No abstract available.
Down Syndrome* ; Myeloproliferative Disorders*

No abstract available.
Neck*

Repeat cesarean section is one of the leading causes to make increasing a rate of cesarean section. Trial of labor TOL after cesarean section is attempt to reduce the rate of repeat cesarean section. Trial of labor has been well established as a safe alternative in carefully selected women with transverse scars in the lower uterine segment. This study was based on 104 cases of delivery with prior cesarean birth at the Chonbuk National University Hospital from January, 1991 to June, 1997. The results were as follows: 1) Among 1400 cases with previous cesarean delivery, trial of labor was done in 104 cases (7.4%). Among 104 cases, vaginal birth was successfully completed in 96 cases (92.3%). 2) Among 28 cases with PGE2, vaginal tablet, vaginal delivery was done in 23 cases (82.1%). 3) Among 22 cases with more than 4 of Bishop score, vaginal delivery was done in 21 cases (95.5%), and among 6 cases with less than 3 of Bishop score, vaginal delivery was done only 2 cases (33.3%). 4) There was no matemal death or uterine rupture in the cases of trial of labor, But in 2 cases, uterine dehiscence was observed in 4 cases and postpartal bleeding (more than 400ml) was developed. 5) In the cases of cesarean section, mean of hospital day was 7 days and medical fee was about 400,000 won. In the cases of vaginal birth after cesarean section, mean of hospital day was 2.6 days and medical fee was about 100,000 won. In condusion, vaginal birth after cesarean section is safe and effective alternative to elective repeat cesarean section and also the use of PGE, vaginal tablet is so effective to increase success rate of vaginal delivery. After all, positive these trials might decrease cesarean rate and increase maternal health and quality of medical care.
Cesarean Section ; Cesarean Section, Repeat ; Cicatrix ; Dinoprostone ; Fees, Medical ; Female ; Hemorrhage ; Humans ; Jeollabuk-do ; Maternal Health ; Parturition ; Pregnancy ; Prostaglandins E ; Trial of Labor ; Uterine Rupture ; Vaginal Birth after Cesarean* ; Vaginal Creams, Foams, and Jellies

Cecal Diverticulitis(CD) is a rare condition with a higher incidence in Oriental populations, which symptoms and signs are closely simulate acute appendicitis. The present study was designed to resume the optimal therapeutic modalities. A retrospective review was conducted between 1991 and 1996 on 28 surgically treated patients(18 men, 10 women ; mean age 45 years) with documented CD in Kon-Kuk University Hospital. Most patients presented with right lower quadrant pain and tenderness. Acute appendicitis was the preoperative diagnosis in 89.2%(25/28) of the patients. The CD patients were divided into three groups : CD-RC(right hemicolectomy group; n=4), CD-DV(diverticulectomy group; n=5), and CD-AP(appendectomy only group; n=19) by operative options. Information on patient demographics, duration of symptom, white blood cell count, radiologic studies, operative procedure, operation time, hospital days, duration of intravenous antibiotics administration, complications and recurrent symptoms were reviewed and analyzed. CD-RC and CD-DV patients required more hospital days than CD-AP(mean 20.6 days, 9.6 days versus 8.4 days, respectively) and more complications(50%, 60% versus 26%). There was no recurrent patient in this series and also there were no reoperated cases. But there was one death in CD-RC group. Of the 4 patients who had right hemicolectomy, one was expired by sepsis and one had minor wound infection. Minor wound infections are the most common complications : 5 in CD-AP, 3 in CD-DV group. Conclusively, if CD could be diagnosed preoperatively, surgical management should be reserved and initial medical treatment with intravenous antibiotics should be considered, and in those patient who underwent emergency operation presumed acute appendicitis, right hemicolectomy with primary ileocolic anastomosis is recommended with acceptable low morbidity. But alternatively appendectomy only is a safe and effective procedure for the treatment of CD if there is no evidence of free perforation, abscess formation or strongly suggested cecal carcinoma.
Abscess ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Demography ; Diagnosis ; Diverticulitis* ; Emergencies ; Female ; Humans ; Incidence ; Leukocyte Count ; Male ; Retrospective Studies ; Sepsis ; Surgical Procedures, Operative ; Wound Infection

