Cholelithiasis and cholecystitis frequently necessitate cholecystectomy. Experience is increasing with laparoscopic cholecystectomy, a technique that avoids much of the morbidity, pain, prolonged hospital day, and recovery complications associated with the traditional approach. And the safety of laparoscopic cholecystectomy was confirmed. Besides appendectomy, cholecystectomy is the second most common nonobstetric procedure performed in pregnant women. We have performed one case of a successful laparoscopic cholecystectomy in the second trimester of pregnancy. Pregnancy was once a contraindication of laparoscopic operation, but no longer.
Appendectomy ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholelithiasis ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women

The results of hepatic portojejunostomy performed in 34 patients with biliary atresia between May 1989 and December 1997 were analyzed. These patients were divided into three groups based on age of surgery; group 1 (< or =60 days, n = 11); group 2 (61~90 days, n = 14), and group 3 (>90 days, n = 9). Jaundice was cleared in 22 cases (64.7%). There was no significant difference of jaundice-free rate according to the age at operation between group 1, 2, 3. After a mean follow-up period of 33.9 month (range 18days-105.7 month), there were eleven deaths from hepatic failure(6), esophageal varix bleeding even though anicteric(2), sepsis by cholangitis(1), heart failure(1) and renal failure(1). Two of group 1 and 3 had received liver transplantation. With follow-up of average 33.9 months (18days-106months, one follow-up loss), 5-year cumulative survival rate by Kaplan-Meier method was 65.9%. The 5-year survivals of group 1, 2, 3 were 63.6%, 77.9%, 41.4%. There was no significant difference of survival rates according to the age at operation between group 1, 2, 3. Moreover, two cases of group 3 survived more than 5 years. Therefore, hepatic portojejunostomy can be considered as a primary surgical modality for biliary atresia in a patient of 90 days or more. Early detection of esophageal varix and possible sclerotherapy is necessary for long term survival.
Biliary Atresia* ; Chungcheongnam-do* ; Esophageal and Gastric Varices ; Follow-Up Studies ; Heart ; Hemorrhage ; Humans ; Jaundice ; Liver Transplantation ; Sclerotherapy ; Sepsis ; Survival Rate

No abstract available.
Occupational Diseases*

BACKGROUND: The regional fat distribution is known to be related with some cardiovasular risk factors independently to total body fat amount. Regional fat distribution pattern can be assessed by waist to-hip ratio(WHR). WHR distribution patterns depend on age, sex, race and show regional difference. But, our own unique data are inadequate, so we tried to investigate distribution patterns, cut off points and related factors of WHR in middle aged men and women among Korean. METHODS: The study population were middle aged men and women above 40 years old who visited our hospital for routine check up from April to July, 1996. We measured height, weight, blood pressure, waist circumference, hip circumference, fasting blood sugar and total cholesterol in 1,000 persons. We gathered data about diet habits, exercise, smoking and drinking status by standard questionnaire. We analized above data by using SAS for Window 6.10. RESULTS: The study population numbers of men and women were 494 and 499, and average ages of men and women were 49.3 and 50.5 years respectively. For men, the average WHRs as a whole were 0.895, and 0.893, 0.893 and 0.911 in their forties, fifties and above sixties respectively. For women, the average WHRs as a whole were 0.827, and 0.816, 0.837 and 0.850 in their forties, fifties and above sixties respectively. The percentage above WHR 1.0, 0.95, and 0.90 in men were 2.4%, 11.7% and 46% and the percentage above WHR 0.90, 0.85, and 0.80 in women were 8.2%, 32.9% and 68.7%. Adjusting by age, body mass index, WHR was significantly correlated with weight, systolic blood pressure, diastolic blood pressure in men only. For men, WHR was associated with alcohol drinking positively and with exercise negatively. For women, WHR was associated with alcohol drinking and smoking status positively. CONCLUSIONS: The WHR had a tendency to increase according to age. The 90th percentile points in men and women were 0.957 and 0.894 respectively. WHR was related with several cardiovascular risk factors and several life styles.
Adipose Tissue ; Adult ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Continental Population Groups ; Drinking ; Fasting ; Female ; Food Habits ; Hip ; Humans ; Life Style ; Male ; Middle Aged* ; Risk Factors ; Smoke ; Smoking ; Waist Circumference ; Waist-Hip Ratio* ; Surveys and Questionnaires

