No abstract available.
Child* ; Humans ; Liver Cirrhosis* ; Liver*

Retropsoas space below the level of kidney has been suggested as a portion of inferior extensions of perirenal and anterior and posterior pararenal spaces. With this being true, the space may play an important role in disease extension. A study was performed to verify the existence of retropsoas peritoneal recess by means of identifying the extension of bowel loops into this space. Abdominal CT scans of 146 cases evaluated retrospectively revealed extension of 5 small bowel and 7 large bowel loops (6 descending and 1 ascending colons)(n=12/8.2%) into the retropsoas space verifying its existence. Since pathologic collection within the retropsoas space might be falsely inter preted as a retroperitoneal pathology and percutaneous uroradiologic intervention could result in intraperitoneal injury or contamination without the knowledge on the existence of this space, observation of this space is essential in CT scans.
Kidney ; Pathology ; Retrospective Studies ; Tomography, X-Ray Computed

Biofeedback is the treatment of choice for functional defecation disorders such as idiopathic chronic constipation and neurogenic fecal incontinence. The pre-existing biofeedback systems have many disadvantages. The aims of current project are, first, to develop the biofeedback system into the application software in the Windows environment, and, second, to assess the possibility of clinical usage for patients with functional defecation disorders. The hardware and software of the BASCO (Biofeedback Anal Sphincter Control) system were based on the signal measurement and signal processing of anal sphincter EMG (Electromyography). BASCO system was applied to 5 normal healthy controls and 20 patients with functional defecation disorders. Patients group was categorized as constipation group (N1=15) and incontinence group (N2=5). With use of current system, EMG-based biofeedback therapy was performed, and the outcome was analysed. Anal EMG signal data was processed by the software, and displayed in the monitor of personal computer. The software of EMG-display and database management were adequately operated. In N1 group, a paradoxical elevation or equalized activity of anal EMG pattern was shown in the simulated defecation. In N2 group, low electrical activity was shown. These findings were used for the EMG-based biofeedback therapy as a pilot study. The clinical symptoms were improved in 12 of N1 group and 3 of N2 group in the period of 3.7 (range, 1~12) months follow-up. In Conclusion, newly-developed BASCO system was adequately operated in the volunteer and patients groups. The multi-tasking and multi-processing functions were adequately shown in the real time. Current results could be used for clinical appraisal. Specifically, this system could be used for the practical application of biofeedback therapy in the patients with chronic constipation or fecal incontinence.
Anal Canal* ; Biofeedback, Psychology* ; Constipation ; Defecation* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Microcomputers ; Pilot Projects ; Volunteers

No abstract available.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile*

No abstract available.
Thioctic Acid*

PURPOSE: It has been known that there are several areas of T2 hyperintensities in normal white matter of brain, such as terminal zones of myelination, ependymitis granularis, ones of posterior internal capsule, and perivascular space. The aim of our study is to demonstrate another region of T2 hyperintensities in normal pediatric age group. MATERIALS AND METHODS: We have studied brain MR for 10 normal volunteers and 35 patients without having intracranial lesions in pediatric age group(3-19 years). RESULTS: In 5 among 45 cases, focal T2 hyperintensities were seen in the parietal periventricular white matter beneath the postcentral gyri. They were noted as poorly defined, 5--10mm sized areas of increased signal intensities on T2 weighted axial images. They were also characterized by bilateral, posteromedially oriented, short band-like or oval areas. Interestingly, they were directly continuous with the T2 hyperintensity of posterior internal capsule. In spite of the relatively high frequency in the pediatric population as in our study, this finding has not been reported in the asymptomatic adults. CONCLUSION: The results show that the bilateral anterior parietal hyperintense areas may be another terminal zones of delayed myelination affecting the parietopontine tract. They should be differentiated from pathologic T2 hyperintensities by their characteristic findings.
Adult ; Brain ; Healthy Volunteers ; Humans ; Internal Capsule ; Myelin Sheath ; Rabeprazole*

