No abstract available.

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

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

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

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

PURPOSE: Pain is the most distressing feature of cancer patients. Thoracoscopic splanchnicectomy, first performed in 1993, has caused a resurgence of interest in surgical treatment of such excruciating pain. We wish to introduce a method of splanchnicectomy. METHODS: Five patients underwent a splanchnicectomy for intractable cancer pain, over a period of 11 months. We evaluated the type of splanchnicectomy performed and the results. The procedure was done using a double lumen catheter to deflate the lung at the operation side under general anesthesia with the patient in the lateral decubitus position. A small opening was made with scissors in the pleura of the 5th intercostal space to expose the terminal branch of the greater splanchnic nerve. Six-Seven branches of splanchnic nerve were cut downward until the splanchnic nerve trunk and then cut. A left thoracoscopic splanchnicectomy was done in one case, and a bilateral thoracoscopic splanchnicectomy in four cases. RESULTS: The splanchicectomy appears to result in significant reduction of abdominal pain in all cases. There were no postoperative complications. CONCLUSION: As a conclusion, thoracoscopic splanchnicectomy is the treatment of choice for intractable intraabdominal cancer pain, affording drug cessation and recovery of daily activity in most patients.
Abdominal Pain ; Anesthesia, General ; Catheters ; Humans ; Lung ; Pleura ; Postoperative Complications ; Splanchnic Nerves ; Thoracoscopy

BACKGROUND/AIMS: For the investigation of the efficacy and safety of intravenous levofloxacin, The clinical study was carrried out in 30 patients with abdominal operation, especially in hepatobiliary and pancreatic division. METHODS: Randomly chosen patients received intravenous levofloxacin (250mg bid) for only 7 days. Clinical and microbiological evaluation were conducted on the day of starting and finishing levofloxacin treatmeat except for the case of combined use of antibiotics. RESULTS: The most commonly isolated organism was staphylococcus aureus(33%, 3/9). The overall bacteriologic eradication rate was 67%, (6/9) with clinical success rate was 96%(29/30), There were no significant dverse effects to stop the administration of the drug. CONCLUSION: These results suggest that intravenous levofloxacin is effective and safe antibiotics in the fields management of abdominal operation especially in hepatobiliary and pancreas surgery.
Anti-Bacterial Agents ; Humans ; Levofloxacin* ; Pancreas ; Staphylococcus

BACKGROUND/AIMS: Along with the expansion of the field of laparoscopic surgery, many laparoscopic instruments have been developed and these all together made laparoscopic surgery possible in many operative procedures which used to be considered impossible to be done using a laparoscope. Suturing is a technique quite often required during laparoscopic surgery and so far we have used imported suture material. In this article, we have compared the safety and harmfulness of suture material developed domestically in Korea with those imported using house rabbits. METHODS: A total of 40 white house rabbits from New Zealand weighing 3.0-3.4 Kg were used from July 1, 2000 until April 30, 2001. Under general anesthesia, we created a pneumoperitoneum using a veress needle with a pressure of 10 mmHg followed by insertion of a 5mm laparoscope right above the umbilicus and two 5mm trocars were inserted in the right and left midclavicular lines 5cm below the costal margin. After perforating the pylorus of the stomach using laparoscopic scissors, we sutured two sites using Laploop and then perforated the body of the stomach and again sutured two sites but this time using Vicryl #3-0 for comparison with Laploop. 10 house rabbits were sacrificed each on post operation days 10, 20, 30 and 40 and tissues obtained from those house rabbits were compared using the Sewell method. RESULTS: Suturing and ties were done without any problems and there were no postoperative complications or deaths. On postoperation days 10 and 20, Laploop showed a moderate degree of tissue reaction proved by a Sewell score of 57 and 48 respectively and on postoperation days 30 and 40, a mild to moderate degree of tissue reaction occurred with a S score of 36 and 33 respectively. In models using Vicryl, the S scores were 67 an 62 on postoperation days 10 and 20 respectively showing a moderate degree of tissue reaction and on postoperation days 30 and 40, it showed a mild to moderate degree of tissue reaction with a S score of 52 and 44 respectively which is similar to the results obtained by Laploop. CONCLUSION: Imported Vicryl and Laploop were both applicable in terms of biologic compatibility but Laploop was easier to apply, more cost effective compared to Vicryl but most of all, there were no complications such as a loosening of a knot or a knot being undone. Therefore it could be concluded that Laploop shows a promising future as a suture material in laparoscopic surgery.
Anesthesia, General ; Korea ; Laparoscopes ; Laparoscopy ; Needles ; New Zealand ; Pneumoperitoneum ; Polyglactin 910 ; Postoperative Complications ; Pylorus ; Rabbits* ; Stomach ; Surgical Instruments ; Surgical Procedures, Operative ; Sutures ; Umbilicus

Hepatocellular carcinoma (HCC) during pregnancy is a rare event and reports are isolated and highly scattered. HCC during pregnancy carries a poor prognosis because of difficulty in diagnosis due to the fetus. The impact of pregnancy on the prognosis of patients with HCC and the risk factors of developing HCC during pregnancy remains controversial. At present, the screening of maternal serum alpha-fetoprotein(AFP) in the second trimester of pregnancy is a standard procedure for detection of fetal malformation. An elevated maternal serum AFP level may not always be of fetal origin and some maternal diseases could present an elevated maternal serum AFP. The ultrasonography for abdomen has been accepted as a simple and safe method for this group. We have experienced two cases of HCC during pregnancy over the last 5 years. One was diagnosed with a palpble abdominal mass which was revealed to be HCC at 12 weeks of pregnancy and died 2 months after the diagnosis without treatmemt. The second was incidentally found to have abnormal serum AFP at 17 weeks of pregnancy and underwent the extended right hepatic lobectomy without complication. We suggest that careful physical examination and abdominal ultrasonography seems to be the best screening tools for early diagnosis of HCC in pregnancies with high serum AFP level.
Abdomen ; Carcinoma, Hepatocellular ; Diagnosis ; Early Diagnosis ; Female ; Fetus ; Humans ; Mass Screening ; Physical Examination ; Pregnancy Trimester, Second ; Pregnancy* ; Prognosis ; Risk Factors ; 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