No abstract available.
Hepatitis B, Chronic/*drug therapy ; Humans

It is generally considered that enteral feeding is superior to parenteral nutritional support. Thus enteral meal should be given whenever patients have proper gastrointestinal function to take enteral feeding. Because the morbidity and mortality for surgical jejunostomy have been reported as high as 50% and 10% respectively, direct percutaneous endoscopic jejunostomy has been developed to reduce the morbidity and mortality. A 55-year-old male patient, who was suffering from dysphagia and oropharyngeal aspiration, was transferred to the division of gastroenterology to be done permanent enteral feeding. His stomach was resected (subtotal gastrectomy with billroth II anastomosis) due to peptic ulcer hemorrhage 10 years before. We performed direct percutaneous endoscopic jejunostomy without any complication. Herein, we report a successful case.
Deglutition Disorders ; Enteral Nutrition ; Gastrectomy* ; Gastroenterology ; Gastroenterostomy ; Humans ; Jejunostomy* ; Male ; Meals ; Middle Aged ; Mortality ; Nutritional Support ; Peptic Ulcer Hemorrhage ; Stomach

Microspherocytosis is known as a hallmark of hereditary spherocytosis (HS) which is one of the most common hemolytic anemias with a prevalence of one per 5000, and is inherited as Mendelian dominant. In this disorder, the patient's red cells become spheroidal, osmotically less resistant in the peripheral circulation, and are selectively trapped in the spleen, but survive normally after splenectomy. The exact mechanism for the formation of microspherocytosis has not been elucidated, although extensive investigations demonstrate that HS red cells are intrinsiclly defective and the patient's spleen does "condition" the metabolically abnormal red cells. The authors report here, one case of severe microspherocytosis in which changes in facial bone structure and transfusion dependency are noted, and an early splenectomy is indicated.
Human ; Infant ; Male ; Spherocytosis, Hereditary/surgery* ; Splenectomy*

The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

Verrucous hemangioma is a variant of a capillary, cavernous, or mixed hemangioma which undergoes a reactive proliferative epidermal change. Most verrucous hemangiomas appear on the lower extremities, and most are present at birth or appear during childhood. We observed two patients who showed typical clinical and histopathological findings of verrucous hemangioma. Treatment was done by wide surgical excision and skin graft. The first rnale patient had a good therapeutic result but the second female patient had a recurrence at one month post-operative.
Capillaries ; Female ; Hemangioma* ; Humans ; Lower Extremity ; Parturition ; Recurrence ; Skin ; Transplants

There were 105 patients with multiple rib fracture or flail chest who had underwent surgical rib fixation using Judet's strut from Aug. 1989 to Aug. 1995. They were 86 men and 19 women, and the age distribution was from 17 to 77(mean 48+/-12). The most common cause of accident was a traffic accident(81%). The mean number of rib fracture was 5.5 and the distribution of patient were flail chest(72, 64.7%), severe displaced rib Fracture(18, 17.1%), traumatic chest wall deformity(10, 95%) and others(5, 4.7%). The operative mortality was 1 patient(0.96%) and the incidence of postoperative complication were 13 patients(12.3%). The duration of perioperative artificial ventilator therapy was 90.5+/-22.6 hours. Our method allowed shorter duration of an artificial ventilation and decreased a functional sequelae. We find this technique to be better than previously published methods, since it provides better stabilization and immobilization of the ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.
Age Distribution ; Congenital Abnormalities ; Female ; Flail Chest* ; Humans ; Immobilization ; Incidence ; Male ; Mortality ; Postoperative Complications ; Rib Fractures* ; Ribs* ; Thoracic Wall ; Thorax ; Ventilation ; Ventilators, Mechanical

Primary biliary cholangitis is a chronic inflammatory autoimmune liver disease that is characterized by a positive antimitochondrial antibodies test and progressive destruction of the small intrahepatic bile duct. Ankylosing spondylitis is a chronic, systemic, inflammatory disease of the spine and the sacroiliac joints. The association between these two is very low. This paper reports a rare case who had ankylosing spondylitis and developed primary biliary cholangitis.

