PURPOSE: To analyze hemodynamic parameters of electrical bioimpedance on increased blood pressure induced by pneumoperitoneum and compare hemodynamic effects of propofol and isoflurane during laparoscopic cholecystectomy. METHODS: Systemic vascular resistance index(SVRI), index of contractility(IC), end diastolic index(EDI), mean arterial pressure(MAP) and heart rate(HR) were measured after anesthetic induction, 5, 10, 15 and 30 minutes after CO2 insufflation and after CO2 removal. RESULTS: In isoflurane group, MAP, IC, SVRI were increased but EDI was decreased after induction of pneumoperitoneum. In propofol group, MAP, SVRI were increased but IC was decreased after induction of pneumoperitoneum. HR was not changed during operartion. CONCLUSION: After induction of pneumoperitoneum, MAP is increased by increased IC and SVRI in isoflurane. In case of propofol, the MAP is increased by increased SVRI. It seems that increased transmural pressure of lymphatics and splanchnic vasculatures rather than sympathetic stimulation increases SVRI after pneumoperitoneum.
Blood Pressure* ; Cholecystectomy, Laparoscopic* ; Heart ; Hemodynamics* ; Insufflation ; Isoflurane ; Pneumoperitoneum* ; Propofol ; Vascular Resistance

PURPOSE: The mortality and morbidity rate after pancreaticoduodenectomy (PD) is still high, although the operative techniques and skills and the perioperative care has been improved. The incidence of PD for benign disease is 5~20%. The aim of this study is to determine the factors that differentiate between the benign group and the malignant group by comparing the clinical manifestations, and we studied the safety of performing PD for benign diseases by observing the early and late postoperative complications. METHODS: We retrospectively studied 124 patients who had been diagnosed with benign or malignant pancreatic diseases and who underwent PD between April 1995 and December 2005. We divided the patients into two groups, i.e., the benign group (20) and the malignant group (104), to compare their clinical characteristics and postoperative outcomes. Result: Chronic pancreatitis was the most common disease (35%) in the benign group and distal CBD cancer was the most common disease (40.4%) in the malignant group. Jaundice, weight loss, and elevation of CA 19-9 were more frequent in the malignant group than in the benign group (p<0.05). There were no statistical differences in the mortality rate (10.0% vs 6.7%), reoperation rate (5.0% vs 4.8%), hospital stays (27.1 days vs 24.0 days), early complications (30.0% vs 44.6%) and late complications (22.2% vs 26.4%) between the two groups. There were no mortality and newly developed malignancy during 33.4 months of follow-up period in benign group. CONCLUSION: On the preoperative evaluation, jaundice, weight loss, and elevation of CA 19-9 were more frequent in the malignant group. The postoperative early and late complications showed no difference between the two groups and complication rate was generally favorable. Thus, PD can be performed safely for benign diseases that cannot be treated in a conservative fashion and also for other clinically suspicious malignant diseases.
Follow-Up Studies ; Humans ; Incidence ; Jaundice ; Length of Stay ; Mortality ; Pancreatic Diseases ; Pancreaticoduodenectomy* ; Pancreatitis, Chronic ; Perioperative Care ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Weight Loss

Parkinsonism is not commonly associated with intracranial tumors. The most common brain tumor causing parkinsonism is meningiomas. We are presenting two cases of meningiomas whose major manifestations included parkinsonism. In one, parkinsonian symptoms initially partially responded to L-dopa and bromocriptine. A CT scan taken for a stroke-like episode revealed a meningioma of left frontal convexity. After neurological sequelae of CO poisoning, the patient poorly responded to antiparkinsonian drugs. Surgical treatment of meningioma did not result in satisfactory control of extrapyramidal symptoms. In the other with a parasagittal meningioma, parkinsonian symptoms were postoperatiYely improved. Because no curative treatment is available for the majority of parkinsonian patients, early detection of an underlying neoplasm may result in a most rewarding outcome. It would be desirable to perform CT or MRI in cases of parkinsonism with other associated neurological manifestation. Unilaterality of parkinsonian symptoms may also be indication.
Brain Neoplasms ; Bromocriptine ; Frontal Lobe* ; Humans ; Levodopa ; Magnetic Resonance Imaging ; Meningioma* ; Neurologic Manifestations ; Parkinsonian Disorders* ; Poisoning ; Reward ; Tomography, X-Ray Computed

No abstract available.
Neoplasm Metastasis*

Abdominal wall leakage of dialysate in continuous ambulatory peritoneal dialysis (CAPD) patients is uncommon complication. We experienced one case of abdominal wall leakage in CAPD patient confirmed by CT peritoneography. She complained weight gain, decreased ultrafiltration volume, and localized abdominal wall edema without clinical evidence of hernia. CT peritoneography of the abdomen showed leakage of contrast dye from the site of insertion of the CAPD catheter into the anterior abdominal wall. The dialysate was completely drained and CAPD was discontinued. She was switched temporally to hemodialysis and abdominal wall edema disappeared. When CAPD was restarted seven days later, the edema appeared. After CAPD catheter was removed and reinserted at the opposite site, she returned to CAPD without leakage.
Abdomen ; Abdominal Wall* ; Catheters ; Edema ; Hernia ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis ; Ultrafiltration ; Weight Gain

