PURPOSE: Choledochal cyst is a rare malformation of the pancreatobiliary ductal system, manifested by dilatation of biliary tree with or without anomalous insertion of the common bile duct into pancreatic duct. The purpose of this study is to review the incidence of anomalous pancreatobiliary union(PBU) and the shape of common bile duct based on the angle of pancreatic duct and common bile duct union. MATERIALS AND METHODS: We analyzed cholangiopancreatographic findings of 21 patients with choledochal cyst, emphasizing PBU. The PBU was classified into acute-angled PBU, right-angled PBU, normal PBU, and unknown PBU on the basis of common bile duct insertion to pancreatic duct. The shape of common bile duct dilatation was evaluated with regard to angle of PBU. RESULTS: Fourteen of 21 patients had anomalous PBU with slender or ectatic form of common channels. Three patients had normal opening of common bile duct and pancreatic duct, and in remaining 4 patients the PBU was not visualized. Among 14 patients with PBU, 5 patients had right-angled PBU and 9 patients had acute-angled PBU. Cystic form of common bile duct dilatation was seen in 13 patients and cylindrical form was in 8 patients. Cystic dilatation of common bile duct was seen in 4 patients out of 5 right-angled PBU. CONCLUSION: Patients with choledochal cyst had high incidence of anomalous PBU with common channel (67%). The shape of common bile duct dilatation was cystic in 62% of patients, and the right-angled PBU was prone to be cystic dilatation (80%).
Biliary Tract ; Choledochal Cyst* ; Common Bile Duct ; Dilatation ; Humans ; Incidence ; Pancreatic Ducts

BACKGROUND: Reactive oxygen free radicals have been implicated as an important factor in the development of ischemia-reperfusion injury of heart. Captopril, a SH-containing angiotensin converting enzyme(ACE) inhibitor has been reported to provide the protective effect in different models of myocardial ischemia and reperfusion injury of animal hearts. It is postulated that the myocardial protective effect may be related to a potential anti-free radical effect independent of ACE inhibition. The present study was designed to elucidate the myocardial protective mechanism of Captopril by investigating the drug effect on the experimentally induced oxygen free radical-mediated myocardial injury in isolated hearts of rats. METHODS: The heart isolated from rat was perfused retrogradly by Langendorff method. Myocardial dysfuntion was induced by oxygen free radicals generated by electrolysis of the perfusing solution(Kreb-Henseleit) with 2mA direct current for 45 sec. The cardiac functions(left ventricular pressure, dP/dt, heart rate, coronary flow) and the ventricular content of a lipid peroxidation product, malondialdehyde(MDA) were measured under presence of absence of Captopril and the compairing drugs(enalaprilat, cysteine and dithiothreitol). RESULTS: Electrolysis of oxygen-saturated Krebs-Henseleit perfusing solution led to the production of superoxide anion increasingly with intensity and duration of the applied electric current. The hearts perfused with the electroyzed solution demonstrated significant decrease in left ventricular pressure, dp/dt, heart rate, coronary folw and increase in myocardial MDA content. The depression of myocardial function as well as the increase of MDA content and oxygen radical production were reversed by Captopril(0.75~2mM) dose-dependently. Enalaprilat, a non-SH containing ACE inhibitor, however, showed no protective effect at all. Cysteine and dithiothreitol, the SH-containing agents without ACE inhibitory action showed also protective effects on the myocardial depression induced by electrolysis. CONCLUSION: It is suggested that Captopril may exert protective effect on oxygen radical-mediaed myocardial injury probably by its antioxidative and anti-free radical mechanism related to SH-group.
Angiotensins ; Animals ; Captopril* ; Cysteine ; Depression ; Dithiothreitol ; Electrolysis ; Enalaprilat ; Free Radicals ; Heart ; Heart Rate ; Lipid Peroxidation ; Myocardial Ischemia ; Oxygen ; Rats ; Reperfusion Injury ; Superoxides ; Ventricular Pressure

PURPOSE: Congenital limb anomalies are manifested in various degree of severity and complexity bearing confusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. MATERIALS AND METHODS: Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications;failure of formation of parts, failure of differentiation of parts, duplications, overgrowth, and undergrowth. RESULTS: The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. CONCLUSION: The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies.
Classification ; Extremities* ; Hand ; Humans ; Incidence ; Lower Extremity ; Retrospective Studies ; Upper Extremity

PURPOSE: To provide for popularization of out-patient surgery, we investigated actual problems occurring after minimally invasive surgery in children. MATERIALS AND METHODS: We reviewed the medical records of 132 patients(154 operations) who performed minimal invasive surgery from January, 1996 to June 1998. All problems following operation were identified in terms of kinds, degrees, and their correlations, including fever, pain, nausea, vomiting, and wound condition, etc. RESULTS: The age of the patients were 0.1 to 16 years(mean, 4.5 years). Of 154 operations hydrocelectomy were 84, orchiopexy 41, and they were 81.2% of all. Operation time were 25 minutes to 150minutes(mean, 63minutes). There were 170 postoperative problems including mild ones, among whom 100 patients revealed changes in body temperature over 37.0degrees C and 43 patients high fever over 37.5degrees C and these fevers were resolved spontaneously even with conservative treatment in short duration excluding one patient who took 39.3degrees C sustaining for 3 days and had a mild touch of flu before operation. 5 patients complained severe wound pain to be injected analgesics without actual wound problem such as bleeding or hematoma, etc. One patient couldn`t void urine to need nelaton catherization one time. CONCLUSIONS: With proper selection and strict preoperative preparation of patients, meticulous anesthesia and operation, careful postoperative check and easy call to doctor, there would be no critical problems following minimally invasive urologic surgery in children.
Analgesics ; Anesthesia ; Body Temperature ; Child* ; Fever ; Hematoma ; Hemorrhage ; Humans ; Medical Records ; Nausea ; Orchiopexy ; Outpatients ; Surgical Procedures, Minimally Invasive* ; Vomiting ; Wounds and Injuries

