No abstract available.

A study on the status of nutrition in a Korea rural community, Su-dong Myun, Nam Yang-ju Gun, Kyung-Gi Do, was carried out from September to November, 1983 through community nutrition survey by medical students(practice of preventive medicine).

The purpose of this survey has been to examine into community nutrition information in order to enforce maternal child health and entire community nutrition. The estimation of the status of nutrition especially, used a application of convenient method, the following results were obtained;

1) In general characteristics 81.7% respondents were house-wife. The age of respondents was 41-50 rated the highest with 23.3%, the educational level was that elementary school level rated the highest with 33.3%.

2) In income the average monthly income was that below 100,000won rated the highest with 45.0%.

3) Two generation of family structure rated 48.3% with the highest 26.7%.

4) 38.3% of all found in insufficient time to prepare for a meal, 51.7% interested about food nutrition, 55.0% concerned about food and nutrition.

5) Self-supply of main food and side-dish food were 71.7%, 30.0% respectively.

6) In the place of purchase, village store were 17.4% in main food, and 4.8% in side-dish food.

7) In a means of transportation, 71.6% conveyed by bus or the other vehicles in main food, and 92.8% in side-dish food.

In order to find out the effectiveness of B.C.G. vaccination in rural school children, a study was carried out through analyzing the result of tuberculin test and old B.C.G. scar checking which were done in primary school and secondary school of Su-dong Myun, Nam Yang-ju Gun from 1981 to 1983.

And following results were obtained;

1) The old B.C.G. scar rate of primary school children was the highest in 2nd grade children with 99.0% and the lowest in 5th grade children with 64.5% in 1981.

2) The tuberculin positive rate in primary school children was 20.1% and the rate was not different between male and female in 1981.

3) The age specife tuberculin positive rate was shown the tendency of increasing according to the grade such as 8.3% in 1st grade, 14.4% in 2nd grade and 35.6% in 3rd grade children. And the tendency of decreasing was shown such as 30.4% in 4th grade and 13.0% in 5th grade and 16.3% in 6th grade children in 1981.

4) The tuberculin positive rate was shown the tendency of increasing according to the time passing after B.C.G. vaccination such as 21.0% among the children group who are received B.C.G. vaccination one year before and 27.1% among the group received two years before and 31.4% among the group received three years before.

5) The tuberculin positive rate of primary school children was 21.5% in the group with old B.C.G. scar and 13.1% in the group without B.C.G. scar.

The purpose of the present study is to measure concentration of plasma estradiol and progesterone and to determine the concentration of the estradiol receptor in the uterine endometrium at the early pregnant rat.

The results obtained were as followings:

1) Plasma estradiol concentration showed the highest value on day 1 and the lowest on day 2, increasing again on day 3 and 4.

2) Concentration of plasma progesterone increased sharply on day 3, maintaining gradual increase thereafter. Rats ovariectomized on day 2, however maintained lower progesterone levels than those of day 1, throughout the preimplantational period.

3) The concentration of nuclear estradiol receptor seemed to be well correlated with the concentration of plasma estradiol throughout the preimplantation peried. Treatment of estradiol appeared to increase the concentration of estradiol receptor on day 3 and 6 in ovariectamized rats.

4) The differentiation of the uterine endometrial tissue seemed to be closely related to ovarian steroid hormones.

Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration.

This is the site of predilection for vocal cord nodules.

The author performed laryngomicrosurgery for 50 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 3 years.

The results obtained were as follows:

1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy.

2) In children, surgery is rarely indicated because most nodules in children regress during adolescence.

3) For patients who use their voices professionally, voice therapy is indicated for three months.

4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered.

5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position.

6) Removal of the nodule should be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule.

7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch.

8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.

The free flap and myocutaneous flap transfer by microvascular anastomosis has been developed recently for wide employment in reconstructive surgery and has been used in many clinical applications.

