PURPOSE: There have been numerous retrospective and uncontrolled study of laparoscopic appendectomy. Although most of these have concluded that the laparoscopic appendectomy is at least as good as open appendectomy, there has been considerable controversy as to whether laparoscopic appendectomy is superior. METHODS: We performed total 47 cases of laparoscopic appendectomy (LA) during one year from January 1997 to December 1997 and these were compared with 50 cases of open appendectomy (OA) in same period to assess the clinical usefulness. RESULTS: The sex, male to female ratio and severity of appendicitis were similar in both groups. The anesthetic time was longer in the LA group (P<0.05) but operative time was similar. Gas-passing time and diet-intake time in postoperative period were earlier in LA group (P<0.05). The LA group required less analgesics in postoperative period. In LA group, no case was converted to open appendectomy and overall complication rate was lower in LA group but this was not statistically significant. Among the postoperative complication, the wound infection rate was absolutely lower in LA group (P<0.05). The diagnostic rate for acute abdomen including acute appendicitis was superior in LA group, especially in reproductive women. The hospital stay was shorter in LA group (P<0.05) and hospital charges was not different in both group. CONCLUSION: Laparoscopic appendectomy offers considerable advantages over open appendectomy because this has ability to reduce postoperative complications and shorten recovery times and is useful for detecting the cause of acute abdomen other than acute appendicitis. So we expect this technique will be alternative operation or new standard operation in selected cases for suggestive acute appendicitis.
Abdomen, Acute ; Analgesics ; Appendectomy* ; Appendicitis ; Female ; Hospital Charges ; Humans ; Length of Stay ; Male ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Wound Infection

Purpose: The purpose of this study was to evaluate the forced vital capacity and sway area of respiratory muscles taping with threshold inspiratory muscles training for 1 week. Methods: Nineteen stroke patients were divided into two groups: experimental group (respiratory muscles taping with threshold inspiratory muscles training, n=10) and control group (threshold inspiratory muscles training, n=9). Forced vital capacity tests were performed using a spirometer. The instrument records the forced vital capacity (FVC). COP excursion test was performed using Zebris. The instrument records the sway area. All tests were measured before and after intervention. Results: The experimental group and control group showed significant increase in FVC (p<0.05). The sway area showed a significant decrease only in the experimental group (p<0.05). The FVC and sway area was no significant difference between the two groups (p>0.05). Conclusion Threshold inspiratory muscles training is an effective intervention for improving FVC. Threshold inspiratory muscles training with respiratory taping is an effective intervention for improving FVC and sway area. Threshold inspiratory muscles training with respiratory taping can improve balance ability.

Purpose: The purpose of this study was to evaluate the forced vital capacity and sway area of respiratory muscles taping with threshold inspiratory muscles training for 1 week. Methods: Nineteen stroke patients were divided into two groups: experimental group (respiratory muscles taping with threshold inspiratory muscles training, n=10) and control group (threshold inspiratory muscles training, n=9). Forced vital capacity tests were performed using a spirometer. The instrument records the forced vital capacity (FVC). COP excursion test was performed using Zebris. The instrument records the sway area. All tests were measured before and after intervention. Results: The experimental group and control group showed significant increase in FVC (p<0.05). The sway area showed a significant decrease only in the experimental group (p<0.05). The FVC and sway area was no significant difference between the two groups (p>0.05). Conclusion Threshold inspiratory muscles training is an effective intervention for improving FVC. Threshold inspiratory muscles training with respiratory taping is an effective intervention for improving FVC and sway area. Threshold inspiratory muscles training with respiratory taping can improve balance ability.

BACKGROUND: The growth of elderly population increased the need for oral health care. Elderly patients with poor teeth alignment needs more attention with orthodontic treatment METHODS: Elderly patients visiting department of orthodontics, Kangdong Sacred Heart Hospital between 2000-2004 were treated with fixed appliances in one or both dental arches. Treatment plans were different from than that of younger patients and included uncommon and strategic removals of teeth and prosthesis. RESULTS: There was decrease in orthodontic treatment forces with increasing age, and the observation made from this study was favorable in the patients' as well as in the orthodontist's, point of view. It was possible to move the remaining teeth considerably, and the retention was made with various fixed appliances. CONCLUSIONS: Orthodontic treatment is not limited by patient age. However, it is wise not to extend treatment goals too far beyond the patients' objective needs
Aged* ; Dental Arch ; Heart ; Humans ; Oral Health ; Orthodontics ; Prostheses and Implants ; Tooth

