Many kinds of different treatment options for fecal incontinence such as biofeedback therapy, anterior or posterior sphincteroplasty, pelvic floor repair, gracilis or gluteus muscle transposition have been introduced. However, appropriate indications for these treatment options have not yet been delineated up to now. PURPOSE: The aim of this study was to access the preoperative severity of fecal incontinence by physiologic tests to give an idea that indications of appropriate selection criteria and parameters for assess the outcome could be simultaneously considered by preoperatively objective physiologic data. MATERIALS AND METHODS: From January 3, 1997 to, August 1, 1997 all patients with fecal incontinence who visited colorectal clinic in the Department of Surgery, Korea Veterans Hospital, were classified into two groups according to the severity of fecal incontinence (0~20): Group I (1~9), Group II (10~20) and compared them with the results of physiologic tests: anorectal manometry, endorectal ultrasound (ERU), cinedefecography, and pudendal nerve terminal motor latency (PNTML). Statistical analysis was performed by Student's-t test, and Chi-square test and p<0.05 was considered significant. RESULTS: The number of GI was 25, and GII was 22. There were no differences between the two groups in terms of age (GI: 57.7+/-14.5, GII: 61.4+/-14.0years), gender (male: female, 19:6, 16:6), cause (neurogenic; 11/25 (GI),7/22(GII), postanal surgery; 6/25,6/22) obstetric trauma (2/25, 2/22), anal trauma (1/25, 1/22) diabetes melitus (1/25, 2/22), rectal prolapse (2/25, 1/22), and others (2/25, 3/22), duration of fecal incontinence (64.4+/-82.2, 48.7+/-65.3 months), high pressure zone (3.3+/-1.7, 3.5+/-1.4 cm), mean resting pressure (50.5+/-27.0, 51.9+/-18.7 cm H2O), maximal resting pressure (88.4+/-50.6, 89.4+/-41.8 cm), maximal squeezing pressure (150.6+/-71.0, 129.7+/-59.5 cm H2O), rectoanal inhibitatory reflex (13/21, 8/21 positive), sensitivity (37.5+/-15.2, 41.8+/-29.0 cc), compliance (19.0+/-14.5, 21.4+/-39.4 cc/cm H2O) in anorectal manometric findings, anal sphincter defect (13/21, 15/22 positive), size of defect (60+/-26.30degrees, 71 +/-30.8degrees/360degrees), thickness of the external anal sphincter (3.46+/-0.78, 3.84 +/-1.02 cm), thickness of internal anal sphincter (1.58+/-0.79, 1.74+/-0.81 cm) in ERU, anorectal angle in rest (85.2+/-28.0degrees, 97+/-22.9degrees), squeeze (72+/-27.1degrees, 82 +/-19.7degrees), push (100+/-43.9degrees, 117.9+/-34.5degrees), length of perineal descent in rest (3.7+/-1.2, 3.6+/-1.7 cm), squeeze (2.9+/-1.5, 2.7+/-1.5 cm), push (7.9+/-3.5, 6.6+/-2.6 cm) in cinedefecography. However, rectal capacity in manometry (212.5+/-99.9, 155+/-51.5 cc, p<0.05), right PNTML (1.73+/-0.39, 2.71+/-0.83 ms, p<0.001), and left PNTML (1.83+/-0.43, 2.94+/-0.80 ms, p<0.001) were significantly increased in GII compare to those of GI. CONCLUSION: As the severity of fecal incontinence was increased, rectal capacity, right and, left PNTML were increased.
Anal Canal ; Biofeedback, Psychology ; Compliance ; Fecal Incontinence* ; Female ; Hospitals, Veterans ; Humans ; Korea ; Manometry ; Patient Selection ; Pelvic Floor ; Pudendal Nerve ; Rectal Prolapse ; Reflex ; Ultrasonography

Pseudoepitheliomatous, keratotic and micaceous balanitis is a rare distictive clinical entity that represents a histologic spectrum ranging from hypertrophic hyperpalstic penile dystrophy to verrucous carcinoma. This condition is thought to be a malignant growth potential by resistance to treatment and its tendency toward local recurrence. We report two cases with similar clinical presentation of hyperkeratotic plaque and micaceous scaly patches on the glans penis that were compatible with pseudoepitheliomatous, keratotic and micaceous balanitis. Histopathologically, case 1, 48 year-old male was progressed to squamous cell carcinoma and case 2, 78 year-old male, was shown pseudoepitheliomatous hyperplasia without malignant changes.
Aged ; Balanitis* ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous ; Humans ; Hyperplasia ; Male ; Middle Aged ; Penis ; Recurrence

