No abstract available.
Ethics*

No abstract available.
Ethics*

Organ-preserving and minimally invasive surgery should be considered in treating benign and borderline pancreatic lesions. However, total pancreatectomy is recommended for several pancreatic pathologies involving the entire pancreas. With the development of laparoscopic experiences and technique, laparoscopic pylorus-preserving pancreaticoduodenectomy (PPPD) and subtotal (extended) distal pancreatectomy are regarded as safe surgical procedure. Therefore, laparoscopic total pancreatectomy can be composed of two different surgical processes; (1) laparoscopic PPPD, and (2) subtotal (extended) distal pancreatectomy. Especially, subtotal (extended) distal pancreatectomy can be done by combined splenectomy or by excision or conserving both splenic vessels. When total pancreatectomy cannot be avoided in clinical situation, laparoscopic total pancreatectomy is feasible, safe, and can be a potential option. Techniques and potential indications will be discussed in this presentation.

Organ-preserving and minimally invasive surgery should be considered in treating benign and borderline pancreaticlesions. However, total pancreatectomy is recommended for several pancreatic pathologies involving the entirepancreas. With the development of laparoscopic experiences and technique, laparoscopic pylorus-preservingpancreaticoduodenectomy (PPPD) and subtotal (extended) distal pancreatectomy are regarded as safe surgicalprocedure. Therefore, laparoscopic total pancreatectomy can be composed of two different surgical processes;(1) laparoscopic PPPD, and (2) subtotal (extended) distal pancreatectomy. Especially, subtotal (extended) distalpancreatectomy can be done by combined splenectomy or by excision or conserving both splenic vessels. Whentotal pancreatectomy cannot be avoided in clinical situation, laparoscopic total pancreatectomy is feasible, safe, andcan be a potential option. Techniques and potential indications will be discussed in this presentation.

No abstract available.
Korea* ; Swine*

No abstract available.
Hemorrhoidectomy* ; Mucous Membrane*

Central serous retinopathies were arbitrarily divided into two groups; one mainly with edema of the macula and the other with discoloration opacity and a number of tiny yellow spots in and around the macula. Eight cases of central serous retinopathy with macular edema were selected to have oral administration of chlordiazepoxide, 20mg to 60mg a day. Of eight cases of the variety, six cases showed a marked improvement of visual acuity and a complete subsidence of macular edema within ten days after the administration of the drug. Two other cases were also benefitted by the regime. The drug was found to be equally effective even in the patients who had been on the other treatments for varying lengths of time without success. The mode of action of the drug is not yet fully understood. It is, however, assumed that the effectiveness of the drug on the disease might be due to relief of the stress which, in turn, leads to the relaxation of spasm of the retinal and or choroidal arterioles in the vicinity of the macula.
Administration, Oral ; Arterioles ; Central Serous Chorioretinopathy* ; Chlordiazepoxide* ; Choroid ; Edema ; Humans ; Macular Edema ; Relaxation ; Retinaldehyde ; Spasm ; Visual Acuity

In the operative treatment of an indirect rupture of tendo calcaneus, we should consider difficult repair and postoperative adhesion with surrounding tissues. In this paper, the new surgical technique for indirectly ruptured tendo calcaneus was introduced and evaluated. From July 1994 to Sep. 1995, we experienced 10 cases of closed rupture of Achilles tendon which was treated with reversed tendon sheath wrapping of juncture site after direct repair. This technique consists of conventional core suture with strong suture material followed by fine tide up sutures around the ragged outer margin of the ruptured end. Then, we made a delicate incision on the synovial sheath of the tendon two inch proximal to the tendon juncture site and elevated it carefully and rolled it back reverse direction to wrap around the juncture site, then hooked it up with the synovial sheath of distal part of ruptured tendon. It was very helpful to prevent adhesion by lowering the endotendon cellular ingrowth between tendon proper and tendon sheath by wrapping the ragged end of rupture site. Their least follow-up period was 12 months. The clinical outcome of the patients was assessed according to the criteria of Hooker, and there were eight cases of excellent (80%), and two cases of satisfactory results. We report good results with the reversed tendon sheath wrapping around juncture site after direct repair of Achilles tendon, as a new technique the treatment of indirectly ruptured tendo calcaneus.
Achilles Tendon ; Calcaneus* ; Follow-Up Studies ; Humans ; Rupture* ; Sutures ; Tendons*

Generally, exposure and the operative technique are common difficulty encountered in the total knee arthroplasty of ankylosed knee due to old infection sequelae. Also the postoperative range of motion and relief of pain is poor due to deformity and excessive soft tissue contracture around knee. There have heen few reports, however, that address the reconstructive challenge of total knee arthroplasty in a previously infected ankylosed knee. We perfoined TKA in thirty six patients who had ankylosed knee between July l986 and Dec. 199S. After follow up of average five years and one month, we analysed the results. The definition of ankylosis was a knee ROM less than 90 degree. Average age of patients were 36.7 years old. Twelve patients were meii and twenty four patients were women. Sixteen patients of partial ankylosis and twenty patients of complete ankylosis were performed operation. There were nineteen cases of healed tubercuiosis knees and seventeen cases of healed pyogenic knees. For the release of soft tissue contracture in 9 cases, we lengthened quadrceps tendon with the method of modified V-Y advancement technique. Patella tendon was proximally reattached with staples and suture in 6 cases and tibial tubercle was proximally transferred in 3 cases. As results, the postoperative average range of motion was 79.3 (30 - l21') in complete ankylosis, 107 (60 - 135 ) in partial ankylosis. The average Hospital for Speciai Surgery knee rating score improved from 56.3 points preoperatively to 84.8 points postoperatively. Radiolucent line was observed in two Knees with less than 2mm width in three years and four months, and four years postoperatively, hut the patient had no pain. In five patients who had poor gain of range of motion after operation, we perfonned arthroscopic adhesiolysis. In conclusion, regarding patient selection, reasonable hony development, relative]y healthy extensor mechanism and adequate soft tissue condition are important for success of TKA in old intection sequelae. TKA of ankylosed knee in old infection sequelae is a successful procedui which can ohtain the restoration of function of the ankylosed knee.
Ankylosis ; Arthroplasty* ; Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee* ; Patellar Ligament ; Patient Selection ; Range of Motion, Articular ; Sutures ; Tendons

No abstract available.
Humans ; Infant, Newborn* ; Lipoproteins* ; Plasma*