No abstract available.
Endocardial Cushion Defects* ; Endocardial Cushions* ; Hernia, Diaphragmatic*

OBJECTIVES: The purpose of this investigation was to review the distribution and treatment of gynecologic disease in pediatric and adolescent patients. METHODS: Two hundred forty-four pediatric and adolescent patients were evaluated clinically, who were admitted to Department of Obstetrics and Gynecology, Chungnam National University Hospital from Jan. 1989 to Sep. 1999. RESULTS: The most common disorder was ovarian tumors(43.0%) including 78.1% of neoplastic diseases and 21.9% of nonneoplastic diseases, and followed by pregnancy-associated disorders(20.5%), infectious disorders(11.5%), congenital abnormalities(9.8%), traumas(7.4%) and miscellaneous(7.8%). Pregnancy asso ciated disorders include abortion(42%), gestational trophoblastic disease(30.0%), and ectopic pregnancy(28%). Infectious disorders include acute pelvic inflammatory disease(53.6%), hydrosalpinx(21.4%), condyloma accuminata(10.7%) and tuberculous salpingitis(3.5%). Congenital abnormalities include congenital uterine anomalies(41.7%), imperforate hymen(20.8%), male hermaphroditism(12.5%), female hermaphroditism(8.3%), pure gonadal dysgenesis(8.3%) and mixed gonadal dysgenesis(8.3%). Traumas include vulvar laceration (33.3%), vulvar hematoma(33.3%), and vaginal wall laceration(33.3%). CONCLUSION: We analyzed two hundred forty-four pediatric and adolescent patients who were admitted to Department of Obstetrics and Gynecology, Chungnam National University Hospital from Jan. 1989 to Sep. 1999. The most common disorder was ovarian tumors(43.0%) and followed by pregnancy-associated disorders (20.5%), infectious disorders(11.5%), congenital abnormalities(9.8%), traumas(7.4%) and miscellaneous(7.8%).
Adolescent* ; Chungcheongnam-do ; Congenital Abnormalities ; Female ; Genital Diseases, Female ; Gonads ; Gynecology ; Humans ; Lacerations ; Male ; Obstetrics ; Pediatrics ; Pregnancy ; Trophoblasts

BACKGROUND: Although dental implantation has become widespread and acceptable treatment for dental prosthodontics, maxillary posterior jaw region is often complicated by the pneumatization of the maxillary sinus and physiological resorption of the alveolar bone. When this occurs, the residual bone between the floor of the sinus and the crestal ridge is inadequate for the placement of implants. The sinus elevation procedure provides a way to increase the amount of available bone and to allow the placement of longer implants. MATERIALS & METHODS: We studied 11 patients requiring the implant placements and the maxillary sinus elevation simultaneously from 1996 to 2003 in our clinic. Nine patients were males and two patients were females, aged from 39 to 72(mean=51.6). Four patients had medical compromised states; angina pectoris, diabetes, hypertension, hepatitis. Patients didn't show any pathologic findings clinically or radiographically. We studied the success and survival rate of implants, factors increasing the osseointegrating capacity of implants. RESULTS: The success rate of osseointegration of implants was 93%. At least 6 months after loading on implants, the survival rate of implants was 78.5%. Autogenous bone graft and adequate residual bone height(>6mm) increased survival rate of implants. CONCLUSION: Successful implant placement with maxillary sinus elevation mainly depends on sufficient residual bone height, healthy maxillary sinus, autogenous bone graft.
Angina Pectoris ; Dental Implantation ; Dental Implants ; Female ; Hepatitis ; Humans ; Hypertension ; Jaw ; Male ; Maxillary Sinus* ; Osseointegration ; Prosthodontics ; Survival Rate ; Transplants

