No abstract available.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile*

This study was undertaken to observe the effects of centrally administred antihistamines on the blood pressure. Diphenhydramine(DPH), a H1-receptor antagonist, and ranitidine(RAN), a H2-receptor antagonist were administered intracerebroventricularly(icv) on urethane-anesthetized rabbits. 1) Both DPH and RAN administered intraccebroventricularly increased blood pressure, however the intravenous(iv) adminstration of them did not affect blood pressure. The pressor response to icv DPH was dose-dependent, but that to icv RAN was not. 2) The pressor response to icv DPH(1mg) was either markedly attenuated or reversed to depressor response by the pretreatment with icv phentolamine(250,500ug), and iv chlorisondamine(0.1, 1mg/Kg) and iv phenoxybenzamine(1mg/Kg). In cord-sectioned rabbtis, icv RAN) 1mg) did not produce pressor response. 3) The pressor responsr to icv RAN(1mg) was not affected by the pretreatment with icv phentolamine(500ug), iv chlorisondamin(1mg/Kg) and iv phenoxybenzamine(1mg/Kg), and iv phenoxybenzamine(1mg/Kg). RAN also producted pressor response in cordsectioned rabbits. These results suggest that the pressor response to icv DPH is elecited by increasing peripheral sympathetic tone via the stimulation of central alpha-adrenoreceptors and the pressor response to icv RAN is produced by releasing some humoral facotr which can increase blood pressure.
Blood Pressure ; Diphenhydramine* ; Histamine Antagonists ; Rabbits* ; Ranitidine*

The authors represented an analysis on 10 patients with traumatic epidural hematomas of the posterior fossa who had treated successfully from January 1984 to October 1985. The result were summarized as follows ; 1) Age incidence comprised ranging from 4 to 62 years and 6 were males and 4 were females. 2) Site of hematoma was related with fracture site closely and bleeding source confirmed during operation was transverse sinus in 4 cases, occipital sinus in 1 case, fracture site in 3 cases and unknown in 2 cases and it had close relationship between fracture site and large venous sinus. 3) Outcome was good in most cases except death in 1 and moderate disability in 1 case. Factors contributing to outcome were early detection and adequate treatment and also associated supratentorial injury.
Female ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Male ; Skull Fractures

Gastric duplication is an extremely rare disease that is commonly encountered during the first and the second decades. It is usually located in the greater curvature and forms a complete cystic structure. It usually presents non-specific post-prandial abdominal discomfort or is free of symptoms. Its significance is that it is associated with gastric malignancy or gastric ulcer and is difficult to differentiate from gastric submucosal tumor. We recently encountered an unusual case of gastric duplication, which developed in a 29-year-old man whose chief complaint was chronic abdominal discomfort. With a preoperative impression of gastric submucosal tumor, we explored his abdomen and found the gastric duplication located in the greater curvature side and performed a wedge resection. He was uneventfully discharged on the 12th postoperative day.
Abdomen ; Adult ; Humans ; Rare Diseases ; Stomach ; Stomach Ulcer

PURPOSE: We compared the safety of the double-stapling method with that of the hand-sewn method when performing a Billroth I anastomosis (BI) after a radical subtotal gastrectomy. METHODS: Fifty-three (53) patients who received a BI with stapler from February 1998 to April 1999 were compared with 24 patients who received a BI with the hand-sewn method from January 1996 to December 1998. All the patients were divided into three groups according to the type of reconstruction: Group 1 (n=42), double- stapling method, Group 2 (n=11), anastomosis through posterior gastric wall, and Group 3 (n=24), hand- sewn method. The length of the greater curvature, lesser curvature, and proximal margin and the number of resected lymph nodes were compared for radicality, and the incidence of complications was reviewed. ANOVA and the chi-square test were used for the statistical analysis. RESULTS: The mean ages were 55.2+/-10.8, 59.8+/-9.7, and 54.7+/-11.9 years for groups 1, 2, and 3, respectively. The sex ratios were 2.2:1, 1.2:1, and 1.4:1. The lengths (cm) of the greater curvature were 17.2+/-2.5, 18.4+/-2.5, and 18.6+/-3.3, and the lengths of the lesser curvature were 10.4+/-1.5, 10.9+/-1.6, and 10.7+/-2.1; however, the differences were not statistically significant (p>0.05). The lengths of the proximal resection margin were 5.4+/-2.5, 8.2+/-3.3, and 6.0+/-3.2 (p<0.05), and the numbers of resected lymph nodes were 25.3+/-8.3, 19.1+/-5.8, and 32.+/- 13.7 (p<0.01). We experienced no complication in any group, except one case of leakage in the hand-sewn group. CONCLUSION: The double-stapling technique is a safe operative method in BI after a radical subtotal gastrectomy with its very low complication rate. Especially, the so- called Tornado method is a more useful method since it doesn't need a gastrotomy in the remnant stomach.
Gastrectomy* ; Gastric Stump ; Gastroenterostomy* ; Humans ; Incidence ; Lymph Nodes ; Sex Ratio ; Stomach Neoplasms ; Tornadoes