Ultrasonography is a very useul diagnostic modality for the evaluation of clinically suspicious abdominalmasses in infants and children, especially in assessing their existence, size,location, origin and internalconsistency. Authors analyzed and present ultrasonographic findings of 92 pathologically and/or clinically provenpediatric abdominal masses that were studied and treated in Chonnam University Hospital during recent 4 years. Theresults were as follows: 1. The most common originating site was kidney(26 cases: 28.3%), followed bygastrointestinal tract (21 cases: 22.8%), genital organ(17 cases: 18.5%), non-renal retroperitoneum (13cases:18.5%), hepatobilary tract (12 cases:13.0%), and anterior abdominal wall (3 cases: 3.3%) in ordre offrequency. 2. The most common mass was hydonephrosis(18 cases: 19.6%). Neuroblastoma(7 cases:7.6%),hepatoblastoma, ovarian teratoma, periappendiceal abscess and abdominal tuberculosis(6 cases: 6.5%, respectively),Wilms tumor(5 cases: 5.4%) were next in order of frequency. 3. The sex distribution is rather similar, that is ,male 42(45.7%) and female 50(54.3%), but characteristically choledochal cyst(2 cases) and genital mass(17 cases)were found only in females. Considering age distribution, 78 cases(84.8%) were found within the range of one to 15years of age. The rest, 14 cases(15.2%), were under the age of one year. 4. With ultrasonography, the diagnosis ofhydronephrosis could be made easily in every case and we could evaluate its severity and level of obstruction withhigh accuracy. 5. All Wilms tumor were large, round or oval, sharply marginated and relatively homogenous solidmasses. 6. All neuroblastomas were irregular shaped, poorly defined, heterogeneous solid masses. Tumorcalcification and extension across the midline were noted in 6 cases(85.7%) and 5 cases(71.4%), respectively. 7.All periappendiceal abscesses had irregular thickened wall and posterior acoustic enhancement: 4 cases (66.7%)among them were mixed echo pattern and 2 cases(33.3%) ehco free. 8. Among the 6 abdominal tuberculoses, 2 wereseen as irregularly defined solid masses, 1 as conglomeration of multiple hypoechoic nodulles and 3 as mixedpatterns. 9. All hepatoblastomas were seen to be poorly marginated solid masses with more echogenicity thanadjacent normal hepatic echo in 5 cases except one. 10. Among the 6 ovarian teraomas, 4 cases were cystic and 2cases solid. Acoutic shadowing was seen in 3 cases. 11. Choledochal cyst (2 cases), hydrops of gallbladder(1cases) and cyst of pancreas head(1 cases) had similar ultrasonic appearance as a large elliptical systic mass,but, it was important in differential diagnosis to ascertain the existence of gallblader and the connectionbetween the cyst and bile duct.
Abdominal Wall ; Abscess ; Acoustics ; Age Distribution ; Bile Ducts ; Child ; Choledochal Cyst ; Diagnosis ; Diagnosis, Differential ; Edema ; Female ; Hepatoblastoma ; Humans ; Infant ; Jeollanam-do ; Male ; Neuroblastoma ; Pancreas ; Sex Distribution ; Shadowing (Histology) ; Teratoma ; Tuberculosis ; Ultrasonics ; Ultrasonography ; Wilms Tumor

