This is a clinical analysis of 48 patients who had tuberculous peritonitis laparoscopically confirmed at the Gastroenterologic Department of the Korea University Hae Wha Hospital from March 1980 to February 1988, and the results are as fallows: 1) The ratio of male to female was 1:1.7, and the age of the peak incidence was the third decade. 2) The freqeent symptoms were abdominal distension (77.1%), abdominal pain (60.4%), and fever (60.4%); others were indigestion (27.1%), diarrhea (18.8%), weight loss (6.3%), abdominal mass (6.3%), vomiting (6.3%), and dysmenorrhea (2.1%). The freguent physical signs were ascites (93.8%) and abdominal tenderness (45.8%); others were palpable mass (8.3%), hepatomegaly (8.3%), and mild jaundice (4,2%). 3) Hematologic findings in mean value revealed 11.8 g/m% in hemoglobin, 6088/mm in WBC, and 36 mm/hour in ESR, 4) Ascitic analysis revealed 1,031 in specific gravity, 5.2% in protein, and 1700/mm in WBC count with lymphocytic predominance (83%). AFB stain and culture were all negative in the specimens less than 20 ml. 5) On chest X-ray, pulmonary Tuberculosis or associated lesions were noted in 19 patients (39.6%). 6) Studded whitish miliary tubercle, omental change, ad adhesions were noted in a mixed nature. 7) Classifications according to laparoscopic finding revealed wet type in 28 patients (58.3%), mixed type in 13 patients (27.1%), and dry type in 7 patients (14.6%); and laparoscopic type was not related with the duration of symptom up to admission. 8) Microscopic finding of biopsy specimens revealed caseous necrosis or granuloma in 43 patient (89.6%) and nonspecific inflammation in 5 patients. In these 5 patients, characteristic gross findings of tuberculous peritionitis were noted. 9) Intestinal perforation was developed in 2 patients.
Abdominal Pain ; Ascites ; Biopsy ; Classification ; Diarrhea ; Dysmenorrhea ; Dyspepsia ; Female ; Fever ; Granuloma ; Hepatomegaly ; Humans ; Incidence ; Inflammation ; Intestinal Perforation ; Jaundice ; Korea ; Male ; Necrosis ; Peritonitis, Tuberculous* ; Specific Gravity ; Thorax ; Tuberculosis, Pulmonary ; Vomiting ; Weight Loss

PURPOSE: This study aims to investigate gender differences in the association between depressive symptoms and weight, weight perception, and body satisfaction among Korean adolescents. METHODS: A secondary data analysis was performed on data from 33,374 adolescents who participated in the 2015 Adolescent Health Behavior Online Survey. They were classified as underweight, normal weight, or overweight/obese; weight perception was classified into perception of being underweight, normal weight, or overweight/obese; and weight satisfaction into desire to gain weight, satisfied, and desire to lose weight. RESULTS: Among boys, perception of being underweight (adjusted odds ratio [AOR]: 1.20, 95% confidence interval [CI]: 1.07~1.35) and desire to gain weight (AOR: 1.45, 95% CI: 1.30~1.62) were associated with depression. Among girls, perception of being overweight or obese (AOR: 1.18, 95% CI: 1.07~1.29) and a desire to lose weight (AOR: 1.30, 95% CI: 1.18~1.42) were associated with depression. CONCLUSION: Gender differences were observed in the association between weight perception and depression in adolescents. The perception of being underweight among boys and the perception of being overweight/overweight among girls were associated with depression. Thus, gender-specific intervention programs to correct weight perception and weight satisfaction are needed in order to relieve depressive symptoms in adolescents.
Adolescent Health ; Adolescent* ; Body Weight ; Depression* ; Female ; Humans ; Ideal Body Weight ; Odds Ratio ; Overweight ; Statistics as Topic ; Thinness ; Weight Perception*

