No abstract available.
Intervertebral Disc*

OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

This study was carried out for the comparison of the head postures between mouth breathers and normal nasal breathers. For this purpose, a test group of 28 mouth breathers, between the ages of 8 to 12 years old and a control group of 25 nasal breathers were used. Following results were obtained after comparing the craniofacial and craniocervical angulations to the True Vertical line. 1. In the comparisions relating to the True Vertical Line, results were obtained using four items; NSL/VER, FH/VER, NL/VER, PMV/VER. Variations were observed in all the items and the craniofacial angulations in the mouth breathers group showed more superior position compared to the control group. 2. In the comparisions relating to the craniocervical angulations, results were obtained using four items; NSL/OPT, FH/OPT, NL/OPT, PMV/OPT. Variations between the two groups were observed only in the PMV/OPT item and the mouth breather group showed more craniocervical angulations compared to the control group.
Child ; Head* ; Humans ; Mouth* ; Posture*

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.
Asia ; Asian Continental Ancestry Group* ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Financial Management ; Humans ; Internship and Residency ; Intubation ; Patient Care ; Patient Transfer ; Peer Review ; Triage ; Ultrasonography

No abstract available.

BACKGROUND: The use of caudal morphine for postoperative analgesia has been increased in popularity since 1981. The purpose of this study was to compare the effect of analgesia and incidence of side effects of a mepivacaine-morphine mixture with mepivacaine alone. METHODS: Forty patients were randomly divided into two groups. In group 1, caudal block was performed with 1% mepivacaine 1 ml/kg alone. In group 2, caudal block was performed with 1% mepivacaine 1ml/kg-morphine 0.03 mg/kg mixture. Postoperative five-point pain scores and side effects were measured. RESULTS: There were no significant differences in sedation dose, incidence of side effects and supplemental analgesics. Pain scores were significantly lower at postoperative 2 and 3 hours in mepivacaine-morphine mixture group. CONCLUSIONS: Caudal epidural mepivacaine-morphine (0.03 mg/kg) mixture is effective in children for control of postoperative pain without significant side effects.
Analgesia* ; Analgesics ; Child* ; Humans ; Incidence ; Mepivacaine ; Morphine* ; Pain, Postoperative

The recurrence is common problem to treat pterygium. Many surgical procedures were adopted to reduce the recurrence rate. We evaluated the surgical results of limbal conjunctival autograft transplantation (LCAT) accompanying application of 0.02% mitomycin C intraoperatively in 10 patients (10 eyes) who had a recurrent pterygium. There were 7 eyes with first recurrence and 3eyes with second recurrence. Mean age of the patients was 57.4 years, and mean follow-up period was 9.3 months. After a pterygium was excised, a sponge soaked in a solution of mitomycin C 0.02% was applied to the sclera at the site of the surgical bed for 2 minutes, then superior temporal limbal tissue was taken with conjunctival flap and transplanted to the excised area. None of all cases recurred for follow-up period and donor conjunctival site was well reepithelialized. In concluion, LCAT accompanying application of 0.02% mitomycin C intraoperatively was effective and safe method for recurrent pterygium.
Autografts* ; Follow-Up Studies ; Humans ; Mitomycin* ; Porifera ; Pterygium ; Recurrence ; Sclera ; Tissue Donors

BACKGROUND: Residual pleural thickening is frequently seen following treatment for tuberculous pleurisy, and pleural decortication is performend occasionally in patients with severe residual pleural thickening. However, predictive factors for the development of residual pleural thickening are uncertain at the initial diagnosis of the tuberculous pleurisy. Therefore, the purpose of this study was to identify the associated factors for residual pleural thickening at initial diagnosis. METHODS: We separated 63 patients diagnosed as tuberculous pleurisy into two groups; group 1 consisted of patients without residual pleural thickening and group 2 comprised patients with residual pleural thickening at the end of tuberculous pleurisy treatment. We analyzed the clinical characteristics, radiological findings, pleural biopsy and characteristics of pleural fluid between group 1 and group 2. RESULTS: The study population and clinical symptoms of the two groups were not significantly different and the duration of symptoms before treatment and the peripheral WBC were similar between the two groups. The presence of pulmonary tuberculosis, pleural fluid loculation or the amount of pleural effusion sid not differ significantly between the thwo groups. The incidence of positive AFB staining(group 1 : 8%, group 2 : 38%) and granuloma(group 1 : 30%, group 2 : 62%) on pleural biopsy specimens was significantly higher in group 2 than in group 1. Pleural fluid WBC and differential count, adenosine deaminase level, pH, preotein level or glucose level did not differ between the two groups. However, group 2 had higher LDH levels (1370±208mg/dl) than group 1 (860±71mg/dl, p<0.05). CONCLUSION: In tuberculous pleurisy, patients with residual pleural thickening following treatment demonstrated a higher incidence of posivive AFB staining and granuloma on the pleural biopsy specimens or higher LDH level in the pleural fluid than patients wihtout residual pleural thickening From these results, we speculate that the amonut of tuberculous bacilli and granuloma are probably correlated with residual pleural thickening in the tuberculous pleurisy.
Adenosine Deaminase ; Biopsy ; Diagnosis ; Drug Therapy* ; Glucose ; Granuloma ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Pleural Effusion ; Pleurisy* ; Sudden Infant Death ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

