Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.
Bladder Fistula/diagnosis/etiology ; Female ; Fistula/*diagnosis/*etiology ; Human ; Intestinal Fistula/diagnosis/etiology ; *Pelvis ; Ureteral Diseases/diagnosis/etiology ; Urinary Fistula/diagnosis/etiology ; Uterine Diseases/diagnosis/etiology ; Vaginal Fistula/diagnosis/etiology

Freys syndrome is characterized by attacks of facial erythema and gustatory sweating occurring in the cutaneous distribution of the auriculotemporal nerve. After sugery, trauma, abscess, or other diseases of the parotid gland, the postganglionic sympathetic and parasympathetic nerve fibers are disrupted. Some misdirected auriculotemporal nerve fibrils join with the distal sympathetic nerves innervating the sweat glands and subcutaneous vessels. We report a case of Freys sindrome in a 6-year old boy without any definite injury to the parotid gland. After considering our case and review of literature of Freys syndrome in children, we conclude that there may be a congenital defect in the auriculotemporal nerve innervation responsible for cases occuring in children.
Abscess ; Child* ; Congenital Abnormalities ; Erythema ; Humans ; Male ; Nerve Fibers ; Parotid Gland ; Sweat Glands ; Sweating, Gustatory

No abstract available.
Neoplasm Metastasis ; Small Cell Lung Carcinoma ; Thyroid Gland

No abstract available.
Orchiectomy* ; Testis*

Diastematomyelia, a form of spinal dysraphism, is characterized by a division of the spinal cord or canda equina resulting the form a bony or cartilaginous spur which transfixes the neural elements and dura. The presence of a structure of neural crest origin in the subarachnoid space connecting the spicules suggested that the anomaly resulted from delayed closure of the neural tube and its investments. The cinical finding are presumed due to its restriction, tethering of the normal apward migration of the spinal cord. Congenital anomalies of one or both lower extremities and spine are frequently found with this condition. The surgical removal is recommended as a prophylactic measure against further progressive neurological damage. The purpose of this paper is to presented becanse it was associated with clubfoot and adds to understanding of teratogenesis of diastematomyelia.
Clubfoot ; Investments ; Lower Extremity ; Neural Crest ; Neural Tube ; Neural Tube Defects ; Spinal Cord ; Spinal Dysraphism ; Spine ; Subarachnoid Space ; Teratogenesis

No abstract available.
Animals ; Olfactory Bulb* ; Olfactory Mucosa* ; Rats* ; Synapses*

Even though various kinds of diagnostic and therapeutic measures have been used for the detection and cure of the acute osteomyelitis, this disease is difficult to be eradicated in many clinical cases. However it is rather easy to treat once this disease can be detected in early stage. So far radiological examination and many kinds of maneuvers including blood culture, clinical laboratory, xeroradiography, computed tomography have been performed for the early detection of this disease but invalid in the most cases. Recently some authors reported that the bone scanning was useful for the early detection of acute osteomyelitis, but this method also had difficulty in differential diagnosis and uncertaninty of its activity. This study aims to try to find methods of early detection of acute osteomyelitis. Experimental osteomyelitis was developed by the inoculation of Staphylococcus aureus to proximal tibias of 39 young rabbits already sclerosed by solution of sodium morrhuate. By comparing the clinical, radiological, bacteriological and laboratory findings in sequence from 2 days to 7 weeks after inoculation, the following results were obtained. 1. The incidence of experimental osteomyelitis after inoculation of staphylococcus aureus SNUH-S-188 in suspension of 1×10(7) colony forming units was 84%, 74%, and 79% in radiological, blood culture and pathologic examination respectively. 2. The leucocytosis was noticed only in early stage and slight degree of anemia was found during the 1st and 2nd weeks after inoculation. The sedimentation rate was increased only in early acute stage and same was eosinophil count. The leucocyte alkaline phosphatase(LAP) and platelet count. showed no significant abnormal changes. 3. Lymphocyte and eosinophil turned over from normal and eosinophil was predominant in experimental osteomyelitis. 4. Serum calcium, phosphorus, total protein and albumin showed significant decrease in all stages and was conversely paralle1 to changes in groin temperature. The level of BUN was normal indicating normal kidney function in experimental osteomyelitis. 5. Even though the enzymes of which showed no significant changes enrolled alkaline phosphatase and serumgluiamicoxalic-transaminase(S-GOT), but some increa.e was attained to 27% and 44% respectively. 6. It is important and significant to find continuous increase of lactic dehydrogenase (LDH) and creatine phosphokinase (CPK) since 48 hours after inoculation and author, think these will be the reliable and sensitive indices in early detection of the development of osteomyelitis and efficacy of therapeutic measures.
Alkaline Phosphatase ; Anemia ; Calcium ; Creatine Kinase ; Diagnosis, Differential ; Eosinophils ; Groin ; Incidence ; Kidney ; Lymphocytes ; Methods ; Osteomyelitis ; Oxidoreductases ; Phosphorus ; Platelet Count ; Rabbits ; Sodium Morrhuate ; Staphylococcus aureus ; Staphylococcus ; Stem Cells ; Tibia ; Xeroradiography

