No abstract available.
Anesthesia, Local* ; Lipectomy* ; Male ; Penis*

One fetal demise of twin pregnancy in the second or third trimester is an unusual and difficult problem in the managemcnt of pregnancy. It can be associated with an increased risk for mortality and morbidity in the remaining fetus and with maternal DIC. 255 twin gestations were delivered at our hospital between December 1984 and August 1998. 8 cases of twin pregnancies with one fetal demise were observed. We reviewed 8 cases of twin pregnancies with one fetal demise that had been managed conservatively. The incidence of twin pregnancies with one fetal demise was 3.14% in the study population. The incidence of preterm delivery was 87.5%. The perinatal mortality rate of surviving twins was 25%. There were no cases of maternal disseminated intravascular coagulation or infection. There were no cases of neurologic damages in the surviving twins. The main cause of neonatal death was prematurity. An expectant approach to the twin pregnancies with one fetal demise seems reasonable.
Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Fetus ; Humans ; Incidence ; Mortality ; Perinatal Mortality ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin*

Fifty five children with endoscopically proven esophageal varices from Jul. 1987 to Dec. 1992 were analyzed for endoscopic and clinical characteristics. The results were as follows: 1) According to etiological classification of portal hypertension in 55 cases, 35 cases showed intrahepatic causes 964%) and 20 cases had extrahepatic causes (36%). The most common clinical manifestation on admission was hematemesis (42%) and abdominal mass (36%). 2) Portal vein thrombosis was the most common cause of portal hypertension. Patients with portal vein thrombosis showed more frequent bleeding than with intrahepatic portal hypertension. Most of them had the first bleeding episode before 7 years old of age. Progression of portal hypertension in portal vein thrombosis was more rapid and bleeding episode was earlier than that in most of intrahepatic causes of the portal hypertension. 3) Twenty patients showed gastritis (10 cases), duodenitis (4 cases), gastric ulcer (4 cases) and esophagitis (2 cases) besides varix on the endoscopic examination. In 4 cases, the cause of upper GI bleeding was found as duodenal ulcer (3 cases) or hemorrhagic errosive gastritis (1 case) with no variceal bleeding. 4) Among 36 cases with variceal bleeding, 20 cases had predisposing factors for bleeding such as medication for URI including Aspirin. 5) More than one episode of bleeding were noted in 36 cases (65%) of the patients with varix. Thirty-one cases were treated conservatively with success. The remaining 5 cases with severe bleeding were managed with IV pitressin, SB-tube insertion and emergency shunt operation. High mortality rate (40%) was found in these patients group. In conclusion, in patients with clinically suspected portal hypertension, regular endoscopic examination might be recommended for the earlier recognition and effective prevention of variceal bleeding. for bleeding varices, in addition to conservative management, active treatment such as pitressin, SB-tube, sclerotherapy, endoscopic variceal ligation and emergency shunt operation should be considered with the emergency endoscopy which can identify bleeding focus and predict the chance of rebleeding.
Aspirin ; Causality ; Child* ; Classification ; Duodenal Ulcer ; Duodenitis ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices* ; Esophagitis ; Gastritis ; Hematemesis ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation ; Mortality ; Sclerotherapy ; Stomach Ulcer ; Varicose Veins ; Vasopressins ; Venous Thrombosis

Nineteen children found to have gallstones at Seoul National University of Children's Hospital from Jun. 1982 to Jun. 1992 were reviewed. The results were as follows: 1) The mean age was 10 years, with 9 boys and 10girls. Most of the cases(63%) were over 10 years of age. 2) Clinical manifestations were abdominal pain(14 cases), nausea and/or vomiting (5 cases), fever (2 cases), jaundice (2 cases) and fatty food intolerance (1 case). Five cases were asymptomatic. Of 14 cases with abdominal pain, only 5 cases showed typical biliary colic which suggests cholelithiasis. 3) Associated conditions in cholelithiasis were Wilson disease (5 cases), congenital hereditary spherocytosis (2 cases), choledochal cyst (2 cases), total parenteral nutrition following ileal resection (1 case). And the other conditions which had association with cholelithiasis are not certain, and they were nephrotic syndrome, histiocytic cytophathic panniculitis, meningococcal meningitis, portal vein thrombosis and cardiac cirrhosis. The remaining 4 cases showed no associated conditions or diseases. 4) Eleven of 19 patients with cholelithiasis (58%) showed cholecystitis. 5) Cholecystectomy was performed in 4 cases with frequently recurred abdominal pain or associated diseases which needed operative correction. Symptoms completely subsided after operation. In conclusion, cholelithiasis in children has a variety of associated conditions and nonspecific abdominal symptoms were nore common than classic biliary colic. Although cholelithiasis in pediatric population are uncommon problems, the possibility of gallstones should be considered in the evaluation of abdominal pain in children with associated conditions.
Abdominal Pain ; Child ; Cholecystectomy ; Cholecystitis ; Choledochal Cyst ; Cholelithiasis* ; Colic ; Fever ; Fibrosis ; Gallstones ; Hepatolenticular Degeneration ; Humans ; Jaundice ; Meningitis, Meningococcal ; Nausea ; Nephrotic Syndrome ; Panniculitis ; Parenteral Nutrition, Total ; Seoul ; Venous Thrombosis ; Vomiting

No abstract available.
Urinary Incontinence*

No abstract available.

No abstract available.

No abstract available.
Toes*

Objective: Cerebral white matter changes (WMCs) and silent brain infarcts (SBIs) are common radiological findings in neurologically asymptomatic elderly people. Their presence is associated with an increased risk of stroke or dementia. Homocysteine (Hcy) can cause atherosclerosis and may thus act as a useful marker of stroke prior to symptom onset. This study aimed to evaluate the utility of Hcy as a surrogate marker for early intervention for stroke in community-dwelling healthy elderly persons with cerebrovascular lesions such as WMCs and SBIs. Methods: We assessed the relationship between the Hcy level and presence of WMCs/SBIs on brain computed tomography (CT) in 554 elderly individuals aged ≥65 years with no history of stroke or dementia. Results: The mean age of the participants was 74.43±7.32 years. Of the 554 patients, 106 (19.1%) had WMCs and/or SBI findings on brain CT. The mean Hcy level was higher in participants with WMCs/SBIs (P=0.001). The WMCs/SBIs group had a significantly greater number of participants with high Hcy levels than the non-WMCs/SBIs group (P<0.001). High Hcy levels (≥12.3 μmol/L) was significantly associated with WMCs and SBIs even after adjusting for age, Korean Mini Mental Status Examination score, education level, and vascular risk factors such as hypertension, diabetes, hyperlipidemia and smoking status. Conclusion: The result of our study suggests that regular monitoring of homocysteine level as a modifiable risk factor may be helpful for predicting the association of cerebrovascular lesions such as WMCs and SBIs for the prevention of future ischemic stroke and cognitive impairment.

No abstract available.
Stomach Neoplasms* ; Tuberculosis, Pleural*