BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

No abstract available.
Porphyrias, Hepatic*

The purpose of this study was to evaluated the improve method of demineralization and damage on the enamel stufece related to bonded orthodontic bracket. Enamel surface of the 40 Intact premolars were treated by acid etching and various fluoride application methods and then maintained in the patient mouth of 3 months. After extraction of all the sampled premolars, enamel surfaces were evaluated by Scanning electron microscope. The obtained results were as follow. 1. Enamel surface relate to bonded orthodontic bracket showed demineralization and damage, slightly. 2. Group 6 treated by 2% NaF iontophoresis presented and almost similarity to normal enamel surface. 3. Group 2 treated by acid etching had demineralization and damage on the enamel surface much more than other groups treated by various fluoride application methods. 4. Demineralization and damage on the enamel surface caused by bonded orthodontic bracket is improved by various fluoride application methods.
Bicuspid ; Dental Enamel* ; Fluorides ; Humans ; Iontophoresis ; Mouth ; Orthodontic Brackets*

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

No abstract available.
Cesarean Section, Repeat* ; Female ; Fistula*

No abstract available.
Female ; Humans ; Leukemia, Promyelocytic, Acute* ; Pregnant Women*

BACKGROUND: A strategy of mechanical ventilation that limits tidal volume while permitting hypercapnia has been recommended for patients with the acute respiratory distress syndrome. We attempted to evaluate the effects of protective-ventilatory strategy on the outcome of the acute respiratory distress syndrome. METHODS: The study was performed on 31 patients over 16 years old who were under the mechanical ventilation with the diagnosis of acute lung injury (ALI)/ARDS in the Surgical ICU. Pulmonary artery catheter was inserted after start of ventilation. A tidal volume (VT) of 10 to 12 ml per kg and positive end expiratory pressure (PEEP) 10 cmH2O or less was used in conventional group (n = 15), and VT of 6 to 8 ml/kg and PEEP 15 cmH2O or less was used in protective group (n = 16). Arterial blood gas analysis, hemodynamic parameters and metabolic parameters were recorded 1, 3, 5 and 7 day interval. RESULTS: 1) VT, PEEP and respiratory rate showed statistical differences between groups (10.5 +/- 1.2 vs. 6.7 +/- 0.8 ml/kg, 7.7 +/- 3.3 vs. 13.3 +/- 3.1 cmH2O, 15.0 +/- 3.7 vs. 20.3 +/- 4.1 rate/min), but minute volume didn't showed significant difference in between groups. 2) Mortality was 46% in the conventional group and 25% in protective group (P < 0.001). 3) Significant difference was identified in PaO2/FiO2 (176.9 +/- 81.7 vs. 274.7 +/- 83.5), wedge pressure (11.1 +/- 3.7 vs. 16.2 +/- 3.9 mmHg) and mean pulmonary artery pressure (23.0 +/- 4.5 vs. 30.2 +/- 6.5 mmHg) during study periods. 4) The incidence of barotrauma and dialysis for renal failure were similar in the both groups. CONCLUSIONS: Protective ventilatory strategy with low VT and high PEEP shows low mortality in ALI/ARDS patients, it is recommended method for the ALI/ARDS patients.
Acute Lung Injury ; Adolescent ; Barotrauma ; Blood Gas Analysis ; Catheters ; Diagnosis ; Dialysis ; Hemodynamics ; Humans ; Hypercapnia ; Incidence ; Mortality ; Positive-Pressure Respiration ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Respiratory Rate ; Tidal Volume ; Ventilation

Successful treatment of the non-growing patient with an open bite of either dental skeletal pattern often presents a difficult challenge. The morphologic pattern in anterior open bite is characterized by longer vertical dimensions, an increase in development of the maxillary posterior dento-alveolar structure and a steep mandibular plane. In such cases, molar intrusion would be a good remedy for treatment. This article reports the successful treatment and retention of two anterior open-bite cases. We used orthodontic mini-implants for treatment and a circumferential retainer with posterior bite block or skeletal fixed retainer for retention. The diagnostic criteria and mechanics for appropriate treatment are discussed. Our results suggest that open bite can be reduced successfully with intrusion of molars using orthodontic mini-implants (OMI) without orthognathic surgery, and that circumferential retainer with posterior bite block and skeletal fixed retainer are effective for retention.
Adult ; Bites and Stings ; Humans ; Mechanics ; Molar ; Open Bite ; Orthognathic Surgery ; Retention (Psychology) ; Vertical Dimension

To elucidate iron utilization patterns of Staphylococcus aureus according to the growth, we checked the residual iron concentration and the production of siderophores at the indicated times while culturing S. aureus ATCC 6538 and 25923 strains in brain heart infusion broth. By using streptonigrin susceptibility test and investigating growth curves in three culture media of which iron concentration is 0.2, 20, 45 uM, respectively, we found out that iron metabolism of 6538 strain was more active than that of 25923 strain. In point of tendency of iron consumption, 6538 strain steeply consumed iron just before the onset of stationary phase, but 25923 strain did gradually iron throughout the growth phase. Nevertheless, total amount of iron consumed by each strain during the growth was almost no difference between the strains. CAS diffusion assay in detecting siderophores showed that siderophore production followed iron consumption. These results suggest that the siderophores play significant role in iron utilization in vitro.
Brain ; Culture Media ; Diffusion ; Heart ; Iron* ; Metabolism ; Siderophores ; Staphylococcus aureus* ; Staphylococcus* ; Streptonigrin