No abstract available.
Splints* ; Sterilization, Tubal*

BACKGROUND: Diverticulosis of the cecum and ascending colon is a rare disease in Western countries, it is more common in the Orient. Making the diagnosis preoperatively could be difficult, and the intraoperative assessment and decision of optimal treatments are difficult. METHODS: Therefore, we reviewed the patient's charts of diverticulosis of the cecum and ascending colon at our hospital from 1992 to 1997. RESULTS: During the past 5 years, a total of 53 cases of diverticulosis of the cecum and ascending colon had been treated at this hospital. Mean age was 41.8 years (range 20-70). The male to female ratio was 1.8 : 1. Frequent complaints were abdominal pain (46 cases, 86.8%), followed by diarrhea (5 cases, 9.3%), indigestion (4 cases, 7.5%), and bowel habits change (2 cases, 3.8%). Mean duration of illness was 3.5 days(range 24 hours~15 days). In non-surgical cases, diagnoses were established with barium enema, CT scan, or ultrasonography. The accuracy of these methods was 91%, 75%, and 25%. In surgical cases, the preoperative diagnoses were appendicitis(13 cases, 50.1%), diverticulitis (7 cases, 31.8%), and abscess (2 cases, 9.1%). Treatments of the cecum and ascending colon diverticulitis were conservative management (3 teases,58.5%) and surgical treatment (22 cases,41.5%). The operative procedures were right hemicolectomies (2 cases), ileocecal resections (2 cases), diverticulectomies (6 cases) and appendectomies only (11 cases). CONCLUSION: These results suggest that correct diagnosis of the diverticulitis of the cecum and ascending colon made before treatment is very important because correct assessment of diverticulitis intraoperatively is difacut. Liberal use of diagnostic modalities could facilitate to make correct diagnosis to set a proper plan for treatment.
Abdominal Pain ; Abscess ; Appendectomy ; Barium ; Cecum* ; Colon, Ascending* ; Diagnosis ; Diarrhea ; Diverticulitis ; Diverticulum* ; Dyspepsia ; Enema ; Female ; Humans ; Male ; Rare Diseases ; Surgical Procedures, Operative ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Animals ; Dogs ; Mandible

Intussusception is a relatively common disease in children, but it is a rare clinical entity in adults. More than 80% of all patients with intussusception are less than two years of age, but adults account for only 5 to 10 percent of all intussusception cases. The significance of this disease in the aspect of statistics is mentioned as "rule of fives", which means 5% of all intussusceptions occur in adults, and it accounts for up to 5% of all cases of bowel obstruction in adults. In children, classic symptoms include episodic abdominal pain, "current-jelly" stool and a sausage-shaped abdominal mass on examination. However, in adults, it is likely to appear with non-specific gastrointestinal trouble without classic symptoms. Therefore, it is very important to use early diagnositic tool. In contrast to childhood intussusception, which is idiopathic in 90% of cases, adult intussusception has a definable lesion in more than 90% of cases 3). Tumors, both benign and malignant, are the most frequent cause of intussusecption in adults. We experienced seven cases of adult intussusception at Inha hospital from Jan. 1994 to Dec. 1997. The patients of adult intussusception are classified as three cases of ileoileal type and four ileocecal type. There were no specific signs or symptoms with patient experienced. It included abdominal pain, diarrhea and palpable mass. Their diagnosis was made in six patients using abdominal CT scan. It is difficult to define a diagnosis preoperatively, because the symptom of adult intussusception are variable and insignificant among individuals. We had been taken the final diagnostic tool with the abdominal CT scan in six of seven patients, which revealed "target lesions" in all cases. So, it is useful in the diagnosis of adult intussusception. Bowels were resected for the treatment of adult intussusception. The extent of the resection was contained the lesion and the defunctioned segments. The operations were performed as four segmental resections of small bowel and three ileocecal resections. The pathological findings were disclosed as three tumors, three lymphadenopathies and a adhesion of bowel. We concluded that the abdominal CT scanning is a usefull diagnostic tool in the diagnosis of adult intussusception.
Abdominal Pain ; Adult* ; Child ; Diagnosis ; Diarrhea ; Humans ; Intussusception* ; Tomography, X-Ray Computed*

