No abstract available.
Hemorrhage*

No abstract available.
Lupus Erythematosus, Systemic*

Hepatolithiasis is said to exist when stones are present in the right or the left hepatic ducts or their tributaries. Although it is a pathophysiologically benign disease, it causes frequently serious problems-recurrent cholangitis, liver abscess, obstructive jaundice, liver cirrhosis, and sepsis - and has challenged surgeons. Until recently, its fundamental pathogenetic mechanisms have not been elucidated, but bile duct stenosis, bile stasis, and secondary infection are considered as important pathogenetic factors. Therefore, the ultimate goal of the treatment is directed to the correction of these factors. We were retrospectively reviewed 119 cases of patients with hepatolithiasis treated by various surgical methods from Jul. 1989 to Dec. 1996 at the Department of Surgery of Maryknoll Hospital, Pusan. There were 72 women and 47 men, and the mean age was 45.5 years. Thirty-nine patients (32.8%) had previous histories of operations related to biliary stone diseases - cholecystectomy (n=13), T-tube choledocholithotomy (n=21), choledochoduodenostomy (n=9), Roux-en-Y choledochojejunostomy (n=6), and transduodenal sphincteroplasty (n=1). Operative procedures were 24 (20.2%) lithotomy, 60 (50.4%) drainages, and 35 (29.4%) hepatectomies and determined by the location of the stones, the general condition of the patient, and the anatomical change (stenosis or cystic dilatation) in intrahepatic duct. Postoperative complications occurred in 33 (27.7%) patients : wound infection (n=23), atelectasis (n=5), intra-abdominal bile collection (n=3), choledochocutaneous fistula (n=2), hemobilia (n=1), and adhesive ileus (n=1). Residual stones were detected in 39 (32.7%) patients by T-tube cholangiography, ultrasonography, computed tomography. The instances of residual stones was the lowest (17.1%) for hepatectomy compared to 45.8% for a lithotomy and 39.3% for a drainage. The follow-up study showed symptom improvement in 91.5% of the patients with a hepatectomy compared to 58.3% for a lithotomy and 71.7% for a drainage which was statistically significant(P<0.05). Since incomplete stone removal in hepatolithiasis and presence of stenosis in intrahepatic duct frequently require a repeat operation or other invasive management, the authors conclude that a hepatectomy, as an initial treatment for hepatolithiasis, is a safe, satisfactory treatment where possible.
Adhesives ; Bile ; Bile Ducts ; Busan ; Cholangiography ; Cholangitis ; Cholecystectomy ; Choledochostomy ; Coinfection ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Follow-Up Studies ; Hemobilia ; Hepatectomy ; Hepatic Duct, Common ; Humans ; Ileus ; Jaundice, Obstructive ; Liver Abscess ; Liver Cirrhosis ; Male ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Sepsis ; Sphincterotomy, Transhepatic ; Surgical Procedures, Operative ; Ultrasonography ; Wound Infection

A case of contact dermatitis due to herb onintment is described in a 24 year-old female patient. After topical application of herb ointment, she developed erythematous papules and plaques on the face and neck. Patch test revealed positive reactions to ammoniated mercury, thimerosal, and the herb ointment. Energy-dispersive X-ray microanalysis of the herb ointment showed a striking peak for mercury.
Dermatitis, Contact* ; Electron Probe Microanalysis ; Female ; Humans ; Neck ; Patch Tests ; Strikes, Employee ; Thimerosal ; Young Adult

