M llerian anomalies have been infrequently encountered clinical problem for the obstetrician gynecologist, incidence was estimated to occur in 1% to 6% of all women. Recently, the use of vaginal ultrasound, MRI and endoscopic techniques have led to more accurate description and classification of m llerian anomalies. This report of a complete uterine septum with duplication of the cervix and a longitudinal vaginal septum with hemivaginal stricture represents a unique case of septate uterus, which to our knowledge previously has not been reported.
Cervix Uteri* ; Classification ; Constriction, Pathologic* ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Ultrasonography ; Uterus*

No abstract available.
Acute-Phase Proteins ; Bacterial Infections*

PURPOSE: To evaluate the effectiveness of Ahmed valve implantation for refractory glaucoma following pars plana vitrectomy. METHODS: Seventeen eyes of 15 patients suffering from secondary glaucoma following pars plana vitrectomy underwent Ahmed valve implantation. All the eyes were in critical condition, and intraocular pressure could not be controlled with anti-glaucoma medications. Success was characterized by an intraocular pressure less than 22 mmHg and greater than 6 mmHg, regardless of anti-glaucoma medication usage. RESULTS: The total success rate was 83.4% at 6 months and 76.4% at the final visit. The reduction in intraocular pressure and the number of medications used postoperatively were both statistically and clinically significant (p< 0.005). Postoperative complications included: transiently increased intraocular pressure, transient hyphema, early postoperative hypotony, choroidal detachment, malposition of the valve tip, and phthisis bulbus. CONCLUSIONS: Ahmed valve implantation is a safe and effective method for refractory glaucoma following vitrectomy.
Vitrectomy/*adverse effects ; Treatment Outcome ; Retrospective Studies ; Prosthesis Implantation/*instrumentation ; Prosthesis Design ; Postoperative Complications ; Middle Aged ; Male ; Intraocular Pressure/physiology ; Humans ; *Glaucoma Drainage Implants ; Glaucoma/etiology/physiopathology/*surgery ; Follow-Up Studies ; Female ; Aged ; Adult

BACKGROUND: Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and METHODS: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. RESULTS: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. CONCLUSIONS: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.
Ascites ; Carcinoma, Hepatocellular* ; Female ; Humans ; Liver Cirrhosis ; Male ; Radiotherapy* ; Survival Rate

No abstract available.
Blood Coagulation*

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

A case of adenocarcinoma of cystic duct associated with GB empyema is presented. A 72 year old male was admitted to Kwangju Christian hospital because of abdominal pain in right upper quadrant for 4 days. He underwent explolaparotomy under the impression of GB empyema or GB cancer. For seeking causative factor of GB empyema, serial sections of cystic duct and mapping were performed. We can find adenocarcinoma of cystic duct in the specimen removed at cholecystectomy. The criteria for disgnosis of cystie duct carcinoma which was outlined by Farrar. These criteria are; 1) The growth must be restricted to the cystic duct, 2) There is no neoplastic process in the gall bladder, hepatic and common bile duct. 3) Histopathological examination must be comfirm carcinoma. Here we report a case of adenocarcinoma of cystic duct associated with GB empyema with brief review of Literature.
Abdominal Pain ; Adenocarcinoma* ; Aged ; Cholecystectomy ; Common Bile Duct ; Cystic Duct* ; Empyema* ; Gwangju ; Humans ; Male ; Urinary Bladder

No abstract available.
Carcinoma, Non-Small-Cell Lung* ; Fingers*

In the figure 3, designation of severity of bronchopulmonary dysplasia (BPD) was misprinted. Open bars (white) represent severe BPD, not mild BPD. Closed bars (Black) represent mild BPD, not severe BPD. Gray bars in the middle represent moderate BPD without change.

BACKGROUND: Because systolic and diastolic dysfunction frequently coexist in acute myocardial infarction(AMI), we hypothesize that a combined measure of ventricular performance using Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic chest pain. METHOD AND RESULTS: Seventy-one patients with AMI (47 male, 59+/-11 years) and 45 patients with normal coronary artery (29 male, 52+/-11 years) were included in the study for measurement of cardiac performance index and established parameters of ventricular function using conventional echo-Doppler methods. a new derived index of cardiac performance: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The mean value of the index was significantly different between normal and AMI(p<0.01). The degree of inter-group overlap was smaller for the index compared to other parameters. within functional groups, the value of the index did not appear to be related to heart rate, mean arterial pressure and the degree of mitral regurgitation. CONCLUSION: cardiac performance index is a conceptually new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it is useful as screening test for patients with cardiac dysfunction due to AMI.
Arterial Pressure ; Chest Pain ; Coronary Vessels ; Echocardiography, Doppler ; Heart Rate ; Humans ; Male ; Mass Screening* ; Mitral Valve Insufficiency ; Myocardial Infarction* ; Relaxation ; Ventricular Function