BACKGROUND: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. MATERIAL AND METHOD: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. RESULT: There were 21 male and 6 female patients. Mean birth weight was 2.62+/-.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). CONCLUSION: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.
Birth Weight ; Cause of Death ; Colon ; Constriction, Pathologic ; Empyema ; Esophageal Atresia* ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mortality ; Retrospective Studies ; Tracheoesophageal Fistula

To measure the mutagenic activity of micro-organic pollutants in drinking water, mutagenic test was conducted using Salmnella typhimurium TA 98 strain on the water sample taken from three water supply station and six tap water in Seoul in July and November 1987. The results were as follows : 1. The average amounts of organic matters in raw, treated, and tap water sampled in July were 0.38mg/l, 0.28mg/l, and 0.45mg/l, respectively, and sampled in November were 0.34mg/l, 0.24mg/l, and 0.22mg/l, respectively. The amount of organic matters of tap water sampled in November did not increase while that of tap water sampled in July increased compare to those of raw or treated water. 2. The amount of organic matters is the highest in neutral fraction compare to acidic and basic fractions. 3. In the five out of six tap water and raw water of Paldang and Kuui station sampled in July, the mutagenic ratios were greater than two (both direct and indirect mutagenicity). 4. In the three out six tap water and raw and treated water of Kuui station sampled in November, the mutagenic ratios were greater than two. 5. While mutagenic were low in acidic and basic fraction, they were high in neutral fraction. The samples which had high mutagenic activity in the total amount also showed high mutagenic activity in neutral fraction. 6. While mutagenic activity was decreased after the treatment of water, it was increased in tap water as the distance from the water supply station increases.
Drinking Water* ; Drinking* ; Seoul* ; Water ; Water Supply

No abstract available.
Amniotic Fluid* ; Corticotropin-Releasing Hormone* ; Female ; Obstetric Labor, Premature* ; Pregnancy

No abstract available.

No abstract available.
Cisterna Magna*

No abstract available.
Gestational Trophoblastic Disease*

PURPOSE: In the management of Hirschsprung's disease (HD), conventional Duhamel's, Swenson's or Soave's procedures have generally been performed. The author tried a new procedure, a transanal one-stage pull-through procedure (TOP). The aim of this study is to compare functional outcome of TOP with the conventional procedures that are generally used in treating HD. METHODS: Thirty-one cases received TOP procedure from November 2000 to December 2003. The postoperative results were evaluated by performing a retrospective medical record review, and by using as questionnaire. These results were then compared with reports' on patients after using one of the conventional procedures. RESULTS: In this study, the mean age of patients was 73.4 days, the mean hospital stay was 5.7 days and the mean follow-up period was 20.1 months. Postoperative results were as follows: (1) 23 cases (74.2%) had 1~2 times of defecation per day. (2) 26 cases (83.9%) had no problematic soiling. (3) 22 cases (70.9%) had soft consistency of stool. (4) 24 cases (77.4%) had no straining during defecation. (5) 25 cases (80.7%) didn't need stool softner. (6) In 14 cases (45.2%), an anal dilator was necessary for transient postoperative anal stricture. (7) After 24 months of age, a diaper was not necessary in 12 cases (70.6%). (8) The parents felt satisfactory in 28 cases (90.3%) for their children, as compared with the children from other families, and the parents felt satisfactory in 18 cases (94.7%) for the HD children compared with the other children of their family.(9) 23 cases (74.2%) had not shown constipation findings on simple abdomen film. (10) At the first digital rectal examination, perianal rash was found in 13 cases (41.9%), anastomotic stricture had occurred in 12 cases (38.7%), and normal squeezing pressure was felt in 27 cases (87.1%). However, at the last examination during the follow-up period, perianal rash was found in 2 cases (6.5%), the anastomotic stricture had not persisted, and normal squeezing pressure was felt in all cases (100%). (11) On the barium study, 13 months after operation, no retention of contrast within 24 hours was shown in 21 cases (95.5%). (12) According to the SanFilippo system, there were 24 excellent cases (77.4%) and 7 good cases (22.6%), so all the cases showed a favorable functional outcome. (13) In comparison with other reports' results, there was no significant difference between the author's outcomes and other reports' outcomes (p=0.752). CONCLUSION: This transanal one-stage pull-through procedure (TOP) seems to be as effective as the traditional method for the management of HD.
Abdomen ; Barium ; Child ; Constipation ; Constriction, Pathologic ; Defecation ; Digital Rectal Examination ; Exanthema ; Follow-Up Studies ; Hirschsprung Disease* ; Humans ; Length of Stay ; Medical Records ; Parents ; Surveys and Questionnaires ; Retrospective Studies ; Soil

