No abstract available.
Common Bile Duct*

No abstract available.

No abstract available.
Rectal Neoplasms*

No abstract available.
Rectal Neoplasms*

Although many kinds of operation for rectal prolapse exist, generally they could be divided into the transabdominal and transperineal approach. The former has low recurrence rate as compared with the latter, but needs laparotomy. Unfortunately, many patients with rectal prolapse are old and debilitated. So they are not suitable candidates for a major abdominal operation. For those patient, a transperineal method may be proper, but the recurrence rate may be high and continence is not always achieved. We reviewed 12 patients who were older than 70 years of age and treated by the Thiersch operation among the 52 cases of rectal prolapse from Feb. 1992 to Mar. 1997 at Kwangju Christian Hospital. The results were summarized as follows; 1) The male to female ratio was 1 : 1.4. 2) Durations of rectal prolapse were distributed from 6 months to 30 years. Seven cases had duration of longer than 10 years. 3) The preoperative incidence of incontience was 8 (67%) of 12 cases. Among the 8 patients with incontinence, the male was 3 (37.5%) and female was 5 (62.5%). 4) Postoperative review of incontinence revealed complete disappearance in 4 cases (50%), improvement in 3 cases (37.5%), and no improvement in 1 case (12.5%). 5) After the Thiersch operation, rectal prolapse recurred in only 1 of the 12 cases (8.3%), a wound infection developed in 1 case (8.3%), defecation difficulty due to the small Thiersch ring was present in 3 cases (25%). The results of this study show that the Thiersch operation may be an effective method in treating rectal prolapse, especially in patient who are old or have poor general condition and manifested incontinence.
Defecation ; Female ; Gwangju ; Humans ; Incidence ; Laparotomy ; Male ; Rectal Prolapse* ; Recurrence ; Wound Infection

This study was conducted to find out an appropriate means for preventing the juvenile delinquency (JD), which is supposed to be greatly realted to family environment. The data were collected through a questionnaire survey with a means of writing by themself, to 257 middle and high school students and 309 juvenile delinquents who were in confinement. The questionnaire was consisted of 27 items of juvenile delinquencies, 15 questions about personal environment in their period of childhood, 36 questions on their home atmosphere, 25 items with regard to their parental behavior to their children in the rearing of them. The extent of delinquency was calculated by summing the numbers of experienced delinquencies of the listed items. The study subjects were divided into two groups; student group (SG) and juvenile delinquent group (JDG) and the collected data were analyzed with the extent of delinquency in each group by SPSS/PC+statistical package. The extent of JD was increased as the study subjects grew older, defective families were more common, total family income was more poor, parents' educational level was lower, personal expenses were higher and the conflicts between parents were more high in JDG as compared with of SG. The differences were statistically significant. As long as the extent of delinquency is concerned, delimquent points of JDG were significantly higher as compared with that of SG in all items except one item, below the primary school item in fathers' educational level. (In order to prevent JD in our country, it is recommended that educational level and the living standared of the lower class people should be raised, the sound families which do have less conflictsshould be established as much as possible, the present educational system which is making much conflicts between parents and their offsprings should be changed so that their given temperament would be brought up to the highest level, defective families should be reduced as much as possible and adults should not do actions that are considered not to be done by youngsters and must set a good example.)
Adult ; Atmosphere ; Child ; Humans ; Juvenile Delinquency* ; Parents ; Surveys and Questionnaires ; Temperament ; Writing

No abstract available.
Cerebral Palsy* ; Muscle Spasticity*

No abstract available.
Cerebral Palsy* ; Congenital Abnormalities* ; Forearm* ; Humans ; Muscle Spasticity* ; Pronation* ; Wrist*

Rupture of the lumbar artery is usually associated with trauma but rarely has been reported in association with anticoagulation. We present a 71-year-old man who developed spontaneous rupture of the lumbar artery leading to a retroperitoneal hematoma while receiving continuous renal replacement therapy (CRRT). The bleeding was confirmed by computed tomography and angiography and was controlled successfully using selective angiographic embolization. We suggest that spontaneous retroperitoneal bleeding should be considered in a case of sudden decrease in hemoglobin in a CRRT patient.
Aged ; Angiography ; Arteries* ; Hematoma* ; Hemorrhage* ; Humans ; Renal Insufficiency, Chronic ; Renal Replacement Therapy* ; Rupture ; Rupture, Spontaneous

Most of the peripheral nerve injuries from crushing or compressive forces are accompanied by surrounding soft tissue injuries. As a result, poor vascularity due to fibrosis and sacr formation compromises regeneration of the grafted nerve. Vascularized nerve graft shows superior regeneration to that of a non-vascularized one. However, the human body provides few donor sites of vascularized nerve graft clinically. We presumed that the prefabricated myoneural or adiponeural flap, which include fabricated nerves wrapped with surrounding vascularized muscle or adipose tissue flap, influences superiorly on the regeneration of grafted nerve because that surrounding vasculatity indirectly enhances the vascularity of the grafted nerve itself. Thirty adult male Sprague-Dawley rats were divided into three groups: 1) conventional reversed autogenous graft of the femoral nerve alone(n=10); 2) nerve graft entubulated with abdominal adipose tissue flap with a pedicle of inferior epigastric artery(n=10); 3) nerve graft entubulated with adductor muscle flap with a pedicle of the first muscular branch of the femoral artery(n=10). At three months postoperatively, grafted nerves were examined by electrophysiologic study to check amplitudes and motor nerve conduction velocities, as well as histopathologic study for evaluation of regenerated nerve cells, fibrosis and neo-vascularization. Consquently, nerve regeneration was found in all three groups. Both the myoneural and adiponeural flap groups had better improved results of nerve regeneration compared to that of the conventional nerve graft group. The result of myoneural flap group was superior to that of the adiponeural flap group. The myoneural flap group showed minimal fibrosis and less prominent neovascularization around moderately regenerated nerves. The adiponeural flap group showed more severe perineural and endoneural fibrosis, as well as vascular proliferation around focal regenerated nerves. The results of myoneural flap group proved to be statistically significant. We concluded that it is possible to use nerve graft entubulated with a vascularized muscle flap (myoneural flap) as a substitute for vascularized nerve graft.
Abdominal Fat ; Adipose Tissue ; Adult ; Femoral Nerve ; Fibrosis ; Human Body ; Humans ; Male ; Nerve Regeneration* ; Neural Conduction ; Neurons ; Peripheral Nerve Injuries ; Rats, Sprague-Dawley ; Regeneration ; Soft Tissue Injuries ; Tissue Donors ; Transplants*