PURPOSE: To evaluate CT findings for the differential diagnosis of mechanical bowel obstruction and paralytic ileus. MATERIALS AND METHODS: Without information relating to clinical or operative findings, we retrospectively analyzed the CT scans of 24 patients with mechanical bowel obstruction and 19 patients with paralytic ileus. Final diagnosis was confirmed by operation (n=26), or by clinical symptoms, radiologic findings and follow-up study CT findings were obtained : 1) the diameter of the most dilated part of the small bowel, and the thickness and enhancing pattern of the dilated small bowel wall; 2) the diameter of the most dilated part of the descending colon and the ratio of the diameter of the small bowel to that of the descending colon; 3) the number of transitional zones, length and thickness. and 4) associated ascites and its location. RESULTS: The mean diameters of the most dilated part of the small bowel in mechanical bowel obstruction and paralytic ileus were 3.6cm and 2.9cm, respectively. The diameter of the small bowel in mechanical bowel obstruction was significantly greater than in paralytic ileus(p< .05). The mean thickness of dilated small bowel wall was 4.0mm in mechanical bowel obstruction and 2.4mm in paralytic ielus, and target-like enhancement was prominent in mechanical bowel obstruction (46%) (p< .05). he mean diameter of the most dilated part of the descending colon was not significantly different to that of the most dilated part of the small bowel, but the ratio of the diameter of the small bowel to that of the colon was 2.9 in mechanical bowel obstruction and 1.9 in paralytic ileus, respectively, which was statistically significant (p< .05). A transitional zone was seen in 23 cases (96%) of mechanical bowel obstruction and in nine (47%) of paralytic ileus. In mechanical bowel obstruction, mean transitional zone length was 2cm, shorter than that of paralytic ileus (3.4cm) (p< .05) The thickness of transitional zone and the presence of ascites and its locations were not significantly different between mechanical bowel obstrction and paralytic ileus. CONCLUSION: In the differential diagnosis of mechanical bowel obstruction and paralytic ileus, the following CT findings were considered useful : diameter of the most dilated part of the small bowel ; thickness and target-like enhancing pattern of dilated small bowel wall ; ratio of the diameter of the small bowel to that of the descending colon ; and the number of transitional zones, and their length.
Ascites ; Colon ; Colon, Descending ; Diagnosis ; Diagnosis, Differential* ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction* ; Retrospective Studies ; Tomography, X-Ray Computed

We describe a 42-year-old woman with a primary leiomyosarcoma of the breast. It is an extremely rare tumor, with only about 16 cases reported. Usually it is presented with palpable mass of benign characters. The origin of the tumor is controversal and the differential diagnosis includes other sarcomas and metastatic ones. The uncertain behavior of it makes the management difficult but conservative surgery is available in the case of anatomically suitable. Axillary lymphatic dissection is not needed and the roles of the chemotherapy and radiotherapy are not clear. Some studies revealed a local invasion and degree of cellular atypia as some prognostic predictive value.
Adult ; Breast* ; Diagnosis, Differential ; Drug Therapy ; Female ; Humans ; Leiomyosarcoma* ; Radiotherapy ; Sarcoma

The authors have experienced a case of Duchenne type of progressive muscular dystrophy in a 9 year old boy who was presented with significantly increased serum enzymes related to this disedase and musle biopsy findings compatible with muscular dystrophy, reported with review of literatures concerned.
Biopsy ; Child ; Humans ; Male ; Muscular Dystrophies*

