No abstract available.
Twins, Conjoined*

No abstract available.
Twins, Conjoined*

Two cases of vaginal injury due to Coitus are presented. One is the case of the laceration of midportion of posterior vaginal wall with shock and the other one in the laceration of posterior vaginal fornix and pelvic peritoneum. They are all in multiparity. And a review of literature on vaginal injury due to coitus is made briefly.
Coitus* ; Female ; Lacerations ; Parity ; Peritoneum ; Shock

The effectiveneas of compression plate fixation in promoting fracture healing could be due to a specific stimulus of compression on bone formation or to enhanced immobilization. ASI type heavy plate fixation for fracture of the femoral shaft was examined on occasions in three patient in the period 1971–1973. We believe that the major effect of the compression as applied through a compression plate is that of enhanced stabilization.
Fracture Healing ; Humans ; Immobilization ; Osteogenesis

Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent (60.2%). 3. The most common indications for cesarean section were previous cesarean section (30.2%), CPD (26.9%), malpresentation (22.7%), and fetal distress (3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion (31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499 gm was the most prevalent (39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most (97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7. Among the cause of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin. and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10 gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased (44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbidity of lower segment transverse cesarean section was the least (14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.
Anesthesia ; Anesthesia, General ; Cesarean Section* ; Cystectomy ; Emergencies ; Female ; Fetal Distress ; Fever of Unknown Origin ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Infant ; Membranes ; Pregnancy ; Retrospective Studies ; Rupture ; Sterilization ; Urinary Tract Infections ; Wound Infection

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condy le, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.
Abscess ; Accidents, Traffic ; Analgesics ; Bandages ; Burns, Chemical ; Curettage ; Dental Pulp ; Drainage ; Education ; Emergencies* ; Emergency Medical Services ; Foreign Bodies ; Gangwon-do* ; Head and Neck Neoplasms ; Hemorrhage ; Hemostasis ; Humans ; Hypnotics and Sedatives ; Incidence ; Jaw Fractures ; Male ; Neuritis ; Oral Hemorrhage ; Primary Health Care ; Republic of Korea ; Retrospective Studies ; Sialadenitis ; Soft Tissue Injuries ; Stomatitis ; Stomatognathic Diseases ; Surgery, Oral ; Sutures ; Temporomandibular Joint Disorders ; Toothache ; Trigeminal Neuralgia ; X-Ray Film

Background/Aims: The use of endoscopic submucosal dissection (ESD) for treating undifferentiated-type early gastric cancer is controversial. The objective of this study was to perform a meta-analysis to compare the long-term outcomes of ESD and surgery for undifferentiated-type early gastric cancer. Methods: The PubMed, Cochrane Library, and EMBASE databases were used to search for relevant studies comparing ESD and surgery for undifferentiated-type early gastric cancer. The methodological quality of the included publications was evaluated using the Risk of Bias Assessment tool for Nonrandomized Studies. The rates of overall survival, recurrence, adverse event, and complete resection were determined. Odds ratios (ORs) and 95% confidence intervals (CIs) were also evaluated. Results: This meta-analysis enrolled five studies with 429 and 1,236 participants undergoing ESD and surgery, respectively. No significant difference was found in the overall survival rate between the ESD and surgery groups (OR, 2.29; 95% CI, 0.98–5.36; p=0.06). However, ESD was associated with a higher recurrence rate and a lower complete resection rate. The adverse event rate was similar between the two groups. Conclusions ESD with meticulous surveillance esophagogastroduodenoscopy may be as effective and safe as surgery in patients with undifferentiated-type early gastric cancer. Further large-scale, randomized, controlled studies from additional regions are required to confirm these findings.

Background/Aims: The use of endoscopic submucosal dissection (ESD) for treating undifferentiated-type early gastric cancer is controversial. The objective of this study was to perform a meta-analysis to compare the long-term outcomes of ESD and surgery for undifferentiated-type early gastric cancer. Methods: The PubMed, Cochrane Library, and EMBASE databases were used to search for relevant studies comparing ESD and surgery for undifferentiated-type early gastric cancer. The methodological quality of the included publications was evaluated using the Risk of Bias Assessment tool for Nonrandomized Studies. The rates of overall survival, recurrence, adverse event, and complete resection were determined. Odds ratios (ORs) and 95% confidence intervals (CIs) were also evaluated. Results: This meta-analysis enrolled five studies with 429 and 1,236 participants undergoing ESD and surgery, respectively. No significant difference was found in the overall survival rate between the ESD and surgery groups (OR, 2.29; 95% CI, 0.98–5.36; p=0.06). However, ESD was associated with a higher recurrence rate and a lower complete resection rate. The adverse event rate was similar between the two groups. Conclusions ESD with meticulous surveillance esophagogastroduodenoscopy may be as effective and safe as surgery in patients with undifferentiated-type early gastric cancer. Further large-scale, randomized, controlled studies from additional regions are required to confirm these findings.

PURPOSE: The prevalence and incidence of the superior mesenteric ischemic diseases are increasing nowadays because of the increase of aged people and cardiovascular diseases. The morbidity and mortality of the superior mesenteric ischemic diseases are so high and detrimental because acute mesenteric infarction results post operatively reperfusion injury short bowel syndrome and sepsis. A successful management requires very efficient diagnostic and therapeutic measures. So, we reviewed the medical records of superior mesenteric ischemic diseases and identified the clinical and therapeutic characters of these disease. METHOD: Between January 1991 and December 2000, 33 patients with a clinical diagnosis of superior mesenteric ischemic diseases supported by clinical and imaging studies were included in this study. The medical records of the 33 patients who had admitted Korea University Hospital were reviewed retrospectively and identified the clinical characters, the diagnostic tools, underlying diseases and the therapeutic modalities. RESULT: The most common cause of theses disease was the superior mesenteric arterial embolism and the peak incidence was identified in 7th and 8th decades. These diseases were diagnosed with physical examination, abdominal CT or angiogram, but almost half of them were identified at the operative field. 29 patients were treated surgically and the rest of them were medically. At result 12 patients died of these diseases (36.4%). The high WBC count (15,000/ml) and shock were considered as prognostic factors predicting for the mortality (p=0.005). CONCLUSION: The old persons who were suffered from the nonspecific abdominal pain should be suspected of these diseases and treated with properly applied diagnostic tools and therapeutic modalities, especially they show the leukocytosis and the clinical evidence of shock.
Abdominal Pain ; Cardiovascular Diseases ; Diagnosis ; Embolism ; Humans ; Incidence ; Infarction ; Ischemia ; Korea ; Leukocytosis ; Medical Records ; Mortality ; Physical Examination ; Prevalence ; Reperfusion Injury ; Retrospective Studies ; Sepsis ; Shock ; Short Bowel Syndrome ; Tomography, X-Ray Computed