No abstract available.
Colon* ; Diverticulitis* ; Laparoscopy*

Conjoined twins occur when there is imcomplete fission of the inner cell mass later at approximately 13 to 15 days after fertilization. The earlist case in the literat.ure appears to be that of the Biddenden Maids who were born in England in 1100. since then over two hundred cases of successful separation were reported on literature. And also successful separation cases were reported by Seung et al.(1991) in Korea. Conjoined twins occur between one in 50,000 to 100,000 births but real incidence is one in 200,000 because two thirds are stillbirth or died immediately after birth. The conjoined twins are not associated with maternal age, race or family history and 70 % of them are females. We experienced a case of conjoined twins with omphalopagus and performed surgical separation. A brief review of related literatures was done.
Animals ; Continental Population Groups ; England ; Female ; Fertilization ; Humans ; Incidence ; Korea ; Maternal Age ; Murine Acquired Immunodeficiency Syndrome ; Parturition ; Stillbirth ; Twins, Conjoined*

No abstract available.
Humans ; Lupus Erythematosus, Systemic* ; Renal Veins* ; Thrombosis*

BACKGROUND: Although there are several methods for evaluating bone quality, Hounsfield units (HU), a standardized computed tomography (CT) attenuation coefficient, provide a useful tool for estimating focal bone mineral density (BMD). The aim of this study is to investigate the HU for evaluating the degree of osteoporosis in greater tuberosity with regard to anchor positioning. METHODS: Forty patients diagnosed as normal on shoulder CT were included and categorized according to age and gender. Axially sectioned CT images were processed to 3-dimensional models containing information about bone quality using Mimics (14.11 platform v14.1.1.1 Materialise). Three-dimensional anchors were simulated and positioned according to 6 regions of interest (ROI) in the greater tuberosity classified using Tingart's system. Mean HU of intra-anchor volumes in the 6 regions was measured. RESULTS: A significant decrease in HU was observed with increasing age (p=0.0001) and menopause (p<0.001). A significant difference in HU was found between male and female groups with males showing the higher values (p=0.0001). HU of proximal areas of ROI was higher than those of distal areas (p<0.005). However, although mean HU of distal posterior ROI showed the lowest values, no statistically significant difference was found between anterior, middle, and posterior regions (p=0.087). CONCLUSION: Mean HU of ROIs provides a tool for preoperative assessment of focal BMD, which is a factor of suture anchor stability and can be used to aid decision-making regarding secure anchor positioning for rotator cuff repair. Our data support that the most secure point is the proximal regions of ROI.
Bone Density* ; Female ; Humans ; Humerus* ; Male ; Menopause ; Osteoporosis ; Rotator Cuff ; Shoulder ; Suture Anchors

No abstract available.
Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Neoplasm Metastasis

No abstract available.
Blood Pressure* ; Child* ; Humans ; Seoul*

Periductal mastitis is an inflammatory disease of uncertain etiology affecting the major breast ducts and has been given a variety of names by different authors. The treatment of this condition varies according to the clinical manifestations and the state of recurrence. Thirty-two cases of periductal mastitis during the period of 5 years from March 1991 to February 1996 were reviewed to investigate the clinical characteristics and to assess the results of different surgical procedures. The mean age of the patients was 41.2 years with a range of 26~64 years. The clinical manifestations included mastalgia (93.8%), abscess (43.8%), palpable mass (37.5%), nipple retraction (34.1%), and nipple discharge (21.9%). Aerobic and anaerobic bacteria were isolated in nine of 16 cultures. Acute inflammatory indurations in 6 patients were treated with antibiotics(cephalosporine combined with metronidazole) alone, and abscesses in 14 were treated by incision and drainage plus antibiotics. Twelve patients with a discrete mass had primary excision of the mass and diseased major ducts under antibiotics cover. Recurrence rates after initial treatment for inflammatory indurations, abscesses, and discrete masses were 66.7%, 50%, and 16.7%, respectively, and the median recurrence rate was 31.3%. Thirteen patients with recurrent diseases were treated by excision of the entire major duct system following appropriate preoperative management including, antibiotics and/or incision and drainage; this resulted in satisfactory healing in all without recurrences. In conclusion, initial treatment for patients with inflammatory indurations or abscesses should be more conservative even though nearly half of such patients eventually may require further surgery. Also, there were several recurrences even after excision of the diseased major duct system. To avoid these recurrences, we suggest that a discrete inflammatory mass that does not respond to antibiotic therapy and any recurrent diseases be treated by excision of the entire major duct system rather than by excision of only the diseased ducts.
Abscess ; Anti-Bacterial Agents ; Bacteria, Anaerobic ; Breast ; Drainage ; Female ; Humans ; Mastitis* ; Mastodynia ; Nipples ; Recurrence

