BACKGROUND: Recently, partial pancreatectomy has been performed for treatment of benign pancreatic lesion with special attention to functional preservation of adjacent organs. In contrast to traditional pancreaticoduodenectomy( Whipple's procedure) and pylorus-preserving pancreaticoduodenectomy(PPPD), the duodenum-preserving pancreatic head resection(DPPHR) preserves stomach, duodenum, jejunum, extrahepatic bile duct, and this procedure is reported to preserve function of adjacent organs, to reduce morbidity and mortality rates. The indications of DPPHR are benign lesion of the head of the pancreas as well as complications of chronic pancreatitis, including distal common bile duct obstruction, duodenal obstruction, colonic stenosis, pseudocyst of the head of the pancreas, internal pancreatic fistula, portal or splenic vein stenosis. Also this procedure is indicated for the management of the pancreatic head injury. Reconstructive methods following resection of the pancreatic head are modified variously, this methods are end-to-end anastomosis of the pancreatic duct, Roux-en-Y pancreaticojejunostomy, pancreaticogastrostomy, pancreaticoduodenostomy. MATERIALS AND METHODS: The authors performed DPPHR in 4 patients; pseudocyst of the pancreatic head 1, pancreatic head injury 2, chronic pancreatitis 1. Two patients with pseudocyst of the pancreatic head and pancreatic head injury underwent end-to-end anastomosis of the pancreatic duct after resection of the head of the pancreas. This procedure involved insertion of feeding tube into the pancreatic duct and then end-to-end anastomosis of the pancreatic duct. Other two patients with pancreatic head injury and chronic pancreatitis underwent Roux-en-Y pancreaticojejunostomy after resection of the head of the pancreas. RESULTS: Two patients with end-to-end anastomosis of the pancreatic duct developed leakage of the anastomotic site of the pancreatic duct at 3rd and 8th postoperative days, respectively. So this patients were performed reoperation, Roux-en-Y pancreaticojejunostomy. But the peripancreatic abscess developed after reoperation and then performed drainage of the abscess. This patients were improved and discharged. Total hospital stay was 35days and 34days, respectively. Other two patients underwent Roux-en-Y pancreaticojejunostomy after resection of the head of the pancreas. This patients were improved without complications and discharged within 1 month. CONCLUSIONS: In our experiences, DPPHR can be appropriated in the treatment of complications of chronic pancreatitis, benign lesion of the head of the pancreas, pancreatic head injury. And we consider that the Roux-en-Y pancreaticojejunostomy is more safe reconstructive method, compare with the end-to-end anastomosis of the pancreatic duct.
Abscess ; Bile Ducts, Extrahepatic ; Colon ; Common Bile Duct ; Constriction, Pathologic ; Craniocerebral Trauma ; Drainage ; Duodenal Obstruction ; Duodenum ; Head* ; Humans ; Jejunum ; Length of Stay ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreatic Fistula ; Pancreaticojejunostomy ; Pancreatitis, Chronic ; Reoperation ; Splenic Vein ; Stomach

No abstract available.
Bacteria, Anaerobic*

No abstract available.
Bacteria, Anaerobic*

The causes of subclavian artery obstruction are arteriosclerosis, chest trauma, extrinsic compressive lesion of tumor or fibrosis, ateritis and coractation of aorta. Symptoms associated with subclavian artery obstruction can manifest dizziness, vertigo, ataxia, bilateral visual change because of vertebral-basilar artery insufficiency, or manifest fatigue, claudication, rest pain, digital necrosis because of arm ischemia. Treatment of subclavian artery occlusive lesion can be only medical treatment if patients was asymptomatic and a variety of surgical procedures-endarterectomy, carotid-subclavian bypass, subclavian- subclavian bypass, axillo-axillary bypass-can be recommended according to the state of surrounding vessel and general condition of patients. We experienced a case of subclavian artery obstruction in a 65 years-old male with severe claudication in left upper extremity and who had suffered from ischemic symptoms of left lower extremity. Patient was surgically treated by femoro-femoral bypass on occlusive lesion of the left lower extremity and carotid-subclavian transposition on left subclavian lesion. Postoperative result was excellent and claudication of left upper and lower extremities were completely relieved.
Aged ; Aorta ; Arm ; Arteries ; Arteriosclerosis ; Ataxia ; Dizziness ; Fatigue ; Fibrosis ; Humans ; Ischemia ; Lower Extremity ; Male ; Necrosis ; Subclavian Artery ; Thorax ; Upper Extremity ; Vertigo