The anatomy of the flap and the specific size, pattern and location of the vessel are important in the wide and varied reconstructive applications of the flap. The mean length and diameter were measured and the course and variation of the dorsalis pedis artery and adjacent area were studied in 44 dissections using 22 Korean cadavers and the vascular pedicles in the latissimus dorsi and adjacent area in 18 dissections using 9 Korean cadavers.

The results are summerized as follows:

1) The mean diameter of the dorsalis pedis artery on the upper limit of the extensor retinaculum is 2.9mm and the mean length of the vascular pedicle from the 1st web space is 13.5cm.

2) The mean diameter of the 1st dorsal metatarsal artery is 1.5mm and the mean length of the vascular pedicle from the 1st web space is 4.5cm.

3) The mean diameter of the thoracodorsal artery and vein before distribution to the latissimus dorsi are 2.1mm and 2.2mm and the mean length of the vascular pedicle from the axillary artery and vein before distribution to the latissimus dorsi is 11.9cm.

4) In the couse and variation of the dorsalis pedis artery, type I, 77%, normal course of the dorsalis pedis artery is most common.

5) There are consistent T-shaped relationship among subscapular, thoracodorsal, circumflex scapular arteries and serratus arterial branch.

6) Vascular structures at the latissimus dorsi are bifurcated into lateral and medial intramuscular bundles.

Recently, microvascular anastomoses has been developed for wide employment in clinical appliance. However, in end-to-end anastomoses of arteries less than 1mm in diameter, the vascular occlusions have been often occured due to suture materal, suture method and aneurysm, thrombosis and infection at the site of repair.

To obtain the more successful microvascuar method and research the histopathology of the vessel wall after repair, We did the experimental comparison of the different methods of microvascular anastomoses in rat femoral artery less than 1mm in diameter.

The experiment was done in 3 different groups. In group 1:6-8 sutures was done. In group 2:6-8 sutures and application of amniotic cuff to the anastomotic site was done. In group 3:4 sutures and application of anastomotic site was done.

The results are summarized as follows.

1) In all each three groups, patency was 90% and thrombosis was 10%.

2) Aneurysm formation was 40% in group 3, 30% in group 1, 2.

3) Infection was 20% in group 2, 3 and the absence in group 1.

4) The histopathology of the microvascular anastomotic site revealed intimal loss, medial necrosis, elastic lamella loss and subintimal hyperplasia in all groups.

5) The histopathologic comparison of the outer surface of the vessel wall in each groups revealed as followed,

(1) group 1 : much neovascularization and a few inflammatory cells.

(2) group 2, 3 : less neovascularization and much inflammatory cells and much fibrosis than group 1.

The traumatic liver injury rising rapidly in its frequency with the increase of traffic accident, industrial accident and violence, etc. Mortality rate due to liver injuries has decreased due to the speedy transpotation and improvement in management, but about 15 to 30% of the mortality rate is still noted.

The report a clinical study of experiences with 19 cases of liver injuries which were treated by surgical intervention at the Ewha Womans University Hospital from January 1977 to June 1978.

The following results were obtained:

1) The sex distribution was 16 males and 3 females with a significant high incidence in male and ratio 5.3:1 and the age distribution revealed a high incidence in the 2nd decade.

2) The seasonal distribution showed that liver injury was more prevalent in summer season, comparative statistics for the 7 years suggested that the liver injury has been gradually increasing recently.

3) The nature of the injury was blunt trauma in 17 cases(89.47%) and penetrating injury in 2 cases(10.53%) respectively. There were 15 cases of traffic accident trauma. There were 2 industrial accident, and all the penetrating injury was made with knife, no gunshot injury was noted.

4) There was predilection between the right lobe(84.21%) and the left lobe(36.84%) while there was incidence of bilateral involvement of the liver(21.05%)

well related to the mortality rate. The chest injury was the most common among the associated injures.

6) The peritoneal irritation sign was present in the majority of the case(94.74%) and 72.73% of the cases were diagnosed with paracentesis with most probable diagnostic accuracy.