BACKGROUND: Although dental implantation has become widespread and acceptable treatment for dental prosthodontics, maxillary posterior jaw region is often complicated by the pneumatization of the maxillary sinus and physiological resorption of the alveolar bone. When this occurs, the residual bone between the floor of the sinus and the crestal ridge is inadequate for the placement of implants. The sinus elevation procedure provides a way to increase the amount of available bone and to allow the placement of longer implants. MATERIALS & METHODS: We studied 11 patients requiring the implant placements and the maxillary sinus elevation simultaneously from 1996 to 2003 in our clinic. Nine patients were males and two patients were females, aged from 39 to 72(mean=51.6). Four patients had medical compromised states; angina pectoris, diabetes, hypertension, hepatitis. Patients didn't show any pathologic findings clinically or radiographically. We studied the success and survival rate of implants, factors increasing the osseointegrating capacity of implants. RESULTS: The success rate of osseointegration of implants was 93%. At least 6 months after loading on implants, the survival rate of implants was 78.5%. Autogenous bone graft and adequate residual bone height(>6mm) increased survival rate of implants. CONCLUSION: Successful implant placement with maxillary sinus elevation mainly depends on sufficient residual bone height, healthy maxillary sinus, autogenous bone graft.
Angina Pectoris ; Dental Implantation ; Dental Implants ; Female ; Hepatitis ; Humans ; Hypertension ; Jaw ; Male ; Maxillary Sinus* ; Osseointegration ; Prosthodontics ; Survival Rate ; Transplants

OBJECTIVE: To evaluate the usefulness of back pain questionnaires for lumbar disc screening among Korean young males. METHODS: We carried out a survey for lumbar disc screening through back pain questionnaires among the volunteers with or without back pain. Three types of back pain questionnaire (Oswestry Low Back Pain Score, Aberdeen Low Back Pain Scale, and Acute Low Back Pain Screeing Questionnaire) were randomly assigned to the examinees. The authors reviewed lumbar imaging studies (simple lumbar radiographs, lumbar computed tomography, and magnetic resolutional images), and the severity of lumbar disc herniation was categorized according to the guidelines issued by the Korean military directorate. We calculated the relationship between the back pain questionnaire scores and the severity of lumbar disc herniation. RESULTS: The scores of back pain questionnaires increased according to the severity of lumbar disc herniation. But, the range of scores was very vague, so it is less predictable to detect lumbar disc herniation using only back pain questionnaires. The sensitivity between the back pain questionnaires and the presence of lumbar disc herniation was low (16-64%). CONCLUSION: Screening of lumbar disc herniation using only back pain questionnaires has limited value.
Back Pain ; Humans ; Intervertebral Disc Displacement ; Korea ; Low Back Pain ; Magnetics ; Magnets ; Mass Screening ; Military Personnel ; Surveys and Questionnaires

OBJECTIVE: Cervical lateral mass screw insertion and rod fixation is a useful method for stabilizing the cervical disease, so various modified techniques were present. Many surgeons had reported the biomechanical safety according to the screw positioning method in the cervical spine, but the modified Magerl's method (Yoon's method) was not well studied. So, this study assessed the radiological efficacy of the modified Magerl's method with long-term follow-up. METHODS: This study retrospectively reviewed 323 lateral mass screws of 50 patients who had followed-up at least 2 years. Radiologic data were analyzed as parameters of complications after operation, including kyphotic or lordotic change, bone fusion, pull-out or malposition of screw, foraminal stenosis, adjacent disc degeneration or aggravation, pseudoarthrosis, and vertebral artery injury. RESULTS: The mean follow-up period was 32 (24 to 52) months. There were kyphotic changes in 4.0%(2 of 50 cases). Unsuccessful bone fusion occurred in 4.0%(2 of 50 cases). Among the 323 screws, screw pull-out (4.0%. 2 of 50cases, 3 of 323 screws), foraminal invasion (1.2% of total screws), and facet injury (0.6% of total screws) occurred. CONCLUSION: The lateral mass screw insertion and rod fixation by the modified Magerl's method (Yoon's method) is a safe and reliable technique with low rate of complication related to instruments in minimum 2 years follow-up.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion ; Spine ; Vertebral Artery

