PURPOSE: Choledochal cyst is a rare malformation of the pancreatobiliary ductal system, manifested by dilatation of biliary tree with or without anomalous insertion of the common bile duct into pancreatic duct. The purpose of this study is to review the incidence of anomalous pancreatobiliary union(PBU) and the shape of common bile duct based on the angle of pancreatic duct and common bile duct union. MATERIALS AND METHODS: We analyzed cholangiopancreatographic findings of 21 patients with choledochal cyst, emphasizing PBU. The PBU was classified into acute-angled PBU, right-angled PBU, normal PBU, and unknown PBU on the basis of common bile duct insertion to pancreatic duct. The shape of common bile duct dilatation was evaluated with regard to angle of PBU. RESULTS: Fourteen of 21 patients had anomalous PBU with slender or ectatic form of common channels. Three patients had normal opening of common bile duct and pancreatic duct, and in remaining 4 patients the PBU was not visualized. Among 14 patients with PBU, 5 patients had right-angled PBU and 9 patients had acute-angled PBU. Cystic form of common bile duct dilatation was seen in 13 patients and cylindrical form was in 8 patients. Cystic dilatation of common bile duct was seen in 4 patients out of 5 right-angled PBU. CONCLUSION: Patients with choledochal cyst had high incidence of anomalous PBU with common channel (67%). The shape of common bile duct dilatation was cystic in 62% of patients, and the right-angled PBU was prone to be cystic dilatation (80%).
Biliary Tract ; Choledochal Cyst* ; Common Bile Duct ; Dilatation ; Humans ; Incidence ; Pancreatic Ducts

No abstract available.
Aspergillosis* ; Maxillary Sinus*

Many plastic surgeons have been tried to attain ultimate goal lies in restoring the original shape and function of the facial aesthetics, in reconstruction of deformities resulting from facial hypertrophic scar and skin defects. This would require consideration in terms of hanmony in color match, skin texture and thickness. Various forms of skin graft, local flap, distant flaps, free flap and tissue expander have been employed in restoring skin defects and deformities of the cheek and submental area, and the use of large local flaps utilizing the cervicofacial skin flaps or tissue expander have brought about improved aesthetic results. the authers have obtained satisfactory results in treating 2 cases of wide hypertrophic scar of the cheek and submental area with combination of wide cervical flap and intraoperative tissue expansion using foley catheter. the merits of this combined operative methods are as follows : 1. It is not necessory to keep tissue expander for a long period. 2. This technique is able to diminish the cost of multistage operation and using of tissue expander. 3. There is no psychologic problems due to undesirable facial appearance during tissue expansion period. 4. Rapid intraoperative tissue expansion by foley catheter during elevating wide cervical flap can allow to dissect one, preserving the perforators without bleeding in a short time. 5. Wide cervical flap and additional expanded tissue by means of intraoperative tissue expansion could brought into suturing avoiding tension of oral commissure and lip eversion. 6. Preservation of perforators of cervical flap above the platysma muscle raised flap's survival rate and then this result could prevent distal ischemic necrosis after flap coverage.
Catheters ; Cheek ; Cicatrix, Hypertrophic* ; Congenital Abnormalities ; Esthetics ; Free Tissue Flaps ; Hemorrhage ; Lip ; Necrosis ; Skin ; Survival Rate ; Tissue Expansion Devices ; Tissue Expansion* ; Transplants

PURPOSE: Congenital limb anomalies are manifested in various degree of severity and complexity bearing confusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. MATERIALS AND METHODS: Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications;failure of formation of parts, failure of differentiation of parts, duplications, overgrowth, and undergrowth. RESULTS: The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. CONCLUSION: The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies.
Classification ; Extremities* ; Hand ; Humans ; Incidence ; Lower Extremity ; Retrospective Studies ; Upper Extremity

No abstract available.
Hernia, Diaphragmatic*

BACKGROUND: Recently, inireaing numbers of chemotherapeutic agens are being used to treat cancer patients. Mucocutaeous complications are commonly sen in association with the administration of these medicaticins. OBJECTIVE: We conducted a study in cancer chemotherapy patient so determine the suspected chemotherapeutic agents ancl frequency of various mucocutaneous side effects in these patients. METHODS: The study involved 140 patients admitted from Decerrae 1993 to September 1994 for cancer chemot herapy at Korea University Guro Hospital. RESULTS: The mucocutaneous side effects during chemotherapy were alopecia(55%), hyperpig mentation(32.9%), stomatitis(20%), phlebitis(12.9%), flushing(8.6%) descending order. Visual grade II, IV alopecia patients were most common, but as the chemot retpy cycle increased so, the severer the alopecia. Although the onset of the alopecia were variake many patients experienced alopcia within 17 to 24 days after the start of chemotherapy. Serpeitie supravenous fluorouracil hyperpigmentation were commor,(17.9%), Diffuse and longitudinal or horizontal band like nail pigmentation were observed, and, pigmented macules were also observei, epecially on the palms and digits. Stomatitis usually developed within 10 days after the start of chemotherapy and it persist ed for about 7 days and the most of the lesions were resolved spor Laeously. Other clinical manifestations accompanied with chmotherapy were tinea infection(16.4%), acne(7.1%), oral thrush (7%), white nail band(4.3%), pruritus(2.9%) in descending order. CONCLUSION: So, physiciars need to be aware of the widely divergnal cutaneous reactions which may occur with the use of antiancer medications.
Alopecia ; Candidiasis, Oral ; Drug Therapy* ; Fluorouracil ; Humans ; Hyperpigmentation ; Korea ; Pigmentation ; Stomatitis ; Tinea

