No abstract available.
Liver Abscess* ; Liver*

No abstract available.

No abstract available.
Colonoscopy* ; Tuberculosis*

No abstract available.
Erythrocytes*

BACKGROUND: Many physicians hesitate to discuss do-not-resuscitate (DNR) orders with patients or family members in critical situations. In the intensive care unit (ICU), delayed DNR decisions could cause unintentional cardiopulmonary resuscitation, patient distress, and substantial cost. We investigated whether the timing of DNR designation affects patient outcome in the medical ICU. METHODS: We enrolled retrospective patients with written DNR orders in a medical ICU (13 bed) from June 1, 2014 to May 31, 2015. The patients were divided into two groups: early DNR patients for whom DNR orders were implemented within 48 h of ICU admission, and late DNR patients for whom DNR orders were implemented more than 48 h after ICU admission. RESULTS: Herein, 354 patients were admitted to the medical ICU and among them, 80 (22.6%) patients had requested DNR orders. Of these patients, 37 (46.3%) had designated DNR orders within 48 hours of ICU admission and 43 (53.7%) patients had designated DNR orders more than 48 hours after ICU admission. Compared with early DNR patients, late DNR patients tended to withhold or withdraw life-sustaining management (18.9% vs. 37.2%, p = 0.072). DNR consent forms were signed by family members instead of the patients. Septic shock was the most common cause of medical ICU admission in both the early and late DNR patients (54.1% vs. 37.2%, p = 0.131). There was no difference in in-hospital mortality (83.8% vs. 81.4%, p = 0.779). Late DNR patients had longer ICU stays than early DNR patients (7.4 ± 8.1 vs. 19.7 ± 19.2, p < 0.001). CONCLUSIONS: Clinical outcomes are not influenced by the time of DNR designation in the medical ICU. The late DNR group is associated with a longer length of ICU stay and a tendency of withholding or withdrawing life-sustaining treatment. However, further studies are needed to clarify the guideline for end-of-life care in critically ill patients.
Advance Directives ; Cardiopulmonary Resuscitation ; Consent Forms ; Critical Illness* ; Hospital Mortality ; Humans ; Intensive Care Units ; Resuscitation Orders* ; Retrospective Studies ; Shock, Septic

No abstract available.
Blood Donors* ; HIV* ; Humans ; Mass Screening*

No abstract available.
Colorectal Neoplasms*

We report herein our surgical experience of Hartmann's procedure reversal using laparoscopic technique in a 72-year-old woman who underwent Hartmann's procedure for an obstructing sigmoid colon cancer 6 month earlier. The purposes of this report are to describe our technique of laparoscopic reversal of Hartmann's procedure, to introduce several technical tips in avoiding pitfalls, and to review its safty and efficacy. In brief, the colostomy was freed from the abdominal wall using a conventional technique, then a center rod and an anvil of a circular stapler were inserted into the colon. CO2 insufflation was performed through this insertion. Using a five-cannula technique, rectal stump was mobilized, then colorectal anastomosis was performed laparoscopically via a transanal stapled approach. The operating time was 130 minutes and blood loss was 50 ml. There were no intra- and postoperative complications. Up to now, with a 4-month follow-up period, the patient has been well without having any problems associated with this operation
Abdominal Wall ; Aged ; Colon ; Colostomy ; Female ; Follow-Up Studies ; Humans ; Insufflation ; Laparoscopy ; Postoperative Complications ; Sigmoid Neoplasms

Radiofrequency catheter ablation (RFCA) has been established as an effective and safe treatment modality for atrioventricular nodal reentrant tachycardia and WPW syndrome. Surgical ablation or direct current catheter ablation had been performed to cure focal atrial tachycardia (AT), however, these treatments had limitations such as the need of open thoracotomy or the risk of barotrauma. RFCA could be an effective treatment modality for cure of AT. We performed RFCA for AT in 22 patients (male 13, mean age 38.1+/-15.4 years) among 831 patients who underwent electrophysiologic study between Jul. 1996 and May. 1999. Clinical pattern of tachycardia was paroxysmal (17 patients) or incessant (mean duration of symptoms, 41.1+/-42.3 months). Associated cardiac diseases were tachycardia-mediated cardiomyopathy (3 patients), aortic stenosis (1 patient) and ventricular septal defect with pulmonic stenosis (1 patient). AT was induced by programmed electrical stimulation in 17 patients: AT in the other 5 patients was incessant. The RFCA was successful in 17 patients (77.3%). The mean interval between atrial electrogram of mapping catheter and P wave of surface ECG was -53.5+/-24.9msec in 17 successful sites. Fractionated atrial activities were invariably found in the successful sites. Successful sites of RFCA for right AT were around coronary sinus ostium (5), crista terminalis (4), lower portion of sinus node (1), inferior portion of tricuspid annulus (1), and His area (1), respectively. In left AT, lateral portion near atrioventricular groove (2), inferoposterior portion (2) and near left atrial appendage (1) were successful site. During follow-up (mean 23 months), one patient had recurrence (recurrence rate 5.9%). RFCA for AT is an effective and curative treatment in selected cases.
Aortic Valve Stenosis ; Atrial Appendage ; Barotrauma ; Cardiomyopathies ; Catheter Ablation* ; Catheters ; Coronary Sinus ; Electric Stimulation ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Follow-Up Studies ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Pulmonary Valve Stenosis ; Recurrence ; Sinoatrial Node ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Thoracotomy ; Wolff-Parkinson-White Syndrome

Complications of mitomycin C soaking method during pterygium surgery and its effect on recurrence rate were compared with postoperative use of topical mitomycin C. Sixty three patients(seventy three eyes) with primary pterygium received surgery with the bared sclera method. Thirty nine eyes randomly chosen were treated with cotton applicator soaked with 0.2mg/ml mitomycin C for 5 minutes after the excision of pterygium(soaking group). Thirty four eyes underwent the same surgical procedure and received topical 0.2mg/ml mitomycin C postoperatively, twice a day for five days(eye drop group). During the mean follow-up period of 13 months, recurrence rate was 15.4%(6 eyes) in soaking group and 20.6%(7 eyes) in eye drop group respectively. This difference was not statistically significant(p>0.5). There were no specific complications related to mitomycin C treatment in both groups during the follow-up periods. The soaking method of 0.2mg/ml mitomycin C was found as effective and safe as postoperative use of topical 0.2mg/ml mitomycin C for prevention of the recurrence of primary pterygium.
Follow-Up Studies ; Mitomycin* ; Pterygium* ; Recurrence ; Sclera