We performed a meta-analysis using results in the Korean literatures to determine whether laparoscopic appendectomy (LA) or open appendectomy (OA) provide the better outcome in possible acute appendicitis patients. To perform the meta-analysis, an extensive literature search was conducted, giving priority to the Journal of the Korean Surgical Society, and domestic literature in its search database, published since January 1993, to ascertain the usefulness of LA in the treatment of acute appendicitis. The criteria used for the quality evaluation were as follows: 1) study subjects must have been evaluated clinically for suspected acute appendicitis, and 2) articles were included only if sufficient data (e.g. patient number, mean and standard deviation of patient outcome variables) were available regarding patient outcomes for LA or OA treated appendicitis. Of the 136 articles retrieved, 8 studies (1, 258 patients) were selected for quantitative meta-analysis. Because insufficient data was available in some studies, operating time and hospitalization days were assessed for all 8 studies, but the time required to return to full functioning was assessed for only 3 studies. Overall effect size estimates were calculated using a random effect model for four patient outcomes (operating time, Q=38.6699, p < 0.001; length of stay, Q=19.3876, p < 0.001; postoperative hospital stay, Q=20.9164, p < 0.001; and return time to full functioning, Q=41.5061, p < 0.001). Because the overall effect size for operating time was -0.3218 (95% confidence interval [CI] -0.6108 to -0.0328), LA operating time was significantly greater than that of OA. In addition, a significant difference was found between the two modalities in terms of the length of hospital stay. Overall effect size in terms of the time required to return to full functioning was 1.9757 (95% CI 1.0066 to 2.9448), and LA reduced the time required by about 2 days versus OA. Considering the overall odds ratio (0.33) and 95% CI (0.20 to 0.55) the incidence of wound infection was significantly lower in LA than in OA. This review of the published evidence suggests that LA is more useful for treating acute appendicitis, especially when perforated appendicitis is suspected.
Acute Disease ; Appendectomy/*methods ; Appendicitis/*surgery ; Human ; Korea ; *Laparoscopy ; Support, Non-U.S. Gov't

No abstract available.
Pulmonary Alveolar Proteinosis*

Sjogren syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in dry mouth and eyes. Approximately one-third of patients present with systemic manifestations, but respiratory muscle involvements have been rarely reported. We report a case of acute respiratory failure complicated by primary Sjogren syndrome. Muscle biopsy revealed perivascular lymphocytic infiltrations. Corticosteroid therapy improved respiratory muscle weakness. Sjogren syndrome should be considered as one of the underlying diseases causing acute respiratory failure.
Autoimmune Diseases ; Biopsy ; Exocrine Glands ; Humans ; Mouth ; Muscular Diseases ; Respiratory Insufficiency ; Respiratory Muscles* ; Respiratory Paralysis ; Sjogren's Syndrome*

Mitomycin (MMC) is a naturally ocurring alkylating agent, introduced for clinical use as early as 1958. This drug is useful in the therapy of gastrointestinal carcinomas when used in combination with 5-fluorouracil. Nephrotoxicity among toxicities from MMC is unusual with cumulative doses less than 30 mg/m2. In large studies in which the incidence of MMC nephrotoxicity were assessed, 3-15% of patients developed total dose related renal dysfunction. Three patients in our clinical practice have developed thrombotic microangiopathy clearly related to MMC. We report the clinical and pathologic features of our cases. In view of the probable dose-related and delayed toxicity of MMC, it seems necessary to monitor regularly after initiation of chemotherapy. Early detection of the renal impairment and withdrawal of MMC might halt further progression of renal failure.
Drug Therapy ; Fluorouracil ; Humans ; Incidence ; Mitomycin* ; Renal Insufficiency ; Thrombotic Microangiopathies*