No abstract available.
Blood Pressure* ; Extremities*

We performed hand-assisted laparoscopic surgery for a 67-year-old male with a 5.6 cm sized abdominal aortic aneurysm. To the best of our knowledge, this is the first report in Korea. After an initial hand dissection of the abdominal aorta under laparoscopy, we performed proximal anastomosis and distal abdominal aorta suture ligation through a 6 cm abdominal incision. Distal anastomosis was done at the bilateral common femoral arteries. He resumed his oral intake 6 hours after the surgery and discharged at the 4th postoperative day.
Aged ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Femoral Artery ; Hand ; Hand-Assisted Laparoscopy ; Humans ; Korea ; Laparoscopy ; Ligation ; Male ; Sutures

No abstract available.
Cryopreservation* ; Humans* ; Spermatozoa*

Protozoa of the genus Cryptosporidium are small coccidian parasite known to infect the mucosal epithelium of a variety of animals including human, causing fatal course in immunodeficient patients as well as self-limited illness in healthy individuals. Various life cycle stages including trophozoite, meront, merozoite, gametocyte and oocyst in infected mucosa are a diagnostic feature. Electron microscopy (EM) provides sufficient findings for genus and species identification of this parasitic organism. The authors presented scanning and transmission EM findings of Cryptosporidium parvum infection in two children: one with acute lymphoblastic leukemia and the other without any evidence of immune compromise.
Animals ; Child ; Cryptosporidium parvum ; Cryptosporidium* ; Epithelium ; Humans* ; Intestines* ; Life Cycle Stages ; Merozoites ; Microscopy, Electron ; Mucous Membrane ; Oocysts ; Parasites ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Trophozoites

Transanal total mesorectal excision (taTME) is known to be a novel surgical approach for patients who are difficult to resolve with the traditional trans-abdominal approach. However, most of the colorectal surgeons are unfamiliar with the technique, which can lead to serious complications such as urethral injury. Hence, training through the fresh frozen cadaver has been gradually included in the formal taTME training course. The authors trained the taTME procedure with two cadavers in 2016. Two surgeons who were experts in trans-anal minimally invasive surgery and had minimal experiences in taTME performed the procedure. The total procedure time from the purse string suture to the anterior communication took about 65 minutes. The procedure proceeded well without any inadvertent injury to anatomic structures. The usefulness of the cadaveric model in training taTME was confirmed and the experience of single port surgery and trans-anal operation before the cadaveric training is considered to be important.
Cadaver* ; Humans ; Laparoscopy ; Minimally Invasive Surgical Procedures ; Rectal Neoplasms ; Surgeons ; Sutures

No abstract available.
Kidney* ; Rhabdomyolysis* ; Transplantation*

PURPOSE: Lymph node metastasis is an important factor for predicting the prognosis of colorectal cancer patients. However, approximately 60% of patients do not receive adequate lymph node evaluation (less than 12 lymph nodes). In this study, we identified a more effective tool for predicting the prognosis of patients who received inadequate lymph node evaluation. MATERIALS AND METHODS: The number of metastatic lymph nodes, total number of lymph nodes examined, number of negative metastatic lymph nodes (NL), lymph node ratio (LR), and the number of apical lymph nodes (APL) were examined, and the prognostic impact of these parameters was examined in patients with colorectal cancer who underwent surgery from January 2004 to December 2011. In total, 806 people were analyzed retrospectively. RESULTS: In comparison of different lymph node analysis methods for rectal cancer patients who did not receive adequate lymph node dissection, the LR showed a significant difference in overall survival (OS) and the APL predicted a significant difference in disease-free survival (DFS). In the case of colon cancer patients who did not receive adequate lymph node dissection, LR predicted a significant difference in DFS and OS, and the APL predicted a significant difference in DFS. CONCLUSION: If patients did not receive adequate lymph node evaluation, the LR and NL were useful parameters to complement N stage for predicting OS in colon cancer, whereas LR was complementary for rectal cancer. The APL could be used for prediction of DFS in all patients.
Colonic Neoplasms ; Colorectal Neoplasms* ; Complement System Proteins ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Methods* ; Neoplasm Metastasis ; Prognosis* ; Rectal Neoplasms ; Retrospective Studies