PURPOSE: The purpose of this study was to evaluate the spectrum of MR characteristics of cystic acoustic neurinomas and to correlate with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the MR findings of 12 patients with cystic acoustic neurinomas. The signal intensity and enhancement pattern of the cystic components as well as the location relative to the tumors were analyzed. RESULTS: A total of 30 cysts were found in 15 acoustic neurinomas;28 were intratumoral cysts and the remaining two were extratumoral cysts. The signal intensity of all 28 intratumoral cysts was higher than that of CSF on Tl-weighted images, and isointense to CSF on T2-weighted images, while the signal intensity of the two extratumoral cysts was same as CSF on both Tl-weighted and T2-weighted images. Rim enhancement was seen in 27 of 28 intratumoral cysts but in none of the two extratumoral cysts. CONCLUSION: We concluded that intratumoral cyst was due to tumoral necrosis, hemorrhage or degenerative change and extratumoral cyst due to secondary arachnoid cyst formation.
Acoustics* ; Arachnoid ; Hemorrhage ; Humans ; Necrosis ; Neuroma, Acoustic* ; Retrospective Studies

Spinal epidural abscesses were evaluated using Gadolinium-enhanced magnetic resonance imaging (MRI) in 19 surgically and clinically confirmed cases, including 13 with tuberculous spondylitis and 6 with pyogenic spondylitis. We observed rim enhancement patterns in 10 patients and diffuse enhancement patterns in 9 patients. The spread patterns were localized to ventral or dorsal epidural space and encircled entire epidural space. We conclude that rim enhancement indicates abscess and diffuse enhancement indicates granulation tissue and fibrosis. Tuberculous epidural abscess spreads to ventral epidural space and pyogenic epidural abscess encircles entire epidural space.
Abscess ; Epidural Abscess* ; Epidural Space ; Fibrosis ; Granulation Tissue ; Humans ; Magnetic Resonance Imaging* ; Spondylitis

Intracavitary metastasis is an uncommon secondary cardiac malignancy and metastasis to the right atrium and ventricle is even less common. Prior reports have demonstrated an association of this disease entity with sudden death. We report a recent experience of intracavitary cardiac metastasis of a primary hepatoma in a 24-year-old woman who presented with a exertional dyspnea and a syncopal episode.
Carcinoma, Hepatocellular* ; Death, Sudden ; Dyspnea ; Female ; Heart Atria ; Humans ; Neoplasm Metastasis* ; Syncope ; Young Adult

PURPOSE: The purpose of this study is to evaluate the CT and MR findings of brain absecss with emphasis on the thickeness and signal intensity of abscess wall. MATERIALS AND METHODS: Twenty CT scans and seven MR studies of 23 patients with brain abscess (27 abscesses) were retrospectively reviewed with respect to thickeness and signal intensity of abscess wall, shape and size of abscess, etc. Thickness of abscess wall was measured in the greatest abscess diameter on the CT scans and MR images obtaihed after intravenous administration of contrast material. RESULTS: Enhancing abscess wall was 2mm--6mm (average 3mm) thick. The abscess wall was uniform in thickness in 14 cases (52%), thinner in the roedial wall than lateral wall in 8 cases (30%), and thicker in the medial wall than lateral wall in 5 cases (18%). Signal intensity of abscess wall was isointense relative to gray matter on Tl-weighted MR images and hypointense on both proton- and T2-weighted MR images in 7 out of 8 lesione (88%). The inner margin of the abscess wall was smooth in 14 (52%) and irregular in 13 lesions (48%). The outer margin was smooth in 15 (55%) and irregular in 12 lesions (45%). The size of the abscesses was variable, ranging from lcm to 6cm in diameter. They were round (16 cases), elliptical (6 cases), or multilobulated (5 cases) in shape. Satellite or daughter abscesses were found in 5 patients. CONCLUSION: Abscess wall showed variable thickness in the medial and lateral walls with no specific findings. Other CT and MR findings were also nonspecific, although hypointensity of abscess wall on T2-weighted MR images may be helpful in diagnosis of brain abscess.
Abscess* ; Administration, Intravenous ; Brain Abscess* ; Brain* ; Diagnosis ; Humans ; Nuclear Family ; Retrospective Studies ; Tomography, X-Ray Computed

