PURPOSE: This retrospective study was designed to review and analyze the results of Delorme's procedure for rectal prolapse. METHODS: Between 1990 and 1999, twenty-nine patients with rectal prolapse underwent Delorme's procedure. These patients had had no previous operation for rectal prolapse. This study was proceeded retrospectively through the out-patient clinic and by telephone questionnare. RESULTS: Twelve cases (41%) were males and 17 cases (59%) were females. Mean age was 55.5 years (range, 23~86 years). The duration of the symptoms was ranged from 3 months to 60 years, with the mean period of 12.2 years. The follow-up period after the operation was from 3 months to 10 years (mean follow-up, 45 months). The internal rectal prolapses were 11 cases (38%), and the complete rectal prolapses were 18 cases (62%). The common preoperative bowel habits were incontinence with 6 cases (21%) and constipation with 10 cases (34%). After the operation, incontinence and constipation were improved in 4 cases (67%) and 6 cases (60%) respectively. Additional 2 cases of constipation occurred among 19 cases who hadn't had it preoperatively but the use of laxative helped in improving the symptom. The mean operation time was 71 minutes and in 24 cases (83%), the operation was proceeded with spinal anesthesia. In 27 cases (93%), the amount of bleeding during the operation was less than 100 cc, and in 1 case (3.4%), blood transfusion was needed because the amount was more than 400 cc. The three patients (10%) had postoperative complications(one perianal abscess due to anastomotic dehiscence and two urinary retention). There was one case of recurrence (3.4%) after the operation and no postoperative mortality. CONCLUSIONS: Delorme's procedure has the short operation time, causes less bleeding and is possible with regional anesthesia. Delorme's procedure has low complication rate, results in good bowel function and has a low recurrence rate. Therefore, Delorme's procedure can be performed with satisfactory outcome in elderly patients and the poor general conditioned patients as well as younger patients. As recurrence rates is low and continence is improved, this procedure may be the preferred initial treatment of all patients with rectal prolapse.
Abscess ; Aged ; Anesthesia, Conduction ; Anesthesia, Spinal ; Blood Transfusion ; Constipation ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Mortality ; Outpatients ; Rectal Prolapse* ; Recurrence ; Retrospective Studies ; Telephone

Acute myocardial infarction and subsequent heart failure are leading causes of death worldwide. Stem cell-based therapies have improved cardiac function in recent clinical trials, but cardiomyocyte regeneration has not been demonstrated in human hearts. Angiogenesis and restoration of cardiac perfusion have been successfully performed using bone marrow derived stem cells and other adult stem cells. Resident cardiac stem cells are known to differentiate into multiple heart cell types, including cardiomyocytes. Furthermore, induced pluripotent stem cells are a focus of research due to the great potential for customized stem cell therapy.
Adult Stem Cells ; Bone Marrow ; Cause of Death ; Cell Differentiation ; Heart ; Heart Failure ; Humans ; Induced Pluripotent Stem Cells ; Myocardial Infarction ; Myocytes, Cardiac ; Perfusion ; Regeneration ; Stem Cells

