No abstract available.
Amenorrhea* ; Cytogenetics* ; Female

No abstract available.
Amenorrhea* ; Cytogenetics* ; Female

This study was to investigate the various parts of the mandible related to inferior alveolar nerve conductive anesthesia in 228 dry skulls of Korean adults. Five morphological variations were observed and four measurements were undertaken. The following results were obtained. 1. The Position of coronoid notch in the anterior border of the ramus of mandible is classified into three types and percentage of each type was as follows : Type I (Coronoid notch in the middle part of the anterior border of the ramus of mandible) : 83.3% Type II (Coronoid notch in the inferior part of the anterior border of the ramus of mandible) : 12.7% Type III (No coronoid notch in the anterior border of the ramps of mandible) : 4.0% 2. The position of the lingula of mandible to the imaginary line of the molar occlusal plane is classified into three types and percentage of each type was as follows : Type I (Above the imaginary line of the mandibular molar occlusal plane) : 87.3% Type II (Coincide with the imaginary line of the mandibular molar occlusal plane) : 8.6% Type III (Below the imaginary of mandibular molar occlusal plane) : 4.3% 3. The position of the lingula of the mandible in the internal oblique line-posterior border of the ramus of mandible dimension is classified into three types and percentage of each type was as follows : Type I (Anterior part in the internal oblique line-posterior border of the ramus of mandible dimension) : 82.9% Type II (Middle part in the internal oblique line-posterior border of the ramus of mandible dimension) : 11. 4% Type III (Posterior part in the internal oblique line-posterior border of the ramus of mandible dimension) : 5.7% 4. The position of the apex of the lingula of mandible to the deepest point of the coronoid notch in the anterior border of the ramus of mandible is classified into three types and percentage of each type was as follows : Type I (Coincide with the deepest point of the coronoid notch) : 82.0% Type II (Above the deepest point of the coronoid notch) : 13.2% Type III (Below the deepest point of the coronoid notch) : 4.8% 5. The position of the apex of the lingula of mandible to the imaginary line of the mandibular molar occlusal plane is classified into three types and percentage of each type was as follows : Type I (Above the 8mm) : 65.7% Type II (Above the 5mm) : 18.6% Type III (Above the 10mm) : 15.7% 6. Angle between the line connecting the apex of the lingula of mandible-1-2 premolars in the contralateral side and median line of the mandible is classified into three types and percentage of each type was as follows : Type I (50°) : 67.2% Type II (45°) 21.4% Type III (55°) : 11.4% 7. The averages of the measurement of the various bony landmarks of the mandible related to inferior alveolar nerve conductive anesthesia were as follows : ① Distance from deepest point of the coronoid notch to internal oblique line : 9.2mm ② Distance from internal oblique line to the apex of the lingula of mandible : 11.6mm ③ Distance from deepest point of the coronoid notch to apex of the lingula of mandible : 19.7mm ④ Height of the lingula of mandible : 9.8mm
Adult ; Anesthesia* ; Architectural Accessibility ; Bicuspid ; Dental Occlusion ; Humans ; Mandible* ; Mandibular Nerve* ; Molar ; Skull

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

Rectus sheath hematoma of the abdominal wall is a well-recognized, but uncommon condition, caused by a tear in an epigastric vessel and characterized by sudden onset of severe abdominal pain and palpable mass. In most cases, a precipitating cause can be demonstrated. Causes include external trauma, strenuous activities, coughing, lifting, sneezing, vomiting, straining while urinating or defecating, golfing, pregnancy and the puerperium, anticoagulation therapy, infection, chronic diesase, arteriosclerosis, hypertension, prior paracentesis or laparotomy, inadequate hemostasis or excessive retraction in surgery, and idiopathy. Unfortunately, the correct diagnosis often is missed, and the hematoma is found only during an exploratory laparotomy. Treatment should be conservative in most instances. Although the mortality rate for patients with rectus sheath hematoma is low, the condition may be fatal if the volume of the hemorrhage is large and if treatment is delayed. Hence, it should be included in the differential diagnosis of any patient who presents to the emergency department with acute onset of abdominal pain. Our purpose is to familiarlize emergency physicians with the pathophysiology, the diagnosis, and the treatment of rectus sheath hematoma. We describe a patient with fatal rectus sheath hematoma presenting to the emergency department and give a review of the literature.
Abdominal Pain ; Abdominal Wall ; Arteriosclerosis ; Cough ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Emergency Service, Hospital ; Golf ; Hematoma* ; Hemorrhage ; Hemostasis ; Humans ; Hypertension ; Hypovolemia* ; Laparotomy ; Lifting ; Mortality ; Paracentesis ; Postpartum Period ; Pregnancy ; Shock* ; Sneezing ; Vomiting

