No abstract available.
Hydrops Fetalis*

To assess the role of anorectal physiologic study for the diagnosis of chronic idiopathic constipation. METHODS: A retrospective study of 81 constipated patients (23 male, 58 female) of mean age 48 16.6 (16~83) years who had no abnormalities in colonoscopy, barium enema, and rectal exam was done. 81 patients underwent defecography and cine-defecography, of which 66 patients underwent anal manometry, 52 patients underwent colonic transit time study (CTT), and 27 patients underwent anal plug electromyography (EMG). RESULTS: Nonrelaxing puborectalis syndrome (NRPR), rectocele, rectal intussusception, anal dyschezia, and sigmoidocele were observed in 27 (33.3%), 26 (32.1%), 14 (17.3%), 3 (3.7%), and 2 (2.5%) of the patients, respectively. Normal cinedefecography finding was observed in 21 (25.9%) patients. More than one abnormal finding was found in 11 (13.6%) patients. Abnormal findings included colonic inertia in 6 (11.5%) patients and pelvic outlet obstruction in 2 (3.8%) patients. Normal colon transit time was observed in 44 (84.6%) patients. Anal hypertonia was observed in 23 (34.8%) patients by anal monometry, of which 3 patients were diagnosed with anal dyschezia in cinedefecography. 13 (48.1%) patients were diagnosed with NRPR in anal plug EMG. The correlation rate between cinedefecography/EMG, defecography/CTT, and CTT/EMG were 81.5%, 61.5%, and 51.9% respectively in the diagnosis of NRPR. Sensitivities of the three tests were 72.7% for cinedefecography, 66.7% for EMG, and 7.7% for CTT in diagnosing NRPR (p<0.05). Positive predictive values of the three tests were 80% for anal plug EMG, 72.7% for cinedefecography, and 50% for CTT in the diagnosis of NRPR. CONCLUSIONS: Defecography and EMG were complements each of the other in diagnosis of pelvic outlet obstruction especially NRPR, but CTT has no role.
Barium ; Colon ; Colonoscopy ; Complement System Proteins ; Constipation* ; Defecography ; Diagnosis* ; Electromyography ; Enema ; Humans ; Intussusception ; Male ; Manometry ; Rectocele ; Retrospective Studies ; Time and Motion Studies

No abstract available.
Arteries* ; Prognosis*

No abstract available.
Tetralogy of Fallot*

No abstract available.
Rabbits*

PURPOSE: To assess the effectiveness of cinedefecography (CD), anal electromyography (EMG), and anal manometry (ARM) for the diagnosis of non-relaxing puborectalis syndrome (NRPR) and to compare the outcomes for patients after biofeedback therapy (BF). METHODS: The clinical criteria used in this study for NRPR included straining, incomplete evacuation, tenesmus, and the need for enemas, suppositories, or digitation. Patients who satisfied the clinical criteria were evaluated by use of anorectal physiology tests: CD, EMG, and ARM. The EMG criteria included failure to achieve a significant decrease in the electrical activity of the puborectalis (PR) during attempted evacuation. The ARM criteria included failure to achieve a significant decrease in intra-anal pressure during attempted evacuation. The CD criteria included either paradoxical contraction or failure of the PR to relax together with incomplete evacuation. Other possible etiologies for incomplete evacuation, such as rectal intussusception or rectocele, were excluded in all cases. Fifty-eight constipated patients diagnosed as having NRPR by at least one of anorectal physiolosic tests had more than one BF session. The outcomes for fifty-one patients (mean age, 44.8 years; male-to-female ratio, 22:29) were reported as either improved or unimproved at a mean follow-up of 12.7 (range, 2~30) months. The sensitivities, the specificities, and the positive and negative predictive values for the CD, EMG, and ARM diagnoses of NRPR were calculated to assess the diagnostic accuracy of each test and to identify predictors associated with the outcome of BF. RESULTS: The sensitivities of EMG, CD, and ARM were 96%, 89%, and 85%, respectively (P>0.05). The positive predictive values of the three tests were 63% for EMG, 52% for ARM, and 51% for CD (P>0.05). The negative predictive values of the three tests were 90% for EMG, 43% for ARM, and 25% for CD (P<0.05). The specificities of the three tests were 38% for EMG, 13% for ARM, and 2% for CD (P<0.05). The positive predictive values the two-study-positive groups and the three-study-positive group were 63% for the EMG- and ARM-positive group, 61% for the CD- and EMG-positive group, 51% for the CD- and ARM-positive group, and 61% for the three-study- positive group (P>0.05). CONCLUSIONS: A combination of the CD and the EMG tests is suggested for the diagnosis of NRPR.
Arm ; Biofeedback, Psychology ; Diagnosis* ; Electromyography ; Enema ; Follow-Up Studies ; Humans ; Intussusception ; Manometry ; Physiology ; Rectocele ; Suppositories

