We report a case of gastro-colic fistula caused by ectopic gastric mucosa developed at transverse colon. Fistula was detected by colonofiberscopy. And fistulous tract was proved by barium enema. Meckel's diverticulum scan finding was similar to that of GI bleeding; e.g. injected radioactivity was secreted into the lumen and moved along the lumen. There was no bleeding. And there was no diverticulum in the colon. Absence of diverticular pouch may explain this unusuaal GI bleeding-like scan finding rather than focal collection of radioactivity, which is typical of ectopic gastric mucosa found in the Meckel's diverticulum. Ectopic gastric mucosa was confirmed by colonfiberscopic biopsy. We suggest GI bleeding-like pictures should be included differential diagnosis of Tc-99m-O4 (ectopic gastric mucosa or Meckel's diverticulum) scan.
Barium ; Biopsy ; Colon ; Colon, Transverse ; Diagnosis, Differential ; Diverticulum ; Enema ; Fistula* ; Gastric Mucosa* ; Hemorrhage ; Meckel Diverticulum ; Radioactivity ; Radionuclide Imaging ; Sodium Pertechnetate Tc 99m*

We analyzed the factors of importance for nonunion in series of 91 open fractures of tibial diaphysis which were treated with external fixation. Factors analyzed included, age and sex of the patients, the mechanism of injury, the amount of soft tissue damage, the grade of comminution, the level at which the tibia was fractured, the presence of an intact fibula, the presence of the multiple injuries, the type of the external fixation used(AO external fixator, EXTOR; monotube external fixator, Ilizarov), and the need to supplement the stability of the reduction. We found that the amount of soft tissue damage and comminution of the fracture played a role in the development of the nonunion.
Diaphyses ; External Fixators ; Fibula ; Fractures, Open ; Humans ; Multiple Trauma ; Tibia ; Tibial Fractures*

PURPOSE: Piccolo et al. advocated the usefulness of Tc-99m-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied Tc-99m-MDP uptake pattern and lesions/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of Tc-99m-MDP scan. MATERIALS AND METHODS: Total 34 patients were studied with physical examination, mammogram and Tc-99m-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq Tc-99m-MDP. Breast uptake pattern of Tc-99m-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammo-grain. RESULTS: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of Tc-99m-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 2/7, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. CONCLUSION: Tc-99m-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.
Biopsy ; Biopsy, Needle ; Breast Neoplasms ; Breast* ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Mammography ; Physical Examination ; Prospective Studies ; Technetium Tc 99m Medronate*

For the clinical analysis and evaluation on the patients with gestational trophoblastic disease(GTD), a study was done retrospectively on 114 patients with GTD(60 in Hydatidiform mole, 10 in invasive mole, 44 in choriocarcinoma) treated from Jan. 1, 1985 to Dec. 31, 1994 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea. We obtained the following results ; The incidence of GTD was 1 per 73 deliveries in H. mole, 1 per 437 deliveries in invasive mole, and 1 per 99 deliveries in choriocarcinoma. The most prevalent age was 21-40 groups. Abnormal vaginal bleeding was a main symptom and sign. 30.6% of H. mole was managed by dilatation and curettage. 90.0% of invasive mole and 51.4% of choriocarcinoma were managed by surgical treatment and chemotherapy. The overall remissinon rate of choriocarcinoma was 71.4%(100.0% in stage I, 66.7% in stage II, 54.5% in stage III, 50.0% in stage IV).
Busan ; Choriocarcinoma ; Dilatation and Curettage ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Incidence ; Korea ; Obstetrics ; Pregnancy ; Retrospective Studies ; Trophoblasts ; Uterine Hemorrhage

To evaluate the effectiveness of conization in the diagnosis of cervical cancer, the histopathologic finding of 464 consecutive cases were analized with respect to the cytology, punch biopsy and hysterectomy. Cold knife conization was performed under direct visualization(naked eye conization) from January, 1987 to Octorber 1994 at department of Obstetrics and Gynecology, Kosin Medical Center. The results were summerized as follows : 1. The rate of agreement and underdiagnosis of between pap smear and naked eye conization were 43.7% and 47%. 2. The rate of agreement and underdiagnosis of between punch biopsy and naked eye conization were 64.5% and 21.8% 3. Subsequent hysterectomy was done on the 382 case and their incidence of residual disease rate was 44.2%(169 cases). Their incidence of residual lesion was increased with severity of the carcinomatous change. 4. The rate of complication undergoing conization was 8.4%(39 cases).
Biopsy ; Conization* ; Diagnosis ; Gynecology ; Hysterectomy ; Incidence ; Obstetrics ; Uterine Cervical Neoplasms

