No abstract available.
Pancreaticoduodenectomy*

No abstract available.
Ectromelia*

BACKGROUND/AIMS: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. METHODS: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. RESULTS: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). CONCLUSIONS: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.
Helicobacter pylori* ; Helicobacter* ; Humans ; Medical Records ; Metronidazole ; Probiotics* ; Research Personnel

A 63 year-old man was admatted to our hospital because of dulI epigastralgia. Upper G-I series reveaied the generalized thickened, tortuous mucosal folds in the stomach and duodenal bulb, Two ovold large pits on the antrum were observed endoscopically, Tha relevant literatures on the subject were reviewed.
Humans ; Middle Aged ; Pylorus* ; Stomach

PURPOSE: It has been customary to perform brain ultrasonogram (brain US) for the early detection of intraventricular hemorrhage (IVH) during intensive care of neonates. On the other hand magnetic resonance imaging (MRI) has been greatly restrictioned due to its complicated procedures. This study was conducted to identify changes in neonates' brain structure and to gain basic data for the long-term follow-up of neurologic sequelae in the future. For this purpose, the findings obtained from both brain US performed within one postnatal week and MRI at the time of discharge were compared and analysed. METHODS: Brain US within one postnatal week and MRI at discharge were carried out on 67 neonates who were discharged from the neonatal intensive care unit of Fatima Hospital from July 01, 1996 to June 30, 1998. We compared and analysed IVH found in the brain US, and focal parenchymal hemorrhage, periventricular leukomalacia (PVL), basal ganglia hemorrhage, and encephalomalacia revealed the MRI performed at discharge. RESULTS: It was found that out of 67 cases from the brain US, there were 13 with IVH of Grade l & ll, 11 with IVH of Grade lll or higher, one with focal parenchymal hemorrhage, and three with PVL. Also the MRI found seven with focal parenchymal hemorrhage, one with basal ganglia hemorrhage, six with PVL, three with encephalomalacia, and one with ventricular dilatation. CONCLUSION: For infants with IVH of Grade lll or higher, MRI performed at discharge is considered to be very useful in identifying structural parenchymal abnormality and the presence or absence of its associated lesions as well as in carrying out long-term follow-up.
Basal Ganglia Hemorrhage ; Brain* ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Critical Care ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging* ; Ultrasonography*

Compare to aortic aneurysm, peripheral artery aneurysm is rare but has a tendency of developing multiple arterial aneurysms at the same time. Popliteal artery is the most frequent site of involvement and followed by femoral artery. More than 90% of peripheral artery aneurysms are occurred at these two arteries. Since we have no written nationwide report of peripheral artery aneurysm, we reviewed aneurysms that developed outside of the thoracoabdominal cavity and compared it with western reports. From January 1991 through December 1998, we experienced 19 cases of peripheral artery aneurysms and these included pseudoaneurysms that developed long after vascular trauma. Most frequent ages were 30's and about 3/4 of the patients were male. More than 75% of the patients had symptom of pulsating mass or tender mass when they visited hospital but symptoms associated with mass, such as compression of surrounding structure, were developed in only one patient. Nine cases were developed at femoral arteries and three at popliteal artery and these included 5 cases of pseudoaneurysm. One patient showed multiple arterial aneurysms and 7 patients had atherosclerosis or hypertension. Three cases had Behcet's disease and two of them developed pseudoaneurysm at arterial puncture site and vascular anastomotic site. Most of the aneurysms were excised and performed patch graft, bypass graft or simple closure according to the size of the aneurysm. Three of the patients were died due to myocardial infarction, sepsis and advanced renal failure but aneurysm related mortality was only one who developed sepsis after bypass graft. In summary, we have different incidence of peripheral artery aneurysm in site, multiplicity and presenting symptoms but these are not sufficient because of small limited number of patients. Nationwide report and analysis is necessary.
Aneurysm* ; Aneurysm, False ; Aortic Aneurysm ; Arteries* ; Atherosclerosis ; Femoral Artery ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Myocardial Infarction ; Popliteal Artery ; Punctures ; Renal Insufficiency ; Sepsis ; Transplants

Intracoronary stent implantation can improve coronary hemodynamics and myocardial ischemia in patients with symptomatic bridging. However, percutaneous coronary intervention for this lesion is limited due to the high prevalence of restenosis and risk of complications. We present a case of a totally occluded long-segment myocardial bridge in a patient with hypertrophic cardiomyopathy who was successfully implanted with a bare metal stent under intravascular ultrasound guidance without complications. The patient has been free of ischemic symptoms with stent patency for 10 years.
Cardiomyopathy, Hypertrophic* ; Follow-Up Studies* ; Hemodynamics ; Humans ; Myocardial Bridging ; Myocardial Ischemia ; Percutaneous Coronary Intervention* ; Prevalence ; Stents ; Ultrasonography

