Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal ; Episiotomy ; Female ; Fistula ; Follow-Up Studies ; Humans ; Radiotherapy ; Rectovaginal Fistula* ; Rectum ; Recurrence ; Vagina

No abstract available.
Hemorrhage*

Baboon syndrome is used to denote a systemic allergic contact dermititis with a characteristic color and distribution pattern. It is also referred to as mercury exanthem, because inhalation of mercury vapor usually causes the skiri lesion in a sensitized person. Diffuse pi,ikish erythema of the buttock, upper inner thigh, and axilla are characteristic features. We report a case of baboon syndrome developed after exposure to the smoke of a burning amulete a charm written on a piece of paper in a 12 year-old female. Mercury sensitivity was confirrned by a patch test. Atomic absorption by a spectrographic method and Scanning electron microscopy/energy dispersive for analysis X-ray detected mercury in the urine and the ed scraped pigments from the amulet, respectively.
Absorption ; Axilla ; Burns ; Buttocks ; Child ; Erythema ; Exanthema ; Female ; Humans ; Inhalation ; Papio* ; Patch Tests ; Smoke* ; Thigh

No abstract available.
Humans ; Lung Neoplasms* ; Lung* ; Survival Analysis*

Aconitine is a main component of Aconitum carmichaeli, a Chinese herb known to be effective for arthritis and neuralgia. Many senior citizens consume the herb as a folk remedy. Aconitine-associated cardiogenic toxicity has been observed but aconitine-induced cerebrovascular event has not been reported so far. We report two elderly patients who became unconscious and showed neurological dysfunction soon after ingesting aconitine for pain control. We speculate that the aconitine induced cardiac arrhythmia. This resulted in cardiogenic emboli formation with subsequent large territory cerebral infarction.
Aconitine

No abstract available.

No abstract available.
Hematoma*

No abstract available.
Funnel Chest*

A number of noninvasive technics have been advocated as reflecting left ventricular performance. These methods include systolic time intervals, echocardiography and imaging of the left ventricular chamber with radionuclides during systole and diastole. Radionuclide evaluation of left ventricular function by means of the gamma camera and gating currently appears to be the most reliable noninvasive method for approximating angiographic evaluation of left ventricular performance. Utilizing the radionuclide angiography, we measured the left ventricular function in 19 normal healthy control, 60 patients with coronary artery diseases 7 patients with dilated cardiomyopathy, 5 patients with hypertension. 1) Left ventricular ejection fraction decreased in 12 patients with anterior myocardial infarction (39.9+/-11.6%), 17 patients with inferior myocardial infarction (49.9+/-8.4%) and 7 patients with dilated cardiomyopathy (19.0+/-5.8%), and there was a statistically significant difference compared with 19 normal control group (63.5+/-8.2%)(p<0.005). However there were no statistically significant difference between normal control group, patients with hypertension (58.8+/-7.6%) and patients with angina pectoris (60.1+/-6.5%). 2) Left ventricular ejection fraction decreased in both anterior and inferior myocardial infarction, and there was a statisically significant difference between both groups (p<0.01). All 13 patients with acute myocardial infarction had abnormal LVEF (40.5+/-9.1%) whcih was significantly lower than that of 16 patients with old myolardial infarction (50.1+/-10.5%)(p<0.01).
Angina Pectoris ; Cardiomyopathy, Dilated ; Coronary Artery Disease* ; Coronary Vessels* ; Diastole ; Echocardiography ; Gamma Cameras ; Humans ; Hypertension ; Infarction ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Radioisotopes ; Radionuclide Angiography* ; Stroke Volume ; Systole ; Ventricular Function, Left*

No abstract available.
Clonorchiasis* ; Clonorchis sinensis