No abstract available.
Hernia, Hiatal*

In order to discover difference that may exist in quantity of medical care services, length of stay and hospital changes between insured and non-insured patients, records for primary Cesarean section patients discharged between July 1978 and June 1980 from a university hospital were examined. In addition, Cesarean section rates among the total deliveries for a two-year period between the groups were studied. The results showed that volume of services was greater and length of stay was longer among the insured, however, charges were higher among the non-insured. Cesarean section rates were statistically significantly different between insured and non-insured patients for every age group except the group of 35 or more.
Cesarean Section* ; Female ; Humans ; Length of Stay ; Pregnancy

PURPOSE: Prolonged fetal hypoxia stimulates erythropoiesis in fetal life and induces increased nucleated erythrocytes(NRBC) counts at the early newborn period. To evaluate the relationship between prolonged fetal hypoxia and neonatal intraventricular hemorrhage (IVH), and the prediction of neonatal IVH by neonatal NRBC. METHODS: We compared the daily courses of the absolute NRBC count in preterm new- boms at 34 weeks' gestation or earlier with(n=17) and without(n=20) IVH for 7 days of life. RESULTS: Absolute NRBC counts at birth were higher in neonates with IVH than in control neonates(2,499/mm3+/-3,748 and 412/mm3+/-272, respectively, P=0.0022). The cut-off value of 1,000/mm3 for absolute NRBC counts at birth showed the best parameter estimate of the predictive model for IVH at early newborn period with 100% of positive predictive value and 74.1% of negative predictive value. CONCLUSION: Prolonged fetal hypoxia inducing fetal erythropoiesis near labor is closely related to IVH at early newborn period. Thabsolute NRBC counts at birth is the very important predictable marker for the condition.
Erythroblasts* ; Erythropoiesis ; Fetal Hypoxia ; Hemorrhage* ; Humans ; Infant, Newborn* ; Parturition ; Pregnancy

PURPOSE: To investigate the neuroprotective effect of growth hormone(GH) on neuronal cell necrosis and apoptosis at 1 week and 3 weeks after hypoxic ischemic brain injury. METHODS: Sprague-Dawley rats, seven-day-old, were used. Rats were anesthetized with ether less than 5 minutes. The right carotid artery was cut between double ligation. And then, rats were allowed to recover for 30 minutes followed by exposure to 8% oxygen at 37 degrees C for 2 hours for hypoxic ischemic insult. The study group was divided into 2 groups, control group(N=3) and GH treated group(N=3). GH treated group received intraperitoneal injection of GH 1 IU 2 hours after hypoxic ischemic insult following daily adminstration as same dose for 5 days. Rats were decapitated at 1 week and 3 weeks after hypoxic ischemic brain injury. After then, right hippocampal CA1 and CA3 neurons of rat brains were examined. RESULTS: Necrosis was significantly less in GH treated group than control group, and was more prominent at 3 weeks in both groups. The apoptosis was not found in GH treated and control group. CONCLUSION: GH has a neuroprotective effect on neuronal cell deaths(especially necrosis) from 1 week to 3 week after hypoxic ischemic insult in neonatal rat.
Animals ; Apoptosis ; Brain Injuries* ; Brain* ; Carotid Arteries ; Control Groups ; Ether ; Growth Hormone* ; Injections, Intraperitoneal ; Ligation ; Necrosis ; Neurons ; Neuroprotective Agents* ; Oxygen ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Colorectal Neoplasms* ; Neoplasm Metastasis*

PURPOSE: The aim of this study was to compare conventional scissors and Harmonic Scalpel(R) hemorrhoidectomy. METHODS: Two hundred and five patients were prospectively assigned to two groups in the consecutive order. The group was divided into Group A (Harmonic Scalpel(R) excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative complications were also analyzed. RESULTS: The operative time was 16.6 +/- 0.9 minutes 25.3 +/- 0.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1 +/- 0.1 and 4.5 +/- 0.1 days (p<0.05). Pain scores in the group A were significantly lower than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two patients in group B developed secondary hemorrhage, but no patient had anal stricture. CONCLUSIONS: The Harmonic Scalpel(R) excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative pain without remarkable early or late postoperative complications.
Anesthesia ; Constriction, Pathologic ; Fecal Impaction ; Hemorrhage ; Hemorrhoidectomy* ; Hospitalization ; Humans ; Length of Stay ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Skin ; Urinary Retention

The present study investigated the prevalence rate of Cryptosporidium parvum as a cause of diarrhea. We examined 942 stools of unidentified reasons occurring in patients in whom no immunosuppression had been detected. We examined the stools for Cryptosporidium parvum via modified acid-fast staining. The clinical records of all of the positive patients were then analyzed. Nine (1%) of the stools among the 942 diarrheal patients were positive for C. parvum. The positive rate in the males was 1.1% (6/522) and the positive rate of the females was 0.7% (3/420). Age distribution revealed that the highest positive rates were in patients in their sixties, with a positive rate of 2.5% (4/158). In the clinical tests, levels of c-reactive protein, erythrocyte sedimentation rates, and neutrophil proportions were normally increased in the peripheral blood, whereas the lymphocyte proportion exhibited a tendency towards decrease. The pathological findings were compatible with an inflammatory reaction in the host.
Adult ; Aged ; Animals ; Child, Preschool ; Cryptosporidiosis/*epidemiology/immunology ; *Cryptosporidium/isolation & purification ; Cryptosporidium parvum/isolation & purification ; Diarrhea/*epidemiology/immunology/parasitology ; Feces/parasitology ; Female ; HIV Seronegativity ; Humans ; Immunocompetence ; Korea/epidemiology ; Lymphocyte Count ; Male ; Middle Aged ; Prevalence ; Research Support, Non-U.S. Gov't ; Staining and Labeling