PURPOSE: The conventional surgical treatment for patients with potentially curable low rectal cancer is abdominoperineal resection. Recently there has been increasing interest in the use of preoperative radiation therapy and sphincter-saving procedure as primary therapy for selected low rectal cancers. We report our institutional experience with this approach. METHODS: From 1995 to 1997, Twelve patients with resectable distal rectal cancer were offered sphincter-saving procedure, excluding the patients whose pretreatment tumor presentation demonstrated fixation to anal sphincter or puborectalis muscle. The distance from the anal verge to the distal tumor margin at initial diagnosis ranged from 1 to 5 cm. Patients received a median 50.4 Gy and chemotherapy Surgery was carried out 4 to 8 weeks after radiation. RESULTS: No patient had toxic reaction that required interruption of chemoradiation. Four patients (33%) had complete pathologic response, but one patient with complete clinical response had residual cancer. Seven patients underwent hand-sewn coloanal anastomosis and five patients transanal excision en bloc. All patients were able to successfully undergo a sphincter-saving procedure. With a mean follow-up of 23 months (range, 6~32), the authors noted no recurrence or complication. Sphincter function was good in 92%. Daily bowel movements was two (range, 1~10). CONCLUSION: Preoperative chemoradiation appears promising in terms of better patient compliance, lesser toxicity, and downstaging tumor, making the sphincter-saving procedure feasible in carefully selected cases. Surgical resection remains essential to confirm and to achieve complete clinical remission. The results of preoperative chemoradiation and sphinctersaving procedure are encouraging, but more experience is needed to determine whether this approach ultimately has similar local control and survival rate compared to standard surgery.
Anal Canal ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm, Residual ; Patient Compliance ; Rectal Neoplasms* ; Recurrence ; Survival Rate

No abstract available.
Sarcoidosis*

No abstract available.
Humans

The improved survival rate of premature infants requiring intensive care, shows an increased risk for nosocomial infections such as disseminated fungal infection. Renal candidasis usually occurs secondary to systemic disease, and can Iead to obstructive uropathy by fungus ball. A male neonate was born in week 28 of the gestational period. His birth weight was 1200gm. He required mechanical ventilation and surfactant for respiratory distress syndrome, umbilical artery and vein catheterization, percutaneous central veneous catheterization(PCVC) for parenteral nutrition, steroid, aminophylline and broad spectrum anibiotics. Hypertension developed on the 29th hospital day, but was not controlled by diuretics and antihypertensive drugs. on the 40th hospital day, he had abdominal distension, anuria, and azotemia. A Renal ultrasonogram showed that the ureteropelvic junction of the left kidney was completely obstructed with fungus balls. A percutaneous nephrostorny tube, made in a pigtail shape by hand, was inserted under fluoroscopy guidance, and the obstruction of the pelvis was resolved by wire manipulation. Parenteral amphotericin B and oral flucytocine were started, and the left renal pelvis was directly drained and irrigated by percutaneous nephrostomy tube. Candida albicans(C. albicuns) was cultured from urine and a percutaneous central venous catheter tip. His general condition improved, and follow up urine culture revealed no fungus. On follow-up renal ultrasonogram, renal cortex echogenicity and fungus ball had disappeared except for mild left renal calyectasis and pelvic thickening. This report describes a case of obstructive uropathy by fungus ball in systemic candidiasis of prematurity, and reviews the related literature.
Aminophylline ; Amphotericin B ; Antihypertensive Agents ; Anuria ; Azotemia ; Birth Weight ; Candida ; Candidiasis ; Catheterization ; Catheters ; Central Venous Catheters ; Cross Infection ; Diuretics ; Fluoroscopy ; Follow-Up Studies ; Fungi ; Hand ; Humans ; Hypertension ; Infant, Newborn ; Infant, Premature ; Critical Care ; Kidney ; Kidney Pelvis ; Male ; Nephrostomy, Percutaneous* ; Parenteral Nutrition ; Pelvis ; Respiration, Artificial ; Survival Rate ; Ultrasonography ; Umbilical Arteries ; Veins

To know the amplification pattern according to relative concentration ratio in mixed samples, two STRloci, vwF locus and MBP locus and two VNTR loci, D1S80 locus and d17S5 locus were amplified in DNA with various concentration of two individuals were easily identified. But when the concentration of one person were lowered to 1/20-1/40 of the other's the intensity of product bands diminshed and hardly discernible. Also different amplification efficiency according to the template length was noted, especially in VNTR loci. Using automatic sequencer and RFLP scan program, the intensity OD of each PCR product band could be calculated, and this correlates the felative amplification efficiency of each allele. By using this we could construct quantitative PCR for the mixed samples. This could be used in practical case work for forensic purpose, and also be a valuable candidate for 'chimerism detection' in case of bone marrow transplatation.
Alleles ; Bone Marrow ; DNA ; Humans ; Minisatellite Repeats ; Polymerase Chain Reaction* ; Polymorphism, Restriction Fragment Length