To evaluate the results and clinical impact of defecography in patients with anorectal diseases, 304 defecographic examinations from 304 patients were reviewed. The defecographic results were screened for the anorectal angle and perineal descent at rest, squeezing and during straining. Changes of rectal configuration and canal width during straining were reviewed. 304 patients had defecation problems such as terminal constipation, defecation defficulty, blood or mucus discharge, tenesmus, obstruction sensation etc. They were performed anorectal physical examination and anal manometry etc., and were later treated by operation and conservative management. Normal anorectal angle were measured to be 101°, 91°, 131°at rest, during squeezing and straining respectively. In the spastic pelvic floor syndrome, increase of anorectal angle less than 10 ° from rest to straining was observed. Incontinent patients had a larger anorectal angle (mean: 128°) at rest. 7.8cm of perineal descent was found in descending perineal syndrome in comparison to 4.0cm in normal. Normal anal canal width was measured 1.4cm only during straining but identified in incontinent patients at rest (mean:1.2cm). Abnormal rectal configuration was found in 254 defecographic examinations: rectoceles were observed in 235 cases and were associated with rectal prolapse in 115 cases, and rectal prolapses were found in 134 cases. In conclusion, the anorectal angle was valuable in evaluation of spastic pelvic floor syndrome and fecal incontinence. Degree of perineal descent was abnormally increased in descending perineal syndrome. In the cases of the rectoceles and rectal prolapses, defecography is helpful in preoperative evaluation of rectal wall change and postoperative follow up.
Anal Canal ; Constipation ; Defecation ; Defecography* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Mucus ; Muscle Spasticity ; Pelvic Floor ; Physical Examination ; Rectal Prolapse ; Rectocele ; Sensation

No abstract available.
Intervertebral Disc*

An unusual case of embryonal rhabdomyosarcoma of the bladder in a 77 year old man, who presented with difficult urination, gross hematuria and vague lower abdominal pain. Herein, we report a case of rhabdomyosarcoma. which revealed early recurrence and rapid growing up after partial cystectomy.
Abdominal Pain ; Adult* ; Aged ; Cystectomy ; Hematuria ; Humans ; Recurrence ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal ; Urinary Bladder* ; Urination

Leiomyoma is rare. Most of patients present with urinary tract infection, hematuria, dyspareunia, or complaint of mass. A case of leiomyoma on urethrovaginal septum in a 36 years old female was presented. The presenting symptom was a protruding mass at the anterior vaginal wall The mass was removed surgically and confirmed as a leiomyoma pathologically.
Adult ; Dyspareunia ; Female ; Hematuria ; Humans ; Leiomyoma* ; Urinary Tract Infections

