No abstract available.
Humans ; Stomach Neoplasms* ; Young Adult*

The clinical study on recurrent dislocation of the shoulder was performed on fourteen cases who were treated by Putti-Platt operation from July 1967 to November 1968. The cases studied were treated at the 17th Army Hospital in Kwang-ju and U.S. 121st Evacuation Hospital in Bu-pyung. Ages in initial dislocation were varied from 11 to 25 with an average of 18 years. Five cases of them were recurred over ten times prior to operation. On radiological findings, Hill-Sachs lesion has been revelaed in 57.1%. On pathological finding, Bankart lesion was seen in 78.5% and detachment of the glenoid labrum with capsular separation in 28.6%. No recurrence has been encountered in this s ries, and average rarige of abduction was gained upto 165 and external rotation 30°.
Clinical Study ; Dislocations ; Gwangju ; Hospitals, Military ; Recurrence ; Shoulder

Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal ; Episiotomy ; Female ; Fistula ; Follow-Up Studies ; Humans ; Radiotherapy ; Rectovaginal Fistula* ; Rectum ; Recurrence ; Vagina

Spinal cord infarction as a complication of spine surgery occurs rarely. Herein, a case of spinal cord infarction, which developed in a 69 year old woman following posterior decompression and internal fixation for a T11 bursting fracture, is descirbed. The anesthetic induction and intraoperative course were uneventful, except at the end of the procedure, where her blood pressure suddenly dropped from 130/90 to 90/60 mmHg. The patient was aggressively treated with a transfusion and vasopressor, the blood pressure then returned to its usual value within 10 minutes. However, during a physical examination in the recovery room, the patient was found to have flaccid lower limbs, with impaired sensory function below the T8 level. Her cord diameter had increased, and a high signal lesion was observed within the thoracic spinal cord, from T9 to T12 level on T2-weighted MR images, which was diagnosing as a spinal cord infarction, was and showed no improvement despite the immediate and aggressive treatment.
Aged ; Blood Pressure ; Decompression ; Female ; Humans ; Infarction* ; Lower Extremity ; Physical Examination ; Recovery Room ; Sensation ; Spinal Cord* ; Spine*

Regionalization of high-risk perinatal care has been advocated because intensive care for small and ill newborn infants lowers mortality and morbidity. This report is based on analysis of admissions to the Neonatal Intensive Care unit (NICU) at the Wonju christian Hospital during the 4-year period from January, 1988 to December, 1991. There were 786 inborn infants and 1155 outborn infants admitted to the NICU. The results of our study follow; 1) Mean gestational ages were 36.8 weeks in inborn infants and 39.0 weeks in outborn infants. Mean birth weight was 2.5kg in inborn and 3.0kg in outborn infants. 2) The high-risk maternal factors, such as cesarian section delivery, eclampsia, preeclampsia, multiple pregnancy and placental anomaly were significantly more frequent in inborn infants than in outborn infants. 3) Perinatal sphyxia, HMD and transient tachypnea of newborn (TTN) were more common in inborn than in outborn infants, but pneumonia, meconium aspiration syndrome, and seizure were more common in outborn infants. 4) The positivity of bacterial cultures in blood and urine was higher in outborn infants than in inborn infants. The most frequently isolated microorganism was staphylococcus species in both inborn and outborn infants. 5) Hospital days, duration of TPN, duration of mechanical ventilation, frequency of seizure, and frequency of transfusion were longer or more frequent in inborn than in outborn infants. 6) Mortality rate was higher in inborn infants than in outborn infants. 7) In outborn infants, mortality rate was higher in infants whose transporting time was longer than 2 hours than for infants within 2 hour distances. However, this difference was not statistically significant. 8) These findings suggest that many lower birth weight and severly ill infants were not transported to the NICU of Wonju Christian Hospital perhaps due to poor transport systems, distance or socio-economic status. In conclusion, the improvement of transporting systems and socio-economic conditions will be required within this region.
Birth Weight ; Eclampsia ; Female ; Gangwon-do ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Critical Care ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Mortality ; Perinatal Care ; Pneumonia ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Respiration, Artificial ; Seizures ; Staphylococcus ; Transient Tachypnea of the Newborn