7) 14 cases of patients were admitted within 6 hours after injury.

8) In most cases suture repair, adequate hemostasis and drainage procedure were employed but in 3 cases, common bile duct was exploration and cholecystectomy needed and also 2 cases, hepatic resection and 5 cases, segmental resection was performed.

9) The incidence of postoperative complication was 36.84%(7 cases) and common complication were wound infection, intestinal obstruction and persistant bleeding.

10) The overall mortality rate was 15.79%(3 cases) and this 3 cases of the associated injuries of other organs were noted.

The maximum exercise testing using treadmill walking was performed in 36 patients of diabetes mellitus who were admitted to the Ewha Womans University Hospital from March, 1983 to August, 1983 and 30 normal control subjects to evaluate the efficacy of significance to detect latent coronary artery disease in diabetes mellitus as a chronic complication.

Among 36 patients of diabetes mellitus, ten(27.8%) were treadmill exercise test positive, of whom two had ST depression in resting electrocardiogram but eight didn't have any changes in resting electrocardiogram.

Since treadmill exercise test can be a useful sensitive diagnostic tool for early detection of latent coronary artery disease in the patients of diabetes mellitus as a chronic complication.

To observe the neurobehavior of premature infants, Brazelton Neonatal Behavioral Assessment Scale was performed on 88 newborns, of gestational age 31 weeks to 40 weeks. The infants were devided into 5 groups according to gestational ages and means, standard deviation and correlation coefficient on 26 items of BNBAS were calculated.

High correlation between items and gestational age was observed in the dimension of social interactive process and only part of items in the state control was significantly correlated. The poorest correlation was found in the dimension of motoric interactive process.

Even though BNBAS is made for mature fullterm newborns, it can be used to evaluate the neurobehavior of premature infants with special consideration of prematurity It becomes clear that since neurobehavior of premature infants are unstable, inconsistent and generally poor in response to external stimuli, the relationship between the prematures and caretakers is likely to be less optimal than fullterms, which, in extreme case, can lead to child abuse, and which should be prevented by cooperation between the caretakers and medical personnels.

One hundred and twenty cases of endometrial tissue curettaged from the patients of primary and secondary sterility were studied by the methods of histopathologic and histochemical examination.

The following results were obtained:

1) The cases aged from 25 to 29 were most frequent.

2) The pathologic lesions of the endometrium were present in 12 cases. The cases of chronic endometritis were most common and were 6(5.0%). There were 2 cases of cystic hyperplasia and 2 cases of atrophy. Each one case of tuberculosis and endometrial polyp was also present.

3) Most cases among 108 cases after excluding 12 cases of pathologic lesions showed mild degree of glandular tortuosity and secretory activity with mild to moderate degree of predecidual change of stromal cells.

4) The glandular secretion of PAS positive material was mild in many cases of endometrium. However, there were many cases of absence of PAS positive material. The stromal cells showed negative or mild positive PAS staining in almost all cases.

5) The alcian blue staining revealed positivity in the glandular cytoplasm of all cases and positivity in the luminal secretion of many cases.

6) The differences of histopathology and histochemical reaction between primary and secondary sterility were not significant.

Many papers on Behcet's syndrome published during the past forty years, open with the statement that the diease was discovered by Behcet and first described by him in 1937.

Behcet's syndrome is characterized by four major components : iridocyclitis(historically with hypopyon), aphthous lesions in the oral mucosa, ulceration of the genitalia, and erythema nodosum in the skin of the extremities, but the ocular symptoms may be the most important and serious manifestation of the disease. Central nervous system involvement, most often due to necrotizing vasculitis, may be the most protean manifestation of the disease, leading to death.

Oral lesion is early symptoms in this dieasese which encounter otolaryngologist at first, so we need carefull examination at early of this disease, because it lead blindness and death that was involved in the eye and nervous system in late stage.