This study was investigated the changes during treatment and retention period in the Class III malocclusion patients and explored the correlationship between factors that showed relapse tendencies and pre-treatment skeletal pattern and the changes during treatment period. Numbers of total sample were 24 and their Hellman's dental age at the start of treatment was over III B and were retained at least over 1 year 6 months. The following conclusion were obtained by comparing the differences between treatment period and retention period, and after analysing the correlationship of factors that manifested relapse tendencies. 1. The angles formed by FH plane and occlusal plane, FH plane and mandibular plane, and mandibular incisor and mandibular plane changes showed rebound effect during retention period and among them occlusal plane angle and IMPA show reverse correlationship. 2. Upward displacement of the occlusal plane at the end of treatment has returning tendency, is proportional to the displacement during treatment period, but the angle between maxillary and mandibular 1st molar to its basal bone have been constantlsy maintained during the retention period. 3. Mandibular plane decrease during retention period and downward backward rotation during treatment period show correlationship.
Dental Occlusion ; Humans ; Incisor ; Malocclusion ; Molar ; Recurrence

From Oct. 1974 to Jun. 1979, 47 diaphyseal fractures of the forearm bones in 36 patients were treated with compression plates. Among them 36 diaphyseal fractures in 28 patients (23 with acute fractures. and 5 with non-union) followed for average 8.3 months from three months to thirty seven months were studied. 19 fractures of the radius and 17 fractures of the ulna were treated with compression plates. Fifteen fractures which were delayed for operation for more than 3 weeks or had severe comminution, had primary iliac bone grafts. The fracture unlon of the radius and ulna was obtained in all cases and average healing time for the radius was 11.9 weeks and for the ulna was 12.3 weeks. The final functional results were excellent, 16 and satisfactory,7. The over all rates of excellent and satisfactory results were 82.2 percent. Therefore compression plate is one of the excellent methods to treat diaphyseal fractures and non-union of the forearm bone.
Forearm ; Humans ; Radius ; Transplants ; Ulna

Lewy bodies (LBs) and Lewy neurites (LNs) are pathological hallmarks of Parkinson’s disease (PD) or dementia with LBs (DLB). Incidental Lewy body disease (iLBD) is defined when LBs and LNs are found in the brain of normal elderly individuals. A 65-year-old man presented with autopsy-proven Lewy body pathology (LBP). He had never complained of cognitive impairments or parkinsonian motor symptoms, and he had always maintained independence in activities of daily living. Hypopigmentations in the locus coeruleus and substantia nigra were discovered during the autopsy. The patient showed severe-to-extremely severe LBs in the neocortex and limbic areas, except in the nucleus basalis of Meynert, amygdala, and brainstem, according to microscopic findings. Hence, using several of the previously known staging systems, it was difficult to classify the patient’s LBP type. Furthermore, these findings were unique because they had never been observed before in iLBD.

When examining in the patients with epiphora, it is common to evaluate only the insufficiency or obstruction of lacrimal pathway by irrigation or dacryocystography and to over look the conjunctival conditions near the punctum in most cases. Authors found marked redundancy of conjunctival tissue around the punctal area in 8 patients(12 eyes) who complained of epiphora. They have neither lacrimal pathway insufficiency and obstruction, nor facial palsy or lid laxity that can impass the lacrimal pump action, and also no anatomical anomaly of the puncta. In fluorescein dye dissappearence test of these patients, the clearance of dye was markedly delayed on the lesion site(Grade 3 to 4). Epiphora was dramatically improved after simple resection of redundant conjunctiva under surgical microscope. The Hematoxylin-Eosin and Toluidine-Blue staining of resected conjunctiva revealed infiltration of many inflammatory cells and increase of metachromatic cells in the conjunctival stroma.
Conjunctiva ; Facial Paralysis ; Fluorescein ; Humans ; Lacrimal Apparatus Diseases*

No abstract available.
Dislocations* ; Knee*

Adult intussusception is a rare entity. Most adult intussusceptions require surgical intervention because they have a high rate of pathologic leading point. Mandatory laparotomy and en bloc resection is recommended in colonic intussusceptions due to the possibility of malignancy. We report herein 3 cases of adult colonic intussusceptions. The intussusceptions were located in the sigmoid and rectum, which were managed by laparoscopic colectomy. Case 1 was managed by laparoscopic anterior resection and diverting ileostomy combined with perineal reduction. Perineal approach facilitated laparoscopic reduction. In case 2, intraoperative colonoscopy was performed to determine the distal resection margin. Intraoperative colonoscopy showed edematous bowel mucosa as well as leading point after reduction of intussusceptions. Case 3 showed asymptomatic transient rectorectal colonic intussusceptions.
Adult ; Colectomy ; Colon ; Colon, Sigmoid ; Colonoscopy ; Humans ; Ileostomy ; Intussusception ; Laparoscopy ; Laparotomy ; Mucous Membrane ; Rectum