The authors evaluated the clinical significance of the bilirubin values as screening test means for predicting the occurrence of neonatal jaundice earlier after birth, by using the transcutaneous bilirubinometry which is known to measure the bilirubin values in a noninvasive, accurate and simple way. The results obtained were as follows: 1. In comparison between the test group(showing the symptom of a jaundice within 72 hours after birth) and the control group, there were found no statistically significant differences in terms of sex, delivery type, birth weight, gestational age and mother's age, while being found statistically significant differences in terms of transcutaneous bilirubin at birth(TcBbirth), transcutaneous bilirubin at 24 hours after birth(TcB24hr), increase in transcutaneous bilirubin per hour during the first 24 hours after birth(TcBin/hr) and transcutaneous bilirubin at 72 hours after birth(TcB72hr)(p<0,05). 2. The correlation test using the Pearson's coefficient produced statistically significant correlationship between each transcutaneous bilirubin index (TcBbirth, TcB24hr, TcBin/hr and TcB72hr) and serum bilirubin concentration at 72 hours after birth(B72hr)(p<0.05), while the result of the correlation test using the Spearman's roh showed statistically significant correlationship only between TcB24hr or TcB72hr and B72hr(p<0.05). As it was, the correlationship between TcB72hr and B72hr was highest in both Pearsons coefficient and Spearman's roh tests, followed by that between TcB24hr and B72hr. 3. In view of the ROC graph, the most effective means of predicting the occurrence of the neonatal jaundice was TcB72hr followed by TcB24hr, TcBbirth and TcBin/hr in their order. In particular, TcB24hr was conceived to be useful as screening test for determining an early discharge from the nursery within 48 hours. On the other hand, since the negative predictive value of TcBbirth, and TcB24hr is higher, the possibility that those infants showing a lower value of these indices may well be free later from a serious neonatal jaundice even if they should be discharged earlier from the nursery. In conclusion, those four indices predicting the neonatal jaundice in a simple, quick and noninvasive manner using the transcutaneous bilirubinometry were considered to be effective screening test means whereby any serious neonatal jaundice developed earlier after delivery can be successfully predicted.
Bilirubin ; Birth Weight ; Gestational Age ; Hand ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal* ; Mass Screening* ; Nurseries ; Parturition

Superficial gastritis has been classified as a type of chronic gastritis, since a report of Schindler in GASTRLTIS, 1947. Howev~er, Benedict reported that superficial gastritis is only acute gastritis or shows normal mucosa histologically. The com mon endopical findings of chronic superficial gastritis were adherent mucus, edema, redness. The common redness which were encounterd are patchy redness and comb-like redness(Kammrotung). We studied the relationship between the redness of superficial gastritis and acute inflammatory changes histologically. Each case of superfieial gastritis was biopsied to redening and non-redening mucosa respectively. We collected 24 cases with 48 biopsy specimens. The results are as follows: Acute inflammatory changes were found only one case in redness and none in non-redness groups. There was no difference in acute inflammatory changes in two groups. The degree of mucosal atrophy were 62.5%, 66.7% in normal mucosa, 12.5%, 16.7~% in mild atrophy, 25%, 12.5% in moderate atrophy, 0%, 4.l% in severe atrophy with respect to redness and non-redness mucosa respectively. There was no difference in degree of mucosal atrophy in two groups. Mucosal atrophies were higher in older ages above 41 years old than below 40 and with increasing age, there was increasing tendency of mucosal atrophy. In conclusion, There was no relationships between mucosal redness and acute in flammatory changes histologically and also between mucosal redness and degree of atrophy.
Adult ; Atrophy ; Biopsy ; Edema ; Gastritis* ; Humans ; Mucous Membrane ; Mucus

Gastrocelic fistula of malignant origin is a rare complication, usually due to gastric or colon cancer. Possible other etiologic factors resulting in gastrocolic fistula are peptic ulcer, trauma, carcinoid tumor, intestinal tuberculosis, Crohn's disease, lymphoma, intraabdominal abscess, diverticulitis and etc. At the present, earlier diagnosis and treatment of gastric and colon cancer may explain the low frequency of malignant gastrocolic fistula than the past but the review of Korean literatures revealed only two reports of gastrocolic fistula secondary to gastric cancer and another from benign gastric ulcer. Yet, there has been no report of fistula due to colon cancer. We experienced a case of colon cancer with postural dizziness, fecal eructation who was diagnosed as gastrocolic fistula by endoscopy, barium enema, UGI series and finally underwent operation. Therefore, we report this case with the review of literatures.
Abscess ; Barium ; Carcinoid Tumor ; Colon* ; Colonic Neoplasms* ; Crohn Disease ; Diagnosis ; Diverticulitis ; Dizziness ; Endoscopy ; Enema ; Eructation ; Fistula* ; Lymphoma ; Peptic Ulcer ; Stomach Neoplasms ; Stomach Ulcer ; Tuberculosis

