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

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*

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

BACKGROUND: Nucleoside transport inhibitor(NTI) Keeps AMP, ADP, ATP levels high in myocytes by inhibiting adenosine cataboilsm so that it may preserve the myocardial contractability during ischemia In this study we investigated the effects of cyclic AMP phosphodiesterase inhibor(C-AMP PDSI) and S-P-nitrobenzyl-6 -thioniosine(NBT; a sort of NIT) on myocadial preservation and changes of constituent enzyme. MATERIAL AND METHOD: Twenty-six isolated rabbit hearts were perfused with Krebs-Henseleit buffer solution for 20 minutes arrested for 20 minutes and ten reperfused for 30 minutes. The following four groups were prepared and hemodynamic changes coronary effluent lactate dehydrogenase (LDH) a-hydroxybutylic accid(a-HBD) levels and myocardial LDH creatine kinase-MB (CK-MB) adenosine deaminase(ADA) a-HBD levels and myocardial LDH creatine kinase-MB (CK-MB) adenosine deaminase(ADA) a-HBD levels were analysed before and after cardiac arest ; Group I(control) ; the heart was only perfused with K-H ; Group II ; the heart was perfused with K-H including C-AMP PDSI(Amrinone 25mg/L); Group III ; the heart was perfused with K-H including NBT(4.19mg/L) ; Group IV ; the heart was perfused with K-H including C-AMP PDSI + NBT. RESULT: Left venticular developed pressure(LVDP) at 10 minutes of the equilibrium was significantly higher in group III(72.1+/-5.3 mmHg p<0.01) and group III(72+/-5.6 mmHg P<0.025) as compared with group I (40.8+/-4.7mmHg) and LVDP at 20 minutes of the reperfusion was significantly higher in group II(74+/-5.3mmHg P<0.01) and group III(72+/-5.6mmHg p<0.025) as compared with group I (44.2+/-4.6mmHg). Percentage recovery of LVDP at the reperfusion was the highest in group II(123.3%) Percentage recovery of coronary flow at the equilibrium reperfusion were higher in group II(310%, 270%) group III(230%, 290%) group IV(310%, 280%) as compared with group I (100%) respectively. Myocadial LDH level was significant lower in group IV(33495+/-1802 IU/gm p<0.04) as compared with group I(48767+/-1421 IU/gm) Myocadial CK-MB level was significant higher in group II(74820+/-1421 IU/gm) compared with group I 45450+/-1737 IU/gm) Myocadial ADA level was significant higher group IV(1215+/-8 IU/gm p<0.05) compared with group I(125+/-15 IU/gm) but there was no significant difference between group I and group II ,III, IV in changes of coronary effluent LDH, a-HBD levels. CONCLUSIONS: C-AMP PDSI solely appears to have a better effect on myocardial preservation after ischemia than NBT but with no synergistic effect and it could keep CK-MB leve high in myocardial tissues.
Adenosine ; Adenosine Diphosphate ; Adenosine Triphosphate ; Creatine ; Cyclic AMP ; Heart ; Hemodynamics ; Ischemia ; L-Lactate Dehydrogenase ; Muscle Cells ; Myocardial Ischemia ; Myocardium* ; Reperfusion

PURPOSE: Computed tomography theoretically should improve detection of foreign bodies and provide more information of adjacent soft tissues. And the CT scanner and PACS program proved to be an excellent instrument for detection and localization of most facial foreign bodies above certain minimum levels of detectability. The severity of injury in penetrating trauma to the face, it is often underestimated by physical examination. Diagnosis of a retained foreign object is always critical. METHODS: From March, 2005 to February 2008 a study was done with 200 patients who had facial trauma. Axial and coronal CT images were obtained with a General Electric(Milwaukee, Wis) 9800 CT scanner at 130kV, 90mA, with a 2-mm section thickness and a 512x512 matrix. RESULTS: Axial and coronal CT images at various window widths should be used as the first imaging modality to detect facial foreign bodies. The attenuation coefficients for the metallic and nonmetallic foreign bodies ranged from -437 to +3071 HU. As a general rule, metallic foreign bodies produced more Hounsfield artifacts than nonmetallic foreign bodies, thus providing a clue to their composition. All of the metallic foreign bodies were represented by a single peak and had a maximum attenuation coefficient of +3071 HU. Of the nonmetallic foreign bodies, glass had an attenuation coefficient that ranged from +105 to +2039, while plastic had a much lower coefficient that ranged from -62 to -35. wood had the lowest range of attenuation coefficients: -491 to -437. CONCLUSION: The PACS program allows one to distinguish metallic from nonmetallic foreign bodies and to individually identify the specific composition of many nonmetallic foreign bodies. This program does not, however, allow identification of the specific composition of a metallic foreign body. We recommend this type of software program for CT scanning of any patient with an injury to the face in which a foreign body is suspected.
Artifacts ; Foreign Bodies ; Glass ; Humans ; Physical Examination ; Plastics ; Wood

