No abstract available.
Drainage* ; Humans ; Jaundice, Obstructive*

No abstract available.

No abstract available.
Toes*

Proper management of childhood and adolescent varicocele remains still controversial. In general, all methods for varicocele ablation for adults are available and include open surgical ligation, laparoscopic ligation, or percutaneous ablation. We evaluated the usefulness of percutaneous embolization of internal spermatic vein in boys with varicocele. Between February 1988 to May 1996, 48 boys of 53 varicoceles underwent percut aneous embolization. In 49 cases, the embolization were technically possible and in the other 4 cases, we could not access the internal spermatic vein because of vasospasm and venous abnormality. The results were successful in 40 cases (81.6%) and failed in 9 cases (18.4%), including 4 (8.2%) of persistent and 5 (10.2%) of recurred cases. There were no major complications except 3 cases of extravasation of contrast material. Percutaneous embolization may be recommended as a primary treatment for childhood and adolescent varicocele.
Adolescent* ; Adult ; Humans ; Ligation ; Varicocele* ; Veins*

Two cases of renal infarctions were presented with review of literature.
Infarction*

A retrospective review of 36 patients with infective endocarditis by strict case definition was performed from 1972 through April of 1984. Male to female ratio was 1:1.25, with mean age of 19.1. Thirty of the 36 patients(83.3%) had the history of predisposing heart diseases: congenital heart disease was most frequent one below the age of 20, rheumatic heart disease between the age of 20-39 and degenerative heart disease above the age of 40. The commonest presenting symptoms were fever, dyspnea, and malaise, and the commonest signs were fever, murmur, and hepatomegaly. Average hemoglobinand hematocrit were 10.1g/dl and 30.8% respectively, showing moderate degree of anemia. White cell count was 11,600+/-5400/mm3 and erythrocyte sedimentation rate was 46+/-18mm/hr. Over four fifths of the patients demonstrated proteinuria and elevated C-reactive protein. Two thirds of the patients showed microscopic hematuria and one third showed positive rheumatoid factor. Eight patients(22.2%) showed arrhythmia and 4(11.1%) showed conduction abnormalities on electrocardiography. The commonest etiologic microorganisms were alpha-hemolytic streptococcus(30.6%) and staphylococcus aureus(22.2%). Abacteremic cases were found in 38.9% of the patients. To compared with alpha-hemolytic streptoccus endocarditis the cases caused by staphylococcus aureus showed the shorter duration of symptoms before admission, the less frequent complication, the higher fever, and the more elevated white cell counts. To penicillin, alpha-hemolytic streptococcus was sensitive in most cultures and staphylococcus arueus was resistant in half of them, and to aminoglycosides vice versa. To cefazolin, both microorganisms were sensitive in most cultures. In 18 of 24(75%) patients vegetation was visualized by echocardiography. The most frequent site of involvement was the mitral valve. And in vegetation detected group complication rate by embolism was found to be higher. The common complications were congestive heart gailure in 24(66.75%), embolism in 8(22.2%), and metastatic infection in 6(16.7%). The mortality rate of infective endocarditis was 25%, and the causes of death were cerebral embolism in 3(8.3%), septic septic shock in 3(8.3%), congestive heart failure in 2(5.6%), and mycotic aneurysmal rupture in 1(2.8%). Conclusively in infective endocarditis the author observed the increasing prevalence of degenerative heart disease as a prdisposing heart disease and increasing incidence of staphylococcus aureus as a causative microorganism. Adn the differences of clinical characteristics between staphylococcus ureus and alpha-hemolytic streptococcus endocarditis would be helpful in diagnosis and treatment of infective endocarditis as well as recognition of prognosis.
Aminoglycosides ; Anemia ; Aneurysm, Infected ; Arrhythmias, Cardiac ; Blood Sedimentation ; C-Reactive Protein ; Cause of Death ; Cefazolin ; Cell Count ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Embolism ; Endocarditis* ; Estrogens, Conjugated (USP) ; Female ; Fever ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Heart Failure ; Hematocrit ; Hematuria ; Hepatomegaly ; Humans ; Incidence ; Intracranial Embolism ; Male ; Mitral Valve ; Mortality ; Penicillins ; Prevalence ; Prognosis ; Proteinuria ; Retrospective Studies ; Rheumatic Heart Disease ; Rheumatoid Factor ; Rupture ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Streptococcus

Background/Aims: Periampuilary diverticulum has been known to be associated with various bilio-pancreatic diseases such as choledocholithiasis and disturbs performing selective cannuiation of ERCP and EST. This present study aims to investigate anatomical morphology of periampullary diverticulum and to determine whether periampullary diverticulurn influences difficulty and complication performing of ERCP and to analyse the relationship between periampullary diverticulum and choledocholithiasis. Methods: We reviewed records of chart and diverticular pictures in 1389 cases of underwent ERCP and evaluated the incidence, size, direction, location of periampullary diverticulum and its influence against performing of ERCP and investigated its relationship with bilio-pancreatic diseases such as choledocholithiasis.(continue..)
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Diverticulum* ; Incidence

