No abstract available.

This clinical trial was undertaken on 32 infants and chhildren who had G-I symptoms caused by a few diseases, such as meningitis, parenteral infection and intestinal infection. Out of 32 patients, six had vomiting only, caused by meingitis and habitual vomiting, eighteen had vomiting and diarrhea both which caused by parenteral infection and rest of them (8) had diarrhea only, caused by intestinal infection. Polybutine syrup, which 5.0 ml contain 24 mg of trimebutine, was given to these patients as follows; 2.5 ml twice a day at 6 months of age, 5.0 ml twice a day at 6 months to one year and 10 ml three times a day at 1-5 years of age. In ten of 24 patients, who had vomiting only (6), vomiting and diarrhea (18), the symptoms were improved within 48 hours, and rest of them (10) was also shown the improvement of their symptoms within 5 days after medication. In comparison of polybutine treated group and not treated group, the effectiveness of polybutine treatment for the symptoms was statistically meaningful.
Diarrhea ; Humans ; Infant ; Meningitis ; Trimebutine ; Vomiting

Although the "Duodenogastric reflux" was often developed in normal persons, it was more frequently developed in the majority of patients who had a gallstone disease or malfunctioned gallbladder. The "duodenogastric reflux" induced chronic gastritis, peptic ulcer, and esophagitis causing upper abdominal symptoms. After the cholecystectomy was performed, most patients have no further symptoms but a significant minority of patients still have persistent symptoms. Such symptoms was often explained with the "duodenogastric reflux". We examined the degree of duodenogastric reflux in the patients with gallstones and the changes of the degree of the duodenogastric reflux after the laparoscopic cholecystectomy in these patients. The study population consisted of 9 patients with gallstone disease. The clinical symptoms (upper abdominal pain, bloating, early satiety, nausea, vomiting, heartburn, dysphagia, indigestion, fat intolerance) were graded and all subjects had standard esophageal manometry to identify the location of the lower esophgeal sphincter and the 24 hour gastric pH monitoring to ascertain the duodenogastric reflux at before and 3 months after laparoscopic cholecystectomy. On the results of our study, the severity of clinical symptoms was decreased after operation and the time percentage above pH 7, longest time above pH 7, frequency above pH 7 and frequency persistent 5 min above pH 7 in supine and upright position were not significantly different after operation at statistical analysis. It is revealed that the degree of duodenogastric reflux was not changed on 24 hour gastric pH monitoring. We concluded that laparoscopic cholecystectomy did not affect on the duodenogastric reflux in the patients of gall bladder stone.
Abdominal Pain ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Deglutition Disorders ; Duodenogastric Reflux* ; Dyspepsia ; Esophagitis ; Gallbladder ; Gallstones* ; Gastritis ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Nausea ; Peptic Ulcer ; Urinary Bladder Calculi ; Vomiting

Isoconazole nitrate is one of the broad-spectrum antimycotic agents recently developed from imidazole derivatives. Authors performed ulticenter trials to evaluate the therapeutic effect of Travogen and Travocort in superficial fungal diseases. In the usual superficial fungal diseases, Travogen was applied 4 weeks. In the inflammatory and eczematoid superficial fungal diseases, Travocort was applied 2 weeks initially and then followed by 2 weeks application of Travogen. One hundred and ninty one patients with superficial fungal diseases were included in this study during g months from December, 1982 to August, 19$3 The obtained results were as follows; The overall cure rate of Travogen and Travocort in each superficial fungal diseases were gl 7g (tinea pedis), 98. L% (tinea cruris), 1ppg, (tinea corporis), 9g. 100% (tinea manus), 1ppg (tinea capitis) and 1pgg (candidiasis) respectively. Trichophyton rubrum(51. 3%), Trichophyton mentagrophytes(29.3g), Tricho -countinue-
Humans ; Trichophyton

