No abstract available.
Rectal Neoplasms*

No abstract available.
Rectal Neoplasms*

Although many kinds of operation for rectal prolapse exist, generally they could be divided into the transabdominal and transperineal approach. The former has low recurrence rate as compared with the latter, but needs laparotomy. Unfortunately, many patients with rectal prolapse are old and debilitated. So they are not suitable candidates for a major abdominal operation. For those patient, a transperineal method may be proper, but the recurrence rate may be high and continence is not always achieved. We reviewed 12 patients who were older than 70 years of age and treated by the Thiersch operation among the 52 cases of rectal prolapse from Feb. 1992 to Mar. 1997 at Kwangju Christian Hospital. The results were summarized as follows; 1) The male to female ratio was 1 : 1.4. 2) Durations of rectal prolapse were distributed from 6 months to 30 years. Seven cases had duration of longer than 10 years. 3) The preoperative incidence of incontience was 8 (67%) of 12 cases. Among the 8 patients with incontinence, the male was 3 (37.5%) and female was 5 (62.5%). 4) Postoperative review of incontinence revealed complete disappearance in 4 cases (50%), improvement in 3 cases (37.5%), and no improvement in 1 case (12.5%). 5) After the Thiersch operation, rectal prolapse recurred in only 1 of the 12 cases (8.3%), a wound infection developed in 1 case (8.3%), defecation difficulty due to the small Thiersch ring was present in 3 cases (25%). The results of this study show that the Thiersch operation may be an effective method in treating rectal prolapse, especially in patient who are old or have poor general condition and manifested incontinence.
Defecation ; Female ; Gwangju ; Humans ; Incidence ; Laparotomy ; Male ; Rectal Prolapse* ; Recurrence ; Wound Infection

BACKGROUND: The optimal management of malignant obstruction of the left colon and rectum is controversial. METHODS: A retrospective study was performed of 33 patients who underwent one-stage operation(n=11), staged operation(n=20), and palliative colostomy(n=2) at Kwangju Christian Hospital between January 1992 and December 1996. RESULTS: Eleven patients underwent one-stage operations(7 cases with anterior resection, 3 cases with left hemicolectomy, 1 case with Miles' operation). In this group, postoperative morbidity was 36.3% including 1 wound infection(9.0%), 1 anastomotic leakage (9.0%), 1 postoperative intestinal obstruction and 1 pulmonary complication, but there was no postoperative death. The average of hospital stay in this group was 18.1 days and the first day of normal diet was 6.0 days. Twenty patients underwent staged operations including 12 cases of Hartmann's procedure. In this group, postoperative morbidity was 35.0% including 3 wound infections(15.0%), 2 pulmonary complications(10.0%), 1 parastomal hernia and 1 fistula. There were two postoperative deaths as a result of sepsis. The average of hospital stay in this group was 34.9 days and the first day of normal diet was 6.8 days. CONCLUSION: We believe that one-stage operation was of value in management of malignant obstruction of the left colon and rectum in selected patients.
Anastomotic Leak ; Colon* ; Diet ; Fistula ; Gwangju ; Hernia ; Humans ; Intestinal Obstruction ; Length of Stay ; Rectum* ; Retrospective Studies ; Sepsis ; Wounds and Injuries

No abstract available.
Nephrotic Syndrome*

PURPOSE: To investigate the timing of colostomy closure and the associated risk factors that affect the development of complication after colostomy closure. METHODS: We have reviewed and analyzed the results of 28 patients with colostomy closure at the Kwangju Christian Hospital from January 1993 to December 1997. We investigated to associated literatures on this subject for timing of colostomy closure, preparing a patient for colostomy closure, suture technique, wound management, underlying disease process related to the incidence of complication and experience of surgeons. RESULT: Wound infection developed in 4 patients (14.4%). Anastomotic leakage occurred in one patient (3.6%). Small bowel obstruction developed in two patients (7.2%). Overall incidence of complication was 25%. The incidence of complications in patients with trauma who underwent colostomy was 44.4% and patients without trauma, 15.8%. Complication rate was 16.6% for loop colostomies and 40% for end colostomies. The morbidity was 40% for colostomies on the left side, 18.7% for transverse colostomies, and 0% for colostomies (2 ileostomies) on the right side. The morbidity rate for closures within 6 weeks for the initial operation was 50%; for those within 6 to 12 weeks, 8.3%; and for those after 12 weeks, 16.6%. CONCLUSION: The optimal timing of closure varies from patient to patient, but closure within 6 weeks of the initial operation significantly increased the morbidity. Colostomies on the left side are associated with a higher morbidity rate than transverse colostomies or colostomies on the right side.
Anastomotic Leak ; Colostomy* ; Gwangju ; Humans ; Incidence ; Risk Factors ; Suture Techniques ; Wound Infection ; Wounds and Injuries