The authors observed one case of typical Kaposi's sarcoma who was 24 year old male. This patient complained of dark-brownish pigmented macules and oozing ulcer on the right knee joint area since at birth and the lesions were slowly growing and increased the number with pain. The skin lesions revealed 3*2.5cm sized dark-brownish colored macuIe, 2.5*3*1cm sized blood discharged nodule and 1* 1cm to l. 5* l. 5cm sized dark-brownish atrophic macules on the right inguinal area.Histopathologically, a biopsy was done on the right knee joint area, the finding showed angiomatous and fibrotic nature, I.e. the blood vessels in the dermis were dilated and increased in number. The endothelial cell was large and protrude into the lumen and showed small group of extravasated erythrocytes in granulation tissue, and showed extensive proliferation of spindle shaped cells that extended irregularly into various direction.
Biopsy ; Blood Vessels ; Dermis ; Endothelial Cells ; Erythrocytes ; Granulation Tissue ; Humans ; Knee Joint ; Male ; Parturition ; Sarcoma, Kaposi* ; Skin ; Ulcer ; Young Adult

Epithelial-myoepithelial carcinoma of intercalated duct(origin) is a recently described tumor characterized by its typical biphasic pattern of central duct like cell and peripheral clear cell. We described a case of epithelial-myoepithelial carcinoma in a 10-year-old boy. Microscopically, the tumor showed typical biphasic pattern, diffuse proliferation of clear cells and linining epithelial cells of tubular structures. Immunohistochemically, the clear cell showed positive reaction to S-100 protein, and the epithelial cells expressed cytokeratin indicating myoepithelial and epithelial differentiation respectively. Biphasic differentiation of the tumor cells could be also proved by electronmicroscopic study.

This study is based on 155 patients of congenital me colon. For the diagnosis, 93 cases were histologically proven and the remaining 63 cases were diagnosed on clinical basis including barium enema or surgical gross findings. On histologic examination, 80 cases(86%) showed typical features of absence of ganglion cell in the myenteric plexus and the 13 cases(14%) had atypical features which were segmental absence Of ganglion cell in one case. There we 127 males(82%) and 28 females(18%). The age at diagnosis was younger than 30 days in 87 cases(56%), I month to 1 year in 39 cases(25%) and older than I year in 29 cases(18%). The levels of aganglionosis were variable: short segment (rectosigmoid) in 134 cases(86%), intermediate segment (more proximal colon) in 14 cases(100%). and 6 cases(4%) had total aganglionosis. Common clinical presentations were abdominal distention, delayed meconium passage or bilious vomiting in neonate, and chronic constipation in infancy or childhood. Following initial colostomy or ileostomy, a definitive procedure was performed in 151 cases(Duhamel type in 150 cases; Soave type in 2 cases; Swenson type in 3 cases). Frequently associated problems after definitive procedure were persistent constipation(ll%) due to septum formation, fecaloma, remnant aganglionic segment and rectal stenosis. Overall mortality rate was 4%, and increased mortality was associated with enterocolitis(14%) which was the most frequent cause of death. The follow-up study longer than 3 months was available in 138 patients who underwent a definitive procedure(mean 2 year 11 months). Seventy-three cases(53%) had normal bowel function, 38cases(27.5%) had occasionally used enema or stool softners, and 27 cases(19.5%) had severe constipation or soiling. The bowel habit improved with time, and were considered normal in 60% of patients after follow-up more than 3 years. The results of definitive procedures for congenital megacolon including Duhamel operation was satisfactory, and long-term follow-up appeared an important and critical component of patients'care.
Child ; Male ; Female ; Infant, Newborn ; Humans ; Mortality ; Follow-Up Studies

The objectives of this study were to investigate the efficacy and dose-effect relationship for glycopyrrolate in the suppression of the oculocardiac reflex, and to compare glycopyrrolate with the reported equivalent dose of atropine. Glycopyrrolate 5 and 7.5ug/kg and atropine 10 and 15ug/kg were studied in 40 paediatric patients to assess more fully the dose of glycopyrrolate required for adequate prevention of the oculocardiac reflex. The results obtained were summarized as follows: 1) The increase in the mean heart rate 5 min after the test drug was statistically significant in all of the four groups. 2) Both drugs showed a dose-related response for reduction in slowing of heart rate after rectus muscle traction. 3) There is great individual variation in response to muscle traction within each group, no group being fully protected from marked slowing in heart rate. 4) The frequency of arrhythmias with low doses of both drugs was more than in high doses with both drugs.
Anesthesia* ; Arrhythmias, Cardiac ; Atropine* ; Child* ; Glycopyrrolate* ; Heart Rate* ; Heart* ; Humans ; Reflex, Oculocardiac ; Traction