No abstract available.
Knee*

No abstract available.
Femur*

No abstract available.
Vulva*

PURPOSE: Left-sided hepatolithiasis has been often treated by left hepatectomy and bile duct exploration. Choledochotomy has been the preferred route for conducting exploration of the biliary system, and a T-tube has been routinely inserted. As the left hepatic duct opening can be an alternative route for bile duct exploration instead of choledochotomy, we analyzed the clinical usefulness of this alternative access route by performing a prospective study. METHODS: 42 consecutive cases of left hepatectomy for left- sided or bilateral hepatolithiasis were performed by one surgeon between January 2000 and June 2002. The left hepatic duct opening was the preferred access route for bile duct exploration. Choledochotomy was done only for large stone removal, variant biliary anatomy and intentional T-tube insertion for residual intrahepatic duct stone. RESULTS: Consecutive 42 left hepatectomies did not result in any serious surgical complications except for infection. Choledochotomy could be omitted for 35 of 42 patients and a T-tube was inserted in 7 patients. Residual right lobe stone was removed by choledochoscopy through the T-tube tract in 2 patients. On the 5 year follow-up, only one patient had to undergo percutaneous transhepatic stone removal due to the recurrence of hepatolithiasis. CONCLUSION: We think that bile duct exploration through the left hepatic duct opening is a reasonable and useful method to avoid choledochotomy and T-tube insertion for the patients with left-sided hepatolithiasis.
Bile Ducts ; Biliary Tract ; Follow-Up Studies ; Hepatectomy* ; Hepatic Duct, Common* ; Humans ; Prospective Studies ; Recurrence

PURPOSE: In this study, we investigated the therapeutic potential of regulated negative pressure vacuum-assisted wound therapy for inguinal lymphatic complications in critically ill, liver transplant recipients. METHODS: The great saphenous vein was harvested for hepatic vein reconstruction during liver transplantation in 599 living-donor liver transplant recipients. Fourteen of the recipients (2.3%) developed postoperative inguinal lymphatic complications and were treated with negative pressure wound therapy, and they were included in this study. RESULTS: The average total duration of negative pressure wound therapy was 23 days (range, 11 to 42 days). Complete resolution of the lymphatic complications and wound healing were achieved in all 14 patients, 5 of whom were treated in hospital and 9 as outpatients. There was no clinically detectable infection, bleeding or recurrence after an average follow-up of 27 months (range, 7 to 36 months). CONCLUSION: Negative pressure wound therapy is an effective, readily-available treatment option that is less invasive than exploration and ligation of leaking lymphatics and provides good control of drainage and rapid wound closure in critically ill patients.
Critical Illness ; Drainage ; Follow-Up Studies ; Hemorrhage ; Hepatic Veins ; Humans ; Ligation ; Liver ; Liver Transplantation ; Negative-Pressure Wound Therapy ; Outpatients ; Recurrence ; Saphenous Vein ; Transplants ; Wound Healing

PURPOSE: The endoscopic surgery has been widely used and developed in operations of the thyroid and parathyroid gland because of the cosmetic advantage and the development of laparoscopic instrument. Since the first endoscopic thyroid surgery in late 1990's, many endoscopic operations for thyroid tumors have been performed in Korea. The authors analyzed the current status of endoscopic thyroid surgery performed in Korea. METHODS: We have collected and analyzed the data of endoscopic thyroid operations using survey. RESULTS: The surgeons working in 16 hospitals answered the questions in survey. The total endoscopic thyroid operations were performed over 1,200 cases until the end of 2004. In the pathologic diagnosis, nodular hyperplasia was most frequent in 64.5%. The axillary approach was most frequently applied in 9 hospitals (56.2%). Most of endoscopic thyroid operations were performed in 2~3 hours. The operation time was decreased according to the experience. The endoscopic surgery for malignant tumors were also performed in 11 hospitals, The hospital stay was usually 3~4 days. The most common complications in endoscopic thyroid surgery were temporary recurrent laryngeal nerve paralysis and anteior chest wall discomfort or paresthesia. The most common reason for conversion to conventional surgery was the intraoperative diagnosis as for a malignancy. CONCLUSION: Endoscopic thyroid surgery has been perfomed in many hospitals not only special thyroid clinic in Korea. The operation cases are increasing rapidly in these days. According to the development of technique and instrument, the endoscopic surgery are applied to various neck disease involving malignancy. The safety and efficacy of endoscopic surgery for malignancy should be further evaluated with accumulation of experience of endoscopic operation and long term follow-up of thyroid cancer patients.
Diagnosis ; Follow-Up Studies ; Humans ; Hyperplasia ; Korea* ; Length of Stay ; Neck ; Paralysis ; Parathyroid Glands ; Paresthesia ; Recurrent Laryngeal Nerve ; Surgeons ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*

