No abstract available.
Colon* ; Colonic Neoplasms* ; Humans ; Vaccination*

No abstract available.
Leukemia*

OBJECTIVE: To identify the factors which can delay home discharges or transfers to other hospitals of rehabilitation inpatients in a tertiary hospital and the change of discharge destination during past 6 years. METHOD: This was a retrospective study of patients with a diagnosis of stroke, traumatic brain injury or spinal cord injury who were admitted to our hospital in 1996, 1999, 2001 and 2003. Demographic data, length of stay, discharge destination and functional status by the FIM(TM) instrument were studied by a medical record review. RESULT: Patients who were transferred to other hospitals or discharged with delay showed significantly lower admission and discharge FIM scores, lower FIM efficiencies, longer length of stays and longer intervals between the onset and admission to a rehabilitation ward. CONCLUSION: Lower functional outcome was associated with a longer length of stay and discharge to another hospital. It would be necessary to establish the long term rehabilitation care facilities with extended rehabilitation program for the patients with lower functional gains in a rehabilitation unit of the tertiary hospitals.
Brain Injuries ; Diagnosis ; Humans ; Inpatients* ; Length of Stay ; Medical Records ; Rehabilitation* ; Retrospective Studies ; Spinal Cord Injuries ; Stroke ; Tertiary Care Centers*

PURPOSE: In general, sinusitis in children is diagnosed by clinical symptom and paranasal sinus x-ray. Sinus plain x-rays in children is simple, inexpensive, and speedy. However, it requires proper interpretative techniques, because different development of each sinus, soft tissues overlying sinuses and bony structure require precise diagnosis. This study was conducted to compare plain x-rays with OMU CT scans. METHODS: From September 1996 through August 1997, thirty nine patients who were diagnosed as sinusitis based on clinical symptoms and plain x-rays at the pediatric department of Seoul Adventist Hospital were studied. Water's view, Caldwell's view and lateral view were taken for the plain x-rays with concurrent OMU CT scans prior to treatments. RESULTS: Ten cases (25.6%) out of 39 patients showed posterior nasal drip and fourteen cases (35.9%) showed nasal obstruction. Twelve cases (30.8%) were related to allergic diseases and seven cases (58.3%) among these 12 cases were bronchial asthma. Sensitivity of plain x-ray were 88.5+/-12.9% for maxillary sinuses, and 59.9+/-13.65% for ethmoidal sinuses. CONCLUSION: When maxillary sinusitis is suspected, plain X-ray for maxillary sinuses is enough to diagnose sinusitis, but for ethmoidal sinuses it may be underestimated or overestimated in comparison with OMU CT scan. Ethmoidal sinusitis requires careful diagnosis and follow-up because it plays important roll for chronic sinusitis due to its structure. Therefore, we recommends OMU CT scan to diagnose paranasal sinusitis of children with plain X-ray.
Asthma ; Child* ; Diagnosis ; Ethmoid Sinusitis ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Nasal Obstruction ; Seoul ; Sinusitis* ; Tomography, X-Ray Computed*

Carcinosarcoma of the pancreas is a rare malignant tumor that shows a combined or mixed proliferation of carcinomatous and sarcomatous cells. This tumor has been variously called carcinosarcoma, pleomorphic large cell carcinoma, giant cell carcinoma, and undifferentiated carcinoma. A 52-year-old man was hospitalized for evaluation of his epigastric pain and jaundice. An abdominal computed tomography revealed the presence of a poorly enhancing mass, arising from the head of the pancreas. Pylorus preserving pancreaticoduodenectomy was performed. The final pathologic diagnosis was undifferentiated carcinoma with 2 distinct components. One component was a conventional infiltrating pancreatic ductal adenocarcinoma, and the other component was sarcoma. We present here a case of carcinosarcoma of the pancreas along with a review of the literatures.
Adenocarcinoma ; Carcinoma ; Carcinoma, Giant Cell ; Carcinoma, Large Cell ; Carcinosarcoma* ; Diagnosis ; Head ; Humans ; Jaundice ; Middle Aged ; Pancreas* ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pylorus ; Sarcoma

No abstract available.
Scrub Typhus* ; Seoul*

A neurofibroma of the gastrointestinal tract is frequently associated with type 1 neurofibromatosis. A solitary neurofibroma, which refers to a localized neurofibroma occurring in patients without stigmata of neurofibromatosis, can rarely occur in the stomach. The majority of neurofibromas of the stomach remain small and asymptomatic, and are usually found incidentally. Surgical resection is required for symptomatic relief and for confirmation of the diagnosis. Herein, the case of a 68-year-old woman found to have a solitary neurofibroma in the angle of stomach is reported. The patient underwent a laparoscopy assisted distal gastrectomy, with a gastroduodenostomy. The gross, microscopic and immunohistochemical findings were consistent with the diagnosis of a neurofibroma of the stomach.
Aged ; Christianity ; Diagnosis ; Female ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Laparoscopy ; Neurofibroma* ; Neurofibromatoses ; Neurofibromatosis 1 ; Stomach*