BACKGROUND: For the patient with chronic obstructive pulmonary disease requiring long-term oxygen therapy, oxygen concentrator machines are already widely available for use in home. In this study, we used mongrel dogs as test subjects to compare the functional efficiency and safety of the oxygen concentrator developed by our own research team with those of the imported FORLIFE (TM) machine made by AIRSEP Corp. Method and method: To test mechanical reliability, the concentrations of oxygen delivered were measured after 4 hours of continuous operation. Sixteen mongrel dogs were divided into two equal groups. Mongrel dogs in group A were given oxygen using the imported oxygen concentrator, and those in group B using the machine developed. 5 l/min of oxygen were given, after which vital signs were analyzed, arterial blood gases measured, and blood chemistry tests carried out. RESULTS: After 4 hours of continuous operation, the imported model performed better, giving 98+/-3% oxygen, compared to our model, which gave 91+/-1%. In the animal experiments, oxygen concentrations were measured at the inlet of face mask 1, 2, 3, and 4 hours after continuous administration, and there was no statistically significant difference (repeated measures of analysis of variance p=0.70) between the values of 70.6+/-2.5%, 67.1+/-2.9%, 68.2+/-2.6%, and 64.9+/-3.9% that were measured from group A, and the values of 65.1+/-4.8%, 65.2+/-3.6%, 68.7+/-4.3%, and 66.0+/-5.0% measured from group B. Before oxygen administration, and at 1, 2, 3, and 4 hours after oxygen administration, arterial blood partial pressure of oxygen 87.2+/-2.5 mmHg, 347.4+/-29.3 mmHg, 353.4+/-21.2 mmHg, 343.0+/-28.8 mmHg, and 321.6+/-24.4 mmHg, respectively, were read from group A, which were not statistically different (p=0.24) to the values of 102.5+/-9.6 mmHg, 300.3+/-17.1 mmHg, 321.6+/-23.7 mmHg, 303.4+/-27.4 mmHg, and 273.5+/-25.9 mmHg read from group B. Nonetheless, the arterial blood partial pressure of oxygen values appear to be somewhat higher in dogs that were given oxygen using the imported oxygen concentrator. CONCLUSIONS: From these results the prototype oxygen concentrator developed appears to function relatively satisfactorily compared to the imported, established model, but may be criticized for the excessive noise generated and poor long-term endurance or consistency, which need improvement.
Animal Experimentation ; Animals* ; Bays ; Chemistry ; Dogs ; Gases ; Humans ; Lung Diseases ; Masks ; Noise ; Oxygen* ; Partial Pressure ; Pulmonary Disease, Chronic Obstructive ; Vital Signs

A prospective and longitudinal investigation concerning clinical outcomes and morphologic changes of large lumbar disc herniations by MR imaging. To compare the clinical outcomes and the natural morphologic changes of between sequestered and large central extruded disc herniations. The spontaneous disappearance or diminution of large herniated lumbar discs in the spinal canal is known. Poor clinical outcome and small changes of herniated discs have been shown for large central extruded disc herniations with conservative treatment. The study population consisted of 22 patients with sequestration and a large central as extrusion established by an MR imaging study. Seventeen (11 patients with sequestration, and 6 patients with a large central extrusion) patients underwent a follow-up MR imaging study. The size of the herniated disc was measured on serial MR imaging studies, and the changes in size were classified into four categories. Clinical evaluations were also performed using a visual analogue scale (VAS), the Oswestry lowback pain disability questionnaire, the straight leg raising test (SLRT) and so forth. Both the sequestered and large central extruded disc herniations showed a successful clinical outcome after conservative treatment in 17 of 22 patients (77%) in total: 11 of 13 patients (85%) with sequestered disc herniations, and 6 of 9 patients (67%) with large central extruded disc herniations. VAS and Oswestry disability scoring showed a greater change in the group with sequestration than in the group with large central extrusions. In the group with sequestration, seven patients reported the disappearance of herniated disc materials, and four patients showed a marked decrease in the size of their herniated discs in follow-up MR images. However, in the group with large central extrusions, only two patients showed a decrease in the size of their herniated discs. Large central extruded disc herniations can be treated successfully by conservative treatment. Outcomes seemed to be as good as or slightly inferior to those of sequestered disc herniations. However, a greater morphologic decrease in the herniated discs occurred more frequently for sequestered disc herniations than for large central extruded disc herniations.
Adult ; Aged ; Comparative Study ; Female ; Human ; Intervertebral Disk Displacement/*diagnosis/*therapy ; Longitudinal Studies ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Prospective Studies ; Treatment Outcome

