No abstract available.
Diagnosis* ; Stomach Neoplasms*

No abstract available.

Insulinoma is the most frequent endocrine tumor of the pancreas and the first of the endocrine-secreting tumor of the gut to be recognized by Nicholls in 1902. Recurrent episodes of hypoglycemia is the main cause of the symptoms and signs which were sweating, pallor, dizziness, habitual change, convulsion and coma. In 1935, Whipple and Frants were described so-called “Whipple's triad”: the patient's symptoms occur with fasting or exercise; at the time of symptoms, the serum glucose in 50mg/dl or less; and the symptoms are relieved by the administration of glucose. While these criteria were timely, they proved to be rather nonspecific and may be found in other conditions that result in fasting hypoglycemia. We experienced a 44-year-old female patient who had repeated attacks of convulsion, unconsciousness and coma for 3 years. Although she has been treated with anticonvulsant, the symptoms and signs were not disappeared. At the time of administration, she was a full coma state due to hypoglycemia and was dramatically reversed by intravenous administration of the glucose solution. The preoperative test such as provocative test, abdominal CT and celiac angiography revealed insulinoma and after enucleation the pathologic diagnosis was the same. We like to report an adult female patient with insulinoma and the review of literatures briefly.
Administration, Intravenous ; Adult ; Angiography ; Blood Glucose ; Coma ; Diagnosis ; Dizziness ; Fasting ; Female ; Glucose ; Humans ; Hypoglycemia ; Insulinoma* ; Pallor ; Pancreas ; Seizures ; Sweat ; Sweating ; Tomography, X-Ray Computed ; Unconsciousness

BACKGROUND: The aim of this study was to evaluate the effects of respiratory depression of IV-PCA using morphine which has potent respiratory depression or nalbuphine which has less potent respiratory depression among opioids. METHODS: Forty patients were divided into two groups; Group M was used morphine, and Group N was used nalbuphine as a drug for IV-PCA. When patient emerges from general anesthesia, Group M was given initial bolus of 0.1 ml/kg of 0.1% morphine solution and connected Basal Bolus PCA infusor R containing morphine 50 mg per 40 ml in normal saline. Group N, similarly Group M, was given initial bolus of 0.1 ml/kg of 0.1% nalbuphine solution, and connected PCA infusor containing nalbuphine 50 mg per 40 ml in normal saline. To compare respiratory depression, arterial blood gas analyses were done preoperatively and at 1, 6 and 12 hour after IV-PCA. Simultaneously, analgesic and side effects were evaluated. RESULTS: There were no remarkable respiratory depression such as hypercarbia(PaCO2 > 50 mmHg), hypoxemia(PaO2 < 60 mmHg) and slow respiratory rate in both groups. Analgesic and side effects were similar in both groups. CONCLUSIONS: We conclude that IV-PCA using morphine or nalbuphine is relatively effective and safe method for the postoperative pain control. Ordinarily, IV-PCA dose not induce respiratory depression unless overdose in careless or mistaken mishaps are developed.
Analgesia, Patient-Controlled* ; Analgesics, Opioid ; Anesthesia, General ; Blood Gas Analysis ; Humans ; Infusion Pumps ; Morphine* ; Nalbuphine* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Respiratory Insufficiency* ; Respiratory Rate

