Twelve patients with inflammatory bowel disease had been operated at the department of surgery, Chonnam University Hospital during the period from March 1988 to February 1997. In this study, we report on the operative cases regarding age, sex, symptoms, duration of disease, location of disease, preoperative diagnosis, operative indication, frequency of operation, histopathologic findings and follow up. The results were as follows: 1) The male to female ratio in ulcerative colitis was 1 : 1, and the mean age was 54.5 years. In Crohn's disease, male to female ratio was 2.3 : 1 and the mean age was 42.1 years. 2) The mean duration of symptoms in ulcerative colitis was 39 months and in Crohn's disease was 13.9 months. The common symptoms in ulcerative colitis were abdominal pain, bloody diarrhea, indigestion, weight loss and in Crohn's disease abdominal pain, palpable mass, weight loss, indigestion. Extraintestinal symptoms in Crohn's disease were cholelithiasis like symptom, anal fistula, anal fissure. 3) The involvement site in ulcerative colitis was large bowel only, but in Crohn's disease small bowel (50%), large bowel (20%), small and large bowel (30%) were involved. 4) Preoperative diagnosis in ulcerative colitis was accurate, but in Crohn's disease accurate diagnosis was made only in 20% and the other cases were operated under the impression of different diseases or conditions (intestinal tuberculosis (50%), bowel perforation (20%), mechanical ileus (10%)). 5) The indication of surgery in ulcerative colitis was intractability to medical treatment, on the other hand, in Crohn's disease most operative cases were made under the emergentconditions (bowel perforation, bowel obstruction, enterocutaneous fistula, abdominal mass). The frequency of operation in ulcerative colitis were two times in one case, three times in one cases. In Crohn's disease half of cases experienced two or three times of surgery. The method of operation in ulcerative colitis was total proctocolectomy with J-pouch ileoanal anastomosis. In Crohn's disease resection of diseased bowel segment was performed.
Abdominal Pain ; Cholelithiasis ; Colitis, Ulcerative ; Colonic Pouches ; Crohn Disease ; Diagnosis ; Diarrhea ; Dyspepsia ; Female ; Fissure in Ano ; Follow-Up Studies ; Hand ; Humans ; Ileus ; Inflammatory Bowel Diseases* ; Intestinal Fistula ; Jeollanam-do ; Male ; Rectal Fistula ; Tuberculosis ; Weight Loss

Colorectal carcinoma in patients under 40 years and over 70 years of age is unusual but not rare. The prognosis of these two groups, compared with remainder of patients, is thought to be unfavorable. From Jan. 1981 to Dec. 1997, 541 patients with primary colorectal cancer who were treated by surgical resection were analyzed retrospectively. They were divided into three age groups according to the age at admission, i.e. under 40 years, over 70 years and between 40 and 69 years(control group). Among three age groups, sex ratio, tumor characteristics(size, location , depth of invasion, lymph node metastasis, liver metastasis, peritoneal metastasis, histopathologic classification, stage, DNA ploidy pattern), serum CEA level and survival were compared and analyzed. The results were as follows: 1) In the young patient group(52 cases), female predominence, large tumor size, high proportion of mucinous adenocarcinoma in histopathologic classification, more frequent metastasis to regional lymph node, frequent peritoneal metastasis and high incidence in tumor location at transverse colon were noted(p<0.05). 2) In the elderly group(69 cases), deep invasion of tumor(T4) was noted (p<0.05). In addition, among them, concomittent diseases were presented in 25 patients(36%). They were diabetes(8), cardiac arrhythmia(4), old myocardial infarction(2), liver cirrhosis(5), COPD(3), previous cancer(3). 3) The 5-year survival rates of the young patient group and that of elderly patient group were lower than that of the other(p<0.01). 4) There was no significant differences in liver metastasis, tumor stage, DNA ploidy pattern, serum CEA level among three age groups.
Adenocarcinoma, Mucinous ; Aged* ; Classification ; Colon, Transverse ; Colorectal Neoplasms* ; DNA ; Female ; Humans ; Incidence ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Ploidies ; Prognosis ; Retrospective Studies ; Sex Ratio ; Survival Rate