PURPOSE: We compared the safety of the double-stapling method with that of the hand-sewn method when performing a Billroth I anastomosis (BI) after a radical subtotal gastrectomy. METHODS: Fifty-three (53) patients who received a BI with stapler from February 1998 to April 1999 were compared with 24 patients who received a BI with the hand-sewn method from January 1996 to December 1998. All the patients were divided into three groups according to the type of reconstruction: Group 1 (n=42), double- stapling method, Group 2 (n=11), anastomosis through posterior gastric wall, and Group 3 (n=24), hand- sewn method. The length of the greater curvature, lesser curvature, and proximal margin and the number of resected lymph nodes were compared for radicality, and the incidence of complications was reviewed. ANOVA and the chi-square test were used for the statistical analysis. RESULTS: The mean ages were 55.2+/-10.8, 59.8+/-9.7, and 54.7+/-11.9 years for groups 1, 2, and 3, respectively. The sex ratios were 2.2:1, 1.2:1, and 1.4:1. The lengths (cm) of the greater curvature were 17.2+/-2.5, 18.4+/-2.5, and 18.6+/-3.3, and the lengths of the lesser curvature were 10.4+/-1.5, 10.9+/-1.6, and 10.7+/-2.1; however, the differences were not statistically significant (p>0.05). The lengths of the proximal resection margin were 5.4+/-2.5, 8.2+/-3.3, and 6.0+/-3.2 (p<0.05), and the numbers of resected lymph nodes were 25.3+/-8.3, 19.1+/-5.8, and 32.+/- 13.7 (p<0.01). We experienced no complication in any group, except one case of leakage in the hand-sewn group. CONCLUSION: The double-stapling technique is a safe operative method in BI after a radical subtotal gastrectomy with its very low complication rate. Especially, the so- called Tornado method is a more useful method since it doesn't need a gastrotomy in the remnant stomach.
Gastrectomy* ; Gastric Stump ; Gastroenterostomy* ; Humans ; Incidence ; Lymph Nodes ; Sex Ratio ; Stomach Neoplasms ; Tornadoes

PURPOSE: Recurrent gastric cancer has a very poor prognosis due to its diagnostic difficulties, variant recurrence patterns and no effective treatment modalities. In this study, we retrospectively analyzed treatment results of the recurrent gastric cancer. MATERIALS AND METHODS: We reviewed 1,286 patients who had taken radical surgery for primary gastric cancers and were diagnosed to have recurrences of their primary diseases. According to the medical records, we retrospectively analyzed the gross features, histologic types and TNM stages of primary gastric cancers. The symptoms, diagnostic modalities, durations, recurrence patterns, treatments and prognoses of recurrent diseases were also reviewed. RESULTS: The median survival time of total recurrent gastric cancer patients was 6.8 months. Ldegrees Co-regional and distant recurrences had better results than peritoneal and mixed recurrences (p<0.01). Curative resection of recurrent cancer was done in only 1.6% (18 cases in ldegrees Co-regional recurrence and 4 cases in distant recurrence), but in these cases, significant survival gain (5 year survival rate: 30.5%) was found compared to other treatment modalities (p<0.01). In multivariate analysis, the type of first operation, TNM stage, duration till recurrence, recurrence pattern, and treatment modality of recurrence were meaningful for the survival time after recurrence. CONCLUSION: In selective cases, recurrent gastric cancer had an effective treatment modality and was expected to have prolonged survival. Therefore, a careful diagnosis and an active treatment of the patients who have the recurrent gastric cancers should be done, especially for the ldegrees Co-regional recurrence.
Diagnosis ; Humans ; Medical Records ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms* ; Survival Rate