Because operationg room time is one of the most expensive hospital resources, cancellation of a planned surgery is a wasteful expenditure of specialized human manpower and other medical resources. To decrease the rate of cancellation, we performed this prospective study about patients who planned elective surgery under general or regional anesthesia frome September 1, 1990 to December 31, 1990 in the operating room of Yeungnam University Hospital. Daily, the total number of planned surgeries and cancelled patients were recorded, and the most important reasons for cancelling by an individual patient were also recorded. The results were as follows: 1)The total number of planned elective surgeries was 3,102 patients and total number of cancelled patients was 502 patients. Thus the mean rate of cancellation was 16.2%. 2)The highest rate of cancellation was in October(21.2%), and the departmental variation was hte highest rate in dental(37.5%) and the lowest rate in the ophthalmic department(8.6%). 4) The reason of cancellation were as follows: combined systemic diseases or abnormal laboratory findings(42.4%) were most common, and the next was no admission(14.5%), heavy schedule or deficinecy of operating room(10.3%), refusal of operation(8.6%), insufficinet patient preparation(7.8%), and affairs of operator or department(7.4%), and others. As a result of this study, there are several ways to decrease the cancellation rate in operating room of yeungnam University Hospital. The first is a careful preoperative evaluation of patient's physical status and results of labaratory examination before hospitalization, and then the common practice of outpatient surgery, appropriate plan of overall elective operation, reasonable management of an operating room, and good relationships between the individual department, especially surgeons and concultant. If we follow the above mentioned ways, disruptions of the surgical schedules may be avoided and a more economical management of the operationg room is possible.
Ambulatory Surgical Procedures ; Anesthesia, Conduction ; Appointments and Schedules ; Disulfiram ; Health Expenditures ; Hospitalization ; Humans ; Operating Rooms ; Prospective Studies

Splenic abscess is an uncommon lesion and may be present either as a localized area of infection in the spleen or as a part of generalized sepsis. The diagnosis is difficult because of the rather nonspecific clinical picture. Hence, splenic abscess has a high mortality rate and is after diagnosed only at autopsy. Computerized tomography (CT) offers the clinician a reliable tool for the diagnosis of intra-abdominal abscess. A successful outcome is dependent on an early diagnosis and prompt treatment by splenectomy with antibiotic cover. We experienced a care of splenic abscess which was diagnosed by CT and treated by splenectomy with antibiotics. Postoperative course was relatively uneventful.
Abdominal Abscess ; Abscess* ; Anti-Bacterial Agents ; Autopsy ; Diagnosis ; Early Diagnosis ; Mortality ; Sepsis ; Spleen ; Splenectomy

Leriche syndrome is a chronic disorder mostly in male and is a specific symptom complex due to thrombotic obliteration of the aortic bifurcation as result of an atherosclerotic change. The symptoms include 1) extreme liability to fatigue of both lower limbs; 2) symmetric atrophy of both lower limbs; 3) pallor of the legs and feets; 4) inability to maintain stable erection. There are several methods for surgical management of this disorder; 1) thromboendarterectomy with or without sympathectomy; 2) aortoiliac bypass graft; 3) aortofemoral bypass graft. Here we report a case of Leriche syndrome which was successfully managed with aortobifemoral bypass graft with Dacron and reviewed literatures on it briefly.
Atrophy ; Endarterectomy ; Fatigue ; Foot ; Humans ; Leg ; Leriche Syndrome* ; Lower Extremity ; Male ; Pallor ; Polyethylene Terephthalates ; Sympathectomy ; Transplants

No abstract available.
Breast* ; Humans*

No abstract available.
Stomach Neoplasms*

Mesenteric fibromatoses occur as sporadic lesions or as parts of familial adenomatous polyposis, are clonal lesions prone to locally aggressive behavior, but lack metastatic capacity. Fibromatoses harbor somatic beta-catenin or adenomatous polyposis coli (APC) mutations, leading to intranuclear accumulation of b-catenin. We report a case of mesenteric fibromatosis presenting as a 5.4x4.8 cm submucosal tumor of the jejunum in a 42-year-old woman. Histologically, the tumor consisted of proliferation of bland, elongated-spindle fibroblasts with collagen deposition and a characteristic prominent vasculature. Immunohistochemically, the tumor cells showed nuclear staining for beta-catenin. Mesenteric fibromatosis should be included in the differential diagnosis of submucosal spindle cell tumors of the gastrointestinal tract, and nuclear immunoreactivity for beta-catenin may help distinguish these tumors form histological mimics.
Adenomatous Polyposis Coli ; Adult ; beta Catenin ; Collagen ; Diagnosis, Differential ; Female ; Fibroblasts ; Fibroma ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Intestine, Small ; Jejunum