BACKGROUNDS: Reflux esophagitis has been known to be a frequent complication after a total gastrectomy. Reflux esophagitis is very annoying to the patients, so various types of reconstructions has been introduced to eliminate this complication. METHODS: This study is a retrospective clinical analysis of 34 patients with gastric cancer who were treated with a total gastrectomy from January 1989 to December 1997 at the Department of Surgery, Seoul Adventist Hospital. RESULTS: During 9 years, the operation was performed on 194 patients with gastric cancer, amomg which 34 (17.3%) were total gastrectomies. The peak age was in the 5th and the 6th decades (58.8%), and the sex ratio of males to females was 1.6:1. The sites of the stomach cancer were the cardia (C) in 10 cases (29.4%), the body (M) in 19 cases (55.9%), and the cardia and body in 5 cases (14.7%). The TNM classification was stage I in 15.6% of the cases, stage II in 15.6% of the cases, stage III in 62.5% of the cases, and stage IV in 6.3% of the cases. Three methods of alimentary tract reconstruction were used:a loop esophagojejunostomy with a Braun anastomosis (27), a Roux-en-Y esophagojejunostomy (6), and an uncut Roux procedure (1). The reflux esophagitis rates for patients treated with a loop esophagojejunostomy with a Braun anastomosis and for patients treated with a Roux-en-Y esophagojejunostomy were 25.9% and 16.7%, respectively. The perioperative mortality was 5.8%, and the causes of death were pneumonia and anastomotic leakage. The most common recurrent site was the anastomotic site. CONCLUSIONS: Reflux esophagitis developed more often after a loop esophagojejunostomy with a Braun anastomosis than after a Roux-en-Y anastomosis. This finding was not significant statistically. Thus, further study of more cases is needed.
Anastomosis, Roux-en-Y ; Anastomotic Leak ; Cardia ; Cause of Death ; Classification ; Esophagitis, Peptic* ; Female ; Gastrectomy* ; Humans ; Male ; Mortality ; Pneumonia ; Retrospective Studies ; Seoul ; Sex Ratio ; Stomach Neoplasms*

BACKGROUND: Interleukin-1alpha is interesting lymphokine to cardiologists because it has been implicated as a regulatory protein in the development and clinical sequale of atherosclerosis, including the modulation of low density lipoprotein metabolism, the regulation of vascular smooth muscle cell mitogenesis, the stimulation of leukocyte adherence to endothelium, and procoagulant activity. But most interleukin-1alpha remains in the cytosol of cells in its precursor form, and is transported to cell surface. and associated with cell membrane. Therefore considerable amount of interleukin-1alpha, contrast to interleukin-1beta, is not released by cells into the extracellular space and the circulation. Despite of increased production of interleukin-1alpha, circulating level may not be elevated because of autocrine and paracrine action of that. In order to elucidate whether interleukin-1alpha is systematically elevated or not in patients with coronary artery disease who are complaining of chest pain, we undertook this study. METHODS: We isolated lymphocytes from peripheral blood in patients and control group. After the peripheral lymphocytes were cultured in the presence or absence of phytohemmagglutinin in RPMI-1640 media for 24 hours, we measured the content of interleukin-1alpha in supernatant by radioimmunoassay. RESULTS: 1) In the absence of phytohemagglutinin, the mean value of Interleukin-1alpha in the supernatant was 29.13+/-17.42 pmol/ml in control group and 27.28+/-18.80 pmol/ml in patients group(p=NS). 2) In the presence of phytohemagglutinin, the mean value of Interleukin-1alpha in the supernantant was 36.53+/-20.72 pmol/ml in control group and 152.13+/-91.85 pmol/ml in patient group(p<0.0001). CONCLUSION: Significant increase of interleukin-1alpha in the presence of phytohemagglutinin in the patient group means that the peripheral lymphocytes in patients with coronary artery disease are activated to produce interleukin-1alpha.
Atherosclerosis ; Cell Membrane ; Chest Pain ; Coronary Artery Disease* ; Coronary Vessels* ; Cytosol ; Endothelium ; Extracellular Space ; Humans ; Interleukin-1alpha* ; Interleukin-1beta ; Leukocytes ; Lipoproteins ; Lymphocytes* ; Metabolism ; Muscle, Smooth, Vascular ; Radioimmunoassay

Image-guided localized, water-suppressed in vivo 1H MR spectroscopic studies were performed on the brain tumors in 3 patients. In all 3 patients, in vivo 1H MR spectra in brain neoplastic tissues revealed that the signal intensities of N-acetylaspartate (NAA) choline (Cho) resonances were decreased and increased, respectively, comparing with healthy normal tissue. A distinct lactate signal was identified in all three patients. A ratio that the observed metabolite alterations from localized, water-suppressed in vivo 1H MR spectroscopy can be useful as an index of brain tumors, and that the technique is clinically to highlight as one promising modalities in brain tumors for more accurate diagnosis.
Brain Neoplasms* ; Brain* ; Choline ; Diagnosis ; Humans* ; Lactic Acid ; Magnetic Resonance Spectroscopy*

