No abstract available.
Fractures, Bone* ; Hematoma*

No abstract available.
Aneurysm ; Femoral Artery

No abstract available.
Aortic Aneurysm, Abdominal ; Stomach Neoplasms ; Stomach

As the result of the study concerning "bone inducibility of chitosan", 1. "BMP-2"was observed mainly through the test when the "osteoblast"is exposed to the "chitosan". The expression of BMP-2 was 542.63 times compared to control after 2 hours exposure and it was maintained 16.60 times till 24 hours. 2. The expression of BMP-4 was decreased compared to control during exposure. 3. The expression of BMP-7 revealed two peaks during exposure. 4. The expression of osteocalcin was increased in early phase, and then decreased. Although it is not clear whether the "chitosan"is clinically effective material as a "bone induction material", we could say that it has a function for bone induction. Further detailed study will be required.
Bone Morphogenetic Protein 7 ; Chitosan* ; Humans* ; Osteoblasts* ; Osteocalcin

Superior mesenteric artery syndrome is a rare clinical disease in Korea. The authors experienced three cases of the superior mesenteric artery syndrome. All of patients complained of continuos bilious vomiting, epigastric discomfort, epigastric fullness, and weight loss. The superior mesenteric artery syndrome was diagnosed preoperative, by using physical examination, gastrofiberscopy, upper gastrointestinal series, abdominal computerized tomography (CT), and spiral CT angiogram. We performed a Roux-en-Y duodenojejunostomy. We measured the angle between the aorta and that superior mesenteric artery by using a spiral CT angiogram. The angles were 10o, 11o, and 11o. Postoperatively they were improved. A spiral CT angiogram was a noninvasive method of diagnosing the superior mesenteric artery syndrome compared with a femoral angiography. The Roux-en-Y duodenojejunostomy was the proper method of treatment for the superior mesenteric artery syndrome.
Angiography ; Aorta ; Humans ; Korea ; Mesenteric Artery, Superior* ; Physical Examination ; Superior Mesenteric Artery Syndrome* ; Tomography, Spiral Computed ; Vomiting ; Weight Loss

PURPOSE: We evaluated the relationship of prostate-specific antigen (PSA) and obesity indices (weight, body mass index [BMI] and waist circumference [WC]) in Korean middle-aged men. MATERIALS AND METHODS: From February to September 2013, 1,900 police men under 60 years old who participated in a prostate health screening program were included this cross-sectional study. All subjects underwent clinical examinations including weight, height, BMI, WC, fasting blood sugar, lipid profiles, estimated glomerular filtration rate (GFR), and PSA. Total prostate volume (TPV) was assessed clinically. Spearman correlation and multiple linear regression tests were performed to evaluate the obesity indices and PSA relationships. RESULTS: The mean age was 52.0±4.7 years, and the mean PSA was 0.97±0.99 ng/mL. The PSA showed a significant positive correlation with the age (r=0.108, p < 0.01), TPV (r=0.349, p < 0.01), height (r=−0.052, p < 0.05), weight (r=0.186, p < 0.05), low-density lipoprotein cholesterol (r=0.056, p < 0.05), and GFR (r=−0.096, p < 0.01). All obesity indices including weight, BMI, and WC showed negative correlations with PSA (beta=−0.013, p < 0.001; beta=−0.039, p < 0.001; and beta=−0.010, p=0.005; respectively) in age and TPV-adjusted model. CONCLUSIONS: Common obesity indices (weight, BMI, and WC) were associated with lower PSA in Korean middle-aged population. Thus, an individual's degree of obesity should be considered when PSA is checked in the first prostate cancer screening of life.
Blood Glucose ; Body Mass Index ; Cholesterol ; Cross-Sectional Studies ; Fasting ; Glomerular Filtration Rate ; Humans ; Linear Models ; Lipoproteins ; Male ; Mass Screening ; Obesity ; Police ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Waist Circumference

PURPOSE: The goal of this study is to analyze the trends in surgical management of Benign prostatic hyperplasia (BPH) in Korea during the last 5 years from 2014 to 2018. MATERIALS AND METHODS: We retrieved the medical statistics associated with the Healthcare Big Data Opening System available online. We analyzed the number of cases after 2014 for transurethral resection of prostate (TURP), photoselective vaporization of the prostate (PVP), and holmium laser enucleation of the prostate (HoLEP), respectively. We then analyzed and charted the cases according to the number of patients hospitalized or treated as outpatients, depending on age group, type of medical institutions, and the location of medical institutions. RESULTS: The number of patients with BPH has increased steadily. The number of TURP and HoLEP procedures steadily increased, while the number of PVP interventions decreased dramatically. The number of HoLEP cases increased by 22% from 2014 to 2018, which is the fastest rate among the three surgeries. In addition, the number of patients aged 75 years or older as well as the proportion of inpatient surgeries compared with outpatient treatments has increased. The number of cases undergoing TURP increased rapidly in general hospital and those treated with HoLEP increased in the general and tertiary referral hospitals. CONCLUSIONS Interventions using TURP and HoLEP has increased, and the age of patients undergoing surgery has increased gradually. Cases treated with TURP and HoLEP in general and tertiary referral hospitals showed an increasing trend from the metropolitan area to the province.

