PURPOSE: This study was to evaluate the clinical usefulness of 99mTc-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation or evisceration. MATERIALS AND METHODS: Twenty-four patients (M:F=7:17, mean age: 36 years), who buried a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Dynamic and static scintigraphy on the orbit fossa were obtained after injection of 740 MBq 99mTc-MDP to evaluate the status of vascularization. The study was performed from the 3 to 33 weeks after surgery. According to the visual analysis, activity greater than nasal bridge was graded as 4, equal to the nasal bridge as 3, less than nasal bridge but greater than normal orbit as 2, greater than normal orbit but less than grade 2 as 1. Uptake ratio was also calculated by measuring the implants activity (H) and contralateral orbit activity (N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. RESULTS: Twenty-one patients who had bone scintigraphy at 11 weeks after surgery showed increased uptake above grade 2 and greater H/N ratio than 1.56. Of these, 19 patients who had drilling surgery for permanent peg application showed adequate bleeding during the procedure. The activity grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. Accomplishment of vascularization was not affected by the surgical way such as enucleation or evisceration. CONCLUSION: 99mTc-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for 99mTc-MDP bone scintigraphy may be 11-20 weeks after enucleation or evisceration.
Durapatite* ; Hemorrhage ; Humans ; Orbit ; Prognosis ; Radionuclide Imaging* ; Technetium Tc 99m Medronate*

During the period of May 10 to June 6, 1987, we have conducted the survey about the number of the food daily taken and the in take of nutrition of the 83 pregnant women who have registered at Sudong Myun and Mikum-myun, Yangchu-gun which are demonstration are of the public health and medicine of the College of Medicine, Ewha Women's University, and of the 100 pregnant women who have been to the University Hospital attached to the above School. The result of the survey is as follows: 1) Among the above pregnant women, primigravida constituted 91 women and multigravida 92 women. As for the month of pregnancy, those who have been pregnant for ten months numbered 43 women (23.5%), which was the highest number. As for age, those who were 25 to 29 years old constituted 63.9%, which was the highest in percentage. 2) As for the level of education, those who graduated from high school constituted 49.2%, which was the highest in percentage. As for occupation, those who were entirely in charge of household affairs as housewives were 89.6%, which comprised most of the jobs held by the above women. 3) As for the composition of a family in environmental food and nutrition, one generation was 68.3%, and two member family was 42.6% which was the highest. As for those taking care of cooking and serving meals, housewives constituted 95.1%. 4) As for the economic situation of dietary life, those who were in the highest level (A level), were 47.0% in an urban area and 41.0% in rural area, which were the highest in percentage. 5) The food which the above people selected after being pregnant was fruit not only in an urban area, but also in a rural area. And in terms of the percentage of fruit, and urban area and a rural area showed 44.0% and 54.2% respectively. As for milk, and urban area and a rural area showed 28.0% and 8.4% respectively, which disclosed that the rate of a rural area was much lower than that of an urban area. 6) As for the number of food intake, 10-14 was 54.0% in an urban area, which was the highest. And 5-9 was 73.5% in a rural area, which was the highest. 7) As for the composition of food taken according to the number of food taken, meat showed the lowest rate in 5-9 group. (P<0.05) As the number of food taken increased, the rate of food taken(Points) increased (2.4). Milk and milk products showed al low rate in 5-9 group and 15-19 group (P<0.05). Fruit intake showed a similar rate in all groups. As for vegetables, the rate of intake was high, as the number of food taken increased. Cereals showed a similar rate in all troups. And the points of intake was high. As for fat, hte rate of intake was high, as the number of food taken increased. 8) In 5-9 group in the number of food intake, energy was 79.9% of RDA, protein was 64.9%, fat was 90.0%, carbohydrate was 81.6%, iron was 83.0%, calcium was 71.1%, vitamin A was 94.3%, vitamin B1 was 77.8%, vitamin B2 was 79.2%, and vitamin C was 88.2%, so that it showed the lowest sufficiency rate of RDA. 15-19 group maintained the balance in energy and all nutrients nearly. In 20-24 group, fat was 142.4%, vitamin B2 was 105.6% and vitamin C was 102.2%, so that it exceeded RDA.
Adult ; Ascorbic Acid ; Calcium ; Edible Grain ; Cooking ; Eating* ; Education ; Family Characteristics ; Female ; Fruit ; Humans ; Iron ; Meals ; Meat ; Milk ; Occupations ; Pregnancy ; Pregnant Women ; Public Health ; Riboflavin ; Thiamine ; Vegetables ; Vitamin A

