To identify the efficacy of laparoscopic cholecystectomy, we retrospectively analyzed 600 cases of laparoscopic cholecystectomy who were treated at the Department of Surgery, Chung Ang University from September 1990 to December l992. We intentionally divided periods into 3 groups to observe the frequency of morbidity and mortality, early and late complications, duration of operation and postoperative hospitalization with accumulaton of surgical experiences and techniques. The most prevalent age group was 6th decades, male to female ratio was 1: 1.47 and associated diseases were hypertension, obesity, pulmonary tuberculosis in order of frequency and previous abdominal operations were appendectomy, TAH, C-section in order of frequency. The duration of operation was 38.6 minutes and postoperative hospitalization was 6.2 days. The most frequent pathologic diagnosis was chronic cholecystitis. The postoperative complications were noted in 15 cases(2.5%) including 5 cases of bleeding 4 cases of bile leakage. The number of patients who needed parenteral narcotics was decreased in later peiod. According to oral cholecystogram, opacification correlated with duration of operation of laparoscopic cholecystectomy.
Appendectomy ; Bile ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Diagnosis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Hypertension ; Intention ; Male ; Mortality ; Narcotics ; Obesity ; Postoperative Complications ; Retrospective Studies ; Tuberculosis, Pulmonary

The functional and morphologic cardiac developments are determined by the morphogenesis, growth and remodeling of the heart resulted from the cell proliferation and apoptosis. We studied the distribution of the proliferation and apoptotic activity of myocardial cells according to the developmental stages in embryos of C57bl/6 mice. Serial histologic sections were stained with PCNA and TUNEL method and were analyzed with image analyzer (BMI, Seoul). The ventricular myocardium of an embryonic heart could be divided into trabecular, inner compact and outer compact layers. Proliferation indices at layers of the left ventricular myocardium on embryonal days (ED) 13, 14, 16, 17 and 18 were 19.9%/47.4%/60.4%, 16.1%/45.8%/60.3%, 24.6%/45.6%/38.1%, 23.3%/17.7%/18.3% and 31.2%/28.0%/19.4% (trabecular/ inner compact/ outer compact) and the right ventricle, 11.0%/34.4%/60.5%, 23.0%/44.0%/69.0%, 29.2%/42.9%/35.1%, 30.4%/30.5%/22.3% and 32.4%/28.4%/16.3%. The apoptotic indices of the left ventricle/VIF were 0.23%/3.66% on ED 13-14, 0.42%/1.31% on ED 16 and 0.05%/0.60% on ED 17-18. The results show that the proliferation of the myocytes was maximal at the outer compact layer on ED 13 and 14 but lowest on ED 17 and 18. This decrease was more pronounced at the left ventricle. The innermost trabecular layer showed a constant proliferation activity of 11.0-32.4%. The presence of spatiotemporal differences in the cell proliferation reveals regional regulation in the developmental timing of cardiac development. Functional maturation is considered to be responsible for the change of proliferation activity. The apoptosis was most frequent and intense in the VIF and crux throughout the periods of each embryonal day where as rarely seen in the ventricular myocardium, especially in the trabecular layer of myocardium. These findings suggest that the apoptosis plays the role in the development of atrioventricular, ventriculoarterial septation and valve formation. Our results also reveal that the participation of apoptosis in formation of the trabeculation can be denied.
Animals ; Apoptosis* ; Cell Proliferation* ; Embryonic Structures ; Heart ; Heart Ventricles ; In Situ Nick-End Labeling ; Mice ; Morphogenesis ; Muscle Cells ; Myocardium ; Proliferating Cell Nuclear Antigen

PURPOSE: Since the introduction of short vein bypass (SVB), many have reported its feasibility when long vein bypass (LVB) cannot be performed due to limited vein conduit. However, the presence of inflow-vessel disease may affect graft patency and thus require endovascular treatment prior to surgery. Our study aims to analyze the results between SVB and LVB. MATERIALS AND METHODS: From 2009 to 2013, 27 bypass procedures were reviewed retrospectively. Outcomes such as patency rate, postoperative ankle brachial index (ABI) and limb salvage rate between SVB and LVB were compared. Wound healing time and primary patency rate were analyzed and the former was also analyzed according to the respective angiosome and revascularization type. RESULTS: There were 11 males and 16 females and the mean age was 66.6+/-12.3 years. Twenty four patients had TransAtlantic Inter-Society Consensus (TASC) D and 3 patients had TASC C lesions below knee. The 1-year cumulative patency rate between SVB and LVB were 63% and 66%, P=0.627. The limb salvage rate (100% vs. 73%; P=0.280) and postoperative ABI (0.592 vs. 0.508; P=0.620) were higher in the SVB group than in the LVB group, although the differences were not significant. There was no difference in wound healing time by angiosomal revascularization type. In situ vein graft showed higher patency rate than reversed greater saphenous vein (75% vs. 61%; P=0.00) CONCLUSION: The results of SVB were similar to those of LVB. SVB is feasible in the setting of limited conduit availability, in combination with endovascular treatment in the presence of proximal lesions.
Ankle Brachial Index ; Consensus ; Extremities* ; Female ; Humans ; Ischemia* ; Knee ; Limb Salvage ; Male ; Retrospective Studies ; Saphenous Vein ; Transplants* ; Veins* ; Wound Healing

No abstract available.
Fistula* ; Thyroglossal Cyst*

PURPOSE: Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. METHOD: Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. RESULTS: Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. CONCLUSION: The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.
Aged ; Behavioral Symptoms* ; Caregivers ; Dementia* ; Frail Elderly ; Humans ; Models, Theoretical ; Nursing Homes* ; Nursing* ; Ownership ; Psychotropic Drugs

Crohn's disease, a chronic relapsing, multisystemic, inflammatory disorder, may involve any part of the gastrointestinal tract and shows a cobblestone-like appearance on intestinal mucosa. There are also extraintestinal features, including lesions of the skin, eye, and joints. Ulcers, fissures, sinus tracts, abscesses, and vegetant plaques have been reported for the perianal skin lesions of Crohn's disease. We experienced a case of Crohn's disease in a 21-year-old Korean female showing a skin lesion with a cobblestone-like appearance in the perianal region.
Abscess ; Crohn Disease* ; Female ; Gastrointestinal Tract ; Humans ; Intestinal Mucosa ; Joints ; Skin* ; Ulcer ; Young Adult

PURPOSE: We studied the effectiveness and toxicities of 5-fluorouracil+leucovorin, combination chemotherapy in advanced or recurred colo-rectal cancer patients, who didn't have previous chemotherapy and enrolled from August 1993 to July 1998. MATERIALS AND METHODS: All patients were treated with leucovorin followed by 5-fluorouracil for 5 consecutive days every 4 weeks. Among 43 patients who were enrolled, 40 patients received treatment at least 2 courses, and they were evaluable. Male to female ratio was 21 to 19. In serum CEA level, 27 patients were greater than 5 ng/ml and 13 were less than 5 ng/ml. And primary site was colon in 21 patients and rectum in 19 patients. RESULTS: The complete response rate was 7,5% and the partial response rate was 25%. The median survival duration was 14.7 months, the median response duration was 16.0 months, and median time to progression was 7.3 months. In the analysis of response, survival duration, time to progression according to various characteristics of patients, serum CEA level and liver involvement were revealed significant difference in survival duration, time to progression (p=0.0122, 00350 & 0.0202, 0.0123) on univariate analysis, but no significant difference on multivariates. Hematologic and non-hematologic toxicities were mild and tolerable. CONCLUSION: This study indicates that the combination of 5-fluorouracil (370 mg/m) and leucovorin (20 mg/m) is effective and tolerable regimen in advanced or recurred colo-rectal cancer patients without previous chemotherapy.
Colon ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Fluorouracil* ; Humans ; Leucovorin* ; Liver ; Male ; Rectal Neoplasms* ; Rectum

No abstract available.
Hematoma*

The changes of electroencephalogram(EEG) in patients with dementia are most commonly studied by analyzing power or magnitude in certain traditionally defined frequency bands. However because of the absence of on identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to chaos theory, irregular signals of EEG cal also result from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the correlation dimension. The authors have analyzed EEG epochs from three patients with dementia of Alzheimer type and three matched control subject. The result showed that patients with dementia of Alzheimer type had significantly lower correlation dimension than non-demented controls on 12 channels. Topographic analysis showed that the correlation dimensions were significantly lower in patients with Alzheimer's disease on frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia with dementia of Alzheimer type have a decreased complexity of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating correlation dimension can be a promising tool for detecting changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*

BACKGROUND: The fast EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used far transporting emergent patients. Authors, here upon, report the transporting experiences. METHODS: From Dec. 1, 1996 to Dec. 31,1997, Samsung Medical Centers EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. RESULT: A total of 65 patients were transported. Male to female ratio was 1.95 : 1. The mean transport time was 64.1min(10-160 min). Majority of the evacuated patients was surgical patients (General Surgery'16, Orthopedic surgery : 10, Neurosurgery : 6, Infernal medicine 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation amended The patients. No medical problems or deaths developed during the air evacuation period. CONCLUSION: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.
Aircraft* ; Critical Illness ; Emergencies* ; Female ; Humans ; Korea ; Male ; Neurosurgery ; Orthopedics ; Pediatrics ; Prospective Studies