Cystic lymphangioma of the gallbladder is quite a rare tumor with only a few cases having been reported in the literature. We describe here a rare case of cystic lymphangioma of the gallbladder, which was unusual in that the patient presented with biliary pain and an abnormal liver test. Ultrasonography and computed tomography of the abdomen showed a multi-septated cystic mass in the gallbladder fossa and an adjacent compressed gallbladder. Endoscopic retrograde cholangiography showed there was no communication between the bile tract and the lesion, and there were no other abnormal findings with the exception of a laterally compressed gallbladder. After performing endoscopic sphincterotomy, a small amount of sludge was released from the bile duct. The histological findings were consistent with a cystic lymphangioma originating from the subserosal layer of the gallbladder. This unusual clinical presentation of a gallbladder cystic lymphangioma was attributed to biliary sludge, and this was induced by gallbladder dysfunction that was possibly from compression of the gallbladder due to the mass.
Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Female ; Gallbladder Neoplasms/*diagnosis/pathology/surgery ; Humans ; Lymphangioma, Cystic/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Chemoradiation therapy prior to pancreaticoduodenectomy has several effects. First, it ensures that patient who undergo resection subsequently complete multimodality therapy and helps to avoid resection in patients with rapid progressive disease. Second, it allows radiation therapy to be delivered to well oxygenated cells before surgical devasculation. Finally, in such cases there is a chance of resection of unresectable pancreatic cancer by downstaging. METHODS: A patient with cytologic proof of localized adenocarcinoma of the pancreatic head recieved preoperative chemoradiation (Taxol, 50 mg/m2 IV for 3 hours weekly 3 cycles, Gemcytabine 1,000 mg/m2/day IV for 3 days weekly 2 cycles, 4,500 cGy) with the intent of proceeding to resection, Restaging was performed by computed tomography and magnetic resonance imaging every months from 5 weeks due to the ongoing decreasing of tumor size following the completion of chemoradiation. Upon laparotomy, the patient was found to not have any suspected metastatic disease and the tumor size was 2 3 cm on the pancreas head infiltrating to the portal vein approximately 3 cm in length along right side. Pancreaticoduodenectomy was performed with partial portal vein and superior mesenteric vein resection followed by reconstruction of the vascular anastomosis by using the right side internal jugular vein. Perioperative complication did not occur. RESULTS AND CONCLUSION: Preoperative chemoradiation of localized advanced pancreatic has a low incidence of operative complication and enhanced resectability.
Incidence ; Adenocarcinoma ; Neoplasm Metastasis ; Pancreatic Neoplasms

BACKGROUND/AIMS: The most effective method of improving survival in patients with HCC is early diagnosis and curative hepatic resection. However, longterm survival after curative resection remains low because of high recurrence rate after resection. The purpose of the study is to assess the prognosis and the efficacy of the various treatment modalities on recurrent HCC after curative resection. METHODS: The clinical records of 50 patients with recurrent HCC were reviewed retrospectively who underwent curative surgery in Yonsei University, Severance Hospital from Jan. 1987 through Oct. 1994. The cummulative recurrent rate after resection, the response rate of treatment after resection, the median progression free survival and the survival after recurrence according to the treatment modalities were evaluated. RESULTS: The cummulative recurrent rate after resection was 3.9% at 3 month, 8.3% at 6 month, 14.1% at 12 month, 21.5% at 24 month, 23.4% at 36 month and 24.4% at 60 month. The response rate of treatment after recurrence was 23.7% (9 patients). The median progression free survival of the patient with reoperation and hepatic embolization was 13.9 months, that of conservative treatment group was 6.8 months and that of no treatment group was 4 months(p = 0.004). The survival after recurrence of HCC was 19.7 months in reoperation and hepatic embolization group, 11.4 months in multimodality group, 16.9 months in conservative treatment group and 8.4 months in no treatment group(p=0.0998). CONCLUSION: Reoperation and hepatic embolization for HCC after curative resection was effective in improving progression free survival, but overall survival were not significantly different according to the treatment modalities. This results proposed that reoperation and hepatic embolization for recurrent HCC after curative resection improve progression free survival.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Early Diagnosis ; Humans ; Prognosis* ; Recurrence ; Reoperation ; Retrospective Studies

It has been reported that dyspeptic symptoms in a minority of the patients who undergo cholecystectomy are persistent. Cholecystectomy may have a direct effect on the development of dyspeptic symptoms, predisposing the patient to increased duodenogastric reflux. Excessive reflux of noxious duodenal content into the stomach has been associated with chronic gastritis, gastric ulceration, and esophagitis. We examined 9 patients with gallstone disease who underwent laparoscopic cholecystectomy to determine the changes in the gastroesophageal reflux and the esophageal function. All the patients underwent looth standard esophageal manometry to study esophageal function and 24-hr esophageal pH monitoring to ascertain the gastroesophageal reflux the prior to at the time of, and 3 months after the laparoscopic cholecystectomy. The mean lower esophageal sphincter(LES) length, the abdominal esophageal sphincter length, and the resting pressure of LES were increased from 3.1 cm, 2.3 cm 19.9 mmHg to 3.2 cm, 2.6 cm, 22.9 mmHg, with no statistical significance. The mean sphincter function index increased from 1484 to 1888 after the operation with no statistical significance. The mean ampulitude of contraction in the upper, the middle, and the lower portions of the esophageal body, but again increased from 44.4 mmHg, 59.8 mmHg, and 87.5 mmHg to 56.7 mmHg, 84.44 mmHg, and 117.8 mmHg, respectively, after the operation. The mean DeMeester acid reflux score decreased from 13.5 to 7.0 after the operation(p=0.343). In this study, the laparoscopic cholecystectomy did not affect the lower esophageal sphincter function. However there was an increase in the amplitude and the duration of contractions in the esophageal body. Therefore, the heartburn that persists after a cholecystectomy may be an esophageal origin. We suggest that all patients with biliary symptoms, but without documented acute cholecystitis should undergo full upper gastrointestinal investigations with esophagogastroduodenoscopy and pH monitoring (especially dual channel gastric and esophageal pH moniotring) to differentiate the esophageal pathology from other origins.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Duodenogastric Reflux ; Endoscopy, Digestive System ; Esophageal pH Monitoring ; Esophageal Sphincter, Lower ; Esophagitis ; Gallstones* ; Gastritis ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Pathology ; Stomach ; Stomach Ulcer

