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

PURPOSE: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of 99mTc-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of 99mTc-DMSA in predicting early diabetic nephropathy. MATERIALS AND METHODS: 99mTc-DMSA scan was performed and a total renal uptake of 99mTc-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of 99mTc-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of 99mTc-DMSA and other clinical parameters were analyzed. RESULTS: The total renal uptake of 99mTc-DMSA of Group II (40.8+/-11.0%) was significantly lower than that of Group I (54.4+/-6.3%, p<0.001). The uptake of Group III (27.7+/-12.0%) was significantly lower than those of both GroupI and Group II (p<0.001). 99mTc-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.702, p<0.001). CONCLUSION: 99mTc-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, 99mTc-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.
Creatinine ; Diabetic Nephropathies ; Humans ; Incidence ; Kidney Failure, Chronic ; Proteinuria ; Technetium Tc 99m Dimercaptosuccinic Acid*