No abstract available.
Echocardiography* ; Mass Screening*

PURPOSE: Incorrect umbilical venous catheter(UVC) position results in an increased incidence of complications and rnisleading pressure measurements. Most modern catheters are radiopaque and are easily seen on plain film radiographs but the exact relation of the catheter tip to vascular anatomic landmarks is not available. We assessed the ability of ultrasonography to locate the tip of UVC. And we described the relationship between the locations of the tip of UVC on the ultrasonography and the anatomical landmark seen on the radiography. METHODS: From February 1997 to June 1997, 40 newborns admitted to NICU at Guro Hospital, Korea University, and required UVC insertion for clinical care. UVC position was checked by anteroposterior and cross table lateral radiography. And then ultrasonographic assessment was performed using Hewlett Packard Sonos-1000(Hewlett Packard, UK) with a 5 MHz transducer. The ultrasonographic examinations were documented on hard copy and compared with current plain film radiographs. The sensitivity, specificity, positive predictive value, negative predictive value for the radiography as a test to detect properly positioned UVC were calculated. RESULTS: 1) In 23 of 40 newborns the UVCs were properly positioned by anteroposterior radiography (T8-T10), but ultrasonographic examination showed that 3 UVCs were malpositioned(false positive value 13%). Detection of properly located UVC by anteroposterior radiography had a sensitivity of 76.9%, specificity of 78.6%, positive predictive value of 87% and negative predictive value of 64.7%. 2) In 13 of 40 newborns the UVCs were properly positioned by anteroposterior radiography (T8- T9), ultrasonographic examination showed that all UVCs were positioned in RA and IVC(false positive value 0%). Detection of properly located UVC by anteroposterior radiography had a sensitivity of 50%, specificity of 100%, positive predictive value of 100% and negative predictive value of 51.9%. 3) In 18 of 40 newborns the UVCs were properly positioned by cross table lateral radio- graphy(less than 7mm between diaphragm and tip of UVC), but ultrasonographic examination showed that all UVCs were positioned in RA and IVC(false positive value 10.5%). Detection of properly located UVC by cross table lateral radiography had a sensitivity of 69.2%, specificity of 100%, positive predictive value of 100%, negative predictive value of 63.6%. CONCLUSION: Ultrasonographic catheter localization is a noninvasive technique that uses no ionizing radiation and has no known deterimental side effects, and allows direct visualization of the pertinent vascular anatomy and provides more information than traditional radiography. Use of ultrasonographic guidance at the time of UVC insertion allows the catheter position to be immediately adjusted, with confirmation of the amended position, obviating the need for repeated radiological evaluations. When ultrasonography is unavailable, proper placement of UVC can be estimated by use of radiography to position the tip of UVC between the eighth and ninth thoracic vertebral body by anteroposterior radiography and less than 7mm above or below the diaphragm by cross table lateral radiography.
Anatomic Landmarks ; Catheters* ; Diaphragm ; Humans ; Incidence ; Infant, Newborn* ; Korea ; Radiation, Ionizing ; Radiography* ; Sensitivity and Specificity ; Transducers ; Ultrasonography

No abstract available.
Free Tissue Flaps*

This study evaluated the effects of glucose in human retinal pigment epithelial (RPE) cells to investigate the cause of diabetic retinal complications. Human RPE cells were cultured in media containing 5.5 mM, 11.0 mM, and 16.5 mM D-glucose. The present study performed proliferation and migration assays, and conducted western blotting for the protein expression, as well as RT-PCR for the mRNA expression, of MMP-2 and -9, and TIMP-1 and -2. The results of the western blotting analysis showed that increasing glucose concentration significantly increased the expression of MMP-2 and -9, but significantly decreased the expression of TIMP-1 and -2. Moreover, the RT-PCR results indicated significant increases in the mRNA expression of MMP-2 and -9, as well as of TIMP-1 and -2, by raising glucose concentration. This study provides fundamental data for future research on the mechanism of retinal complication in diabetic patients.
Blotting, Western ; Cell Movement ; Cell Proliferation ; Cells, Cultured ; Comparative Study ; Dose-Response Relationship, Drug ; Glucose/*pharmacology ; Humans ; In Vitro ; Matrix Metalloproteinases/genetics/*metabolism ; Pigment Epithelium of Eye/*drug effects/enzymology ; RNA, Messenger/metabolism ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors ; Tissue Inhibitor of Metalloproteinases/genetics/*metabolism

Shortened dental arch (SDA) as a treatment goal is the concept that stable occlusion and enough masticatory force can be achieved by restoration to the second premolars when the situation is not favorable. SDA could be applied both natural teeth and implant supported fixed prostheses. This case dealt with a patient who has grade 2 intellectual disability and a lot of missing teeth. Because of intellectual disability, patient cooperation during treatment could not be expected. Therefore every treatment should be done under general anesthesia. In addition to that, ridge resorption around molar area was severe and there were maxillary sinus pneumatization and maxillary sinusitis which increased failure probability. SDA concept was adopted to reduce risk factor and minimize general anesthesia. After the treatment, functional and esthetic improvement was achieved and oral hygiene was fortified by periodic recall check and education.
Anesthesia, General ; Bicuspid ; Bite Force ; Dental Arch ; Humans ; Intellectual Disability ; Maxillary Sinus ; Maxillary Sinusitis ; Molar ; Mouth ; Mouth Rehabilitation ; Oral Hygiene ; Patient Compliance ; Prostheses and Implants ; Risk Factors ; Tooth

A primary tumor of mesenteric origin is rare. We encountered a malignant gastrointestinal stromal tumor (GIST) of mesenteric origin that demonstrated severe necrosis, and report the CT findings and review the literature.
Gastrointestinal Stromal Tumors* ; Mesentery* ; Necrosis