PURPOSE: To investigate the incidence and characteristics of vertical deviation in the intermittent exotropia. METHODS: Fifty consecutive intermittent exotropes over age of 5 were prospectively studied. Patients with any significant ocular and neurologic abnormalities or orbital anatomic abnormalities, definite oblique dysfunction with A or V pattern were excluded. Ophthalmologic evaluation included visual acuity, ocular movements, measurements of angle of deviation by prism cover test, Bielschowsky head tilt test, stereoacuity test, and fundus observation for torsion by indirect ophthalmoscopy. RESULTS: We found that 27 children(54%) had concomitant hypertropia in primary position. Mean amount of hypertropia was 4.81 PD(range: 2~20 PD). Thirty nine children(78%) showed positive Bielschowsky head tilt test. No objective torsion was observed. No inferior oblique overaction was found except for only 2 patients. All subjects had good visual acuity and stereopsis. CONCLUSIONS: The incidence of vertical deviation in the intermittent exotropia is much higher than expected. All of the vertical deviations show positive Bielschowsky head tilt test.
Depth Perception ; Exotropia* ; Head ; Humans ; Incidence ; Ophthalmoscopy ; Orbit ; Prospective Studies ; Strabismus* ; Visual Acuity

No abstract available.

The purpose of this study is to provide the basic data and their analysis to improve hospital foodservice by identifying patient satisfaction with different attributes of hospital foodservice and its influencing factors using self written survey on nine hundred fifteen hospitalized patients in 28 general hospitals in Seoul and Kungki area. The statistical analysis of data was done by SAS/WIN package(Version 6.11) to determine Descriptive Analysis, T-test, Analysis of Variance, Pearson's Correlation, and Factor Analysis. The summary of the study results is as follows: 1. Among sixteen food-service quality attributes, the most unsatisfying one was the meal itself, the provision of nutrition informations, the possibility of menu choices, immediate response on meal problems, and the taste of the meal. 2. There was a positive correlation between the general quality satisfaction and freshness, nutritional considerations, and the temperature of the dishes and trays, and variety of menu in food-service quality were also correlated positively. 3. Based on the result of statistical analysis on the expectation and recognition in hospital food-service quality attributes vs quality satisfaction, expectation was negatively correlated with quality satisfaction: however, recognition was positively correlated.
Hospitals, General ; Humans ; Meals ; Patient Satisfaction* ; Seoul

Mutation in the p53 suppressor gene is the most common genetic alteration found in human cancers including primary brain tumors. Ki-67 labeling index(LI) is known to be a marker of proliferating activity. The purpose of this study was to verify whether an immunohistochemical expression of p53 antibody and Ki-67 LI could be related to different clinicopathologic parameters including histologic grade, size, invasiveness and recurrence of the brain tumors. Materials were based on the 147 surgically resected brain tumors during the last two years. Of the 147 brain tumors, there were 35 astrocytic tumors, 35 meningiomas, 10 oligodendrogliomas, 7 craniopharyngiomas, 5 dysembryoplastic neuroepithelial tumors, 4 medulloblastomas, 5 ependymomas, 23 pituitary adenomas, 9 schwannomas, and 14 other brain tumors. The p53 expression and Ki-67 LI were higher in malignant brain tumors including astrocytic tumors, medulloblastoma, PNET and gliosarcoma. The p53 positivity was correlated with histologic grades and tumor recurrence. The brain tumors with a high Ki-67 LI(>6%) also showed a close relationship to a higher histologic grading, radiological invasiveness and recurrence. There was no evident correlation with the age and tumor size with p53 expression and Ki-67 LI. These results suggest that p53 overexpression and high proliferation potential of the tumor cells are associated with the higher histologic grade and aggressive clinical course in the central nervous system tumors.
Brain Neoplasms* ; Brain* ; Central Nervous System Neoplasms ; Craniopharyngioma ; Ependymoma ; Genes, Suppressor ; Gliosarcoma ; Humans ; Medulloblastoma ; Meningioma ; Neoplasms, Neuroepithelial ; Neurilemmoma ; Neuroectodermal Tumors, Primitive ; Oligodendroglioma ; Pituitary Neoplasms ; Recurrence

Our purpose is to describe a successful twin pregnancy and delivery after intracytoplasmic sperm injection (ICSI) followed by calcium ionophore with spermatozoa from a globozoospermic man. On the second attempt of ICSI, all of eight metaphase II oocytes were fertilized with treatment with calcium ionophore. Day 3 transfer of six normally developing embryos resulted in an ongoing twin pregnancy, and two preterm healthy babies were born in the 33th week of gestation. To the best of our knowledge, this is the first report of pregnancy and delivery after ICSI followed by calcium ionophore with spermatozoa from a globozoospermic man in Korea.
Calcium* ; Embryonic Structures ; Humans ; Metaphase ; Oocytes ; Pregnancy ; Pregnancy, Twin* ; Sperm Injections, Intracytoplasmic* ; Spermatozoa*