Conventional radiologic methods had given the limited informations about itraabdominal abscesses. Today,however, CT and ultrasongraphy provide detailed anatomic location, number and dimension of intraabdominal abscessand also permit percutaneous placement of catheter large enough to effect drainage. Percutaneous catheter drainageof intraabdominal abscess now offers an alternative to surgery. This simple method of mechanical drainage, whenemployed with systemic antibiotics, can be successful in treating the majority of intraabdominal abscesses.Authors analysed 24 cases of percutaneous abdominal abscess drainage performed at chonnam Natinal UniverstiyHospital from May 1985 to June 1986. The results were as follows: 1. The sites of abscesses; liver in 14cases(58.3%), psoas muscle in 3 cases(12.5%), subphrenic space in 3 cases (12.5%), pelvic cavity in 2 cases(8.3%),perirenal space in 2 cases(8.3%). 2. Complications during or after procedures were minor in the majority of cases.3. Average duration of drainage was as follows: 7.8days in liver abscess, 15.3 days in psoas abscess, 6 days inpelvic abscess, 7 days in subphrenic abscess.
Abdominal Abscess ; Abscess ; Anti-Bacterial Agents ; Catheters ; Drainage ; Jeollanam-do ; Liver ; Liver Abscess ; Methods ; Psoas Abscess ; Psoas Muscles ; Subphrenic Abscess

BACKGROUND: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. METHODS: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. RESULTS: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. CONCLUSIONS: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed.
Congenital Abnormalities ; Elbow ; Follow-Up Studies ; Fracture Fixation ; Humans ; Humeral Fractures ; Humerus* ; Male ; Postoperative Complications ; Range of Motion, Articular

PURPOSE: To determine the value of Gd-DTPA enhanced fat-suppression(GEFS) MR imaging in the characterization and differentiation of benign from malignant ovarian tumors. MATERIALS AND METHODS: MRI findings of thirty-seven patients with surgically proved 44 ovarian tumors (30 benign, 14 malignant) were studied retrospectively. MR imaging with conventional spin echo (CSE;Tl-weighted image TR/TE 450/20, T2-weighted image TR/TE 3500/30, 90) and GEFS were performed with a 1.5T GE signa. MRI findings of tumors including cystic or solid, wall and septal thickness, necrosis, invasion to adjacent organ, ascites and lymphadenopathy were assessed separately by using CSE and GEFS images, and then tumors were characterized as benign or malignant. RESULTS: Compared with CSE image, GEFS MR image showed better visualization of solid component in 5 malignant lesions, wall thickness in 5 malignant and 1 benign lesions, septal thickness in 3 malignant and 1 benign lesions, necrosis in 1 malignant lesion, and adjacent soft tissue invasion in 5 malignant lesions. Correct characterization of malignant tumors was increased from 71% on CSE image to 93% on GEFS image. However, correct characterization of benign tumors was 93% on both images. CONCLUSION: GEFS MR imaging could be useful for characterization of ovarian tumors, especially in malignant cases, and employed for differentiation of benign from malignant tumors.
Ascites ; Gadolinium DTPA* ; Humans ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Necrosis ; Retrospective Studies

No abstract available.

The computed tomographic(CT) findings of fourteen patients with inflammatory disease and 28 with neoplasm who had an abnormal colonic wall thickening, were retrospectively studied to establish CT criteria for each disorder in differentiating inflammatory from neoplastic lesions. According to homogeneity, density and contour of mural thickening and pericolic inflammatory change in enhanced CT scans, we classified colonic wall abnormalities into 6 patterns: I) multilayering with inner and outer hyper- and middle hypodensities, II) homogeneously hyperdense with pericolic inflammatory change, III) heterogeneously hyperdense with pericolic inflammatory change, IV) homogeneously heperdense with lobulated contour, V) heterogeneously hypodense with lobulated contour and VI) heterogeneously mixed densities with irregular lobulated contour. Type I, II and III were distinctively identified in inflammatory disease, type IV, V in neoplasm, and type VI in boty diseases. We conclude that enhanced CT could be helpful in the initial diagnosis and/or suggestion of abnormal colonic wall disease and differentiation of inflammatory from neoplastic diseases.
Colon* ; Diagnosis ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed