From January 1993 to December 1995, 47 patients with rectal carcinomas underwent a rectal anastomosis using the double stapling technique at the Surgical Department of Kwang-ju Christian Hospital. The major advantages of the double stapling technique for lower rectal cancer over the single stapling technique or a hand-sewn operation are as follows:1) Insertion of a purse-string suture is eliminated, and application of a linear stapler to close the distal rectum may be performed with greater ease. 2) In addition, fecal contamination and spillage of tumor cells from the rectal segment are minimized. 3) Differences in the sizes of the colons and rectums are not a concern in constructing the anastomosis. 4) The operating time is shorter. The following results were obtained by a comparison with 24 patients with rectal carcinoma who had undergone a rectal anastomosis using the double stapling technique from January 1989 to December 1992 which was reported in a previous study:1) Anastomotic stenosis was decreased from 8.3% to 4.2% because of reduced ischemia due to the double row of staples and the reduced injury due to compression of tissue between the anvil and the cartridge with experience. In addition, it resulted from reduced tension of the anastomosis due to sufficients mobilization of the proximal colon and from selection of large cartridge (33 mm). 2) Anastomotic leakage, even though the same location as the tumor and in the advanced age group, was decreased from 4.2% to 0% because the blood circulation was maintained and unnecessary tension was reduced with experience. In addition, it resulted from reinforced suture of the anastomotic site which was performed after anastomosis. 3) Systemic recurrence was the same result as that of the previous study(4.2/4.3%). 4) Local recurrence, even though at the same distal distance from the margin of the cancer, was increased from 0% to 2.1% because of advancing the pathologic stage (B2, C1>B1, B2) and increasing the poorly differentiated pathologic type.
Anastomotic Leak ; Blood Circulation ; Colon ; Constriction, Pathologic ; Gwangju ; Humans ; Ischemia ; Postoperative Complications ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sutures

From January 1993 to December 1995, 47 patients with rectal carcinomas underwent a rectal anastomosis using the double stapling technique at the Surgical Department of Kwang-ju Christian Hospital. The major advantages of the double stapling technique for lower rectal cancer over the single stapling technique or a hand-sewn operation are as follows:1) Insertion of a purse-string suture is eliminated, and application of a linear stapler to close the distal rectum may be performed with greater ease. 2) In addition, fecal contamination and spillage of tumor cells from the rectal segment are minimized. 3) Differences in the sizes of the colons and rectums are not a concern in constructing the anastomosis. 4) The operating time is shorter. The following results were obtained by a comparison with 24 patients with rectal carcinoma who had undergone a rectal anastomosis using the double stapling technique from January 1989 to December 1992 which was reported in a previous study:1) Anastomotic stenosis was decreased from 8.3% to 4.2% because of reduced ischemia due to the double row of staples and the reduced injury due to compression of tissue between the anvil and the cartridge with experience. In addition, it resulted from reduced tension of the anastomosis due to sufficients mobilization of the proximal colon and from selection of large cartridge (33 mm). 2) Anastomotic leakage, even though the same location as the tumor and in the advanced age group, was decreased from 4.2% to 0% because the blood circulation was maintained and unnecessary tension was reduced with experience. In addition, it resulted from reinforced suture of the anastomotic site which was performed after anastomosis. 3) Systemic recurrence was the same result as that of the previous study(4.2/4.3%). 4) Local recurrence, even though at the same distal distance from the margin of the cancer, was increased from 0% to 2.1% because of advancing the pathologic stage (B2, C1>B1, B2) and increasing the poorly differentiated pathologic type.
Anastomotic Leak ; Blood Circulation ; Colon ; Constriction, Pathologic ; Gwangju ; Humans ; Ischemia ; Postoperative Complications ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sutures

BACKGROUND: In the Republic of Korea, there had been no reports about indigenous malaria cases since 1984 until a vivax malaria case was detected in 1993. Thereafter fram 1993 to 1996, 486 malaria cases were reported. Most of the patients were soldiers in the northern militarized zone. However, since 1997, several patients with malaria were detected in Kang Hwa where there had previously been no report of malaria cases. It is our intent to report the 16 cases diagrnosed in Kang Hwa Community Hospital from January 1, 1997 to August 10, 1998. METHODS: Medical records of the malaria cases from January 1, 1997, to August 10, 1998 in Kang Hwa Community Haspital were reviewed. All of the patients had no histories of traveling abroad, drug abuse or blood transfusion. They were all civilians. Laboratory studies including blood cell count, routine chemistry and platelet-associated IgG(PAIgG) and abdominal sanography were taken. RESULTS: All of the patients were diagnosed with malaria by blood smears. Common symptams were fever(100%), headache(94%), rigors(81%), myaJgia(56%), nausea or vomiting(44%), alternate day fever (25%), left flank pain(19%), diarrhea(13%), and abdominal pain(13%). Splenomegaly was detected in 92% of cases by sonography. Laboratory findings included leukopenia(37.5%), anemia(37.5%) and thrombocytopenia(81.3%). Platelet-associated IgG was elevated in 1 of 5 thrombocytopenic patients who had had the laboratory study performed. All recovered withaut complications. CONCLUSIONS: Cases of indigenous malaria have been progressively increasing in the Republic of Korea. Fortunately, patients responded well to treatment, but continued interest will be required in the future.
Blood Cell Count ; Blood Transfusion ; Chemistry ; Fever ; Hospitals, Community ; Humans ; Immunoglobulin G ; Malaria ; Malaria, Vivax ; Medical Records ; Military Personnel ; Nausea ; Republic of Korea ; Splenomegaly ; Substance-Related Disorders ; Thrombocytopenia

