This clinical study is based on review of records of 87 patients with postoperative adhesive intestinal obstruction who were managed at the Department of Surgery of Dongbu City Hospital during 5 years from September, 1992 to August, 1997. The results of study were as follows: 1) The most prevalent age group was 5th decade(44.8%) and male to female ratio was 1.7:1. 2) The previous operations were operation for appendicitis(32.2%), operations for peritonitis due to peptic ulcer perforation(24.1%), gynecologic operations(13.8%), operation for gastric malignancy(8.1%). 3) The mean value of duration between previous operations and postoperative adhsive intestinal obstruction was 36 months and the mean value of duration of symptoms was two days. 4) 42(49.2%) of 87 patients were admitted under 24 hours after onset of symptoms. 5) The chief complaints on admission were abdominal pain(98.8%), vomiting(81.6%), abdominal distension(78.2%), failure to flatus(55.2%). 6) 23 cases(45.1%) of 51 cases having one or more abnormal physical and laboratory finding(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis) were operated, and 5 cases(13.9%) of 36 cases having no physical finding were operated (p value < 0.05). 7) Emergency operation was performed in 9 cases, elective operation was performed in 19 cases which had deteriorating clinical course despite of conservative management for 48 hours, and conservative treatement was performed in 59 cases. 8) The postoperative complications were observed in 6 cases and the most common complication was wound infection(14.3%). In conclusions, The longer symptom duration and the longer interval between previous operation and onset of symptoms, the higer probability of surgical treatment is expected. The need for surgical treatment was increased acording the number of physical and laboratory findings(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis). For the cases which have unimproving and deteriorating clinical course despite of conservative management for 72 hours, surgical operation shoud be considered.
Adhesives* ; Defecation ; Emergencies ; Female ; Hospitals, Urban ; Humans ; Intestinal Obstruction* ; Male ; Peptic Ulcer ; Peritonitis ; Postoperative Complications ; Wounds and Injuries

Eccrine chromhidrosis(colored sweating), resulting from the contamination of the sweat by dyes, pigment from microorganisms such as those of Piedraia or Corynebacterium, or other chernicals, is a very rare disease. We report a case of eccrine chromhidrosis which revealed dark-brown colored pigmented spots analyzed by energy dispersive X-ray microassay and scanning electron microscopy, which were thought to be composed of silver iodide(AgI) formed by the conjugation of silver components from outside and iodide components of eccrine sweat, on the face, postauricular area, legs, and finger tips.
Coloring Agents ; Corynebacterium ; Fingers ; Leg ; Microscopy, Electron, Scanning ; Rare Diseases ; Silver* ; Sweat

No abstract available.
Biopsy* ; Child* ; Humans

Background: The insulin-like growth factors, IGF-I and
Animals ; Calcimycin ; Calcium ; Egtazic Acid ; Extracellular Fluid ; Glucose ; Hepatocytes ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Liver ; Metabolism ; Parathyroid Hormone ; Perfusion ; Rats ; Somatomedins

Among the 413 patients of the lumbar herniated nucleus pulposus(HNP) who were admitted and treated at Dong-A University Hospital from March 1990 to May 1994, we analyzed 387 patients who checked magnetic resonance imaging(MRI). MRI study followed by open disectomy was carried out on 127 patients of the lumbar HNP, and we analyzed the clinical and operative findings of the lumbar HNP and compared these with MRI findings. The following results were obtained. 1. MRI findings of 387 patients consisted of bulging discs in 107 cases(27.6%), protruded discs in 165 cases(42.6%), extruded subligamentous discs in 73 cases(18.9%), extruded transligamentous discs in 34 cases(8.8%) and sequestered discs in 8 cases(2.1%). 2. MRI findings of 127 patients who had been treated with open discectomy consisted of protruded discs in 53 cases(41.7%), extruded subligamentous discs in 47 cases(37.0%), extruded transligamentous discs in 19 cases(15.0%) and sequestered discs in 8 cases(6.3%). 3. Operative findings revealed the protruded discs: 49 cases(38.6%), extruded subligamentous discs: 52 cases(40.9%), extruded transligamentous discs: 18 cases(14.2%) and sequestered discs: 8 cases(6.3%). 4. In sequestered disc, we could get the highest sensitivity, specificity and accuracy with MRI in distinguishing from another type of lumbar HNP. MRI can be available for accurate assessment of type and location of the lumbar HNP and it can show the high specificity, sensitivity and accuracy in preoperative diagnostic method.
Diskectomy ; Humans ; Magnetic Resonance Imaging ; Methods ; Sensitivity and Specificity

No abstract available.
Progeria*

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

No abstract available.