The sacral area is the most frequent site of pressure sore. Because bony prominence is broad and flat along with little soft tissue padding. Between many muscle flaps, the gluteus maximus myocutaneous flap is the most reliable one for surgery of sacral pressure sores. After complete resection of ulcer, the gluteus maximus muscle detached from its original site including posterior iliac crest. After adequate dissection proceeded and bony prominence removed, flap repair is done at the central line. When performing this flap, most surgeon use elliptical design and incision. In the past, we also used elliptical incision and sometimes experienced some drawbacks especially when wound extended close to anus. There are difficulties on repair of perianal skin, central tension of long vertical scar, perianal skin adhesion and natal cleft distortion and resulting asymmetry of gluteal contour and contamination of operation site by defication. After review of the photographs in the references dealing with pressure sores, we had an impression that there are skin adhesion near the anus in some cases and actually experienced such cases in other surgeon's operations. This time, we applicate new design called the "Bomb-shape" design when performing this flap to patients who have a broad wound extent close to anus or perianal skin. The "Bomb-shape" design is a concept of adding bilateral subcutaneous incisions to lower part of classic elliptical incision and we named as such because it resembles the military bomb in shape. We expect the effect of preserving the perianal skin and preventing the skin adhesion or natal cleft distortion and performed this procedure in 15 patients whose defect close to anus. Consequently, benefits of this method are spreading tension of vertical scar, decreased contamination in wound care, earn skin stability without perianal skin adhesion or natal cleft distortion, so maintain the symmetry of gluteal contour and get better cosmetic result. There is no significant increase in operation time in that no need of handling the "dog-ear", and all 15 patients have good results and are satisfied, so we introduce this flap design carefully with concurrent review of literature.
Anal Canal ; Bombs ; Cicatrix ; Concurrent Review ; Humans ; Military Personnel ; Myocutaneous Flap ; Pressure Ulcer* ; Skin ; Ulcer ; Wounds and Injuries

Generally we use the preauricular incision to access and remove the parotid gland tumor. But the preauricular approach has some complications such as damage of facial nerve and sensory nerve, Frey's syndrome, and postoperative scar. Especially, the postoperative scar can often cause an unesthetic result and mental stress in young patients. Therefore, if we avoid preauricular incision to be performed outside of tragus, the postoperative scar would be hardly remarkable, and patients would be satisfied cosmetically. We performed surgical excision using a modified endaural and neck approach in a 21-year-old female with a pleomorphic adenoma and 15-year-old male with a neurofibroma occured in the parotid gland. A new, modified endaural and neck approach is a combined method of the modified endaural incision by Starck et al and Gutierrez's neck extension. We obtained an adequate access and the cosmetically acceptable postsurgical scar. The postoperative scars were hidden in the external ear and the hairline. Moreover, except the neck dissection can this approach be applied to the surgery of temporomandibular joint as well as the parotid gland tumor.
Adenoma, Pleomorphic ; Adolescent ; Cicatrix ; Ear, External ; Facial Nerve ; Female ; Humans ; Male ; Neck Dissection ; Neck* ; Neurofibroma ; Parotid Gland* ; Sweating, Gustatory ; Temporomandibular Joint ; Young Adult