BACKGROUND: Tsutsugamushi disease, which is caused by Orientia tsutsugamushi, is an acute febrile illness transmitted by infected mites. Recently, the incidence rate has been increased especially in the Daejeon and Chungcheongnam-do. We analyzed the patients with tsutsugamushi disease, who lived in Daejeon and Chungcheongnam-do, to find out their clinical manifestations and factors affecting the disease duration. METHODS: A total of 102 patients who were diagnosed with tsutsugamushi disease at the department of family medicine in a university hospital from September 2005 to November 2005 were studied. We analyzed their clinical characteristics and investigated the clinical factors associated with disease duration in tsutsugamushi disease by multiple regression analysis. The term "disease duration" was defined as the interval from symptom onset to discharge. RESULTS: Among 102 patients, 33 were males and 69 were female, and the mean age was 57.4 years. The average interval from symptom onset to admission was 6.6 days. The average interval from symptom onset to discharge was 14.5 days. From multiple regression analysis, interval from symptom onset to admission (beta=0.470, P<0.001), serum albumin level (beta=-3.441, P= 0.019), and abnormal findings of chest X-ray (beta=2.925, P=0.021) were shown to independently contribute to disease duration (R(2)= 0.458). CONCLUSION: Disease duration is significantly correlated with clinical factors such as abnormal findings of the chest X-ray, lower serum albumin level, and longer interval from symptom onset to admission. These factors could be used as parameters of the severity of disease in patients with tsutsugamushi disease.
Chungcheongnam-do ; Female ; Humans ; Incidence ; Male ; Mites ; Orientia tsutsugamushi ; Scrub Typhus* ; Serum Albumin ; Thorax

BACKGROUND: Laparoscopic cholecystectomy has become the gold-tandard treatment for symptomatic gallbladder diseases. The evaluation and the treatment of common duct pathology is an essential component in the surgical management of biliary tract disease. The purpose of the present study was to identify the value and the importance of laparoscopic cholangiography compared to endoscopic retrograde cholangiography (ERC) in a laparoscopic cholecystectomy and to suggest the role of laparoscopic cholangiography in the management of patients undergoing laparoscopic cholecystectomy. METHODS: A laparoscopic cholecystectomy was attempted in two hundred six consecutive patients treated at Hallym University between January 1993 and December 1996. Patients were divided into three groups: In group I, 167 patients were examined with preoperative ERC while in group II, 17 patients were examined with laparoscopic cholangiography; Group III included 22 patients who were not examined with preoperative ERC or laparoscopic cholangiography. RESULTS: The average age was 52.78 years in group I, 45.62 years in group II, and 49.22 years in group III. The average operative time was 76.88 minutes in group I, 131.47 minutes in group II, and 85.22 minutes in group III. The operative time in group II was longer than that in group I (p<0.001). The duration of postoperative hospitalization was 4.9 days in group I and 4.11 days in group II, but this difference was not statistically significant (p=0.166). Conversion to an open cholecystectomy was 17/167 (10%) in group I, 1/17 (5%) in group II and 5/22 (22%). No complications or deaths occurred that were due to laparoscopic cholangiography. The postoperative complications in group I/II/III included bile leakage (3/0/2), bleeding in the bed of the gallbladder (5/0/0), wound bleeding (2/1/1), recurrent common duct stones (2/0/0), subcutaneous emphysema (4/1/0), shoulder pain (12/3/0), and wound infections (15/2/1). CONCLUSIONS: Although cholangiography may not be indicated for all patients undergoing a laparoscopic cholecystectomy, it will eventually be required. We conclude that laparoscopic cholangiography, as well as ERC, is a good method for evaluating the biliary tree. Laparoscopic cholangiography is clinically useful in patients who have negative ultrasonography and a dilated bile duct. Also, laparoscopic cholangiography has many advantages, especially at a teaching hospital: it outlines the anatomy of the extrahepatic biliary tree, identifies anomalies of surgical importance in time before iatrogenic damage is inflicted, detects stones in the cystic duct, discovers unsuspected stones, and develops experience with the technique. However, it is technically diffult to cannulate cystic duct and extends the operating time.
Bile ; Bile Ducts ; Biliary Tract ; Biliary Tract Diseases ; Cholangiography* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cystic Duct ; Gallbladder ; Gallbladder Diseases ; Hemorrhage ; Hospitalization ; Hospitals, Teaching ; Humans ; Operative Time ; Pathology ; Postoperative Complications ; Shoulder Pain ; Subcutaneous Emphysema ; Ultrasonography ; Wound Infection ; Wounds and Injuries

BACKGROUND: Mesenteric infarction is a significant cause of death in elderly patients, and is being reported with increasing frequency. The diagnosis seldom is made prior to the onset of gangrene, despite an increased awareness of the lethality of mesenteric ischemia. The outcome for patients with mesenteric ischemia depends on the age of the patient, the extent and the severity of the ischemia and the effectiveness of the collateral blood supply. METHODS: We retrospectively reviewed the cases of 23 patient with mesenteric infarction who had been treated at the Department of Surgery, Hallym University, Chunchon Sacred Heart Hospital, between September 1988 and August 1977. RESULTS: The mean age was 52.3 years and the ratio of males to females was 1:1.6. The most frequent underlying diseases were hypertension, congestive heart failure, atrial fibrillation, and myocardial infarction. The radiologic study of a simple plain abdomen revealed a paralytic ileus in 87% of the cases; a partial vascular occlusion was shown under angiogram. The mean time lapse from onset of symptom to operation was 38.3 hours. Eight (34.8%) patients died when renal failure, ARDS or peritonitis developed. CONCLUSIONS: The cause of the persistently high mortality in patients with mesenteric in farction and to define a more effective form of management based on our results and recent clinical or laboratory findings. This study was concluded that early detection of the mesenteric infarction was reduced postoperative complications.
Abdomen ; Aged ; Atrial Fibrillation ; Cause of Death ; Diagnosis ; Female ; Gangrene ; Gangwon-do ; Heart ; Heart Failure ; Humans ; Hypertension ; Infarction* ; Intestinal Pseudo-Obstruction ; Ischemia ; Male ; Mortality ; Myocardial Infarction ; Peritonitis ; Postoperative Complications ; Renal Insufficiency ; Retrospective Studies