OBJECTIVE: We applied chest radiographs to scoliosis screening for conscription. Prevalence, types of scoliosis, and insight of examinees with scoliosis were investigated. METHODS: In this study, chest radiographs of 2417 males, who had been given an examination for conscription at the Seoul Regional Military Manpower Administration from April 2009 to May 2009, were analyzed. The prevalence of scoliosis more than a 10 degrees Cobb angle was calculated. The insight of scoliosis was investigated in every examinee and thoracolumbar radiographs were checked in those examinees with more than a 20 degree Cobb angle. RESULTS: Among 1904 males, 477 (19.7%) exhibited scoliosis involving more than a 5 degrees Cobb angle were and 131 (5.4%) exhibitedmore than a 10 degree Cobb angle. In those 131 cases, 18 (13.7%) had a known history of problems with scoliosis. Among the group measuring less than a 10 degree Cobb angle, 1.7% of them misunderstood scoliosis. Insight of scoliosis increased according to the severity of spinal curvature; however, nearly half of the cases with a 20 degree or greater Cobb angle had no insight with respect to their scoliosis. CONCLUSION: In male adolescents, the prevalence of scoliosis with a greater than 10 degree Cobb angle was 5.4% and there was a low insight with respect to scoliosis.
Adolescent ; Benzeneacetamides ; Humans ; Male ; Mass Screening ; Military Personnel ; Piperidones ; Prevalence ; Scoliosis ; Thorax

OBJECTIVE: The transplantation of bone marrow cells into the injured spinal cord improves neurologic functions in experimental animals. However, it is unclear whether bone marrow cells can similarly improve the neurologic functions of complete spinal cord injury patients. To study their therapeutic effects in human spinal cord injury (SCI), we transplante autologous bone marrow cells into the SCI sites and administer granulocyte macrophage-colony stimulating factor (GM-CSF) in three complete SCI patients. METHODS: Bone marrow cell transplantation with GM-CSF administration was performed on two patients (patients1 and 2), wherein concentrated bone marrow cell pastes were injected into the injury area using a sterile 21 gauge fine needle. The total volume of bone marrow cells injected was 1.8ml (cell concentration 1.1X106/ul). Patient 3 was administered GM-CSF only. The follow up periods were 5 months (patient 1), 4 months (patient 2) and 6 months (patient 3). RESULTS: Sensory improvements were followed immediately after the operations. Sensory recovery in the sacral segment was noticed at 3 weeks (patient 1), 13 days (patient 2) and at 2 months (patient 3) postoperatively. Significant motor improvements were noticed at 3 months in patients 1 and 2, and at 4 months in patient 3. All three patients showed neurologic improvements at the last follow up 5, 4 and 6months respectively (Frankel grade C, AIS grade C). CONCLUSION: Treatment of SCI patients with autologous bone marrow cell transplantation and GM-CSF administration shows some beneficial effects during the early postoperative periods. However, long-term and more comprehensive clinical studies are required.
Animals ; Bone Marrow Cells* ; Bone Marrow Transplantation* ; Bone Marrow* ; Follow-Up Studies ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Humans ; Needles ; Ointments ; Postoperative Period ; Spinal Cord Injuries* ; Spinal Cord* ; Stem Cells ; Transplantation

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