OBJECTIVE: The goal of this article is to analyze the clinical characteristics of intramural pregnancy through the review of currently available 36 case reports. METHODS: A comprehensive computer literature search was performed in MEDLINE and EMBASE database from 1966 to 2003. And domestic literature search was preformed in KSOG database. After data collection, we reviewed and analyzed meaningful clinical variables of each case report. RESULTS: 36 articles were included. The age at diagnosis ranged from 20 to 41 years old, and the mean age was 31.2 years (S.D.:5.6). The gestational period at diagnosis ranged from 6th to 30th weeks, more than half of the cases occurred from 6th to 10th week (58.3%). Significant risk factors were history of dilatation and curettage (47.2%) and history of cesarean section (25.0%). Common clinical symptoms and signs were vague abdominal pain (58.3%) and vaginal bleeding (54.2%) in unruptured case, and sudden onset of severe abdominal pain (100%) and muscle guarding (75.0%) in ruptured case. The preoperative diagnostic accuracy was 0% before introduction of ultrasonography into the clinical practice, 48.2% after ultrasonography was available. Of 36 patients, 27 patients (75.0%) were treated with laparotomy, and 5 patients (13.8%) were treated with methotrexate. Survival outcome of fetus was very poor. Only in 1 case, the pregnancy persisted beyond the 30th week, and the fetus survived after cesarean hysterectomy. CONCLUSION: With the advanced diagnostic tools and close monitoring of patients, we can improve the diagnostic accuracy and clinical outcome of intramural pregnancy.
Abdominal Pain ; Adult ; Cesarean Section ; Data Collection ; Diagnosis ; Dilatation and Curettage ; Female ; Fetus ; Humans ; Hysterectomy ; Laparotomy ; Methotrexate ; Pregnancy* ; Risk Factors ; Ultrasonography ; Uterine Hemorrhage

Implant-supported overdenture is known as a useful appliance, instead of using the conventional complete denture, for better retention and stability. In this study 4 types of materials such as, gold bar/plastic clip(group AuP), gold bar/metal clip(group AuM), palladium bar/plastic clip(group PdP), and palladium bar/metal clip(group PdM) were used to evaluate the retention forces according to the type of clips and alloys used for bar fabrication, in the Hader bar system. Repeated insertions and removals of overdenture were conducted in each group, and the retention forces were measured and compared the data of each group according to the number of insertion and removal. The obtained results were as follows, 1. In the comparison of retention forces according to type of bar-clip, retention was increased in the order of group AuM, PdM, PdP, AuP, and the retention force of group AuM was significantly increased compared with those of others(p<0.05). 2. In the comparison of retention forces according to the number of insertion, only group PdP showed significant decrease in retention(p<0.05). 3. In the comparison of retention forces according to the type of bar and clip, there was no significant difference in the type of bar, but the retention of plastic clip was significantly higher than that of metal clip when Au bar was used(p<0.05). 4. In the observation of the bar surface, group AuM using Au bar and metal clip showed the most scratches among bar groups.
Alloys ; Denture, Complete ; Denture, Overlay* ; Palladium ; Plastics

For the improvement of denture fitness of changed residual ridge, denture liner can be used. Denture liner should be very stable physically in various environments of the mouth as well as be bonded strongly with denture resin. In this study, the specimens bonded with four kinds of soft denture liner and three kinds of hard denture liner were used to test the physical properties of the liners. All experimental groups were stored in 37+/-1degrees C distilled water for 24hours, followed by thermocycling between 15degrees C and 45degrees C with 15 second dwell time. 1000, 2000, 3000 cycles of thermocycling were excuted and physical properties were measured by Instron Universal Testing Machine. The obtained results were as follows: 1. In tensile bond test of soft liners, it was shown that both of Molloplast-B(R) specimens before and after thermocycling had the highest tensile strength, and in case of hard liners, Dura-liner II(R)speimen had the highest tensile strength before and after thermocycling. Depending on thermocycling, Soft-Relining(R), Denture-Relining(R),Molloplast-B(R), Coe-soft(R) and Kooliner(R) specimen showed significant difference(p<0.05). 2. In strain test of soft liners, it was shown that Molloplast-B(R) specimen before thermocycling and the Coe-soft(R) after thermocycling showed highest results, and in case of hard liners, the Dura-Liner II(R) speimen before and after thermocycling had the highest result. Depending on thermocycling. Denture-Relinig(R). Molloplast-B(R) and Dura-Lner II(R) specimen showed significant difference(p<0.05). 3. In Maximum distance test of soft liners, the Molloplast-B(R) specimen before thermocycling and the Coe-soft(R) after thermocycling showed highest results, and in case of hard liners, the Dura-Liner II(R) specimen before and after thermocycling showed highest results. Depending on thermocycling, Denture-Relining(R), Molloplast-B(R) specimens showed significant difference(p<0.05). 4.In elasticity test of soft liners , the Molloplast-B(R) specimen before and after thermocycling showed highest results, and in case of hard liners, the Dura-Liner II(R) specimen before thermocycling and the Tokuso-Rebase (R) after thermocycling showed highest results. Depending on thermocycling, Soft-Relining(R) , Molloplast-B(R) specimens showed significant difference(p<0.05).
Denture Liners* ; Dentures* ; Elasticity ; Mouth ; Tensile Strength ; Water