BACKGROUND: For the evaluation of infectious or inflammatory disease, Tc-99m HMPAO WBC scan has been used. But techniques involving radiolabelled leukocytes scan were difficult, and have failed to distinguish between bacterial infection and non-bacterial inflammation. To overcome this difficulty, we evaluated Tc-99m Ciprofloxacin in clinically suspected bacterial infection. METHODS: We used this agent for 31 patients who had suspected sites of infection. And then we compared the imaging results of these patients with those of radiolabelled leukocyte scan. RESULTS: There was no adverse effect. 29 patients was involved for the interpretation. Infective spondylitis was the most common suspected disease (41%). Bateriologic culture was positive in 10 patients. The most common organism was meticillin-susceptible S. aureus (5 cases). The sensitivity and specificity of Tc- 99m Ciprofloxacin was 83.3% and 66.6%, and those of Tc-99m HMPAO WBC was 62.5% and 83.3%, repectively. For the diagnosis of infective spondylitis the sensitivity of Tc-99m Ciprofloxacin was 80.0% and that of Tc-99m HMPAO WBC was 40.0%. CONCLUSOIN: Tc-99m Ciprofloxacin shows relatively high sensitivity and specificity. Tc-99m Ciprofloxacin was superior to Tc-99m HMPAO WBC for the diagnosis of infection in axial skeleton.
Bacterial Infections ; Ciprofloxacin* ; Communicable Diseases* ; Diagnosis* ; Humans ; Inflammation ; Leukocytes ; Sensitivity and Specificity ; Skeleton ; Spondylitis ; Technetium Tc 99m Exametazime

One hundres and two cases of traumatic liver injury were treated during 11 years from January 1986 to December 1996 at the department of surgery, Chunchon Sacred-Heart Hospital, Hallym University, and analysis of clinical manifestation and factors affecting to the mortality were carried out, and the results were as follows. The male to female ratio was 2.6:1. The liver is most commonly injuried following blunt trauma, and the most common cause of blunt trauma was automobile accidents(83.3%). Right lobe injuries consisted of 82.4% of the cases, left lobe injuries were 11.8%, and injuries affecting both lobes were 5.9%. Among the clinical symptoms, peritoneal irritation sign was most common(52.9%). Other symptoms consisted of adominal distension(46.1%), chest pain or dyspnea(42.2%), abdominal wound(12.8%). Arriving at emergency room, patients with shock symptoms were present in 10.8% of all cases. Needle abdominal, paracentesis was performed in 44 cases, and a positive tap showed in 33 cases. In 44.1% of the cases, the liver injury was accompanied with rib fracture, 36.3% with hemothorax or pneumothorax, 32.4% with fracture of long-bone, 17.7% with head injury. Accompaning injuried intraabdominal organs that occured in order from highest to lowest percentage were the kidneys, spleen, small intestines, large intestines, stomach, diaphragm, pancreas and duodenum. Using the AAST Organ Injury Severity Classification, Grade II injuries were 31.4%, Grade I injuires were 28.4%, and Grade III injuries were 19.6%. Conservative management was the preferred method in 26 cases, and operations were performed in 76 cases. Suture and drainage were performed in 66 cases. Hepatic resection procedures were perfromed in three cases. The incidence of complication was 44.1%. The most common post-operative complications were respiratory problems, such as atelectasis, pneumonia, pleural effusion, and ARDS. The mortality rate was 15.7%, and the most common cause of death was hypovolemic shock due to massive bleeding. Accompanying head injuries, renal failue, and ARDS were also cause of death. Factors affecting to the mortality were the severity of the injury, the prescence of shock, systolic blood pressure at arrival, initial value of hematocrit, and the prescence of the abdominal distension.
Automobiles ; Blood Pressure ; Cause of Death ; Chest Pain ; Classification ; Craniocerebral Trauma ; Diaphragm ; Drainage ; Duodenum ; Emergency Service, Hospital ; Female ; Gangwon-do ; Hematocrit ; Hemorrhage ; Hemothorax ; Humans ; Incidence ; Intestine, Small ; Intestines ; Kidney ; Liver* ; Male ; Mortality ; Needles ; Pancreas ; Paracentesis ; Pleural Effusion ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Rib Fractures ; Shock ; Spleen ; Stomach ; Sutures