No abstract available.
Humans

No abstract available.
Histiocytosis*

We tried to analyze the status of 10 units of frozen thawed apheresis platelet concentration by 6% DMSO method for the evaluation of practical applicability. The platelet concentrations were transferred to PL-732(Baxter, USA) cryopreservation bag, and DMSO is added to those bag at slow rate until expected final 6% concentration is achieved, thereafter those were directly placed to -80 degrees C refrigerator for freezing. Someday later from I week to 1 month, those were thawed at 37 degrees C water bath, and then washed by same volume of ABO matched plasma. In the course of cryopreservation, about 7% of platelets were lost and the mean recovery rate of platelet was 93% compared with those of unfrozen status. LDH, the values of platelet lysis, and pH were within normal limits, whereas platelet aggregation test shows decreased aggregation to collagen and ristocetine compared with those of unfrozen status(p<0.05) but they were clinically acceptable. We suggest that the frozen platelets may be useful in a some clinical situation such as hematologic malignancy and solid tumor by autologous transfusion.
Baths ; Blood Component Removal ; Blood Platelets* ; Collagen ; Cryopreservation* ; Dimethyl Sulfoxide* ; Freezing ; Hematologic Neoplasms ; Hydrogen-Ion Concentration ; Plasma ; Platelet Aggregation ; Ristocetin ; Water

No abstract available.
Iliac Vein ; Leiomyosarcoma

Dissecting aneurysm involves development of a hematoma in the media of aorta, which is usually contagious with the lumen of the aorta via a tear in the media. The high percentage of co-existing diseases such as other cardiovascular diseases in these patients accounts for much of the surgical morbidity and mortality. Complications in Dacron patch graft surgery for repair of descending thoracic aortic aneurysm include massive hemorrhage, myocardial ischemia, myocardial infarction, heart failure, paraplegia and renal failure. A 60 year-old, 59kg woman underwent Dacron patch graft surgery for descending thoracic aortic aneurysm, under the high thoracic epidural block supplemented with light general anesthesia(N2O-O2). During operation, systolic blood pressure of upper extremities ranging from 120 mmHg to 100 mmHg was maintained, while diastolic pressure was maintained from 60 mmHg to 4) mmHg. Mean arterial pressure of 15-20 mmHg was maintained in lower extremities. When aorta was declamped, hypotension and bradycardia continued for 10 minutes. After administration of epinephrine and CaCl2, vital signs were stable. Total aorta cross-clamping time was 47 minutes, and total urine output was 200 ml. Although mannitol and steroid were administered for prevention, paraplegia occured postoperatively because of prolonged aorta cross clamping time.
Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm, Thoracic* ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Cardiovascular Diseases ; Constriction ; Epinephrine ; Female ; Heart Failure ; Hematoma ; Hemorrhage ; Humans ; Hypotension ; Lower Extremity ; Mannitol ; Middle Aged ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Paraplegia* ; Polyethylene Terephthalates ; Renal Insufficiency ; Transplants ; Upper Extremity ; Vital Signs