BACKGROUND: Epidermal growth factor (EGF) , a potent stimulant of epithelialization, has been noted to increase the tickness of the epidermis, increase the epithelial cell proliferartion and keratinization, and accelerate wound contraction. OBJECTIVE: Our purpose was to evaluate the efficacy of topical application of recombinant human epidermal growth factor (rhEGF) in the healing of full-thickness excision and burn wound. METHODS: Full-thickness excision and burn wound were made on the back of the male Wistar rat. Recombinant human epidermal growth factor was applied twice a day and the size of the wound was measured with planimetry every other day for 21 days. The keratinocytes of the circumcised foreskin were cultured in different concentrations of recombinant human epidermal growth factor and proliferation of the keratinocytes was evaluated. RESULTS: 1. Regardless of wound types or base types, wound healing in the experimental groups (rhEGF 10, 30, 50g/g) was generally better than that in the control or vehicle group. 2. The duration of wound healing was decreased as follows in order; in full-thickness excision wound, rhEGF 50 g/g group, rhEGF 30 g/g group, rhEGF 10 g/g group, vehicle group, and control group and in full-thickness burn wound, rhEGF 30 g/g group, rhEGF 50g/g group, rhEGF 10g/g group, vehicle group, and control group. 3. In the biopsy specimen taken from the wound at 9th and 13th day, neodermis, neovascularization, the thickness and maturation of the collagen bundles, and reepithelithelialization were more increased in the experimental groups than in the control or vehicle group. 4. In vitro culture of epidermal cells showed similar proliferation in the concentration of rhEGF higher than 10 ng/ml. CONCLUSION: these findings suggest that topical application of recombinant human epidermal growth factor in the healing of full-thickness excision and urn wound.
Animals ; Biopsy ; Burns ; Collagen ; Epidermal Growth Factor* ; Epidermis ; Epithelial Cells ; Foreskin ; Humans ; Keratinocytes ; Male ; Rats ; Ticks ; Wound Healing* ; Wounds and Injuries*

No abstract available.
Orientia tsutsugamushi* ; Rickettsia* ; Ulsan*

BACKGROUND/AIMS: Pancreaticoduodenectomy is the procedure of choice in patients with periampullary cancers. Marked improvements in morbidity and mortality rates following pancreaticoduodenectomy have been reported in recent years. However, pancreatic leakage still occurs in 5% to 25% of patients and is a major cause of morbidity and mortality. METHODS: Between January 1990 to June 1999, eighty-two patients underwent pancreaticoduodenectomy. We compared preoperative, intraoperative characteristics as well as postoperative sandostatin usage in those patients who experienced (n=21) versus those who did not experience pancreatic leakage (n=61). Information was retrospectively collected from hospital record. RESULTS: The clinical leakage rate in this series was 25.6% (n=21). There were no significant differences in preoperative characteristics comparing those with versus those without pancreatic leakage. Among intraoperative characteristics, duct stenting and transfusions were significantly associated with the pancreatic leakage. Finally, postopeative sandostatin usage was able to reduce significantly the incidence of pancreatic leakage. CONCLUSION: Although consensus among surgeons does not exist as to opeative tenchnique and postoperative management, stenting and less bleeding as well as sandostatin usage had better results in this study.
Consensus ; Hemorrhage ; Hospital Records ; Humans ; Incidence ; Mortality ; Octreotide ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Retrospective Studies ; Stents