PURPOSE: This study was undertaken to evaluate how well anorectal manometry diagnose anal sphincter injury, especially with regard to the parameter of radial asymmetry. METHODS: Anorectal manometry were performed in 27 male patients with anal fistula of transsphincteric type. The postoperative values of each manometric parameter including radial asymmetry (RA) were compared with preoperative ones. And also, the association between the sites of functional defect assessed by cross-sectional pressure data under station pull-through (SPT) technique and those of anatomical defect made by fistulotomy operation were determined. RESULTS: Under rapid pull-through (RPT) technique, maximum resting pressure (MRP); 113.1 21.3 mmHg (preoperative value) vs 68.0 18.5 mmHg (p=.000) (postoperative value), RA of MRP; 16.7 3.7% vs 24.1 7.5% (p=.002), Maximum squeeze pressures (MSP); 199.0 35.2 mmHg, 169.6 48.7 mmHg (p=.006), RA of MSP; 15.5 3.7%, 22.8 3.5% (p=.000). Under SPT technique, MRP; 100.4 39.5 mmHg vs 71.2 34.6 mmHg (p=.000), RA of MRP; 16.3 7.9% vs 24.2 10.8% (p=.026), MSP; 299.1 71.6 mmHg vs 231.4 90.3 mmHg (p=.004), RA of MSP; 13.0 6.1% vs 22.0 8.4% (p=.001). Sites of functional defects interpreted upon SPT data were coincidental with sites of anatomical defects made by fistulotomy in 88.9% (MRP) and 92.6% (MSP) of cases. CONCLUSIONS: Manometric radial asymmetry could be a useful parameter in diagnosing anal sphincter injury and locating the site of defect.
Anal Canal* ; Diagnosis* ; Humans ; Male ; Manometry ; Rectal Fistula

In order to provide some basic data for the control of air water pollution in Korea, the suthors have estimated the amount of air and water pollutant emitted from industries which are employed over 20 employes. This study have done from July 1, 1972 to the end March 1973. The results are as follows: 1. Total number of establishments tith over 20 employees is 5,197 in Korea and the largest gorup establishments was the manufacturing of texttiles with 1,363 establishments(26.2%). 2. By order of number of employees it was observed that there 2,800 industries with 20-59(53.9%) employees, 1,101 with 50-99(21.2%), 571 with 100-199(11.0%), 501 with 200-499(9.6%) and 225with over 500(4.3%) respectively. 3. By order of regional distribution, it was observed that there were 2,257 industries in Seoul (43.3%) and 736 industries in Pusan(14.2%). 4. Industrial coal consumption was 596,154 M/T in 1972, but it'11 be 315,000 M/T in 1980, Fuel consumption was 4,972,000 K1 in 1972, and estimated volume will be 19,3700,000 K1 in 1980. 5. Ttotal amounts of air polutants emitted from industris by fuel combustion were sulfur oxides 79,459 tons, carbon monoxide 33,908 tons, particulate 31,304 tons and hydrocarbon 30,280 tons in 1972 but in 1990 there will be sulfur oxides 1,010,474 tons, nitrogen oxides 204,575 tons, carbon monoxide 68,014 tons, particulate 64,820 tons and hydrocarbon 67,622 tons, respectively. 6. Annual emitted air pollutants through the working processes were sulfur oxides 91,250 tons and nitrogen oxides 32,485 tons in 1972, but sulfur oxieds 118,625 tons and nitrogen oxides 42,555 tons will be present in 1980, respectively. 7. Annual emitted air pollutants by national unit area amounted to 0.77 tons/km2/year in 1965 and 14.7 ton/km2/year in 1980. 8. Total industrial wastes from all industries in Korea were estimated at 810,360 tons/day in 1972; manufacturing of chemicals and plastic products showed the highest amount of wastes at 470,000 tons/day. 9. The amounts of water pollutants due to industrial wastes were the .B.O.D., 471.5 tons/day,suspended solid 331.5 tons/day, CN, 2.3 tons/day, and Cr. 3. 4 tons/day in 1972, but it might be evident of a B.O.D of 3.388 tons/day, suspended solid 2,544 tons/day, CN 20.1 tons/day, and 26.5 tons/day in 1990. 10. Total population equivalent of B.O.D. was 943,000 in 1972, and the estimated value in 1990 will be6, 780, 000.
Air Pollutants ; Carbon Monoxide ; Coal ; Industrial Waste ; Korea* ; Nitrogen Oxides ; Plastics ; Seoul ; Sulfur ; Sulfur Oxides ; Water Pollutants* ; Water Pollution