No abstract available.
Animals ; Horns* ; Nevus, Sebaceous of Jadassohn*

OBJECTIVES: Xylitol is an effective anticarious natural sugar substitute, by inhibiting the virulence of Streptococcus mutans (S. mutans). However, long-term xylitol consumption leads to an emergence of the xylitol-resistant (XR) strains. This study aimed to confirm the general characteristics, mRNA expression of gtf genes, and adhesive ability of the xylitol-sensitive (XS) and XR S. mutans , by xylitol-treated concentrations. METHODS: S. mutans KCTC3065 was maintained in TYE medium, containing 0.4% glucose with 1% xylitol for 30 days at 37degrees C, 10% CO2 to form XR strain and the same procedures, without xylitol, were repeated for the formation of XS S. mutans. Both XS and XR were cultured by xylitol-treated concentrations (0%, 0.1% and 1%), then, general characteristics, such as growth and acid production, mRNA expression of gtf genes and adhesive ability were analyzed. RESULTS: Xylitol reduced the cell growth of XS S. mutans in a dose-dependent manner, but did not reduce the XR. Xylitol inhibited acid production of XS in a dose-dependent manner. However, it did not inhibit that of XR. Xylitol reduced the gtfB and gtfD mRNA expression of the XS S. mutans, which the genes synthesized soluble and insoluble extracellular polysaccharides, but not reduced that of the XR. By a microtiter plate assay, biofilm formation was more reduced in the XR strains, which means biofilm's adhesive ability of XR S. mutans was lower than that of the XS. CONCLUSIONS: These results indicate that a lower level of adhesive ability for XR S. mutans is related with mRNA expression level of gtf genes, which suggested that the XR strains may be less cariogenic than that of the XS.
Adhesives ; Biofilms ; Glucose ; Glucosyltransferases ; Polysaccharides ; RNA, Messenger ; Sprains and Strains ; Streptococcus ; Streptococcus mutans ; Sweetening Agents ; Xylitol

A 3-year-old boy with Wilms' tumor had unusual severe hypertension, polydipsia, polyuria, and hypokalemia. Physical examination on admission was unremarkable except for the presence of a smooth, firm mass in the right abdomen. Computerized tomography showed a tumor occupying upper two thirds of the right kidney. Plasma renin activity and aldosterone concentration were markedly elevated, 37.7 mg/ml/hour (normal supine 0.15-2.33 mg/ml/hour) and 120.1 ng/dl (normal supine 1 to 16 ng/dl), respectively. His hypertension, varied from 150/90 mmHg as high as 240/180 mmHg, was not effectively controlled by antihyperensive drugs. Because of concern for the complications of hypertension, a right nephrectomy was performed on the sixth hospital day. At laparotomy, there was no evidence of mechanical compression of the renal artery by the tumor. The tumor, about 8 cm in diameter, was confined within the renal capsule without involvement of the renal blood vessels at the hilum. Histopathologically, it was characteristic Wilms' tumor of favorable histology. On electron microscopy, the tumor cells contained many electron dense secreting granules in the cytoplasm, suggesting that the tumor itself was the source of the renin and cause the clinical manifestations. Shortly after nephrectomy, signs and symptoms were relieved dramatically, and plasma renin activity and aldosterone concentration were also decreased to normal.
Abdomen ; Aldosterone ; Blood Vessels ; Child* ; Child, Preschool ; Cytoplasm ; Humans ; Hypertension* ; Hypokalemia* ; Kidney ; Laparotomy ; Male ; Microscopy, Electron ; Nephrectomy ; Physical Examination ; Plasma ; Polydipsia* ; Polyuria* ; Renal Artery ; Renin ; Wilms Tumor*