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

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

A 69-year-old-male patient was admitted because of left upper quadrant (LUQ) abdominal pain He had hard palpable mass (abaut 15x l0cm) in LUQ abdomen and mild elevated serum alkaline phosphatase (349 IU/L) and amylase (216 U/L) levels at the admission time. Abdominal CT scan revealed huge, well-marginated cystic mass in enlarged spleen with increased densities in dependent portion of cystic mass, about 8x13cm in size. Another small well-capsulated. cystic mass in anterior aspect of spleen was also seen. After ERCP, urgent surgical intervention was done. Final diagnosis was chronic pancreatitis with large intrasplenic (l2x9.5 cm) and retroperitoneal pseudocysts. So we are reporting above case with pertinent review of literatures.
Abdomen ; Abdominal Pain ; Alkaline Phosphatase ; Amylases ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Humans ; Pancreatitis, Chronic* ; Spleen ; Splenomegaly ; Tomography, X-Ray Computed

No abstract available.

PURPOSE: Early diagnosis of neonatal sepsis is very difficult because of no specific clinical and laboratory findings. It also takes at least 48 hours of incubation period to isolate the organism by culture study. So several laboratory tests have been evaluated for their usefulness in rapid detection of the neonatal sepsis. Those are evaluated either singly or in combination with a defined scoring system include leukocyte count with differential count, platelet count, C-reactive protein level, erythrocyte sedimentation rate, haptoglobin level, fibronectin level, leukocyte alkaline phosphatase and so on. But no single test or combination with others has proved superior to the leukocyte count and differential count as a reliable indirect indicator of neonatal bacterial infection. We performed this study to determine the appropriate screening test for early detection of neonatal sepsis. METHODS: During the period of May 1991 through April 1997, we selected 200 neonates who were admitted to the neonatal intensive care unit of Kon-Kuk University Medical Center Seoul Hospital. All of the cases were retrospectively evaluated and divided two groups; sepsis group-88 neonates who were confirmed by blood cultures, and control group-112 neonates who had no evidence of neonatal bacterial infection. RESULTS: The results were as follows; 1) The sex ratio of male to female was 1.5:1 in the sepsis group and showed significant difference between two groups (P<0.05). The incidence of neonatal sepsis in prernature infant was higher in sepsis group than control group (P<0.05), and mean body weight was lower in sepsis group (2351.4148.3g) than control group (Z821.8 142.6g) significantly (P<0.05). 2) Predisposing perinatal factors associated with neonatal sepsis were premature rupture of membrane (> or = 24hrs) (14.5%) meconiurn staining (6.8%), asphyxia (Apgar score < or = 6 at 5mins) (5.7%), eclampsia and preeclampsia (4.5%), maternal infection (3.4%) and bleeding (including placenta previa, abruptio placenta) (1.1%) in order of frequency. Among th, only premature rupture of membrane was significant difference between two groups (P<0.05). Others risk factors including umbilical catheterization, endotracheal intubation, ventilatory care, total parenteral nutrition were also signi- ficant difference between two groups (P<0.05). 3) The common presenting symptoms of neonatal sepsis were jaundice (48.9%), poor feeding (45.5%), ternperature instability (43.2%), lethargy (30.7%), irritability, dyspnea, diarrhea, vomiting, tachypnea, and cyanosis in order of frequency. Among the above symptoms, poor feeding, dyspnea and cyanosis were significant difference between two groups (P<0.05). 4) The peripheral blood findings (leukocyte count, platelet count, ESR) showed no significant differences between two groups (P>0.05). The acute phase reactants (APR) score above two (37/88) and positive C-reactive protein (51/88) in the sepsis group were regarded as significantly high compared to the control group. 5) In the cases with APR score above two including positive C-reactive protein and abnormal total leukocyte count, sensitivity was 17.0%, specificity 97.3% positive predictive predictive value 83.3%, and negative predictive value 60.0%. CONCLUSIONS: The higher frequency of neonatal sepsis was proved in the cases of APR score above two including positive C-reactive protein. In the cases with abnormal total leukocyte count and APR score above two including positive C-resctive protein, the specificity was 97.3% and the positive predictive value was 83.8%. So APR score above two including positive C-reactive protein and abnormal total leukocyte count could be regarded as an useful test method for early detection of neonatal sepsis.
Academic Medical Centers ; Acute-Phase Proteins ; Alkaline Phosphatase ; Asphyxia ; Bacterial Infections ; Blood Sedimentation ; Body Weight ; C-Reactive Protein ; Catheterization ; Catheters ; Cyanosis ; Diarrhea ; Dyspnea ; Early Diagnosis* ; Eclampsia ; Female ; Fibronectins ; Haptoglobins ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Intubation, Intratracheal ; Jaundice ; Lethargy ; Leukocyte Count ; Leukocytes ; Male ; Mass Screening ; Membranes ; Parenteral Nutrition, Total ; Placenta Previa ; Platelet Count ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Risk Factors ; Rupture ; Sensitivity and Specificity ; Seoul ; Sepsis* ; Sex Ratio ; Tachypnea ; Vomiting

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*