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

No abstract available.
Cholecystectomy* ; Cholecystectomy, Laparoscopic*

With advancement of endoscopical instruments and technique, gallstone diseases can be managed with laparoscopic cholecystectomy which has rapidly and radically changed the surgical treatment of gallstone diseases. The ideas of laparoscopic surgery was introduced by Germany gynecologist Semm, in 1967 and was first performed by French surgeon Mouret, Dubois in 1987. Although many reports of early laparoscopic cholecystectomy were excellent, many surgeons want to know the surgical results of laparoscopic cholecystectomy are enough good to perform comparing with the conventional cholecystectomy, especially in early complications and late complications. (continue...)
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Gallstones ; Germany ; Laparoscopy

Transscleral diode laser retinopexy and cryoretinopexy were performed in pigmented rabbits, and light and electron microscopic, and immunohistochemical studies were done. Acute lesions produced by cryoretinopexy showed significant retinal destruction and, in contrast, those produced by transscleral diode laser showed reaction limited to the outer retina and choroid. Chronic lesions by cryoretinopexy showed marked retinal thinning and chorioretinal adhesions. Pigment-laden cells were aggregated at the level of the retinal pigment epithelium, with some having migrated into the sensory retina. The laser lesions showed similar findings but less in size and severity. Acute lesions showed absence of reactivity with all antibodies. While marked expressions of GFAP, vimentin, and S-100 epitopes were seen in chorioretinal scar tissues made with cryoretinopexy, expressions with less intensity were seen with diode retinopexy. Migrating pigment-laden cells were labelled positive for cytokeratins and few cells were positive for anti-macrophage antibody. These results suggest that although transscleral diode laser induce less inner retinal destruction and more localized burns than cryoretinopexy, both forms of treatment produce similar deep retinal Muller cell reaction, as demonstrated by the immunohistochemical studies.
Antibodies ; Burns ; Choroid ; Cicatrix ; Epitopes ; Keratins ; Lasers, Semiconductor* ; Rabbits ; Retina ; Retinal Pigment Epithelium ; Retinaldehyde ; Vimentin

Eighty children who had horizontal strabismus were examined with Titmus and random-dot stereogram(TNO) for the stereoacuity. The patients were analyzed about visual acuity and types of strabismus. In addition, we also analyzed thirty three patients who received correction surgery for the strabismus for evaluation of the changes of postoperative visual acuity and its relationship to the stereoacuity. The results were as follows: 1. The stereoacuity tested by the TNO was proportional to the change of visual acuity, but that of the Titmus was not proportional. 2. The stereoacuity in the exodeviation was higher than the esodeviation. The stereoacuity in the intermittent exotropia was higher than the constant exotropia, and there was no difference in stereoacuity between the accommodative and nonaccommodative esotropia. 3. The visual acuity was improved postoperatively. 4. The postoperative stereoacuity was also improved. The patients with esodeviation showed more improvement in the stereoacuity compared with that of the patients with exodeviation.
Child* ; Esotropia ; Exotropia ; Humans ; Strabismus* ; Visual Acuity

In comparison with other hazards of anesthesia, fires and explosions occur very infrequently because of precautions for their prevention so that they are relatively insignificant. The authors had experience of a case of explosion with fire in an oxygen delivery tube and the wrapping cloth of the oxygen cylinder. A piece of plaster used for prevention of leakage from the oxygen delivery tube occluded the filter in a pin-index system of an anesthesia machine. It is suspected that adiabatic compression may produce a momentary temperature of over 900 degrees C in an occluding part, thus igniting minute particles detached by the gas stream from the walls of the oxygen delivery tube. In case of malfunctioning in anesthetic apparatus, it should be repaired only by expert engineers.
Anesthesia* ; Explosions ; Fires ; Oxygen* ; Rivers

BACKGROUND: Clinical features of malignant melanoma (MM) are known to be different according to racial and environmental factors. Recently, there have been reports of an increase of MM. OBJECTIVE: We evaluated the incidence of tumors, age and sex distribution, tumor sites, and histopathological patterns. METHODS: Clinical records were reviewed for 35 cases of MM with a histologically confirmed diagnosis for patients who visited the Department of Dermatology, Chungnam National University Hospital during the 20 years from 1980 to 1999. Histopathologic and clinical characteristics were also reviewed. RESULTS: A total of 35 malignant melanoma cases diagnosed at Chungnam National University Hospital during the past 20 years from 1980 to 1999 were included for the clinico-histopathologic study. The ratio of man to woman with MM was 1 : 1.33 with a mean age of 55 years. Acral lentigenous melanoma was the most common clinico-histopathologic pattern. CONCLUSION: The incidence of MM has increased during the past 20 years. The common site, and histopathologic patterns show a significant difference from Caucasians.
Chungcheongnam-do ; Dermatology ; Diagnosis ; Female ; Humans ; Incidence ; Melanoma* ; Sex Distribution

