Angiodysplasia of small bowel is uncommon and frequently undiagnosed and presents a taxing surgical problem. It is usually diagnosed for unexplained gastrointestinal bleeding. For the surgeon, the main technical problem is that the lesion is impalpable, and invisible to the naked eye, so it usually cannot be identified unless bleeds actively at the time of surgery. Arteriography gives a little information about wax and wane pattern of bleeding in the lesion. Endoscopy is often unfruitful because the majority of lesions are submucosal and rarely exceed a few millimeters in diameter. Transillumination of the intestinal wall from inside of the lumen to the outside in a dark room can define the precise vascular anatomy of the wall. The delicate lesion of the angiodysplasia can be identified by this transillumination method. We described a simple intraoperstive endoscopic translllumination technique used successfully to identify an angiodysplasia in the small bovwel prior to the bowel resecion. This report summarized our experience and review of literature.
Angiodysplasia* ; Angiography ; Endoscopy ; Hemorrhage ; Taxes ; Transillumination*

In view of ever rising water pollution problems of river in the vicinity of large urban communities, the author has made an investigation on the pollution of water sampled from Han River (Seoul area) and Nakdong River (Daegu city area) during the period from july to December, 1970. The water samples were taken twice a month during the study period of 6 months from 7 points (locations) along the main stream of Han River at Seoul city and 5 points of Nakdong River at Daegu city. The samples ware measured and analyzed in accordance with the recognized methods in the "Standard Methods or Examination of Water and waste" by American Public Health Association. The obtained results are as follows: I.Han River. 1. Average turbidity was 5.1 units ranging from 1 to 10 units and the turbidity of down stream was higher than that of the upper stream. 2. pH value showed slight alkalinity (mean ; 7.2) except Yunchang-Dong (6.9). 3. The mean value of Dissolved Oxygen contents (D.O) was 7.2 ppm (range of 3.4-10.5ppm). D.O of the upper stream (8.2 ppm. at Walker Hill boating place, 8.0 ppm. at the Gwangzang Bridge and Ddookdo) was higher than that of he downstream (5.6ppm. at Yunchang-Dong. 6.4ppm. at the 2nd Han River Bridge), and D.O in the winter season was higher than that in the summer season, respectively. 4. The mean value of the Biochemical Oxygen Demand (B.O.D.) was 28.3 ppm. (range of 6.2-64.8ppm). The mean value of B.O.D. was 48.7 ppm. at Yunchang-Dong. 42.3ppm. at the 2nd Han River Bridge, 34.0 ppm. at the 1st Han River bridge, 28.5 ppm. at the 3rd Han River Bridge, 19.2 ppm. at Dookdo, 13.2 ppm. at the Gwangzang Bridge, and 10.2 ppm. at the Walker Hill boating place in order of value. B.O.D. in July and August (35.6 and 34.5 ppm.) were the highest and that in November and December (18.6 and 21.2 ppm.) were the lowest. 5. Suspended Solids (SS) were from 15.0 to 667.0 ppm. with the mean of 222.1 ppm "Suspended Solids" of the water samples at Yunchang-Dong and the 2nd Han River Bridge were found to be 378.1 ppm. and 283.9 ppm. respectively which were higher than at the Gwangzang Bridge (134.1ppm.) and at Walker Hill boating place (79.3ppm). 6. Coliform colonies counting of the water samples ranged from 0-2, 500x10/100ml. with the mean value of 205.6x10/100ml. The most contaminated water sample by coliform were from the point of the 2nd Han River Bridge with 640.8x10/100ml while the lowest ones were from Walker Hill boating place with 17.2x10/100ml. There was also a seasonal variation in coliform contamination that is the higher in summer and the lower in winter. II. Nakdong River. 1. The mean value of turbidity was 2.3 units with range of 0 to 9.0 units. The highest point was at Geumho River (7.2 units). and the lowest point was at Gangzung and Moonsan (0.45 and 0.41 units). 2. The mean value of pH was 7.5 (range of 7.1-8.5) and highest point was Geunho River with 8.5. 3. The mean value of D.O was 8.1ppm. (range of 3.4-11.2 ppm.). D.O. of the upper stream showed higher value than that of the down stream, and the winter season than the summer season. 4. B.O.D. ranged from 2.6 to 57.0 ppm. (mean; 20.4 ppm.). The water sample at Geumho River showed the highest value (41.5ppm) while at Moonsan and Gangzung showed the lowest (4.6 and 4.7 ppm.). 5. The mean value of suspended solids was 48.7 ppm. (range of 4.0-182.0 ppm.). The highest month was July (63.7 ppm.) and August (62.1 ppm.) and the lowest month was October (37.0 ppm.) and December (24.4 ppm.). 6. The mean value of the coliform colonies was 22.7x10/100ml. (range of 0-243x10/100ml.). The highest number of the colonies was found in the sample water at the Whawon recreation area (50.5x10/100ml.) followed by the Geumho River (33.9x10/100ml;), the Goryung Bridge (28.3x10/100ml.), Gangzung(0.7x10/100ml), and Moonsan (0.6x10/100ml.).
American Public Health Association ; Daegu ; Hydrogen-Ion Concentration ; Oxygen ; Recreation ; Rivers* ; Seasons ; Seoul ; Ships ; Water Pollution* ; Water*

