No abstract available.
Carcinoma, Bronchogenic*

We report metastatic omental hepatocellular carcinoma in two patients with post-lobectomy hepatocellular carcinoma who have had previous abdominal surgery or the rupture of hepatocellular carcinoma. Ometal metastatic masses were similar to primary masses of the liver in pathologic findings as well as in radiologic findings.
Carcinoma, Hepatocellular* ; Humans ; Liver ; Rupture

The goal of total knee replacement is to relieve pain, to stabilize joint movement and to correct deformity. It is indicated for patients with rheumatoid arthritis, osteoarthritis and severe post-traumatic arthritis. The author analyzed 71 patients(106 cases), who received the PFC type of total knee replacement from August 1992 and the results were as follows; 1. Among the 71 patients, male was 8 patients and female was 63 patients whose average age was 56 years and average follow up period was 24 months, ranged from 8 months to 3 years 8 months. 2. Rheumatoid arthritis was the most common cause with 31 patients(56 cases) followed by osteoarthritis with 39 patients(49 cases). There was also one patient(1 case) that showed bony union of the knee due to old tuberculosis. The average duration of the illness was 12 years and the average weight of the patients was 57.7kg. 3. Flexion contracture decreased from an average of 21 degrees to 5 degrees after the operation. The range of motion increased from an average of 92 degrees before the operation to 117 degrees afterwards in cases of rheumatoid arthritis and decreased slightly from 108 degrees to 106 degrees in cases of osteoarthritis. 4. The tibiofemoral angle was corrected from an average 1.5 degrees varus before the operation to an average 6.7 degrees valgus after operation. Eighty seven percent of patients with rheumatoid arthritis showed valgus deformity and seventy eight percent of degenerative osteoarthritis patients showed varus deformity preoperatively. 5. Radiographically, the joint line position shifted an average 2.3mm in rheumatoid arthritis and an average 0.3mm in osteoarthritis. The component position, the femoral flexion was an average 89.6 degrees in the anteroposterior view, an average 87 degrees in the lateral view. 6. The thickness of the patella measured in the operating room of 61 cases was an average 21mm and after resection of patella, the remaining bone measured an average of 13.6mm. 7. To achieve soft tissue balance, 29 patients(33 cases) underwent medial stripping and 23 patients(30 cases) had patella lateral release. 8. The Insall Knee Rating Score was used to evaluate the results. The results were 69 cases excellent, 33 cases good, 3 fair and 1 poor. Ninety two percent of the patients had good or excellent results in average 24 months follow-up. 9. The complications consisted of one case of delayed deep infection, one case of patellar subluxation and one case of supracondylar fracture of the femur.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Operating Rooms ; Osteoarthritis ; Patella ; Range of Motion, Articular ; Tuberculosis

The rectal prolapse syndome is a disease entity includes rectocele and rectal prolapse, presenting prolapse(procidentia) of rectum. In rectocele, rectum is prolapsed anteriorly into the vagina, whereas in procidentia, inferiorly out of the anus. This study was aimed at analyzing pathogenesis and adequacy of surgical treatment in rectocele and rectal prolapse. Twenty-one patients with rectocele and 18 patients with rectal prolapse were assessed pre- and post-operatively in respect to symptoms and signs, pathogenesis, defecography, and manometry. In analysis of symptoms and sings, constipation was the commonest in both diseases(86% of rectocele and 67% of rectal prolapse) and incontinence was not infrequently found in both diseases as well(14% of rectocele and 33% of rectal prolapse). In analysis of the underlying causes, two patients with rectal prolapse had prolapse from childhood. Defecography showed anorectal angle of rectal prolapse in rest and push period. They were significantly wider than those of rectocele(p<0.05). The perineal descent of rectal prolapse was longer than that of rectocele. In analysis of the associated factors, average number of delivery was more than three times in both diseases(3.5 of rectocele and 5.1 of rectal prolapse). We could easily find previous operation history in both diseases. Among them, hysterectomy was the most frequent, especially in patients with rectocele. The hemorrhoids was associated more common in rectocele than in rectal prolapse(p<0.05). Preoperative maximal resting pressure of rectal prolapse was more significantly decreased than that of rectocele(p<0.05). The sensation of fullness was significantly decreased in patients with rectal prolapse postoperatively(p<0.05). Patients with rectocele underwent levator plication by transrectal or vaginal approach. Patients with rectal prolapse underwent posterior rectopexy in 11 patients, resection and rectopexy in 3 patients, Delorme's operation and Thiersch operation in 2 patients each. Constipation was significantly improved in patients with rectocele postoperatively(p<0.05). Incontinence was markedly improved in patients with rectal prolapse postoperatively(p<0.05). At the interview about subjective improvement of symptom, 95% of patients with rectocele and 89% of patients with rectal prolapse were satisfied with surgery. In conclusion, rectocele and rectal prolapse can be categorized as rectal prolapse syndrome because both diseases have anatomical derangements caused by similar pathogenesis such as altered bowel habits, anatomical factor, delivery, past history of hysterectomy, and hemorrhoids. Levator plication and posterior rectopexy seem to be useful surgical methods of anatomical repair for the respective disease.
Anal Canal ; Constipation ; Defecography ; Hemorrhoids ; Humans ; Hysterectomy ; Manometry ; Prolapse ; Rectal Prolapse* ; Rectocele ; Rectum ; Sensation ; Vagina

