No abstract available.

BACKGROUND: This study was performed to investigate the outcomes of vascular operations that were done in patients with atheroscerosis obliterans (ASO) of lower limb. MATERIAL AND METHOD: Forty patients underwent vascular operations from December 1996 to June 2004. The patient's records were analyzed retrospectively. Mean age was 66+/-8 years (range, 47~81 years). Gender ratio was 37:3 (male:female). RESULT: The operations were done on 50 lower limbs of 40 patients. The names of operations were femoropopliteal bypass in 12 patients (30%), femorofemoral bypass in 12 (30%), femorofemoral bypass and femoropopliteal bypass in five (12.5%), aorta-lower limb artery bypass in five (12.5%), axillofemoral bypass in two (5%), iliopopliteal bypass in two (5%), and endarterectomy in two (5%). All bypass surgeries were done with prosthetic conduits. Mean follow up period was 33.2+/-23.2 months (range, 3.8~90.2 months). The cumulative patency rates of 1 and 5 years were 75.5 and 58.7% respectively. In six patients, amputation of the lower limb was done. In eight patients, 12 complications occurred. After the first operation, 10 patients underwent reoperations. CONCLUSION: Our lower limb arterial bypass surgery revealed acceptable patency rate, but not a few patients required reoperations. An epochal treatment modality that can inhibit the progress of ASO and improve long term patency should be established.
Amputation ; Arteries ; Atherosclerosis* ; Endarterectomy ; Extremities ; Follow-Up Studies ; Humans ; Lower Extremity* ; Retrospective Studies

The mature cystic teratoma is the most common ovarian neoplasm arising in young women and comprises approximately 10-20% of all ovarian tumors. But malignant transformation is an uncommon complication in a mature cystic teratoma(dermoid cyst) of ovary, usually being reported in about 2% of cases. Among those rare tumors with malignant change in a mature cystic teratoma, 80% are squamous cell carcinoma, 7-8% are sarcomas of various types, 6-7% are adenocarcinoma, and the remainder include thyroid carcinomas, carcinoids, and melanomas, and choriocarcinomas, and mixed malignancies. We experienced a case of adenocarcinoma arising in mature cystic teratoma of the ovary and report this case with a brief review of literatures.
Adenocarcinoma* ; Carcinoid Tumor ; Carcinoma, Squamous Cell ; Choriocarcinoma ; Female ; Humans ; Melanoma ; Ovarian Neoplasms ; Ovary* ; Pregnancy ; Sarcoma ; Teratoma* ; Thyroid Neoplasms

A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.
Adenocarcinoma ; Aged ; Anemia ; Angina, Unstable ; Chest Pain ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Gastrectomy* ; Hemorrhage ; Humans ; Male ; Physical Examination ; Stomach Neoplasms ; Transplants

Canal wall down mastoidectomy is often selected for the complete eradication of lesion and prevention of recurrence in patients with cholesteatoma. However, potential complications include a chronically draining cavity, retention of debris that requires frequent cleaning, difficulty with fitting a hearing aid. Aimed at solving these problems, surgeons have attempted reconstruction with a variety of techniques and materials: the reconstruction of an anatomically correct canal wall and complete obliteration of the mastoid cavity. We recently experienced a case of a retroauricular skin defect and cavity after canal wall down mastoidectomy of a 58-year-old male patient. The skin defect and cavity were repaired using a local skin flap, mastoid obliteration and posterior wall reconstruction methods using Tutoplast(R)(Allograft cancellous bone chip). We report this along with a review of literature.
Cholesteatoma ; Dust ; Hearing Aids ; Humans ; Male ; Mastoid ; Middle Aged ; Reconstructive Surgical Procedures ; Recurrence ; Retention (Psychology) ; Skin ; Transplantation, Homologous

Background: The aim of this study is to compare the postoperative analgesic effect of infiltration between the popliteal artery and the capsule of the knee (IPACK) and the effect of periarticular multimodal drug injection (PMDI) in addition to adductor canal block (ACB) after total knee arthroplasty. Methods: Among patients who received total knee arthroplasty from June 2017 to December 2017, 50 who underwent ACB with additional IPACK and 50 who received ACB with additional PMDI were selected for this study.We compared the postoperative pain numerical rating scale (NRS), the number of times patient-controlled analgesia was administered and the amount administered, the total amount of opioids given, and complications associated with the procedure between the two groups. Results: NRS measured at rest and 45° knee flexion at days 1 and 2 after surgery was significantly lower in the IPACK group than in the PMDI group. The resting NRS measured at day 3 after surgery was also significantly lower in the IPACK group than in the PMDI group, and the NRS at 45° knee flexion measured from day 3 to day 5 showed a significant reduction in the IPACK group. No complications relating to the procedure occurred. Conclusions IPACK may be a better option than PMDI for controlling acute phase pain in patients undergoing total knee arthroplasty.

Internal jugular vein cannulation is commonly used for the anesthetic management of patients undergoing a major operation. Complications associated with internal jugular vein cannulation such as a carotid artery puncture, pneumothorax and hemothorax, have been reported; however, thrombotic complications of arteries due to accidental arterial punctures are rare. We report a case of thrombotic obstruction of the subclavian artery associated with inadvertent arterial puncture following an attempted internal jugular vein cannulation.
Arteries ; Carotid Arteries ; Catheterization ; Hemothorax ; Humans ; Jugular Veins ; Pneumothorax ; Punctures ; Subclavian Artery ; Thrombosis

OBJECTIVES: The purpose of this study was to develop the Korean version of the Social Adjustment Scale II-Revised Version (KSAS II-RV) in the schizophrenics. METHODS: KSAS II-RV was administered to 67 schizophrenic patients and 78 matched normal controls for examining the reliability and validity. RESULTS: Data analysis showed statistically significant reliabilities and validities of KSAS II-RV. The test-retest reliability, inter-rater reliability, and internal consistency for total scores of KSAS II-RV were 0.85, 0.89. and 0.87, respectively. Evidence for discriminant validity of KSAS II-RV comes from the results that the mean scores of schizophrenic patients were significantly high than those of normal controls. Construct validity was assessed by calculating the 10 inter-subareas correlations of the KSAS II-RV, and all except the sexual adjustment area were statistically significant. Significant correlations between the global area scores of KSAS II-RV and those of Global Assessment of Functioning Scale lend support for the concurrent validity of this instrument indirectly. CONCLUSION: KSAS II-RV was found to be a valid and reliable instrument which can be used to evaluate the degree of social adjustment in the schizophrenic patients.
Humans ; Reproducibility of Results* ; Schizophrenia ; Social Adjustment* ; Statistics as Topic

PURPOSE: Hepatoid adenocarcinomas of the stomach are gastric carcinomas with both adenocarcinomatous and hepatocellular differentiations. Their incidence is rare, and they usually produce large amounts of alpha-fetoprotein (AFP). They have a specific pathologic feature, frequently occur together with liver metastasis and have a poor prognosis. This study was undertaken to understand the characteristics of clinical feature. METHODS: Fourteen hepatoid adenocarcinoma cases of gastric cancer were analyzed among 3243 patients who were treated for gastric cancer at our center between Jan 1996 and August 2003 (0.43%). RESULTS: There were 13 males and one female patient, with a median age of 59 years, ranging from 40 to 75. Ten tumors were located in the antrum, 2 in the body and 2 in the fundus. The size of the tumors varied from 2.3 to 11.0 cm. Direct invasions to adjacent organ were (4 to the pancreas and 1 to the colon). Four cases had visible lymph node enlargement at the time of the operation, ranging (from 3.5 to 6.0 cm). During the operation, 2 patients were found to have metastasis to the liver, 1 to the retroperitoneum, and 1 was positive on peritoneal washing cytology. The preoperative serum CEA levels were elevated in 7 patients, and 5 in 8 patients showed very high preoperative serum AFP levels ranging from 34.5 to 3724 ng/ml. All patients underwent a gastrectomy, and a hepatectomy in cases of liver metastasis. Pathological staging revealed one in stage Ib, four in stage II, one in stage IIIb and eight in stage IV. Immunohistochemical stainings was performed on all patients. Ten cases were positive for AFP. During follow up, eight patients died due to tumor (mean survival time: 10.6 months). Five had liver metastasis and 3 a recurrence in the peritoneum. The 6 remaining patients are still alive. CONCLUSION: 1. Hepatoid adenocarcinomas are rare and preoperatively diagnosis. The preoperative diagnostic methods of pathological consideration and preoperative serum AFP levels of all gastric cancer patients are recommended. 2. Hepatoid adenocarcinomas of the stomach have frequent and early postoperative liver metastasis and a poor prognosis, not only in advanced gastric caner but also in early cancer. Therefore, a possibly curative resection and more aggressive study for liver metastasis are recommended as being mandatory, and more sufficient treatment for these cases should be investigated.
Adenocarcinoma* ; alpha-Fetoproteins ; Diagnosis ; Female ; Follow-Up Studies ; Gastrectomy ; Hepatectomy ; Humans ; Incidence ; Liver ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pancreas ; Peritoneum ; Prognosis ; Recurrence ; Stomach Neoplasms ; Stomach*

BACKGROUND: Onlay vein patch coronary angioplasty has been known to be an option for coronary artery stenosis in the selective iesions MATERIAL AND METHOD: During the period between July 1997 and August 1999, coronary angioplasty using autologous saphenous vein was done on 16 sites in 14 cases for the stenotic lesion at the bifurcation area and significantly stenosis distal to anastomosis. RESULT: Early patency of the angioplasty site was 85.7% at postoperative day 7. There was no statistically difference in graft patency, operative parameters, and complications compared to conventional anatomosis(p>0.05). CONCLUSIONS: Despite the small number of cases, the patency rate of the coronary patch angioplasty was comparable to the conventional CABG. Coronary artery only patch angioplasty could be performed in highly selected coronary arteries.
Angioplasty* ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis ; Coronary Vessels ; Inlays* ; Saphenous Vein* ; Transplants ; Veins