PURPOSE: Acute appendicitis is the most frequently encountering extrauterine surgical condition in pregnancy. Prompt diagnosis of acute appendicitis in pregnancy is not easy on the basis of clinlical findings, which may be obscured or altered by the presence of a gravid uterus. In most of cases, prompt diagnosis and early surgical intervention could result in optimal maternal and fetal outcomes. MATERIAL AND METHODS: We performed retrospective analysis of 20 cases, which were operated under the diagnosis of acute appendicitis in pregnancy from 1990 to 1995 at the department of surgery, Soonchunhyang University Hospital. RESULTS: 1) The incidence of the acute appendicitis in pregnancy was one per 742 deliveries and the diagnostic accuracy was 85%. 2) The majority of patiens was in the 3rd decade of age (76.5%). 3) Gestational stages at onset of symptom were first trimester in 6 patients (35.3%) and second trimester (52.9%) in most patients. 4) The majority of patients(82.4%) spent less than 24 hours preoperatively. 5) The symptoms in order of frequency were; abdominal pain (100%), nausea (70.5%), vomiting (41.1%), fever (23.5%), chill (11.8%), constipation (11.8%), diarrhea (5.9%). The maximal tenderness was noted on McBurney's point (29.4%) and above McBurney's point (58.8%) in most of patient. 6) The leukocyte counts were mostly in the range of 10,000 to 15,000 mm3 (47.1%) and 15,000 to 20,000 mm3 (35.3%). 7) Several types of incisions were employed: a McBurney incision was used in 8 cases (47.1%), a transverse incision in 8 cases (47.1%), and a low midline incision in 1 case (5.8%). A general anesthesia was done in 6 patients (35.3%), a spinal anesthesia done in 8 patients (47.1%), and an epidural anesthesia done in 3 patients (17.6%). A drain was placed intraabdominally in 2 cases. 8) Among 17 cases, three were reported as focal appendicitis (17.6%), ten as suppurative one (58.8%), one as ganagrenous one (5.9%) and three as perforated one (17.6%). 9) The postoperative complications included 1 wound infection and 4 artificial abortions. There was no maternal death, preterm labor, or spontaneous abortion. CONCLUSION: Despite of diagnostic obstacles due to pregnancy, acute appendicitis can be diagnosed without major difficulty. High index of suspicion is required during diagnostic procedures and prompt surgical intervention improves maternal and fetal outcomes...EABS:
Abdominal Pain ; Abortion, Spontaneous ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Appendicitis* ; Constipation ; Diagnosis ; Diarrhea ; Female ; Fever ; Humans ; Incidence ; Leukocyte Count ; Maternal Death ; Nausea ; Obstetric Labor, Premature ; Postoperative Complications ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy* ; Retrospective Studies ; Uterus ; Vomiting ; Wound Infection

No abstract available.

No abstract available.
Colonoscopy* ; Constriction, Pathologic*

No abstract available.
DNA*

Candida albicans is the most common cause of infectious esophagitis and usually is an opportunistic infection in immunocompromised patients. Dysphagia and odynophagia are the usual presenting complaints and, importantly, oral lesions are absent in 50 percent of patients. The role of gastrointestinal endoscopy in diagnosing fungal infections of the esophagus is primary. It is the most definitive and often the only method of detecting esophageal candidiasis. Accurate endoscopic diagnosis by biopsy or brushing leads to the initiation nf effective therapy. We have experienced a case of esophageal candidiasis in an 11-year-old girl who was immunologically normal and whose main symptoms were epigastric abdominal pain and nausea for 4 months. The endoscopic and pathologic findings of esophageal candidiasis were presented.
Abdominal Pain* ; Biopsy ; Candida albicans ; Candidiasis* ; Child* ; Deglutition Disorders ; Diagnosis ; Endoscopy, Gastrointestinal ; Esophagitis ; Esophagus* ; Female ; Humans ; Immunocompromised Host ; Intestines* ; Nausea ; Opportunistic Infections ; Stomach*