Gastrocolic fistula is a rare lesion which is caused most commonly by carcinoma of colon or stomach. The less common causes of gastrocolic fistula are follows: trauma, faulty gastrocolic anastomosis during gastrectomy, benign gastric ulcer, syphilis, carcinoid tumor, tuberculosis, intraperitoneal abscess, lymphoma, perforated diverticulum of colon, and ulcerative colitis. The locations of fistulae are mostly between greater curvature of stomach and distal half of the transverse colon. In the case of penetrating benign gastric ulcer and gastrcolic fistula, it is usually associated either with asipirin or with prolonged steroid administration. A 36-year-old male who had an unusual gastrocolic fistula secondary to non-surgically treated benign gastric ulcer is presented. The exitence of a gastrocolic fistula was dernonstrated by radiological examination of the colon and the stomach. In this patient, the colonoscope passde through the fistula and the stomach could be examined. Careful preparation was carried out preoperatively with intravenous fluids and blood transfusions. Resection of the distal stomch, fistulous tract, and segment of the transverse colon was then accamplished.
Abscess ; Adult ; Blood Transfusion ; Carcinoid Tumor ; Colitis, Ulcerative ; Colon ; Colon, Transverse ; Colonoscopes ; Diverticulum ; Fistula* ; Gastrectomy ; Humans ; Lymphoma ; Male ; Stomach ; Stomach Ulcer* ; Syphilis ; Tuberculosis

Double primary cancer means that more than two cancers with different origin exist independently in an individual. The diagnosis of double primary cancer was determined by following criteria. Each of the tumors must present a definite picture of malignancy, and each must be distinct, and the probability of one being a metastasis of the other must be excluded. Small cell carcinoma has a distinct biological behavior such as, early invasion and metastasis, a rapid clinical course, and significant sensitivity to chemotherapy. Small cell carcinoma in the esophagus is relatively rare, and rarer when it is combined with other malignant disease. We have experienced a case of double primary cancer, a 70-year-old man with esophageal small cell carcinoma and gastric adenocarcinoma, which were diagnosed by gastrointestinal endoscopic biopsy. A review of the Korean medical literature failed to reveal any previously described case of esophageal small cell carcinoma with gastric adenocareinoma. We report this case with review of literatures.
Adenocarcinoma* ; Aged ; Biopsy ; Carcinoma, Small Cell* ; Diagnosis ; Drug Therapy ; Esophagus ; Humans ; Neoplasm Metastasis

No abstract available.
Breast* ; Estrogens*

Intestinal tuberculosis has been known since antiquity. After about 1950's, effective antituberculous chemotherapy and an improved standard of living resulted in a steady decline in all forms of tuberculosis. However, intestinal tuberculosis has been reported with impressive frequency in developing countries including Korea. Disease affecting the duodenum is reported to be rare and isolated duodenal tuberculosis sparing the rest of the intestine is uncommon. We experienced a case of tuberculosis of duodenal bulb associated pulmonary tuberculosis. The diagnosis was made on the basis of the histological study of the endoscopic biopsy specimen. We have confirmed the healing of the duodenal lesion by the follow-up endoscopy after 9 months treatment of antituberculous medication.
Biopsy ; Developing Countries ; Diagnosis ; Drug Therapy ; Duodenum* ; Endoscopy ; Follow-Up Studies ; Intestines ; Korea ; Socioeconomic Factors ; Tuberculosis* ; Tuberculosis, Pulmonary*

BACKGROUND: Successful resuscitation of the brain requires unimpaired blood recirculation. However, unfortunately there are several factors against the successful recirculation. No-reflow phenomenon, characterized by a lack of reperfusion after cerebral ischemia, is the most important pathogenic factor during the early period of spontaneous circulation(ROSC). This study addresses question that pentoxifylline(PTX) ameliorates no-reflow phenomenon after cardiac arrest. METHODS: Fourteen rats were divided three group ; Sham group(n=2), 12 minutes cardiac arrest group without PTX(group I, n=6), and 12 minutes cardiac arrest group pretreated with PTX(group II, n=6). Group II were premedicated by intravascular injection of 5mg/kg PTX into the external jugular vein before 5minutes of the arrest-induction. We induced cardiac arrest with endotracheal clamping and muscle relaxant. And then, resuscitation was initiated. Arterial blood samples were drawn at the femoral artery before 5 minutes of arrest-induction and at the 5 minutes after restoration of ROSC. Reperfusion of brain was visualized by injection of 0.3g/kg of 15% FITC-albumin at 5 minutes after restoration of ROSC, and the animals were decapitated 2 minutes later. The left hemisphere was fixed with 4% formalin, and coronal sections of 200um thickness at three different standard levels of the rat brain were investigated with fluorescence microscopy. Density of microvasular filling were identified and calculated. RESULTS: Our observation demonstrated that 1. There were no significant differences of blood pressures, heart rates, and results of blood gas analysis between group I and II during the prearrest steady state. 2. There were no significant differences of blood pressures, heart rates, and results of blood gas analysis between group Iand II at 5minutes after ROSC. 3. Group II premedicated with PTX, showed significant increased capillary refiling(0.310+/-0.035)than group I without PTX(0.181+/-0.040). CONCLUSIONS : The results showed that during the prearrest steady state, premedication of PTX ameliorated the no-reflow phenomenon in the rat model of the asphyxial arrest. Further experimental studies are required to focus on the effects of postarrest infused PTX, The neurologic outcome, and the clinical applications.
Animals ; Blood Gas Analysis ; Brain ; Brain Ischemia ; Capillaries ; Constriction ; Femoral Artery ; Formaldehyde ; Heart Arrest* ; Heart Arrest, Induced ; Heart Rate ; Jugular Veins ; Microscopy, Fluorescence ; Models, Animal ; No-Reflow Phenomenon* ; Pentoxifylline* ; Premedication ; Rats* ; Reperfusion ; Resuscitation

