No abstract available.
Korea*

BACKGROUND: The diagnosis of intraabdominal solid organ injuries is easy for accuracy of the imaging studies, but that of hollow viscus perforations is sometimes relatively difficult. And some of gastrointestinal perforations can be missed and their diagnosis may be delayed. This can result in high morbidity and mortality. So, I studied the incidence and causes of each gastrointestinal tract perforation. METHOD: Four hundred eighty four patients were reviewed, who visited the Emergency Center of Seoul Red Cross Hospital for their gastrointestinal perforations from January, 1987 to December, 1998. Medical records were reviewed in a retrospective manner. The incidence and causes of each hollow viscus perforation, the preferability of each perforation from the pattern of trauma, age and sex distribution in each perforation and associated injuries with trauma were analyzed. RESULTS: The most common perforations were in duodenum(254cases, 52.4%) due to mainly peptic ulcer. The incidence was in order of small bowel(32.6%), stomach(7.4%), colorectum(6.6%) and esophagus(0.8%) after that. Trauma induced perforations were 164 cases(33.9%) and the ratio between blunt and penetrating trauma was 3.9 : 1. Small bowel was most vulnerable site of perforation from both trauma. Duodenum and esophagus were relatively stable from trauma. There were no cases from blunt trauma in stomach and esophagus. The male to female ratio was 5.1 : 1. CONCLUSION: Each hollow viscus has each preferred cause of perforation. It's diagnosis was not easy everytime, sometimes it was really difficult. But pattern of causes in perforations will be helpful to decision making process. In difficult cases, suspicion is very important. And in suspicious perforation of hollow viscus, diagnosis and the decision to operate will be made by frequent physical examination and proper investigating tests.
Decision Making ; Diagnosis ; Duodenum ; Emergencies ; Esophagus ; Female ; Gastrointestinal Tract* ; Humans ; Incidence* ; Male ; Medical Records ; Mortality ; Peptic Ulcer ; Physical Examination ; Red Cross ; Retrospective Studies ; Seoul ; Sex Distribution ; Stomach

No abstract available.

No abstract available.

Tumor angiogenesis has been found to have prognostic significance in many tumor types for predicting an increased risk of metastasis. We assessed tumor vascularity in 28 cases of borderline malignancy and 71 cases of carcinoma of the ovary which had been resected and diagnosed, using the highly specific endothelial cell marker CD34. The numbers of microvessels were counted in 200 magnification in three highly vascularised areas. The numbers of microvessels in carcinomas were higher than that in the borderline malignancy of serous and mucinous tumors. The number of microvessels of mucinous carcinomas was significantly higher than that of serous carcinomas. There were neither significant differences in the number of microvessels according to histological tumor types (p=0.075) nor significant differences in the number of microvessels according to FIGO stages (p=0.072). But in serous carcinomas, the number of microvessels was higher in the FIGO III-IV stage than in the FIGO I-II stage (p=0.017). This study showed higher neovascularization in malignant tumor than borderline malignancy, and in the advanced stage (FIGO III-IV) than less advanced stage (FIGO I-II) of serous carcinomas.
Adenocarcinoma, Mucinous ; Endothelial Cells ; Female ; Microvessels ; Mucins ; Neoplasm Metastasis ; Ovary

Eleven magnetic resonance(MR) and CT imagings were performed in nine patients with mild to moderate degree oddelayed neuropsychiatric symptoms following acute carbon monoxide(CO) poisoning, to evaluate the capability of MRin demonstrating any additional finding to CT. The MR images were obtained using 0.15 Tesla resistive system withvariuos combination of three pulse sequences, including partial saturation recovery, T2-weighted spine echo andinversion recovery. Bilateral white matter abnormalities suggesting demyelination were demonstrated in 4 patientswith MR and in only 2 patients wtih CT. The contrast discrimination between normal and abnormal white matterproved to be better with T2-wieghted spin echo and inversion recovery than with partial saturation recovery andCT. But necrosis of the globus pallidus(1 patient) and diffuse atrophy(3 patients) were equally demonstrated onboth MR and CT. It is suggested that MR be used as a initial imaging method in the evaluation of the delayedencephalopathy following acute CO poisoning, especially for the detection of the possible white matter lesions.
Brain Diseases ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Demyelinating Diseases ; Discrimination (Psychology) ; Humans ; Methods ; Necrosis ; Poisoning ; Spine ; White Matter

Generally, exposure and the operative technique are common difficulty encountered in the total knee arthroplasty of ankylosed knee due to old infection sequelae. Also the postoperative range of motion and relief of pain is poor due to deformity and excessive soft tissue contracture around knee. There have heen few reports, however, that address the reconstructive challenge of total knee arthroplasty in a previously infected ankylosed knee. We perfoined TKA in thirty six patients who had ankylosed knee between July l986 and Dec. 199S. After follow up of average five years and one month, we analysed the results. The definition of ankylosis was a knee ROM less than 90 degree. Average age of patients were 36.7 years old. Twelve patients were meii and twenty four patients were women. Sixteen patients of partial ankylosis and twenty patients of complete ankylosis were performed operation. There were nineteen cases of healed tubercuiosis knees and seventeen cases of healed pyogenic knees. For the release of soft tissue contracture in 9 cases, we lengthened quadrceps tendon with the method of modified V-Y advancement technique. Patella tendon was proximally reattached with staples and suture in 6 cases and tibial tubercle was proximally transferred in 3 cases. As results, the postoperative average range of motion was 79.3 (30 - l21') in complete ankylosis, 107 (60 - 135 ) in partial ankylosis. The average Hospital for Speciai Surgery knee rating score improved from 56.3 points preoperatively to 84.8 points postoperatively. Radiolucent line was observed in two Knees with less than 2mm width in three years and four months, and four years postoperatively, hut the patient had no pain. In five patients who had poor gain of range of motion after operation, we perfonned arthroscopic adhesiolysis. In conclusion, regarding patient selection, reasonable hony development, relative]y healthy extensor mechanism and adequate soft tissue condition are important for success of TKA in old intection sequelae. TKA of ankylosed knee in old infection sequelae is a successful procedui which can ohtain the restoration of function of the ankylosed knee.
Ankylosis ; Arthroplasty* ; Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee* ; Patellar Ligament ; Patient Selection ; Range of Motion, Articular ; Sutures ; Tendons

