From November 1987 to December 1995, 76 patients with periampullary cancer underwent resectional surgery in the department of surgery, Kosin medical college. The object of this study was to assess the prognostic factors of the periampullary cancer after pancreaticoduodenectomy. The postoperative mortality rate was 11.8%. Significant morbidity occurred in 39.5% of the patients, early reoperation was required in 9.2% of these patients, and the mean hospital stay was 21.7 days. Univariate analysis on all patients revealed that the survival rate was significantly related to the size of the tumor (> or =3.0 cm 13%, <3.0 cm 41.4%; p<0.05), lymph node status (invasion 8.7%, no invasion 31.8%; p<0.05) and the age of the patient (>50 20.5%, < or =50 34.5%; p<0.05). The site was less significant(distal CBD 27%, ampulla of Vater 16.7%, pancreas 9%, duodenum 2%; p>0.05). These results indicated that patients with a tumor size lesser than 3cm, without lymph node involvement, and under the age of 50 had a long term survival rate.
Ampulla of Vater ; Duodenum ; Humans ; Length of Stay ; Lymph Nodes ; Mortality ; Pancreas ; Pancreaticoduodenectomy* ; Reoperation ; Survival Rate

To investigate the effect of disposable contact lenses (CL) on the corneal epithelial healing, a prospective study of 30 myopic epikeratoplasties which were divided into 3 groups according to the method for promoting the corneal epithelial healing was conducted. The groups are consisted of 10 eyes with pressure patch, 10 eyes with Acuvue(R) disposable CL and 10 eyes with SeeQuence(R) disposable CL. Corneal epithelial healing was completed in the pressure patch, Acuvue(R) CL and SeeQuence(R) CL group at 3.4, 3.5 and 3.4 postoperative days, respectively. Corneal epithelial healing rate during postoperative 1, 2 and 3 days are 0.33, O.78, and O.44mm2/hour in pressure patch group, O.24, O.92 and O.37mm2/hour in Acuvue(R) CL group, and O.30, O.79 and O.38mm2/hour in SeeQuence(R) CL group respectively. From the above results, it is concluded that there was no statistically significant difference of the corneal epithelial healing time and rate between the pressure patching and disposable bandage CL wearing after myopic epikeratoplasty.
Bandages* ; Contact Lenses* ; Epikeratophakia* ; Prospective Studies

Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation.
Anesthesia, General ; Humans ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Pharyngitis* ; Prone Position* ; Supine Position

This study was performed to investigate the corneal epithelial healing time and rate according to the method for promoting the reepithelization after myopic epikeratoplasty. A prospective study was conducted on 30 myopic epikeratoplasties which were divided into 3 groups according to the method for promoting the epithelial healing. The groups consisted of 10 eyes with pressure patches, 10 eyes with Acuvue(R) disposable contact lens (CL) and 10 eyes with SeeQuence(R) disposable CL. The cornea epithelial healing time were 3.4, 3.5 and 3.4 postoperative days for the pressure patch, Acuvue(R) CL and SeeQuence(R) CL groups, respectively. The corneal epithelial healing rates during postoperative 1, 2, and 3 days were 0.33, 0.78, and 0.44 mm2/hour for the pressure patch group; 0.24, 0.92 and 0.37 mm2/hour for the Acuvue(R) CL group; and 0.30, 0.79 and 0.38 mm2/hour for the SeeQuence(R) CL group. These results suggest that a disposable contact lens may not hinder epithelial healing compared with a pressure patch.
Adult ; Bandages ; Contact Lenses ; Cornea/*physiology/surgery ; *Corneal Transplantation ; Epithelium/physiology ; Female ; Humans ; Male ; Middle Aged ; Myopia/*physiopathology/surgery ; Prospective Studies ; Time Factors ; Wound Healing/*physiology