During the period from July 1st to the end of November 1970, a survey on air pollution and noise level was made in Seoul, Pusan and Taegu, the three largest cities in Korea. Each city was divided into 4-6 areas : the industrial area, the semi-industrial area, the commercial area, the residential area, the park area and the downtown area. Thirty eight sites were selected from each area. A. Method of Measurement : Dustfall was measured by the Deposit Gauge Method, sulfur oxides by PbO2 cylinder method, suspended particles by the Digital Dust Indicator, Sulfur dioxide (SO2) and Carbon Monoxide (CO) by the MSA & Kitakawa Detector and the noise levels by Rion Sound Survey meter. B. Results: 1. The mean value of dustfall in 3 cities was 30.42 ton/km2/month, ranging from 8.69 to 95.44. 2. The mean values of dustfall by city were 33.17 ton/km2/month in Seoul, 32.11 in Pusan and 25.97 in Taegu. 3. The mean values of dustfall showed a trend of decreasing order of semi-industrial area, downtown area, industrial area, commercial area, residential area, and park area. 4. The mean value of dustfall in Seoul by area were 52.32 ton/km2/month in downtown, 50.54 in semi-industrial area, 40.37 in industrial area, 24,19 in commercial area, 16.25 in park area and 15.39 in residential area in order of concentration. 5. The mean values of dustfall in Pusan by area were 48.27 ton/km2/month in semi-industrial area, 36.68 in industrial area 25.31 in commercial area, and 18.19 in residential area. 6. The mean values of dustfall in Taegu by area were 36.46 ton/km2/month in downtown area, 33.52 in industrial area, 20.37 in commercial area and 13.55 in residential area. 7. The mean values of sulfur oxides in 3 cities were 1.52mg SO3/day/100cm2 PbO2, ranging from 0.32 to 4.72. 8. The mean values of sulfur oxides by city were 1.89mg SO3/day/100cm2 PbO2, in Pusan, 1.64 in Seoul and 1.21 in Taegu. 9. The mean values of sulfur oxides by area in 3 cities were 2.16mg SO3/day/100cm2 PbO2 in industrial area, 1.69 in semi-industrial area, 1.50 in commercial area, 1.48 in downtown area, 1.32 in residential area and 0.94 in the park area, respectively. 10. The monthly mean values of sulfur oxides contents showed a steady increase from July reaching a park in November. 11. The mean values of suspended particles was 2.89mg/m3, ranging from 1.15 to 5.27. 12. The mean values of suspended particles by sity were 3.14mg/m3 in Seoul, 2.79 in Taegu and 2.25 in Pusan. 13. The mean values of noise level in 3 cities was 71.3 phon, ranging from 49 to 99 phon. 14. The mean values of noise level by city were 73 phon in Seoul, 72 in Pusan and 69 in Taegu in that order. 15. The mean values of noise level by area in 3 cities showed a decrease in the order of the downtown area, commercial area, industrial area and semi-industrial area, park area and residental area. 16. The mean values of noise level by area in 3 cities indicated that the highest level was detected in the downtown area in Seoul and Taegu and in the industrial area in Pusan. 17. The daily average concentration o sulfur dioxides (SO2) in 3 cities was 0.081 ppm, ranging from 0.004 to 0.196. 18. The daily average concentration of sulfur dioxides by city were 0.092 ppm in Seoul, 0.089 in Pusan and 0.062 in Taegu in that order. 19. the weekly average concentration of carbon monoxides (CO) was 27.59 ppm. 20. The daily average concentration of carbon monoxides by city were 33.37 ppm. in Seoul, 25.76 in Pusan and 23.65 in Taegu in that order. 21. The concentration of SO2 and CO reaches a peak from 6 p.m. to 8 p.m. 22. About 3 times probably the daily average concentration of CO could be detected in the downtown area probably due to heavy traffic emission in comparison with that in the industrial area. 23. As for daily variation of the concentration of SO2 and CO it was found that the concentration maintains relatively higher value during weekdays in the industrial area and on the first part of the week in the downtown area.
Air Pollution* ; Busan* ; Carbon ; Carbon Monoxide ; Daegu* ; Dust ; Korea ; Noise* ; Seoul* ; Sulfur ; Sulfur Dioxide ; Sulfur Oxides