BACKGROUND AND OBJECTIVES: Computerized tomography (CT) is the method of choice in radiologic diagnostic evaluation of cholesteatoma, since it reveals the presence of soft tissue mass and erosion of bony structure. Also CT enable us to predict the route of cholesteatoma extension, so we hope to hypothesize the unknown pathogenesis of cholesteatoma indirectly. MATERIALS AND METHODS: Preoperative CT and surgical treatment were performed on 80 patients with acquired cholesteatoma from 1996 to 1998 at otolaryngology department in Hanyang University Hospital. The charts and CT findings of the patients were retrospectively reviewed and analyzed according to types of cholesteatoma and its location and extension route. RESULTS: Pars flaccida cholesteatoma is the highest incidence of cholesteatoma and it is possible to predict the direction of progression of cholesteatoma using CT in most cases. Sensitivity of destruction of ossicles and semicircular canal in CT is over 96%. Incidence of obstruction of tympanic isthmus and eustachian tube is higher in pars flaccida cholesteatoma than in pars tensa cholesteatoma. CONCLUSION: Temporal bone CT is a very useful tool to evaluate the clinical characteristics and predict the pathogenesis of cholesteatoma by evaluating of extension route of it.
Cholesteatoma* ; Eustachian Tube ; Hope ; Humans ; Incidence ; Otolaryngology ; Retrospective Studies ; Semicircular Canals ; Temporal Bone

Dysgeusia after tonsillectomy is a rare complication and there have been a few reports in the literature. The most possible cause of this complication is thought to be direct or indirect injury to the glossopharyngeal nerve or its lingual branch. Other suggested causes are lack of dietary zinc and habitual drug intake. We report a 51-year-old man, who presented severe parageusia and phantogeusia following tonsillectomy that was performed for chronic tonsillitis. The surgery was performed by electrocautery dissection without identifiable injury to the glossopharyngeal nerve. Dysgeusia developed 3 weeks after the operation and he complained loss of appetite and significant weight loss. He did not take any drug habitually that could affect his sense of taste. His serum zinc level (48 microgram/dl, normal range : 61-121 microgram/dl) was decreased. We prescribed a mineral supplement containing vitamin B complex and therapeutic dose of zinc. Eight months after the operation, his taste function was not recovered and he still retained problems related to diet. This case indicates that a patient should be informed of the risk of postoperative taste disturbance after tonsillectomy as being one of the rare complications.
Appetite ; Diet ; Dysgeusia ; Electrocoagulation ; Glossopharyngeal Nerve ; Humans ; Middle Aged ; Palatine Tonsil ; Reference Values ; Tonsillectomy* ; Tonsillitis ; Vitamin B Complex ; Weight Loss ; Zinc

PURPOSE: Local anesthetics can decrease postoperative pain after appendectomy. This study sought to verify the efficacy of bupivacaine on postoperative pain and analgesics use after single-incision laparoscopic appendectomy (SILA). METHODS: Between March 2014 and October 2015, 68 patients with appendicitis agreed to participate in this study. After general anesthesia, patients were randomized to bupivacaine or control (normal saline) groups. The assigned drugs were infiltrated into subcutaneous tissue and deep into anterior rectus fascia. Postoperative analgesics use and pain scores were recorded using visual analogue scale (VAS) by investigators at 1, 8, and 24 hours and on day 7. All surgeons, investigators and patients were blinded to group allocation. RESULTS: Thirty patients were allocated into the control group and 37 patients into bupivacaine group (one patient withdrew consent before starting anesthesia). Seven from the control group and 4 from the bupivacaine group were excluded. Thus, 23 patients in the control group and 33 in the bupivacaine group completed the study. Preoperative demographics and operative findings were similar. Postoperative pain and analgesics use were not different between the 2 groups. Subgroup analysis determined that VAS pain score at 24 hours was significantly lower in the bupivacaine group (2.1) than in the control group (3.8, P = 0.007) when surgery exceeded 40 minutes. During immediate postoperative period, bupivacaine group needed less opioids (9.1 mg) than control (10.4 mg). CONCLUSION Bupivacaine did not decrease pain and analgesics use. When surgery exceeded 40 minutes, bupivacaine use might be associated with less pain and less analgesics use.