Early gastric cancer (EGC) is defined as a carcinoma confined to the mucosa or submucosa of the stomach, with or without lymph-node metastasis. Synchronous liver metastasis is 5~12.8% in advanced gastric cancer, but is very low in EGC. A 64-year-old woman was admitted to St. Vincent's Hospital with a complaint of epigastric pain. Gastrofiberscopic examination showed a polypoid mass on the gastric antrum. Abdominal computed tomography demonstrated an intraluminal polypoid mass in the gastric antrum, but no tumor mass in the liver. A laparotomy revealed a solitary liver metastasis, we performed a distal partial gastrectomy with a group-2 lymph-node dissection and resection of metastatic liver tumor. Histologic examination showed a tubular adenoma with a focal carcinomatous change, which was confined to the gastric mucosa and to the metastatic adenocarcinoma in the liver. We present a case of early gastric mucosal cancer associated with synchronous liver metastasis, along with a review of the literature.
Adenocarcinoma ; Adenoma ; Female ; Gastrectomy ; Gastric Mucosa ; Humans ; Laparotomy ; Liver* ; Middle Aged ; Mucous Membrane ; Neoplasm Metastasis* ; Pyloric Antrum ; Stomach ; Stomach Neoplasms

PURPOSE: We investigated the factors influencing the time to reach full enteral feeding in very low birth weight infants. We compared the days of life to start tube or oral feeding, to regain birth weight, and to establish full enteral feeding in very low birth weight infants and determined the risk factors delaying full enteral feeding. METHODS: We reviewed the medical records of 214 newborn infants less than 1,500 g at birth, who were delivered at Chonnam National University Hospital from January 1, 1997 to May 31, 2000. These infants were divided into three groups by birth weight (less than 1,000 g, 1,000-1,249 g, and 1,250-1,499 g). Gestational age, birth weight, the days of life to start first tube or oral feeding, to regain bith weight and to reach full enteral feeding, and the possible risk factors delaying the progress of enteral feeding were analyzed. RESULTS: The gestational age was 29.69+/-2.33 weeks and the birth weight was 1,212+/-194.3 g. The time to start tube or oral feeding, to regain birth weight, and to establish full enteral feeding were significantly later and longer in the lower birth weight group. The time to reach full enteral feeding was related to the duration of mechanical ventilation and oxygen therapy, and was significantly longer in the infants with severe respiratory distress syndrome (RDS), chronic lung disease (CLD), apnea, intraventricular hemorrhage (IVH), cystic periventricular leukomalacia, sepsis/disseminated intravascular coagulopathy, ricketts, and total parenteral nutrition. CONCLUSION: The time to reach full enteral feeding was inversely related to the birth weight, and the risk factors for delayed full enteral feeding were the presence and/or the severity of diseases related to the prematurity such as the duration of mechanical ventilation and oxygen therapy, RDS, CLD, apnea, IVH, and sepsis.
Apnea ; Birth Weight ; Enteral Nutrition* ; Gestational Age ; Hemorrhage ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Jeollanam-do ; Leukomalacia, Periventricular ; Lung Diseases ; Medical Records ; Oxygen ; Parenteral Nutrition, Total ; Parturition ; Respiration, Artificial ; Risk Factors ; Sepsis

PURPOSE: To evaluate the frequency, distribution, appearance, and clinical outcome of brainstem injury, asseen on MR, in a prospective study of patients with traumatic perimesencephalic subarac-hnoid hemorrhage (pSAH)seen on initial CT scan. MATERIALS AND METHODS: MR images were prospectively obtained in 38 patients with headinjury who on initial CT scans showed pSAH. To identify the amount and location of pSAH, the CT scans of allpatientd, and MRI findings were evaluated according to the presence, location and signal intensity of brainsteminjury, and other combined intracranial injuries. Initial Glasgow coma scale(GCS) and Glasgow outcome scale(GOS),as noted on clinincal records, were reviewed. RESULTS: Brainstem injury was demonstrated on MR images in 30patients(79%). The majority of these lesions (76.7%) were located in the dorsolateral portion, and nonhemorrhagiclesions were more frequent(70%) than hemorrhagic. In patients with brainstem injury, as seen on MR imaging, theGOS score was worse, especially in those with combined diffuse axonal injury in the corpus callosum and cerebralwhite matter. The location and amount of pSAH seen on CT was not related with brainstem injury or clinicaloutcome. CONCLUSION: The presence of pSAH in patients with acute head trauma, as seen on CT was thought to be anindicator of brainstem injury, and MR imaging was necessary. If such injury was identified on MRI, this waspredictive of a worse clinical outcome.
Brain Stem* ; Coma ; Corpus Callosum ; Craniocerebral Trauma ; Diffuse Axonal Injury ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Prospective Studies ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed