The purpose of this study is to review epidemiological and clinical characteristics of diverticular disease of the colan in Korea and to discuss the difference of the findings from those in other countries. Reviewing all thebarium enema films taken at the Seoul National University Hospital retrospectively for the last 8 years. that is, from January 1, 1980 to December 31, 1987, we observed the annual and overall incidence of the disease, the number and location of the diverticula, and the presenting symptoms of the cases. The results are summarized as follows: 1) Out of the patients examined, 237 cases had one or more diverticula in the colon, the overall incidence being 1.32%, 2) The annual incidence increased progressively for the last 8 years, from 0.25% in 1980 to 2.53% in 1987. 3) The mean age of the patients at the time of diagnosis was 51 years. The male to female ratio was 2.5. 4) The diverticula were located on the right side in 81.0% of the cases, on the left side in 10.6%, and on both sides in 8.4%. 5) In 82 cases (34.6%) single diverticulum was found, whereas 34 cases (14.3%) had more than 10 diverticula. 6) The most frequent symptoms for taking barium enema were abdominal discomfort and pain (34. 2%) and changes in bowel habits (33.8%}, whereas 45 casea (19.0%) had the examination just for a routine health check. In conclusiion, the diverticular disease of the colon is still uncommon in Korea as compared with in western countries, and the right colon type is far more freqtaent than the left colon type. However in recent years the incidence increases quite rapidly and the left colon type is getting more common.
Barium ; Colon* ; Diagnosis ; Diverticulum ; Enema ; Female ; Humans ; Incidence ; Korea* ; Male ; Retrospective Studies ; Seoul

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.
Adult ; Aneurysm* ; Aorta, Thoracic* ; Aortic Valve ; Brain Ischemia ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Male ; Middle Aged ; Perfusion ; Sternotomy ; Thoracotomy ; Transplants

No abstract available.
Cervix Uteri* ; Female

Laparoscopy was performed successfully at operation in 18 consecutive boys who had 19 nonpalpable testes Of the testes. 2 were in the inguinal region. 6 were in the just proximal to the internal inguinal ring. 2 were high intra-abominal position. and 9 were vanished testes (intracana1icular). In every case of vanished inguinal testis and intracanalicular testis. vas and gonadal vessels were observed laparoscopically to exit the internal inguinal ring. In these vanished testes. hernia or patent processus vaginalis was not observed and contralateral testes were located normally in the scrotum. OF 8 intraabdominal testes. 6 were detected laparoscopically. Laparoscopy provided localization or either testis or the course of spermatic vessels in all patients and these information facilitated accurate planning of operative repair.
Gonads ; Hernia ; Humans ; Inguinal Canal ; Laparoscopy* ; Scrotum ; Testis*

This study was aimed at investigation of the stimulatory innervations on the rat urinary bladder. Detrusor muscle strips of 15 mm long were suspended in isolated muscle chambers containing 1 ml of PSS maintained at 37℃ and aerated with 95% O²/5% Co². Isometric myography was performed, and the results were as followings: Muscle strips showed “on-contraction” by electric field stimulation (EFS) frequency-dependently. The EFS-induced contraction was not affected by hexamethonium, a ganglion blocker, but abolished by tetrodotoxin, a nerve conduction blocker. Physostigmine, a cholinesterase inhibitor enhanced the EFS-induced contraction which was inhibited by hemicholinium, an inhibitor of choline uptake at the cholinergic nerve ending. Such an EFS-induced contraction was antagonized by atropine only partially, and the atropine-resistant portion was completely abolished by the desensitization of purinergic receptors by prolonged incubating of the strips in the presence of high concentration of ATP. Bethanechol, a cholinergic agonist, elicited concentration-dependent contraction. Adenosine triphosphate (ATP), a purinergic agonist, induced a weak but concentration-dependent contraction of short duration. Bethanechol-induced contraction was not affected by ATP-desensitization, and ATP-induced contraction was not affected by tetrodotoxin. These results suggest that there are at least two main stimulatory components of innervations in the detrusor muscle, cholinergic muscarinic and purinergic; and those receptors are independent each other.
Adenosine Triphosphate ; Animals ; Atropine ; Bethanechol ; Choline ; Cholinergic Agonists ; Cholinesterases ; Ganglion Cysts ; Hemicholinium 3 ; Hexamethonium ; Myography ; Nerve Endings ; Neural Conduction ; Physostigmine ; Rats* ; Receptors, Purinergic ; Tetrodotoxin ; Urinary Bladder*