There are several surgical or non-surgical methods for osmidrosis, which have their own merits and drawbacks. Especially, recurrence and scarring of operation site are cumbersome problems. One of the limitations of each method is recurrence of osmidrosis. The authors evaluated surgical treatments of recurrent cases. The authors experienced 14 recurrent osmidrosis cases from January 1998 to December 2003. Previous methods in recurrent cases are as follows; dermal shaving with Inaba dermal shaver(3 cases), liposuction method(10 cases), non-surgical hair removal method(4 cases). The authors managed recurrent cases with radical excision in 4 recurrent cases which had severe scar with large fibrotic tissue due to previous operations, and dermal manual resection in 10 cases. We had no recurrence in our series and no complications like hematoma, seroma, infection, wound disruption or dehiscence and brachial plexus compression. In conclusion, dermal manual resection can be applied to recurrent osmidrosis cases, and radical resection is also applicable to managing recurrent cases with severe scar with large fibrotic tissue.
Brachial Plexus ; Cicatrix ; Hair Removal ; Hematoma ; Lipectomy ; Recurrence ; Seroma ; Wound Infection

Most common signs of human aging often include skin fold and wrinkles in the lateral canthal area. It is called "crow's feet". The accordion-like activity of the orbicularis oculi muscle during movements of facial expression accentuates this phenomenon because the muscle shortens but the skin does not. The purpose of this study is to present the classification of the crow's feet and to look for it's clinical characteristics in Koreans. The pictures of lateral view of the crows feet in 105 patients taken with digital camera are classified by their age, sex, types and degree of direction. Results show that there are three types of crows feet such as upper, lower and bidirectional types. Bidirectional type is the most common type(85%), lower directional type is 15% and upper directional type is 5%. In thirties, bidirectional type is 50% but the rate of this type increases in older groups. So in over sixties, bidirectional type is almost 100%. There are no differences between the two sexes. The degree of the direction of wrinkles increases in thirties and forties, but in fifties or over no difference was seen. In summary, this study could be helpful to decide the procedure in correction of the crow's feet.
Aging ; Classification* ; Crows ; Facial Expression ; Foot* ; Humans ; Skin

Blow-out fractures usually occur at the weakest point of orbital wall such as medial wall or orbital floor. The operative treatment of blow-out fracture involve restoration of intra-orbital soft tissue and bony structural integrity. The surgical reduction of medial blow-out fracture are mainly transcutaneous, transnasal and transconjunctival approaches. The conventional methods has several disadvantages, such as external scar, narrow operative field and injury of neurovascular bundle. But medial transconjunctival approach has advantages such as minimal scar, short operative time and relative safety. We experinced 26 cases of medial blow-out fracture using medial transconjunctival approach from June 2001 to May 2003. Preoperatively 21 cases showed diplopia and 14 cases showed enophthalmos. In postoperative complications, diplopia were 2 cases, enophthalmos was 1 case, anterior displacement of implant were 2 cases, conjunctival scar were 2 cases and injury of caruncle was 1 case. We report the medial transconjunctival approach that was effective treatment for medial blow-out fracture without specific complications.
Cicatrix ; Diplopia ; Enophthalmos ; Operative Time ; Orbit ; Orbital Fractures* ; Postoperative Complications