BACKGROUND: Clinical trials have shown that b-adrenergic blocking drugs are effective and well tolerated in patients with mild to moderate congestive heart failure. Carvedilol is a mild b1-selective adrenergic blocking agent with vasodilating properties due to a blocker and antioxidant and anti-proliferative properties. This study assessed the efficacy and safety of carvedilol in patients with moderate to severe congestive heart failure caused by idiopathic dilated cardiomyopathy. METHODS: We enrolled 27 patients with moderate to severe congestive heart failure with a left ventricular ejection fraction of 35% by MUGA scan. Each patient was randomly assigned to either control (n-9) or carvedilol (n-18, target dose 25 mg bid) for 6 months while background therapy with digoxin, diuretics, and ACE inhibitor remained constant. RESULTS: Compared to the control group, patients in the carvedilol group showed significant increase of left ventricular ejection fraction (p<0.05). In addition, patients in the carvedilol group had a tendency to show a decrease in left ventricular end-diastolic dimension and heart rate. Also, the carvedilol group had a greater frequency of symptomatic improvement than the control group. There was neither serious side effects nor hospitalization. CONCLUSION: These finding indicate that carvedilol produces important clinical benefits in patients with moderate to severe heart failure treated with digoxin, diuretics, and ACE inhibitor without serious side effects.
Cardiomyopathy, Dilated ; Digoxin ; Diuretics ; Heart Failure* ; Heart Rate ; Hospitalization ; Humans ; Stroke Volume

PURPOSE: To evaluate the relationship between a limb-length discrepancy and the clinical and radiological outcomes after bipolar hemiarthroplasty for femur neck fractures in elderly patients. MATERIALS AND METHODS: Between August 2004 and January 2007, 60 out of 80 cases over 65 years who underwent cemented bipolar hemiarthroplasty for femur neck fractures with a more than 2 years follow-up were evaluated retrospectively by dividing the patients into two groups, > 5 mm (group 1) and < 5 mm (group 2) of limblengthening. Harris hip score, the activity of daily living(ADL), dislocation rate, pain by a visual analogue scale (VAS) and acetabular wear by radiographic measurements were analyzed. RESULTS: For each group, the Harris hip score in group 1 and 2 was 80.0 and 76.2, respectively. The ADL in group 1 and 2 was respectively, 36 and 29 preoperatively, 56 and 52 postoperatively. The visual analogue scale in group 1 and 2 was 3.53 and 2.23 (P=0.002), respectively, and acetabular wear was encountered in 6 and 8 cases in group 1 and 2, respectively. The VAS score was significant. There was no difference in acetabular wear and dislocation between the two groups (P>0.05). CONCLUSION: Limb-lengthening by hemiarthroplasty may be a cause of pain but with little effect on the overall functional outcome.
Activities of Daily Living ; Aged ; Dislocations ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Humans ; Retrospective Studies

OBJECTIVE: To report the successful delivery in a patient of recurrent spontaneous abortion caused by chromosomal abnormality. MATERIAL AND METHOD: Case report. RESULTS: Twelve oocytes were obtained by in vitro fertilization. Of eleven oocytes fertilized, two embryos turned out to be normal by using fluorescent in situ hybridization on blastomere biopsy. The patient succeeded in pregnancy and the result of amniocentesis was found to be normal. She delivered the healthy female baby by cesarean section. CONCLUSIONS: The successful delivery is possible in recurrent spontaneous abortion related with reciprocal translocation by using preimplantation genetic diagnosis.
Abortion, Spontaneous* ; Amniocentesis ; Biopsy ; Blastomeres ; Cesarean Section ; Chromosome Aberrations ; Embryonic Structures ; Female ; Fertilization in Vitro ; Humans ; In Situ Hybridization, Fluorescence ; Oocytes ; Pregnancy ; Preimplantation Diagnosis*

Transient synovitis of the hip is non-specific inflammation and self limited condition, which is most common cause of painful limping in children under 10 years of age. Ultrasonography presents some merits, simple, rapid, non-invasive, low cost, repetitive to assess soft structures in and around the hip joint compared to other diagnostic methods. We prospectively studied 32 cases of unilateral transient synovitis at OPD from Jan. 1988 to Oct. 1989 using 5-7.5 MH, probe ultrasonography. 2-times serial check up in symptomatic and asymptomatic stage about capsule thickness and bone-capsule distance in 3 different positions of the both hips were performed for comparision. The following results were obtained; 1. Boys were 25 cases (78%) and 26 cases (83%) were between 3 and 7 years old of age. 2. Bone-capsule distance in ultrasonography revealed abnormal increase in 72%. 3. External rotation position showed wider bone-capsule distance than other position. 4. Capsule thickness was 3.3mm in diseased and 3.0mm in sound, 0.3mm decrease after treatment. 5. Bone-capsule distance was 4.5mm in symptomatic stage, 2.7mm in asymptomatic stage, 1.8mm decrease after treatment in averge.
Child ; Hip Joint ; Hip ; Humans ; Inflammation ; Prospective Studies ; Synovitis ; Ultrasonography