No abstract available.
Nails ; Onychomycosis

PURPOSE: The solid variety of cerebella r tumors in adult is relatively uncommon. This study is to describe the characteristic MR findings of various solid cerebellar tumors in adult. METHODS: Twenty three cerebellar solid tumors from 22 consecutive patients over age of 15 with surgical confirmations were retrospectively evaluated with MR imaging. H istologic diagnosis included hemangioblastoma (n=6), metastasis (n=6), high-grade astrocytoma (n=3), and medulloblastoma (n=8). The MR findings were reviewed with attention to the size, the signal intensity of the tumors, pattern of enhancement, tumoral margin, degree of peritumoral edema, signal void vascular structures within and/or around the tumor, and location in relation to attachment to the pial surface of the tumor. RESULTS: Solid hemangioblastomas consistently showed slightly low or iso signal intensity on T1 -weighted images and high intensity on T2-weighted images, dense homogeneous enhancement, and signal void vessels within and/or around the mass. Metastatic tumors showed various find ings with predominantly low or iso signal intensity on T2-weighted images. Medulloblastomas was midline and/or paramidline in location, and had larger mass formation. High-grade astrocytomas revealed nonspecific MR findings with no signal void vessels. CONCLUSION: Hemangioblastoma, metastasis, malignant astrocytoma, and medulloblastoma should be included in differential diagnosis of solid cerebellar tumors in adult. Dense homogeneous enhancement and signal void vessels are characteristic of hemangioblastoma. The signal intensity of the tumor, and presence of signal void vessels, location and enhancement pattern can be some value in differential diagnosis of solid cerebellar tumors in adult.
Adult* ; Astrocytoma ; Cerebellar Neoplasms* ; Diagnosis ; Diagnosis, Differential ; Edema ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging ; Medulloblastoma ; Neoplasm Metastasis ; Retrospective Studies

PURPOSE: To describe the CT and MR imaging features in patients with intracranial dolichoectasia. MATERIALS AND METHODS: The CT(n=21), MR(n=20) and MRA(n=11) imaging features seen in 28 patients (M:F=12:16 aged beetween 65 and 82 (mean, 65) years with intracranial dolichoectasia were retrospectively reviewed with regard to involved sites, arterial changes(maximum diameter, wall calcification, high signal intensity in the involved artery, as seen on T1-weighted MR images), infarction, hemorrhagic lesion, compression of brain parenchyma or cranial nerves, hydrocephalus and brain atrophy. Involved sites were classified as either type 1 (involvement of only the posterior circulation), type 2 (only the anterior circulation), or type 3 (both). RESULTS: In order of frequency, involved sites were type 1(43%), type 3(36%) and type 2(22%). Dolichoectasia was more frequently seen in the posterior circulation(79%) than in the anterior (57%). Arterial changes as seen on T1-weighted MR images, included dolichoectasia(mean maximum diameter 7.4mm in the distal internal carotid artery, and 6.7mm in the basilar artery), wall calcification(100% in involved arteries) and high signal intensity in involved. Cerebral infarction in the territory of the involved artery was found in all patients, and a moderate degree of infarct was 87%. Hemorrhagic lesions were found in 19 patients(68%); these were either l o b a r ( 53%), petechial(37%), or subarachnoid (16%), and three patients showed intracranial aneurysms, including one case of dissecting aneurysm. In 19 patients(68 %), lesions were compressed lesions by the dolichoectatic arteries, and were found -in order of descending frequency- in the medulla, pons, thalamus, and cerebellopontine angle cistern. Obstructive hydrocephalus was found in two patients (7 %), and 23 (82 % ) showed a moderate degree of brain atrophy. CONCLUSION: In patients with intracranial dolichoectasia, moderate degrees of cerebral infarction and brain atrophy in the territory of involved arteries, as well as hemorrhagic lesions and compression of the brain stem or cranial nerves, were not infrequently seen on CT and MR images. These changes were in addition to the basic arterial change(dolichoectasia, arterial wall calcification and intraluminal high signal intensity) seen on T1-weighted MR images.
Aneurysm, Dissecting ; Arteries ; Atrophy ; Brain ; Brain Stem ; Carotid Artery, Internal ; Cerebellopontine Angle ; Cerebral Infarction ; Cranial Nerves ; Humans ; Hydrocephalus ; Infarction ; Intracranial Aneurysm ; Magnetic Resonance Imaging* ; Pons ; Retrospective Studies ; Thalamus