Percutaneous transhepatic cholangiography(PTC) is of value in differential diagnosis of cholestatic diseases. Authors had performed PTC in 120 patients with flexible needle of 23 gauge at the Department of Radiology, KangNam St, Mary's Hospital and Myung Dong St. Mary's Hospital during the period from Jan. 1976 to April 1980. PTC was accomplished successfully in 112 of 120 patients. Diagnoses included cholangiocarcinomas (27 cases), arcinomas ofpancreas head (21 cases), ampullary carcinomas (4 cases), metastatic carcinomas(4 cases), metastatic carcinomas (5cases), bile duct stones(27 cases), sclerosing cholangitis(6 cases), hepatitis(6 cases), liver cirrhosis(6 cases), post operative adhesions(5 cases), chronic pancreatitis(3 cases), stomach carcinomas(3 cases), clonorchiasis(2cases), blood clot (1 case), and remaining normal 4 cases. Some characteristic PTC findings were (1) segmentalannular narrowing and abrupt complete obstruction and polypoid filling defects of the bile duct incholangiocarcinoma, (2) typical nipple or rat-tail appearance of the distal commmon bile duct in pancreatic headcarcinoma, (3) single or multiple sharply and smoothly outlined filling defects whthin bile duct in all cases ofstones, (4) complete obstruction with shallow concavity in ampullary carcinoma, (5) diffuse or segmental narrowingof the intrahepatic bile duct and common bile duct in sclerosing cholangitis, (6) multiple tiny polypoid fillingdefects of gallbladder, common hepatic duct, and common bile duct in clonorchiasis, (7) normal appearance inhepatitis. The overall diagnostic accuracy of PTC in 66 operated cases was 89.4%, and complications following the examination were signficantly reduced by using a fine flexible needle(23 gauge). From the present study it is concluded as follows; 1. To evaluate obstructed or stenosed site accurately, aspiration of bile juice must bepreceded by a 23 gauge needle connected to either 10mo or 5ml syringe. 2. To diagose carcinoma of hte ampullaryportion, serial spot filmings were indispensible ot demonstrated modified appearance of obstructive lesions due tocontraction of Oddi sphincter. 3. In contrast to other reports, the most common site of cholangiocarcinomas wasthe common hepatic duct (12 of 27 cases) in our series. Rat-tail appearance was seen in both pancreatic headcarcinoma and carcinoma involving the distal end of the common bile duct. 4. PTC was a more valuable method for diagnosis of clonorchiasis.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangiography ; Cholangitis, Sclerosing ; Clonorchiasis ; Common Bile Duct ; Diagnosis ; Diagnosis, Differential ; Gallbladder ; Head ; Hepatic Duct, Common ; Humans ; Liver ; Methods ; Needles ; Nipples ; Sphincter of Oddi ; Stomach ; Syringes

There is still discussion concerning the methods for treating Tossy type 3 dislocations of the acromioclavicular joint. Since 1995, the authors have treated 10 patients of type 3 dislocations by arthroscope-assisted modified Weaver and Dunn operation with favorable results. The operation consisted of diagnostic shoulder arthroscopy, arthroscopic resection of acromial end of coracoacromial ligament with bone block, excision of distal end of clavicle, bone block transfer of coracoacromial ligament into the medullary canal of clavicle, and augmentation between coracoid process and resected distal end of clavicle with the Mersilene tape. The advantages of this arthroscope-assisted modified Weaver and Dunn operation are as follows: (1) Using the shoulder arthroscope, associated patholgy in the shoulder joint can be found and treated appropriately. (2) Arthroscopic resection of the acromial end of coracoacromial ligament can give the small incision and least damage to the deltoid muscle so that immediate post-operative range of motion exercise can be possible. (3) Bone block transfer of coracoacromial ligament and augmentation between coracoid process and resected clavicular end can prevent displacement of the resected clavicular end.
Acromioclavicular Joint ; Arthroscopes ; Arthroscopy ; Clavicle ; Deltoid Muscle ; Dislocations ; External Fixators* ; Hand* ; Humans ; Ligaments ; Range of Motion, Articular ; Shoulder ; Shoulder Joint

Various anatomical defects have been described in the surviving co-twin who had stillborn, macerated monozygotic co-twin with disseminated intravascular coagulation. The suggested mechanism was the transfer of emboli or thromboplastic materials of dead fetus to co-twin through placental vascular anastomoses. Multicystic encephalomalacia is the condition defined anatomically by the presence of multiple cavities in the great part of both cerebral hemispheres. The most common pathogenesis is circulatory disturbance caused by neonatal asphyxia during the perinatal period. We experienced two cases of monozygotic twin with deceased co-twin at 26 weeks, 33 weeks of gestation and confirmed the diffuse multicystic encephalomalacia by cranial ultrasonography and MRI in a surviving co-twin. Only one patient has been followed who showed spastic cerebral palsy and severe mental retardation. We report two cases of multicystic encephalomalacia in a surviring co-twin with a intrauterine fetal death and its related literatures.
Asphyxia ; Cerebral Palsy ; Cerebrum ; Disseminated Intravascular Coagulation ; Encephalomalacia* ; Fetal Death* ; Fetus ; Humans ; Intellectual Disability ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy, Twin ; Twins, Monozygotic ; Ultrasonography

No abstract available.
Child* ; Humans ; Pheochromocytoma*

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason for the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium irate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.
Hand ; Health Expenditures ; Humans ; Insurance ; Insurance Carriers ; Insurance, Health* ; Korea* ; Outpatients ; Public Health ; Tertiary Healthcare