This paper to report the author's experience over 18 years at Dept. of ENT in Ewha womans university hospital from 1964 to 1982, 18 cases has been studied and treated clinically, and following results were obtained:

1) Sex distribution were male to female; 3.5:1.

2) Age distribution were 84% in 2nd and 3rd decade.

3) Among 18 cases, 6 cases were complete form and 12 cases were incomplete from.

4) Incidence of four major symptoms were 100% in complete form.

5) In incomplete form : incidence of oral lesion were 100%, skin lesions were 84%, eye lesion were 42%, and genital lesions were 33% as in order.

6) The result of Behcetin test were 100% positive in complete form and 66% positive in incomplete form.

7) Treatment were conservative with antiboitics antihistamine, ACTH, vitamin, and sulfa.

8) One cases with complications of the central nervous system died within 3 years after the onset of this disease. Incidence of blindness were 50% of cases in complete form and 17% in incomplete form.

Citations

Citations to this article as recorded by  

• A Case of Erythema Nodosum-like Lesions of a Behcet's Disease Patient treated with Wolbi-Tang
  Sang-Chul Baek, So-Hyun Jo, Eun-Hee Jo, Min-Cheol Park
  The Journal of Korean Oriental Medical Ophthalmology and Otolaryngology and Dermatology.2012; 25(2): 83.     CrossRef

The purpose of this study was to observe the correlation between the severity of esophageal varices and various clinical findings.

Thirty-four patients with esophageal varices were selected for the study from Jan. 1981 to Sept. 1983 at the Ewha Womans University Hospital.

The varices were classified by the Sesoko's method into 3 grades according to severity. The grade I or mild varices are those with unequivocal distension and tortuosity of the vein forming fold-like elevations. The grade II or moderate varices look like hemispherical or nodular prominance in some parts of the elevated structure below the 2nd narrowing. The grade III or severe varices are the longitudinally aligned, nodular or beads-like bulging of highest degree of veins, usually throughout the entire length of the esophagus.

The observed results are summerized as follows.

1) The ratio between male and and female was 4:1. In age ditribution, the incidence was most prevalent in 4th to 5th decade.

2) Underlying liver diseases were liver cirrhosis(23 cases), carcinoma of the liver(9 cases) and chronic hepatitis(2 cases).

3) Esophagoscopy is good method for observing the variceal morphology, number, location, degree and bleeding sites in this study. Esophagoscopy is the far better method in the diagnosis of esophageal varix than esophagography. Almost the mild varices were not demonstrated by esophagography and one third of moderate varices were not detected by the routine esophagography.

4) There was no significant correlation between the size, number, location or color of the varices and variceal bleeding.

5) There was no correlation between the severity of esophageal varices and hepatomegaly. But there was a tendency for some correlation among the severity of esophageal varices, splenomegaly and ascites.

We have experienced 61 cases of hypertensive intracerebral hemorrhage who were admitted to the Department of Neurosurgery of Ewha Womans University Hospital from January 1981 to October 1983.

We analyzed the result of the treatment of hypertensive intracerebral hemorrhage and assessed prognostic factors affecting the result of treatment of hypertensive intracerebral hemorrhage.

The following results were obtained.

1) The age distribution was ranged from 36 to 74, and the fifth decade was most frequently involved, 22 among 61 patients(36.1%).

2) The ratio of male to female was about 1.8:1 and the age of the patient did not significantly influence on the result of operative cases in all age group, but in the non-operative cases increased mortality above fifth decade was noted.

3) The most frequent site of hypertensive intracerebral hemorrhage was putamen in 50.8%; followed by thalamic 19.7%, subcortical 11.5%, pontine 9.8% and cerebellar hemorrhage 8.2%. Intraventricular hemorrhage occurred in 27.2%.

4) Calculated amounts of hematoma based on CT scans ranged from 5 to 150cc roughly. The amount of hematoma did not directly related to the outcome of operated cases if the hematoma was less than 65cc, while the mortality was considerably increased if the hematoma was more than 65cc.

5) In correlation between arterial blood pressure and outcome, the mortality of below systolic BP 150mmHg was 20%, of above BO 150mmHg was 41.3%.

6) The operative mortality of the hypertensive intracerebral hemorrhage was 27.8%, and 48% in non-operative cases.

7) The surgical treatment obtained better result than non-operative treatment in the cases showing progressive change in consciousness following intracerebral hemorrhage and the conservative treatment obtained relatively good result in the cases showed progressive improvement of conscious level following intracerebral hemorrhage.

8) The interval from the attack to surgical intervention did not constantly influence on the result of surgery and it might be wise to decide the time of surgical intervention according to the progressive changes in conscious level and neurological status after bleeding.

A clinical study was made on 74 cases of genitourinary tuberculosis who had been admitted to the Department of Urology, College of Medicine, Ewha Womans University during the period from April 1976 to August 1983, and following results were obtained.

1) There were 74 cases of genitourinary tuberculosis, 4.3% of total 1709 patients who were hospitalized during the period, and there was a tendency of decreasing annual incidence of genitourinary tuberculosis.

2) The age distribution showed the peak incidence in the young-adult group(56.7%) and the male to female ratio was 1:1.3.

3) Bilateral urinary tracts were affected in 9 cases(14.8%) among 61 cases, while only right urinary tract was involved in 24 cases(39.3%) and left one 28 cases(45.9%).

4) The initial chief complaints were frequency(59.5%), hematuria(32.4%), flank pain(29.7%), painful urination(27.0%) and scrotal swelling(17.6%), in the order of frequency.

5) Twenty four cases(32.4%) were consulted 6 months through one year after onset of symptoms.

6) Tuberculous disease other than genitourinary tract was noted in 32 cases(52.5%), of which 15 cases(24.6%) had pulmonary tuberculosis.

7) Urinalysis revealed hematuria in 54.0% of all cases, pyuria in 47.3% and proteinuria in 39.2%, and Acid-fast stain was positive in 27.0%.

8) On excretory urogram, non-visualization of the kidney was found in 33.8% of all cases, delayed visualization in 27.0%, calyectasis in 20.3% and ureteral deformity in 16.2%.

9) Among 60 operated cases, 39 cases(52.7%) were managed with nephroureterectomy, 11 cases(14.9%) with epididymectomy and 6 cases with urinary diversion after contralateral nephroureterectomy.

5289 pediatric age group patients in the emergency room in E.W.U. Hospital during 3 years from Jan. 1980 to Dec. 1982.

The results were obtained as follow

1) Among the patients visiting the emergency room, the patients under the 15 years of age were 29.1% of total emergency patients.

2) The male to female ratio was 1.7:1.

3) Monthly distribution of patients showed progressive increasing from May to October, and the high incidence in October.

4) Most frequent diseases was respiratory disease(21.8%), followed by accident(18.3%), gastrointestinal disease(16.5%) and neurologic disease(9.8%).

5) In the respiratory disease, the most frequent disease was upper respiratory infection(59.3%), followed by pneumonia(10.2%) and bronchiolitis(5.3%). In the accident, the most frequent disease was trauma(52.4%). In the gastrointestinal disease, the most frequent disease was gastroenteritis(84.6%). In the neurologic disease, the most frequent disease was febrile convulsion(43.9%). In the neonatal disease, the most frequent disease was neonatal hyperbilirubinemia(24.8%).

6) Adimission rate through emergency room was 32%.

Respiratory insufficiency frequently occurs in patients after thoracoabdominal surgery, because of sudden inability of the pulmonary system and adult respiratory distress syndrome(ARDS).

We experienced a case of ARDS which developed during general anesthesia in panperitonitis due to perforated stomach, and reviewed etiology, clinical features, diagnosis and treatment in ARDS.

Hirschsprung's disease is a congenital abnormality characterized by chronic constipation secondary to the absence of myenteric parasympathetic nerve ganglia in the distal large intestine.