No abstract available.
Child* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Infant* ; Poisoning*

BACKGROUND: To date, a laparoscopic gastrectomy has been performed by a small number of surgeons around the world, but the laparoscopic approach has been extended to Billroth I and a total gastrectomy. To evaluate the validity of the procedure, we present the results of six patients who underwent a gastrectomy using a laparoscopic technique. METHODS: First, two patients had a totally intra-abdominal laparoscopic B-II gastrectomy, and one of two also had a bilateral truncal vagotomy. The rest had a laparoscopic-assisted gastrectomy. One patient had concurrently an open reduction and an internal fixation with a K-wire for a patellar fracture. Indications were (a) gastric outlet obstruction due to peptic ulcer disease in five patients and (b) duodenal ulcer bleeding in one patient. RESULTS: Except for one patient who had stump leakage, which was solved by conservative therapy, there were no complications or operative mortality. The operating time and the cost were less for the patients who had their operations later in the series and who had laparoscopic-assisted operation. CONCLUSIONS: These forms of laparoscopic gastric surgery for patients with complications of peptic ulcer disease may be useful from the standpoint of minimal access, rapid recovery, less pain, and good cosmesis.
Duodenal Ulcer ; Gastrectomy* ; Gastric Outlet Obstruction ; Gastroenterostomy ; Hemorrhage ; Humans ; Mortality ; Peptic Ulcer ; Stomach Diseases* ; Vagotomy, Truncal

PURPOSE: Infrared thermography is a diagnostic procedure that can objectively visualizes the status of muscle, in musculoskeletal disease, as myofascial pain syndrome. Thus, we evaluated the clinical significance of infrared thermography in patients with chronic pelvic pain. MATERIALS AND METHODS: Forty-five patients with chronic pelvic pain were enrolled in this study as patient group, with thirty-three normal persons as the control group. The patients with a urinary tract infection and an organic disease were excluded. Before the thermography was checked, we made all patients mark the subject pain site, and inform of the pain severity, on the visual analogue scale (VAS) sheet. We analyzed hot spots on the thermographic images, pain sites and VAS sheets, and the thermographic changes, before and after a 2% lidocaine injection at the tender point, on the physical examination. RESULTS: The sensitivity, specificity and the false positive and negative of infrared thermography were 79.5 (M:F=76.5:81.8), 64.1 (M:F=66.7:61.9), 24.2 (M:F=25.0:23.5) and 32.6% (M:F=31.6:30.8), respectively. However there was no clinical significance between the pain severity and the temperature difference of the thermography. The concordance rate of thermographic and symptomatic changes, after the 2% lidocaine injection at the tender point, was 78.9%. CONCLUSIONS: Infrared thermography can objectively demonstrate the subjective pain, and is a useful method in follow-up, after treatment for chronic pelvic pain with a tender point.
Follow-Up Studies ; Humans ; Lidocaine ; Musculoskeletal Diseases ; Myofascial Pain Syndromes ; Pelvic Pain* ; Physical Examination ; Sensitivity and Specificity ; Thermography* ; Urinary Tract Infections