No abstract available.
Animals ; Embryonic Structures* ; Female ; Follicular Fluid* ; Humans* ; Mice*

No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

BACKGROUND/AIMS: A laparoscopic cholecystectomy (LC) has many clinical advantages and is now recognize as the choice of treatment for gallstones. However a laparoscopic cholecystectomy is often not feasible or is converted to the conventional open method in patients with acute cholecystitis because of inflammation around the gallbladder, adhesion, unclear anatomy, or intraoperative complications. Recent studies recommended that acute cholecystitis patients or gallbladder empyema patients undergo a percutaneous transhepatic GB drainage (PTGBD) first and a laparoscopic cholecystectomy later because PTGBD can be very helpful for improving the patient's state. METHODS: This study was carried out on 99 patients with acute cholecystitis or GB empyema who underwent a laparoscopic cholecystectomy after PTGBD at Eulji University School of Medicine from January 1996. These cases were compared with a control group of 41 patients who showed similar symptoms, ultrasonographic finding, operative finding, and pathologic results. RESULTS: There were no differences in the age and the sex distributions, the symptom duration, laboratory finding except alkaline phosphatase and leucocytosis. Among PTGBD group, a successful laparoscopic cholecystectomy was possible in 63 patients (63.6%), the other 36 patients were converted to open cholecystectomy. In control group, only 15 patients (36.6%) out of 41 underwent a successful laparoscopic cholecystectomy. This difference was statistically significant (P= 0.003). We analyze two groups about factors that can affect open conversion during laparoscopic cholecystectomy. In multivariate analysis, preoperative PTGBD and degree of wall thickening are the independent risk factors that can convert LC into open cholecystectomy. CONCLUSION: We think that a laparoscopic cholecystectomy performed some time after PTGBD to improve the patient's condition by eliminating acute inflammation or decompressing the gallbladder may be recommended for management of acute cholecystitis patients with severe clinical symptoms and ultrasonographic findings of marked gallbladder dilatation or pericholecystic fluid collection.
Alkaline Phosphatase ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Dilatation ; Drainage ; Empyema ; Gallbladder ; Gallstones ; Humans ; Inflammation ; Intraoperative Complications ; Multivariate Analysis ; Risk Factors ; Sex Distribution

No abstract available.
Cholera* ; Korea*

OBJECTIVES: To determine the relations between seven blood lipids such as total cholesterol(TC), triglyceride(TG), HDL-cholesterol(HDL), LDL-cholesterol(LDL), apolipoprotein A-1(Apo A1), apolipoprotein B(Apo B) and lipoprotein(a)(Lp(A)) and the coronary heart diseases(CHD), the quantitative techniques of meta-analysis were applied to studies of blood lipids and CHD in Koreans. METHODS: We searched the Korean and the English literature published from 1980 to August, 1997 by manual search and bibliography review. Information on sample size, study design, participant characteristics(gender, age) and blood lipid levels were abstracted by reviewers using inclusion criteria. Estimates of the effect sizes of blood lipid levels on CHD in Koreans and corresponding 95% confidence intervals were calculated using random-effect models. RESULTS: We identified 16 case-control studies to apply meta-analysis. The overall effect sizes for CHD were 20.3(95% CI : 14.23-26.22) in TC, 24.8(95% CI : 12.6-36.86) in TG, 15.16(95% CI : 3.99 - 26.33) in LDL, -3.48(95% CI : -5.79 - -1.17) in HDL, -9.78(95% CI : -16.98 - -2.58) in Apo-a1, 17.88(95% CI : 9.72 - 26.05) in Apo B and 18.95(95% CI : 17.88 - 20.02) in Lp(a). CONCLUSIONS: Our results suggested that seven blood lipids were significantly associated with CHD in Koreans. Well-designed and prospective studies between blood lipids and CHD in Koreans should be performed.
Apolipoproteins ; Apolipoproteins B ; Case-Control Studies ; Coronary Disease* ; Heart ; Risk Factors* ; Sample Size

PURPOSE: The hepatolithiasis and associated cholangitis result in liver atropy, biliary stricture, liver abscess and intrahepatic malignancy, and a hepatic resection should be performed in such cases. The technical difficulty and accompanied inflammation with a hepatic resection frequently cause postoperative complications. Therefore, the factors affecting the postoperative complications were evaluated. METHODS: Twenty one patients, with hepatolithiasis that had received a hepatectomy at the Department of Surgery, Eulji University Hospital between March 2001 and January 2003, were reviewed. RESULTS: The postoperative complications were intraabdominal abscess (7 cases), pleural effusion (3 cases), wound complication (3 cases), T-tube site leakage (1 case), cardiac arrest (1 case), acute pancreatitis (1 case), hepatitis A (1 case) and delayed gastric emptying (1 case). The overall complication rate was 57% (12/21 patients) and the most common complication was an intraabdominal abscess (7 cases). The factors that may affect these complications were analyzed. Preoperative percutaneous transhepatic biliary drainage (PTBD) increased the postoperative complications, which was statistically significant (p=0.027). Especially, preoperative PTBD and hepaticojejunostomy increased the rate of an intraabdominal abscess, which was statistically significant (p=0.026, p=0.008). CONCLUSION: With hepatolithiasis requiring hepatic resection there is a need to avoid unnecessary preoperative PTBD and bypass surgery for the reduction of postoperative complications, including an intraabdominal abscess. Conversely, it is considered important to remove every stone and avoid needless bypass surgery under an operation and for a hepatic resection to be performed after removing PTBD, where possible.
Abscess ; Cholangitis ; Constriction, Pathologic ; Drainage ; Gastric Emptying ; Heart Arrest ; Hepatectomy ; Hepatitis A ; Humans ; Inflammation ; Liver ; Liver Abscess ; Pancreatitis ; Pleural Effusion ; Postoperative Complications* ; Wounds and Injuries