OBJECTIVES: The purpose of this study was to investigate whether longitudinal changes in positive and negative symptoms affect cognitive functioning in chronic schizophrenia. METHODS: Sixty-eight patients diagnosed with DSM-IV schizophrenia were examined on two occasions over 6 months for symptoms and cognitive changes. Symptoms were measured by PANSS. Cognitive functions were examined for sustained attention, executive function, concentration and attention, and verbal memory and learning using Degraded Stimulus Continuous Performance Test, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test, respectively. Twenty control subjects were assessed to compare the cognitive scores of remitted schizophrenic patients. RESULTS: Patients showed significant improvement in symptoms and all cognitive tests after 6 months treatments. Significant improvements in positive and negative symptoms did not predict improvements in any aspect of cognitive functioning measured. Normal controls performed significantly better than remitted schizophrenic patients on all cognitive tests. The results show no relationship between change in symptoms and change in cognition in chronic schizophrenia. CONCLUSION: We suggest that symptomatic and cognitive impairment may be a distinct construct. These findings highlight the importance of treating cognitive impairment in addition to the clinical symptoms of schizophrenia.
Cognition ; Diagnostic and Statistical Manual of Mental Disorders ; Executive Function ; Follow-Up Studies* ; Humans ; Learning ; Memory ; Schizophrenia* ; Verbal Learning ; Wisconsin

Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by clinical neurologists and neurotoxicologists to evaluate neurotoxicity in working population is a necessity for the occupational physician. To investigate the effects of carbon disulfide(CS2) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of CS2-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between CS2-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.
Axons ; Carbon Disulfide* ; Carbon* ; Disease Outbreaks ; H-Reflex ; Humans ; Incidence ; Lower Extremity ; Male ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Solvents

Vivax malaria, which was once thought to be eradicable since more than 20 years ago, has made a dramatic resurgence since 1993 in the northern parts of Kyeonggi-do in the background of 0.13 of the annual parasite incidence in the population of 956,773 and 2 positives (0.07%) of asymptomatic parasitaemia among the 2,937 residents of mass blood survey in the area in 1969. The majority of the cases were soldiers infected in several counties located within 5 km from the Demilitarized Zone (DMZ) in 1994. Since then, malaria cases have increased and have tended to expand toward eastern and southern areas. Korean malaria is characterized by asymptomatic parasitaemia with long prepatent period, so malaria cases, including those manifesting as general fever should be treated with a combination of chloroquine and pyrimethamine to prevent the completion of sporogonic cycle in the mosquitoes. For the most effective control of vector mosquitoes, residual insecticides should be applied in the military houses and animal shelters with thermal fogging, including the control of the pre-stages of physiological age of the mosquitoes within 25 km from the DMZ. It is strongly suggested that military uniforms be treated with 0.5% permethrin complex (permethrin 39%+cyfluthrin 1%) or permethrin formulation. Further genetic studies are desired to determine the subspecies of Plasmodium vivax because Korean strain of malaria is likely to be a complex form of Plasmodium vivax vivax and Plasmodium vivax hibernans.
Animals ; Chloroquine ; Culicidae ; Fever ; Gyeonggi-do ; Humans ; Incidence ; Insecticides ; Korea* ; Malaria* ; Malaria, Vivax ; Military Personnel ; Parasites ; Permethrin ; Plasmodium vivax ; Pyrimethamine ; Weather

No abstract available.
Constriction, Pathologic* ; Sutures* ; Trachea*

No abstract available.
Aged* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Hypercholesterolemia*

Immunohistochemical staining was performed in 20 skin granulomas of 16 patients with leprosy using antisera against lysozyme and S-100 protein. In lepromatous leprosy, lysozyme positive cells and S-100 protein positive cells were rarely found in the dermis. However, the histoid leprosy specimen had large numbers of lysozyrne positive cells and S-100 protein positive cells in granuloma. In borderline group, lysozyme positive cells and S-l00 protein positive cells were found in the dermis. S-100 protein positive cells were diffusely distributed throughuut the granuloma in borderline lepromatous leprosy, while they were often found in lymphocytic mantle in borderline tuberculoid leprosy. In tuberculoid leprosy, lysozymal staining was encouritered in epitheloid cells and giant cells, but S-100 protein positive cells were predominantly found encircling granuloma. In the epidermis, great numbers of S-l00 protein positive cells were found in tuberculoid leprosy than in lepromatous leprosy.
Dermis ; Epidermis ; Giant Cells ; Granuloma ; Humans ; Immune Sera ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Multibacillary ; Leprosy, Paucibacillary ; Leprosy, Tuberculoid ; Muramidase* ; S100 Proteins ; Skin