BACKGROUND: Handgrip and cold pressor test may increase the afterload of the heart. And in left ventricular hypertrophy, it is known that mitral flow pattern is affected by decreased left ventricular compliance. We investigated the effects of handgrip and cold pressor test on mitral flow pattern in patients with left ventricular hypertrophy. METHODS: Handgrip and cold pressor test were performed in 12 subjects with left ventricular hypertrophy and in 14 healthy normal subjects. In supine position, blood pressure, heart rate and Doppler echocardiographic parameters(early peak flow velocity : E, atrial peak flow velocity : A) were obtained at rest, 1 and 3 minutes after the onset of tests respectively. RESULTS: In both groups, handgrip and cold pressor test increased blood pressure slightly without a statistical significance. In left ventricular hypertrophy group, there were significant increments in heart rates at 1 minute of handgrip (78+/-12min-1, p<0.001) and cold pressor test(77+/-7min-1, p<0.05) as compared to that at rest (73+/-12min-1). Mitral flow velocities did not show significant change after the tests in control group. A waves after 1 minute of handgrip(85.2+/-18.4cm/sec, p<0.05) and cold pressor test (87.3+/-17.8cm/sec, p<0.001) showed significant increases as compared to that at rest (79.1+/-14.9cm/sec) in left ventricular hypertrophy group whereas E waves did not. CONCLUSION: Although handgrip and cold pressor tests did not affect the mitral flow significantly in control group, each test raised A waves in left ventricular hypertrophy group. These results suggest that increased A waves may be due to a rise in afterload and decreased left ventricular compliance caused by handgrip and cold pressor test in left ventricular hypertrophy group.
Blood Pressure ; Compliance ; Echocardiography ; Heart ; Heart Rate ; Humans ; Hypertrophy, Left Ventricular* ; Supine Position

BACKGROUND: Pregnancy in human and rodents is associated with dramatic matemal metabolic changes. Insulin-like growth factors (IGFs) are mitogenic peptides that are essential for fetal and maternal tissue growth during pregnancy. They circulate complexed primarily with a serum IGF-binding protein (IGFBP-3) which regulates the availability of the IGFs to their specific target tissues. METHODS: To examine the changes of IGFs and IGFB-3 during pregnancy, we measured serum total IGF-I, free IGF-I, IGF-II and IGFBP-3 by using specific radioimmunoassay, immunoradio-metric assay, western ligand blot and western immunoblot. Blood samples were obtained from 88 pregnant women between 6-40 weeks gestation. RESULTS: While serum IGF-I levels increased up to 50% in late pregnancy, serum IGF-II levels remained unchanged. However, serum free IGF-I levels were significantly higher during pregnancy than in nonpregnancy. Western ligand blot analysis revealed that IGFBP-3 in pregnancy serum was significantly decreased at 6 weeks of gestation, continued decreased level until term, and returned to a nonpregnant level by postpartum 10 day. Serum IGFBP-3 profiles in Western immunoblot analysis revealed that 30 kDa fragments of IGFBP-3 were detectable in pregnancy serum but not in nonpregnancy serum. In contrast, serum IGFBP-3 levels using radioimmunoassay was significantly increased in late pregnancy. CONCLUSIONS: 1) serum IGF-I was significantly elevated in late pregnancy 2) serum IGF-II was not significantly changed 3) free IGF-I significantly elevated throughout gestation 4) intact IGFBP-3 was markedly reduced after 6 weeks of gestation.
Blotting, Western ; Female ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Peptides ; Postpartum Period ; Pregnancy* ; Pregnant Women ; Radioimmunoassay ; Rodentia ; Somatomedins