Hereditary anhidrotic ectodermal dysplasia is a rare condition characterized by underdeveloped ectodermal structure including the skin, teeth or skin appendages. The patient has characteristic feature of anhidrosis, hypotrichosis and defective dentition. We experienced a case of hereditary anhidrotic ectodermal dysplasia in a l-month-old male infant who had unexplained recurring fever, anhidrosis and characteristic facial feature, so we established the diagnosis with clinical feature and skin biopsy.
Biopsy ; Dentition ; Diagnosis ; Ectoderm ; Ectodermal Dysplasia* ; Fever ; Humans ; Hypohidrosis ; Hypotrichosis ; Infant ; Male ; Skin ; Tooth

PURPOSE: This study is to investigate the job stress and presenteeism of nurses with work shift. METHODS: The data were collected through questionnaires from 281 clinical nurses working for a university hospital located in D city from 13 to 28 of February, 2009. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe verification test, Pearson correlation coefficient and multiple linear regression using SPSS/WIN 16.0. RESULTS: The mean score of job stress was 3.47. Work overload and psychological burden scored the highest point as the sub-category of work stress factor. Work performance loss out of presenteeism showed 26.89 and perceived productivity, 79.79. Also 94.7% of respondents answered they had health problems. A significantly positive correlation was found among job stress, work performance loss and health issue. To determine the factors affecting persenteeism, work performance loss was associated with work overload and perceived productivity with interpersonal relationship conflict. CONCLUSION: Based on the findings of the study, job stress is positively correlated with work performance loss, and health problems. Therefore, health problems of nurses with work shift need to be considered and plans to manage their job stress affecting presenteeism need to be developed at an earlier stage.
Surveys and Questionnaires ; Efficiency ; Linear Models

Eight neonates with transient tricuspid insufficiency are presented which was confirmed clinical and two dimensional echocardiographic assessment. We found that two dimensional Doppler echocardiography was very useful in the detection of transient tricuspid insufficiency during neonatal age as noninvasive method. Transient tricuspid insufficiency is a clinical disorder in the newborn period caused by myocardial dysfunction, secondary to asphyxia with or without hypoglycemia and associated with right ventricular overloading caused by pulmonary hypertention. The clinical diagnosis was based on a history of perinatal distress, distinctive murmur, ECG changes, biochemical abnormalities and myocardial imaging. 1) The sex ratio of TTI was 1:1. 2) The average gestational age was 34 weeks and mean body weight was 2.06 Kg, respectably. 3) Major symptoms were dyspnea, cyanosis, and tachypnea. 4) Tricuspid regurgitation was detected from the lst day to the 4th day of the life and was improved from the 7th day to the 30th day of the life. 5) The peak velocity through tricuspid valve ranged from the 2.7 m/sec to 4.0 m/sec and the estimated right ventricular pressure ranged from 39 mmHg to 74 mmHg. 6) Associated diseases were neonatal hyperbilirubinemia (100%), prematurity (87.5%), atrial right to left shunt (87.5%), patent ductus arteriosus (75%), hyaline membrane disease (25%), and transient tachypnea of newborn (12.5%).
Asphyxia ; Body Weight ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia, Neonatal ; Hypoglycemia ; Infant, Newborn ; Sex Ratio ; Tachypnea ; Transient Tachypnea of the Newborn ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ventricular Pressure

Hemifacial microsomia is a common congenital craniofacial deformity involving bone and soft-tissue. Mandibular hypoplasia is the most obvious skeletal manifestation of hemifacial microsomia. In the past, complete realignment of the skeleton was preferred to soft-tissue correction, which was clearly second choice. However, in this study, simultaneous correction of bone and soft tissue deformities were equally important in treatment of hemifacial microsomia. One-stage and simultaneous bone and soft tissue reconstruction is possible and staged operations of the skeleton and soft tissue are no longer necessary, except in special cases. Even in children and adolescents, good results and normal growth potential can be achieved with simultaneous correction of bone and soft tissue.
Adolescent ; Child ; Congenital Abnormalities* ; Goldenhar Syndrome ; Humans ; Skeleton

Dyke-Davidoff-Masson syndrome is a rare disorder which developed hemiatrophy of brain, enlargement of ventricles and prominent pneumatization of petrous pyramid of the temporal bone. It manifests hemiparesis, varying type seizure, and mental retardation. We experienced two cases of Dyke-avidoff-Masson Syndrome, in a 6/12 year-old boy and a 1, 10/12 year-old girl who were admitted to our department of pediatrics, because of convulsion and hemiparesis The brain CT scan showed marked dilatation of lateral ventricle, prominent sylvian fissure and cortical sulci. So we report two cases of Dyke-Davidoff-Masson syndrome with review of literature.
Brain ; Dilatation ; Female ; Humans ; Intellectual Disability ; Lateral Ventricles ; Male ; Paresis ; Pediatrics ; Petrous Bone ; Seizures ; Temporal Bone ; Tomography, X-Ray Computed