No abstract available.
Diagnosis* ; Ultrasonography*

No abstract available.
Diagnosis* ; Ultrasonography*

The aim of this study was to establish whether the pylorus-preserving pancreatico-duodenectomy (PPPD) is a safe, but radical, procedure in the treatment of malignant periampullary lesions, without increased morbidity and mortality rates, compared with the standard Whipple's procedure (PD). From 1993 to 1996, a PD (N = 25) or a PPPD(N = 15) was performed on 40 patients. Postoperative mortality rates were 2% after the PD and 0% after the PPPD. The mean operation time and blood loss in the PPPD group were 465 minutes and 840ml, respectively, and in the PD group were 444 minutes and 1080ml, respectively, both statistically insignificant. During follow-up, no differences were found in the postoperative complications, the recurrence of disease, and survival rates according to operation type, lymph node metastasis, or pancreas invasion. No differences were found the numbers of days of gastric drainage, liquid diet, and regular diet, but a delayed gastric emptying time was found in the PPPD group(40% of the patients after PPPD vs 12% after PD). Tumor-containing duodenal or gastric resection margins were not found in either group of patients. The hospital stay was the same for both groups (38 days after PPPD, 37 days after PD). The mean duration of follow-up was 23 months. Weight gain fter operation during follow-up was relatively more favorable after a PPPD. In conclusion, a PPPD is a safe, but radical, procedure and can be an alternative choice, without compromising curability. to a PD in the treatment periampullary cancer. No difference in either the morbidity or the mortality rates existed between the two procedures. Further investigation will be needed to understand the delayed gastric emptying time in the PPPD group, but during 3 months, of follow-up weight gain was better in the PPPD group.
Diet ; Drainage ; Follow-Up Studies ; Gastric Emptying ; Humans ; Length of Stay ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Pancreas ; Pancreaticoduodenectomy* ; Postoperative Complications ; Recurrence ; Survival Rate ; Weight Gain

Mature cystic teratoma, commonly called dermoid cyst, is the most common benign germ cell tumor of the ovary in children. Malignant transformation is rare, approximately 2%. As laparoscopic procedures are applied widely in pediatric surgery, a female chlid with a mature cystic teratoma may be an ideal candidate for laparoscopic surgery. Two children received laparoscopic operations successfuly for lower abdominal crises, twisted adnexa. There was no operative complication. Laparoscopic approach for ovarian lesions in infancy and childhood appears to be an effective and safe method for diagnosis as well as definitive therapy.
Child ; Cystectomy* ; Dermoid Cyst ; Diagnosis ; Female ; Humans ; Laparoscopy ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

Mature cystic teratoma, commonly called dermoid cyst, is the most common benign germ cell tumor of the ovary in children. Malignant transformation is rare, approximately 2%. As laparoscopic procedures are applied widely in pediatric surgery, a female chlid with a mature cystic teratoma may be an ideal candidate for laparoscopic surgery. Two children received laparoscopic operations successfuly for lower abdominal crises, twisted adnexa. There was no operative complication. Laparoscopic approach for ovarian lesions in infancy and childhood appears to be an effective and safe method for diagnosis as well as definitive therapy.
Child ; Cystectomy* ; Dermoid Cyst ; Diagnosis ; Female ; Humans ; Laparoscopy ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

It is known that pediatric inguinal hernia is caused by the incomplete closure of processus vaginalis (PV). In the case of unilateral hernia, possibile contralateral patent PV should be considered because of its delayed appearance as well as its risk of incarceration. Direct visualization of patent PV could be done by contralateral exploration or by indirect exploration through the ipsilateral opening site of the affected hernia assisted with laparoscope. A patient group (321 persons) to whom laparoscopy was not performed from March 2000 to March 2003 was analyzed and compared with a patient group (280 persons) to whom laparoscopy was performed from April 2003 to September 2005. With all 601 patients, the sex ratio (male/female) of patients was 3.8:1. The side distribution was 57.7% in the right, 32.1% in the left and 10.1% in bilateral. There was no difference of sex and side distribution between before and after laparosopy adoption. We did not find an age correlation in natural closure of the residual PV of the peritoneum. Contralateral hernia developed in 14 persons (2.5%) after the operation of unilateral inguinal hernia before laparoscope adoption. But no contralateral hernia developed after April 2003 with laparoscopy. We think that if we use laparoscopy, being a safe and accurate method, to check whether the contralateral residual PV is opened or closed, possible future contralateral operation can be avoided.
Hernia ; Hernia, Inguinal ; Humans ; Laparoscopes ; Laparoscopy ; Peritoneum ; Sex Ratio

A 39-year-old man, his 35-year-old wife, and their 13-year-old daughter were found dead in their home. The man and his daughter were found lying in her bedroom, with his head wrapped in a plastic bag connected to four helium gas cylinders by green polypropylene tubes. Fragments of the burnt ignition briquette were found in the bucket located at her feet. His wife was found in a decomposed state lying on her right side in her bedroom. Autopsy findings for the man were unremarkable except for cherry pink lividity; the blood carboxyhemoglobin concentration was 73%. Autopsy findings were unremarkable for the woman as well, except for a few petechial hemorrhages and conjunctival congestion. The daughter showed no definite abnormalities; however, her blood and lung contained helium gas. The deceased man's suicide note, evidence gathered at the scene, and postmortem examination revealed that this was a case of dyadic death.
Adolescent ; Adult ; Asphyxia ; Autopsy* ; Carboxyhemoglobin ; Deception ; Estrogens, Conjugated (USP) ; Female ; Foot ; Head ; Helium* ; Hemorrhage ; Humans ; Lung ; Nuclear Family ; Plastics ; Polypropylenes ; Prunus ; Spouses ; Suicide

