No abstract available.

No abstract available.
Hemorrhage* ; Hemorrhoids* ; Ligation* ; Rubber*

No abstract available.
Genu Varum*

No abstract available.
Rectal Prolapse*

Vascular grafts are often required in clinical stiuations to bridge arterial or venous grafts. Numerous studies exist in the literature concerning the results of such arterial and venous graft of relatively large vessels. There are only a few reports dealing with experimental microvascular grafts. Histopathological features of the grafted vessels were studied after autogenous venous grafts,autogenous arterial grafts and venous allografts using microsurgical techniques. The results were summerized as follow. 1. The patency rate of grafted vessels by microsurgical techniques was 86.8%. 2. In autogenous venous grafts histopathological changes occur later, and to a less pronounced degree, than that in autogenous arterial grafts. 3. Venous allografts showed severe acute inflammatory reaction throughout the layer at 3~7 days postoperatively, but histopathological features of grafted vessels of autografts and venous allografts' did not differ each other in later results. 4. Autogenous venous grafts, autogenous arterial gtafts and venous allografts persist as living sucture but undergo certain histological changes consisting of fibrous reinforcement. 5. It may be said that histological examination of the specimen led general conclusion that the most useful microvascular graft to reestablish circulation of damaged vessels is the autogenous venous graft, but autogenous arterial graft and venous allograft are also applicable when autogenous venous tissue is not available.
Allografts ; Autografts ; Transplants

Interlocking nailing technique has many advantages in the fracture treatment. Such as the prevention of infection and devitalization by closed technique, stable intramedullary osteosynthesis, bone grafting effect of reaming debris, and early restoration of loading and function, comparing to the conventional intramedullary nailing. However, we met many problems during the operative procedure due to deficient concept and technique. We have checked the possible problems during and after the procedure of interlocking nailing for the tibia or femur fractures in 69 cases. 1. Sixty nine cases were consisted by 26 cases of femur fractures and 43 cases of tibia fractures. 2. The inadequate implant length was the most common error in the implant selection (4 cases in femur, 6 cases in tibia). 3. A new fragment was made in 12 patients(17%) during surgery, more commonly in the femur (9 cases), especially medial side and distal to the fracture line. 4. Bone shortening, angulation deformity or rotational deformity, caused by incomplete reduction, were developed more commonly in the tibia than in the femur. 5. Post-operative deep infection were developed in 2 cases(3%). 6. Delayed or non-union were developed in 18 cases(28%), who were followed for more than 3 months. 7. Circumferential wiring or bone grafting using semiclosed technique is thought to be useful to prevent delayed or nonunion when there is a wide gap between fractured fragments pre-operatively.
Bone Transplantation ; Congenital Abnormalities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Surgical Procedures, Operative ; Tibia

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
Amyloid ; Amyloidosis ; Congo Red ; Eosinophils ; Female ; Humans ; Hyalin ; Light ; Lymph Nodes ; Mediastinum ; Middle Aged ; Thorax ; Thymoma ; Thymus Gland

The aim of this study was to find out an effective method of laparoscopic oncologic right hemicolectomy based on vascular anatomy of the right colon and patterns of lymph node metastasis. From September 1994 to November 1997,20 hemodynamically stable patients received curative laparoscopic-assisted right hemicolectomy for adenocarcinoma by one surgeon. Simultaneously anatomic variations of right colonic vessels and patterns of lymph node metastasis were analyzed. All operations were performed by laparoscopic-assisted method that consisted of intracorporeal mobilization of the right colon followed by extracorporeal resection and anastomosis and lymph node dissection up to superior mesenteric vessels under direct vision through mini-incision just above the root of superior mesenteric vessels. Ileocolic (ICA) and mid colic artery (MCA) existed constantly (100%), right colic artery (RCA) existed only in 12 cases (60%). Mean distance from origin of MCA to ICA was 3.2cm. Mean number of lymph nodes harvested from SMA area was 2.9 per case. In 2 cases, they showed metastasis. Astler-Coilers stage Bl, B2, Cl, C2 were distributed in 6, 8, 1, 5 cases respectively. Mean number of lymph node dissected and length of resection margin was 29.3 and 8.7 cm. Operative time, time to oral intake, hospital stay was 187 minutes,2.6 days,7.2 days, respectively. Open conversion was needed in 1 case due to duodenal invasion. Mean 14 months follow-up showed 2 recurrences. One who have had duodenal wedge resection due to cancer invasion underwent reresection of duodenum because of duodenal recurrence 12 months after the first operation. The other suddenly died of myocardial infarction after operation for ovarian recurrence 8 months later to her right hemicolectomy. Right colonic vascular anatomy was so various but the area from MCA to ICA was constantly within 4 cm and, lymph nodes in that area must be cleared. Therefore, laparoscopic intracorporeal mobilization and extracorporeal resection of the right colon and lymph node dissection through small incision was effective, safe and one of the best method to get advantages of laparoscopic and open surgery simultaneously.
Adenocarcinoma ; Arteries ; Colic ; Colon ; Duodenum ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Myocardial Infarction ; Neoplasm Metastasis ; Operative Time ; Recurrence

PURPOSE: Although staged operations have been thought a main treatment for obstructive left colon cancer, their disadvantages make one-stage operations popular. We tried to identify technical feasibility and oncologic safety of one-stage operation with intra-operative lavage (IOL) for the treatment of obstructive left colon and rectal cancer. METHODS: From June 1996 to May 1999, of 456 colorectal cancer patients, 25 with obstructive left colon or rectal cancer underwent surgery. In 18 of those, we intended to do a one-stage operation with IOL. Male (n=14) were predominant to female (n=4). Mean age was 61.2 (29~78) years. Lesions were located on the sigmoid colon in 8, rectum in 4, descending in 3, and rectosigmoid junction in 3 cases. Operative technique: Lymphovascular division was initiated at the origin of IMA followed by mobilization of the left colon up to the splenic flexure and distal transverse colon. Thereafter antegrade irrigation of the proximal colon with warm normal saline was done by using a corrugated tube. Anastomoses were made by hand or stapler in end-to-end or side-to-end fashion. RESULTS: Mean operative time was 221 (185~360) min. No significant post-operative complications occurred except for two wound infections and one pulmonary atelectasis. There was one unexpected conversion to Hartmann's procedure due to intra-operative fecal soilage during the lavage. Within 18 months follow-up period, 4 recurrences occurred with two of them expiring. CONCLUSIONS:: One-stage operation for the treatment of obstructive left colon cancer with IOL could avoid colostomy or reoperation, and, was technically feasible, safe, and oncologically acceptable.
Colon* ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms* ; Colorectal Neoplasms ; Colostomy ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Operative Time ; Pulmonary Atelectasis ; Rectal Neoplasms ; Rectum ; Recurrence ; Reoperation ; Therapeutic Irrigation* ; Wound Infection