PURPOSE: Intestinal atresia is a well-recognized cause of bowel obstruction in the newborn. The management of neonates with intestinal atresia has improved in recent decades due to refinements in neonatal intensive care, operative techniques, use of total parenteral nutrition (TPN), and neonatal anesthesia. More recently, the survival rate has risen rapidly up to 90%. METHODS: Twenty-five (25) cases of intestinal atresia were encountered at Kwangju-Christian Hospital between January 1985 and December 1998. We reviewed sex, gestational age, body weight, clinical manifestations, associated ano malies, causes, interval to operation, preoperative complications, operative methods, and postoperative complications. RESULTS: Sites involved were the duodenum (n=10; 40%), the jejunum (n=5; 20%), and the ileum (n=10; 40%). The sex distribution was male predominant (1.8:1). The overall survival rate in our hospital was 76%. CONCLUSION: Refinements in neonatal intensive care and perioperative management were important in decreasing postoperative mortality.
Anesthesia ; Body Weight ; Duodenum ; Gestational Age ; Humans ; Ileum ; Infant, Newborn ; Intensive Care, Neonatal ; Intestinal Atresia* ; Jejunum ; Male ; Mali ; Mortality ; Parenteral Nutrition, Total ; Postoperative Complications ; Sex Distribution ; Survival Rate

PURPOSE: Thyroid disease is the most common form of endocrinologic disease. Despite recent advances in diagnosis, controversy still remains concerning the surgical management of thyroid disease. The aim of this study was to analyze the clinical distribution and the inclination of surgical treatment for thyroid disease. METHODS: The medical records from 1,743 patients who had undergone thyroid resections for thyroid diseases between January 1989 and December 1998 at Kwangju Christian Hospital were reviewed retrospectively. RESULTS: Of the 1,743 patients with thyroid diseases, 1,285 had benign diseases and 458 had carcinomas, resulting in a 26.3% prevalence of malignancy. Female patients were predominate, being 6.89 times the number of males. The peak incidence of age was the 4th decade for patients with benign diseases (29.4%) and the 5th decade for those with malignant diseases (26.0%). Both benign (39.4%) and malignant diseases (42.1%) were more prevalent on the right lobe. The incidence of carcinomas was 28.9% in solitary nodules and 29.3% in multinodular goiters. In the histopathologic study, the most common type was a papillary carcinoma (84.5%) in malignancies and an adenomatous goiter (48.8%) in benign diseases. The most commonly performed surgical procedures were a total thyroidectomy (75.4%) for malignancies and a lobectomy for benign diseases (63.3%). Postoperative complications were 3.1% in patients with benign diseases and 29.7% in those with malignancies. Regional recurrence or distant metastases appeared in 5.5% of the patients during the 10 years following treatment. CONCLUSION: The treatments of choice were a thyroid lobectomy for patients with benign diseases and a total thyroidectomy for those with malignant diseases. However, the decision to perform a surgical resection should be based on the age and the general condition of patient.
Carcinoma, Papillary ; Diagnosis ; Female ; Goiter ; Gwangju ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Medical Records ; Neoplasm Metastasis ; Postoperative Complications ; Prevalence ; Recurrence ; Retrospective Studies ; Thyroid Diseases* ; Thyroid Gland* ; Thyroidectomy

A nineteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. In physical examination, thickening of the scalp with furrowing (cutis verticis gyrata) and greasy thickening of skin (pachyderma) was prominent. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis and incidental microadenoma of pituitay gland. After extensive investigation to exclude systemic and endocrine causes, the patient was diagnosed as pachydermoperiostosis (PDP). PDP is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified though few endocrine abnormalities were seen. To aware of these clinical phenotype would help to differentiate PDP from acromegaly.
Acro-Osteolysis ; Acromegaly ; Extremities ; Fingers ; Humans ; Hyperhidrosis ; Joints ; Male* ; Osteoarthropathy, Primary Hypertrophic* ; Osteogenesis ; Phenotype ; Physical Examination ; Scalp ; Skin ; Young Adult*

BACKGROUND: It is well known that intracoronary thrombolysis during the early period of acute myocardial infarction leads to the limitation of myocardial necrosis, preserves left ventricular function, and improves survivals. The recanalization rate of intracoronary rrokinase infusion into infarct-related coronary artery was known as 62-94 percents in previos studies. The various factors influence the outcome of intracoronary thrombolysis, including total dose of urokinase, time from onsrt of chest pain to thrombolysis. The purpose of this study was to evaluate whether the occlusion site morphology influences recanalization rates of intracoronary thrombolysis. METHODS: We evaluated infarct-related coronary artery morphology of 56 acute mycardial infarction patients who performed intracoronary thrombolytic therapy within 6-12 hours after the onset of acute myocardial infarction. Intracoronary urokinase infusion was performed at a rate of 25000 IU/minute. The presence of calcification, collaterals, side branches and the stump site morphologies(thrombus type, pencil type, cutting type) were identified on magnified 35mm cine frames. RESULTS: Reperfusion was successed in 34 patients and failed in 22 patients. There were no statistically significant difference in the pressure of calcification, collaterals, and side branches between success and failure groups. Intracoronary thrombus was identified in 21 percent of success group, but not in failure group. The reperfusion rates according to stump site morphology were 76% in thrombus type, 58% in cutting type, and 42% in pencil type(p<0.05). CONCLUSION: Our study indicates the presence of intracoronary thrombus and the morphology of thrombus type is more effective in intracoronary thrombolysis in acute myocardial infarction. The identification of types of the coronary obstruction will be helpful for the selection of intracoronary thrombolysis in acute myocardial infarction patients. And the results suggest that the difference of stump composition show different stump morphologies.
Chest Pain ; Coronary Vessels* ; Humans ; Infarction ; Myocardial Infarction* ; Necrosis ; Reperfusion ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Ventricular Function, Left