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

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

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

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 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

Twenty-one patients undergoing aortic valve replacement for pure aoritic regurgitation were studied retrospectively to evaluate the left ventricular function and internal dimension change before, 1-6 weeks(early postoperative) and 2-36 months after(late postoperative) aortic valve replacement by serial echocardiography. Postoperatively, NYHA function class improved remarkably (from 3.3+/-0.6 to 1.4+/-0.7). Early postoperatively, left ventricular end-diastolic dimension (EDD), left ventricular end-systolic dimension(ESD), left ventricular fractional shortenting(FS) significantly decreased in all patients(7.6+/-1.2cm vs 5.8+/-1.5cm P<0.001, 5.5+/-1.3cm vs 4.7+/-1.3cm P<0.001, 39+/-12% vs20+/-8% P<0.001 respectively). Interventricular septum thickness(IVS) and posterior wall thickness (PW) were slightly thickened before(1.4+/-0.3cm, 1.3+/-0.3cm respectively) and in the early postoperative period (1.3+/-0.4cm, 1.3+/-0.3cm respectively) without significant interval change. Late postoperatively, EDD and ESD decreased significantly (7.8+/-1.2cm vs 5.1+/-0.8cm P<0.01, 5.1+/-1.1cm vs 3.4+/-0.8cm P<0.001. respectively), and FS increased significantly (25+/-9% vs 34+/-9%, P<0.05). Among 3 patients of so called high risk group mentioned by Henry(22,33), ESD and FS improved to normal range in 2 patients, and ESD decreased to 4.4cm and FS increased to 33% in the other one. EDD and ESD decreased significantly in both group I(preoperative ESD<5.5cm) and group II(preoperative ESD<5.5cm), without no decrement difference between two groups, and there was a significant difference of FS decrement between group I and group II at early postoperative period. Preoperative ESD correlated highly with the early postoperative EDD(r=0.89) and ESD(r=0.87) with statistical significance, and moderately high with late postoperative EDD(r=0.45), ESD(r=0.50) and FS(r=0.42) without statistical signiticance. We concluded that there was significant improvement in left ventricular function in pure aortic regurgitation patients postoperatively. Preoperative left ventricular and systolic dimension above 5.5cm and fractional shortenting below 25% are not so reliabel index of poor postoperative prognosis.
Aortic Valve Insufficiency* ; Aortic Valve* ; Echocardiography* ; Humans ; Postoperative Period ; Prognosis ; Reference Values ; Retrospective Studies ; Ventricular Function, Left