Traditionally, open choledochotomy with T-tube choledochostomy had been considered as the "gold standard" for choledocholithiasis. Recently, the frequency of performing the open choledochotomy with T-tube choledohostomy has decreased due to the progression of several less invasive procedures and laparoscopic technques, but until now open choledochotomy with T-tube choledochostomy is the most popular procedure in choledocholithiasis. Therefore we reviewed 126 cases who were treated with open choledochotomy with T-tube choledochostomy from January 1987 to June 1996 at our institution in order to inspect the several problematic points especially after T-tube removal. The results are summarized as follows, 1) The sex ratio of male to female was 1:1.29, and the average age was 59.6 years old. 2) 119 cases (94.4%) were biliary tract stone disease and 7 cases (5.6%) were non-calculous benign biliary tract disease. The most common etiologic disease was GB and CBD stone (37.3%). 3) Most of postoperative T-tube cholangiography was performed within 14 days (84.1%). 4) The number of patients containing some residual stone at postoperative T-tube cholangiography was 29 cases (23%). 14 of these patients were treated by Dormia-basket stone removal and its success rate was 85.7%. 5) The T-tube was removed within 2 months in 109 cases (86.5%). 6) The number of complications after T-tube removal were 8 cases (6.3%). All of them had bile peritonitis symptomes, and three of them were treated by reoperation. 7) The postoperative complications were noted in 27 cases (21.4%). and the most frequent complication is wound infection (25.8%). The postoperative mortality was noted in 1 case (0.8%).
Bile ; Biliary Tract ; Biliary Tract Diseases ; Cholangiography ; Choledocholithiasis ; Choledochostomy* ; Female ; Humans ; Male ; Mortality ; Peritonitis ; Postoperative Complications ; Reoperation ; Sex Ratio ; Wound Infection

PURPOSE: Intravesical prostatic protrusion (IPP) is a morphological change of prostate protruded into bladder and might be related to bladder outlet obstruction (BOO) depending on the extent of protrusion. There is a high possibility that lower urinary tract symptoms (LUTS) tends to get worse as IPP grows. Therefore, it is necessary to examine the effect of IPP on LUTS after revision of prostate volume in order to identify the direct effect of IPP on BOO and LUTS. MATERIALS AND METHODS: A retrospective study of 296 male patients diagnosed with benign prostate hyperplasia (BPH) between August 2006 and December 2008 were performed. The patients were evaluated with international prostate symptoms score (IPSS) and quality of life (QoL), uroflowmetry (UFR), post-void residual urine volume (PVR), prostate volume and IPP as measured by transurectal ultrasound (TRUS). The changes of IPSS after 8 weeks of medication treatment and the occurrence rates of transurethral resection of prostate (TURP) and acute urinary retention (AUR) were compared. By checking IPSS and UFR, the improvement of voiding symptom was evaluated. RESULTS: The population of patients with moderate enlargement (30-50gm) of prostate extent was 147 (49.6%) out of 296, the whole examined population. There were correlation between IPP and IPSS (p=0.002) and the storage symptoms score was significantly increased (p=0.014). After 8 weeks of medication treatment, both moderate BPH patients with IPP showed similar improvement in storage symptom compared to non-IPP groups. But, the TURP was significantly performed more with IPP (p=0.040) than non-IPP groups and more AUR has occurred (p=0.013). After TURP, IPP group resulted in improvement of IPSS, storage symptoms score and voiding symptoms score statistically compared to non-IPP group. As the change of UFR and IPSS after TURP had shown, the improvements of voiding volume, maximal flow rate (Qmax), and average flow rate (Qavg) in IPP groups were smaller however, it is no correlation in statistical view. CONCLUSIONS: Moderate BPH group with IPP has a higher possibility of having AUR and surgical treatment while showing significant correlation with storage symptoms. A further prospective study is necessary for identification of improvement of IPSS and UFR after TURP and IPP should be checked carefully during TRUS.
Humans ; Hyperplasia ; Indoles ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Retention

