No abstract available.
Choledochal Cyst* ; Cholestasis*

This study is based on 155 patients of congenital me colon. For the diagnosis, 93 cases were histologically proven and the remaining 63 cases were diagnosed on clinical basis including barium enema or surgical gross findings. On histologic examination, 80 cases(86%) showed typical features of absence of ganglion cell in the myenteric plexus and the 13 cases(14%) had atypical features which were segmental absence Of ganglion cell in one case. There we 127 males(82%) and 28 females(18%). The age at diagnosis was younger than 30 days in 87 cases(56%), I month to 1 year in 39 cases(25%) and older than I year in 29 cases(18%). The levels of aganglionosis were variable: short segment (rectosigmoid) in 134 cases(86%), intermediate segment (more proximal colon) in 14 cases(100%). and 6 cases(4%) had total aganglionosis. Common clinical presentations were abdominal distention, delayed meconium passage or bilious vomiting in neonate, and chronic constipation in infancy or childhood. Following initial colostomy or ileostomy, a definitive procedure was performed in 151 cases(Duhamel type in 150 cases; Soave type in 2 cases; Swenson type in 3 cases). Frequently associated problems after definitive procedure were persistent constipation(ll%) due to septum formation, fecaloma, remnant aganglionic segment and rectal stenosis. Overall mortality rate was 4%, and increased mortality was associated with enterocolitis(14%) which was the most frequent cause of death. The follow-up study longer than 3 months was available in 138 patients who underwent a definitive procedure(mean 2 year 11 months). Seventy-three cases(53%) had normal bowel function, 38cases(27.5%) had occasionally used enema or stool softners, and 27 cases(19.5%) had severe constipation or soiling. The bowel habit improved with time, and were considered normal in 60% of patients after follow-up more than 3 years. The results of definitive procedures for congenital megacolon including Duhamel operation was satisfactory, and long-term follow-up appeared an important and critical component of patients'care.
Child ; Male ; Female ; Infant, Newborn ; Humans ; Mortality ; Follow-Up Studies

No abstract available.
Caroli Disease*

Intractable ulcerating enterocolitis of infancy is uncommon, inhereditary disease characterized by ulcerating stomatitis, severe perianal disease, affecting the whole gastrointestinal tract, mainly colon with flask shaped large ulcer. It was first described by Sanderson et al in 5 cases of infant with intractable diarrhea having above clinical manifestation. It should be differentiated with Crohn's disease and Behcet's disease. We experienced a case of intractable ulcerating enterocolitis in an infant. A 17 month old patient was admitted because of intractable diarrhea since 2 months of age. Radilogical and endoscopic examination revealed chronic ulcerative inflammation with pseudopolyps involving ileum and entire colon. Ileocolectomy was performed because of its unresponsiveness to medical theraphy. The histology of resected specimen showed large flask shaped ulcer with underlying edge in the colon, terminal ileum. No evidence of granuloma suggesting Crohn's disease or vasculitis suggesting Behcet's colitis were noted. We report this case as an example of Intractable ulcerating enterocolitis (Sanderson et al).
Colitis ; Colon ; Crohn Disease ; Diarrhea ; Enterocolitis ; Gastrointestinal Tract ; Granuloma ; Humans ; Ileum ; Infant* ; Inflammation ; Stomatitis ; Ulcer* ; Vasculitis

No abstract available.
Tracheoesophageal Fistula*

Ischemic enteritis is caused by embolism or thrombosis of superior mesenteric artery and nonocclusive ischemia. Mesenteric venous thrombosis, drugs, and vasculitis are less frequent etiologic factors. In children, occlusion of microcirculation by fibrin thrombi initiated by endotoxemia may be an etiology. Severe abdominal pain, vomiting, and diarrhea with evidence of gross or microscopic bleeding are common presenting symptoms. Angiography may be diagnositic and permit therapeutic intervention. Revascularization with resection of necrotic bowel is the treatment of choice. We experienced a case of ischemic enteritis that was presented with projectile vomiting and diarrhea. Diagnosis was confirmed histologically. Radiological findings suggested multiple adhesive ileus. Laparatomy was followed by resection of the necrotic bowel.
Abdominal Pain ; Adhesives ; Angiography ; Child ; Diagnosis ; Diarrhea ; Embolism ; Endotoxemia ; Enteritis* ; Fibrin ; Hemorrhage ; Humans ; Ileus ; Ischemia ; Mesenteric Artery, Superior ; Microcirculation ; Thrombosis ; Vasculitis ; Venous Thrombosis ; Vomiting

Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionnaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The major results were as follows. First, physicians were more prevalent 35~44 group (38.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization, city (78.0%) in geographical location. Age group of 35-54 and specialist were more prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatient load of all physician were 77.1 persons on average. Age group of 35~44 had the most outpatient load (90.3 persons) among all age group, 6~10 years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factorsnumber of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.
Efficiency* ; General Practitioners ; Health Manpower ; Humans ; Male ; Outpatients ; Surveys and Questionnaires ; Specialization

No abstract available.
Child* ; Humans

No abstract available.
Meconium* ; Peritonitis*

PURPOSE: The purpose of this study is to fabricate the new zirconia block (CNU block) and to evaluate fit of core and porcelain veneered zirconia crown. MATERIAL AND METHODS: The experimental blocks were fabricated from the commercial ytrria-stabilized zirconia powder (KZ-3YE Type A). The powder was uniaxial pressing and the green bodies were conducted using the Cold Isostatic Pressing. The zirconia blocks were presintered at 1040degrees C and the final sintering was performed at 1450degrees C. The Kavo Everest ZS blank(R) (KaVo, Biberach/Ri beta.) was used as a control group. The linear shrinkage of CNU block and Kavo block were compared. Twenty-one cores for porcelain veneered crowns were fabricated with CAD/CAM system (Everest(R), Biberach/Ribeta.). Group I: seven cores fabricated from Kavo blocks, Group II: seven cores fabricated from CNU blocks, Group III: seven cores from CNU blocks and porcelain veneering for crowns. All specimens were cemented and sectioned into two planes: diagonal and bucco-lingual. The measurement of the marginal, internal, and occlusal fit was carried out using SEM (S-4800(R)) at 30 x. The results were analyzed by one-way ANOVA test. RESULTS: The linear shrinkage of the CNU block and the KaVo block was 19.00% and 20.09%. The marginal gap of cores (29.67 +/- 6.58 micrometer) fabricated from CNU blocks showed significantly smaller than that of the cores of Kavo blocks (36.84 +/- 7.18 micrometer) (P < .05). The internal gaps of the porcelain veneered crowns (32.23 +/- 6.33 micrometer) were larger than those of the other two groups (37.57 +/- 6.81 micrometer and 38.14 +/- 6.81 micrometer). CONCLUSION: No statistically significant difference was found in between experimental groups and control group. The experimental groups in marginal gap showed significantly smaller than the control group.
Cold Temperature ; Crowns ; Dental Porcelain ; Ethylnitrosourea ; Zirconium