No abstract available.
Child* ; Humans ; Pneumonia*

Various methods have been described for surgical treatment of recurrent shoulder dislocation. Arthroscopic techniques for stabilizing the shoulder have the theoretical advantage of reduced complication, decreased discomfort, and improved motion. The arthroscopic Bankart procedure was performed in 23 cases at Department of Orthopaedic Surgery, Yonsei University College of Medicine, from January, 1991 to December, 1993. This study is an attempt to evaluate results of arthroscopic Bankart procedure by Caspari's technique. Results of this study were as follows: l. According to the clinical evaluation of Rowe, results were excellent in 18 cases, good in 2 cases, fair in 1 cases and poor in 2 case. The prognosis was related to the size of Hill-Sachs lesion. 2. Complication after treatment included 5 cases of knot problem, 1 case of subluxation, and 2 cases of redislocation. Redislocation was developed in one patient who played ice hockey at 2 months after operation and in one patient who played soccer at 8 months after operation. Subluxation was developed in one patient who had psychologic problem. Among 5 patients who had knot prob- lem, two patients had a operation of removal. In conclusion, Caspari's suture technique in arthroscopic Bankart procedure needs some modification on the insertion point of the guide pin and suturing technique. And arthroscopic Bankart procedure by Caspari's technique offers good cosmetic results, low perioperative morbidity, low complications except knot irritation, and excellent results by the Rowe's criteria for patients with anterior shoulder instability.
Arthroscopy ; Hockey ; Humans ; Prognosis ; Shoulder ; Shoulder Dislocation ; Soccer ; Suture Techniques

PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase

Patients with inflammatory bowel disease are known to have hypercoagulability and an increased risk for venous thromboembolism. The deep veins of the lower extremities and the pulmonary veins are the most common sites of thrombosis in ulcerative colitis. However, hepatic vein thrombosis (Budd-Chiari syndrome) is a very rare extra-intestinal complication of ulcerative colitis in children. We describe a case of hepatic vein thrombosis in a 15-year-old girl with ulcerative colitis who presented with abdominal pain and hematochezia. Doppler ultrasonography and an abdominal CT scan revealed the characteristic filling defects caused by large thrombi in both hepatic veins. These lesions were successfully treated with conventional management for ulcerative colitis and anticoagulation therapy.
Abdominal Pain ; Adolescent ; Budd-Chiari Syndrome ; Child ; Colitis, Ulcerative ; Gastrointestinal Hemorrhage ; Hepatic Veins ; Humans ; Inflammatory Bowel Diseases ; Lower Extremity ; Pulmonary Veins ; Thrombophilia ; Thrombosis ; Ulcer ; Ultrasonography, Doppler ; Veins ; Venous Thromboembolism

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sputum*

Background : Recurrent wheezing in infants is manifested in a number of disease spectrums and gastroesophageal reflux ( GER ) has been known to be associated with apnea, recurrent pneumonia, asthma, chronic cough, and wheezing. The prevalence of GER in infants with recurrent wheezing and the relationship between atopy and GER in infantile asthmatics have not yet been established, but it was hypothesized that microaspiration of food allergen could induce food-induced wheezing. Objective : To evaluate the prevalence of GER in infants with recurrent wheezing episodes, and to determine whether the presence of atopy affects the prevalence of GER in infantile asthmatics. Method : Seventy infants with recurrent wheezing episodes were evaluated for GER using 24 hour continuous esophageal pH monitoring. Patients were classified into five groups, : 12 atopic asthmatics : 20 nonatopic asthmatics : 15 infants with recurrent bronchiolitis : 8 infants with recurrent pneumonia : and 15 infants with chronic lung disease ( CLD ) of prematurity. GER was considered to be prevalent when reflux index was higher than 95 percentile of normal values by Vandenplas, 1991. Result : The prevalence of GER in infants with recurrent wheezing was 21.4%. The prevalence of GER in each group was 25% in atopic asthmatics, 20% in nonatopic asthmatics, 6.7% in infants with recurrent bronchiolitis, 12.5% in infants with recurrent pneumonia, and 40% in infants with CLD of prematurity. There were no significant differences in prevalence of GER between atopic asthmatics and nonatopic asthmatics, between asthmatics with atopic dermatitis and those without, and between asthmatics with family history of allergy and those without. CONCLUSION: The prevalence of GER in infants with recurrent wheezing was high, especially in infantile asthmatics and infants with chronic lung disease of prematurity. The presence of atopy may not affect the prevalence of GER in infantile asthmatics.
Apnea ; Asthma ; Bronchiolitis ; Cough ; Dermatitis, Atopic ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hypersensitivity ; Infant* ; Lung Diseases ; Pneumonia ; Prevalence* ; Reference Values ; Respiratory Sounds*

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

No abstract available.
Larynx*

PURPOSE: The aim of this study is to compare the shock wave lithotripsy (SWL) with the rigid ureteroscopic stone removal (URS) in order to establish the efficacy in treating upper ureteral stones according to the stone size. MATERIALS AND METHODS: We reviewed 328 patients who have been treated for upper ureteral stones between January 1999 and December 2002. 227 patients were treated with SWL, and 101 patients were treated with URS. We analyzed the success rates of the stone removal, reasons for failure, and complication rates of each procedure. RESULTS: The overall success rate of the URS was 93.1%. In terms of stone size, the success rates were 94.5% (<10mm) and 91.3% (>10mm), respectively. With the SWL treatments, the overall success rates after the first, second, and third sessions were 59%, 78%, and 92.5%, respectively. According to the stone size, the success rates were 96.5% (<10mm) and 85.7% (>10mm) after third sessions, respectively. The success rate was significantly affected by the size of the stone in the SWL group, but this was not the case with the URS group. The associated complication rates of URS and SWL were 11% and 7%, respectively. CONCLUSIONS: In this study, URS was relatively more efficacious than SWL when the stone was larger than 10 mm. The proper selection of patients for in situ SWL or URS would improve the results of the initial treatment.
Humans ; Lithotripsy* ; Shock* ; Ureter* ; Ureteral Calculi ; Ureteroscopy

Immediate implant placement is one of the treatment options in postextraction sites in anterior region. This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior maxilla using a flapless approach and modifying a provisional restoration. The case reported illustrates the practical procedure involved in developing natural esthetics with modifying a provisional restoration. The technique provides an accurate impression of the soft tissue through the intraoral use of provisional restoration. The final restoration uses a custom-made titanium abutment and porcelain fused gold crown. The technique is relatively simple and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores and white esthetic scores after 1 year.
Crowns ; Dental Implants, Single-Tooth ; Dental Porcelain ; Esthetics ; Humans ; Maxilla ; Titanium