PURPOSE: Revascularization is a useful method for treating Kienbock's disease. The aim of this study was to evaluate the use of the second dorsal metacarpal vascular pedicle to treat Kienbock's disease. MATERIALS AND METHODS: A retrospective study was carried out on 9 patients who had undergone vascular pedicle graft for Kienbock's disease between 1999 and 2003. The mean follow up period was 35 months. At the time of surgery, 2 patients were graded as stage II, 6 as IIIa and 1 as IIIb. The ulnar variance was neutral in all cases. A vascular pedicle graft using second dorsal metacarpal vessel were performed and temporary scaphotrapeziotrapezoid (STT) fixation were applied for 6 months. RESULTS: Wrist motion except for the radial deviation and grip strength had improved significantly. The patients returned to work after an average of 22 weeks. Resorption of the sclerosis was observed in 7 cases, but lunate collapse was observed in the simple radiograph in 6 cases. According to Lichtman's criteria, 7 cases were satisfactory but 2 cases with a relative old age were unsatisfactory. According to Nakamura's classification, 5 cases were good, 3 cases were fair and 1 case was poor. CONCLUSION: In Kienbock's disease with neutral ulnar variance, a revascularization procedure of vascular pedicle graft with temporary STT fixation is a good treatment method but the patient's age should be considered when determining the revascularization procedure. A prospective study will be needed to determine the optimal duration of temporary STT fixation.
Classification ; Follow-Up Studies ; Hand Strength ; Humans ; Osteonecrosis* ; Retrospective Studies ; Sclerosis ; Transplants* ; Wrist

No abstract available.
Heart Neoplasms*

OBJECTIVES: This study was to investigate the effects of aesthetic surgery on mental health. METHOD: Sixty-four patients were assessed for their mental health and the degree of satisfaction with their body image before and after operations. The subjects' mental health was evaluated by the Korean version of Symptom Check List-90(SCL-90), a satisfaction scale with body image, and a questionnaire for demographic data and operation. RESULTS: 1) The average score of SCL-90 significantly improved from 68.17(S.D.+/-48.26) to 58.03(S.D.+/-46.93) after operation(p<0.01). The scores of all subscales for somatization symptoms, interpersonal sensitivity, depression, hostility and psychoticism improved significantly. Significant improvement was also found in patients who were in their 20's and 40's, had family support and had positive attitudes toward their operations. Family support had a more positive influence in the group who had a poorer state of mental health before the operation. 2) The average score of satisfaction with their body image improved significantly from 58.54(S.D.+/-23.14) to 78.14(S.D.+/-18.30)(p<0.01). The more they were satisfied with their body image, the more their mental health state improved. The degree of improvement in satisfaction was significant (p<0.01) in patients who had shown a poorer mental health state before operation. CONCLUSION: These results suggest that aesthetic surgery has positive influence on patients' mental health and improved satisfaction with their body image and also that, in selection of patients for aesthetic surgey, their age and possible family support should be considered.
Body Image ; Depression ; Hostility ; Humans ; Mental Health* ; Surveys and Questionnaires

BACKGROUND/AIMS: Ozone is an environmentally reactive oxidant, and pycnogenol is a mixture of flavonoid compounds extracted from pine tree bark that have antioxidant activity. We investigated the effects of pycnogenol on reactive nitrogen species, antioxidant responses, and airway responsiveness in BALB/c mice exposed to ozone. METHODS: Antioxidant levels were determined using high performance liquid chromatography with electrochemical detection. Nitric oxide (NO) metabolites in bronchoalveolar lavage (BAL) fluid from BALB/c mice in filtered air and 2 ppm ozone with pycnogenol pretreatment before ozone exposure (n = 6) were quantified colorimetrically using the Griess reaction. RESULTS: Uric acid and ascorbic acid concentrations were significantly higher in BAL fluid following pretreatment with pycnogenol, whereas gamma-tocopherol concentrations were higher in the ozone exposed group but were similar in the ozone and pycnogenol pretreatment groups. Retinol and gamma-tocopherol concentrations tended to increase in the ozone exposure group but were similar in the ozone and pycnogenol pretreatment groups following ozone exposure. Malonylaldehyde concentrations increased in the ozone exposure group but were similar in the ozone and pycnogenol plus ozone groups. The nitrite and total NO metabolite concentrations in BAL fluid, which parallel the in vivo generation of NO in the airways, were significantly greater in the ozone exposed group than the group exposed to filtered air, but decreased with pycnogenol pretreatment. CONCLUSIONS: Pycnogenol may increase levels of antioxidant enzymes and decrease levels of nitrogen species, suggesting that antioxidants minimize the effects of acute ozone exposure via a protective mechanism.
Animals ; Antioxidants/*pharmacology ; Ascorbic Acid/metabolism ; Bronchial Hyperreactivity/chemically induced/metabolism/*prevention & control ; Bronchoalveolar Lavage Fluid/chemistry ; Bronchoconstriction/drug effects ; Disease Models, Animal ; Female ; Flavonoids/*pharmacology ; Inhalation Exposure ; Lung/*drug effects/enzymology/physiopathology ; Malondialdehyde/metabolism ; Mice ; Mice, Inbred BALB C ; Nitric Oxide/metabolism ; Oxidative Stress/*drug effects ; *Ozone ; Uric Acid/metabolism ; Vitamin A/metabolism ; alpha-Tocopherol/metabolism

