A cholecystectomy is one of the most frequent operations in the field of surgery. Recently, a laparoscopic cholecystectomy (LC) has become a commonly performed procedure for treatment of gallbadder disease, mainly gallstone disease. It has the advantages of less postoperative pain, fewer complications, and more rapid recovery. There is no doubt that LC will be the first choice for the treatment of gallbladder disease. We performed this study to research problem and to improve the successbility of this operation. We analyzed 300 patients who underwent a laparoscopic cholecystectomy from January 1, 1993 to December 31, 1996, at the Department of Surgery, College of Medicine, Pusan National University. The main results are as follows:1) The age range of the patients was from 17 to 72 years. There were 104 males and 196 females. 2) The most common previous operation was an appendectomy; the second most common was pelvic surgery. 3) The common chief complaints were right upper guadrant pain and indigestion. 4) Radiologic finding showed, gallstones in 212 cases and polyps in 30 cases. 5) The removed stones varied in size and number. 6) Postopertive complications were puncture site infection, bile leakage, pulmonary complications, etc. 7) The mean postopertive hospital stay was 4.2 days. 8) Intraoperative conversion to an open cholecystectomy was due to severe inflammation, adhesion, bleeding, etc. In conclusion, resolution of technical difficulties, meticulous training and experience, proper patient selection, and more developed tools are required.
Appendectomy ; Bile ; Busan ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Dyspepsia ; Female ; Gallbladder Diseases ; Gallstones ; Hemorrhage ; Humans ; Inflammation ; Length of Stay ; Male ; Pain, Postoperative ; Patient Selection ; Polyps ; Punctures

PURPOSE: The aim of this study was to identify perception, use status and factors influencing use of medical alert identification (ID) in diabetic patients who are on insulin. METHODS: A survey was conducted from December 2013 to April 2014 with 198 people who were asked to participate in the survey. RESULTS: The medical alert ID perception score was 3.54 on a 5-point scale. Most of respondents (82.8%) knew about the medical alert ID, but only 23.2% of respondents wore a medical alert ID and only 43.5% of respondents always wore a medical alert ID. Perception and frequency of possession were positively correlated (r=.41, p<.001). The most influential factor for the possession of a medical alert ID was the perception of the medical alert ID (β=.41, p<.001). The perception of the medical alert ID explained 17% of variance in possession of a medical alert ID. CONCLUSION: Most of diabetic patients who take insulin received education about hypoglycemia and knew about the medical alert ID, but only few of them wore a medical alert ID. Findings from this study indicate that perception is an important variable related to possession of a medical alert ID in this population.
Diabetes Mellitus ; Education ; Humans ; Hypoglycemia ; Insulin ; Surveys and Questionnaires

PURPOSE: This study aimed to compare the clinical outcome of acute poststreptocaccal glomerulonephritis (APSGN) between patients who had presented with gross hematuria and those with microscopic hematuria. METHODS: Thirty-nine patients with acute poststreptococcal glomerulonephritis, who were diagnosed from January 2000 to April 2003 were enrolled. RESULTS: The mean age was 8.85 years and the male to female ratio was 1.1:1. Seventeen patients presented with gross hematuria at diagnosis(group A) and twenty-two patients had microscopic hematuria only(group B). There were no significant differences between the two groups in the incidence of edema, fever or history of respiratory infection and oliguria. But hypertension was more frequent in group B. Laboratory data showed decreased C3 and C4 level in group B. Spot urine protein/creatinine ratio and 24hr urine protein showed higher levels in group A. CONCLUSION: Patients with gross hematuria at diagnosis had lower incidence of hypertension and a higher rate of nephrotic range of proteinuria than patients with microscopic hematuria. However, no difference in the duration of admission or complication rate was observed. All patients had clinical improvement during follow-up. We conclude that gross hematuria is not a significant prognostic factor for poststreptococcal glomerulonephritis.
Diagnosis ; Edema ; Female ; Fever ; Follow-Up Studies ; Glomerulonephritis* ; Hematuria* ; Humans ; Hypertension ; Incidence ; Male ; Oliguria ; Proteinuria ; Streptococcal Infections

