No abstract available.
Intestinal Fistula*

No abstract available.
Humans ; Moral Development* ; Students, Medical*

Primary tumors of the heart are rare, and one-third of them are malignant. The most common malignant intracardiac tumor is angiosarcoma, which usually involves right atrium. MR features in one patients with right atrial angiosarcoma is presented and the literature briefly reviewed. Angiosarcoma demonstrated slightly heterogeneous intermediate signal intensity on T1-weighted images, high signal intensity on T2-weighted images and higher signal intensity on Gd-DTPA enhanced images. MRI provided more information regarding the extent of the tumor than 2D echocardiography or CT.
Echocardiography ; Gadolinium DTPA ; Heart ; Heart Atria ; Hemangiosarcoma* ; Humans ; Magnetic Resonance Imaging*

No abstract available.
Humans ; Tuberculosis, Pulmonary*

Most stress urinary incontinence require a surgical correction for stabilizing the urethrovesical junction Many procedures had been applied for the treatment of stress urinary incontinence. Recently we experienced two cases of stress urinary incontinence, corrected by endoscopic suspension of bladder neck with percutaneous nephrostomy needles, ang good results were obtained. Herein we reported a more simple and safe modified procedure with some literatures.
Neck ; Needles ; Nephrostomy, Percutaneous ; Urinary Bladder ; Urinary Incontinence*

Ventriculoperitoneal shunt (VP shunt) for hydrocephalus is thought to inhibit the closure of processus vaginalis by increasing intraabdominal pressure, thus it promotes the inguinal hernia. We reviewed the incidence and characteristics of the inguinal hernia in VP shunted patients, and tried to estimate the patency rate of processus vaginalis in early childhood. A reprospective review of patients undergone insertion of VP shunt between January 1980 and May 1998 at Seoul National University Children Hospital was done. 262 patients were included in this study. Among them, 28 patients developed inguinal hernia (10.7%). Six patients developed inguinal hernia before the insertion of VP shunt. According to the age of VP shunt, the inguinal hernia developed in 16.2% (12/74) of patients who had undergone VP shunt before 6 months old, 12.4% (11/89) between 6 months and 2 years old and 5.1% (5/99) after 2 years old. Among 22 patients excluding 6 patients who developed hernia before VP shunt, the incidence of inguinal hernia after VP shunt was 8.6% (22/256) with male predominance (M:F=18:4). 8 patients developed inguinal hernia bilaterally (36.4%). It is suggested that at least 14% of processus vaginalis is patent until 2 years old.
Child ; Child, Preschool ; Hernia ; Hernia, Inguinal* ; Humans ; Hydrocephalus ; Incidence ; Infant ; Male ; Seoul ; Ventriculoperitoneal Shunt*