A 72-year-old female with 10% TBSA flame, mostly partial thickness, was treated topically with 10% mafenide acetate cream and 1% silver sulfadiazine cream. On day 28, burn wound was nearly healed but black colored, 3~5 mm sized maculopapular lesions developed in healed facial burn wound. Similar skin lesion progressed in both hand and both wrist. All skin lesions were peeled off. On day 30, biopsy was performed. An excisional biopsy of the lesion in the left cheek revealed benign papilloma. On day 44, we excised all skin lesions and performed STSG. All graft sites were healed 14th day after STSG.
Aged ; Biopsy ; Burns ; Cheek ; Female ; Hand ; Humans ; Mafenide ; Papilloma ; Silver Sulfadiazine ; Skin ; Transplants ; Wrist

PURPOSE: We report seven cases of pancreas transplantation, first performed in Korea, in the context of postsurgical radiologic studies. MATERIALS AND METHODS: All patients with insulin-dependent diabetes mellitus received transplants from cadevaric(n=6) or living related donor(n=1). Retrospective analysis of 27 US(including 19 Duplex US), two CT, four MRi, and three scintigraphy for these patients was made with surgico-pathological correlation in five cases. RESULT:Of the seven patients, three-month graft survival was five and one-year survival was two. One patient died of abdominal abscess following surgery. US gave the valuable informations regarding the graff swelling, vascular complication, and perigraff fluid collection. RBC bleeding scan was effective of the presence or absence and location of intestinal bleeding. CT was useful in determining the extent and severity of the pancreatitis. MRI gave a little information about functional status of the grafted pancreas. CONCLUSION: The choice of appropriate imaging modalities for postsurgical work up in patients who had pacreas transplantation depends on the clinical conditions of the patients and complications suspected. Further prospective studies appear to be necessary to eatablish the interval and modality choice for early detection of the complication.
Abdominal Abscess ; Diabetes Mellitus, Type 1 ; Graft Survival ; Hemorrhage ; Humans ; Korea ; Magnetic Resonance Imaging ; Pancreas Transplantation* ; Pancreas* ; Pancreatitis ; Radionuclide Imaging ; Retrospective Studies ; Transplants

Background: Radiographic modalities have been commonly used to evaluate pectus carinatum (PC), and compressive orthotic bracing is the most widely accepted treatment method. The aim of this study was to determine the efficacy of 3-dimensional (3D) body surface scanning as an alternative modality for the evaluation of PC. Methods: The medical records of 63 patients with PC who were treated with compressive orthotic bracing therapy between July 2017 and February 2019 were retrospectively analyzed. Using both 2-view chest radiography (posteroanterior and lateral view) and 3D body scanning, the height of maximal protrusion of the chest wall was measured both before and after 2 weeks of bracing therapy. The difference between the pre- and post-treatment measurements was calculated for both modalities, and these differences were compared and analyzed. Results: Based on the comparison between the pre- and post-treatment radiographs, bracing therapy produced favorable outcomes in all patients (p<0.001). The measurements obtained via 3D scanning were strongly correlated with those obtained via chest radiography (r=0.60). Conclusion Based on the findings of this study, 3D body surface scanning appears to be an effective, radiation-free, and simple method for the post-treatment follow-up evaluation of PC, and thus can be considered an alternative to radiography.

PURPOSE: Comparing with suture and staple, skin graft fixation with Histoacryl (N-butyl-cyanoacrylate, B.Braun, Germany) has two advantages. Fixation is simple, painless and removal process is unnecessary. There are few reports that compare histoacryl with conventional methods for skin graft fixation in FTSG. However, there are no comparative studies in STSG. The purpose of this study is to show our experience of skin graft fixation with histoacryl in STSG of burn patients. METHODS: This study included those who was burned less than 10% of TBSA and needed STSG. The patients who had underlying disease (DM, hypertension, liver disease, lung disease) were excluded. 29 patients who visited Bestian burn center from January to July 2009 was enrolled in the study. In STSG, skin graft was fixed with histoacryl and authors marked the fixed points with pen. Fixation rate was checked in 7 days after STSG and take rate was checked in 14 days after STSG. RESULTS: The patient group consisted of 7 males and 22 females. The mean extent of burn area was 2.3%. The type of injury consisted of 18 contact, 8 scald, 1 flame, 2 friction. 31 STSG of 29 patients was done. STSG was done at 24th day after burn, the mean area of wound for STSG was 51 cm2. Mean numbers of fixation point with histoacryl per patients were 14.1. 430 of 436 fixation were stable and fixation rate was 98.6%. There was no infection case. Take rate was 99.1% in 14 days after STSG and it took 21 days for wound opening. CONCLUSION: Until now, suture and staple are common methods in skin graft fixation. However, it is disadvantageous that suture and staples should be removed. Histoacryl does not need those process. This study showed that take rate was 99.1% and fixation rate was 98.6% in fixation with histoacryl. In STSG, Skin graft fixation with histoacryl could be alternative methods for suture and staple.
Burn Units ; Burns ; Enbucrilate ; Female ; Friction ; Humans ; Hypertension ; Liver Diseases ; Lung ; Male ; Skin ; Sutures ; Tissue Adhesives ; Transplants

