The mean age, mean disease duration, presence of uveitis, peripheral arthritis, HLA-B27, enthesopathy, Schober test and chest expansion in the patients with ankylosing spondylitis and undifferentiated spondyloarthropathy with cardiac abnormalities were not different from those in the patients without cardiac abnormalities. CONCLUSION: The frequency of cardiac abnormality was higher in patients with ankylosing spondylitis and undifferentiated spondyloarthropathy than in normal controls. The frequency, type and severity of cardiac involvement in patients with ankylosing spondylitis were not different from those in patients with undifferentiated spondyloarthropathy.
Aortic Valve ; Aortic Valve Insufficiency ; Arthritis ; Bradycardia ; Electrocardiography ; HLA-B27 Antigen ; Humans ; Rheumatic Diseases ; Spondylarthropathies* ; Spondylitis, Ankylosing* ; Thorax ; Uveitis

No abstract available.
Hyperplasia* ; Islets of Langerhans* ; Nesidioblastosis*

Cesarean hysterectomy remains a necessary procedure for life saving during intractable obstetric hemorrhage. The procedure itself is usually associated with considerable perioperative morbidity, especially when performed under emergency conditions. In this study, the outcomes of 15 cases of cesarean hysterectomy performed at Catholic university of Taegu-Hyosung hospital for 5 years from January, 1993 to December, 1997 were reviewed. There were 22,251 deliveries during this period, cesarean hysterectomy was performed in 13 of 5,753 cesarean section(0.22%) and in 2 of 16,698 vaginal deliveries(0.12%), so more frequently after cesarean section than vaginal deliveries. The age of patients varied from 23 to 39 years old. The higher the age of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of emergency cesarean hysterectomy was in uterine atony(53.3%), followed by placental disorders(33.3%), uterine rupture(6.7%), and uterine myoma with pregnancy (6.7%). All patients who had cesarean hysterectomy received transfusion from 3 pints to 13 pints. In aspect of fetal outcomes, live birth were 12 cases(80%), one case was fetal death in utero(6.6%), 2 infants were dead during the early neonatal period(13.3%) due to prematurity and RDS (respiratory distress syndrome), so the perinatal mortality rate was 20.0%. The postoperative complications were wound disruption, hematoma, febrile morbidity and disseminated intravascular coagulopathy.
Adult ; Cesarean Section ; Emergencies ; Female ; Fetal Death ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Infant ; Leiomyoma ; Live Birth ; Perinatal Mortality ; Postoperative Complications ; Pregnancy ; Wounds and Injuries

This study was conducted to evaluate the effect of ambroxol on preventing the infantile respiratory distress syndrome (IRDS) in preterm birth at the Dept. of Obstetrics and Gynecology of Taegu Catholic Medical Center during the period from Jan. 1996 to Dec. 1996. Total of 68 cases were evaluated including 16 ambroxol group and 52 control group. The result were as follows : 1. In the comparison of preventing IRDS, there was 0 case of IRDS in ambroxol group and 7 cases of IRDS in control group (13.46 %). There was a significant difference between two groups (p<0.05). 2. The side effects of ambroxol after administration were nausea in 5 cases, headache in 3 cases, and chest discomfort in 4 cases, but these were not serious and self controlled. 3. There was no significant difference in neonatal morbidity between two groups (p > 0.05).
Ambroxol* ; Daegu ; Gynecology ; Headache ; Nausea ; Obstetrics ; Premature Birth ; Respiratory Distress Syndrome, Newborn* ; Thorax

For some cyanotic children with deficient pulmonary blood flow, the Blalock-Taussig shunt is a life-saving or temporizing form of palhation. Extensive experience has been gathered, and mortality and morbidity as well as the incidence of shunt stenosis and thrombosis have significantly decreased. However, even nowadays, the most frequently encountered complication excluding mortality in early postoperative course is occlusion of the shunt. We experienced a case of Blalock-Taussig shunt occlusion with thrombus. We diagnosed him as ventricular septal defect with pulmonary atresia by echocardiography and performed a right classic Blalock-Taussig shunt at 7th day of age, Oxygen saturation was gradually decreased since the 6th day postoperative. He was diagnosed as thrombosis of shunt at 12th day postoperative by cardiac angiography, and then was treated with a local low-dose urokinase infusion(1,000U/kg/hr) through Cobra catheter(Cook. In. Co.). After 21 hours, thrombolysis of shunts was comfirmed. We stopped the urokinase and medicated low-dose aspirin(5mg/kg/day). After the eighth day, shunt flow by echocardiography was patent.
Angiography ; Child ; Constriction, Pathologic ; Echocardiography ; Elapidae ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Infant, Newborn* ; Mortality ; Oxygen ; Pulmonary Atresia ; Thrombosis* ; Urokinase-Type Plasminogen Activator*