Laryngomalacia is repoted as the most common cause of congenital stridor. The majority of cases have mild symptom and do not require surgical intervention. However, in approximately 10 per cent of these infants the condition is life-threatening. The standard treatment for these patients has been to perform a tracheostomy. Recent reports have shown encouraging results following endoscopic surgery to the supraglottic structures. We report a case of patient in whom a tracheostomy was avoided by performing an CO2 laser microsurgeries on supraglottis.
Humans ; Infant ; Laryngomalacia* ; Lasers, Gas ; Microsurgery ; Respiratory Sounds ; Tracheostomy

Neurilemmoma, like other non-epithelial tumors, seldom occurs in the thyroid gland. We present a case of a 61-year-old woman with a neurilemmoma of her left thyroid lobe. She was clinically and biochemically euthyroid, and underwent a left thyroid lobectomy without complications. The tumor was an encapsulated solid mass, 34x23x1 5mm in size and was diagnosed as neurilemmoma. Neurilemmoma of the thyroid gland tends to develop in the right lobe, but this case was in the left.
Female ; Humans ; Middle Aged ; Neurilemmoma* ; Thyroid Gland*

PURPOSE: We aimed to clarify the risk factors associated with the development of ONFH by comparing patients with hematologic diseases and osteonecrosis of the femur head (ONFH) to those patients without ONFH and who have hematologic diseases MATERIALS AND METHODS: The study population was limited to the patients admitted to our Hematology-Oncology department from 1 January 1994 to 31 May 2007. The patients were divided into 2 groups (those with ONFH, 54 patients and those without ONFH, 54 patients) and the risk factors for ONFH were evaluated by a comparative analysis. We analyzed the effect of a history of bone marrow transplantation (BMT), graft-versus-host disease (GVHD), total body radiation (TBI) and the amount of steroid used as the risk factors for ONFH. RESULTS: On the multiple logistic regression analysis, a total steroid use of >g/BMI was statistically identified as a significant risk factor for ONFH. The history of BMT and TBI were not statistically correlated with the development of ONFH. Among the patients with BMT, allogenic BMT and a history of GVHD were not statistically correlated with the development of ONFH on the multiple logistic regression analysis. CONCLUSION: Patients with hematologic diseases and who have used steroid >1.5g/BMI should carefully observed because they are more likely to develop ONFH.
Bone Marrow Transplantation ; Femur Head ; Graft vs Host Disease ; Head ; Hematologic Diseases ; Humans ; Logistic Models ; Osteonecrosis ; Risk Factors

BACKGROUND: Quantitative measurement of hippocampal T2 relaxation time is an objective means of determining the frequency and severity of signal abnormalities. To evaluate the diagnostic properties of T2 relaxometry in temporal lobe epilepsy(TLE), we measured T2 relaxation time of bilateral hippocampi in pathology-proven TLE patients and normal controls. METHODS: We investigated 10 TLE patients who had temporal lobectomy with MR T2 relaxation mapping. All patients underwent in phase I or II studies, and had pathologic diagnosis. Also we measured T2 relaxation time in 10 normal volunteers. RESULTS: The pathologic findings of 10 TLE patients were followings: 8 hippocampal sclerosis (including dual pathology of necrotic granuloma), 1 calcified fibrous nodule, and 1 normal hippocampus. The mean T2 relaxation time of normal controls is 67.5msec, which is lower value than previous reports. All patients with hippocampal sclerosis in pathology showed increased T2 time greater than 2 SD of mean value of normal controls. But, the T2 values are upper normal range in non-hippocampal sclerosis. The lateralizing value of T2 relaxometry is 50% in TLE patients, and 62.5% in pathology-proven hippocampal sclerosis groups. CONCLUSIONS: There is a clear distinction of T2 relaxation time between the patients of hippocampal sclerosis and normal controls or non-hippocampal sclerosis. These findings suggest that the T2 relaxation time is a reliable objective measurement of hippocampal pathology, especially hippocampal sclerosis in TLE.
Diagnosis ; Epilepsy, Temporal Lobe* ; Healthy Volunteers ; Hippocampus ; Humans ; Pathology ; Reference Values ; Relaxation ; Sclerosis ; Temporal Lobe*