OBJECTIVE: To compare the efficacy of GnRH antagonist multi dose protocol in controlled ovarian hyperstimulation (COH) for IVF-ET or ICSI with GnRH agonist long protocol. METHODS: From January 2003 to December 2004, total of 583 cycles which underwent IVF-ET or ICSI using r-FSH were enrolled in this study. 447 cycles of the study group were performed in controlled ovarian hyperstimulation by using GnRH antagonist multi dose protocol and 136 cycles of the control group were performed by using GnRH long protocol. We compared patients characteristics, controlled ovarian hyperstimulation outcomes and IVF-ET outcomes between two groups. RESULTS: Patients characteristics and baseline hormone levels were not different between the two groups. The duration of stimulation was significantly shorter in study group comparing with control group (12.8+/-1.5 days vs 13.7+/-1.7 days, p<0.05). There were no differences between the two groups in the number of follicles, endometrial thickness and serum E2 level on hCG day. The pregnancy rate seemed to be lower in the study group (32.4% vs 35.4%), but the difference was not statistically significant. There were also no differences in number of oocytes retrieved, matured oocytes, fertilized oocytes and transferred embryos between two groups. CONCLUSION: GnRH antagonist multi dose protocol in COH might be a simple and effective method compared with GnRH agonist long protocol.
Embryonic Structures ; Gonadotropin-Releasing Hormone* ; Humans ; Oocytes ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic

PURPOSE: To evaluate the radioloic findings of malignant retroperitoneal fibrosis. MATERIALS AND METHODS: Post-contrast CT (n=9) and urographic (n=7) findings of nine patients with malignant retroperitoneal fibrosis were retrospectively analyzed. Primary tumors were found to be advanced gastric cancer (n=6), early gastric cancer (n=1), breast cancer (n=1), and cervical cancer (n=1). We analyzed CT findings with regard to the site of soft tissue lesion, ureteral involvement, the presence or absence of hydronephrosis, and distant metastasis. The level and length of ureteral involvement, presence or abscence of ureteral stenosis, and ureteral displacement as seen on urography, were analyzed. RESULTS: On CT scans, enhanced soft tissue lesions (mass, 5 cases; plaque, 4 cases) encircling the abdominal aorta and IVC were noted in all cases. Thickening of the ureteral wall (n=8), hydronephrosis (n=9), and enlarged lymph node (n=5) were also seen. On urography, irregular stenosis and medial displacement of ureters from level L2 to S2 were noted in all cases. The length of ureteral involvement was 4-6.5cm. CONCLUSION: The common CT findings of malignant retroperitoneal fibrosis were enhanced soft tissue lesion encircling the abdominal aorta and IVC, hydronephrosis, and thickening of the ureteral wall. On urography, ureteral stenosis and medial displacement were seen.
Aorta, Abdominal ; Breast Neoplasms ; Constriction, Pathologic ; Humans ; Hydronephrosis ; Lymph Nodes ; Neoplasm Metastasis ; Retroperitoneal Fibrosis* ; Retrospective Studies ; Stomach Neoplasms ; Tomography, X-Ray Computed ; Ureter ; Urography ; Uterine Cervical Neoplasms

OBJECTIVE: To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. METHODS: This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. RESULTS: The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, −1.8°± 2.8°, p = 0.044; nondeviated side, −3.7°± 3.3°, p = 0.001) and the lower canine inclined lingually on the nondeviated side (4.0°± 5.4°, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. CONCLUSIONS: POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.
Dentition ; Facial Asymmetry* ; Humans ; Malocclusion* ; Molar ; Orthognathic Surgery* ; Osteotomy ; Retrospective Studies

OBJECTIVE: We investigated the norepinephrine transporter (NET) expression in normal and pre-eclamptic placentas and analyzed the invasion activity of trophoblastic cells based on norepinephrine (NE)-NET regulation. METHODS: NET and NE expression levels were examined by western blot and enzyme-linked immunosorbent assay, respectively. Trophoblast invasion activity, depending on NE-NET regulation, was determined by NET-small interfering RNA (siRNA) and NET transfection into the human extravillous trophoblast cells with or without NE treatment and invasion rates were analyzed by zymography and an invasion assay. RESULTS: NET mRNA was expressed at a low level in pre-eclamptic placentas compared with normal placentas and NE concentration in maternal plasma increased significantly in pre-eclamptic women compared to normal pregnant women (p<0.05). NET gene upregulation and NE treatment stimulated trophoblast cell invasion up to 2.5-fold (p<0.05) by stimulating matrix metalloproteinase-9 activity via the phosphoinositol-3-kinase/AKT signaling pathway, whereas NET-siRNA with NE treatment reduced invasion rates. CONCLUSION: NET expression is reduced by inadequate regulation of NE levels during placental development. This suggests that a complementary balance between NET and NE regulates trophoblast cell invasion activities during placental development.
Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Matrix Metalloproteinase 9 ; Norepinephrine ; Norepinephrine Plasma Membrane Transport Proteins ; Placenta ; Placentation ; Plasma ; Pre-Eclampsia ; Pregnant Women ; RNA ; RNA, Messenger ; RNA, Small Interfering ; Transfection ; Trophoblasts ; Up-Regulation