BACKGROUND: It has been documented that certain prognostic factors may affect the outcomes of the old aged victims by trauma. Considering that trauma is the sixth most common cause of death in people over the age of 65 years and there is a rapid growth of elderly population, it is paramount to understand the prognostic factors when dealing with geriatric trauma patients. Hypothesis and Goals : It can be hypothesized that the prognostic factors should be determined independently between populations being consisted of different races, countries, socio-economic states, cultures, or so on. Thus, study was designed to evaluate the factors affecting the outcomes of elderly Korean trauma patients. METHODS: One hundred forty six patients aged over 65 years were retrospectively reviewed, who visited the Emergency Canter of Korea University from January, 1997 to June, 1998. Of 146 patients, 7 were excluded due to discharge against advice or transfer to the other hospitals. Parameters analysed were age, sex, mechanism of injuries, body region injured, Injury Severity Score (ISS), previous medical illness, hospital morbidity, duration of hospital stay, and cost. Each patient was classified into improved or not-improved groups depending on the outcomes, and young-old or old-old group depending on the age. The factors affecting the hospital stay in improved patients were analyzed in the parameters of previous medical illness, hospital morbidity, multiple injuries, ISS, and age. All statistical tests were conducted with two-tailed levels of 0.05. RESULTS: Of 139 patients, the mean age was 74+/-7.1 years, mean ISS 9.3+/-7.26, mean hospital stay 27+/-27.1 days. Most commonly injured body region was the extremities due to fall from a level surface. Rate of previous illness showed 0.94 medical diseases per person and were aggravated after trauma in 39 patients (60.9%). Hospital morbidity rate was 0.46 incidents per person. There were no differences in age and duration of hospital stay between the improved and the not-improved group. Substantial differences were noted in affected body region, incidence of previous illness, and hospital morbidity between the groups (p=NS). Not-improved group had higher ISS (p<0.05). ISS, previous illness and hospital morbidity affected the duration of hospital stay in the improved group. Hospital stay was 40+/-25.1 days in patients with ISS over 6 while 6+/-8.6 days in those with ISS 5 (p<0.05). Hospital stay in the improved was 26+/-26.9 days while 31+/- 24.8 days in the improved old-old group (P=NS). Hospital stay in the young-old minor trauma (ISS5) patients with previous illness and hospital morbidity was 26+/-10.1 days while 4+/-7.3 days in those without previous illness and hospital morbidity (p<0.05). CONCLUSION: Previous medical illness and hospital morbidity, not age, are predictive of outcomes of geriatric trauma patients with respect to hospital stay. As most of the hospital morbidity was a trauma-induced aggravation of previous medical illness and hospital morbidity contributing poor outcomes can be potentially avoidable, routine aggressive care far the geriatric trauma patients with previous medical illnesses is needed.
Aged ; Body Regions ; Cause of Death ; Continental Population Groups ; Emergencies ; Extremities ; Humans ; Incidence ; Injury Severity Score ; Korea ; Length of Stay ; Multiple Trauma ; Retrospective Studies

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

OBJECTIVE: Angiogenesis is a critical factor in the progression of solid tumors. The mechanisms responsible for angiogenesis in cervical neoplasia, however, are not well defined. Our study was aimed to determine the expression of VEGF(Vascular Endothelial Growth Factor), its receptor(KDR), and TGF-beta1(Transforming Growth Factor-beta1) in cervical neoplasia, to determine the role of these angiogenic factors in preinvasive(dysplastic) process and the progression of cervical cancer and to investigate the progression of angiogenesis in the transition from normal cervix to invasive squamous cell carcinoma of the uterine cervix. METHODS: The cervical lesions of 76 patients were punch biopsied and paraffin embedded. Among these, 5 were normal cervix, 36 were cervical intraepithelial lesion I-III, and the other 35 were invasive squamous cell carcinomas. The tissues were immunostained with antiVEGF, antiKDR, and antiTGF-beta1 polyclonal antibody. RESULTS: The expression of VEGF, KDR, and TGF-beta1 in CIN III was stronger than those of CIN I(p<0.01). Their expression were not significantly different among the each staged cervical cancers(p>0.01). CONCLUSIONS: These observations suggest that VEGF, KDR, and TGF-beta1 are important angiogenic factors in cervical neoplasia, especially in an early event to neoplastic transformation of cervical tissues, but these angiogenic factors are not associated with the progression of cervical cancer.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Paraffin ; Phosphotransferases* ; Transforming Growth Factor beta1 ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*