BACKGROUND: We evaluated the efficacy and safety of positive pressure ventilation (PPV) with a laryngeal mask airway (LMA), compared with an endotracheal tube (ETT) during a laparoscopic cholecystectomy. METHODS: Sixty six, ASA I II adults scheduled for an elective laparoscopic cholecystectomy were randomly assigned to LMA or ETT. Anesthesia was induced with fentanyl 2ng/kg, lidocaine 0.5 mg/kg and propofol 2 mg/kg and maintained with a continuous infusion of propofol 6 - 12 mg/kg/h in 67% N2O, atracurium and fentanyl. An ETT or LMA was placed with atracurium 0.5 mg/kg. Respiratory and hemodynamic parameters were measured before and after intraabdominal CO2 insufflation. The surgeon assessed the degree of change in gastric distension under laparoscope. RESULTS: Oxygen saturation, end-tidal CO2, peak inspiratory pressure, expiratory tidal volume and compliance of the respiratory system didn't differ between both groups. Blood pressure and heart rate were lower in the LMA group than in the ETT group only at 5 min after induction (P < 0.05). The maintenance dose of propofol, fentanyl and atracurium were similar in both groups. Degree of change in gastric distension were similar in both groups. The LMA resulted in less coughing after removal than did the ETT (P < 0.05). CONCLUSIONS: PPV with LMA permits adequate pulmonary ventilation and hemodynamic stability during laparoscopic cholecystectomy. Gastric distension occurs with similar frequency in LMA or ETT.
Adult ; Anesthesia ; Atracurium ; Blood Pressure ; Cholecystectomy, Laparoscopic* ; Compliance ; Cough ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Laparoscopes ; Laryngeal Masks* ; Lidocaine ; Oxygen ; Positive-Pressure Respiration* ; Propofol ; Pulmonary Ventilation ; Respiratory System ; Tidal Volume

We report a case of accidental intrathecal administration of Nucomyt(R)(acetylcysteine), a mucolytic agent used for intratracheal instillation. A 21-year-old healthy female with a complete syndactyly at the 4th and 5th toes was scheduled for a web release under spinal anesthesia. Immediately after accidental intrathecal administration of Nucomyt(R)2.4 ml instead of bupivacaine for spinal anesthesia, tonic extension developed at first in the lower extremities and then the upper extremities, too. Thiopental sodium 200 mg was injected intravenously twice. Endotracheal general anesthesia with N2O- enflurane-vecuronium was maintained for the operation for about two hours. For about 1 hour after emergence of general anesthesia, tonic extension intermittently developed in the lower extremities and was controlled with midazolam. Mild elevated blood pressure, tachycardia, tachypnea, high fever (up to 38.5degrees C) and respiratory acidosis occurred. Thirty minutes later, she became mentally clear with a normal neurologic examination. No delayed sequelae were detectable at a follow-up visit 1 month and 1 year after surgery.
Acetylcysteine* ; Acidosis, Respiratory ; Anesthesia, General ; Anesthesia, Spinal ; Blood Pressure ; Bupivacaine ; Female ; Fever ; Follow-Up Studies ; Humans ; Lower Extremity ; Midazolam ; Neurologic Examination ; Syndactyly ; Tachycardia ; Tachypnea ; Thiopental ; Toes ; Upper Extremity ; Young Adult

BACKGROUND: Granuloma annulare is a chronic inflammatory condition of unknown cause. There are only two clinicopathologic studies in Korea. OBJECTIVES: Our purpose was to investigate the clinicopathologic findings of granuloma annulare and literature review. METHODS: Twenty two biopsy-proved cases of granuloma annulare were reviewed. We examined their clinical and pathological findings. RESULTS: The incidence showed a peak under 20 years old(59.1%) and females affected twice as much as males. Average onset years was 21.5 years old and mean disease duration was 20 months. The lesions were located almost in dermis(77.2%) and interstitial infiltration type was most common. CONCLUSION:There were no large epidemiologic difference from previously reported studies. Granuloma annulare is not an uncommon disease. It is important to distinguish granuloma annulare from many other mucin producing, granuloma forming diseases.
Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Incidence ; Korea ; Male ; Mucins