A case of isolated Crohn's disease of appendix is reported. It is a rare disease which commonly mimics the symptoms of acute appendicitis. Review of 221 identical cases previously reported in the world literature revealed slight male predominance(1.17:1) and peak age of incidence in the third decade(24.3 yrs). In contrast to typical Crohn's disease, the rate of postoperative fistula and recurrence was minimal; 1.0% and 3.8%, respectively. Due to these differences, many consider it to be a separate disease entity from Crohn, and a new diagnostic term - "Idiopathic Granulomatous Appendicitis" - has gained wide acceptance in recent years.
Appendicitis* ; Appendix* ; Crohn Disease* ; Fistula ; Humans ; Incidence ; Male ; Rare Diseases ; Recurrence

Epiblepharon is frequently encountered n oriental eyelid, especially in children. It is characterized by a horizontal fold of redundant skin and abundant orbicularis muscle near lid margin, which the lashes vertically, or posteriorly towards the eye. Surgical therapy of epiblepharon in correcting the trichiasis includes lid bracing sutures, burried sutures, skin resection, a Hotz procedure or its modification, and a Jones procedure. In our opinion, these procedures are not sufficient, because these procedures will not correct the epicanthal folds. Epicanthal folds have been a one of the characteristics of Asian over 50 percents of population in Japan and South Korea, and it either reduce the aesthetic result of the double-eyelid procedure or make the correction of the entropion and epiblepharon difficult. Although many surgical procedures are available to eliminate epicanthal folds, scarring on the medial canthus is in still and obstacle for surgeons to overcome. From January of 1998 to October of 1998, we used half z-plasty procedures in 5 cases to correct epicanthal folds in epiblepharon. There were few complications in our series. We believe that half z-plasty can get a good result in the correction of epibolepharon and oriental epicanthal folds.
Asian Continental Ancestry Group ; Braces ; Child ; Cicatrix ; Entropion ; Eyelids ; Humans ; Japan ; Korea ; Skin ; Sutures ; Trichiasis

No abstract available.
Temporomandibular Joint*

No abstract available.
Temporomandibular Joint*

Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.
Anemia ; Blood Transfusion* ; Drug Therapy ; Extremities ; Femur* ; Humans ; Limb Salvage* ; Osteosarcoma* ; Prognosis

Clinical and pathological studies were carried out on 78 patients of ovarian cancer from January 1985 to March 1991. The results are as follows : l. Among 78 patients of ovarian cancer, the age group from 51 to 60 years old was most common which was 18 cases(23.1%). 2. When classified according to the cell type, epithelial cell origin cancers were 59 cases (75.6%), ovarian cancers from germ cell origin 9 cases(11.5%), sex cord stromal cancers 3 cases(3.8%), and metastatic cancers 7 cases(8.9%) respectively. 3. When classified according to the FIGO staging, stage I were 34 cases(43.5%), stage II 8 cases(10.3%), stage III 23 cases(29.5%) and stage IV 13 cases(16,7%), respectively. 4. Preoperative mean CA 125 value of stage I ovarian cancer was 130.2+/-57.3U/ml, stage II 74.2+/-144.4U/ml, stage III 376.9+/-296.8U/ml and stage IV 433.9+/-148.2U/ml respectively. and Also preoperative mean CEA value of stage I ovarian cancer was 3.4+/-3.2ng/ ml, stage II 6.9+/-4.3ng/ml, stage III 4.7+/-4.4ng/ml and stage IV 4.6+/-6.3ng/ml respectively. 5. When classified according to the physical examination, the most common finding was palpable mass which were 38 cases(43.7%), the second, abdominal pain 30 cases(38.4%) and the third, abdominal distension 21 cases(26.9%) 6. When classified according to the operation, ipsilateral oophorectomy was 15 cases(25.5%), ipsilateral oophorectomy and contralateral ovary wedge resection 6 cases(10.2%), total abdominal hysterectomy 17 cases(28.8%), total abdominal hysterctomy and omentectomy 14 cases(23.7%), total abdominal hysterectomy and omentectomy and debulking tumor resetion 4 cases(6.7%) and biopsy only 3 cases(5.1%) respetctively. 7. When calssifide according to the postoterative endometrial finding, atrophic pattern was 28 cases(65.7%), proliferative pattern 10 cases(28.6%) and secretory pattern 2 cases(5.7%) respectively.
Abdominal Pain ; Biopsy ; Epithelial Cells ; Female ; Germ Cells ; Humans ; Hysterectomy ; Middle Aged ; Ovarian Neoplasms* ; Ovariectomy ; Ovary ; Physical Examination ; Statistics as Topic*

