Surgical advance on the general surgical department as minimal access procedure was changed into the laparoscopic cholecystectomy from open cholecystectomy for treatment of cholelithiasis. Laparoscopic cholecystectomy is far less invasive, less painful, less expensive, less complicative, high cosmetic and high eonservative procedure, and reduced hospitalization than open surgery. (continue...)
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Hospitalization ; Korea*

No abstract available.
Cerebral Palsy* ; Humans

No abstract available.
Thrombosis*

No abstract available.
Pneumothorax* ; Thoracotomy*

PURPOSE: The most important consideration for therapy using MSCs is the differentiation of the target organ's cell type. For in-vitro hepatogenic differentiation of MSCs, the main focus is efficient induction of the MSCs into the endoderm stage. Activin A, which is a signaling molecule that is similar to Nodal, promotes the induction of definitive endoderm from both ESs and MSCs. The protocols for induction into definitive endoderm have shown different efficiency and reproducibility depending on the researchers or the sources of the MSCs. Thus, a study on the various conditions of Activin A is needed to efficiently differentiate MSCs into the definitive endoderm lineage of MSCs. METHODS: MSCs were isolated from human adipose tissues and these were cultured in MCM (MSCs Culture Medium) on a human fibronectin coated plate. At 70~80% confluence, the MSCs were harvested and cultured in MCM supplemented with Activin A, at a 50 ng/mL concentration, and FGF4. The expression of the genes related with MSCs or primitive endoderm were analyzed by RT-PCR. The changes of cell morphology for differentiation were also observed by a light microscope & a SEM. RESULTS: The expression of genes related with primitive foregut endoderm was seen in the groups that were treated with a higher concentration of Activin A. The morphology of the cells that differentiated into definitive endoderm were not different from those of the undifferentiated MSCs. The expression of genes related with functional primitive hepatocytes was seen in the early phase during hepatic differentiation. The cell morphology was changed to a similar cuboidal form in a time-dependent manner. CONCLUSION: Activin A promotes a more rapid induction of definitive endoderm. It also makes an efficient condition for the differentiation into primitive foregut endoderm at a higher concentration.
Activins ; Endoderm ; Fibronectins ; Hepatocytes ; Humans ; Light

PURPOSE: The most important consideration for therapy using MSCs is the differentiation of the target organ's cell type. For in-vitro hepatogenic differentiation of MSCs, the main focus is efficient induction of the MSCs into the endoderm stage. Activin A, which is a signaling molecule that is similar to Nodal, promotes the induction of definitive endoderm from both ESs and MSCs. The protocols for induction into definitive endoderm have shown different efficiency and reproducibility depending on the researchers or the sources of the MSCs. Thus, a study on the various conditions of Activin A is needed to efficiently differentiate MSCs into the definitive endoderm lineage of MSCs. METHODS: MSCs were isolated from human adipose tissues and these were cultured in MCM (MSCs Culture Medium) on a human fibronectin coated plate. At 70~80% confluence, the MSCs were harvested and cultured in MCM supplemented with Activin A, at a 50 ng/mL concentration, and FGF4. The expression of the genes related with MSCs or primitive endoderm were analyzed by RT-PCR. The changes of cell morphology for differentiation were also observed by a light microscope & a SEM. RESULTS: The expression of genes related with primitive foregut endoderm was seen in the groups that were treated with a higher concentration of Activin A. The morphology of the cells that differentiated into definitive endoderm were not different from those of the undifferentiated MSCs. The expression of genes related with functional primitive hepatocytes was seen in the early phase during hepatic differentiation. The cell morphology was changed to a similar cuboidal form in a time-dependent manner. CONCLUSION: Activin A promotes a more rapid induction of definitive endoderm. It also makes an efficient condition for the differentiation into primitive foregut endoderm at a higher concentration.
Activins ; Endoderm ; Fibronectins ; Hepatocytes ; Humans ; Light

Reflex sympathetic dystrophy is a common posttraumatic pain syndrome for which no relia- bly effective method of therapy has been found. Oral therapy has been attempted with steroid, tricyclic antidepressant, beta-blocker, and antiseizure medications, none of which are predictably helpful. Multiple invasive treatment, including sympathetic blockade and intravenous regional local anesthetic, reserpine, or guanethidine blocks, have been employed, but again with inconsistent success. Transcutaneous nerve stimulation is effective in some patients but aggravates symptoms in others. Following a report of the use of subarachnoid block in the treatment of reflex sympathetic dystrophy, a symptom that is characterized by vasospasm and cold intolerance, we experienced the ability of subarachnoid block to relieve the symptoms of reflex sympthetic dystrophy.
Guanethidine ; Humans ; Reflex Sympathetic Dystrophy* ; Reflex* ; Reserpine ; Transcutaneous Electric Nerve Stimulation

Unexplained incidental intracranial hemorrhages during induction of general anesthesia are very rare. When it dose occur, anesthetists are involved in serious problems which can lead to disaster. We had a case where a hidden cerebral aneurysm ruptured during the induction in a patient. A 56 year old female was scheduled for a skin graft procedure on her face, anterior chest and both arms. For general anesthesia, she was induced with 300 mg of thiopental and 75 mg of succinylcholine. This was followed by endotraeheal intubation. The Anesthesia was maintained with N2O/O2 and enflurane. Appoximately 10 minutes after the induction was started the patient's pupil became fully dilated and we observed that her light reflexes were gone. Consequently, all anesthetics were discontinued, and the schedule was cancelled. She had a brain CT taken which showed subarachnoid hemorrhage. She died of rebleeding from cerebral aneurysm on the 12th postoperative day during the recovery process.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Appointments and Schedules ; Arm ; Brain ; Disasters ; Enflurane ; Female ; Humans ; Intracranial Aneurysm* ; Intracranial Hemorrhages ; Intubation ; Middle Aged ; Pupil ; Reflex ; Rupture* ; Skin ; Subarachnoid Hemorrhage ; Succinylcholine ; Thiopental ; Thorax ; Transplants

Because operationg room time is one of the most expensive hospital resources, cancellation of a planned surgery is a wasteful expenditure of specialized human manpower and other medical resources. To decrease the rate of cancellation, we performed this prospective study about patients who planned elective surgery under general or regional anesthesia frome September 1, 1990 to December 31, 1990 in the operating room of Yeungnam University Hospital. Daily, the total number of planned surgeries and cancelled patients were recorded, and the most important reasons for cancelling by an individual patient were also recorded. The results were as follows: 1)The total number of planned elective surgeries was 3,102 patients and total number of cancelled patients was 502 patients. Thus the mean rate of cancellation was 16.2%. 2)The highest rate of cancellation was in October(21.2%), and the departmental variation was hte highest rate in dental(37.5%) and the lowest rate in the ophthalmic department(8.6%). 4) The reason of cancellation were as follows: combined systemic diseases or abnormal laboratory findings(42.4%) were most common, and the next was no admission(14.5%), heavy schedule or deficinecy of operating room(10.3%), refusal of operation(8.6%), insufficinet patient preparation(7.8%), and affairs of operator or department(7.4%), and others. As a result of this study, there are several ways to decrease the cancellation rate in operating room of yeungnam University Hospital. The first is a careful preoperative evaluation of patient's physical status and results of labaratory examination before hospitalization, and then the common practice of outpatient surgery, appropriate plan of overall elective operation, reasonable management of an operating room, and good relationships between the individual department, especially surgeons and concultant. If we follow the above mentioned ways, disruptions of the surgical schedules may be avoided and a more economical management of the operationg room is possible.
Ambulatory Surgical Procedures ; Anesthesia, Conduction ; Appointments and Schedules ; Disulfiram ; Health Expenditures ; Hospitalization ; Humans ; Operating Rooms ; Prospective Studies

No abstract available.
Brain* ; Child* ; Humans ; Magnetic Resonance Imaging*