No abstract available.
Craniocerebral Trauma* ; Head*

Eleven patients underwent posterior sagittal anorectoplasty(PSARP) as a secondary procedure. Two of them had rectovaginal fistula and another two had rectocutaneous fistula. Six of the rest complained of frequent fecal soiling and the last one had severe anorectal stricture after perineal anoplasty. Five patients had lived with colostomy until the second operations were carried out. The ages at the time of the secondary PSARP were between 7 months and 29 years. Distal colostogram and MRI were taken to evaluate distal colon, position of the rectum and voluntary muscle. All patients had normal sacrum except one who had anorectal stricture. Seven patients, six with fecal incontinence and the other one with rectovaginal fistula had mislocated anorectums. Three patients, two with rectocutaneous fistula, the other one with anorectal stricture, had abdominal approach to obtain enough length of colon for pull-through procedure. With the posterior midsagittal approach, we could manage all the problems, rectovaginal fistulas, rectocutaneous fistulas, strictures and malpositioned rectums, without difficulty. No patients had serious complications except wound infection in one. All patients were satisfied with the results after redo-PSARPs even though normal continence has been achieved in only one patient. Seven patients who had continuous soiling or rectocutaneous fistula, needed no more diapers even though four of them showed fecal staining under stressful condition and the other three showed intermittent fecal leaking less than once a day. The rest three of the patients maintained their continence with support of drugs and/or enemas because of constipation. The PSARP is a popular procedure as a primary operation; however, our results suggested that this procedure also gave us a good opportunity for management of serious complication developed after primary anoplasties.
Colon ; Colostomy ; Constipation ; Constriction, Pathologic ; Enema ; Fecal Incontinence ; Fistula ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Rectovaginal Fistula ; Rectum ; Sacrum ; Soil ; Wound Infection

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

Aneurysm of the splenic artery are the third most common intra-abdominal aneurysm, following aneurysms of the infrarenal aorta and iliac arteries. Splenic artery aneurysms (SAA) are the most frequent visceral artery aneurysms and account for more than two thirds of all lesions. Incidence of SAA are rare clinical entities(0.01-0.2%) that carry risk of rupture and fatal hemorrhage(35-100%). Fibroblastic dysplasia and atherosclerosis is fecund in the majority, and the fact that these aneurysms developes more commonly in female. Most patients are asymptomatic and the diagnosis is generally made incidentally. The treatment of patient with known SAA is dictated by several factors, including location, age, sex, present of symptom, size, pregnancy. We report ruptured splenic artery aneurysm with hemoperitoneum and review of the literature.
Aneurysm* ; Aorta ; Arteries ; Atherosclerosis ; Diagnosis ; Female ; Fibroblasts ; Hemoperitoneum ; Humans ; Iliac Artery ; Incidence ; Pregnancy ; Rupture ; Splenic Artery*

Chromomycosis is a chronic localized infection of the cutaneous and subcutaneous tissues and characterized by verrucoid, ulcerated and crusted lesions with sclerotic margins. It histologically show confluent granulomatous nodules containing large giant cells of the foreign body type. The organisms are differ from other yeastform fungi by the characteristic chestnut-brown color and by the septate division. A case of 51 year old woman with chromomycosis at submental area is presented.
Female ; Humans

BACKGROUND: Dizziness is a common complaint in patients presenting at emergency departments. Dizziness is difficult to assess because it is a subjective complaint that cannot be measured. We report a clinical analysis of patients with acute dizziness: type, duration, symptom, incidence, etc. METHODS: We reviewed the clinical details and the results of vestibular function tests for 106 acutely dizzy patients who visited the Emergency Department of Wonkwang University Hospital during the period of Jul. 1999 through Dec. 1999. RESULTS: The most common etiology of acute dizziness was the peripheral vestibular system(66%). The most common disease of the peripheral vestibular system was benign paroxysmal positional vertigo(52.9%), and the second most one was vestibular neuronitis(42.9%). In the central nervous system, cerebrovascular accident(63.6%) was the most common cause. All of the patients had experienced a previous vertigo attack, and 42.4% of them had frequent attacks. Dizziness of the cochlear systems were usual in peripheral vertigo. The usual underlying diseases related with vertigo were hypertension, cerebral infarction and diabetes mellitus. CONCLUSION: Dizziness is a complex and frustrating symptom with numerous possible causes. In case with suspected central disorders, CT and MRI have a great diagnostic significance.
Central Nervous System ; Cerebral Infarction ; Diabetes Mellitus ; Dizziness* ; Emergencies* ; Emergency Service, Hospital ; Humans ; Hypertension ; Incidence ; Magnetic Resonance Imaging ; Vertigo ; Vestibular Function Tests