This study was conducted to evaluate the blood lead levels in 141 pregnant women who were not occupationally exposed to lead and their umbilical cord, arid to identify some differences in blood lead levels by living area. ; The subjects-were all delivered at St. Benedict Hospital in Pusan and the blood lead levels were measured by graphite furance atomic absorption spectrophotometer. The summarized results were as follows. 1. The geometric mean lead levels in maternal and cord blood were 8.0+/-1.8microgram/dl, 5.0+/-0.6lmicrogram/dl respectively. 2. Lead levels in maternal (8.7+/-1.7microgram/dl) and cord blood(5.4+/-0.7microgram/dl) of industrial area(n=24) were higher than residential area(n= 124) which were 7.9+/-1.7microgram/dl and 5.0+/-0.6microgram/dl respectively (p<0.05). 3. Maternal blood lead concentration was significantly correlated to cord blood lead concentration (r=0.6090, p<0.001), but other variables (maternal age, paternal smoking, birth weight, etc) were not correlated.
Absorption ; Birth Weight ; Busan ; Female ; Fetal Blood* ; Graphite ; Humans ; Occupations ; Paternal Age ; Pregnant Women ; Smoke ; Smoking ; Umbilical Cord*

PURPOSE: The optimal initial treatment for burn wound is generally applying cold running tap water of temperature 12~18degrees C for approximately 20 minutes. But most of the patients are not susceptible to this initial treatment because they are likely to get embarrassed in such situation. According to statistics of our hospital, 92.2% of patients who visited ER (emergency room) had less than 10 minutes of water cooling. In this study, our aim was to find out the clinical effect of biocellulose sheet (Bestian M(R) pack) as an emergent treatment. METHODS: Between November 2010 and October 2011, 93 patients with burn wound showing first or superficial second degree at first inspection were evaluated in our study. Biocellulose sheet (Bestian M(R) pack) was applied at the wound as soon as possible for 25 minutes and second inspection was done. Routine moisture dressing was done thereafter and patients were followed as outpatient. RESULTS: Among 93 patients, 28 were male and 65 were female. Scalding burn, contact burn, flame burn and other causes were 78, 6, 4 and 5 patients respectively. Average complete healing time was 7.99 days and average follow-up time was 5.49. CONCLUSION: Biocellulose sheet has the effect of cooling down the skin temperature up to 6~8degrees C after 10 minutes of its application. Recent studies reported that appropriate cooling in burn wound improves the zone of stasis and zone of erythema histologically eventually reducing the chance of skin graft. Therefore, biocellulose sheet has the effect of improving initial pain, histologic status, healing time and cost in patients with burn wound whose depth is not deep. Furthermore it reduces the risk of scar formation.
Bandages ; Burns ; Cicatrix ; Cold Temperature ; Erythema ; Female ; Follow-Up Studies ; Humans ; Male ; Running ; Skin ; Skin Temperature ; Transplants ; Water

PURPOSE: This investigation was performed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. METHODS AND MATERIALS: The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. RESULTS: The average of yearly radiation exposure of 347 persons was 1.52+/-1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87+/-1.01 mSv/year, mean 1.22+/-0.69 mSv between 31 and 40 year old and mean 0.97+/-0.43 mSv/year over 41year old ( p<0.001). Men received mean 1.67+/-1.54 mSv/year were higher than women who received mean 1.13+/-0.61 mSv/year ( p<0.01). Radiation exposure in the department of nuclear medicine department in spite of low energy sources is higher than other departments that use radiations in hospital ( p<0.05). And the workers who received mean 3.69+/-1.81 mSv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department ( p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74+/-1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17+/-0.35 mSv/year and upper gastrointestinal room of mean 1.74+/-1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology ( p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75+/-1.17 mSv/year and mean 1.60+/-1.39 mSv/year than other people who work in radiation area in hospital ( p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. CONCLUSION: The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.
Adult ; Angiography ; Barium ; Busan ; Delivery of Health Care ; Documentation ; Education ; Enema ; Female ; Fluoroscopy ; Hospitals, University ; Humans ; Jurisprudence ; Korea ; Male ; Nuclear Medicine