No abstract available.
Anesthesia* ; Animals ; Guinea Pigs* ; Guinea*

Dissecting aortic aneurysm is an emergency condition which requires prompt diagnosis and management. From January 1992 to December 1996, 54 patients were admitted to our department. Patients were categorized according to the Stanford classification of aortic dissection and investigation of the clinical records utilized the retrospective method. Male constituted the majority, according for 38(70.4%) of the total number of patients, whereas females accounted for 16(29.6%). Mean age was 52.1+/-2.2 years old (range:25~82). Clinical findings included chest pain in 46 cases(85.2%), renal failure in 11(20.4%), aortic insufficiency in 10(18.5%) and stroke in 9(16.7%). Predisposing factors were hypertension in 48 cases(88.9%), Marfan's syndrome in 5(9.3%) and diabetes mellitus in 1(1.8%). 21 patients(type A:12, type B:9) underwent surgical treatment. There were three(2 in type A and 1 in type B) deaths in the surgical treatment group and nine(5 in type A and 4 in type B) deaths in the medical treatment group. These results reflect our current policy in the management of dissecting aortic aneurysm.
Aortic Aneurysm* ; Causality ; Chest Pain ; Classification ; Diabetes Mellitus ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hypertension ; Male ; Marfan Syndrome ; Renal Insufficiency ; Retrospective Studies ; Stroke

Recently, the radionuclide angiocardiographic study had been enhanced by rapid development of gamma scintillation camera and computer system, and utilized as noninvasive diagnostic measurement of heart disease. We obtained the following results by the radionuclide angiocardiography with human serum albumin tagged with 99m-Technetium from two groups. One of them was congenital heart disease group(n=50, ventricular septal defect 20, atrial septal defect 6, pulmonary stenosis 2, tetralogy of Fallot 10, truncus arteriousus 1, transposition of great artery 1, patent ductus arteriosus 10) operated from Oct. 1984 to Jun. 1985, and the other was the normal human group(n=10) as control. 1) In the cases of left to right shunt, Qp/Qs values were calculated by th gamma variet fit curve. The preoperative values ranged from 1.441-3.00, the postoperative values were normal among all the patients except one(atrial septal defect, postop. Qp/Qs 2.335). 2) In the cases of right to left shunt, Qp/Qs values showed no apparent change between pre. andpostoperative period, possibly due to still remained collateral circulation and hardly obtained lower value(less than QP/QS 1.0) by computer system, But the double peak curve was noticed in the left ventricular time activity curve, which indicate right to left shunt, disappeared after the surgery, suggesting shunt closed. 3) The ejection fraction of left ventricle was obtained from the congential cardiac patients, ranged 0.38-0.65 before the surgery and 0.41-0.67 after the surgery. 4) The circulation time calculated from the first-pass radionuclide angiocardiography, ranged normal in the most congenital cardiac patients, but prolonged in the severe pulmonary hypertension.
Angiocardiography ; Arteries ; Collateral Circulation ; Computer Systems ; Ductus Arteriosus, Patent ; Gamma Cameras ; Heart Defects, Congenital* ; Heart Diseases ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Hemodynamics* ; Humans ; Hypertension, Pulmonary ; Pulmonary Valve Stenosis ; Serum Albumin ; Tetralogy of Fallot

No abstract available.
Rectovaginal Fistula*

OBJECTIVES: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. METHODS: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. RESULTS: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). CONCLUSION: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.
Adolescent ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Enterobius ; Erythema ; Gynecology ; Hospitals, General ; Humans ; Outpatients ; Physical Examination ; Prospective Studies ; Risk Factors ; Vaginal Discharge ; Vaginitis ; Vulvovaginitis* ; Yeasts

No abstract available.
Rectal Fistula*

PURPOSE: Choledochal cyst is a rare malformation of the pancreatobiliary ductal system, manifested by dilatation of biliary tree with or without anomalous insertion of the common bile duct into pancreatic duct. The purpose of this study is to review the incidence of anomalous pancreatobiliary union(PBU) and the shape of common bile duct based on the angle of pancreatic duct and common bile duct union. MATERIALS AND METHODS: We analyzed cholangiopancreatographic findings of 21 patients with choledochal cyst, emphasizing PBU. The PBU was classified into acute-angled PBU, right-angled PBU, normal PBU, and unknown PBU on the basis of common bile duct insertion to pancreatic duct. The shape of common bile duct dilatation was evaluated with regard to angle of PBU. RESULTS: Fourteen of 21 patients had anomalous PBU with slender or ectatic form of common channels. Three patients had normal opening of common bile duct and pancreatic duct, and in remaining 4 patients the PBU was not visualized. Among 14 patients with PBU, 5 patients had right-angled PBU and 9 patients had acute-angled PBU. Cystic form of common bile duct dilatation was seen in 13 patients and cylindrical form was in 8 patients. Cystic dilatation of common bile duct was seen in 4 patients out of 5 right-angled PBU. CONCLUSION: Patients with choledochal cyst had high incidence of anomalous PBU with common channel (67%). The shape of common bile duct dilatation was cystic in 62% of patients, and the right-angled PBU was prone to be cystic dilatation (80%).
Biliary Tract ; Choledochal Cyst* ; Common Bile Duct ; Dilatation ; Humans ; Incidence ; Pancreatic Ducts

No abstract available.
Blood Transfusion* ; Female ; Humans

No abstract available.
Colorectal Neoplasms*

We deacribe herein a case of Darier-White disease occurring to a 50-year-old man who had a characteristic lesions limited to the sun exposed area and no skin lesion in the sun protected area for 40 years. The akin lesions recurred in summer time and aggravated after sun exposure and disappeared spontaneously in winter time. Histologic findings from the neck lesions revealed hyperkeratosis, parakeratosis, supirabasal lacunae, acantholytic cells, villi, corps ronds and grains.
Edible Grain ; Darier Disease ; Humans ; Middle Aged ; Neck ; Parakeratosis ; Skin ; Solar System*