PURPOSE: To explore possible changes in awake cystometry and expression of beta-adrenoceptors (ARs) as a cause for bladder dysfunction in a male rat model of partial bladder outlet obstruction (pBOO). MATERIALS AND METHODS: Awake cystometry was performed in rats with pBOO (16) and sham-operated rats (16), 8 weeks after the operation. The expression of mRNA and protein of beta-ARs was assessed by real-time PCR and western blot. RESULTS: The bladders with pBOO (1030mg) were increased compared to those in control rats (230mg). In the cystometric studies, the maximum intravesical pressure significantly increased in the pBOO group compared to control group rats (p=0.001). The time to reach maximal intravesical pressure during micturition in the pBOO group was significantly longer than the sham group (p=0.003). The frequency of non-void contraction in the pBOO group was significantly more than the sham group (p=0.006). The mRNA expressions of beta2- and 3-ARs were increased insignificantly in pBOO group compared to sham group. The data of pBOO group expressed as folds of corresponding expression in sham group were 1.28 and 1.46 respectively in beta2- and 3-ARs. Compared to the sham groups, the density of 60Kda protein band recognized by beta2-AR antibodies and the density of 45Kda protein band recognized by beta3-AR antibodies were higher in the bladder from pBOO group rats. CONCLUSION: PBOO of male rats increase the maximal intravesical pressure and contraction time during micturition and the frequency of non-void contraction as well as weight of bladder. The expression of beta2- and 3-ARs subtypes was increased insignificantly compared to sham operated group. This study demonstrates that the changes of cystometric or non-void contraction parameters in pBOO is one of the pathophysiologic processes potentially associated with the alterations of bladder beta-ARs.
Animals ; Antibodies ; Blotting, Western ; Contracts ; Humans ; Male ; Rats ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Salicylamides ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urination

PURPOSE: This study aimed to determine whether symptoms of urinary urgency increase according to the severity of stress urinary incontinence (SUI). For this purpose, we recruited women with symptoms of mixed as well as pure SUI and compared the clinical characteristics of each subgroup. MATERIALS AND METHODS: A total of 241 female patients who were diagnosed with SUI and mixed urinary incontinence (MUI) were analyzed retrospectively. Patients with only SUI were categorized as group 1. Patients with MUI were categorized as group 2. Clinical and urodynamic differences between the 2 groups were compared. RESULTS: The proportion of Stamey grade was significantly different between the 2 groups: grade 1 SUI was higher in group 1, but grades 2 and 3 SUI were higher in group 2. The incidence of urgency was proportional to the degree of Stamey grade (23.5% in grade 1, 36.9% in grade II, and 60.0% in grade III). In the urodynamic study, the presence of detrusor overactivity was significantly higher in group 2 than in group 1 (25.9% vs. 49.4%). Other clinical parameters were also significantly different between the 2 clinical groups: Q-tip angle (group 1: 42.1degrees, group 2: 28.6degrees, p<0.05), maximal urethral closure pressure (group 1: 54.7 cmH2O, group 2: 44.1 cmH2O, p<0.05), maximal bladder capacity (group 1: 356.3 ml, group 2: 282.0 ml, p<0.05), and bladder volume at first desire (group 1: 144.6 ml, group 2: 123.2 ml, p<0.05). CONCLUSIONS: According to this analysis, the more serious the symptoms of SUI, the higher the incidence of urinary urgency.
Female ; Humans ; Incidence ; Retrospective Studies ; Urinary Bladder ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urodynamics

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

Tularemia is a zoonosis caused by Francisella tularensis. It is primarily a disease of wild animals. Human infection is incidental and usually results from interaction with biting or blood-sucking insects, wild or domestic animals, or the environment. An increasing number of cases have been reported in several countries. However, in Korea it has not been reported until now. A 40-year old male patient visited our department on Jan 13, 1997, complaining of multiple swollen lymph-nodes on his axillae and reddish swollen left upper arm which contained an abscess at its central portion for about ten days. On Dec 25, 1996, he found a dead wild rabbit on a nearby mountainside, ate it after cooking it by himself with his hands injured. His abscess was drained and microbiologic examination was done. However no microorganism was isolated. His lymph nodes were surgically removed from both axillae, and we investigated them microbiologically and pathologically. On microbiologic examination, small aerobic gram negative coccobacilli were grown on a chocolate agar plate in an aerobic condition with 5% CO2 at 37 degrees centigrade. On H & E staining, the lymph node showed chronic granulomatous inflammation. We sent the microorganism and lymph nodes to the Centers for Disease Control and Prevention in the United States of America for the definitive diagnosis. Finally the microorganism was identified as F. tularensis by culture morphology, biological tests and immunohistochemical staining. We report the first case of F. tularensis in Korea.
Abscess ; Adult ; Agar ; Americas ; Animals ; Animals, Domestic ; Animals, Wild ; Arm ; Axilla ; Cacao ; Centers for Disease Control and Prevention (U.S.) ; Cooking ; Diagnosis ; Francisella tularensis ; Hand ; Humans ; Inflammation ; Insects ; Korea ; Lymph Nodes ; Male ; Tularemia* ; United States