No abstract available.
Humans ; Lymphocytes* ; Stomach Neoplasms* ; Stomach*

No abstract available.

An adenocarcinoma of the appendix is a rare tumor, and so far only 130 cases have been reported worldwide. We report one patient with peritoneal seeding of an adenocarcinoma. A 51-year-old man was admitted to our hospital with the impression of intestinal obstruction. He had undergone an appendectomy 5 years ago due to acute appendicitis. At that time, postoperative histopathological analysis had revealed an adenocarcinoid tumor in the appendix. The patient had been told to visit our hospital for follow-up but he hadn't visited. When he finally visited our hospital diagnostic laparoscopy revealed the peritoneal seeding of a recurrent adenocarcinoma. A palliative right hemicolectomy was done to relieve the bowel obstruction. After recovering from operation, the patient was treated with the 5-fluoruracil, leucovorin, and oxaloplatin (FOLFOX). The patient was discharged in improved general condition with a future plan for regular cyclic chemotherapy.
Adenocarcinoma ; Appendectomy ; Appendicitis ; Appendix* ; Carcinoid Tumor ; Drug Therapy ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Laparoscopy ; Leucovorin ; Middle Aged ; Neoplasm Metastasis*

Pyoderma gangrenosum is an uncommon, chronic, recurrent cutaneous ulcerative disease. It is difficult to diagnosis and is frequently associated with systemic diseases. There is no specific therapy, nor effective uniform therapy. Systemic treatment with corticosteroids or cyclosporine, alone or together, appeared to be effective in many cases. However, prolonged therapy is associated with significant side effects, and in refractory cases, immunomodulatory therapy is needed. We report a case of pyoderma gangrenosum, which developed in a 41-years-old woman, who showed no symptoms of having an underlying systemic disease. The conduction was successfully treated with prednisolone, cyclosporine and dapsone.
Adrenal Cortex Hormones ; Cyclosporine* ; Dapsone* ; Diagnosis ; Female ; Humans ; Immunomodulation ; Prednisolone* ; Pyoderma Gangrenosum* ; Pyoderma* ; Ulcer

Pyoderma gangrenosum is an uncommon, chronic, recurrent cutaneous ulcerative disease. It is difficult to diagnosis and is frequently associated with systemic diseases. There is no specific therapy, nor effective uniform therapy. Systemic treatment with corticosteroids or cyclosporine, alone or together, appeared to be effective in many cases. However, prolonged therapy is associated with significant side effects, and in refractory cases, immunomodulatory therapy is needed. We report a case of pyoderma gangrenosum, which developed in a 41-years-old woman, who showed no symptoms of having an underlying systemic disease. The conduction was successfully treated with prednisolone, cyclosporine and dapsone.
Adrenal Cortex Hormones ; Cyclosporine* ; Dapsone* ; Diagnosis ; Female ; Humans ; Immunomodulation ; Prednisolone* ; Pyoderma Gangrenosum* ; Pyoderma* ; Ulcer

For many years it had been universally taught that administration of the commonly used analgesic agents retards the progress of labor. It was therefore advised that these agents should not be administered until the labor was active and progress was rapid. In recent years, more scientific analysis of the progress of labor and accurate recording of uterine contractility revealed that this classical teaching was inaccurate. Despite the increasing use of regional analgesia during labor, systemic medications are still widely used to relieve pain and anxiety. There is no ideal, generally applicable analgesic agent for use during childbirth. All systemic medications used for pain relief in labor cross the placenta and may have a depressant effect on the fetus and injudicious administration of an overdose can cause some depression of uterine activity. It is suggested that elimination of pain or anxiety will decrease adrenal medullary release of epinephrine. Since epinephrine is a known inhibitor of uterine activity, a decrease in its serum level should lead to increased uterine activity. Thus it was decided to make an objective estimation of the effects of morphine, meperidine, diazepam and ketamine upon uterine contractility of pregnant rat uteri, in vitro. The results are as follows: 1) Morphine caused a significant concentration dependent decrease in the contractility of pregnant rat uteri. 2) Meperidene did not cause any significant change in the contractility of pregnant rat uteri. 3) Diazempam caused a concentration dependent decrease in the contractility and the contraction disappeared at a concentration of 80 ug/100ml. 4) Ketamine caused a significant concentration dependent decrease in the contractility of pregnant rat uteri. 5) Addition of CaCl2 to the K-H solution did not cause any significant change in the result.
Analgesia ; Analgesics ; Animals ; Anxiety ; Depression ; Diazepam* ; Epinephrine ; Fetus ; Ketamine* ; Meperidine* ; Morphine* ; Parturition ; Placenta ; Rats* ; Uterus*