BACKGROUND: Acute abdominal pain in children is one of the most common problems encountered in our daily practice. The children often are not able to tell us their exact complain symptoms and differential diagnosis of acute abdominal pain is difficult in its first encounter. When family physicians encounter patients with acute abdominal pain in the ambulatory care settings, they must make an appropriate decision for proper management such as admission, referral, discharge and follow-up without firm diagnosis. If it is possible to predict the course or prognosis of acute abdominal pain by clinical data concerning patient, it will be helpful to make a decision for the management of acute abdominal pain. So we tested for hypothesis that patients with acute intermittent abdominal pain and normal simple abdomen X-ray finding is not serious and shows favorable outcome. METHOD: 82 patients with acute abdominal pain were assessed from Oct. in 1996 to Sep. in 1997 at the emergency department of Kyungju Hospital, Dongkuk University. 69 patients among 82 showed normal simple abdomen X-ray findings. 67 patients were discharged and 2 patients were admitted. 64 patients were contacted by phone call after 1 week and reported their outcome of the previous abdominal pain. RESULTS: Among 64 subjects 36 patients were male and 28 patients female. 57 patients complained of intermittent abdominal pain and 7 patients complained continous abdominal pain. Positive predictive value of intermittent abdominal pain and normal simple abdominal x-ray was 98%. Outcome of patients with intermittent abdominal paln was more favorable than that of continuous pain. CONCLUSIONS: Acute intermittent abdominal pain and normal simple abdomen x-ray findings in children shows favorable outcome and can be managedim ambulatory care settings.
Abdomen ; Abdominal Pain* ; Ambulatory Care ; Child* ; Decision Making* ; Diagnosis ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Male ; Physicians, Family ; Prognosis ; Referral and Consultation

PURPOSE: Prostatic tumor induced gene-1 (PTI-1) is a mutated human EF-la and putative prostatic carcinoma tumor-inducing oncogene, that is differently expressed in prostatic cancer and benign prostatic hyperplasia. And, it is more sensitive marker than prostate- specific antigen (PSA) for detecting human prostate cancer in the bloodstream. This study invastigated the expression of PTI-1 in paraffin embedded tissue of prostatic carcinoma, prostatic intraepithelial neoplasia, and benign prostatic hyperplasia using in situ PCR. MATERIALS AND METHODS: we evaluated expression of PTI-1 in prostatic carcinoma with prostatic intraepithelial neoplasia (PIN) of 32 cases, benign hyperplasia of 20 cases, high grade transitional cell carcinoma of 10 cases and colon cancer of 10 cases for control group. Also, the immunohistochemical staining for PSA was performed to comparison with clinical value of PSA. RESULTS: The serum level of PSA was closely related to stage and Gleason score (p < 0.05). However, the results of immunohistochemical stains were variable to stage and Gleason score. PTI-1 using in situ PCR expressed in 50% of prostatic carcinoma, 41% of prostatic intraepithelial neoplasia, 10% of benign hyperplasia and colon cancer (p < 0.05). No expression is observed in transitional cell carcinoma. In prostatic carcinoma, PTI-1 expressed in 43.8% (7/16) of stage II, 50.0% (5/10) of stage III, and 66.7% (4/6) of stage IV (p<0.05). In PIN, expression of PTI-1 was similar to prostatic carcinoma (p<0.05). CONCLUSION: PTI-1 represented a relatively sensitive marker for prostatic carcinoma and PIN, indicator of prostatic carcinoma progression.
Carcinoma, Transitional Cell ; Colonic Neoplasms ; Coloring Agents ; Humans ; Hyperplasia ; Neoplasm Grading ; Oncogenes* ; Paraffin ; Polymerase Chain Reaction* ; Prostatic Hyperplasia* ; Prostatic Intraepithelial Neoplasia* ; Prostatic Neoplasms

Mutation of p53 tumor suppressor gene is now recognized as the most frequent genetic alteration in human neoplasms. Although meningiomas are common intracranial tumors, little is known about the clinical significance of p53 abnormalities in meningiomas. We studied 31 cases of meningioma to investigate the significance of p53 protein expression in meningiomas and its relationships with histological and clinical parameters and proliferative activity. Classical and atypical meningiomas were 16 (51.6%) and 15 cases (43.4%), respectively. p53 protein expression was detected in 4 (25.0%) of 16 classical, and 12 (80.0%) of 15 atypical meningiomas. p53 protein expression was correlated with Ki-67 staining index, atypical type, high histologic score, sheet pattern of the neoplastic cells, vascular proliferation, and male patient (p<0.05). In conclusion, immunohistochemical evaluation of p53 protein and histologic score of meningiomas are useful in assessing the prognosis.
Genes, Tumor Suppressor ; Humans ; Male ; Meningioma* ; Prognosis

It is generally accepted that fractures should be treated by closed methods, however for certain femoral fractures in adults, closed methods yields an unacceptable high incidence of nounlon, malunion, delayed unlon, and disability. For these fractures various methods of open reduction and internal fixation have been recommended, but unfortunately, there are frequent reports of complications and failures. The recently developed association for study of Internal fixation (ASIF) compression plating apparatus, seems to satisfy the basic objectives of internal flxatlons: namely
Adult ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Walking