OBJECTIVES: Polycystic ovary syndrome (PCOS) has the feature of excessive LH, hyperandrogenism and disturbance of folliculogenesis. Also, insulin, IGF-I and IGFBP-1 are involved in the pathogenesis of PCOS. Various surgical and medical therapies have been used and the action mechanisms are related to the endocrine effect. Laparoscopic ovarian electrocautery or laser vaporization is effective in the restoration of ovulation and normal menstrual cycle with minimal invasive procedure especially in the patients resistant to medical therapy. Clomiphen citrate (CC) is used for the ovulation induction in PCOS and the resistance is known to be related to insulin, IGF-I, IGFBP-1 levels. This study was performed to evaluate the effect of the laparoscopic laser vaporization on the levels of LH, FSH, testosterone, IGF-I and IGFBP-1 and on the ovarian response to clomiphen citrate in patients with CC-resistant PCOS. MATERIALS AND METHODS: The fasting basal serum LH, FSH, testosterone, IGF-I and IGFBP-1 level were measured in 10 PCOS patients with CC-resistance and 7 normal controls with regular menstrual cycle. In PCOS, after laparoscopic CO2 laser vaporization, endocrine levels were measured in 1 week interval for 4 weeks and then compared with preoperative levels. RESULTS: In PCOS group, mean serum LH/FSH ratio, testosterone, IGF-I levels were higher and IGFBP-1 level was lower than control. LH/FSH ratio decreased from 2.51+/-0.67 to 1.7+/-0.6 (p<0.05) in 2 weeks, to 0.56+/-0.2 (p<0.01) in 3 weeks and to 1.41+/-0.3 (p<0.01) in 4 weeks after operation. Testosterone level decreased from 1.51+/-0.82 ng/ml to 0.65+/-0.34 ng/ml (p<0.05) in 2 weeks, to 0.56+/-0.67 ng/ml (p<0.01) in 3 weeks after operation. IGF-I level also decreased from 436+/-47.5 microgram/l to 187+/-38 microgram/l (p<0.01) in 1 week, to 167+/-42 microgram/l (p<0.01) in 2 weeks, 179+/-55 microgram/l (p<0.01) in 3 weeks and to 120 +/-43 microgram/l (p<0.01) in 4 weeks after operation. IGFBP-1 level showed no significant change. In 8 of 10 PCOS patients, ovulation was induced with low dose clomiphen citrate. CONCLUSION: Laparoscopic CO2 laser vaporization restores normal menstrual cycle and ovulation through endocrine effect of decreasing LH/FSH ratio, testosterone and IGF-I level and increases the response to CC. Therefore it is useful for restoration of normal menstruation and induction of ovulation in CC resistant PCOS patients.
Citric Acid ; Electrocoagulation ; Fasting ; Female ; Humans ; Hyperandrogenism ; Insulin ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor I ; Laser Therapy* ; Lasers, Gas ; Menstrual Cycle ; Menstruation ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Testosterone ; Volatilization

The purpose of this study was to evaluate the clinical results and recovery of sports activity in patients who received meniscal allograft transplantation. From December 1999 to May 2009, we selected 36 cases out of 38 cases who received meniscal transplantation using fresh frozen allograft. The mean age was 33.8 years (range: 17-50 years) and the mean follow up was 68.8 months (range: 12-142 months). Clinical results were evaluated with knee assessment scoring system (KASS), Lysholm knee score and International knee Documentation Committee. The information of quadriceps and hamstrings strength recovery was obtained using Tegner activity scale, Tegner activity score and Biodex system II (Biodex, USA), and it was used to evaluate the recovery of sports activity. The average KASS score was increased from 61.7 preoperatively to 83.8 postoperatively. The average Lysholm score was increased from 77.7 preoperatively to 87.7 postoperatively. Also, Tegner activity scale, Tegner activity score and the recovery of quadriceps and hamstrings increased at 1year after surgery. In knee joint position sense, the proprioception increased compared to preoperational count. We propose the meniscal allograft transplantation is one of a proper treatment after subtotal or total meniscectomy, which can significantly relieve pain and improve function of the knee joint.
Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Proprioception ; Sports ; Transplantation, Homologous ; Transplants

No abstract available.
Hydrothorax*

PURPOSE: To evaluate the effect of posterior continuous circular capsulectomy (pCCC) and anterior vitrectomy during cataract surgery in children on the development of posterior capsular opacification (PCO). METHODS: 52 eyes of 32 children aged from 3 months to 14 years who underwent pCCC and anterior vitrectomy at the time of cataract removal were evaluated more than 12 months. All eyes were divided into two groups, one group of children under 1 year of age and the other aged 1 year and more. The degree of PCO was evaluated prospectively in both groups. In 16 eyes of 8 children with bilateral cataracts, IOL was inserted in the bag in one eye, and in the anterior vitreous with pCCC capture in the opposite eye. The degree of PCO according to the location of IOL was compared between the two eyes. RESULTS: At 1 month postoperatively, mild PCO was developed in 9 out of 18 eyes of children under 1 year old, and in 14 out of 34 eyes of children of 1 year and over. There was a difference according to age. Severe PCO involving the visual axis was not developed in all eyes during 12 months follow up period. The degree of PCO was more in eyes of children under 1 year, but was not different between eyes with IOLs inserted in the bag and eyes with IOLs in the anterior vitreous. CONCLUSIONS: The development of PCO was much reduced with pCCC and anterior vitrectomy followed by in-the-bag implantation of IOL during cataract surgery in children.
Axis, Cervical Vertebra ; Cataract* ; Child ; Follow-Up Studies ; Humans ; Prospective Studies ; Vitrectomy*