OBJECTIVES: The causes of benign esophageal stricture were postoperative, corrosive, peptic and after esophageal sclerotheraphy, etc. The patients mainly suffered from dysphagia and insufficient nutrition. Recently, balloon and bougie dilatation were introduced to these patients. This study was performed to evaluate the effectiveness and safety of both procedures in different types of strictures METHODS: 32 patients who presented dysphagia enrolled from March 1996 to August 1997 who visited Pusan National University Hospital. Balloon dilatation was performed on 22 patients and bougie on 10 patients. RESULTS: 1) The causes of stricture were postoperative (18 cases), corrosive (10 cases), hypertensive LES (2 cases), peptic (1 case) and web (1 case). 2) Overall cure rate was 59% in bougie dilatation and 40% in balloon dilatation 3) The cure rate of postopertive stricture was 59% which is significantly higher than that of corrosive stricture (27%), and cure rate of hypertensive LES, peptic stricture and web was 100%. 4) The cure rate of corrosive stricture was significantly higher on bougie dilatation than balloon dilatation. 5) The cure rate of postoperative stricture was similiar between balloon and bougie dilatation 6) The length of stricture was inversly affected on cure rate of both dilatation procedures. 7) Overall complication was 5.6% and similiar between balloon and bougie dilatation. CONCLUSIONS: These results suggested that bougie dilatation was recommended on corrosive stricture and balloon dilatation on postopertive stricture
Busan ; Constriction, Pathologic ; Deglutition Disorders ; Dilatation* ; Esophageal Stenosis* ; Humans

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2002. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,045 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,199 cases (72.2%) and that of female 846 (27.8%). Male was over twice more than female. The forties were 766 cases (25.2%), the thirties 692 (22.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,810 cases (59.5%), natural 1082 (35.5%), and the unknown 153 (5.0%). Among 1,810 unnatural deaths, suicide was 416 (23.0%), homicide 394 (21.8%), accident 592 (32.7%), and the unclear 408 (22.5%). Homicide occupied 33.3% of trauma, 49.3% of blunt force injury excluding traffic and fall-down injury, and 88.2% of sharp force injury. The homicide rate in asphyxia was 31.7%,but it went up to 59.2% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 867 cases, occupying 47,9% of 1,810 unnatural deaths, followed by poisoning deaths (269 cases). Blunt trauma was 284 cases (32.8%) and the leading cause of death in traumatic death. Poisoning was 269 cases, among which the agrochemicals were dominant (64cases). Thermal injuries were 193 cases, electrocution 16 cases, and starvation/neglect 9 cases. and 17 cases were directly due to medical procedures.4. Among 1,082 natural deaths, heart diseases were 450 cases (41.6%), and vascular diseases 186 (17.2%), and these two categories were added up to 636 (58.8%). 5. Child deaths under the age of 10 were 179 cases. Homicide was 35 cases (37.2%) out of 94 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 48 cases (26.8%)
Agrochemicals ; Asphyxia ; Autopsy* ; Cause of Death ; Child ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2005. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,851 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,007 cases (70.4%) and that of female 844 (29.6%). Male was over twice more than female. The forties were 807 cases (28.3%), the thirties 573 (20.1%), and these two decades occupied 48.4%. 2. Unnatural deaths were 1,716 cases (60.2%), natural 1011 (35.5%), and the unknown 124 (4.3%). Among 1,716 unnatural deaths, suicide was 497 (29.0%), homicide 426 (24.9%), accident 510 (29.6%), and the unclear 283 (16.5%). Homicide occupied 42.0% of trauma, 75.6% of blunt force injury excluding traffic and fall-down injury, and 85.5% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 60.1% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 716 cases, occupying 41.7% of 1,716 unnatural deaths, followed by asphyxial deaths(296 cases). Blunt trauma was 205 cases (28.6%) and the leading cause of death in traumatic death. Poisoning was 229 cases, among which the ethanols were dominant (58cases). Thermal injuries were 198 cases, electrocution 20 cases, and starvation/neglect 14 cases. and 18 cases were directly due to medical procedures. 4. Among 1,011 natural deaths, heart diseases were 481 cases (47.6%), and vascular diseases 193 (19.1%), and these two categories were added up to 674 (66.7%). 5. Child deaths under the age of 10 were 129 cases. Homicide was 40 cases (62.5%) out of 64 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 41 cases(31.8%)
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Ethanol ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases