Three-dimensional ultrasonographic diagnosis of uterus didelphys, obstructive hemivagina and ipsilateral renal agenesis: Herlyn-Werner-Wunderlich syndrome / 대한산부인과학회지

Three-dimensional ultrsonography has been applied to diagnose mullerian anomalies. However, in Korea, no such case has been reported in literatures. An adolescent female was evaluated for dysmenorrhea, and a hematocolpos was found at private clinic. We performed three-dimensional ultrsonography and found uterus didelphys by confirming seperated uterine fundi and cervices. Abscence of right kidney was also found by ultrsonography. The diagnosis of Herlyn-Werner-Wunderlich syndrome was made and marsupialization of the right hemivagina was performed, with relief of symptoms.

Macronutrient Consumption Pattern in Relation to Regional Body Fat Distribution in Korean Adolescents / 대한지역사회영양학회지

This study was conducted to identify the determinants of regional body fat distribution of obesity(upper body obesity and lower body obesity) for adolescents. The macronutrient consumption pattern utilized the most important variables to test for potential determinants. A total of 726 adolescents living in rural areas in Korea had been observed for four years from 1992 to 1996 about their diet, sexual maturation, serum components and physical growth. The study design was similar to that fo a casecontrol study. Logistic regression analysis were used as an analytical method to identify the determinants of upper body obesity and lower body obesity. Odd ratios were estimated from the regression to identify the determinants of upper body obesity and lower body obesity. Odd ratios were estimated from the regression to identify the risk factors. Fat consumption pattern was the most frequent one among the three macronutrient consumption pattern of carbohydrate, fat and protein. Prevalence of obesity for the subjects was 9.5%. Prevalence of upper body obesity was higher in malestudents than in female students. On the other had, prevalence of lower body obesity was higher in females. The results of the logicstic regression analysis showed that the risk factor for upper body obesity was sexual maturity rather than dietary factors. None of the factors included in the analysis for lower body obesity appear to be the risk factor. The result may suggest that to develop a determinant model for obesity of adolescents, the model should include a wider range of variables other than diet, sexual maturity and changes in blood serum.

Changes of Tuberculous Cavities after Antituberculous Therapy: Analysis with High-Resolution CT

PURPOSE: To evaluate changes in tuberculous cavities, one of the major factors used to determine the activityof tubereulosis, by high-resolution CT(HRCT) in active pulmonary tuberculosis patients after antituberculoustherapy. MATERIALS AND METHODS: The HRCT findings of 41 patients with active tuberculosis were analyzed withparticular emphasis on the appearance of tuberculous cavities before and after therapy. We measured the largestdiameter and maximal wall thickness of the cavities, as well as accompanying changes occurring during follow-up.The mean interval between initial and follow-up study was 8.7 months(minimum:4.1, maximum:33.2;S.D.: +/-5.0) andthe mean duration of antituberculous therapy was 7.5 months(minimum:4.7, maximum:14.8;S.D.: RESULTS: Among 41patients, 54 cavities were found on initial HRCT. Thirty one(57.4%) of these disappeared during follow up HRCTwith residual changes such as residual fibrotic scar(n=15), granuloma(10), paracicatrical emphysema(7),calcification(3), traction bronchiectasis(3), consolidation(3) and bullous emphysema(1). Twenty three of thecavities(42.6%) decreased in size and wall thickness, but did not disappear completely during follow-upexamination. Mean largest diameter and maximal thickness of 23 cavities were 32.0mm(+/-13.9) and 7.9mm(+/-4.8) oninitial HRCT, falling to 20.9mm(+/-12.5) and 4.1mm(+/-2.6), respectively, during follow-up HRCT. Among four patientswho underwent a second follow-up, the largest diameter and maximal thickness of the cavities decreasedcontinuously. In two patients, however, the cavities did not did not disappeas, though in the other two they haddisappeared by the time follow-up HRCT was performed a second time. CONCLUSION: During follow-up HRCT afterantituberculous therapy(mean duration of 7.5 months), 57.4%(31/54) of cavities were seen to have disappeared, withresidual changes such as fibrotic scars, granulomas, paracicatrical emphysema and calcification ; 42.6% of thecavitivies still remained, however, with retractive and fibrotic change. Such fibrotic and retractive changesshould not, therefore, be taken as indicative of active tuberculosis, especially in patients who have successfullycompleted their medication.

The Longitudinal Study of Diet and Sexual Maturity as a Determinant of Obesity for Adolescents / 대한지역사회영양학회지

This study was conducted to investigate the determinants of obesity during adolescnece. A total of 726 adolescents living in rural areas in Korea had been observed for four years from 1992 to 1996 regarding their diet, sexual maturity, blood profile and physical growth. Stepwise multiple regression analysis was used to identify priorities fo the importance between the factors influencing obesity. The average nutrient intake over the three year period was higher than that of the Korean Recommended Dietary Allowances. The prevalence of obesity for the subjects based on BMI was 9.5%. Results of the stepwise multiple regression analysis showed that blood components and sexual maturity were more significant factors for determining the obesity than the dietary factors. The result may suggest that to understand obesity in children it is necessary to develop on analytical model for the children rather than using the existing analytical model developed mostly for adult patients of obesity. The model should include a wide range of variables such as diet, sexual maturity and changes in blood.

Percutaneous Removal of the Retained Biliary Stones: Evaluation of the Results on of Impatient-basis Management

PURPOSE: All procedures for the removal of retained intrahepatic stones were performed on inpatient basis. We evaluated the advantage of the procedures performed on inpatient basis compared with outpatient basis in terms of the success rate, causes of failure and the complication. MATERIALS AND METHODS: Percutaneous removal of retained intrahepatic stones was performed in 58 patients through a T-tube tract on inpatient basis from April 1990 to December 4992. Stones were exclusively intrahepatic in 28 patients, whereas 30 patients had combined stones in common bile duct. Preshaped catheters, baskets, and balloon catheters were used to remove the stones and dilate the strictures of the ducts. Extracorporeal shock wave lithotripsy and choledochoscopy with electrohydraulic lithotripsy were used to crush the impacted stones. RESULTS: The stones were completely removed in 34 (58.6%) of 58 patients and most of the stones were removed in 17 patients (29.3%). The overall success rate was 87.9%. The complications (cholangitis in 13% and pancreatitis in 0.8% per session) were found and successfully managed by appropriate care. CONCLUSION: Better success rate could be achieved by more aggressive appraoch on inpatient basis when compared with previous reports on outpatient basis. We suggest that the procedures should be performed on inpatient basis especially in a case with severe strictures or impacted stones.