The need for a relaparotomy shortly after an initial abdominal operation indicates a serious complication and may frequently constitute a surgical failure. Many of the postoperative symptoms that might indicate the onset of complications may be masked by the usual postoperative course. Reported findings vary widely. Thus there is no clear picture for a surgeon to use as a guide. In an attempt to obtain more definite guidelines regarding the indications for and the timing of reintervention a retrospective study based on a 7-year survey was undertaken to assess the problem of reoperation after abdominal surgery. This study consisted of a retrospective clinical analysis made an 95 patients who required reoperation due to postoperative complications and planned stage operations during 7 years from January 1990 to December 1996. The number of reoperations was 95 cases (24%) among 3932 patients who had undergone abdominal operations at our department. The sex distribution for the reoperations was 58 males and 37 cases in females. The peak age incidence was the 6th decade in 25 cases(26.3%). The most common physical findings of the patient who required reoperations were abdominal pain and tenderness (56.8%). The main cause necessitating reoperation was intestinal obstruction (25.3%). The most common types of reoperations were common bile duct exploration with T-tube insertion(24.2%). The time interval between initial operation and reoperation was within 10 days in 10 cases (10.5%) and 25 months grouped in separate admission in 36 cases (37.9%). The most frequent complication was wound infection(15.8%) and the mortality rate was 4 cases (4.2%). Conservative treatment cannot be recommended for severe complications, such as postoperative bleeding or peritonitis, due to free anastomotic leakage. However, in doubtful cases, when there is mild peritonitis of an undetermined origin, ileus, well-controlled billiary or duodenal leaks, and the like, the high mortality associated with reintervention should be borne in mind. In these cases, conservative treatment with close supervision of the patient may prove the most prudent course.
Abdomen ; Abdominal Pain ; Anastomotic Leak ; Common Bile Duct ; Female ; Hemorrhage ; Humans ; Ileus ; Incidence ; Intestinal Obstruction ; Male ; Masks ; Mortality ; Organization and Administration ; Peritonitis ; Postoperative Complications ; Reoperation* ; Retrospective Studies ; Sex Distribution ; Wounds and Injuries

Objectives: This study investigated causative strains and their antibiotic sensitivity in patients who were hospitalized for maxillofacial odontogenic infections at a tertiary center in South Korea over the past 10 years with the aim of providing guidelines for the selection of appropriate empirical antibiotics. Materials and Methods: Patients with head and neck fascial space abscesses due to odontogenic infections who underwent incision and drainage surgery with pus culture tests between 2013 and 2022 at the Department of Oral and Maxillofacial Surgery, Dankook University Hospital were included. The bacterial isolates and antibiotic sensitivity of each strain were analyzed for 2013-2022, 2013-2017, and 2018-2022. The affected fascial spaces were classified into primary, secondary, and deep neck spaces. Results: In the 192 patients included in this study, 302 strains were detected. Viridans streptococcus had the highest frequency (51.7%), followed by Prevotella spp. (16.9%), Staphylococcus spp. (5.6%), and Klebsiella pneumoniae (4.6%). The identification rate of viridans streptococcus significantly increased from 41.8% in 2013-2017 to 60.9% in 2018-2022. Viridans streptococcus showed an antibiotic sensitivity of 80.5% to ampicillin; the sensitivity to penicillin antibiotics decreased over the study period. Antibiotic susceptibility was approximately 94% for third-generation cephalosporins.K. pneumoniae, which was identified at a high percentage in patients with deep neck space infection, showed increasing antibiotic resistance to most antibiotics over the study period. Conclusion Viridans streptococcus was identified in head and neck fascial space abscesses with the highest frequency. Empirical antibiotics should be effective against this strain; penicillin antibiotics are considered inappropriate. For effective treatment of deep neck space abscesses, bacterial culture and antibiotic sensitivity tests performed as soon as possible are essential.