The effects of different grades of running on esophageal motility and gastroesophageal reflux in the fed state were evaluated. We studied healthy volunteers (male: 12, age: 27+/-5 yr) using ambulatory esophageal manometry, pH catheter and portable digital data recorder. Each exercise was performed 30 min after meal, with 20 min of rest between exercises. Subjects exercised on a treadmill at 40% and 70% maximal heart rate. The number of gastroesophageal reflux episodes, the duration of esophageal acid exposure and percent time pH below 4 were significantly (p<0.01) increased during exercise at 70% maximal heart rate. The frequency of contraction (contraction/min) (p<0.05), frequency of repetition (p<0.01), percent of simultaneous contraction (p<0.01), percent of above 100 mmHg amplitude (p<0.05), and frequency of 2-peak contraction (p<0.01) were significantly increased during exercise at 70% maximal heart rate. However, median amplitude and median duration showed no significant changes between each exercise session. Postprandial running exercises induce gastroesophageal reflux, which correlates with exercise intensity. These effects are mediated by disorganized esophageal motility.
Adult ; *Eating ; Esophageal Motility Disorders/etiology/*physiopathology ; Gastroesophageal Reflux/etiology/*physiopathology ; Human ; Male ; Postprandial Period ; *Running

Purpose: We report a case of neuroretinitis combined with external ophthalmoplegia in a patient who developed a cerebral venous sinus thrombosis after administration of a SARS-CoV-2 vaccine.Case summary: A 26-year-old woman who was on oral contraceptives was diagnosed with a cerebral venous sinus thrombosis 1 month after the first injection of a SARS-CoV-2 vaccine (BNT162b2, Pfizer-BioNTech). The levels of factors 8 and 9 were elevated on the blood test. The corrected visual acuities were 0.3 in both eyes. A complete limitation of abduction and esotropia were evident in the left eye. Both eyes exhibited optic disc swelling and hemorrhage and retinal nerve fiber layer swelling. Subretinal fluid was apparent in the right eye. Three weeks later, the optic disc swellings and hemorrhages had worsened and both eyes evidenced macular stars. After 10 months, the corrected visual acuities improved to 0.9 in both eyes. Ocular motor function and the esotropia also improved. However, the overall contraction of the visual field did not. Conclusions SARS-CoV-2 vaccination can trigger cerebral venous sinus thrombosis, neuroretinitis, and external ophthalmoplegia. In patients with risk factors for such thrombosis, the possibility of ophthalmic complications should be considered after administration of a SARS-CoV-2 vaccine.

Exogenous lipoid pneumonia occurs rarely in healthy people. In most cases, exogenous lipoid pneumonia is usually caused by aspiration of mineral, vegetable, or animal oil. We report the case of 42-year-old woman, who have experienced lipoid pneumonia after silicon injection into her breast for cosmetic purposes. The patient experienced fever, dyspnea, sputum, and hemoptysis after silicon injection into her breast. Chest computed tomography demonstrated non-segmental distribution of bilateral consolidation in both lung fields. A transbronchial lung biopsy specimen shows foamy microphages in alveolar spaces. Papanicolaous staining of bronchoalveolar lavage fluid showed abundant foamy marcrophages and many neutrophils. With these results, we confirmed lipoid pneumonia was associated with silicon oil injection into breast.
Adult ; Animals ; Biopsy ; Breast ; Bronchoalveolar Lavage Fluid ; Cosmetics ; Dyspnea ; Female ; Fever ; Hemoptysis ; Humans ; Lung ; Mammaplasty ; Neutrophils ; Pneumonia ; Pneumonia, Lipid ; Silicone Oils ; Sputum ; Thorax ; Vegetables