BACKGROUND: Self-expandable metallic stent is an effective method in palliative treatment of malignant biliary stricture. However, it is controvesial in benign biliary stricture due to recurrent jaundice, cholangtitis, and finally, obstruction of stent. The purpose of this study was to determine the long-term effectiveness of Gianturco expandable metallic stents in benign biliary strictures. METHODS: We inserted Gianturco self-expandable metallic stent in 13 patients (42~69 years old, 6 men and 7 women) with benign biliary stricture between November 1991 and September 1994 in Wonkwang University Hospital. All patients had a previous history of biliary surgery and underwent balloon dilatation procedure for management of strictures. Insertion routes were percutaneous transhepatic biliary drainage tracks in 8 cases and T-tube tracks in 5 cases. The insertion site was the right intrahepatic duct in 5 cases, the left intrahepatic duct in 2 cases, both intrahepatic ducts in 1 case, common hepatic duct in 1 case, and distal common bile ducts in 4 cases. The stents used were 2~6cm in length and 8~12mm in diameter. The follow-up period was 46months to 81months(mean, 67months). RESULTS: The initial technical success rate was 100% with good immediate patency in all patients. Nine patients(69.2%) had no recurrence of the initial strictures during the follow-up period and 4 patients(30.7%) had further symptoms of biliary obstruction caused by recurrent cholangitis or intrahepatic duct stone formation. These 4 recurrent biliary strictures were treated by surgical methods. The recurrent stricture sites were distal common bile duct(1case), left intrahepatic duct(1case), both intrahepatic ducts(1case), and Roux-en-Y hepaticojejunostomy site(1case). CONCLUSIONS: According to the results of long-term follow-up, expandable metallic stent is a useful method in recurrent biliary strictures, especially in the case where operation is not feasible; poor risk patients, patients refusing operation, multiple biliary operation.
Bile ; Cholangitis ; Common Bile Duct ; Constriction, Pathologic* ; Dilatation ; Drainage ; Follow-Up Studies* ; Hepatic Duct, Common ; Humans ; Jaundice ; Male ; Palliative Care ; Recurrence ; Stents*

No abstract available.
Constriction, Pathologic ; Stents

PURPOSE: A heterotopic pancreas is defined as one for which pancreatic tissue is present outside its usual or habitual location and without an anatomic relation either of continuity or of vascularization with the pancreas proper. Most heterotopic pancreases are incidentally encountered during surgery, and on rare occasions, epigastric pain, weight loss, hemorrhage, gastric outlet obstruction, and intussusception have been directly attributable to the presence of a heterotopic pancreas. The purpose of this article is to report the clinical characteristics of the heterotopic pancreas. METHOD: We retrospectively observed 24 patients, who had been pathologically proven to have a heterotopic pancreas, at the Department of Surgery, Korea University Hospital, from Jan. 1990 to Dec. 1998. RESULTS: 16 of the 24 cases were found incidentally during operations due to by other primary diseases; 8 cases were symptomatic. The ratio of males to females was 1.18:1 and most common sites were the stomach and the duodenum (71%). The mean size of the lesion was 1.26 cm, and the sizes in symptomatic cases were larger (mean 1.89 cm) than those in cases where the lesions were found incidentally (mean 0.94 cm). We experienced a case of a ductal adenocarcinoma originating from the heterotopic pancreas in the jejunum of a 73 year old man. CONCLUSION: A heterotopic pancreas should be considered in the differential diagnosis of submucosal tumors, polyps, ulceration, and intestinal tumors, When suspected, an intraoperative frozen section is recommended, and the range and the method of the operation should be decided based on the results of the frozen section.
Adenocarcinoma ; Aged ; Diagnosis, Differential ; Duodenum ; Female ; Frozen Sections ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Intussusception ; Jejunum ; Korea ; Male ; Pancreas* ; Polyps ; Retrospective Studies ; Stomach ; Ulcer ; Weight Loss

Renovascular hypertension secondary to renal artery vascular disease is the most common form of surgically correctable hypertension. The common causes of renovascular hypertension are atherosclerosis, fibromuscular dysplasia, and Takayasu arteritis. Takayasu arteritis is a chronic nonspecific arteritis of unkown cause that is relatively prevalant in young female subjects. It has been well known that the pathologic feature of the disease consist predominantly of occulsive changes in the aorta and the origin of its major branches. The most important pathogenetic mechanism of hypertension seems to be through renal artery stenosis. We have experimented three hypertensive patients with Takayasu arteritis experienced. Basic diagnosis was established by angiographic study. This article presents surgical treatment methods of Takayasu arteritis with renovascular hypertension and brief review of literatures.
Aorta ; Arteritis ; Atherosclerosis ; Diagnosis ; Female ; Fibromuscular Dysplasia ; Humans ; Hypertension ; Hypertension, Renovascular ; Renal Artery ; Renal Artery Obstruction ; Takayasu Arteritis ; Vascular Diseases

No abstract available.
Animals ; Horns* ; Keratoacanthoma*