PURPOSE: The aim of this study was to determine the advantages of adequate PTGBD in patients with acute complicated cholecystitis. METHODS: We performed a retrospective review of a database that was collected from September 2001 to July 2008. Acute cholecystitis with gangrene or perforation was defined as acute complicated cholecystitis. A PTGBD was performed for the patients immediately after the diagnosis using US or CT and then a tubogram was performed after 5~7 days. After evaluating the gallbladder (GB) and common bile duct (CBD) with a tubogram, we removed the drainage and the patients underwent a LC after readmission. RESULTS: Three hundred seventy four of the 893 patients who were diagnosed with acute cholecystitis underwent PTGBD. While 19 (3.2%) of the total acute cholecystitis patients were converted to open cholecystectomy due to severe inflammation, 14 (3.7%) acute complicated patients were converted to open cholecystectomy. In 79 patients, the pre-operative tubogram showed the presence of CBD stone and so ERCP was performed. There was no post-operative death. CONCLUSION: Performing PTBGD in patients with acute complicated cholecystitis allows the early relief of the symptoms of acute cholecystitis. This allows for sufficient evaluation and treatment for CBD during the PTGBD state. Further, PTBGD decreases the mortality and morbidity in the high-risk patients due to sufficient evaluation and management of the underlying critical disease. PTBGD allows for performing elective cholecystectomy when the patient is in a better condition for surgery. Therefore, PTGBD can be useful for treating acute complicated cholecystitis.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Common Bile Duct ; Drainage ; Gallbladder ; Gangrene ; Humans ; Inflammation ; Retrospective Studies

BACKGROUND AND OBJECTIVES: The purposes of this study was to investigate the characteristics of gentamicin-induced vestibulotoxicity of s otolith organs by assessing the results of earth vertical and the off-vertical axis rotation tests with a morphologic study. MATERIALS AND METHODS: Rabbits were grouped into two groups, ototoxic and ototoxic prevention group. Vestibulotoxicity was induced by injecting gentamicin (GM) into the peritoneum. Prevention of the vestibulotoxicity was studied by injecting NMDA receptor inhibitors (MK-801), iron chelating agents (deferoxamine) peritonially, and osmotic pumps filled with neurotrophic factors (GDNF, BDNF), respectively. The animal rotation system was designed to rotate the animal sinusoidally or in velocity step (constant velocity) rotation. Off-vertical rotation was applied to evaluate the otolithic function. Scanning electron microscopy were examined for the structural changes of the otolithic organs. RESULTS AND CONCLUSIONS: GM-induced vestibulotoxicity was confirmed by gain decreasing in the earth vertical SHA rotation test and bias decreasing in the off-vertical rotation test. However, changes in modulation was not definite. Bilateral prevention of GM-induced vestibulotoxicity was confirmed by systemic injection of deferoxamine and MK-801, and characteristics of unilateral prevention was confirmed by local application of the neurotrophic factors using osmotic pumps. In the SEM study, the GM-induced hair cell damages of the vestibule were identified, which was prevented by the preventive drugs. The reduction of bias value without change of modulation was comparable with the reduction of gain in the earth vertical axis rotation after GM-induced vestibulotoxicity.
Rabbits ; Animals ; Drug Toxicity

Gastric schwannoma is a very rare gastrointestinal mesenchymal tumor. Schwannoma in the gastrointestinal tract is usually not symptomatic, and preoperative abdominal CT or endoscopic evaluation cannot distinguish it from gastrointestinal stromal tumor. Surgical resection of this tumor is adequate to achieve a good prognosis. We performed laparoscopic gastric wedge resection in two patients who had the preoperative diagnosis of gastric gastrointestinal stromal tumor. In both cases, the postoperative immunohistochemistry staining was positive for S-100 protein and it was negative for CD34, which is consistent with gastric schwannoma. We report here on two cases of gastric schwannoma along with a review of the literatures.
Diagnosis ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Laparoscopy* ; Neurilemmoma* ; Prognosis ; S100 Proteins ; Tomography, X-Ray Computed

We present the case report of a 72-year-old female in whom diaphragmatic eventration and secondary gastric volvulus developed 10 years after a left partial pneumonectomy for a bronchiectasis. Eventration of the diaphragm is defined as an abnormal elevation of an intact diaphragm. The abnormally wide subdiaphragmatic space provides the potential for a gastric volvulus, which results from the strong negative intrathoracic pulling force created by the potential subphrenic space and paradoxical movement of the diaphragm. Unless this strong negative force is first eliminated, gastropexy alone will lead to recurrence. Obliteration of the subphrenic space by colonic displacement is a simple and effective way of abolishing this negative subdiaphragmatic pulling force. Treatment of gastric volvulus requires immediate surgical repair to prevent subsequent necrosis and perforation, with surgical correction of the underlying anatomic abnormality being the treatment of choice for gastric volvulus. We experienced a case of gastric volvulus due to diaphragmatic eventration who was treated with colonic displacement.
Aged ; Bronchiectasis ; Colon ; Diaphragm ; Diaphragmatic Eventration ; Displacement (Psychology) ; Female ; Gastropexy ; Humans ; Necrosis ; Pneumonectomy ; Recurrence ; Stomach Volvulus