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

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No abstract available.

No abstract available.
Edema* ; Hemoptysis* ; Lower Extremity*

Effects of various factors related to the process of social action of hospital services on the selecting a hospital were investigated by using of questionnaires answered by 1,319 patients in a certain University Hospital, in Chungchongnam-Do, from November, 1986 to November, 1987. The results summarized were as follows ; 1. Each of the examined factors, that is, sincerity of an attendant physician in medical treatment and explaining the condition of a disease, confidence to doctor and nurse, doctor's and nurse's response to calling by patient, kindness of the hospital staffs and food handlers, sanitariness of hospital, cleanness of clothes and bed sheets, hospital foods, and rest surroundings, are not solely decisive to attitude of hospital utilization, but the factors effects compositely on hospital utilization. 2. Hospital services of the social action process are more effective to hospital utilization in cases of the hospitalization caused by the traffic facility than for the medical skill and facilities.
Hospitalization ; Humans ; Surveys and Questionnaires

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*

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

Hydrocephalus is a common malformation of the central nervous system and its cause may be either congenital or acquired. The imbalance between CSF formation and absorption, obstruction of CSF pathways, impaired venous absorption, and over secretion of CSF results in excessive accumulation of the fluid in the ventricles, leading to hydrocephalus. Although ventriculo-peritoneal shunt is regarded as the main and definitive therapy for rapidly progressive hydrocephalus, shunts in newborns have a high failure rate and thus there have been a search for alternative non-invasive techniques. Acetazolamide is a carbonic anhy- drase inhibitor, which acts by reducing production of CSF in the choroid plexus. Admini- stration of acetazolamide will decrease the rate of CSF production, preventing progressive ventricular enlargement. We experienced three cases of neonatal hydrocephalus successfully treated by long-term administration of acetazolamide. Brief review and related literatures were also presented.
Absorption ; Acetazolamide* ; Carbon ; Central Nervous System ; Choroid Plexus ; Humans ; Hydrocephalus* ; Infant, Newborn ; Ventriculoperitoneal Shunt

A case of multiple myeloma combined with stomach cancer and related literatures were reviewed. A 67 year-old male patient entered the hospital with dysphagia and weight loss for 3 months. Peripheral blood examination revealed anemia with rouleaux formation. Total protein of the serum was 9.9 g/dl with hyperglobulinemia (albumin 2.7 g/dl, globulin 7.2 g/dl, A/G ratio 0.375). On the electrophoresis and immunoelectrophoresis of the serum, the abnormal protein with the pattern of monoclonal gammopathy (IgG-K type) was shown. There were multiple variable sized osteolytic lesions on skull X-ray and abnormal hot uptakes of rips on bone scan and result of rib biopsy was plasmacytoma. Gastrofiberscopy was performed to search for the cause of upper gastrointestinal bleeding, revealed stomach cancer, and the result of the gastric mucosal biopsy proved to be well-differentiated adenocarcinoma.
Adenocarcinoma ; Anemia ; Biopsy ; Deglutition Disorders ; Electrophoresis ; Hemorrhage ; Humans ; Immunoelectrophoresis ; Male ; Multiple Myeloma* ; Paraproteinemias ; Plasmacytoma ; Ribs ; Skull ; Stomach Neoplasms* ; Stomach* ; Weight Loss

In children, the supracondylar fractures of the humerus are common in elbow region, and often associated with various complications and problems in treatment (ie,Volkmann's ischemic contracture, cubitus valgus or varus deformity, rotational deformity). The results of reduction can be measured by Baumann's angle, carrying angle, trochlea-capitellum angle, and displacement of distal radial styloid process on radiological study. So we have made experiments on the process which various three dimensional displacements reflected into two dimensional Baumann's angle and humerocapitellar angle. And we investigated the process of rotation, through various radiological studies by means of molded models of humerus. The results were as follows:l. In experiments, AP & lateral X-ray studies showed no change in rotation of proximal segment of fracture with fixed distal segment of fracture. 2. On the other hand, AP & lateral X-ray showed significant change, in rotation of proximal fracture segment with distal segment of fracture. 3. Supracondylar rotation angle(S.R.A.)depicted as the ratio of the length of proximal fracture width minus that of the distal fracture width in lateral view, to the length of distal fracture width in AP view minus that of the distal fracture width in lateral view. 4. According to the modified Mitchell result, S.R.A. to the result of treatment was average 7.6 degree in excellent group, 15.2 degree in good group and 29.3 degree in unsatisfactory group.
Child ; Congenital Abnormalities ; Elbow ; Fungi ; Hand ; Humans ; Humerus ; Ischemic Contracture