This study was aimed to elucidate the effect of intracerebroventricular losartan administration on arterial pressure regulation during hemorrhage in rats by power spectral analysis of blood pressure and heart rate variability. Nineteen male Sprague-Dawley rats weighing 240-300g were divided into losartan-administered(n=10) and control(n=9) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3ml/kg/min for 5min. Arterial presure was measured with a pressure transducer connected to the contralateral femoral artery for 5min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of systolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency (VLF, 0.02-0.26 Hz), low frequency(LF, 0.26-0.75 Hz) and high frequency(HF, 0.75-5.00 Hz) band were obtained. Basal systolic and diastolic blood pressure was 149+/-9 and 99+/-2mmHg, respectively, and was not changed by hemorrhage in control rats. Basal blood pressure in losartan group was 143+/-9 and 97+/-6mmHg and was significantly lowered to 116+/-13 and 77+/-9mmHg, respectively. HR was significantly increased during and after hemorrhage in both groups. Total power of SP variability in losartan group was 13.9+/-3.2mmHg2 before hemorrhage and was significantly increased to 66.6+/-25.3mmHg2 during hemorrhage. VLF, LF and HF powers of SP variability were 7.3+/-2.0, 3.8+/-1.1 and 2.8+/-0.7mmHg2, respectively, in losartan group and 5.5+/-1.4, 3.7+/-1.5 and 2.8+/-0.8mmHg2 in control rats. VLF and HF powers of SP were increased to 33.0+/-15.2 and 20.3+/-6.4mmHg2 in losartan group, and VLF power was increased to 7.9+/-1.5mmHg2 in control group. VLF power of DP variability increased from 3.3+/-0.9 before hemorrhage to 5.9+/-1.0mmHg2 during hemorrhage in control group. Powers of DP variability in losartan group and those of HR variability in both groups were not changed by hemorrhage. The above results suggested that losartan aggravated the arterial pressure fall during hemorrhage by impairing the sympathetic nerve activation by central angiotensin II.
Angiotensin II ; Animals ; Arterial Pressure ; Blood Pressure* ; Femoral Artery ; Fourier Analysis ; Heart Rate* ; Heart* ; Hemorrhage* ; Humans ; Lateral Ventricles* ; Losartan* ; Male ; Rats ; Rats, Sprague-Dawley ; Transducers, Pressure

Open carpal tunnel release surgery has heen the gold standard method of treatment for who did not respond to conservative treatment and whose neurologic symptoms were progressive. However, open carpal tunnel release using a standard incision frequently associated with delayed return of hand function, residual scar tenderness and pillar pain. So, two new alternative methods such as endoscopic carpal tunnel release and limited incision technique have developed. To define the role of the limited two incision technique, we anaiyzed the postoperative functional results of 40 cases in 33 patients. The patients were divided in two groups. Group A was standard incision group (23 cases in 19 patients) and Group B was limited two incision group (l7 cases in 14 patients). The postoperative functional results were analyzed statistically using chi-square test at postoperative 3, 6, 9 and l2 weeks. There were no significant differences in reliet of numbness and paresthesias in both groups. There was a statistically significant difference in relief of scar tenderness and pillar pain at postoperative 3 and 6 weeks in Group B. There was no significant complication in both groups. We can conclude that the limited two incision technique of carpal tunnel release is a safe procedure which allows rapid return of hand functions with reduced incidence of scar tenderness in the early postoperative stages.
Carpal Tunnel Syndrome ; Cicatrix ; Hand ; Humans ; Hypesthesia ; Incidence ; Neurologic Manifestations ; Paresthesia