BACKGROUND: Bupivacaine is a amide type local anesthetic agent, widely used for its excellent quality of analgesia and long duration of action. But unintended intravenous injection causes severe complication such as convulsion and cardiovascular collapse, which is known for its difficulty in resuscitation. With all the study, the exact mechanism is still unclear and there are much debate on the method of resuscitation. METHOD: We studied the effect of clonidine pretreatment on bupivacaine-induced cardiac toxicity and resuscitation in anesthetized dog. Twelve dogs were divided into two groups. : saline pretreatment group (control, N=6) and clonidine pretreatment group (clonidine group, N=6). The dogs were anesthetized with N2O-O2-enflurane and vecuronium. Thoracotomy was done in 4th or 5th intercostal space for open cardiac massage. After confirming stability of vital signs, we administered clonidine (10 mcg/kg) or saline, and then administered bupivacaine with the rate of 2 mg/kg/min. When the electeocardiogram showed asystole, 20 mcg/kg of epinephrine was administered via central venous line and open cardiac massage with the rate of 120 beat/min. was performed. We observed electrocardiogram (lead II), arterial blood pressure, heart rate, dose of infused bupivacaine to be required for QRS widening and arrest, required time and administered dose of epinephrine for resuscitation. RESULTS: Clonidine group showed significant decrease of heart rate after pretreatment (p<0.05). There was no significant difference in required dose for QRS widening between two groups. The dose administered for inducing arrest was less in clonidine group than control group (p<0.05). The time required for resuscitation was shorter in clonidine group than control group (p<0.05). The total dose of epinephrine required for resuscitation was less in clonidine group than control group (p<0.05). The blood concentration of catecholamine did not showed significant difference during the whole course of experiment. CONCLUSIONS: Above results demonstrated that clonidine, a central nervous system-mediated sympatholytic agent, facilitated cardiac arrest when bupivacaine was infused intravenously and cardiac rescucitation.
Analgesia ; Animals ; Arterial Pressure ; Bupivacaine ; Clonidine* ; Dogs* ; Electrocardiography ; Epinephrine ; Heart Arrest ; Heart Massage ; Heart Rate ; Injections, Intravenous ; Resuscitation* ; Seizures ; Thoracotomy ; Vecuronium Bromide ; Vital Signs

Retrospective studies were performed in 338 cases among 633 cases under the age of 12 who visited the ophthalmologic department of Chonnam National University hospital from Jan. 1982 to Dec 1989. With this sample group, we have assessed information such as detected time of strabismus, type of deviation, sex distribution, refractory power, visual acuity test, angle of strabismus as well as operative result. After through study and analytical review of our data, we report these results of our study. 1. Sex distribution was 161 male(47.6%) and 177 female(52.4%), too redundant. Average age(year) at time of detection of esotropia, exotropia and hypertropia was 2.4, 3.8, 2.4 respectively. 2. Distribution according to type of strabismus was 103 cases(30.5%) of esotropia, 230 cases(68.0%) of exotropia, 5 cases(1.5%) of hypertropia. Again, too redundant. In esotropia, nonaccommodative esotropia included 65 cases(63.1%) and in exotropia, intermittent exotropia included 145 cases(63.0%). 3. Preoperative angle deviation of 25-40 delta in esotropia was observed in 58 cases(56.3%), but was observed 79.6% in 183 cases of exotropia. In those involving hypertropia 32 cases(60.0%) have had preoperative angle deviation below 20 delta, the largest number. 4. Type of refractory abnormality in esotropia was mostly hyperopic. Range of +2.0D - +4.0D was measured in 32 cases(32.3%) and showed variable distribution in exotropia, but the range of -1.0D - +1.0D in 119 cases(55.9%) was the greatest in number. 5. The number of patients who underwent surgery was 234(69.2%) and 104(30.8%) had no operation. Average age(year) at the time of the operation was 3.4 for esotropia, 5.4 for exotropia and 5.5 for hypertropia. Again, too redundant/obvious. 6. In esotropia medial rectus recession(65.3%) was performed, most frequently. In exotropia lateral rectus recession(86.2%) was performed, most often. As a result of primary operative repair of esotropia, normal position was achieved in 12 cases(24.5%). In 34 cases(69.4%), there was undercorrection, one hundred- five and overcorrection was observed in 3 cases(6.1%). 105 cases of exotropia attained normal position, 54 cases had undercorrection, and 22 cases had overcorrection. In vertical strabismus, 3(75%) attained normal position, and one(25%) undercorrection was observed. 7. Amblyopia occurred in 64 cases(18.9%), its distribution was 37 cases of esotropia, 26 cases of exotropia, and 1 case of hypertropia. After performing occlusion, at least a two-level vision test chart improvement was attained in 84.4% of cases.
Amblyopia ; Child* ; Esotropia ; Exotropia ; Humans ; Jeollanam-do ; Paraphilic Disorders ; Retrospective Studies ; Sex Distribution ; Strabismus* ; Vision Tests ; Visual Acuity

No abstract available.
Blood Donors* ; Chungcheongnam-do* ; Humans

No abstract available.
Humans ; Hypophosphatemia*