No abstract available.
Antibodies, Monoclonal* ; Cyclosporine* ; Humans ; Radioimmunoassay*

BACKGROUND: There is increasing concern in many countries about the problem of drug-resistant tuberculosis. Prevalence of primary drug-resistant tuberculosis is the optimal epidemiological indicator for long term monitoring of national tuberculosis control program. Our purpose was The purpose of our study is to assess clinical characteristics and socioeconomic status of patients with drug-resistant tuberculosis. METHODS: We studied 68 cases with durg-resistant Mycobacterium tuberculosis infection diagnosed at the Ewha Womans University Mokdong Hospital from March, 1995 to February, 2000. RESULTS: Patients with primary drug-resistant tuberculosis(PDR) were younger(39.6±16.3 years vs. 48.2±16.5 years; p<0.05), had more population of less than more were under the age of 40 years aged-group(62.9% vs. 36.4%; p<0.05) and were more highly educated than those with acquired drug-resistant tuberculosis(ADR)(38.9% vs. 11.1%; p<0.05). In patients with ADR, the rates of familial history of tuberculosis and living in a rented house residence in a rented house were increased higher than compared with to those of patients with PDR. Patients with ADR had more involved lobes(2.0±0.8 vs. 1.4±0.7; p<0.01) and longer treatment duration than those with PDR(18.3±7.2 months vs. 10.6±6.3 months; p<0.05). Patients with ADR showed larger numbers of resistant were resistant to more number of drugs, lower hospitalization rate and higher rate of self-interruption of medication than those with PDR. In patients with PDR, mono-drug resistance was increased, whereas poly-and multi-drug resistances were decreased compared with those with ADR. Resistance to isoniazid was the highest among antituberculosis drugs, and resistance to isoniazid in patients with ADR was higher than that in patients with PDR(90.9% vs. 71.4%; p<0.05). CONCLUSIONS: Patients with ADR were more likely to include more population be of lower socioeconomic class, and patients with PDR seem seemed to be young and socially active population. For control of drug-resistant Mycobacterium tuberculosis infection, proper isolation and prevention of patient with drug-resistant tuberculosis are needed.
Female ; Hospitalization ; Humans ; Isoniazid ; Mycobacterium tuberculosis ; Prevalence ; Social Class ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

PURPOSE: Recently in light of the development in immunology, interferon- e and inter- leukin-2 or combination therapy with anticancer drugs have been performed. This study aims to verify and compare the efficacy of therapies using interferon- a alone, interferon- a plus vinblastine, and interferon- a plus interleukin-2 plus 5-fluorouracil (5-FU) plus 13-cis retinoic acid (13cRA) in patients with advanced renal cell carcinoma. MATERIALS AND METHODS: A total of 29 patients were randomly assigned to receive treatment with either interferon- a alone or interferon- a plus vinblastine or interferon- a plus interleukin-2 plus 5-FU plus 13cRA from December 1989 to May 1998. The most frequent metastatic sites were the lung, lymph nodes, bone, liver, and brain. We studied the response rates, survival period, and complications of each regimen. RESULTS: Responses were achieved in 1 out of 1~5 patients (6.73?o) on interferon- a alone (partial responses lasting 13 months), 1 out of 9 patients (11.1%) on interferon- e plus vinblastine (partial responses lasting 25 months) and 1 out of 5 patients (20.0%) on interferon-a plus IL-2 plus 5-FU plus 13cRA regimen (partial responses lasting 14 months). The median durations of survival were 18, 33, and 23 months respectively. The overall response rate was 10.3% and overall median duration of survival was 19 months. The most common side effects were flu-like symptom such as fever, chills (93.1%), skin symptom such as erythema, pruritus (31.0%), G-I symptom such as nausea, vomiting (17.2%), netropenia (10.3%), abnormal LFT (10.3%), and thrombocytopenia (3.4%). CONCLUSIONS: This study confirms the manageability and tolerability of several regimen used. There is no significant differences in response rates and survival duration among the regimens used in this study. The effective immunotherapy in patients with metastatic RCC should be evaluated by further studies of larger patients groups even though a minority of patients responded.
Allergy and Immunology ; Brain ; Carcinoma, Renal Cell* ; Chills ; Erythema ; Fever ; Fluorouracil ; Humans ; Immunotherapy* ; Interferon-alpha ; Interferons* ; Interleukin-2 ; Liver ; Lung ; Lymph Nodes ; Nausea ; Pruritus ; Skin ; Survival Rate ; Thrombocytopenia ; Tretinoin ; Vinblastine ; Vomiting