Despite an aggressive surgical debulking followed by front-line chemotherapy, most patients with advanced ovarian carcinoma die of drug-resistant disease. Drug resistance can be overcome in a subset of patients with hematologic malignancies and lymphoma with high-dose therapy (HDT) and hematopoietic stem cell transplantation, suggesting that this therapy may also be value in ovarian carcinoma. We report the successful outcome of HDT and peripheral blood stem cell transplantation (PBSCT) in a 41-year-old nulliparous woman who initially was diagnosed with advanced ovarian carcicnoma with FIGO stage IIIc. Her disease relapsed after 19 months from initial therapy of definitive surgery and intra- and post-operative chemotherapy. Subsequently, she received optimal debulking surgery and salvage chemotherapy followed by HDT with triple- alkylating regimen, composed of cyclophosphamide (100 mg/kg), thiotepa (500 mg/m2), and melphalan (100 mg/m2). Her pretranplant characteristics were platinum-sensitive and complete response state. She showed rapid hematologic recovery and mild regimen-related toxicity (Bear man's toxicity criteria), stomatitis (grade I), cardiac toxicitiy (grade II). She has been followed up for 36 months after the inital therapy and is doing well without relapse.
Adult ; Cyclophosphamide ; Drug Resistance ; Drug Therapy ; Female ; Glycogen Storage Disease Type VI ; Hematologic Neoplasms ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma ; Melphalan ; Ovarian Neoplasms ; Peripheral Blood Stem Cell Transplantation* ; Recurrence ; Stomatitis ; Thiotepa

Diffuse esophageal spasm (DES) is a motility disorder of the esophagus characterized by symptoms of retrosternal chest pain and intermittent dysphagia. The diagnosis of DES has relied on criteria obtained from a standard esophageal manometry (more than one simultaneous contraction in a series of 10 wet swallows with the rest being peristaltic). Because symptoms and/or typical manometric findings are not always documented during the standard manometry, 24 hour manometry may be more useful in such cases. We recently assessed a 29-year-old male patient who complained of chest pain and dysphagia. He showed nonspecific findings on the laboratory based manometry, but DES was diagnosed by his typical manometric findings on the 24 hour manometry. Therefore, a 24 hour manometry should always be performed when the patient's history suggests the presence of DES and the laboratory based manometry failed to detect the symptomatic contractions of DES. Following we report this case with a review of the literature.
Adult ; Chest Pain ; Deglutition Disorders ; Diagnosis* ; Esophageal Spasm, Diffuse* ; Esophagus ; Humans ; Male ; Manometry* ; Swallows

Tuberculous involvement of the esophagus is very rare even in the presence of extensive pulmonary tuberculosis or in the endemic area. This is resulted from local extension to the esophagus from contiguous tuberculosis organs or miliary spread. Such secondary involvement is more common than primary tuberculosis, in which there is no evidence of tuberculosis elsewhere. The diagnosis of esophageal tuberculosis may be difficult. So the radiologic, endoscopic, histologic findings and clinical feature including the response to chemotherapy may be needed to avoid misdiagnosis. Most cases can be treated successfully with antituberculosis medication. A 67-year-old man was admitted to our hospital complaining of swallowing difficulty for 2 months. On the gastrofibroscopic examination, 22 cm sized protruding mass with central deep ulceration was discovered at the mid-esophagus. The biopsy showed the ulcer with chronic granulomatous inflammation and multinucleated giant cells consistent with tuberculosis. After antituberculosis medication, the lesion of esophageal tuberculosis was healed completely remaining minimal ulcer scar.
Aged ; Biopsy ; Cicatrix ; Deglutition ; Diagnosis ; Diagnostic Errors ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Giant Cells ; Humans ; Inflammation ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

Colonic pseudo-obstruction (CPO) is a syndrome characterized by obstructive symptoms and signs without mechanical obstruction. Parkinson's disease is one of the various clinical situations developing CPO. Recently, one study group reported that neostigmine was significantly more effective than placebo in rapidly decreasing colonic dilatation in the majority of patients with acute CPO. We experienced a 69-year-old male patient with Parkinson's disease who complained abdominal distension. There was a marked colonic dilatation on plain abdominal radiographs without mechanical obstruction. Colonic dilatation failed to improve with conservative management. Immediate clinical response was achieved after patient received 2.0 mg of neostigmine intravenously under monitoring by electrocardiography. One month later, he had recurrent colonic dilatation, but no clinical response to second administration of neostigmine, leading to colonic decompression. After a third recurrence of colonic dilatation, the patient was refractory to conservative management, and he underwent surgical treatment.
Aged ; Colon* ; Colonic Pseudo-Obstruction* ; Decompression ; Dilatation ; Electrocardiography ; Humans ; Male ; Neostigmine ; Parkinson Disease* ; Recurrence