No abstract available.
Pancreas* ; Stem Cells*

Colon has the highest bacterial concentration in the gastrointestinal tract. When the colon is perforated, the operator has to decide whether to perform primary closure, resection with anastomosis, proximal colostomy, and exteriorizatoion. In this retrospective study, from October, 1993, through July 1998, 56 patient with panperitonitis due to colon perforation were operated at Ewha womans University medical center. The rectal perforation was limited the intraperitoneal portion. Our cases were divided into two groups. Group I included 34 patients who treated with one step operations of primaryrepair or resection anastomosis. Group II included 22 patients who treated with two step operations of proximal colostomy or exteriorization. The one step operations were performed in 34 patients, proximal colostomy in 21 patients, and exteriorization in 1 patient. There was 13.7% in the incidence of motality and 33.3% in the incidence of morbidity. The Chi-square test was used to evaluate the significance of differences between two groups. Independent risk factors for adverse outcomes were compared and used to analyse the probability for adverse outcomes with respect to the mode of treatmen. The mode of treatment was not dependent on the risk factors. These results suggest that one could select positively primary closure or resection with anastomosis for the treatment of patients with panperitonitis due to colon perforation.
Academic Medical Centers ; Colon* ; Colostomy ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Retrospective Studies ; Risk Factors

BACKGROUND: Atrial fibrillation (AF), commonly considered as a cardiac embolic source, can itself be induced by stroke. We therefore tried to find and analyze this 'stroke-induced' AF. METHODS: From the Inha University Stroke Registry of the past 2 years, 143 middle cerebral artery (MCA) territorial infarct patients who had been admitted within 48 hours after stroke onset were recruited to participate in the study. Electrocardiograms (EKG) on admission and follow-up during hospitalization were analyzed. Also, MCA infarct was subdivided according to insular involvement by brain imaging. RESULTS: Among 143 MCA territorial infarcts, 38 patients had AF on admission (Rt:21; Lt:17). Of those, insular involvements of the MCA infarct was noted in 32 patients. All the patients had a follow-up EKG and AF disappeared in 3 patients (Rt:2; Lt:1). In the remaining 105 patients, 10 patients subsequently developed new AF within 1 week after hospitalization. All those 10 patients had right-sided MCA infarcts and insular involvements were present in 9 patients. In summary, among the 48 MCA infarct associated with AF, 13 AF (Rt:12; Lt:1) were presumed to be the consequence and not the cause of stroke. CONCLUSIONS: Though human insular stimulation and inactivation studies have suggested that AF would be more common in left insular destructive lesions, it was not always supported in clinical series. From our study, presumed 'stroke-induced' AF was highly associated with right insular lesions. The mechanism of arrhythmogenesis by ischemic stroke might be more complicated than previously expected and, not merely the simple inactivation of an anatomical substrate, the insular cortex.
Atrial Fibrillation* ; Electrocardiography ; Follow-Up Studies ; Hospitalization ; Humans ; Middle Cerebral Artery* ; Neuroimaging ; Stroke

15 male patients who received total cystectomy with ileal conduit for bladder tumor were reviewed in relation to the incidence of urethral involvement. Of 15 patients six had recurrent transitional cell carcinoma in the urethral remnant among them one (1/15) received subsequent therapeutic urethrectomy and remaining 5 patients underwent delayed therapeutic urethrectomy after confirmation of urethral tumor but 9 of the 15 had only received total cystectomy. We concluded that the remaining urethra might constitute a potential hazard for further tumor formation. We believe that prophylactic urethrectomy is the way to prevent the recurrence of the malignancy who have multiple tumors, concurrent upper tract tumors, and involvement of the trigone or prostatic urethra.
Carcinoma, Transitional Cell* ; Cystectomy* ; Humans ; Incidence ; Male ; Recurrence ; Urethra* ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion*

We live in a digital world where a variety of wearable medical devices are available. These technologies enable us to measure our health in our daily lives. It is increasingly possible to manage our own health directly through data gathered from these wearable devices. Likewise, healthcare professionals have also been able to indirectly monitor patients’ health. Healthcare professionals have accepted that digital technologies will play an increasingly important role in healthcare. Wearable technologies allow better collection of personal medical data, which healthcare professionals can use to improve the quality of healthcare provided to the public. The use of continuous glucose monitoring systems (CGMS) is the most representative and desirable case in the adoption of digital technology in healthcare. Using the case of CGMS and examining its use from the perspective of healthcare professionals, this paper discusses the necessary adjustments required in clinical practices. There is a need for various stakeholders, such as medical staff, patients, industry partners, and policy-makers, to utilize and harness the potential of digital technology.