OBJECTIVE: To investigate whether synovial fluid adenosine deaminase activity is useful in the differential diagnosis of joint swelling and in estimating the disease activity. METHOD: Adenosine deaminase activity was determined in the synovial fluid taken from patients with rheumatoid arthritis (n=21), osteoarthritis (n=ll), ankylosing spondylitis (n=3), and gouty arthritis (n=2). This enzyme activity was compared with the laboratory indices (ESR, CRP) in the blood and the other parameters in the synovial fluid. RESULT: More increased adenosine deaminase activity was found in the synovial fluid taken from patients with rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis, as compared with that of osteoarthritis patients. Synovial fluid ADA activity was significantly corelated with the WBC count in the synovial fluid, but there was no statistical corelation between other synovial parameters and adenosine deaminase activity. CONCLUSION: Adenosine deaminase activity is useful in the differential diagnosis of joint swelling between inflammatory joint disease and osteoarthritis, but not useful in estimating the disease activity.
Adenosine Deaminase ; Adenosine* ; Arthritis, Gouty* ; Arthritis, Rheumatoid* ; Diagnosis, Differential ; Humans ; Joint Diseases ; Joints ; Osteoarthritis* ; Spondylitis, Ankylosing* ; Synovial Fluid*

BACKGROUND: The protease inhibitor aprotinin reduces blood loss and homologous blood usage after a cardiac operation. The aim of the present study was to investigate the effect of low- and high-dose aprotinin on thromboelastography (TEG) variables and to examine the relationship between the clinical effect of aprotinin and the TEG variables in coronary artery bypass grafting surgery (CABG). METHODS: Twenty-three patients scheduled for an elective CABG were randomly assigned to receive either high does (group H, n = 12) or low does (group L, n = 11) aprotinin. TEG variables, and a coagulation profile test at baseline and arrival in ICU were performed. Amount of blood loss, homologous blood transfusion and heparin requirements were measured. RESULTS: In group L, there were significant increases in r time and k time and significant decreases in MA and alpha angle after aprotinin administration. In group H, just k time after aprotinin administration was significantly increased compared with baseline data. There were no significant differences in amount of blood loss and allogenic blood transfusions between the two groups. There was not a significant correlation between TEG variables and amount of blood loss in both groups. Interestingly a siginificant negative correlation between the length of cardiopulmonary bypass and MA was noted in group H (r = -0.63; P < 0.05). CONCLUSIONS: In CABG patients, aprotinin preserves platelet function more significantly in the high-dose aprotinin group. In addition, TEG variables indicated a later clot formation in the low dose aprotinin group.
Aprotinin* ; Blood Platelets ; Blood Transfusion ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Heparin ; Humans ; Protease Inhibitors ; Thrombelastography*

Compound nevus is considered to be a common benign cutaneous tumor which is composed of nevus cells containing melanin pigment. However, compound nevus which has junctional activity has been described as actual precursors of malignant melanoma. Recently we experienced a case of compound nevus of the auditory canal, causing ear canal obstruction, intermittent hearing impairment and otorrhea in a 34-year-old female patient. The compound nevus was treated with a wide excison and full thickness skin graft by endaural approach.
Adult ; Ear Canal* ; Female ; Hearing Loss ; Humans ; Melanins ; Melanoma ; Nevus* ; Skin ; Transplants

Leiomyoma is a benign myogenic tumor found mainly in the uterus, skin and the alimentary tract. However, leiomyoma of the nasal septum is very rare and only four cases have been reported in the literature. We present a case of leiomyoma that had rose from the nasal septum and had been removed by endoscopic sinus surgery. This case might well be the fifth case in the world.
Leiomyoma* ; Nasal Septum* ; Skin ; Uterus