BACKGROUND: During the past eight years, we have been performing partial autonomic nerve preservation surgery (PANP) for the treaolent of advanced rectal cancer in order to reduce the postoperative male sexual dysfunctions. METHODS: This is a prospective study of 25 rectal cancer patients who underwent PANP from 1990 to 1997. All patient were in Duke C stage and their ages were between 30 and 55. Patients were divided into four types: 1) Partial sacrifice of inferior mesenteric plexus (PSIP). 2) Partial sacrifice of preaortic nerve (PSPN). 3) Complete sacrifice of preaortic nerve with complete pelvic nerve preservation (CSPN). 4) Unilateral sacrifice of pelvic autonomic nerve (USPN). RESULTS: The percentage of ejaculation and erection difficulties at each surgery was as follows: PSIP 0/5 (0%) for ejaculation vs. 0/5 (0%) for erection, respectively, PSPN 5/7 (71.4%) vs. 2/7 (28.6%), CSPN 6/7 (85.7%) vs. 0/7 (0%) and USPN 6/6 (100%) vs. 5/6 (83.3%). Summary: PANP is possible for the treatment of advanced rectal cancer.
Autonomic Pathways* ; Ejaculation ; Humans ; Male* ; Prospective Studies ; Rectal Neoplasms*

No abstract available.
Anus, Imperforate* ; Perineum* ; Ultrasonography*

No abstract available.
Panax* ; Saponins* ; Water*

OBJECTIVES: The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. METHODS: The participants of this study were 126 homehelpers of 50 home visit care agencies at the 2nd Longterm Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. RESULTS: Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. CONCLUSIONS: The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.
Adult ; Female ; Geriatric Nursing/*organization & administration ; Home Care Services ; *House Calls ; Humans ; Korea ; Male ; Middle Aged ; *Workload

Diffuse aspiration bronchiolitis is defined as a clinical entity characterized by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles. Clinical symptoms are bronchorrhea, bronchospasm, and dyspnea, and chest radiographs show the presence of regional or disseminated srnall nodular shadows and hyperlucency. Chest CT should help in detecting diffuse nodular shadows of bronchiolitis. Pathologic findings of diffuse aspiration bronchiolitis are characterized by localization of chronic mural inflammation with foreign body reaction in bronchioles. Recurrence of small amounts of aspiration might play an important role in the pathogenesis of diffuse aspiration bronchiolitis. We report a case of diffuse aspiration bronchiolitis in a 4-month- old female infant who had recurrent aspiration due to dysphagia and presented with recurrent fever, dyspnea and wheezing. She showed typical radiologic and histologic findings compatible to diffuse aspiration bronchiolitis. She was improved with treatment of nasogastric tube feeding. We emphasize the importance of recognizing this disease entity and differentiating it from pulmonary diseases associated with bronchospasm. (J Korean Pediatr Soc 2000;43:842-845)
Bronchial Spasm ; Bronchioles ; Bronchiolitis* ; Deglutition Disorders ; Dyspnea ; Enteral Nutrition ; Female ; Fever ; Foreign-Body Reaction ; Humans ; Infant* ; Inflammation ; Lung Diseases ; Radiography, Thoracic ; Recurrence ; Respiratory Sounds ; Tomography, X-Ray Computed

PURPOSE: The ligation and excision method of hemorrhoids is a simple and rapid procedure, but it has a drawback of possible damage to the anal cushion. To solve this problem, we tried to preserve the anal cushion with superficial ligation and excision method of anorectal mucosa including removal of the hemorrhoidal tissues from the anal cushion after submucosal dissection. However, it was difficult to remove hemorrhoidal vessels with this procedure and it was time consuming. To minimize these problems, we originally tried a new cushion preserving procedure in 15 patients during 1 year. METHODS: R> After mobilization of the anorectal mucosa, hemorrhoidal tissues and anal cushion from the anal sphincter muscles, the anorectal mucosa was first dissected from the anal cushion, then the hemorrhoidal vessels were removed and the remaining anal cushion was reattached to the anal sphincter muscles. RESULTS: The results of this surgery have been satisfactory with only one postoperative bleeding and two anal skin tags. CONCLUSIONS: This method is simple and convenient for preservation of anal cushion with minimal complications when compared with the conventional method of anal cushion preservation.
Anal Canal ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Ligation ; Mucous Membrane ; Muscles ; Skin

Colonic stenting has been suggested as an acceptable therapeutic option for the palliation of malignant colorectal obstruction or to achieve bowel decompression and preparation. It is effective as a bridge to surgery that is useful as an option to avoid emergency colostomy. However, it is associated with complications such as intestinal perforation, stent migration, bleeding, and failure of bowel decompression. Of all the complications, intestinal perforation and failure of bowel decompression are most serious and require surgical treatment. Here we report a case of abdominal compartment syndrome after stent insertion for obstructive colon cancer. The main causative factors for abdominal compartment syndrome were bowel distension associated with endoscopic gas inflation and failure to achieve bowel decompression.
Colon ; Colonic Neoplasms ; Colostomy ; Decompression ; Emergencies ; Hemorrhage ; Inflation, Economic ; Intestinal Perforation ; Intra-Abdominal Hypertension ; Stents

This study was performed to evaluate the effect of topical and intravenous heparin on thrombosis and patency in the microvascular anastomosis of the traumatized veins. Nine white rabbits weighing about 2kg were used. After exposure of both femoral veins, the veins were crushed by the jaws of smooth needle holder in order to create a thrombosis model. Transectional incision was made in the vein. The animals were then divided into 3 groups based on the administration method of heparin: 1) Experimental Group I, topical irrigation of lumen with heparin saline solution (n=6); 2) Experimental Group 2, topical irrigation of lumen with heparin saline solution and intravenous injection of heparin (0.75 mg/kg) via the marginal ear vein for 3 days; 3) Control Group, topical irrigation of lumen with saline solution (n=6). The patency was evaluated with empty-and-refill test and thrombus formation was judged by surgical microscope. The results were as follows: 1. Thirty minutes after microvascular anastomosis, the patency fall Experimental Groups was better than Control group. However, there was no significant difference among groups. 2. Three days after anastomosis, the patency of all Experimental Groups was much more improved than that of Control Group (P<0.05). There was no significant difference between Experimental Group 1 and 2. 3. Three days after anastomosis, the amount of thrombus in all Experimental Groups was much less than that of Control Group (P<0.05). 4. In histologic findings a lot of luminal thrombus were observed around sutured area in Control Groups. Few luminal thrombus was observed in all Experimental Groups. Mild necrosis in the vessel wall was observed around sutured area in all specimens. These results indicate that topical irrigation of heparin may improve the patency and inhibit the formation thrombus in the microvascular anastomosis of the traumatized veins.
Animals ; Ear ; Femoral Vein ; Heparin* ; Injections, Intravenous ; Jaw ; Necrosis ; Needles ; Phenobarbital ; Rabbits ; Sodium Chloride ; Thrombosis* ; Veins

We report a 14-months-old infant who had obstructive jaundice caused by idiopathic fibrosing pancreatitis. Ultrasonography and abdominal computed tomography showed dilatation of the intrahepatic ducts, common bile duct, and the pancreatic duct. Diffuse swelling of the pancreas was also noted on CT. At laparotomy, the head portion of the pancreas revealed a stony hard consistency, and proliferation of fibrotic tissue was confirmed pathologically. Idiopathic fibrosing pancreatitis is a very rare disease entity in childhood, but should be considered in the differential diagnosis of obstructive jaundice in children who demonstrate bile duct and pancreatic duct dilatation and/or diffuse pancreas swelling.
Bile Ducts ; Child ; Common Bile Duct ; Diagnosis, Differential ; Dilatation ; Head ; Humans ; Infant ; Jaundice, Obstructive* ; Laparotomy ; Pancreas ; Pancreatic Ducts ; Pancreatitis* ; Rare Diseases ; Ultrasonography

OBJECTIVE: The Korean Marine Corps enlistees endure tremendous physical and mental stress during basic military training, resulting in an increased risk of musculoskeletal injuries. The aim of this study was to investigate the incidence and type of the musculoskeletal injury problems and the risk factors associated with injuries among the Marine Corps recruits and to suggest preventive measures. METHODS: The study subjects were the Marine Corps recruits (n=8,231) who were enlisted from July, 2008 to March, 2009 for basic military training. We used a prospective cohort design and collected basic demographic information and subject musculoskeletal injury risk factors through a questionnaire on the first day basic training. The subjects were followed for the subsequent 6-week military training period. RESULTS: The cumulative incidence of musculoskeletal injuries was 13.4% during the 6-week training period, and more than half of the injuries involved the lower limbs at or below the level of the knee. Based on multivariate logistic regression analysis, the following factors were related to an elevated risk for injuries: age, height, educational level, subjective health perception, injury history during the past year, and stress scale after entrance. CONCLUSION: Based on our study results, the application of injury prevention measures such as stress management program and gradual fitness increasing program to the Marine Corps recruit training would contribute to the reduction of musculoskeletal injuries.
Cohort Studies ; Humans ; Incidence ; Knee ; Logistic Models ; Lower Extremity ; Military Personnel ; Musculoskeletal System ; Prospective Studies ; Questionnaires ; Risk Factors