OBJECTIVE: Today, Korean medical community faces rapid changes in medical environment due to opening of medical market, more emphasis on making profit and introduction of private medical insurance. Therefore, it is apparent that around, major university hospitals, efforts are being made to adapt to such changes by establishing mid to long range strategic plans. We want to keep pace with changing times and diverse demand of patients by introducing state of the art system, utilizing Radio Frequency Identification and Ubiquitous Sensor Network technologies for improvements. In doing so, we want to distinguish our hospital services from others. However, Hospital Information System that integrates ubiquitous technologies are introduced in limited basis due to problems like standardization and limits on medical use, where responsibilities lie, legal safeguard on transmission, invasion of privacy etc. Particularly, problems like absence of tag design suitable for medical environment, compatibility issue with previous medical information system, and also, problems on sharing information with other organizations and patients need to be addressed on application of Radio Frequency Identification technologies. METHODS: In order to solve such problems, we have designed medical tags for the first time that are consistent with future ubiquitous environment by deciding on medically suitable field with 96bit tag offered by Electronic Product Code as its base. Second, improving on previous multi-tag recognizing crash prevention algorithm, we have designed a priority anti-collision algorithm that reflects priorities on the needs in medical environment, This means, by designing group bit that reflects priorities, this algorithm is able to recognize tags with faster priorities. RESULTS: For performance evaluation of proposed techniques, we have designed medical tags on 96 bit Philips U-code tag to store and to use medical information. A priority anti-collision algorithm showed superior performance than previous algorithm by recognizing tags with at least 4 times faster priorities. CONCLUSION: This study represented a priority anti-collision algorithm based on RFID in healthcare environment. we expected that the designed algorithm could provide high quality services in hospital.
Delivery of Health Care* ; Hospital Information Systems ; Hospitals, University ; Humans ; Information Systems ; Insurance ; Privacy ; Radio Frequency Identification Device*

OBJECTIVES: Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. In this study, we investigated the association among age, the baPWV, and the APG and found a new aging index reflecting arterial stiffness for a healthcare device. METHODS: The APG and the baPWV were simultaneously applied to assess the accuracy of the APG in measuring arterial stiffness in association with age. A preamplifier and motion artifact removal algorithm were newly developed to obtain a high quality PPG signal. In total, 168 subjects with a mean +/- SD age of 58.1 +/- 12.6 years were followed for two months to obtain a set of complete data using baPWV and APG analysis. RESULTS: The baPWV and the B ratio of the APG indices were correlated significantly with age (r = 0.6685, p < 0.0001 and r = -0.4025, p < 0.0001, respectively). A regression analysis revealed that the c and d peaks were independent of age (r = -0.3553, p < 0.0001 and r = -0.3191, p < 0.0001, respectively). CONCLUSIONS: We determined the B ratio, which represents an improved aging index and suggest that the APG may provide qualitatively similar information for arterial stiffness.
Aging* ; Artifacts ; Delivery of Health Care* ; Discrimination (Psychology) ; Photoplethysmography* ; Pulse Wave Analysis* ; Vascular Stiffness

PURPOSE: Laparoscopic totally extraperitoneal (TEP) hernia repair is known to be relatively difficult in cases with a history of lower abdominal surgery. We assess the feasibility of laparoscopic TEP hernia repair in those patients. METHODS: Thirty five patients with a previous history of radical prostatectomy or lower abdominal surgery who underwent laparoscopic TEP hernia repair for inguinal hernia were reviewed retrospectively. All operations were performed by a single experienced surgeon. RESULTS: Thirty three out of the 35 patients (94%) were men. Laparoscopic TEP hernia repair was performed successfully in 30 out of 35 cases. Twenty five cases (71%) were right inguinal hernia, 6 cases (17%) were left hernias, and 4 cases (11%) had an inguinal hernia on both sides. Five cases were converted to transabdominal preperitoneal (TAPP) (n=3) or open methods (n=2). Mean operation time was 111 minutes. The patient group with previous radical prostatectomy was the largest (n=22, 63%) and required a longer operation time (124 minutes). Blood loss was less than 50 cc in all cases. Average hospital stay was 1.2 days after surgery. Voiding difficulties requiring catheterization were observed in 13 cases (37%). CONCLUSION: Laparoscopic TEP hernia repair for a patient with previous history of radical prostatectomy or lower abdominal surgery except for appendectomy can be safely performed by an experienced surgeon, but is not recommended as a standard choice because of a longer operation time and higher conversion rate.
Appendectomy* ; Catheterization ; Catheters ; Hernia* ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Laparoscopy ; Length of Stay ; Male ; Prostatectomy* ; Retrospective Studies