Internal hernia is an unusual cause of the intestinal obstruction. The advances of CT make the diagnosis more easier than in the past. We report one case of internal hernia with herniation of the ileum into the lesser omenturn. The diagnosis could be made when abdominal radiographs showed fixed clustering of the small bowel loops in upper abdomen medial to the stomach. CT and ultrasound showed characteristic interposition of the ileum between the left hepatic lobe and the stomach.
Abdomen ; Diagnosis ; Hernia* ; Ileum ; Intestinal Obstruction ; Stomach ; Ultrasonography

Primary tumors of the adrenal cortex are comparatively rare. In the medical literature they are most frequently reported as single case. Because of their infrequent occurence some features of their clinical behavior and pathologic anatomy are not widely known. For this reason the recording of the 7 cases from the Department of Pathology, School of Medicine, Chungnam National University is thought to be worth while. Of the seven tumors, five were associated with primary aldosteronism, one Cushing's syndrome, and the remaing one virilizing syndrome. All were benign. Females were affected more frequently than males. Adrenocortical adenomas tend to be small, weighing less than 42 gm. The tumors associated with primary aldosteronism were composed of zona fasciculata-like cells and "hybrid" cells. The tumor with Cushing's syndrome consisted of zona reticularis-like cells. The tumor with virilizing syndrome consisted of zone reticularis-like cells.
Female ; Humans ; Adenoma

No abstract available.

No abstract available.
Facial Nerve* ; Paralysis* ; Transplants*

No abstract available.
Free Tissue Flaps* ; Lower Extremity* ; Soft Tissue Injuries*

No abstract available.

Objective: This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6- and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.

Objective: This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6- and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.

Postoperative pain control is one of the main concern for the anesthesiologist. Intermittent narcotic injections caused inadequate pain relief in many patients. Periodic injections could improve analgesia with increased incidence of undesirable side effects including respiratory depression, nausea, vomiting, and urinary retenion. Balanced analgesia may lessen these complications without reducing analgesic effect. I assessed the effect of balanced analgesia using morphine, ketorolac and droperidol. Each 20 gynecological patients were allocated to one of four groups Morphine(initial bolus 2mg followed by 48mg continousi.v. for 2 days) or ketorolac(initial bolus 30mg, follwed by 120mg continousi.v. for 2 days) was continously injected in group 1 and group 2, respectively. In group 3, half doses of morphine and ketorolac in group 1, 2 was used in combinstion. 5mg of droperidol was added to group 3 drugs in group 4. There were no significant changes in blood pressure and heart rate in all groups. Onset time of analgesic effect was faster in morphine containing groups 1, and 4, and the effect was better in all three morphine containing group 1, 3 and 4 than ketorolac group 2. Untoward effects were least in ketorolac group 2. Droperidol could prevent nausea and vomiting, however led to increased incidence of somnolence. It could be concluded that balanced analgesia with morphine, ketorolac and droperidol with fine titration would be better than intravenous morphine or ketorolac alone.
Analgesia* ; Blood Pressure ; Droperidol* ; Heart Rate ; Humans ; Incidence ; Ketorolac* ; Morphine* ; Nausea ; Pain, Postoperative* ; Respiratory Insufficiency ; Vomiting

BACKGROUND: The laparoscopic cholecystectomy has become the treatment of choice for the majority of patients with cholecystopathy. The objectives of this study were to evaluate the safety and the efficacy of the laparoscopic cholecystectomy by reviewing of the case histories of three hundred ten consecutive patients treated with a laparoscopic cholecystectomy. METHODS: We retrospectively analyzed the initial 310 laparoscopic cholecystectomies performed at the Department of General Surgery, Sun General Hospital, from May 1993 to December 1998. Sex, age, associated diseases, previous history of abdominal operation, duration of operation, reason for conversion to open cholecystectomy, hospital stay, and postoperative complications were analyzed. RESULTS: The postoperative diagnosis was chronic cholecystitis in 213 patients, acute cholecystitis in 53 patients, cholesterolosis in 17 patients, gallbladder (GB) empyema in 13 patients, acalculous cholecystitis in 9 patients, and gallbladder carcinomas in 3 patients. The common associated diseases were diabetes mellitus and hypertension. The mean durations of operation, diet, and hospital stay were 77.6 minutes. 1.2 days, and 5 days, respectively. The mean numbers of drainages and injected analgesics were 0.8 and 1.6, respectively. Conversion to an open cholecystectomy was necessary in 8 of the 310 patients (2.6%) who underwent a laparoscopic cholecystectomy either because of severe adhesion (n=6), difficulty with anatomic identification in Calot's triangle (n=1), or severe GB empyema (n=1). The overall postoperative complication rate was 2.6% (8/310). A laparotomy was not required for the treatment of bleeding (5 cases) and residual stones (2 cases). There was no bile duct injury. One patient who had a cerebral infarction died of a cerebrovascular accident. CONCLUSION: We conclude that for benign cholecystopathy the laparoscopic cholecystectomy can be safe and feasible treatment with low morbidity.
Acalculous Cholecystitis ; Analgesics ; Bile Ducts ; Cerebral Infarction ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute ; Diabetes Mellitus ; Diagnosis ; Diet ; Empyema ; Gallbladder ; Hemorrhage ; Hospitals, General ; Humans ; Hypertension ; Laparotomy ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Solar System ; Stroke