Polycystic ovary syndrome is characterized by symptoms of oligomenorrhea, amenorrhea, infertility, hirsutism and obesity. It is known that the women with such diseases would have higher risks to coronary heart diseases, hypertension, DM and endometrial cancer later on, Known risk factors of endometrial cancer are nullipara, late menopause, obesity, DM, unopposed estrogen, tamoxifen treatment, and atypical endometrial hyperplasia ect. 75% of endometrial cancer occurs in age over 50 and 4% of endometrial cancer occurs in age under 40. Particulary endometrial cancer concurrent polycystic ovary syndrome occurs usually in people under age 40 and is commonly well differentiated cell type and is related to good prognosis. We experienced a case of endometrial cancer with polycystic ovary syndrome, who was early dignosed, presented with infertility and got an operation in our hospital, and report this case with a brief review of literature.
Amenorrhea ; Coronary Disease ; Endometrial Hyperplasia ; Endometrial Neoplasms* ; Estrogens ; Female ; Hirsutism ; Humans ; Hypertension ; Infertility ; Menopause ; Obesity ; Oligomenorrhea ; Polycystic Ovary Syndrome* ; Prognosis ; Risk Factors ; Tamoxifen

A clinicostatistical study was made in 405 cases who were admitted to department of pediatrics, general surgery, urology, gynocology of N.M.C. for abdominal surgery from 1973 to 1978 and following results were obtained. 1. Distribution and incidece of surgical abdomen diseases showed acute appendicitis 107 cases(26.4%), inguinal hernia 82 cases(20.2%), intussusception 73 casese(18.0%) and intestinal obstructuction due to congenital origin 47 cases(11.6%). 2. Male was more predominant than female in proportion of 2.32:1. Age distribution revealed highest frequency in 10-15 years with 125 cases(30.8%) followed by 1 month to 1 year with 105 cases(25.9%). 3. In 47 casess of intestinal obstruction due to congenital origin, 3 common diseases were imperforated anus 14 cases, congenital megacolon 12 cases and congenitalpyloric stenosis 12 cases. 4. In 19 cases of acquired intestinal obstruction except intussusception and inguinal hernia, the most common cause was adhesion 10 sease(52.6%). 5. In 30 cases of abdominal mass, wilm's tumor was the commonest with 8 cases(26.7%). 6. In 19 cases of intestinal bleeding and perforation, accidental injury was the commonest cause with 12 cases(63.2%). 7. Highest incidence of diseases in relation to age group were as follows: newborn infant: intestinal obstruction due to congenital origin(96.7%), 1 month-1 year: intussusception (55.7%), 1-2year and 2-6year; inguinal hernia(46.3% and 50.0%), 6-10years and 10-15years; acute appendicitis(52.1% and 61.2%). 8. Overall mortality rate was 6.2%(25 out of 405 cases) and the highest mortality rate was noted in congenital anomaly with 23.1%(12 out of 52 cases).
Abdomen* ; Age Distribution ; Anal Canal ; Appendicitis ; Child* ; Constriction, Pathologic ; Female ; Hemorrhage ; Hernia, Inguinal ; Hirschsprung Disease ; Humans ; Incidence ; Infant, Newborn ; Intestinal Obstruction ; Intussusception ; Male ; Mortality ; Pediatrics ; Urology ; Wilms Tumor