No abstract available.
Oculomotor Nerve Diseases ; Oculomotor Nerve

Since year of 1969. Authors have experienced five cases of seleral grafts for the repair of focal scleral traumatic defect, traumatic ectasia and necrosis after pterygium operation. The results are as follows: (1) Case 1 (13 aged, male) a large scleral defects after perforating injury of left eye was closed successfully with an onlay technique of scleral iso-graft (10 X 10mm) which was obtained from contralateral multiple ruptured eye. (2) Case 2, and 3 (17 and 23 aged, females) small focal scleral ectasias near the limbus (os) as a late complication of penetrating injuries in both cases were improved completely by electric diathermy and the onlay application of scleral allo-graft which were obtained from eye-bank eyes. (3) Case 4 (60 aged, male) a local small progressing undermined scleral necrosis near the nasal limbus (OD) which is supposed as a late complication (8 yrs later) of pterygium removal and strontium 90 irradiation on the scleral side could be cured successfull by a circular lamellar full-thickness scleral allo-graft (6mm). (4) Case 5 (60 aged, male) a much more advanced scleral necrosis and complicated uveitis (os) developed within 2 months after pterygium removal and Mitomycin C drop instillation was replac ed by a scleral allo-graft. But scleral necrosis and inflammatory processes of other. sctes were spreaded out to superior and temporal scleras within a months and then the eye was finally enucleated. Histo-pathology of an enucleated eye showed a chronic inflammatory reaction with many plasma cells and lymphocytes, occassionally giants cells.
Diathermy ; Dilatation, Pathologic* ; Inlays ; Lymphocytes ; Mitomycin ; Necrosis* ; Plasma Cells ; Pterygium ; Sclera ; Strontium ; Transplants* ; Uveitis

Cardioplegic myocardial protection has become the most popular method for coronary artery bypass surgery. In contrast, we reported 17 consecutive coronary artery bypass operations with ventricular fibrilation, nitroglycerine infusion, and moderate hypothermia. The average patients age was 55 years. 11 patients had stable angina, 4 patients unstable angina, 2 patients varient angina, and 6 patients had prior myocardial infarcation. On cardiac catheterization, the mean LVEDP was 17.32+/-2.13mmHg, EF was 0.67, and abnormal LV wall motion was noted in 5 patients. Premedication usually consisted of hydroxyzine 1~3mg/kg with or without morphine 0.05~0.1mg/kg IM. Induction agents was morphine sulfate, diazepam, lidocaine and pancuronium for muscle relaxant. Maintaninance agents were nitrous oxide, morphine with small dose of halothane or enflurane. Almost all case (15 patient) was infused nitroglycerine 0.5~1.5 microg/kg throughout entire procedure. After bypass, average patient's temperature maintained 25~28 degrees C, and ventricular fibrillation were induced with or without cold saline irrigation around the heart. Average mean arterial pressure were maintained 60~80 mmHg during bypass period. At the end of bypass, if spontaneous beating were not occurred under normal temperature, defibrillation were used. After bypass stop, methylprednisolone were injected in 15 patients. Average anesthetic time was 585 min., surgery time was 529 min, bypass time was 237 min. Arterial blood gas and electrolyte was acceptable range during all period. Complication implicated with anesthesia was myocardial infarction (3 patient), arrhythmia and transient vocal cord paralysis, 1 patient, respectively and no mortality. In all cases the anginal pain was improved.
Anesthesia ; Angina, Stable ; Angina, Unstable ; Arrhythmias, Cardiac ; Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diazepam ; Enflurane ; Halothane ; Heart ; Humans ; Hydroxyzine ; Hypothermia ; Lidocaine ; Methylprednisolone ; Morphine ; Mortality ; Myocardial Infarction ; Nitroglycerin* ; Nitrous Oxide ; Pancuronium ; Premedication ; Ventricular Fibrillation* ; Vocal Cord Paralysis

PURPOSE: Application of a laparoscopic technique to common bile duct explorations has been limited due to technical difficulty. With increased experience and technique, laparoscopic surgery has become a possible option for the treatment of common bile duct stones. The purpose of this study was to assess the usefulness of laparoscopic surgery in the treatment of common bile duct stones. METHODS: Between March 1997 and August 1999, 35 patients with choledocholithiasis were treated with laparoscopic common bile duct exploration (4 had a previous biliary operative history). Intraoperative choledochoscopy was used to remove common bile duct stones. The stones were retrieved by using a saline flush, a basket, or a Fogarty catheter. The impacted stones were destroyed using electrohydraulic lithotripsy. RESULTS: Successful laparoscopic stone clearance was achieved in 33 cases (94.3%), and conversion to open surgery occurred in one case (2.9%). The morbidity was 5.7% without mortality. Two cases of retained stone were treated with postoperative choledochoscopic removal via fistula tract and postoperative endoscopic extraction. CONCLUSION: Laparoscopic common bile duct exploration is feasible and safe in most patients. With increased of experience, laparoscopic common bile duct exploration could be used widely.
Catheters ; Choledocholithiasis ; Common Bile Duct* ; Conversion to Open Surgery ; Fistula ; Humans ; Laparoscopy* ; Lithotripsy ; Mortality

No abstract available.
Diabetes Mellitus, Type 2/genetics ; Diabetes, Gestational/*etiology/genetics ; Female ; Humans ; Infant, Newborn ; Korea ; Male ; Pregnancy ; Risk Factors