Fracture of the femoral neck occurred after internal fixation of intertrochanteric fracture of the femur is very rare and have been described previously in terms of stress fracture, stress-riser fracture, Youngs modulus fracture or iatrogenic fracture in the literature. This fracture documented about 20 cases in the English literature and usually occurred in elderly patients with osteoporosis and it always occur in the subcapital region. We report a case of subcapital stress fracture of the femur occurred after internal fixation with compression hip screw of intertrochanteric femur fracture.
Aged ; Elastic Modulus ; Femur Neck ; Femur* ; Fractures, Stress* ; Hip ; Humans ; Osteoporosis

To evaluate the regional differences in the stereometric parameters of optic nerve head in primary open angle glaucoma, we retrieved rim area, disc area, cup volume/disc area, and maximum depth in 6 predefined segements using mean topography measured with Heidelberg Retina Tomograph. Eleven eyes from 11 primary open angle glaucoma patients, whose mean defect in Humphrey C30-2 visual field was -4.2 +/- 2.6dB and intraocular pressure was 18.7 +/- 3.2mmHg, were enrolled in this study. The values of rim area/disc area were significantly different between segments(p<0.05), and increased in the order of temporal. temporoinferior, temporosuperior, nasal nasosuperior, and nasoinferior segment. The values of cup volume/disc area were also significantly different between segments(p<0.05), and decreased in the order of temporoinferior, temporosuperior, temporal, nasosuperior, nasal, and nasoinferior segment. However, the values of maximum depth were not significantly different between segments. These results suggest that optic nerve head damage in primary open angle glaucoma may be different according to the region.
Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Optic Disk* ; Optic Nerve* ; Retina ; Visual Fields

PURPOSE: To find the rebleeding factors in bronchial arterial embolization for treatment of hemoptysis, a retrospective study was performed. MATERIALS AND METHODS:Medical records, anglographic findings and embolic materials of 35 patients who had undertaken arterial embolization for control of hemoptysis were reviewed. The period of follow-up for rebleeding was from 3 to 32 months after arterial embolization. We investigated the anglographic findings of extravasation, neovascularity, intervascular shunt, aneurysm and periarterial diffusion. Neovascularity was classified as mild(numerable neovascularity) and severe(innumerable). RESULTS: Rebleeding occured in 15(43%) among 35 cases. Only two of 11 cases with no past episode of hemoptysis showed recurrence, while 9 of 15 cases who had more than three episodes did. Severe neovascularity were seen in 11 of 15 recurred cases, but seven of 20 non-recurred cases showed severe neovascularity. More than three anglographic findings representing hemoptysis were seen on 11(73%) among recurred 15 cases and seven(35%) among non-recurred 20 cases. The lesion was supplied by more than two different arteries on 8(54%) of the recurred cases, but only three(15%) of the non-recurred cases. Six of seven cases persistent neovascularity after arterial embolization were recurred. CONCLUSION: The history of repeated hemoptysis, severe neovascularity, variable anglographic findings, and post-embolization persistency of neovascularity were the factors related with the rebleeding after arterial embolization for hemoptysis. Careful and active arterial embolization are required on these conditions.
Aneurysm ; Arteries ; Diffusion ; Follow-Up Studies ; Hemoptysis* ; Humans ; Recurrence ; Retrospective Studies

Intravitreal silicone oil injection is useful to manage the complicated retinal detachment. However, many comlications including secondary glaucoma can occur followin gsilicone oil injection. We performed this study to investigate the incidence and risk factors of silicone oil induced secondary glaucoma. The medica records of 213 eyes of 210 consecutive patients who underwent pars plana vitrectomy and silicone oil injection between January 1990 and June 1997, were reviewed retrospectivel. Fifty five of 213 eyes(25.8%) developed secondary glaucoma. The mean follow-up period was 33.4 months. The mean amount of injected silicone oil was 5.0+/-1.0ml, and 33.4 the mean numbers of operation prior to the silicone oil injection was 2.3. 65.5% of secondary glaucoma was developed within 1 year of silicone oil injection. High preoperative intraocular pressure(IOP) (p=0.004), high myopia(p=0.015) and presence of silicone oil in anterior chamber(p=0.004) increased the incidence of secondary glaucoma significantly. In conclusion, patients who have high preoperative IOP, high myopia and silicone oil in anterior chamber must be carefully followed after silicone oil injection due to high incidence of secondary glaucoma, especially during the first 1 year.
Anterior Chamber ; Follow-Up Studies ; Glaucoma* ; Humans ; Incidence ; Intraocular Pressure ; Myopia ; Retinal Detachment ; Risk Factors* ; Silicone Oils* ; Vitrectomy