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

No abstract available.
Gaucher Disease*

Twenty four patients with gap nonunions of the tibia were treated with the Ilizarov intercalary bone transport method. The purpose of this retrospective study is to evaluate the results and complications in gap nonunions of the tibia treated using the Ilizarov method. There were 22 males and two females with an average age of the 35.8 years(range, 23-63 years). The mean follow up period was 30.2 months(range, 17-70 months). Ten of the 24 patients had no external shortening with bone gap, 13 external shortening with gap and one hemicircumferential defect. On average, the size of bone loss measured 8.2 cm(range, 3-18 cm). Twenty-one of 24 patients were treated by whole segment internal transport(fifteen were proximal fragment transport, five were distal fragment transport, one was proximal and distal fragment transport), one patient by anterior hemicircumferential corticotomy and partial bone fragment internal transport and tow patients by fibula transfer. All patients healed with solid bony union, although twelve patients required bone grafts, eleven at the docking site and one at the distraction site. On average, the healing index was 49 days/cm(range, 18-82 days/cm). There was on relationship between the percentage transport(size of the distraction gap/the transporting fragment length x 100) and healing index. Numerous complications were encountered, most commonly delayed union and pin site infection, Conclusively, the application of Ilizarov techniques to gap nonunions of the tibia was very effective, but required correct technique and careful follow-up examination.
Female ; Fibula ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Male ; Methods ; Retrospective Studies ; Tibia ; Transplants

PURPOSE: Most patients diagnosed with a periampullary carcinoma are defined as having an unresectable tumor. Therefore, the appropriate relief of the main symptoms such as obstructive jaundice, duodenal obstruction, and pain is of utmost importance to these patients. In these patients, a biliary bypass can improve the quality of life. However, there is some controversy regarding the efficacy of gastrojejunostomy for preventing a duodenal obstruction. This study, evaluated the effect of a palliative gastrojejunostomy and the quality of life in patients with an unresectable periampullary carcinoma. METHODS: Between January 2000 and December 2003, among a total of 46 patients with an unresectable periampullary carcinoma, 24 patients underwent a palliative gastrojejunostomy (Group I) and 22 patients underwent non surgical management (Group II). In these two groups the frequency of nausea and vomiting, serum protein and albumin levels, oral intake, and other metrics were carefully monitored. RESULTS: Of the 46 patients, there were no significant differences in terms of age, gender, TNM stage, and preoperative symptoms. The incidence of nausea and vomiting preoperatively were similar in both groups (43.8% and 40.5%, respectively, P=0.126). However, there were statistically significant differences at the three months after surgery (36.6%, 54.5%, P=0.033). The preoperative protein and albumin were similar in both groups (6.6 g/dl, 6.4 g/dl). On the other hand, protein and albumin levels 3 months after surgery were significantly different (5.9 g/dl, 5.2 g/dl, P=0.010). CONCLUSION: These results suggest a palliative gastrojejunostomy in patients with an unresectable periampullary cancer can reduce the symptoms related to a duodenal obstruction and might contribute to maintaining the patients' quality of life secondary to possible oral intake for a longer period postoperatively.
Duodenal Obstruction ; Gastric Bypass* ; Hand ; Humans ; Incidence ; Jaundice, Obstructive ; Nausea ; Quality of Life ; Vomiting

OBJECTIVE: Cadaver's sectioned images with high resolution and real color could be used as the source of realistic three-dimensional images. If the sectioned images are registered to a patient's MRIs, three-dimensional images with high resolution and real color that fit the patient, can be produced; the three-dimensional images enable realistic virtual surgery for the patient. The objective of this study was to verify the registration of a cadaver's sectioned images to a patient's head MRIs. METHODS: The sectioned images of the heads of cadaver were associated with segmented images selected at 3 mm intervals. The patient had his head MR scanned at 3 mm intervals; the MRIs were segmented. Software to register the cadaver's sectioned images to the patient's MRIs was developed. On this software, the corresponding dots were identified on both the sectioned images and the MRIs either manually or automatically using segmented images. RESULTS: The registered sectioned images corresponded to the patient's MRIs. Both manual and automatic registrations were satisfied. CONCLUSION: Further study is needed for registering sectioned images to actual patients.
Cadaver ; Head ; Humans ; Imaging, Three-Dimensional