PURPOSE: This study was designed to investigate the correlation between the clinicopathologic characteristics and the recurrence pattern of gastric cancer and to define survival difference according to treatment modality after diagnosis of recurrence. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 4184 patients who had undergone radical surgery for primary gastric cancer from 1986 through 1996. Clinicopathologic factors were analyzed for the relationship of each factor with the pattern of recurrence. And the survival after diagnosis of recurrence was compared among the treatment modalities. RESULTS: Recurrence pattern was confirmed in 1141 patients. Loco-regional recurrence occurred in 291 patients (20.1%), peritoneal recurrence in 383 (26.5%), distant recurrence in 290 (20.1%), and mixed recurrence in 177 (12.3%), respectively. Early recurrence (less than 2 years) occurred in 767 (69.3%), intermediate recurrence (2~5 years) in 286 (25.8%), and late recurrence (more than 5 years) in 54 (4.9%). In multivariate analysis, T stage, N stage, size of tumor and perineural invasion were independent prognostic factors for recurrence. Median survival from diagnosis of recurrence was 24.2 months in the curative operation group, 7.7 months in the chemotherapy group, 7.1 months in the non-curative operation group and 3.3 months in the conservative treatment group, respectively (p=0.000). CONCLUSION: The clinicopathological analysis of recurrent gastric cancer showed recurrent patterns and prognostic factors. Curative resection is suggested to have survival benefit in recurrent gastric cancer patients, although it was possible in patients with limited extent of disease.
Diagnosis ; Drug Therapy ; Humans ; Medical Records ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: This study was designed to investigate the clinicopathologic factors related to peritoneal recurrence and to predict peritoneal recurrence based on clinicopathologic factors. METHODS: A retrospective analysis of 383 patients with peritoneal recurrence, out of 4184 patients who had undergone curative gastric resection at SNUH from 1986 through 1996 was done. RESULTS: Of the patients with peritoneal recurrence, 275 (71.8%), 97 (25.3%), and 11 (2.9%) were early (0~24 months), intermediate (24~60), and late (more than 60) recurrence, respectively. In multivariate analysis, serosal invasion, lymph node metastasis, size of tumor, Borrmann type, perineural invasion and sex were independent prognostic factors for peritoneal recurrence. After classifying all patients into 16 groups on the basis of 4 factors, serosal invasion, lymph node metastasis, Borrmann type, and size, the number and proportion of a patients with peritoneal recurrence was obtained. There was 4.2% peritoneal recurrence in the most favorable group (n = 71), which had a Borrmann type 1 or 2 lesion less than 5 cm in maximal diameter with neither serosal invasion nor lymph node metastasis. There was a 25.4% peritoneal recurrence in the most unfavorable group (n = 331), which had a Borrmann type 3 or 4 lesion more than 5 cm with serosal invasion and lymph node metastasis. CONCLUSION: Our results suggest that patients with a Borrmann 3 or 4 lesion more than 5cm in maximal diameter, with serosal invasion and lymph node metastasis have thehighest risk for peritoneal recurrence. These patients could be considered as candidates for a treatment modality such as intraperitoneal chemotherapy or hyperthermic chemotherapy.
Drug Therapy ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

PURPOSE: Adenomatous polyps in the stomach are rather uncommon, however are related to a malignant transformation. So, in such cases it is important to predict cancer risk and to select an appropriate surgical method. The aim of this study is to examine clinicopathologic factor for predicting malignancy and determine appropriate surgical management of gastric adenomatous polyps. METHODS: A total 41 patients who underwent surgery from 1996 to 1999 for gastric adenomatous polyps at the Department of Surgery, Seoul National University Hospital were included this study. All patients had undergone preoperative endoscopic biopsy and histology was confirmed. Authors analyzed the clinicopathologic factors associated with malignancy and the outcome of surgical treatment. RESULTS: Of the 41 patients, 17 patients had an adenomatous polyp alone, 24 patients had an adenomatous polyp associated with malignancy. The location, number, size and morphology of the polyp were not associated with malignancy. Only cellular atypism in the preoperative biopsy was significantly associated with malignancy. 31 patients underwent subtotal gastrectomy whereas 10 patients wedge resection. All lymph nodes resected in patients with adenocarcinoma were negative. Recurrence of polyp or adenocarcinoma had not occurred in any patients after follow-up of mean 22 months. CONCLUSION: Cellular atypism detected in preoperative histology was associated with malignancy in gastric adenomatous polyp. Lymph node metastasis was negative in patients with malignancy. Our findings support the wedge resection withsafe margin as being appropriate in surgical management of gastric adenomatous polyps.
Adenocarcinoma ; Adenomatous Polyps* ; Biopsy ; Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Polyps ; Recurrence ; Seoul ; Stomach