PURPOSE: Postoperative hypocalcemia is a common complication of thyroidectomy. This study evaluated the incidence and predisposing risk factors for postoperative permanent hypocalcemia after total thyroidectomy. METHODS: There were 1,247 consecutive patients undergoing total thyroidectomy and complete treatment and observation for differentiated thyroid cancer between January 2012 to December 2012 who were enrolled in this study. Patients were divided into two groups, those remaining normalcalcemic (Group I-824 pts) and those who had hypocalcemia requiring treatment (Groups II-423 pts). Group II was subdivided into a transient hypocalcemic group (Group IIA-409 pts) and a permanent hypocalcemic group (Group IIB-14 pts). RESULTS: Female gender, thyroiditis, preserved parathyroid number, lateral lymph node metastasis, RAI treatment, preoperative parathyroid hormone and preoperative vitamin D were significantly associated with the development of postoperative hypocalcemia by multivariate analysis. Comparing patients with transient versus permanent hypocalcemia, tumor size and multiplicity were significantly related to the development of permanent hypocalcemia by multivariate analysis. RAI treatment and parathyroid hormone level on the postoperative third day were significantly related to recovery from transient hypocalcemia to normo-calcemia. CONCLUSION: Risk factors of postoperative hypocalcemia were associated with preoperative patient factors and advanced thyroid cancer. Advanced thyroid cancer was a risk factor for permanent hypocalcemia. To prevent postoperative hypocalcemia, we should focus on patient condition and need to preserve parathyroid gland more carefully in thyroid surgery.
Female ; Humans ; Hypocalcemia* ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Parathyroid Glands ; Parathyroid Hormone ; Risk Factors* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy* ; Thyroiditis ; Vitamin D

There have been numerous reports on the relationship between eosinophilia and toxocariasis. The present study investigated seropositive rates of toxocariasis among healthy people with or without eosinophilia in urban and rural areas, and assessed risk factors for positive antibody test. A total of 610 healthy people, who visited health check-up (Medicheck(R), Korea Association of Health Promotion), 310 from Seoul and 300 from Gyeongsangnam-do, were subjected for this study. Their serum samples were tested by ELISA with the crude antigen of Toxocara canis larvae. Cross-reactions with other tissue invading helminth antigens were also investigated. Total antibody positive rate of toxocariasis was 8.7% of the 610 subjects. When the subjects were grouped into 3 by their eosinophil counts, the antibody positive rates significantly differed by the groups; 5.9% (18/306) in the group<350/microL, 10.0% (11/110) in the group 350-500/microL, and 12.4% (24/194) in the group>500/microL (P=0.028). A total of 22 serum samples cross-reacted with other tissue-invading helminth antigens. A questionnaire analysis recognized drinking alcohol and smoking as significant risk factors of toxocariasis. In conclusion, toxocariasis antibody positive rate is correlated with eosinophil counts. It is recommended that healthy subjects with eosinophilia by routine health examination and risk factors undergo Toxocara serology by multiantigen ELISA to investigate etiology.
Age Distribution ; Comorbidity ; Eosinophilia/*diagnosis/*epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Reference Values ; Republic of Korea/epidemiology ; Risk Factors ; Rural Population/*statistics & numerical data ; Serologic Tests/statistics & numerical data ; Sex Distribution ; Toxocariasis/*diagnosis/*epidemiology ; Urban Population/*statistics & numerical data