A retrospective review of 36 patients with infective endocarditis by strict case definition was performed from 1972 through April of 1984. Male to female ratio was 1:1.25, with mean age of 19.1. Thirty of the 36 patients(83.3%) had the history of predisposing heart diseases: congenital heart disease was most frequent one below the age of 20, rheumatic heart disease between the age of 20-39 and degenerative heart disease above the age of 40. The commonest presenting symptoms were fever, dyspnea, and malaise, and the commonest signs were fever, murmur, and hepatomegaly. Average hemoglobinand hematocrit were 10.1g/dl and 30.8% respectively, showing moderate degree of anemia. White cell count was 11,600+/-5400/mm3 and erythrocyte sedimentation rate was 46+/-18mm/hr. Over four fifths of the patients demonstrated proteinuria and elevated C-reactive protein. Two thirds of the patients showed microscopic hematuria and one third showed positive rheumatoid factor. Eight patients(22.2%) showed arrhythmia and 4(11.1%) showed conduction abnormalities on electrocardiography. The commonest etiologic microorganisms were alpha-hemolytic streptococcus(30.6%) and staphylococcus aureus(22.2%). Abacteremic cases were found in 38.9% of the patients. To compared with alpha-hemolytic streptoccus endocarditis the cases caused by staphylococcus aureus showed the shorter duration of symptoms before admission, the less frequent complication, the higher fever, and the more elevated white cell counts. To penicillin, alpha-hemolytic streptococcus was sensitive in most cultures and staphylococcus arueus was resistant in half of them, and to aminoglycosides vice versa. To cefazolin, both microorganisms were sensitive in most cultures. In 18 of 24(75%) patients vegetation was visualized by echocardiography. The most frequent site of involvement was the mitral valve. And in vegetation detected group complication rate by embolism was found to be higher. The common complications were congestive heart gailure in 24(66.75%), embolism in 8(22.2%), and metastatic infection in 6(16.7%). The mortality rate of infective endocarditis was 25%, and the causes of death were cerebral embolism in 3(8.3%), septic septic shock in 3(8.3%), congestive heart failure in 2(5.6%), and mycotic aneurysmal rupture in 1(2.8%). Conclusively in infective endocarditis the author observed the increasing prevalence of degenerative heart disease as a prdisposing heart disease and increasing incidence of staphylococcus aureus as a causative microorganism. Adn the differences of clinical characteristics between staphylococcus ureus and alpha-hemolytic streptococcus endocarditis would be helpful in diagnosis and treatment of infective endocarditis as well as recognition of prognosis.
Aminoglycosides ; Anemia ; Aneurysm, Infected ; Arrhythmias, Cardiac ; Blood Sedimentation ; C-Reactive Protein ; Cause of Death ; Cefazolin ; Cell Count ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Embolism ; Endocarditis* ; Estrogens, Conjugated (USP) ; Female ; Fever ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Heart Failure ; Hematocrit ; Hematuria ; Hepatomegaly ; Humans ; Incidence ; Intracranial Embolism ; Male ; Mitral Valve ; Mortality ; Penicillins ; Prevalence ; Prognosis ; Proteinuria ; Retrospective Studies ; Rheumatic Heart Disease ; Rheumatoid Factor ; Rupture ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Streptococcus

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

Nine patients of mean age 47.8 years, with suspected sinus node dysfunction, underwent extensive electrophysiological studies. Sinus bradycardia(6the electrophysiological study, AH and HV intervals were prolonged in 2/9 and 1/9 patients, respectively. Maximal sinus node recovery times were prolonged in 7/9 patients, ranging from 1,330 msec to 12,330msec. Sinoatrial conduction times measured by atrial premature stimulation technique were prolonged in 5/7 patients, ranging from 137msec to 310 msec. And sinoatrial conduction time measured by continuous pacing technique also revealed prolonged value in 4/6 patients ranging from 140 msec to 195 msec. The effective refractory periods, of atrium were prolonged in 6/8 patients (320 msec to 470 msec). The effective and functional refractory periods of AV node were prolonged in 3/8 patients (440 csec to 490 msec) and 4/8 patients (530 msec to 560 msec), respectively. Retrograde VA conduction could be observed in 3/7 patients and ventricular effective refractory periods were normal in 7/7 patients. Atrial flutter was induced in 1/9 patients by electric stimulation during electrophysiological study. Above data suggest that the electrophysiological study is very useful in assessing the sinus node function and other electrophysiological properties in sick sinus syndrome patients and also suggest that the data could be utilized in choosing the proper mode of artificial pacemaker for each patient.
Atrial Flutter ; Atrioventricular Node ; Electric Stimulation ; Humans ; Pacemaker, Artificial ; Sick Sinus Syndrome* ; Sinoatrial Node