The clinical symptom complex characterized by syncopal attacks and sudden death in patients with electrocardiographic anomalies, especially a prolonged Q-T interval is known as the Romano-Ward syndrome. When a similar symptom complex is accompanied by congenital deafness, it is called Jervell and Lange-Nieisen syndrome. This study was undertaken to investigate the investigate the incidence of the latter syndrome in the Seoul area. A total of 1,013 children with congenital deafness who attend schools for the deaf were studied by analyzing their electrocardiograms. A corrected Q-T interval of> or =0.44 seconds was defined as a prolonged Q-T interval. The overall incidence of long Q-T syndrome observed in the deaf in the Seoul area was 0.49% as compared to 0.25% reported from elsewhere in the world. The mean age of patients with long Q-T syndrome was 11.3+/-5.9 years and the first syncopal attacks was 4.6+/-1.1 per patient. A valsalva maneuver and exercise tests in the test group were associated with significant changes in T wave configuration and prolonged Q-T intervals while similar changes were not observed in the control group. A larger survey is needed to derive more statistically significant conclusions.
Child* ; Deafness* ; Death, Sudden ; Electrocardiography ; Exercise Test ; Humans ; Incidence ; Romano-Ward Syndrome ; Seoul ; Valsalva Maneuver

No abstract available.
Heart Diseases* ; Heart*

Obesity has been implicated as a significant risk factor for multiple medical condition including hypertention, glucose intolerance, hyperlipidemia, hyperinsulinemia and fatty liver. Furthermore, obesity in childhood is believed to be a reliable predictor of a similar condition in adulthood. During the recent years, there has been a rapid rise in the incidence of childhood obesity in Korea due to increased dietary intake rich in caloric content. This study was undertaken to investigate the epidemiology and potential health complications of obesity observed in elmentary school students. A total of 3,103 children (1630 boys and 1,473 girls), ages ranging from 6 to 12, were studied with personal interview, physical examination, and laboratory evaluation. The results were as follows: 1) The prevalence of obesity was 13.44% with approximately equal distribution among boys (14.42%) and girls (12.36%). 2) The prevalence of childhood obesity in Seoul was significantly higher (18.62%) than that in Suwon (7.85%) and in Hongchon (6.02%). 3) A higher incidence of hypertension was dectected in obese subjects and this was more obvious in girls. 4) Hyperlipidemia and elevated Atherogenic Index were more frequently observed in obese group. 5) although fasting blood glucose levels were similar in both groups. AST and ALT abnormalities were much more prevalent in obese group. It is concluded that hypertension and other metabolic abnormalities are much more frequently observed in obese children and that our effects should be focused on the earliest dection, prevention and management of childhood obesity.
Blood Glucose ; Child* ; Epidemiology ; Fasting ; Fatty Liver ; Female ; Glucose Intolerance ; Gyeonggi-do ; Humans ; Hyperinsulinism ; Hyperlipidemias ; Hypertension ; Incidence ; Korea ; Obesity* ; Pediatric Obesity ; Physical Examination ; Prevalence ; Risk Factors ; Seoul

No abstract available.
Echocardiography* ; Echocardiography, Doppler, Pulsed ; Heart Diseases* ; Heart*

We report a case of factitial panniculitis in a 50-year-old female patient who had multiple variable sized subcutaneous nodules on area accessible to the hands and disappeared by only prohibition of habitual skin massage. Histologic findings showed mostly lobular panniculitis with hemosiderin deposits, many foamy histiocytes and pseudomicrocysts.
Female ; Hand ; Hemosiderin ; Histiocytes ; Humans ; Massage ; Middle Aged ; Panniculitis* ; Skin

No abstract available.
Alprostadil* ; Ductus Arteriosus ; Heart Defects, Congenital* ; Humans ; Infant, Newborn*

No abstract available.
Anemia* ; Child* ; Heart Defects, Congenital* ; Hemodynamics* ; Humans

No abstract available.
Arteries* ; Cardiomyopathy, Hypertrophic* ; Humans ; Infant* ; Mothers*