No abstract available.
Anus, Imperforate* ; Perineum* ; Ultrasonography*

Recently, the proportion of cardiovascular disease as a cause of death in diabetics is in ever increasing tendency. Present study is designed to evaluate the change of myocardial performance by the effect of microangiopathy of diabetics. The measurements of systolic time intervals were obtained from simultaneous high speed recordings(100mm/sec) of electrocardiography, phonocardiography, and carotid pulse tracing in diabetics(male 26, female 31). 1. As the diabetic retinopathy got severe, shortening of LVET and prologation of PEP were noted, but QS2 showed no significant change. 2. PEP/LVET ratio fo diabetics without diabetic retinopathy was significantly higher than that of normal control(p<0.01). 3. PEP/LVET ratio of diabetics with diastolic blood pressure under 95mmHg was significantly higher than that of normal control group(p<0.01), and PEP/LVET ratio of diabetics with diastolic blood pressure over 96mmHg was significantly higher than that of normal control and that of diabetics with diastolic blood pressure under 95mmHg(p<0.01). 4. PEP/LVET ratio of diabetics with proliperative retinopathy was significantly higher than that of normal control and that of diabetics with mild diabetic retinopathy(p<0.01), but this result was not conclusive because of the small case number.
Blood Pressure ; Cardiovascular Diseases ; Cause of Death ; Diabetic Retinopathy ; Electrocardiography ; Female ; Humans ; Phonocardiography ; Systole*

Congenital pericardial defect is relatively rare and two different types, partial and complete, of different clinical significance have been recognized. Most reported defects are complete type and left-sided lesion. Most patients are asymptomatic or complain of vague chest pain. Partial pericardial defect can be potentially fatal due to cardiac herniation and strangulation or coronary insufficiency. Plain chest reontgenography shows abnormal prominence along the cardiac border. 2-D echocardiography demonstrates a drop-off of pericardial echo and protruding cardiac chamber through the defect. Because of the potential fatality, surgical repair is recommended for the partial pericardial defect. We report a case of congenital partial left pericardial defect, which was diagnosed by plain chest reontgenography and 2-D echocardiography, with related literatures.
Chest Pain ; Echocardiography ; Humans ; Thorax

On the contrary to congenital anomalies of intestinal rotation in pediatric patients, those in adults are generally nonsymptomatic and of little consequence. Occasionally, however, an adult may have midgut nonrotation and complain of chronic or recurrent abdominal pain. Intestinal nonrotation can be divided into complete or partial failure of rotation and into abnormalities affecting the proximal segment, the distal segment or both. We report herein a 43-year old female patient with symptomatic partial, cecocolic nonrotation.
Abdominal Pain ; Adult* ; Female ; Humans

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome. RESULTS: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis. CONCLUSION: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
Appendicitis* ; Diagnosis ; Humans ; Incidence ; Multivariate Analysis ; Postoperative Complications

Normal micturition is usually accomplished by 3 years of age. We have experienced micturition dysfunction in neurologically and anatomically normal children, but we are embarrassed in identifying the exact cause of each case and searching for the treatment modalities. I thought there was a possibility of lower urinary tract dysfunction as an evoking factor of micturition dysfunction and so I conducted urodynamic study in neurologically and anatomically normal children with micturition dysfunction at Yonsei University Hospital from April, 1984 till December, 1986 and have come to the conclusion as follows ; 1. There was normal urodynamic findings in 9 cases(26.5%) and single abnormal findings in 18 cases(52.9%) which were composed of 6 cases(17.6%) of unstable bladder findings, 2 cases(5.9%) of hypersensitive bladder, 9 cases(26.5%) of high maximum urethral closure pressure and 1 case(2.9%) of detrusor-sphincter dyssynergia and combined abnormal findings in 7 cases(20.6%). High maximum urethral closure pressure finding, which was main abnormal one were found in 13 cases(38.2%), while unstable bladder in 12 cases(35.3%) among 34 children with micturition dysfunction. 2. Among the urodynamic parameters under anesthetic or awaken state, only the mean value of percentage of bladder capacity to normal was significantly higher in anesthetic group than awaken group. 3. Among the urodynamic parameters according to single symptom, all(percentage of bladder capacity to normal, maximum urethral closure pressure) were lower in incontinent group and maximum urethral closure pressure was higher in frequency group, but these differences were not statistically significant. 4. The satisfactory result of conservative treatment was found in 25 cases(73.5%), and was better in the group with single abnormal finding than with combined abnormal finding. In conclusion, the urodynamic study is essential to get the diagnosis and give the treatment accurately, but there should be more technical improvement doing in pediatric age group.
Ataxia ; Child* ; Diagnosis ; Humans ; Urinary Bladder ; Urinary Tract ; Urination* ; Urodynamics*

Liposarcoma of the spermatic cord is very rare and preoperative diagnosis is difficult. Well differentiated liposarcoma is in general less aggressive than other type of liposarcoma and seldom metastasizes. Radical orchiectomy with wide local excision appear to be adequate treatment modality and offer better prognosis. We report a case of well differentiated liposarcoma in 51-year-old male with brief review of the literatures.
Diagnosis ; Humans ; Liposarcoma* ; Male ; Middle Aged ; Orchiectomy ; Prognosis ; Spermatic Cord*

It has been reported that pupillary paralysis is rare findings in typical Guillain-Barre syndrome(GBS). We experienced a 56-year-old male with fulminant GBS who pupillary paralysis. He showed quadriplegia, total paresis of motor cranial nerves including bilateral ptosis and complete opthalmoplegia. Pupils were dilated up to 8mm and fixed. After a one year follow up, his pupil slowly constricted to light. The instillation of 0.1% pilocarpin caused both pupillary constriction. These results pointed to postganglionic involvement of pupillary parasympathetic nerves.
Constriction ; Cranial Nerves ; Follow-Up Studies ; Guillain-Barre Syndrome* ; Humans ; Male ; Middle Aged ; Paresis ; Pilocarpine ; Pupil ; Pupil Disorders* ; Quadriplegia

The authors experienced three cases of cholangiocarcinoma associated with profuse mucin production. We intended to review and summarize the clinical features of these patients to emphasize the clinical importance of mucin-producing cholangiocarcinoma. All patients were female. Symptoms were mainly right upper quadrant pain and jaundice. Diagnosis was made by characteristic endoscopic retrograde cholangiographic findings and computed tomography. Bile ducts were dilatated and obstructive jaundice had developed as a result of the accumulation of mucin realeased by the tumor. Treatments were hepatic lobectomies for two intrahepatic cholangiocarcinoma patients and extrahepatic bile duct resection and hepaticojejunostomy for one patient. There was no postoperative complication. Pathologies were well differentiated papillary adenocarcinoma in two cases. Two patients are still living without recurrence for over three and four years respectively. One patient who had T4 lesion died of recurrence 38 months after operation. Conclusively, aggressive surgical treatment may be justified in the treatment of mucin hypersecreting cholangiocarcinoma even in advanced stage in view of the favorable outcome after radical operation. Further study is needed to clarify its biological behavior.
Adenocarcinoma, Papillary ; Bile Ducts ; Bile Ducts, Extrahepatic ; Cholangiocarcinoma* ; Diagnosis ; Female ; Humans ; Jaundice ; Jaundice, Obstructive* ; Mucins ; Pathology ; Postoperative Complications ; Recurrence

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax