No abstract available.

We experienced two cases of Gaucher's disease of adult type in brother aged four years and two years. The patients showed hepatosplenomegaly with anemia and thrombocytopenia. Typical Gaucher cells were found in bone marrow and biopsy specimens of liver and spleen through light and electron microscopic examination. Splenectomy was followed by improvement of anemia and thrombocytopenia. A brief review of literature was made.
Adult ; Anemia ; Biopsy ; Bone Marrow ; Gaucher Disease* ; Humans ; Liver ; Siblings* ; Spleen ; Splenectomy ; Thrombocytopenia

Retroperitoneal duodenal rupture is rare and is often difficult to diagnose on the plain abdominal x-ray. From a review of the plain abdomen films of 21 cases with retroperitoneal duodenal rupture, confirmed by operation, pneumoretroperitoneum was revealed in 16 cases; Air in the peritoneum was manifested as a bubbly shadow in 12 cases, a renal halo in 9 cases, air shadow along the right psoas margin in 2 cases, air along the diaphragmatic crus in 2 cases and air in the right properitoneal fat in 2 cases, US and CT also revealed air bubbles and fluid collection around the right kidney. We recommend the plain abdomen as a useful diagnostic method for detection of pneumoretroperitoneum.
Abdomen* ; Kidney ; Methods ; Peritoneum ; Retropneumoperitoneum ; Rupture*

We report a case of left adrenal pheochromocytoma in 17-year-old girl, we observed all of vital sign were returned to normal in 19-th postoperative day
Adolescent ; Female ; Humans ; Pheochromocytoma* ; Vital Signs

For the purpose of epidemiologic study, the patients who visited Severance Hospital Behcet's Syndrome Specialty Clinic were grouped by Shimizu classification into the complete, incomplete, suspected types and evaluated. The results of the evaluation with respect to personal characteristics, geographic distribution, socioeconomic characteristics, family history, and clinical characteristics are as follows. 1. The incidence among the subgroups was incomplete type(46.3%), suspected type(36.7%), complete type(17.0%) and the male to female ratio was 0.60: 1, and the average age of onset was 29.1. years for males and 27.6 years for females. 2. The occupational distribution among males included office workers, 31.5%; drivers, 10.6% and among females was office workers, 6.7%; teachers, 3. 7 %; unemployed, 81.7%. 3. Among the presumed aggrevating factors affecting oral cavity, recurrent tonsillitis(20.8%) was most common, and premenstrual exacervation(12.8%) was most common. 4. The most common initial major manifestation was oral ulcer(80.6%), and the longest duration of major manifestations was oral ulcer(average 6.4 years), and the most frequent relapse of major manifestations was oral ulcer(average 14.6 times/year). 5. The average duration between the appearance of the first and second major manifestations was 5.2 years for complete type, 6.3 years for incomplete type, and 6.6 years for suspected type. 6. Combinations of major manifestations most commonly included oral ulcer, genital ulcers and skin lesions(65.3%) for incomplete type, and oral ulcer, skin lesion(54.8%) for suspected type.
Age of Onset ; Behcet Syndrome* ; Classification ; Epidemiologic Studies ; Family Characteristics ; Female ; Humans ; Incidence ; Male ; Mouth ; Oral Ulcer ; Recurrence ; Skin ; Ulcer

Cushing's syndrome refers to a clinical pictures that develops in a patient who are exposed to excess quantities of cortisol like substances. A case of Cushing's syndrome in 62-year-old man who was followed by a Nelson's syndrome after bilateral adrenalectomy is presented with brief review of literatures.
Adrenalectomy ; Cushing Syndrome* ; Humans ; Hydrocortisone ; Middle Aged

BACKGROUND : The purpose of this study was to determine whether the Billroth I method using an EEA stapler is safe, reliable, and easy-to-use for treatment of gastric cancer compared with a distal gastrectomy with conventional manual anastomosis. METHODS : A prospective comparative study was performed between forty patients with EEA stapling and thirty patients with manual suturing during gastroduodenostomies performed during the past three years with respect to operation time, diameter of anastomosis, postoperative clinical course, and post operative complications. RESULTS : The operation time was significantly shortened by about 50 minutes on the average, in the cases where the EEA stapler was used (p<0.001). On postoperative hypotonic duodenography, the diameter of the anastomosis was significantly larger in the cases where the EEA stapler was used (p< 0.001). However, the postoperative clinical course showed no difference between the two groups. Complications, such as anastomotic stenosis and anastomotic leak age were noted only in the cases where manual suturing was used. CONCLUSIONS : A gastroduodenostomy using the EEA stapler might be a faster, simpler and safer pro cedure compared with the gastroduodenostomy using the conventional manual anastomosis.
Anastomotic Leak ; Bezafibrate ; Constriction, Pathologic ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Prospective Studies ; Stomach Neoplasms ; Stomach*

BACKGROUND: The optimum surgical treatment for rectal prolapse is controversial, and many different operations have been described. The aim of this study is to evaluate the results of a perineal procedure for the treatment of rectal prolapse. METHODS: Between February 1990 and March 1997, 16 consecutive patients underwent perineal rectosigmoidectomy for a complete rectal prolapse. One patient was lost to follow up. The remaining 15 patients were followed up for an average of 58.4 (9~94) months, and clinical and functional outcomes were evaluated. RESULTS: There were 8 males and 7 females, and ages ranged from 18 to 65 years. The mean prolapse duration was 10.7 (0.25~30) years. There were no postoperative deaths. Two patients developed postoperative complications (one wound infection and the other wound hematoma). Five patients had fecal incontinence prior to surgery. Three of the five patients had improved fecal incontinence after the procedure. There were three recurrences (recurrence rate of 20%): one of them underwent a Delorme operation at our institution and others had no treatment. CONCLUSION: A perineal rectosigmoidectomy is a safe and effective operation for the primary treatment of rectal prolapse and has low mortality and morbidity.
Fecal Incontinence ; Female ; Humans ; Lost to Follow-Up ; Male ; Mortality ; Postoperative Complications ; Prolapse ; Rectal Prolapse* ; Recurrence ; Wound Infection ; Wounds and Injuries

The Roux-en-Y esophagojejunostomy is one of the most common means of reconstructive surgery after a total gastrectomy. While these Roux operations work well in the majority of patients, approximately 30% of individuals undergoing them develop the so-called Roux stasis syndrome, consisting of chronic abdominal pain, nausea, vomiting, and postprandial bloating. The Roux stasis syndrome is thought to result from the jejunal transsection performed during the construction of a conventional Roux limb. The aim of this study was to review a new type of uncut Roux procedure, in which staple lines and loop ligation maintain myoneural continuity and prevent the Roux stasis syndrome between the proximal jejunum and the Roux limb. At the same time, a jejunojejunostomy provides distal diversion of pancreaticobiliary secretions. The postoperative courses of 23 cases of the uncut Roux procedure with staples after a total gastrectomy were compared with those of 18 cases of afferent proximal loop ligation with hand-sewn sutures, the procedures having been performed between May 1995 and January 1997. Passage of contrast media through the ligated afferent jejunal loop was identified in 34.8% of cases and occluded staple lines was identified in 38.9% of cases. It was found that the uncut Roux procedure prevents the Roux stasis syndrome and that the current technique has a high incidence of dehiscence of the staple lines and the loop ligation with subsequent reflux esophagitis. Because of the results reported here, other techniques, which maintain enteric myoneural continuity to an uncut Roux limb while providing complete and permanent diversion of the alkaline secretions distally from the esophagus, need to be developed before this type of anatomic reconstruction can be recommended.
Abdominal Pain ; Contrast Media ; Esophagitis, Peptic ; Esophagus ; Extremities ; Gastrectomy* ; Humans ; Incidence ; Jejunum ; Ligation ; Nausea ; Sutures ; Vomiting

PURPOSE: Infection is one of the major causes of morbidity and mortality in children during chemotherapy for leukemia and the development of fever in neutropenic cancer patients frequently indicates infection. The purpose of the present study is to evaluate infectious manifestations during the course of leukemia. METHODS: Seventy eight leukemic children who had one or more occasions of infection during hospitalization from January 1993 to December 1999 at Dong San Hospital, Keimyung University were analyzed. Infection was defined clinically as a single oral temperature of 38.5degrees C or higher or as three consequent oral temperature 38degrees C in a day. RESULTS: Two-hundred and four febrile episodes were studied. The cause of infection was detected in 136 episodes while in 68 episodes the cause was not detected. The causes of infection were : 31 pneumonia, 24 sepsis, 16 urinary tract infections, 15 mucositis, and 14 wound infections. The etiologic pathogens were identified in 53 episodes. Sixty percent of the pathogens were gram negative organisms such as Escherichia coli, Enterobacter, Pseudomonas aeruginosa and Klebsiella. Both gram positive and fungal infections were 17.0%. Most sensitive antibiotics were vancomycin for gram positive organisms and ceftazidime and amikacin for gram negative organisms. Twenty-one patients died due to FUOs, sepsis, pneumonia and severe mucositis. CONCLUSION: Infection was the most frequent cause of death in leukemic patients and fungal infections have increased recently. The risk of infection was higher in patients with severe and prolonged neutropenia. Therefore immediate application of antibiotics and antifungal agents will be needed in the leukemic patient with neutropenia.
Amikacin ; Anti-Bacterial Agents ; Antifungal Agents ; Cause of Death ; Ceftazidime ; Child ; Drug Therapy ; Enterobacter ; Escherichia coli ; Fever ; Hospitalization ; Humans ; Klebsiella ; Leukemia* ; Mortality ; Mucositis ; Neutropenia ; Pneumonia ; Pseudomonas aeruginosa ; Sepsis ; Urinary Tract Infections ; Vancomycin ; Wound Infection