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy

Helicobacter pylori (H. pylori) commonly infects humans worldwide. However, only limited proportions of infected populations develop clinical manifestations ranging from asymptomatic gastritis to gastric cancer. A Korean nationwide survey revealed that the overall H. pylori seroprevalence was 66.9% in 1998, and significantly decreased in later years in all age groups to 59.6% in 2005 and 54.4% in 2011. In terms of geographical regions, the seroprevalence trended significantly downward in most areas over time, except in Kyungsang and Kangwon. The various outcomes of H. pylori infection are caused by imbalances between bacterial virulence factors, host factors including genetic diversity, and environmental influences. H. pylori infection triggers responses by almost all forms of innate and acquired immunity. In the present review, we describe the epidemiology and pathophysiology of H. pylori infection in Korea. A better understanding of the prevalence trend and the mechanisms of immune responses to H. pylori infection will allow public health authorities to develop novel therapeutic strategies.
Adaptive Immunity ; Epidemiology* ; Gangwon-do ; Gastritis ; Genetic Variation ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea* ; Prevalence ; Public Health ; Seroepidemiologic Studies ; Stomach Neoplasms ; Virulence Factors

With a purpose to find out natural transition of endemicity of Malayan filariasis in inland Korea, a survey was conducted in June 1980 in Isan-Myeon of Yongpung-Gun (former Yongju-Gun) where an epidemiological investigation had been carried out in 1973 without any control activities such as chemotherapy. Five sample villages were surveyed for microfilaremia by 20 microliter night blood examination among inhabitants and the results of the surveys conducted in 1973 and 1980 were compared to determine natural transition of the endemicity of malayan filariasis during the period of the last 7 years. The current microfilaria rate among inhabitants in the 5 villages was 2.2 percent on the average (male: 1.6 percent, female: 2.8 percent) from 370 persons examined. By village, the rates were 5.9 percent (number of persons examined: 34) in Baranggol, 0 percent (30) in Guitonggl, 4.2 percent (72) in Alseonggol, 0 percent(65) in Jangjagol and 1.8 percent (169) in Saehae. Extremely low microfilaria rate was noted in young age groups. By age group, no positive case was found in those age groups below 30-39 years except 10-14 age group in which 2 positives (4.4 percent) were found. Two positives each were found in the respective age groups of 40-49(3.2 percent), 50-59 (4.4 percent) and over 60 (3.4 percent). In evaluation of the natural transition of the endemicity during the period of the last 7 years, the microfilaria rate turned out from 13.1 percent in 1973 to 2.2 percent in 1980. The difference in the microfilaria rate was 10.9 percent and the natural reduction rate per year was 1.6 percent on the average. From the examination of 35 cases which had revealed microfilaremia 7 years ago, 85.7 percent(30) of them were found to have converted to microfilaria negatives. On the other hand, from the 151 cases which had revealed no microfilaria in 1973, only 0.7 percent (1) of them was found to have converted to microfilaria positive. In the intensity of microfilaremia, the number of microfilaria/20 microliter blood per positive case was 11.0 in 1973 and 9.1 in 1980. The number of microfilaria/20 microliter per examinee was 1.4 in 1973 and 0.2 in 1980, thus reduced to 1/7 during the period of the 7 years. The retarding endemicity of malayan filariasis in inland Korea was considered to be resulted in by the gradual increase of environmental factors in relation to ecology of vector mosquitoes, which adversely affect to the transmission of malayan filariasis. Followings are suggested to be the factors which control the transmission of the malayan filariasis in this area: Inhabitants are the only natural final host of Brugia malayi infection in this area, gradual elevation of living standards of the inhabitants, gradual awakening of consciousness and behavior among inhabitants to protect themselves from mosquito biting using such as mosquito nets and insecticide sprays, preference of animal bait of vector mosquitoes, Anopheles sinensis, increase in number of domestic animals and fowls being raised in the village areas which play a major part of blood donors to vector mosquitoes, and relatively short (3-4 months) period of mosquito season in a year.
parasitology-helminth-nematoda ; Brugia malayi ; epidemiology

Pelvic kidney, an ectopic renal mass caused by developmental failure, is a rare condition. Here, we report a case of laparoscopic anterior resection in a patient with a solitary pelvic kidney. A 76-year-old man was diagnosed as having rectosigmoid colon cancer. Preoperative computed tomography revealed a left ectopic kidney in his pelvis. Computed tomographic angiography and retrograde pyelography were performed preoperatively to identify the renal vessels and the ureter. To keep the surgical plane intact for complete mesocolic excision, a complete laparoscopic anterior resection was safely performed without open conversion, and there was no injury to the pelvic kidney. The patient was discharged on postoperative day eight without any complication. No deterioration of renal function was observed after surgery. This report describes a case of laparoscopic anterior resection that was safely performed without conversion to open surgery in a patient with a pelvic ectopic kidney.