The role of surgical intervention in patients with diabetic gastroparesis is unclear. We report a case of a 37-year-old man with a history of recurrent episodes of vomiting and long-standing type 2 diabetes mellitus. Esophagogastroduodenoscopy did not reveal any findings of reflux esophagitis or obstructive lesions. A gastric emptying time scan showed prolonged gastric emptying half-time (344 minutes) indicating delayed gastric emptying. Laboratory tests revealed elevated fasting serum glucose and glycosylated hemoglobin (HbA1c, 12.9%) and normal fasting C-peptide and insulin levels. We performed Roux-en-Y reconstruction after subtotal gastrectomy to treat gastroparesis and improve glycemic control, and the patient showed complete resolution of gastrointestinal symptoms postoperatively. Barium swallow test and gastric emptying time scan performed at follow-up revealed regular progression of barium and normal gastric emptying. Three months postoperatively, his fasting serum glucose level was within normal limits without the administration of insulin or oral antidiabetic drugs with a reduced HbA1c level (6.9%). Long-limb Roux-en-Y reconstruction after subtotal gastrectomy may be useful to treat severe diabetic gastroparesis by improving gastric emptying and glycemic control.
Adult ; Barium ; Blood Glucose ; C-Peptide ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Endoscopy, Digestive System ; Esophagitis, Peptic ; Fasting ; Follow-Up Studies ; Gastrectomy ; Gastric Emptying ; Gastroparesis ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemic Agents ; Insulin ; Vomiting

No abstract available.
Aspergillosis* ; Autopsy* ; Humans ; Lupus Nephritis* ; Tuberculosis*

PURPOSE: Laparoscopic cholecystectomy (LC) has replaced open cholecystectomy (OC) for the majority of patients. However, a minority of patients still require conversion to open cholecystectomy during the perioperative period. This study was designed to determine the contributing factors related to conversion to open cholecystectomy. METHODS: The data from 3,510 laparoscopic cholecystectomies, performed at Chung-Ang university hospital from September 1990 to June 2001, were reviewed retrospectively. Pre-operative laboratory data, post-operative pathologic findings, complications, and the reasons for conversion to open cholecystectomy were evaluated. RESULTS: Sixty six (1.88%) of 3,510 patients were converted to open surgery, due to bleeding (39%), adhesion (26%), bile duct injury (23%) and inflammation (6%). These conversion cases were more prevalent in males and needed longer hospital stay. Thickening of the gallbladder wall and gangrenous cholecystitis were frequent pathologic findings among the conversion cases. CONCLUSION: Thickening of the gallbladder wall, inflammation and anatomical variation of the gallbladder were important factors for conversion to open surgery. Thus, these predictive findings allow the surgeons to preoperatively discuss the higher risk of conversion and allow for an earlier judgement and decision on conversion if intraoperative difficulty is encountered.
Bile Ducts ; Cholecystectomy* ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Conversion to Open Surgery ; Gallbladder ; Hemorrhage ; Humans ; Inflammation ; Length of Stay ; Male ; Perioperative Period ; Retrospective Studies

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Mortality*