PURPOSE: The aim of this study was to describe the epidemiological pictures and clinical profiles of Kawasaki disease(KD) in infants 3 months and younger. METHODS: For the epidemiologic study of KD in Korea as a task of Korean Pediatric Cardiology Society, data of total 3,862 KD patients were collected from 1997 to 1999 by survey. Among them, clinical data of 71 KD patients aged 3 months and younger were analyzed and compared with those of the total KD patients group. RESULTS: 71 patients aged 3 months and younger(1.8% of total 3,862 KD patients) included 1 case aged under 1 month, 22 cases aged 1-2 months, and 48 cases aged 2-3 months. The male-to-female ratio was 1.96:1, and the recurrence rate was 1.4%, and the prevalence of cases in sibling was zero. Coronary arterial (CA) abnormalities were detected by echocardiography in 27.5% of the cases, including 10.1% of CA aneurysm cases. There were no case with myocardial infarction or death. CONCLUSION: Comparing with the data of total KD patients group, data from 71 patients aged 3 months and younger showed a somewhat higher male-to-female ratio, incidence of CA abnormalities, and incidence of CA aneurysms, however those had no statistical significance.
Aneurysm ; Cardiology ; Coronary Aneurysm ; Echocardiography ; Epidemiologic Studies ; Epidemiology ; Humans ; Incidence ; Infant* ; Korea ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Infarction ; Prevalence ; Recurrence ; Siblings

A 73-year-old male presented a six-month history of buttock pain radiating into his thigh. The MRI revealed a large enhancing mass lesion involving the sacrum, with extension into the sacral canal. The tumor markers were measured to distinguish skeletal metastasis of carcinoma from primary bone tumor. The CA 19-9 was elevated. Despite the investigation, the primary site of cancer could not be found. Sacral bone biopsy was done. The pathologic examination revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells, consistent with tuberculosis. Sacral tuberculosis is rare in patients with no history of tuberculosis. Such solitary osteolytic lesions involving the subarticular region of large joints may mimic bone neoplasms and may be called "tuberculous pseudotumors." This case report intends to emphasize that bone tuberculosis should be a differential diagnosis in the presence of atypical clinical and radiological features. As tuberculous lesions may be mistaken for neoplasms, a small amount of fresh tissue should be sent for culture even if clinical diagnosis of a tumor seems likely. Described herein is a case of sacral tuberculosis mimicking metastatic bone tumor with elevated CA 19-9.
Aged ; Biopsy ; Bone Neoplasms ; Buttocks ; Diagnosis, Differential ; Giant Cells ; Humans ; Hydrazines ; Inflammation ; Joints ; Male ; Necrosis ; Neoplasm Metastasis ; Sacrum ; Thigh ; Tuberculosis ; Tuberculosis, Osteoarticular ; Biomarkers, Tumor

No abstract available.
Pilomatrixoma*

PURPOSE: Humulus japonicus pollen (Hop J) is a major cause of inhalant allergy in autumn of the Far East countries, and its allergenic potency has been increasing with climate changes. Allergen immunotherapy has been considered in Hop J-sensitized allergic patients; however, Hop J allergen extracts for immunotherapy are not commercially available. We speculate that Humulus lupulus pollen (Hop L) belonged to the same genus may share cross-reacting allergens with Hop J and evaluated allergenic relationships between these 2 pollens. METHODS: Thirteen patients with allergic rhinitis and/or asthma sensitive to Hop J pollens were enrolled in Ajou University Hospital, Suwon, Korea. Hop J pollens were collected locally and lyophilized extracts were prepared, while lyophilized Hop L extracts were provided by Lofarma S.p.A. IgE-ELISA/enzyme-linked immunosorbent assay (ELISA) inhibition tests, sodium dodecyl sulphate-polyacrylamide gel electrophoresis and IgE-immunoblot/immunoblot inhibition analysis using sera from the enrolled subjects were performed. RESULTS: All patients had high serum specific IgE to both Hop J and Hop L extracts by ELISA, but no significant correlation was found between these 2 extracts. ELISA inhibition tests showed significant dose-dependent inhibitions on IgE-bindings to Hop L with serial additions of Hop J extracts in a dose-dependent manner, while minimal inhibitions of IgE binding to Hop J were noted with additions of Hop L. IgE-immunoblot analysis demonstrated that the major allergenic component of Hop J at 12 kDa was inhibited by Hop J, while no inhibitions were noted by Hop L extracts on IgE-immunoblot inhibition analysis. CONCLUSION: These findings suggest that there may not be a significant cross-allergenicity between Hop J and Hop L.
Allergens* ; Asthma ; Climate Change ; Cross Reactions ; Desensitization, Immunologic ; Electrophoresis ; Enzyme-Linked Immunosorbent Assay ; Far East ; Gyeonggi-do ; Humans ; Humulus* ; Hypersensitivity ; Immunoglobulin E ; Immunotherapy ; Korea ; Pollen* ; Rhinitis, Allergic ; Sodium

BACKGROUND: Osteoporosis is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). This study examined the prevalence and risk factors associated with osteoporosis in patients with COPD. METHODS: The bone mineral densities (BMDs) of the lumbar spine and femoral bone were measured in 53 patients with clinically stable COPD and 41 age- and gender-matched control subjects showing a normal lung function. Osteoporosis was defined as a T-score < or =-2.5. The subjects' clinical characteristics and laboratory data were reviewed, and multiple logistic regression analysis was used to identify the risk factors associated with osteoporosis in COPD patients. RESULTS: The prevalence of osteoporosis was 47% and 32% in the COPD patients and controls, respectively. In particular, using the femoral neck T-score, the prevalence of osteoporosis in COPD patients was higher than that in the controls (26% vs. 5%; p=0.006). The average T-score of the lumbar spine (p=0.025) and femoral neck of COPD patients were significantly lower than those of the controls (p=0.001). The forced expiratory volume in the 1 second (FEV1) % predicted (p=0.019; odds ratio [OR], 0.955; 95% confidence interval [CI], 0.919-0.993) and age (p=0.024; OR, 1.144; 95% CI, 1.018-1.287) were independently associated with osteoporosis in patients with COPD. CONCLUSION: Using the femoral neck T-score, the prevalence of osteoporosis in patients with COPD was higher than the age-and gender-matched controls. A lower FEV1 and older age further increase the risk of osteoporosis in patients with COPD.
Bone Density ; Comorbidity ; Femur Neck ; Forced Expiratory Volume ; Humans ; Logistic Models ; Lung ; Odds Ratio ; Osteoporosis ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Spine

Short bowel syndrome in children, most commonly results after extensive bowel resection for necrosis of the bowel. It may be caused by several intestinal catastrophes such as volvulus, hernia and necrotizing enterocolitis. The risk factors on short bowel syndrome are the remaining length of the bowel, the age of onset, the absence of the ileo-cecal valve and the time after resection. Macro and micronutritional deficiencies are the most significant complications of short bowel syndrome. We report a 5 year-old girl, who had a strangulated congenital transmesenteric hernia leading to short bowel syndrome accompanied by iron deficiency anemia.
Age of Onset ; Anemia, Iron-Deficiency ; Child* ; Child, Preschool ; Enterocolitis, Necrotizing ; Female ; Hernia* ; Humans ; Intestinal Volvulus ; Necrosis ; Risk Factors ; Short Bowel Syndrome*

PURPOSE: We performed this study to evaluate the risk of rehospitalization for respiratory syncytial virus(RSV) infection among premature infants discharged from a neonatal intensive care unit(NICU). METHODS: We performed a retrospective study for rehospitalization for RSV infection and risk factors among premature infants who were admitted to NICU and discharged between May 2001 and April 2003 in Wonkwang University Hospital. RSV detection was utilized by direct fluorescent antibody tests in nasopharyngeal aspirates. We also reviewed various risk factors including gestational age, birth weight, sex, ventilatory care, surfactant administration, chronic lung disease(CLD), siblings in school or kindergarten age, and month of discharge. RESULTS: The rehospitalization rate for RSV infection was 6.6%(26/381) in premature infants and 22.2%(4/18) in premature infants with CLD. The most common season of rehospitalization for RSV infection was between November to January, this was 69.2%(18/26) in premature infants, the same as children: 61.2%(93/152). The risk factors for RSV rehospitalization among premature infants were CLD, siblings in school or kindergarten age and discharge between October to December from NICU. CONCLUSION: The risk for RSV rehospitalization among premature infants from NICU was low. Preterm infants subject to risk factors of CLD, siblings in school or kindergarten age, and discharge between October to December from NICU, were most likely to require hospitalization for RSV disease. In CONCLUSION: Prophylaxis for RSV infection should be considered one month before discharge from NICU in the RSV season between October and December.
Birth Weight ; Child ; Gestational Age ; Hospitalization ; Humans ; Incidence* ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Lung ; Respiratory Syncytial Viruses* ; Retrospective Studies ; Risk Factors* ; Seasons ; Siblings