Spontaneous perforation of bile duct in adults is very rare, with less than 30 cases described in the literature to date. We repoit a case of a 65-year-old man who presented with severe colicky abdominal pain and fever, just like symptoms of peritonitis. ERCP provided a preoperative noninvasive confirmation of the diagnosis of the rupture of right intrahepatic duct. The patient was performed T-tube choledochotomy and drainage of retroperitoneal bile collection. The etiolgy, diagnosis, and treatment of spontaneous perforation of bile duct is discussed.
Abdominal Pain ; Adult ; Aged ; Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Drainage ; Fever ; Humans ; Peritonitis ; Rupture

No abstract available.
Antibodies, Monoclonal* ; Blood Cells*

Rieger's syndrome is a rare autosomal dominant developmental anomaly characterized by ocular and systemic abnomalities. These disorders are typically bilateral and usually diagnosed at birth or in the childhood. The most common ocular defects are hypoplasia of the iris, a prominent Schwalbe's line with iris strands and corectopia. A large number of patients have glaucoma due to devel-opmental defects of the anterior chamber angle structure. The authors experienced a case of Rieger's syndrome which was found in 31-year-old female, who had characteristic ocular and other systemic abnormalities. Associated glaucoma was well controlled by filtering surgery.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

In this study, the feasibility of identification and genotypic differentiation of enteroviruses was investigated by using nested reverse transcription-polymerase chain reaction (nested RT-PCR), single-stranded conformation polymorphism (SSCP), and restriction fragment length polymorphism (RFLP) techniques. Two hundred seventy-four clinical samples were assayed by both nested RT-PCR and tube culture method using MRC-5 and MK cells; 58 (86.6%) out of 67 enterovirus culture-positive samples contained enteroviral RNA. In addition, 114 (55.1%) of 207 samples from patients with suspected enteroviral CNS disease with negative viral cultures were positive by the nested RT-PCR. The nested RT-PCR products were genotyped by the SSCP method and the results were compared with serotypes. We could differentiate 6 subtypes, 3 of which are similar to coxsackievirus B3, B5, echovirus 11, plus 3 other subtypes. RFLP cleaved with Sty I, Bgl I, and Xmn I yielded characteristic patterns for each laboratory strains. This study demonstrates the usefulness of the RT-PCR for the rapid diagnosis of enterovirus infection and the potentials of the SSCP method for differentiation of enterovirus strains.
Central Nervous System Diseases ; Diagnosis ; Enterovirus B, Human ; Enterovirus Infections ; Enterovirus* ; Genotype* ; Humans ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single-Stranded Conformational ; RNA

Although febrile convulsion (FC) is a common clinical entity with a high recurrence rate, no specific factors have been identified to be highly predictive of its recurrence. A total of 114 cases of FC identified during a 28 month period (January, 1989-May, 1991) was analysed. A slight predominance of boys over girls (1.3 to 1.0) was observed. the majority of cases (89.4%) were under 3 years of age and the most common age range for the onset of FC was 1~2 years. The most common form of FC was tonic type (54.0%), followed by tonic-clonic (32.5%), clonic (5.3%), and complex partial type (5.3%). Most FC episodes lasted less than 5 minutes (81.6%), and common clinical diagnosis underlying FC were as follows: pharyngotonsillitis (64.0%), bronchitis and/or pneumonia(16.7%), and gastroenteritis (9.7%). The family history for seizure disorder was present in 27.2% of the cases: FC in 21.1%, epiepsy in 4.4%, and both in 1.8%. Among 78 cases of the first FC, 43 cases were followed for 5 to 29 months without prophylactic anticonvulsant therapy. The overall recurrence rate of FC in this group was 67.4% and the highest incidence was observed in patients less than one year old (86.7%). A higher recurrence rate (80%) was observed in patients whose body temperature was lower than 39degrees C, as opposed to higher than 39degrees C (50%). It is concluded that the recurrence of FC is positively correlated with factors such as younger age (less than one year old), and lower body temperature at the time of onset of FC.
Body Temperature ; Bronchitis ; Diagnosis ; Epilepsy ; Female ; Gastroenteritis ; Humans ; Incidence ; Recurrence ; Seizures, Febrile*

Accidental aspiration of barium contrast medium during the upper gastrointestinal study can occur in patients with swallowing disorder, especially in the elderly patients. We experienced a case of respiratory failure followed by death within a few hours in a 85 year-old patient after barium aspiration.
Aged ; Aged, 80 and over ; Barium* ; Deglutition Disorders ; Humans ; Respiratory Insufficiency*

Distance teaming has been the tuning point for accomplishing adult teaming in nursing education. This study was conducted to demonstrate the effectiveness of the distance learning courseware with the RN-BSN students at Yonsei university, College of Nursing. The distance learning courseware was developed cooperatively by content experts, instructional designers. programmers and graphic designers. The course subject, 'Growth and Development' was made by a computerized instructional module using the internet. The programming developed with the virtual school developing support system of Samsung SDS based on the Web Sever and Oracle DB through the Internet. The instructional courseware was developed after taking into consideration the learners' levels of competencies and knowledge and utilized the integrate information through the multimedia, mainly via screens in the computer network. The students learned about the growth and development of infants to adolescents through the interaction with peers as well as instructors using many functional keys on the internet. The effects of learning were evaluated as their satisfaction of this distance learning courseware by 60 RN-BSN students. The student's responses have been very positive. The distance learning courseware for RN-BSN students developed at Yonsei University's Collage of Nursing is an available and interactive method used a Multimedia Instructional Design through the Internet.
Adolescent ; Adult ; Education, Distance* ; Education, Nursing ; Growth and Development ; Humans ; Infant ; Internet* ; Learning ; Multimedia ; Nursing*

We report a case of Hunter' s syndrome with characteristic nodules on the upper back. The patient was a 7-year-old Korean boy who presented with ivory-colored papules and nodules on both sides of the scapula, pectoral regions and lateral aspects of the upper arms. These lesione are regarded as pathognomonic cutaneous markers for Hunter s syndrome. He also presented with truncal hypertrichosis, retarded growth, short neck, round face, claw like contractures of hands, multiple joint contractures, and a clear cornea. Severely elevated glycosaminoglycan levels were present in the patient s urine samples. The patient s 5-year-old brother had similar clinical features.
Animals ; Arm ; Child ; Child, Preschool ; Contracture ; Cornea ; Hand ; Hoof and Claw ; Humans ; Hypertrichosis ; Joints ; Male ; Mucopolysaccharidosis II* ; Neck ; Scapula ; Siblings

No abstract available.
DNA* ; Plasmids* ; Restriction Mapping* ; Yersinia enterocolitica* ; Yersinia*

No abstract available.
Gangwon-do* ; Humans