PURPOSE:Hypochondroplasia is a skeletal dysplasia characterized by poor childhood growth and an inadequate pubertal growth spurt. Final height attainment of hypochondroplasia has been reported to range between 120 and 152cm. Increased availability of growth hormone with the introduction of recombinant human growth hormone has allowed for clinical trials in a number of growth hormone sufficient children with growth problems. The purpose of this study was to assess the growth promoting effect of human growth hormone in children with hypochondroplasia. METHODS:Five patients with hypochondroplasia diagnosed by clinical and radiological findings between 1993 and 1997 at our hospital was aged 3 and 1/2 -11 and 1/2 years. Each patients continuously received human growth hormone 0.6-0.7U/Kg/week, intramuscularly or subcutaneously in 6-7 divided dose for 2 years. Standard auxologic assessment was carried out every 3 month interval in the first year after commencement of therapy and then same assessment was 6 monthly. Bone age was assessed 6 monthly using Gleurich-Pyle method. RESULTS:Mean height velocity of pretreatment and year 1 and 2 of GH treatment were 3.9+/-0.7, 6.5+/-1.8 and 5.7+/-1.5cm/year, respectively. Mean height standard deviation score for chronological age of pretreatment and year 1 and 2 of GH treatment were -2.7+/-0.3, -2.4+/-0.3 and -2.2+/-0.4, respectively. The increase in the height velocity diminishes over the subsequent year. The increment of bone age after GH treatment were same as the increments of chronological age. CONCLUSION: Short-term GH therapy increases the height velocity of children with hypochondroplasia, but the effect of GH therapy on final height remains unknown.
Child* ; Growth Hormone* ; Human Growth Hormone ; Humans

No abstract available.

The use of osseointegrated implants is an accepted procedure for the treatment of Total, or partial edentulism and offers good predictability of long-term success. Osseointegration implies a firm and direct interlocking between vital bone and screw-shaped titanium implants. There should be not to interposed tissue between fixture and bone. This study was undertaken to assess the clinical condition, complication, and prosthodontic aftercare of different implant systems. One hundred fifty-nine patients treated with a total of 503 endosseous implants (364 Steri-oss threaded type, 69 Integral cylinder with HA coated type, 35 Steri-oss threaded with HA coated type, 21 Steri-oss cylinder with HA coated type and 14 3i implant type), Most of the implant were placed in type B and C bone quantity and type 2 and 3 bone quality according to Lekhorm and Zarb. The success rate of Steri-oss threaded type during healing and function was 92%, Steri-oss threaded type with hydroxyapatite coated was 91%, Steri-oss cylinder type with hydroxyapatite coated was 90%, Integral cylinder type with hydroxyapatite coated was 90% and 3i implant type was 93%. One hundred twenty-nine patients had been treated with implant prosthesis. 79 of these patients had received a fixed type prosthesis and 50 patients had received a removable type prosthesis. There were no differences between the implant systems with regard to age, gender. Failures were associated with poor bone quality, smaller implant sizes, a surgical installation technique and stress distribution when in function. Visual analgoue scales recorded as satisfied results functionally and esthetically, but 15% dissatified with chewing ability.
Aftercare ; Dental Implants* ; Durapatite ; Humans ; Mastication ; Mouth Rehabilitation* ; Mouth* ; Osseointegration ; Prostheses and Implants ; Prosthodontics ; Titanium ; Weights and Measures

There are various reports referring to the clinical siignificances and removal of postgastrectomy bezoar. In this case, suture thread were thought to he the important factor of the bezoar formation, This bezoar was removed intaetly uaing fiber-optic endoscope in patinet who had postgastrectomy bezoar, by cutting the thread by biopsy forceps.
Bezoars* ; Biopsy ; Endoscopes ; Surgical Instruments ; Sutures*

Sacral perineural cyst is one group of extradural meningeal cyst at the sacral region. These lesions are distinguished from other spinal cysts because perineural cyst does not communicate with subarachnoidal space. Fluid filled cysts may compress adjacent nerve roots causing low back pain and sciatica which are dramatically improved by surgical excision. Differential diagnosis from other cysts can be accomplished by failure of collection of dye into cyst by initial myelography. C-T myelography rules out other mass lesions and often reveals communication of perineural cyst that filled with contrast medium. Magnetic resonance imaging well demonstrates three dimensinnal configures of an intraspinal cystic mass in initial study. However it is important to recognize that these cysts are one of causes of radiculopathy. We report three cases of sacral perineural cysts with radiculopathy.
Diagnosis, Differential ; Low Back Pain ; Magnetic Resonance Imaging ; Myelography ; Radiculopathy ; Sacrococcygeal Region ; Sciatica ; Tarlov Cysts*

The operative treatment of intraarticular calcaneal fractures has three principal aims; restoration of the height and width of the calcaneus, reconstruction of the subtalar and calcaneocuboid joint surfaces, and stable osteosynthesis. The purpose of this study is to demonstrate the effectiveness of the open reduction and internal fixation by the extended lateral approach for the treatment of the intraarticular calcaneal fractures. Twenty-one calcaneal fractures of 20 patients were treated by open reduction and internal fixation using an extended lateral approach from April, 1993 to March, 1994. The autogenous iliac bone graft was done in all patients. These patients were evaluated from 12 to 24 months (average 15.2 months) after surgery. The following results were obtained; 1. Seventecn cases (80%) out of 21 were estimated as good or excellent result. 2. Preoperative Bohler's angles, Gissane's angles and inclination angles were observed as average -0.5degrees, 101degrees and 38degrees respectively, and these were improved as average 23.3degrees, 117degrees and 54degrees, postoperatively. 3. There were two cases of skin necrosis as complication. In conclusion, the extended lateral approach is one of the good methods for the treatment of intraarticular calcaneal fractures. We think that accurate reduction of the posterior facet, acceptable recovery of Bohler's angle and early postoperative mobilization are the most important things for the best result of the intraarticular calcaneal fracture surgery.
Calcaneus ; Humans ; Intra-Articular Fractures ; Joints ; Necrosis ; Skin ; Transplants

No abstract available.
Drug Therapy* ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Leukemia, Myeloid, Acute*