PURPOSE: The aim of this study was to evaluate the effects and safety of a sleep aid for postoperative analgesia in patients undergoing arthroscopic rotator cuff repair. MATERIALS AND METHODS: Seventy-eight patients were prospectively assigned to either the zolpidem group (multimodal analgesia+zolpidem; 39 patients) or the control group (multimodal analgesia; 39 patients). Self-rated pain levels were assessed twice a day using a visual analog scale (VAS). The need for additional rescue analgesic, duration of functional recovery, and adverse effects were assessed for the first 5 days after surgery. RESULTS: The mean number of times that additional rescue analgesic was required during 5 days after surgery was 2.1+/-2.0 in the zolpidem group and 3.3+/-2.8 in the control group, a significant difference. There were no significant differences between the two groups in mean VAS pain scores during the first 5 days after surgery, although the zolpidem group had lower VAS pain scores than the control group. Additionally, there were no significant differences in duration of functional recovery and adverse effects between the two groups. CONCLUSION: The use of zolpidem for analgesia after arthroscopic rotator cuff repair provided a significant reduction in the need for rescue analgesic without increasing adverse effects. Nevertheless, mean VAS pain scores during the first 5 days after surgery did not differ between the zolpidem group and the control group.
Adult ; Analgesia/*methods ; Analgesics/*therapeutic use ; Arthroscopy/*adverse effects ; Female ; Humans ; Hypnotics and Sedatives/*therapeutic use ; Male ; Middle Aged ; Pain Management ; Pain Measurement ; Pain, Postoperative/drug therapy/etiology/*prevention & control ; Postoperative Period ; Prospective Studies ; Pyridines/*therapeutic use ; Rotator Cuff/injuries/*surgery ; Sleep/drug effects ; Treatment Outcome ; Visual Analog Scale

BACKGROUND: The aim of this study was to describe the mini-open suture bridge technique with porcine dermal patch augmentation for massive rotator cuff tear and to assess preliminary clinical and radiological results. METHODS: Five patients with massive rotator cuff tear for which it was not possible to restore the anatomical footprint underwent mini-open suture bridge repair using a porcine dermal patch. The patients' average age was 53.4 years (range, 45 to 57 years), and the average duration of follow-up was 20.6 months (range, 14 to 26 months). Patients were evaluated with preoperative and postoperative outcome measures, including a visual analog scale (VAS) for pain, the University of California Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score. The structural integrity of repaired rotator cuffs was assessed by magnetic resonance imaging 6 months postoperatively. RESULTS: The average VAS pain score, UCLA score, and ASES score improved from 6.8, 15.4, and 39.4 preoperatively to 0.8, 31.2, and 86.4 postoperatively (p = 0.041, 0.042, and 0.043, respectively). Magnetic resonance images obtained at an average of 8 months after surgery showed that four patients had intact repair integrity with graft incorporation. One patient had a re-tear with partial healing but still had a satisfactory clinical outcome. There was no intraoperative or postoperative complication in any patient. CONCLUSIONS: Mini-open suture bridge repair with porcine dermal patch augmentation can be an option in young patients with high physical demands and massive rotator cuff tears for which it is not possible to restore the anatomical footprint.
Biocompatible Materials ; *Collagen ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostheses and Implants ; Rotator Cuff/injuries/pathology/*surgery ; Suture Techniques ; Tendon Injuries/diagnosis/*surgery

OBJECTIVE: To investigate whether synovial fluid adenosine deaminase activity is useful in the differential diagnosis of joint swelling and in estimating the disease activity. METHOD: Adenosine deaminase activity was determined in the synovial fluid taken from patients with rheumatoid arthritis (n=21), osteoarthritis (n=ll), ankylosing spondylitis (n=3), and gouty arthritis (n=2). This enzyme activity was compared with the laboratory indices (ESR, CRP) in the blood and the other parameters in the synovial fluid. RESULT: More increased adenosine deaminase activity was found in the synovial fluid taken from patients with rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis, as compared with that of osteoarthritis patients. Synovial fluid ADA activity was significantly corelated with the WBC count in the synovial fluid, but there was no statistical corelation between other synovial parameters and adenosine deaminase activity. CONCLUSION: Adenosine deaminase activity is useful in the differential diagnosis of joint swelling between inflammatory joint disease and osteoarthritis, but not useful in estimating the disease activity.
Adenosine Deaminase ; Adenosine* ; Arthritis, Gouty* ; Arthritis, Rheumatoid* ; Diagnosis, Differential ; Humans ; Joint Diseases ; Joints ; Osteoarthritis* ; Spondylitis, Ankylosing* ; Synovial Fluid*