Emergency surgical repair for acute traumatic aortic ruptures has been associated with a high peri-procedural mortality rate. Endovascular stent-grafting, as a less invasive procedure, has shown encouraging results. This report describes a patient with a short landing zone, who was treated by transposing the supra-aortic branch without sternotomy, followed by covered stent-grafting with an extended proximal bare portion to enhance fixation.
Acute Disease ; Aged ; Aortic Rupture/diagnosis/radiography/*surgery ; Female ; Humans ; Stents ; Sternotomy ; Subclavian Artery ; Surgical Procedures, Minimally Invasive ; Tomography, X-Ray Computed

Ectopia cordis is a rare congenital anomaly in which the heart is situated outside the chest cavity and has been known for many years, being reported first in 1671 by Neil Stenson. Ectopia cordis appears closely related with defective embryonic development, arising as the result of defective formation and differentiation of the ventral mesoderm at 14 to 18 days of embryonic life. Ectopia cordis is usually classified into many types according to the site at which the heart protrudes: thoracic type, abdominal type, thoraco-abdominal type, cervical type. We have experinced one case of ectopia cordis which was diagnosed by ultrasonography at 16th gestational weeks in 30 year old multiparity. We report this case with brief review of literatures.
Adult ; Ectopia Cordis* ; Embryonic Development ; Female ; Heart ; Humans ; Mesoderm ; Parity ; Pregnancy ; Thorax ; Ultrasonography ; Ultrasonography, Prenatal*

BACKGROUND: Laryngoscopy and endotracheal intubation are potent stimuli that increase heart rate and blood pressure. Especially, hypertensive patients are more prone to have significant increase in heart rate and blood pressure and cardiac complications such as arrythmia, myocardial ischemia and infarction can lead to fatal situation. This study was designed to evaluate the effectiveness of different dosage of propofol on cardiovascular responses to tracheal intubation in hypertensive patients. METHODS: Sixty hypertensive patients, ASA PS 1 or 2, scheduled for elective surgery were selected randomly. They were divided into three groups(Group 1: propofol 2.0 mg/kg, Group 2: propofol 2.5 mg/kg, Group 3: propofol 3.0 mg/kg, n=20 in each group). Induction of Anesthesia was started with propofol 2.0 mg/kg(Group 1), 2.5 mg/kg(Group 2), 3.0 mg/kg(Group 3) and succinylcholine(1 mg/kg). After tracheal intubation, pancuronium bromide 0.08 mg/kg was injected, 50 % nitrous oxide in oxygen and 2 % enflurane were inhaled. Using noninvasive automatic blood pressure monitor(CRITIKON DINAMAP TM 1846SX, USA), blood pressure(systolic, diastolic, and mean arterial pressure) and heart rate were measured at 4 points; 1) as the control value, on arrival to operating room, 2) 1 minute after tracheal intubation, 3) 3 minutes after intubation, 4) 5 minutes after intubation. RESULTS:In group 3, systolic, diastolic pressure and mean arterial pressure at 1 minutes, 3 minutes, 5 minutes after intubation were less increased than group 1, 2 and blood pressure response was more effectively blunted than heart rate response CONCLUSIONS: we suggested that 3.0 mg/kg of propofol for the induction of anesthesia could blunt hemodynamic changes caused by laryngoscopy and endotracheal intubation in hypertensive patients, but we had to give attention to the side effect until postoperative period.
Anesthesia ; Anesthetics ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Enflurane ; Heart Rate ; Hemodynamics ; Humans ; Infarction ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Myocardial Ischemia ; Nitrous Oxide ; Operating Rooms ; Oxygen ; Pancuronium ; Postoperative Period ; Propofol*