Widespread use of amitriptyline in clinical practice has led to extensive knowledge of its therapeutic and toxic effects. In cases of amitriptyline overdose, delirium, arrhythmia, convulsion, and adult respiratory distress syndrome have been reported, but amitriptyline-associated rhabdomyolysis has been rarely reported in the literature. Several drugs are associated with myositis or myopathy, but amitriptyline-related myositis has not been reported. We describe a 40-year-old woman with rhabdomyolysis and localized myositis in left proximal thigh after she had taken 625mg of amitriptyline.
Adult ; Amitriptyline ; Arrhythmias, Cardiac ; Delirium ; Female ; Humans ; Muscular Diseases ; Myositis* ; Respiratory Distress Syndrome, Adult ; Rhabdomyolysis* ; Seizures ; Thigh

BACKGROUND/AIMS: Not only scintigraphic measurement of gastric emptying(GE) is not standarized, but also several discrepancies exist in the influence of technical factors including instrument and methods of analysis on gastric emptying studies. The aim of this study was to determine whether investigating instruments, methods of analysis, affect gastric emptying rates of a radiolabeled meal in scintigraphic measurement. METHODS: Using two different scanners (single-headed gammma camera and double headed gammma camera), gastric emptying studies of radiolabeled meal (consisting of 1 g of resin) labeled with 2mCi of 99mTc-DTPA (50g of egg, 150ml of milk, 100g of rice; 611Kcal) were done in 16 healthy volunteers (16 men, age 27.5+/-3yrs). Anterior and posterior image were obtained from the supine position with two scanners at every timing interval. Anterior image only was analyzed to determine whether the differences in instruments affect gastric emptying rates. Sum of anterior and posterior counts obtained by double-headed gamma camera were compared to geometric mean. RESULTS: There were significant difference in gastric emptying rates obtained with anterior image between a single-headed scanner and a dual-headed scanner (P < 0.05, T1/2= 105.8+/-16.3 min vs 80.9+/-14.7 min). Sum of anterior and posterior counts was correlated well with geometric mean (r=0.93). Also observed difference between intraobserver and interobserver variation. CONCLUSIONS: These results indicate that instrumental variations in gastric emptying studies should be considered in interpreting individual study results. The simple sum of anterior and posterior counts could be an useful parameter in the analysis and interpretation of gastric emptying data.
Gamma Cameras ; Gastric Emptying* ; Head ; Healthy Volunteers ; Humans ; Male ; Meals ; Milk ; Observer Variation ; Ovum ; Supine Position

BACKGROUND: Right ventricular apical (RVA) pacing induces left ventricular (LV) dyssynchrony, increases the risk of persistent atrial fibrillation in the long term. The aim was to investigate the effects of RVA pacing on left atrial (LA) function, which are unknown. METHODS: Echocardiographic evaluation including LV dyssynchrony based on conventional Doppler, tissue Doppler imaging and speckle tracking strain echocardiography was done before and after (12 months) single-chamber ventricular pacemaker implantation in 40 patients with sick sinus syndrome. Patients were divided to 2 groups, according to the RVA pacing frequency (group I had higher pacing rate of more than 50% and group II, less than 50%). RESULTS: There was no significant difference in LV ejection fraction, however, mean global LV strain, myocardial performance index, and parameters of LV dyssynchrony had shown significant changes after 12 months of RVA pacing. There were also significant increase in the LA volume index and the reduction of peak systolic LA strain and strain rate (SR), peak early and late diastolic SR after RVA pacing. Moreover, there was significant deterioration of LV dyssynchrony and both LA and LV longitudinal function in even group II. LA functional deterioration and LA volume was significantly correlated with the frequency of RVA pacing. CONCLUSION: LV dyssynchrony, induced by RVA pacing, significantly impaired active LA contraction and passive stretching, and these findings were shown in the patients with even less than 50% of RVA pacing. Impairment of LA strain/SR was significantly correlated with the frequency of RVA pacing.
Atrial Fibrillation ; Atrial Function ; Atrial Function, Left ; Contracts ; Echocardiography ; Humans ; Muscle Stretching Exercises ; Sick Sinus Syndrome ; Sprains and Strains ; Track and Field