No abstract available.

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

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.
Myoepithelioma* ; Trachea*

No abstract available.
Carcinosarcoma*

No abstract available.
Carcinoid Tumor*

No abstract available.
Funnel Chest*

Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of individuals has been developed. Counterpart analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. In this study we examined surgical changes in skeletal Class III malocclusion patients(male 40, female 40) and compared them with normal occlusion patients using counterpart analysis. The results indicated that : 1. Skeletal anterior-posterior discrepancy was relieved by shortening of the ramus width(B3). 2. The ramus alignment(R3, R4) was displaced posteriorly and the occlusal plane angle(R5) was rotated clockwise. 3. Skeletal Class III pattern was relieved in the post-operative group, but differences in the level of the cranium(R1, R2) was remaining compared to the normal occlusion patients. 4. In the comparison of surgery methods, the two-jaw surgery group presented changes in the maxillary length(A4), ramus alignment(R3,R4) and occlusal plane angle(R5) compared to the one-jaw surgery group, but the differences were not significant. In the past study about Korean skeletal Class III patients, the skeletal characteristics are upward backward rotation of the cranial base, posterior displacement of the maxilla, forward inclination of the ramus and lengthening of the mandibular body, but in this study, skeletal Class III pattern was relieved by shortening of the ramus width and maxillary advancement by orthognathic surgery, because orthognathic surgery is usually performed on limited areas in the maxilla and the mandible.
Dental Occlusion ; Female ; Humans ; Malocclusion* ; Mandible ; Maxilla ; Orthognathic Surgery ; Reference Values ; Skull Base

The present study was undertaken to evaluate the effect on PVC with IV disopyramide injection in 23 patients with PVC. There were 6 male and 17 female patients with age from 16 to 71 years. Three patients of hypertension, two patients of atherosclerotic heart disease, one patient of myocardial infarction, one patient of mitral stenosis, one patient of cardiomyopathy, one patient of uremic heart, fourteen patients of fuctional PVC were studied. The dose of 100mg of disopyramide was given with IV injection repeatedly until PVC disappeared.(Total: 40 Times) EKG monitering was performed in all cases to reveal the following results while the patients were on the regimen. 1. PVC disappearance rate in 23 patients was 78.2%. Average disappearance time and average dose is 7 minutes, 70.5mg respectively. 2. EKG revealed no change in P-R interval and pulse rate but slight prolongation of QRS and QTc interval. 3. When repeated injection was performed, the effect against PVC was decreased. 4. Acute heart failure as complication of disopyramide was not developed in all patients. As a result of present study, we recommended IV disopyramide injection, when disappearance of PVC was required immediately and safely.
Cardiomyopathies ; Disopyramide* ; Electrocardiography ; Female ; Heart ; Heart Diseases ; Heart Failure ; Heart Rate ; Humans ; Hypertension ; Male ; Mitral Valve Stenosis ; Myocardial Infarction

This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 ; secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987 ; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug stores visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 ; and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.
Age Factors ; Ambulatory Care* ; Education ; Humans ; Insurance* ; Occupations ; Rural Population*