PURPOSE: There have been many trials to find a cure for inoperable multiple hepatocellular carcinomas (HCC), but no effective therapy has been found. As the combined therapy of tumor reductive surgery and intraoperative radio-frequency ablation (RFA) is by far the best known effective treatment modality, the effect of a combined resection and intraoperative RFA for multiple HCC was evaluated. METHODS: Between July 1999 and 2004, a retrograde study was conducted on 8 patients who had undergone combined therapy for HCC, with respect to the number of tumors, location, size, postoperative complications and recurrence. RESULTS: The average age of the patients was 51. A Rt. hepatectomy, Lt. Lateral sectionectomy, bi-segmentectomy, segmentectomy and wedge resection were performed. The total number of tumors and resected tumors were 21 and 8, respectively; with an average size of 6.6 cm. Thirteen tumors, with average size of 2 cm, were treated with RFA. Seven postoperative complications were encountered in 2 patients, with 2 operation related complications biloma and ascites. One patient suffered from pleural effusion and a wound complication. One patient went through a RFA-related complication biliary-cutaneous fistula. Four patients suffered a recurrence one at the RFA site, and the rest at the remnant liver. The treatments used for the recurrences were TACE/ TACI, percutaneous Holmium injection and surgical resection. All patients survived, with an average survival and a median disease free survival time of 15 and 11 months, respectively. CONCLUSION: Until now, surgery has been the least favored choice for the treatment of multiple HCC. However, thinking our opinion, the combined therapy of hepatectomy with intraoperative RFA is beneficial. Our group of patients was small, with a short follow up period, without any definite indication; therefore, it will be necessary to conduct continuous follow up, with the collection of appropriate data.
Ascites ; Carcinoma, Hepatocellular* ; Catheter Ablation ; Disease-Free Survival ; Fistula ; Follow-Up Studies ; Hepatectomy ; Holmium ; Humans ; Liver ; Mastectomy, Segmental ; Pleural Effusion ; Postoperative Complications ; Recurrence ; Thinking ; Wounds and Injuries

BACKGROUND/AIMS: Laparoscopic cholecystectomy has become popular. Occasionally, unsuspected gallbladder carcinoma is diagnosed after the operation by pathologic examination, incidentally. And even when the gallbladder carcinoma is suspected preoperatively, it is determined whether or not the additional radical operation will proceed, according to the pathologic diagnosis after laparoscopic cholecystectomy. Multiple staging systems have been described, including the modified Nevin classification (Donohue et al 1990, Nevin et al 1976), the AJCC TNM staging system, and there are controversies in the surgical management of gallbladder carcinoma for each stage. The purpose of this study was to evaluate the role and the meaning of the laparoscopic cholecystectomy in the surgical management of the gallbladder carcinoma. METHODS: A retrospective analysis was made of 24 patients with gallbladder carcinoma that was confirmed by pathologic diagnosis after laparoscopic cholecystectomy in Severance Hospital between January 1993 and Feburary 2002. RESULTS: Gallbladder carcinoma was found in 1.1% of the 2141 cholecystectomy specimens. Gallbladder carcinoma was suspected preoperatively in 11 patients (45.8%). The location of the lesions was the serosal side in 16 patients (66.7%), the liver bed side in 1 patient, and undetermined in 7 patients. The histologic type was adenocarcinoma in all patient, and well differentiated in 16 patients (66.7%), moderate and poorly differentiated in 8 patients (33.3%). According to the AJCC TNM staging system, there were 13 stage I (54%), 5 stage II (20.8%), 2 stage III (8.3%), 4 stage IV (16.7%). The lymph node metastasis was observed in 4 patients (16.7%). In 18 patients (75%), only laparoscopic cholecystectomies were performed, and additional radical cholecystectomies were performed in 4 patients (16.7%). The patients with stage I and II tumor were alive without recurrence except 1 follow-up loss, and there was not any port site recurrence. CONCLUSION: Laparoscopic cholecystectomy is sufficient with stage I gallbladder carcinoma. It may be considered that the patient with stage II gallbladder carcinoma is closely followed without additional radical cholecystectomy after laparoscopic cholecystectomy, if properly selected. The use of vinyl bag for retrieval of specimen is recommended to avoid the port site recurrence. For advanced gallbladder carcinoma (stage III and IV), the additional radical cholecystectomy is recommended. When gallbladder cancer is suspected, an open operation should be performed with sufficient preoperative staging work-up.
Adenocarcinoma ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Classification ; Diagnosis ; Follow-Up Studies ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Recurrence ; Retrospective Studies