For some cyanotic children with deficient pulmonary blood flow, the Blalock-Taussig shunt is a life-saving or temporizing form of palhation. Extensive experience has been gathered, and mortality and morbidity as well as the incidence of shunt stenosis and thrombosis have significantly decreased. However, even nowadays, the most frequently encountered complication excluding mortality in early postoperative course is occlusion of the shunt. We experienced a case of Blalock-Taussig shunt occlusion with thrombus. We diagnosed him as ventricular septal defect with pulmonary atresia by echocardiography and performed a right classic Blalock-Taussig shunt at 7th day of age, Oxygen saturation was gradually decreased since the 6th day postoperative. He was diagnosed as thrombosis of shunt at 12th day postoperative by cardiac angiography, and then was treated with a local low-dose urokinase infusion(1,000U/kg/hr) through Cobra catheter(Cook. In. Co.). After 21 hours, thrombolysis of shunts was comfirmed. We stopped the urokinase and medicated low-dose aspirin(5mg/kg/day). After the eighth day, shunt flow by echocardiography was patent.
Angiography ; Child ; Constriction, Pathologic ; Echocardiography ; Elapidae ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Infant, Newborn* ; Mortality ; Oxygen ; Pulmonary Atresia ; Thrombosis* ; Urokinase-Type Plasminogen Activator*

Sustained downgaze mostly occurs in association with lesions affecting the dorsal midbrain. We report sustained downgaze in a patient with hepatic encephalopathy. The sustained downgaze existed for seven more days after she regained her consciousness. The persistent downgaze even after regaining full consciousness indicates localized pretectal dysfunction rather than diffuse encephalopathy as the mechanism of sustained downgaze in our patient. The ocular motor dysfunction in hepatic encephalopathy may be due to localized dysfunction of the brainstem

Purpose: Reduced port laparoscopic distal gastrectomy (RPLDG) using 3 ports is less invasive than conventional laparoscopic distal gastrectomy (CLDG) using 5 ports. Although RPLDG performed by expert surgeons is safe and feasible, novice surgeons have difficulty performing this procedure. This study evaluated the surgical outcomes and feasibility of RPLDG performed by a novice surgeon. Materials and Methods: The records of 136 patients who underwent laparoscopic distal gastrectomy for gastric cancer performed by a single novice surgeon between May 2016 and December 2018 were retrospectively reviewed. Among these 136 patients, 52 underwent RPLDG and 84 underwent CLDG. The clinicopathological characteristics, operative outcomes, and short-term postoperative outcomes of the 2 groups were compared. Results: The percentage of women was significantly higher in the RPLDG group than in the CLDG group (48.1% vs. 31%; P=0.045), but other baseline characteristics did not differ significantly between the groups. Billroth II anastomosis was performed significantly more frequent (90.4% vs. 73.8%, P=0.015) and operation time was significantly shorter (207.1±43.3 min vs. 225.5±44.6 min, P=0.020) in the RPLDG group than in the CLDG group. The time to first flatus, postoperative pain score, length of postoperative hospital stay, and incidence and severity of complications did not differ significantly between the groups. Analysis of the learning curve based on the operation time showed that performing RPLDG on 20–30 patients was required to achieve technical proficiency. Conclusions RPLDG is a safe and feasible surgical procedure for the treatment of gastric cancer, even when performed by a novice surgeon.

The physeal injuries in children occur result of trauma, infection, metabolic or ischemic disease, and these conditions cause significant problems, such as growth disturbance, deformity and premature closure of physis. The authors experienced 7 cases of children who had angular deformity of knee and limb shortenings, but no history of obvious causes of physeal injury. All of these cases had severe osteoporosis and underlying disease, which were osteogenesis imperfecta, fibrous dyplasia and long term steroid therapy. The purpose of this study are evaluation of pathomechanism of physeal injuries in severe osteoporotic children. Patients were range of age from 4 to 9 years and had common clinical features, which were angular deformities of knee, limb shortening. Also they had common radiographic findings, that were severe porosis, metaphyseal sclerosis and in some cases, pop corn like calcification around physis. At this, we supposed that chronic mechanical stress in osteoporotic bone make physis be damaged due to loss of capillary circulation and this event appear to result from collapse of bone plate, through which epiphyseal vessel penetrate. In conclusion, the children with severe osteoporosis should be observed carefully about physeal injuries, which pathomechanism are perhaps deprivation of capillary circulation through bone plate. Therefore, We should try to protect bone plate by being conscious of its existence.
Bone Plates ; Capillaries ; Child ; Congenital Abnormalities ; Extremities ; Humans ; Knee ; Osteogenesis Imperfecta ; Osteoporosis* ; Sclerosis ; Stress, Mechanical ; Zea mays