No abstract available.
Humans ; Prognosis* ; Respiratory Insufficiency*

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal*

This study is standard surgical measurement of the size of kidney in normal Korean population that might be basic data of renal size in comparison with radiographic and ultrasonographic measurement for clinical implies. The 235 cases of donors for renal transplantation were measured by the length, width, thickness, weight and the outer diameter of renal vessels as well as identification of branches of renal vein at the time of donor nephrectomy. These data were tested to statistically significant by T- test, ANOVA, Pearson correlation analysis and multivariate analysis. The mean values of renal size were 11.6+/-0.87 (9.2-15.4cm) x 6.1+/-0.81 (4.4-10.0cm) x 4.9+/-0.75(2.2-7.1cm) for male 11.7+/-0.77 (9.8-14.0cm) x 6.2+/-0.85 (4.5-10.0cm) x 5.O+/-0.77 (2.8- 7.1cm) and for female 11.4+/-0.96 (9.2-15.4cm) x 6.0+/-0.75 (4.4-8.2cm) x 4.8+/-0.7 (2.2-7.0cm). The mean value of renal weight were 183.1+/-36.92 (115.0-370.0gm) : for male 188.2+/-40.10 (120.0-370.0gm) and for female 177.6+/-32.41 (115.0-300.0gm). The width, thickness and weight of kidney were larger in male than in female (p<0.05). I found out that the age of donors did not affect the renal length, width, thickness and weight (p>0.05). The renal length, width, and weight increased proportional to the body weight (p<0.05). The renal thickness and weight were different in each range of the body height (P<0.05). The body weight had correlation with renal length (r=0.25), thickness (r=0.32), weight (r=0.36, p<0.001) and width (r=0.16, p<0.05). The body height was correlated well with renal length (r=0.20), thickness (r=0.18) and weight (r=0.25, p<0.05). The body weight was the most reliable factor affecting renal size and weight in multivariate analysis (p<0.05). The mean number of branches of renal vein was 0.36+/-0.63 (0.0-2.0) in right kidney and 3.12+/-0.76 (1.0-6.0) in left one. The mean diameter of the renal artery was 0.61+/-0.132 (0.3-1.0cm) and the mean diameter of the renal vein 1.46+/-0.132 (0.50-2.20cm). The radiographic measurement of renal size was larger than our surgical measurement. The mean renal length and width in radiographic measurement(IVP) were 12.1+/-0.70cm in right kidney, 12.1+/-0.65cm in left one and 6.4+/-0.54cm in right kidney, 6.8+/-0.45cm in left one versus 11.6+/-0.87cm, 11.6+/-0.89cm and 6.1+/-0.81cm, 6.1+/-0.84cm in surgical measurement. Surgical measurements of renal size of donors at the time of renal transplantation were real renal size despite of radiographic and ultrasonographic measurement and provided basic standard data for Korean population that might be utilized in approaching renal disease.
Adult* ; Body Height ; Body Weight ; Female ; Humans ; Kidney ; Kidney Transplantation ; Male ; Multivariate Analysis ; Nephrectomy ; Renal Artery ; Renal Veins ; Tissue Donors

Most renal carcinomas are thought to originate from the epithelial cells of proximal convoluted tubules in the renal cortex. Collecting duct carcinoma is a recently recognized histological variety of renal cell carcinoma considered to arise from the epithelium of the collecting ducts. It is important to distinguish the collecting duct carcinoma from ordinary renal cell carcinoma, because which has an aggressive clinical course with early metastasis and death. But in patients, the natural course of the disease and its response to treatment have not been clearly established. Herein we report a case of collecting duct carcinoma of kidney in 38-year-old woman who had generalized edema and left flank dull pain. The preoperative diagnosis was left renal cell carcinoma on physical examination and radiologic finding, and left radical nephrectomy was done.
Adult ; Carcinoma, Renal Cell* ; Diagnosis ; Edema ; Epithelial Cells ; Epithelium ; Female ; Humans ; Kidney* ; Neoplasm Metastasis ; Nephrectomy ; Physical Examination

No abstract available.
Myasthenia Gravis* ; Pregnancy*

The authors performed prospectively the transcranial Doppler monitoring of bilateral anterior and middle cerebral arteries in 15 patients with ruptured cerebral aneurysm. The entry criteria for the study were confined to the patients who were admitted within 3 days after bleeding and had clinical grades of I, II, or III. The mean frequency shifts of bilateral anterior and middle cerebral arteries were increased immediately after ictus and showed continous further elevation between the 3rd and 8th rupture days. After that, they normalized slowly. The increase of frequency shift preceded clinical ischemic symptoms and an early steep increase of frequency shift was correlated to a high chance for suffering delayed ischemic deficits. The thick clots in subarachnoid cisterns shown on CT scans taken within the third rupture day were correlated well to the severe increase of frequency shifts. The aggressive treatment was done on asymptomatic patients who showed relatively rapid increase of frequency shifts, and they had shown no or trasient mild ischemic symptoms.
Hemorrhage ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Rupture ; Tomography, X-Ray Computed