BACKGROUND: Differential diagnosis of keratoacanthoma(KA) from squamous cell carcinoma(SCC) is often difficult, especially when SCC has KA-like features(KA-like SCC). A number of recent studies have been attempted to separate these two entities with the use of immunohistochemical stains. But the results were inconsistent and the studies with KA-like SCC are rarely reported. OBJECTIVES: The purpose of this study was to examine the expression patterns of p53 protein and Ki-67 antigen on KA and KA-like SCC using immunohistochemical staining method and to evaluate the usefulness of this method in distinguishing each other. METHODS: We performed immunoperoxidase staining(LSAB technique) using monoclonal antibody to p53 protein(PAb1801) and Ki-67 antigen(MIB1) on the formalin-fixed, paraffin-embedded biopsy specimens obtained from 12 patients with KA, 8 patient with KA-like SCC, and 10 patients with well-differentiated SCC. RESULTS: The results were as follows; 1) There was a significant difference in the p53 expression between KA(25%) and SCC group (KA-like SCC=88%, SCC=100%). 2) Mean Ki-67 labeling index was slightly higher for SCC group(KA-like SCC=30.72%, SCC= 31.23%) than for KA(25.30%), but this difference was not statistically significant. 3) In Ki-67 expression, KA showed more pheriperal basal pattern(91%), whereas SCC group showed more diffuse pattern(77%). CONCLUSION: Our results suggest that KA and SCC are distinct entities of different nature and that these immunohistochemical staining methods can be useful methods in differentiating KA-like SCC from KA.
Biopsy ; Carcinoma, Squamous Cell* ; Coloring Agents ; Diagnosis, Differential ; Humans ; Keratoacanthoma* ; Ki-67 Antigen*

BACKGROUND: Differential diagnosis of keratoacanthoma(KA) from squamous cell carcinoma(SCC) is often difficult, especially when SCC has KA-like features(KA-like SCC). A number of recent studies have been attempted to separate these two entities with the use of immunohistochemical stains. But the results were inconsistent and the studies with KA-like SCC are rarely reported. OBJECTIVES: The purpose of this study was to examine the expression patterns of p53 protein and Ki-67 antigen on KA and KA-like SCC using immunohistochemical staining method and to evaluate the usefulness of this method in distinguishing each other. METHODS: We performed immunoperoxidase staining(LSAB technique) using monoclonal antibody to p53 protein(PAb1801) and Ki-67 antigen(MIB1) on the formalin-fixed, paraffin-embedded biopsy specimens obtained from 12 patients with KA, 8 patient with KA-like SCC, and 10 patients with well-differentiated SCC. RESULTS: The results were as follows; 1) There was a significant difference in the p53 expression between KA(25%) and SCC group (KA-like SCC=88%, SCC=100%). 2) Mean Ki-67 labeling index was slightly higher for SCC group(KA-like SCC=30.72%, SCC= 31.23%) than for KA(25.30%), but this difference was not statistically significant. 3) In Ki-67 expression, KA showed more pheriperal basal pattern(91%), whereas SCC group showed more diffuse pattern(77%). CONCLUSION: Our results suggest that KA and SCC are distinct entities of different nature and that these immunohistochemical staining methods can be useful methods in differentiating KA-like SCC from KA.
Biopsy ; Carcinoma, Squamous Cell* ; Coloring Agents ; Diagnosis, Differential ; Humans ; Keratoacanthoma* ; Ki-67 Antigen*