BACKGROUND: Antibiotics are often indiscriminately prescribed for respiratory tract infections. This study was conducted to describe the prescription pattern of family physicians for respiratory tract infections. METHODS: In each clinic of 50 representative family practitioners, about 20 consecutive patients with diagnosis of respiratory tract infection were enrolled into the study. The data were collected by questionnaire to physicians just after patient interview. RESULTS: The number of study subjects was 1020, of which 55.7% was less than 15 year old. Antibiotics were prescribed to 73.9% of total subjects. According to diagnosis, the antibiotic prescription rate was 51.5% in common cold, 86.0% in pharyngitis, 88.6% in bronchitis, 98.9% in sinusitis, and 100% in otitis media. In common cold, the factors which significantly increased the antibiotic prescription were 1)patient age less than 15 year old (OR=1.70, CI=1.06-2.73), 2)more than two visits during the same episode(OR=1.95, CI=1.27-2.99), 3)yellow and thick rhinorrhea(OR=2.22, CI=1.16-4.25), 4)yellow and thick sputum(OR=3.31, CI=1.34-8.19), and 5)throat injection(OR=2.50, CI=1.42-4.39). Among patients to whom antibiotics were prescribed, 48.7% of patients were given the antibiotics by intramuscular injection. The most frequently prescribed antibiotics were penicillin and macroride among per-oral medicine and ribostamycin and lincomycin among intramuscular medicine. The reason for antibiotic prescription were 1)posssibility of bacterial infection(43.4%), 2)prevention of bacterial complication(23.7%), and 3)definite evidence of bacterial infection(22.5%). CONCLUSION: Family practitioners prescribe antibiotics indiscriminately for the respiratory tract infection. The prescription was influence by patient's age, number of clinic-visit, and clinical symptoms and signs.
Adolescent ; Anti-Bacterial Agents* ; Bronchitis ; Common Cold ; Diagnosis ; Humans ; Injections, Intramuscular ; Lincomycin ; Otitis Media ; Penicillins ; Pharyngitis ; Physicians, Family ; Prescriptions* ; Respiratory System* ; Respiratory Tract Infections* ; Ribostamycin ; Sinusitis ; Surveys and Questionnaires

No abstract available.

From 1985 to 1991, we analyzed experiences in the treatment of 37 children with neurogenic bladder who were closely followed up for averaging 25 months. Initial urodynamic study revealed hyperreflexic bladder in 17 patients: 12 with detrusor sphincter dyssynergia. Areflexic bladder was round in 20 patients: 11 with high leak pressure. Among the 17 patients with hyperreflexic bladder. intermittent catheterization had been well performed in 13 patients and in 11 cages of which oral or topical anticholinergics were added Renal function was well preserved and urinary incontinence was improved in 10 of 13 patients and urinary diversion was done in 1 case. In 4 patients that were not treated by intermittent catheterization owing to poor compliances augmentation cystoplasty was performed or to be considered. Four cases of areflexic bladder with high leak pressure had good results with treatment, whereas 4 cases had deterioration of renal function because of poor complianes to treatment. Among 9 cases of areflexic bladder with low leak pressure, 6 cases were treated by intermittent catheterization. In all of which voidine symptoms were improved. The other 3 cases are under observation without any problems except urinary incontinence. As above, we can conclude that preservation of renal function and improvement of urinary incontinence can be achieved with intermittent catheterization and oral or topical anticholinergics in pediatric neurogenic bladder patients and that noninvasive treatment including Crede maneuver may be used in the treatment of patients with areflexic bladder with low leak pressure.
Ataxia ; Catheterization* ; Catheters* ; Child* ; Cholinergic Antagonists ; Humans ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Diversion ; Urinary Incontinence ; Urodynamics

Cutaneous vesicostomy has been suggested as a useful procedure of temporary urinary diversion that can be performed and reversed easily with low incidence of complication We evaluated postoperative courses in 15 patients who underwent vesicostomy for either lower urinary tract dysfunction or obstruction. The age of the patients at the time of vesicostomy ranged from 8 days to 5.8 years(mean 18 months). The indications for vesicostomy were posterior urethral valves(5), neurogenic bladder(5), urethral stricture(31, vesicoureteral reflux(1) and anterior urethral valves(1). Associated anomalies were congenital heart disease(5), imperforated anus(3), subarachnoidal hemorrhage(1) and multicystic kidney(2). Of the 11 patients with dilated upper tracts preoperatively 10 patients improved significantly after vesicostomy while 1 remained stable. Stomal narrowing and mucosal prolapse as complications occurred in 2 patients, but none of these required surgical correction. The vesicostomy was closed successfully in 8 patients at 12 to 53 months after diversion as a simple procedure. Our experience reveals that vesicostomy is thought to be an effective, simple and easily reversible means of temporary urinary diversion to treat selected conditions in infants and children.
Child* ; Cystostomy* ; Heart ; Humans ; Incidence ; Infant* ; Prolapse ; Urinary Diversion ; Urinary Tract

No abstract available.
Cytogenetics* ; Gestational Age*