Osteosarcoma in soft tissue is rare and its prognosis is very grave. Comparing with the osteosarcoma of bone, the former is rarer in incidence, poorer in prognosis and found in older patients. Trauma, irradiation or myositis ossificans are considered to be the causes of this tumor. The radical and meticulous surgery is indispensable to eradicate the focus, but there is not infrequent local recurrence and metastasis. We experienced a case of osteosarcoma in the calf muscle, which seemed apparently to have developed from the myositis ossificans without any definite trauma history. In this case the tumor focus was controlled with surgery and radiation therapy but it was found metastasized to the lung and scalp afterwards.
Humans ; Incidence ; Lung ; Myositis Ossificans ; Neoplasm Metastasis ; Osteosarcoma ; Prognosis ; Recurrence ; Scalp

No abstract available.
Aortic Aneurysm, Abdominal ; Marfan Syndrome

BACKGROUND AND OBJECTIVES: A precise osteotomy is a requirement for successful rhinoplasty. Osteotomy in rhinoplasty is frequently performed via intranasal route through vestibular incision or can be performed by percutaneous approach. The latter has never been reported in the domestic journal. Thus, we aimed to evaluate in this study the usefulness of rhinoplasty using percutaneous osteotomy. MATERIALS AND METHODS: The pateints age ranged from 19 to 38 years. Surgeries were performed on 6 cases who underwent rhinoplasty during the period of October 1999 to February 2000. Osteotomy via external approach was used with the aid of a sharp, straight 2 mm osteotome. RESULT: Irregularity, scoliosis, and broadness of nasal bony pyramid in the study subjects were successfully corrected using percutaneous osteotomy. During the procedure, hemomhage was minimal. Postoperatively, ecchymosis and edema was negligible and scarring was barely perceptible. However, one female patient who have fair complexion complained of osteotomy scar. CONCLUSION: Our results indicate that the percutaneous osteotomy may be used as a good alternative for the osteotomy approach but must used in judicious manner because of osteotomy scar.
Cicatrix ; Ecchymosis ; Edema ; Female ; Humans ; Osteotomy* ; Rhinoplasty* ; Scoliosis

OBJECTIVE: We examined the vasoconstricting poperties of endothelin (ET) on isolated arteries from pregnant as well as non-pregnant uterus. METHODS: Arteries of the uterus were obtained from both hysterectomized uterus and during pregnany hysterectomy for control group and cesarean section for pregnant group. Rings of uterine artery were suspended on muscle chambers at their optimal length for generating tension and contractile properties were examined. RESULTS: ET-1 and ET-2 induced concentration-dependent constriction of both isolated arterial strips from non-pregnant and pregnant uterus. The contraction to ET-1 and ET-2 were more enhanced in full-term pregnancy. Furthermore, in pregnant group, sarafotoxin S6c and IRL 1620, ET. agonists, induced a dose-dependent contraction, which was not shown in those from non-pregnant human. Pretreatment of human uterine arterial strips from pregnant uterus with BQ610, an ET. antagonist, for 10 min resulted in a dose-related rightward shift of ET-1 response curve with diminution of maximal response. Schild plot analysis yielded a pA value of 7.29 with a slope of 0.98. However, BQ788, an ET antagonist, did not produce any rightward shift. The contraction to lower concentration (10-8~3*10-7 M) of sarafotoxin S6c was not affected by BQ788, whereas that to higher concentration (10-s-8*10-7 M) was marked diminished. However, BQ610 did not exnt any efFect on sarafotoxin S6c-induced contraction in arterial staips from pregnant uterus. When the bath solution was replaced with Ca-free physiological salt solution (PSS) containing 1 mM EGTA for 10 min prior to adding sarafotoxin S6c, sarafotoxin S6c-induced contraction was completely abolished. Sarafotoxin S6c (10 nM)-induced contraction was prefetentially blocked by a protein kinase C antagonist, H-7, whereas it was less sensitive to a calmodulin antagonist, calmidazolium, CONCLUSION: Based on above results, we concluded that ET plays an important role in regulating uterine blood flow through the activation of ETa and ETB receptors. Furthermote, ETB receptors may predominantly contribute to the modulation of human uterine circulation in full-term pregnancy.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine ; Arteries* ; Baths ; Calmodulin ; Cesarean Section ; Constriction ; Egtazic Acid ; Endothelin-2 ; Endothelins* ; Female ; Humans* ; Hysterectomy ; Pregnancy ; Protein Kinase C ; Receptors, Endothelin ; Uterine Artery ; Uterus*