The definitive operative treatment for Hirschsprung's disease is divided into three main classes-Swenson abdominal pull-through operation, Duhamel retrorectal pull-through operation, and Soave endo-rectal pull-through operation.

But each of these technics has one or more frequent complications or operative difficultes. Recently, the gastrointestinal stapling device is employed to cut away the common wall between the rectum and pulled-through colon of the Duhamel procedure for Hirschsprung's disease.

The authors performed three Duhamel procedures for Hirschsprungs disease using two GIA Autosutures at Ewha Womans University Hospital during recent several months, and are presenting with review of the world literatures.

Chronic factitious disorder with physical symptoms is an appropriate diagnosis in patients who consciously distort their medical history and produce misleading physical finding and laboratory results through self-inflicted lesions. By simulating patterns of physical diseases, these patients may subject themselves to painful and dangerous diagnostic and treatment procedures. Munchausen syndrome represents a special pattern within the group of chronic factitious disorder with physical symptoms.

The typical patient presents at a hospital as an acute emergency and usually has a lurid yet plausible medical and social history, which is laterfound to be entirely false and fabricated. After several fruitless investications with or without surgical operations, a diagnosis cannot be made and the patient eventually discharges himself and goes to another hospital where the process is repeated. It is importent to diagnose these patients early to avoid unnecessary medical and surgical interventions and to introduce psychiatric treatment.

A typical case of Munchausen syndrome is reported with a brief review of literatures. This is believed to be the first reported case of Munchausen syndrome in Koera.

We had experienced one case of amyloidosis, especially involving kidney associated with nephrotic syndrome and liver who was admitted to Ewha University Hospital due to abdominal distension and extremities edema.

Diagnozis was made characteristic clinical and histopathologic finding with crystal violet and congo red staining produced green birefringence under polarized light.

We sdiscussed this case with review of literatures.

Amebic colitis is an acute disease caused by organism Entamoeba histolytica. This disease is diagnosed with clinical symptoms, laboratory studies, and endoscopy with biopsy.

Now, we report the colonoscopic findings of amebic colitis. Colonoscopic findings are very variable.

There are punctate ulcer, pseudomembrane, pseudopolyp, and hemorrhage. Between above mentioned findings, punctate ulcers are found in almost all patients, except in asymptomatic patients. The lesion of the colon is very friable. So, involved tissue is bleeding with touch.

A case of lead poisoning is presented and recent litures are reviewed. A 47-year old male had been admitted to Ewha Womans University Hospital in March 1983 with chief complaints of abdominal colic & distention, nausea and tingling sensation of lower extremities after ingestion of herb pills(HAE GU SIN). Laboratory examinations are as follows; anemia with hypocromic, microcytic, basophilic stippling of erythrocytes in peripheral blood and bone marrow. Blood level of lead was 34.6mcg/dl, urine level of lead was 128.4mcg/L, coproporphyrine and ▵-ALA in 24hours urine were 270.8mcg/L, 19.9mg/L respectively. After treatment with BAL for 1 day, blood level of lead was 30.4mcg/dl, urine level of lead was 2988.6mcg/L, coproporphyrine and ▵-ALA in 24hours urine were increased to 667.2mcg/L, 5.5mg/L respectively and quantitative analysis of herb pills revealed 10% of containing lead.

We observed one case of giant hydronephrosis, containing 7,500cc of urine. It was caused by stricture at uretero-pelvic junction and confirmed with retrograde pyeloureterogram.

Herein we reported this case with a review of the literatures.

Primary tumors of the ureter are uncommon neoplasms, accounted for about 1 per cent of all urinary malignant lesions. Recently, the number of reported cases had increased.

We observed one case of primary ureteral tumor in 74 year-old male patient. The treatment was done by complete nephroureterectomy with an excision of a cuff of bladder wall around the ureteral orifice.

Herein we reported a case of primary ureteral tumor with a review of the literatures.