No abstract available.
Adenocarcinoma, Mucinous* ; Child* ; Colon* ; Humans ; Mucins*

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Statistics as Topic*

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.
Adult ; Arteries ; Arteriovenous Fistula* ; Cardiomegaly ; Dyspnea ; Edema ; Fistula ; Heart Failure ; Heart Sounds ; Humans ; Lower Extremity ; Pleural Effusion ; Rare Diseases ; Ribs* ; Subclavian Artery* ; Thorax

The migration of intra-uterine devices into the bladder with the formation of stone occurs rarely. We report a case of bladder stone developed on Lippes loop migrated from the uterus.
Foreign Bodies ; Intrauterine Devices* ; Urinary Bladder ; Urinary Bladder Calculi ; Uterus

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. The injuries to the ankle joint result in a severe functional disturbance because of complex anatomical characteristics around the ankle joint. 284 patients of the ankle fracture that were treated in orthopedic Dept. Capital Armed Forced General Hospital from march 1985. to march 1988. were analized in clinical and radiological aspects. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other were sports injury and slipping down in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type(122 case, 42.9%). 3. 211 case(74.3%) were treated with open reduction and internal fixation, and 73 case(25.7%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 4. Accurate reduction and rigid internal fixation of the lateral malleolus with shortening was important factor. 5. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Arm ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Hospitals, General ; Humans ; Musculoskeletal System ; Orthopedics ; Walking

OBJECTIVES: To determine the relationships among quality, satisfaction, value and purchase intention in health care service. METHODS: The data were gathered from out-patients who had used hospital services. They were asked to assess service quality, satisfaction, service value, and purchase intention. A total of 557 usable questionnaires were gathered. The data were analyzed using SAS version 6.12. The analytic methods employed in the study were confirmatory analysis and covariance structural analysis. RESULTS: Service quality exhibited a significant and positive relationship with satisfaction, service value, and purchase intention. Furthermore, satisfaction had a significant and positive relationship with purchase intention. And finally, service value had a significant and positive relationship with both satisfaction and purchase intention. Based on these findings, it is evident that satisfaction was a mediator between service quality and purchase intention. Also service value played a mediating role between service quality and satisfaction. CONCLUSIONS: These results suggest that service quality is an antecedent of satisfaction and service value, and exerts a stronger influence on purchase intentions than satisfaction and service value do. Thus, managers may need to emphasize service quality in health care.
Delivery of Health Care* ; Humans ; Intention* ; Models, Structural* ; Negotiating ; Outpatients ; Surveys and Questionnaires

The nutcracker phenomenon consists in the compression of the left renal vein between the superior mesenteic artery and the aorta, and this syndrome is an infrequent cause of left-sided hematuria. We present a case of the nutcracker syndrome with intermittent gross hematuria to increase the awareness of this possible cause of hematuria.
Aorta ; Arteries ; Hematuria ; Renal Veins

PURPOSE: To verify the changes of segmental motion after posterolateral lumbar fusion. MATERIALS AND METHODS: Thirty-eight cases of lumbar posterolateral fusion with good postoperative results and full range of motion, followed up for at least one year were reviewed. We measured the translation and angulation by the Dupuis method on flexion extension radiographs. RESULTS: 1) The motion at adjacent segments was 0.75 mm translation and 6.5 degree angulation at L1-2, 0.75 mm and 8.62 degree at L2-3, 0.95 mm and 9.67 degree at L3-4, 1.17 mm and 10.67 degree at L4-5 and 0.41 mm and 7.41 degree at L5-S1. The motion at L5-S1 was less than that in the control group, but at other levels it was not different. 2) The total range of motion of lumbar spine in the control group was 47.8 degree. In one-segment fusion the range of motion was 31.1 degree(64.9%), in two-segment fusion was 26.8 degree(56.1%) and in three-segment fusion was 14.3 degree(29.8%). The longer the fusion level was, the smaller the total range of motion of lumbar spine was. 3) The percentage of motion at adjacent mobile segments in the fusion group increased more significantly than that in the control group. CONCLUSIONS: Segmental motion at adjacent segment in the fusion group was similar to the motion in the control group. The compensatory increased motion at adjacent mobile segment was not definite, however, the percentage of motion at adjacent segment increased after spinal fusion.
Range of Motion, Articular ; Spinal Fusion ; Spine

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.
Abscess ; Adult ; Cellulitis ; Child ; Diagnosis ; Diplopia ; Eye Movements ; Humans ; Necrosis ; Orbit* ; Orbital Cellulitis ; Prognosis ; Sinusitis* ; Sutures

STATEMENT OF PROBLEM: Adequate bone quality and quantity were important to achieve initial stability and to prevent early failures. However there were few published data available regarding the actual effect of dimensional change in implant geometry on initial stability. PURPOSE: The purpose of the current study was to investigate the influence of diameter and length changes on initial stability of implants. MATERIAL AND METHODS: Four types of dummy bone (D1, D2, D3 and D4) consisted of cortical and cancellous layers with different thickness were simulated. Implants which had similar surface area to each other (3.5 x 13.0-mm, 4.0 x 11.5-mm, 4.5 x 10.0-mm, 5.0 x 8.5-mm) were inserted in dummy bones. Implant stability as a function of peak insertion torque and resonance frequency values were recorded for each implant. RESULTS: 1. Bone quality was a major influential factor to achieve initial stability (P < .05). 2. In D1, D2 and D3 dummy bones, implant stability quotient values were not significantly different to each other (P > .05), however insertion torques were increased with wider and shorter implants (P < .05). 3. In D4 dummy bone, implant stability quotient values and insertion torques were decreased with wider and shorter implants (P <. 05). CONCLUSION: From a point of view of initial stability, it is suggested that use of wide and short implant may be helpful in avoiding bone augmentation procedures in area of adequate bone quality.
Torque