To repair bone defects in the oral and maxillofacial field, bone grafts including autografts, allografts, and artificial bone are used in clinical dentistry despite several disadvantages. The purpose of this study was to evaluate new bone formation and healing in rat calvarial bone defects using hydroxyapatite (HA, Ca10[PO4]6[OH]2, Bongros(R), Bio@ Co., KOREA) and tricalcium phosphate (beta-TCP, Ca3[PO4]2, Sigma-Aldrich Co., USA) mixed at various ratios. Additionally, this study evaluated the effects of type I collagen (Rat tail, BD Biosciences Co., Sweden) as a basement membrane organic matrix. A total of twenty, 8-week-old, male Sprague-Dawley rats, weighing 250-300g, were divided equally into a control group (n=2) and nine experimental groups (n=2, each). Bilateral, standardized transosseous circular calvarial defects, 5.0 mm in diameter, were created. In each experimental group, the defect was filled with HA and TCP at a ratio of 100:0, 80:20, 70:30, 60:40, 50:50, 40:60, 30:70, 20:80, and 0:100 with or without type I collagen. Rats were sacrificed 4 and 8 weeks post-operation for radiographic (standardized plain film, Kodak Co., USA), histomorphologic (H&E [Hematoxylin and Eosin], MT [Masson Trichrome]), immunohistochemical staining (for BMP-2, -4, VEGF, and vWF), and elementary analysis (Atomic absorption spectrophotometer, Perkin Elmer AAnalyst 100(R)). As the HA proportion increased, denser radiopacity was seen in most groups at 4 and 8 weeks. In general radiopacity in type I collagen groups was greater than the non-collagen groups, especially in the 100% HA group at 8 weeks. No new bone formation was seen in calvarial defects in any group at 4 weeks. Bridging bone formation from the defect margin was marked at 8 weeks in most type I collagen groups. Although immunohistochemical findings with BMP-2, -4, and VEGF were not significantly different, marked vWF immunoreactivity was present. vWF staining was especially strong in endothelial cells in newly formed bone margins in the 100:0, 80:20, and 70:30 ratio type I collagen groups at 8 weeks. The calcium compositions from the elementary analysis were not statistically significant. Many types of artificial bone have been used as bone graft materials, but most of them can only be applied as an inorganic material. This study confirmed improved bony regeneration by adding organic type I collagen to inorganic HA and TCP mixtures. Therefore, these new artificial bone graft materials, which are under strict storage and distribution systems, will be suggested to be available to clinical dentistry demands.
Absorption ; Animals ; Basement Membrane ; Calcium ; Calcium Phosphates ; Collagen Type I ; Dentistry ; Durapatite ; Endothelial Cells ; Humans ; Male ; Osteogenesis ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Tail ; Transplantation, Homologous ; Transplants ; Vascular Endothelial Growth Factor A

during bone harvesting from the chin.
Anatomic Variation* ; Chin*

BACKGROUND/AIMS: Because the efficacy of standard triple therapy for Helicobacter pylori eradication has declined, new regimens such as sequential therapy (ST) and concomitant therapy (CoCTx) have been introduced. The aim of this study was to compare the efficacy of 10-day ST and 10-day CoCTx for H. pylori eradication. METHODS: We retrospectively reviewed the medical records of 316 patients with proven H. pylori infection. They were assigned to one of 2 regimens; ST (n=191) consisted of, lansoprazole 30 mg and amoxicillin 1 g for 5 days followed by lansoprazole 30 mg, metronidazole 500 mg, and clarithromycin 500 mg for 5 days, and CoCTx (n=125) consisted of lansoprazole 30 mg, amoxicillin 1 g, metronidazole 500 mg, and clarithromycin 500 mg for 10 days. All drugs were administered twice a day. Bacterial eradication was checked by using a 13C-urea breath test at least 4 weeks after completion of treatment. RESULTS: The mean age and male to female ratio was 51.74 and 1.03, respectively. Baseline characteristics were not different in both groups. Ten day CoCTx group (94.4%, 118/125) showed better eradication rate than ST group (82.2%, 157/191) (p=0.002). Drug compliances were not statistically different between the two groups (p=0.19). Side effects were more frequently reported in the CoCTx group than in the ST group (p=0.03). CONCLUSIONS: Ten-day CoCTx was superior to ST in terms of eradicating H. pylori infection. Although the CoCTx producing more side effects than ST, CoCTx can be thought to be a promising alternative to ST as a treatment regimen for H. pylori eradication.
Adult ; Aged ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/*therapeutic use ; Breath Tests ; Clarithromycin/therapeutic use ; Drug Administration Schedule ; Drug Therapy, Combination ; Female ; Helicobacter Infections/diagnosis/*drug therapy ; *Helicobacter pylori ; Humans ; Lansoprazole/therapeutic use ; Logistic Models ; Male ; Metronidazole/therapeutic use ; Middle Aged ; Proton Pump Inhibitors/*therapeutic use ; Retrospective Studies ; Risk Factors ; Treatment Outcome