BACKGROUND: The advent of EEA stapler has lowered the leakage rate of esophagogastric anastomoses and thereby contributed to a decrease in the operative mortality of the easophageal resection. Recent surgical reports, however, have documented 10% to 20% prevalence of benign anastomotic stricture formation after the use of EEA stapler to construct an esophagogastric anastomosis. We analyzed the cases of anastomotic strictures to reduce the incidence of anastomotic strictures with EEA stapled esophagogastrostomy. MATERIAL AND METHOD: EEA stapled esophagogastrostomy was performed in 195 parients during the period of over 11 years from Jan. 1986 to Dec. 1996 in Kosin Medical Center. Ten patients of them died in the early postoperative days. In the remaining 185 patients, we studied the incidence and the onset time of anastomotic strictures, relationship between the patients' ages, the anastomotic sites, and the size of the cartridges with incidence of anastomotic stricture. We also studied the method of treatment and its effect in the anastomotic strictures. RESULT: Benign anastomotic strictures occurred in 39 cases among 185 patients (21%), 25 cases (64.1%) of the 39 cases developed in one to three months postoperatively. The patients' ages and the anastomotic sites did not effect with the incidence of anastomotic stricture, but high incidence of anastomotic stricture in EEA stapled esophagogastrostomy (p=0.04)was observed in small cartridge sizes. One or two balloon dilatation (89%) relieved the anastomotic strictures. CONCLUSION: We conclude that a larger size cartridge is recommended in EEA stapled esophagogastrostomy to reduce the incidence of anastomotic stricture if possible, and one or two balloon dilatation would seem to be a safe and reliable method in treating anastomotic stricture when the anastomotic stricture was occurrs.
Constriction, Pathologic* ; Dilatation ; Humans ; Incidence ; Mortality ; Prevalence

A review of sixteen cases of the modified Bristow operation for recurrent anterior dislocation of the shoulder from Feb. 1987 to Feb. 1989 was presented and the following results were obtained. 1. The age of initial dislocation varied from 12 years to 27 years of age with the average of 17.3 years. 2. The age at operation varied from 21 years to 30 years of age with the average of 23.3 years. 3. The times of dislocation vaaried form 7 to 40 times with the average 23.8 times. 4. The average loss of abduction and external rotation were 5.9 and 12.5 degree respectively. 5. The complications and recurrence were not observed in this period
Dislocations ; Recurrence ; Shoulder

Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.
Angiography ; Femoral Artery* ; Fractures, Bone ; Groin ; Humans ; Leg ; Transplants ; Vascular System Injuries

BACKGROUND: Magnesium sulfate (MgSO4) is a drug of choice for women with preeclampsia, with evidence that it reduces progression to eclampsia and maternal mortality. However, no previous studies have been conducted on the effect of magnesium sulfate on labor. This retrospective study investigated the effect of magnesium sulfate on the labor duration and the neonatal outcomes in parturients with preeclampsia. METHODS: We reviewed the medical records of 209 women who delivered vaginally with the diagnosis of preeclampsia from January 1, 2003 to June 30, 2013. They were divided into two groups, primipara (Primi group) and multipara (Multi group). Then, each group was subclassified as MgSO4-treated (Mg group) and MgSO4-untreated group (Cont group) again. Collected data included the duration of each stage of labor and neonatal outcomes. RESULTS: The duration of the 1st stage of labor was significantly longer in the Multi-Mg group, compared with the Multi-Cont group (138 +/- 149 min vs. 88 +/- 92 min, P = 0.025). However, the total labor durations were comparable between the two groups. Primi group had no difference in durations of any stage of labor and the total duration. Neonates showed worse outcomes (lower birth weight, lower Apgar, higher NICU admission rate) in the Primi-Mg group than the Primi-Cont group. CONCLUSIONS: Although preeclamptic multiparous parturients treated with MgSO4 showed longer 1st stage of labor than those untreated with MgSO4, the total labor durations were comparable between the groups.
Diagnosis ; Eclampsia ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Magnesium Sulfate* ; Maternal Mortality ; Medical Records ; Pre-Eclampsia* ; Pregnancy ; Retrospective Studies

OBJECTIVE: Recent advances in stem cell biology make it possible to induce the regeneration of injured axons and to replace lost cells in the injured spinal cord. It has been found that stem cells in human cord blood differentiate into mature neurons and glial cells both in vitro and in vivo. These findings suggest that human umbilical cord blood cells(HUCBs) can be used as therapeutic donor cells in cases of spinal cord injury. METHODS: To attempt the repair an injured cord following spinal cord injury(SCI), we transplanted HUCBs into contused spinal cords. This was found to promote a long-term improvement in neurologic function relative to a lesion-control group. HUCBs were cultured in vitro for 7 days. Bromodeoxyuridine(BrdU) was added to the media to allow the BrdU to integrate into dividing cells. Cultured HUCBs(2x106 cells) were then injected into the injury epicenter 7 days after SCI. The Basso-Beattie-Bresnahan(BBB) locomotor rating system was used to score functional improvement in HUCBs transplanted rats. Immunohistochemical staining for neurofilament, macrotubule associated protein 2(MAP-2), glial fibrillary acidic protein(GFAP), and nestin was performed. RESULTS: Immunohistochemical analysis 5 weeks after SCI showed that gliogenesis of the transplanted donor HUCBs had occurred within the adult rat spinal cord. These donor-derived astrocyte-like cells extended their processes into the host tissues and integrated well. HUCBs derived neurons(neurofilament, MAP-2) and nestin expressing cells were also detected. Behavior analysis using BBB rating scores showed that functional improvement was greater in transplanted rats than in non-treated rats. CONCLUSION: HUCBs are one of the potential sources for transplantation material for the treatment of SCI.
Adult ; Animals ; Axons ; Biology ; Bromodeoxyuridine ; Fetal Blood* ; Humans* ; Nestin ; Neuroglia ; Neurons ; Rats* ; Regeneration ; Spinal Cord Injuries* ; Spinal Cord* ; Stem Cells ; Tissue Donors ; Transplantation ; Umbilical Cord*

Blow-out fracture is frequently encountered in facial bone trauma. And the frequency of medial orbital wall fracture in Asia is high. Various approaches have been reported for medial orbital wall fractures. The field of medial orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital wall, susceptibility of injury of orbital structures. Recently, endoscopic reduction of orbital wall was provided good fuctional and cosmetic results. In order to address this shortcoming we have explored the use of endoscopic external short scar approach in medial orbital wall dissection to allow direct visualization of orbital content and nearly whole fracture components. In this study a direct local approach through a 2cm, modified Z-shaped incision on superior medial orbital area was used as a consistent method to reconstruct medial blow-out fractures. The incision line consist 3 limbs. The angle of the limbs is to 110 degrees. First, 1cm sized line exsists frontonasal line. Second, 5mm sized 2 limbs of the incision line were placed parallel or oblique to the relaxed skin tension line. During the follow-up period of 6 to 12 months, excellent functional and cosmetic results were observed with an inconspicuous scar. Therefore, a direct external short scar incision approach with endoscope on the superior medial orbit may be a consistent method to gain the surgical goal in treatment of blow-out fractures of the medial orbital wall.
Asia ; Cicatrix* ; Endoscopes ; Extremities ; Facial Bones ; Follow-Up Studies ; Orbit* ; Orbital Fractures* ; Skin

Osteomas in the head and neck regions are benign bone neplasms usually found in the frontoethmoid area. Osteomas are usually produce symptoms secondary to pressure on adjacent structures. Although commonly discovered in the external auditory canal of the temporal bone, few cases have been reported in the mastoid or squamous portion of the temporal bone. When located in the mastoid and squamous parts of the temporal bone osteomas can cause cosmetic deformity such as external mass or an auricular protrusion. Other neoplasms of the mastoid region such as osteosarcoma and osteoblastic metastasis should be considered for the differential diagnosis. The authors experienced a case of osteoma that originated from mastoid of temporal bone. We report this rare case and its successful management with a review of the literatures.
Congenital Abnormalities ; Diagnosis, Differential ; Ear Canal ; Head ; Mastoid* ; Neck ; Neoplasm Metastasis ; Osteoblasts ; Osteoma* ; Osteosarcoma ; Temporal Bone

PURPOSE: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise (99m)Tc-MIRI myocardial perfusion single photon emission computed tomography (SPECT) an(l to analyze results with regard to those of exercise. electrocardiography or coronary angiography. MATERIALS AND METHODS: We evaluated 30) patients (mean age S2+/-10 years, 166 males and 135 females) with normal exercise (99m)Tc-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subjects were evaluated for cardiac events and followed for 8-55 months (mean 19+/-10 months) after imaging. RESULTS: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0,21%: per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n-235) exercise electrocardiography (p:NS), There was no cardiac event in ]7 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). CONCLUSION: Patients with normal exercise (99m)Tc-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.
Coronary Angiography* ; Coronary Artery Disease ; Death ; Electrocardiography* ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction ; Perfusion Imaging ; Perfusion* ; Phenobarbital ; Prognosis ; Tomography, Emission-Computed, Single-Photon*

A hypoplastic empty scrotum is a critical factor in the success of implantation of artificial testis. A hypoplastic scrotum increases the postoperative complication, such as wound dehiscence and prosthesis extrusion. Any technique cannot overcome this problem satisfactorily. Furthermore previous operative scars and inflammatory disease as epididymo-orchitis have often added to the difficulties. Enlarging the scrotum by gradual distention of a tissue expander implanted in the contracted scrotum has been successful in overcoming this problem. We report a case of successful artificial testes implantation after gradually enlarging scrotum by tissue expander in a 6 year old boy, who was diagnosed anorchidism with scrotal hypoplasia.
Child ; Cicatrix ; Humans ; Male ; Postoperative Complications ; Prostheses and Implants ; Scrotum ; Testis* ; Tissue Expansion Devices* ; Wounds and Injuries

We report a case of celiac artery dissection after abdominal blunt trauma. A 29-year-old man visited the emergency room for acute left periumbilical pain after abdominal blunt trauma from his child. Computed tomography showed a wedge-shaped splenic infarction with splenic artery thrombus. He was hospitalized for careful observation, and after two days, follow-up computed tomographic angiography showed a progressed celiac artery dissection that involved common hepatic artery and an increased extent of splenic infarction. He underwent conventional angiography, and a self-expandable stent was placed between the celiac axis and the common hepatic artery. After two days, follow-up computed tomographic angiography showed good hepatic arterial blood flow via the stent and no progression of splenic infarction. After ten days, he was discharged without complications.
Adult ; Angiography ; Axis, Cervical Vertebra ; Celiac Artery* ; Child ; Emergency Service, Hospital ; Follow-Up Studies ; Hepatic Artery ; Humans ; Splenic Artery ; Splenic Infarction ; Stents ; Thrombosis