We report two rare cases of extensive bilateral subcutaneous emphysema that occurred during ordinary dental procedures. An air-driven high-speed handpiece, routinely used in dental procedures may cause subcutaneous emphysema when high pressure air is introduced into the loose connective tissues below the dermal layer. The first case occurred with surgical extraction of the lower third molar. The air introduced into the fascial spaces near the surgical field spread to the contralateral spaces, as well as the neck and chest areas. The second case also showed extensive bilateral subcutaneous emphysema caused by the introduction of compressed air from the handpiece during crown preparation without any invasive procedure. Cases where the emphysema extends beyond the treatment site to involve the contralateral cervicofacial areas have been rarely reported. Predicting the occurrence of subcutaneous emphysema is difficult, so it is important to exercise caution during routine dental treatment. If significant bilateral cervicofacial swelling is suspected to be due to subcutaneous emphysema, prompt diagnosis with securing the patient's airway will be necessary.

BACKGROUND: The hematopoietic stem cell bank has been actively recruiting registrants since 1994. This study systematically reviews its operations and outcomes over the last 20 years. METHODS: Retrospective data on a total of 47,711 registrants were reviewed. Relevant data were processed using PASW Statistics for Windows, version 18.0. RESULTS: As of 2013, the Korean Network for Organ Sharing database contained 265,307 registrants. Of these, 49,037 (18%) registrants committed to hematopoietic cell donation from 1994 to 2013. Fifty-seven percent of the registrants were men, and 43% were women. The reasons for opting out of the registry included refusal to donate (70%), family refusal (28%), and others (2%). The donation willingness of registrants was significantly higher than those who refused to receive a mail to confirm their continued enrollment (χ2=6.103, P=0.013). The bank successfully coordinated a total of 512 donors among newly matched donors from 1995 to 2013, of which the bone marrow and peripheral blood stem cell accounted for 40.8% and 59.2% of the total donations, respectively. CONCLUSION: Our recruitment activities focus on promoting voluntary registration and the importance of updating personal contact information. We expect that these data may be useful for diverse studies and demonstrate the positive impacts on the donation program.
Bone Marrow ; Bone Marrow Transplantation ; Female ; Hematopoietic Stem Cells* ; Humans ; Male ; Peripheral Blood Stem Cell Transplantation ; Personnel Selection ; Postal Service ; Retrospective Studies ; Stem Cells ; Tissue Donors

BACKGROUND/AIMS: The cytosolic host protein nucleotide binding oligomerization domain 1 (Nod1) has emerged as a key pathogen recognition molecule for innate immune responses in epithelial cells. The purpose of the study was to elucidate the mechanism by which Helicobacter pylori infection leads to transepithelial neutrophil migration in a Nod1-mediated manner. METHODS: Human epithelial cell lines AGS and Caco-2 were grown and infected with H. pylori. Interleukin (IL)-8 mRNA expression and IL-8 secretion were assessed, and nuclear factor kappaB (NF-kappaB) activation was determined. Stable transfections of AGS and Caco-2 cells with dominant negative Nod1 were generated. Neutrophil migration across the monolayer was quantified. RESULTS: Cytotoxin-associated gene pathogenicity island (cagPAI)(+) H. pylori infection upregulated IL-8 mRNA expression and IL-8 secretion in AGS and Caco-2 cells compared with controls. NF-kappaB activation, IL-8 mRNA expression and IL-8 secretion by cagPAI knockdown strains were reduced compared with those infected with the wild-type strain. NF-kappaB activation, IL-8 mRNA expression and IL-8 secretion in dominant-negative (DN)-Nod1 stably transfected cells were reduced compared with the controls. The transepithelial migration of neutrophils in DN-Nod1 stably transfected cells was reduced compared with that in controls. CONCLUSIONS: Signaling through Nod1 plays an essential role in neutrophil migration induced by the upregulated NF-kappaB activation and IL-8 expression in H. pylori-infected human epithelial cells.
Adult Stem Cells/physiology ; Caco-2 Cells ; Cell Line ; Epithelial Cells/*metabolism/microbiology ; Gene Expression ; Genomic Islands ; Helicobacter Infections/*genetics ; *Helicobacter pylori ; Humans ; Interleukin-8/genetics/secretion ; NF-kappa B/metabolism ; Neutrophils/*physiology ; Nod1 Signaling Adaptor Protein/*physiology ; RNA, Messenger/metabolism ; Signal Transduction ; Transendothelial and Transepithelial Migration/*physiology ; Up-Regulation