BACKGROUND/AIMS: Paracentesis is an acceptable therapeutic modality for the symptomatic relief of dyspnea or abdominal fullness due to tense ascites in patients with cirrhosis. Whereas studies about the effects of paracentesis focused on the changes about hemodynamics, electrolytes and renal function in great detail, the effects of paracentesis on the changes about respiratory system have undergone limited investigations which are defined large-volume paracentesis. METHODS: We performed pulmonary function tests with arterial blood gas analysis just before and 24 hr after paracentesis. The paracentesis of average 2,300ml was carried out in ten liver cirrhosis patients with tense ascites who were free from underlying cardiopulmonary impairment. RESULTS: 1. The results of pulmonary function test just before paracentesis were as followings; FVC( functional vital capacity), FEV1(forced expiratory volume in 1 sec), FEF25 75(forced expiratory effort 25% 75%) and TLC(total lung capacity) were decreased as 78%, 79%, 62.3% and 89% of normal control value respectively, whereas RV(residual volume) was not decreased. DLCO(lung diffusion capacity of carbon monoxide)was decreased as 61.6%. 2. The results of pulmona function test 24 hr after paracentesis were as followings,' The symptomatic relief of dyspnea was achieved in all participated ten patients. Among lung volume parameters, FVC and VC were increased significantly(p=0.003, p=0.004). Whereas TLC was increased without statistical significance(p=0.228), and RV and FRC(functional residual capacity) showed no change. FEV1 was increased significantly(p=0.039), but FEF25 75 and the ratio of FEF1/FVC showed no change. DLCO was not increased. PaOy(partial pressure of oxygen in arterial blood) was impr'oved without statistical significance. CONCLUSIONS: These results suggest that the patients of liver cirrhosis with ascites have restrictive ventilatory impairment with additional obstructive ventilatory impairment. After paracentesis, the restrictive ventilatop impairment is improved by the relief of diaphragmatic motion limitation caused by ascites. Also, paracentesis of(not large volume, like 5000ml, but) relatively small volume, of 2000 3000ml can achieve objective improvement of dyspnea due to tense ascites.
Ascites ; Blood Gas Analysis ; Carbon ; Diffusion ; Dyspnea ; Electrolytes ; Fibrosis* ; Hemodynamics ; Humans ; Liver Cirrhosis ; Lung ; Oxygen ; Paracentesis* ; Respiratory Function Tests ; Respiratory System ; Transcutaneous Electric Nerve Stimulation

PURPOSE: Retinal detachment due to macular holes in highly myopic eyes is now usually treated by intraocular gas tamponade with pars plana vitrectomy. However, reopening of the macular holes occurs frequently. In this study, we performed macular buckling for recurred retinal detachment caused by macular holes in highly myopic eyes that failed with vitrectomy and intraocular gas tamponade. We observed that these complex cases could be successfully repaired with this procedure. METHODS: Retinal detachment resulting from a macular holes was found to be present in 3 highly myopic eyes. Retinal reattachment was obtained in all eyes following pars plana vitrectomy and removal of the internal limiting membrane in the posterior pole and fluid-gas exchange. A few months later, the retinal redetachment occurred as a result of reopened macular hole. We performed macular buckling as reoperation. RESULTS: After the second surgery, the macular hole remained closed and the retina remained reattached in all 3 eyes. Retinal reattachment was maintained for longer than 3 months of follow-up periods, and the final visual acuity was improved. CONCLUSIONS: This small case series suggest that macular buckling is an effective procedure of reoperation for failed initial vitrectomy for retinal detachment with macular holes in highly myopic eyes.
Follow-Up Studies ; Membranes ; Reoperation ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Visual Acuity ; Vitrectomy