PURPOSE: To evaluate clinical outcomes after cataract surgery with bilateral implantation of the diffractive trifocal intraocular lens (IOL). METHODS: Forty-four eyes of 22 patients were analyzed in the present study from July 2014 to December 2014. Phacoemulsification with bilateral implantation of an AT Lisa tri 839 MP IOL (Carl Zeiss Meditec, Jena, Germany) was performed. Over a 6-month follow-up, the main outcome measures were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 80 cm, uncorrected near visual acuity (UNVA) at 40 cm, and spherical equivalent refraction. Visual quality and patient satisfaction were evaluated using a Quality of Vision questionnaire. Finally, the defocus curve was measured. RESULTS: The mean monocular UNVA, UIVA, and UDVA were 0.23, 0.22, and 0.02 log MAR at 1 month, 0.21, 0.20, and 0.01 log MAR at 3 months and 0.20, 0.22, and 0.01 log MAR at 6 months postoperatively, respectively. The mean binocular UNVA, UIVA, and UDVA were 0.16, 0.12, and 0.0 log MAR at 1 month, 0.15, 0.11, and 0.0 log MAR at 3 months and 0.15, 0.13, and 0.0 log MAR at 6 months postoperatively, respectively. Twelve patients reported glare and 17 patients reported halo. Defocus curve showed best visual acuity results at 0.0 D and second peak at - 2.5 D. The intermediate-vision values were stable. CONCLUSIONS: Diffractive trifocal IOL provided excellent distance, intermediate, and near visual outcomes.
Cataract ; Follow-Up Studies* ; Glare ; Humans ; Lenses, Intraocular* ; Outcome Assessment (Health Care) ; Patient Satisfaction ; Phacoemulsification ; Presbyopia ; Telescopes ; Visual Acuity

OBJECTIVE: To determine the incidence of HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome and assess the relationship between the maternal-fetal complications and the severity of HELLP syndrome, classified based on platelet count nadir. METHODS: We reviewed the maternal and neonatal charts of ten pregnancies complicated by HELLP syndrome, managed at Dankook University Hospital between January, 1995 and December, 2002. Women were divided into 2 groups as class I HELLP which had a maternal platelet nadir 50,000 and 100,000/mm3. We compared the maternal and fetal complications between class I and class II HELLP syndrome. But we did not analyze statistically due to small number of patients. RESULTS: There were four cases of class I HELLP and six cases of class II HELLP syndrome. The incidence of HELLP syndrome was 0.10% (10/10,238) in total deliveries and was 2.26% (10/443) in women with severe pre-eclampsia or eclampsia. The mean level of platelet counts nadir was 41,500/mm3 in class I and 64,000/mm3 in class II HELLP. The mean platelet recovery days (more than 100,000/mm3) were 6.0 and 4.2 days in each class. The mean values of the maximal aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT) and uric acid might show no differences, but there might be difference in lactate dehydrogenase (LDH) levels which were 5854 and 1388 IU/L in each class. All patients with class I HELLP syndrome showed maternal complications, but only one patient with class II HELLP showed maternal complications. There might be no differences in the mean gestational ages and birth weights. The neonatal complications were similar in each class. CONCLUSION: Our data suggest that patients with class I HELLP syndrome may be at increased risk for serious maternal complications, but the neonatal complications may be associated with gestational ages.
Alanine Transaminase ; Aspartate Aminotransferases ; Birth Weight ; Blood Platelets* ; Eclampsia ; Female ; Gestational Age ; HELLP Syndrome* ; Humans ; Incidence ; L-Lactate Dehydrogenase ; Liver ; Platelet Count* ; Pre-Eclampsia ; Pregnancy ; Uric Acid

Ten eels (Anguilla japonica) from a fish farm in Korea were examined and diagnosed with a Heterosporis infection. The gross lesions on the trunk were uneven and the concave parts were pasty. Histopathologically, lyses of the trunk muscles, degenerative muscle fibers and the scattered spores were observed. The sporophorocyst (SPC) contained several spores with a variety of shapes. Some SPC were disrupted and the spores in the SPC were scattered in the muscle tissues. Macrophages existed near the scattered spores. Electron microscopy revealed special structures such as sporophorocyst containing various developmental parasitic stages such as meronts, sporonts, sporophorous vesicles and spores.
*Anguilla ; Animals ; Aquaculture ; Fish Diseases/*parasitology/pathology ; Histocytochemistry/veterinary ; Korea ; Microscopy, Electron, Scanning Transmission/veterinary ; Microsporidia/*growth & development/ultrastructure ; Microsporidiosis/parasitology/pathology/*veterinary ; Muscular Diseases/parasitology/pathology/*veterinary