Paraneoplastic neurologic syndrome is a group of assorted disorders resulting from damage to the nervous system in cancer, remote from primary site, and not related to metastasis, infection, or metabolic disorder associated with cancer. Patient with small cell lung cancer sometimes shows various neurological syndromes, but patient with non-small cell lung cancer rarely shows neurologic syndromes and few antineuronal antibodies have been found. Here, we report a case of 53-year-old male patient who developed ptosis and extraocular muscular limitation of left eye due to third and forth cranial nerve palsy in non-small cell lung cancer without brain metastasis. These neurologic symptoms improved after lobectomy without any other treatment immunotherapy.
Antibodies ; Brain ; Carcinoma, Non-Small-Cell Lung ; Cranial Nerve Diseases ; Cranial Nerves ; Eye ; Humans ; Immunotherapy ; Male ; Middle Aged ; Neoplasm Metastasis ; Nervous System ; Neurologic Manifestations ; Paraneoplastic Syndromes ; Paraneoplastic Syndromes, Nervous System ; Small Cell Lung Carcinoma

Pulmonary thromboembolism (PTE) originating from a renal vein thrombosis (RVT) is very rare, especially in relatively healthy young women. The patient described herein presented with a syncope-associated massive PTE. She was previously healthy, except for termination of an ectopic pregnancy with methotrexate 4 months before. The only medication she was taking was an oral contraceptive (OC), which was started 3 months before the PTE. She had no family history of venous thromboembolism (VTE) or any other underlying risk factors. We report the case of a woman who had a PTE originating from a RVT associated with OC use after an ectopic pregnancy.
Contraceptives, Oral ; Female ; Humans ; Methotrexate ; Pregnancy ; Pregnancy, Ectopic ; Pulmonary Embolism ; Renal Veins ; Risk Factors ; Thrombosis ; Venous Thromboembolism

PURPOSE: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. MATERIALS AND METHODS: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. RESULTS: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. CONCLUSION: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.
Gastrectomy ; Gastric Bypass ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Palliative Care ; Prognosis ; Stomach Neoplasms* ; Survival Rate

BACKGROUND: Gejang (marinated crab) is a favorite traditional food and a main source of crab intake among Koreans. The present study aimed to identify the possibility of cadmium inflow to the body through gejang; accordingly, the relationship between gejang intake frequency and amount, and blood cadmium concentrations was investigated. METHODS: Using data from the first Korea National Health and Nutrition Examination Survey in the sixth period in 2013, means and standard errors of blood cadmium concentrations in relation to gejang intake frequency and amount, as well as the monthly intake of gejang, were obtained from 1381 participants for whom data regarding blood cadmium concentration measurements was available. RESULTS: After adjustment for confounding factors, a gejang intake frequency of four or fewer times per week and a monthly intake of 200 cm3 or less had no significant effect on blood cadmium concentrations. However, participants with gejang intake of at least five times per week had a weighted mean cadmium concentration of 2.12 μg/L (p < 0.001), and participants who had a gejang monthly intake of more than 200 cm3 had a weighted mean cadmium concentration of 1.76 μg/L (p < 0.001). CONCLUSION: These results suggest that to minimize the effect of gejang consumption on blood cadmium level, gejang intake should be limited to four or less times per week and 200 cm3 or less per month. Weekly intake of at least five times and monthly intake of more than 200 cm3 may increase blood cadmium levels.
Cadmium* ; Korea ; Nutrition Surveys

BACKGROUND: Shark meat is used as sacrificial food in Gyeongsangbuk-do, and is a major source of dietary mercury. This study aimed to evaluate the effects of shark meat intake or the ritual of Jesa on blood mercury levels within workers living in Gyeongsangbuk-do. METHODS: This study was conducted from September 2016 to October 2016 in two cities of Gyeongsangbuk-do. To compare the differences between urban and rural areas, two workplaces each in Daegu as the urban area and Yeongcheon as the rural area were selected. General characteristics and characteristics related to shark meat consumption of the workers were acquired by personal interviews during their health examination. Blood mercury concentrations were analyzed by the gold amalgamation method using a direct mercury analyzer (DMA-80; Milestone Inc., Shelton, CT, USA). RESULTS: The shark consumption group had a higher blood mercury concentration than the non-consumption group. The levels of blood mercury increased with the frequency, annual intake, as well as most recent date of shark meat consumption. Moreover, the levels of mercury in blood increased according to the annual frequency of participation in Jesa (times per year) and the annual frequency of shark meat consumption during Jesa (times per year). CONCLUSIONS: Shark meat intake and the ritual of Jesa contributed to an increase in the blood mercury levels of workers in Gyeongsangbuk-do. Therefore, it is necessary to evaluate dietary exposure, occupational as well as other factors that may influence blood mercury concentrations in workers during their health examination, particularly in regions with high mercury exposures.
Daegu ; Gyeongsangbuk-do* ; Humans ; Meat* ; Methods ; Occupational Exposure ; Sharks*