This study was designed for the investigation of the effectiveness and limitation of the endovascular coil embolization of intracranial aneurysms. From July 1995 to October 1997, the authors treated 25 patients of intracranial aneurysm with endovascular coil embolization. There were 15 cases of ruptured aneurysms and 10 cases of unruptured aneurysms. The main reasons for the coil embolization were difficult anatomical location and poor neurological condition. Total 28 aneurysms were tried to embolize with coil. Among these, 12 aneurysms were occluded completely, 12 aneurysms partially, and 1 vertebral artery fusiform aneurysm was treated by coil occlusion of the proximal vertebral artery. The complete occlusion was possible in 10 cases of 15 small aneurysms(66.7%), and in 2 cases of 6 large aneurysms(33.3%). Only partial occlusion was achieved in all 3 giant aneurysms. Of 18 small neck aneurysms(4mm) could be occluded completely. There were 3 cases of failure, 2 cases being catherizatioin failure because of the tortuous vessel and 1 case due to local vasospasm. The complications related to the coil embolization were the perforation of the aneurysm caused by the catheterization in 2 cases, rebleeding after partial embolization of the aneurysm in 2 patients of Hunt-Hess grade 4 and 5, and infarction caused by parent vessel occlusion by coil protrusion in 2 cases. In conclusion, the coil embolization can be an alternative modality in the treatment of intracranial aneurysms. But the complete occlusion is not always possible in all cases, and the risk of the rebleeding is still remained in the partially occluded aneurysms. The long-term study is needed to confirm the definite effectiveness of the coil embolization in the treatment of intracranial aneurysms.
Aneurysm ; Aneurysm, Ruptured ; Catheterization ; Catheters ; Embolization, Therapeutic* ; Humans ; Infarction ; Intracranial Aneurysm* ; Neck ; Parents ; Vertebral Artery

OBJECTIVE: This study was to determine the levels of cytokines, lipid peroxides, and total peroxyl radical-trapping antioxidative prameter (TRAP) values of amniotic fluid in pregnant women with preterm premature rupture of membranes (PPROM). METHOD: Amniotic fluid samples were obtained by amniocenteses for chromosomal analyses and other indications(control, n=26). Amniotic fluid samples were also obtained by amnioceteses from pregnant women with preterm premature rupture of membranes (n=22). Amniotic fluid cytokines(IL-6, IL-8) were determined by enzyme-linked immunosorbent assay (ELISA). Lipid peroxide levels of amniotic fluid were measured by thiobarbituric acid (TBA) reaction. The TRAP value of amniotic fluid was assessed by measuring the rate of oxygen consuming during controlled lipid peroxidation by 2,2'-azobis-2-amidinopropane hydrochloride, a water soluble peroxyl radical generator. Ascorbic acid and uric acid were measured by high performance liquid chromatography (HPLC) CoulArray detector of water-soluble antioxidants. Retinol, alpha-tocopherol, and gamma- tocopherol were measured by HPLC-CoulArray detector of fat-soluble vitamins. RESULTS: Cytokine levels of amniotic fluid in pregnant women with PPROM(IL-6: 23.37+/-10.61 ng/ml, IL-8: 10.23+/-3.04 ng/ml) were significantly higher than those in normal pregnant women(IL-6: 0.62+/-0.32 ng/ml, IL-8: 0.55 +/- 0.15 ng/ml), (p<0.05). Lipid peroxide levels of the amniotic fluid in pregnant women with PPROM(10.42+/-1.11 nmol/mg protein) were significantly higher than those in normal pregnant women (7.32+/-0.65 nmol/mg protein), (p<0.05). The amniotic fluid obtained from pregnant women with PPROM showed significantly lower TRAP values (0.46+/-0.04 mM) than those from normal pregnant women(0.62+/- 0.03 mM), (p<0.01). Amniotic fluid ascorbic acid levels in pregnant women with PPROM (52.1+/-15.1 nmol/ml) were significantly lower than in normal pregnant women(231.9+/-33.9 nmol/ml), (p<0.01). There were no significant differences of amniotic fluid uric acid, retinol, alpha-tocopherol, and gamma-tocopherol levels between these groups. CONCLUSIONS: This findings suggest that a low antioxidant activity in amniotic fluid may cause PPROM and demonstrate that antioxidant vitamin, ascorbic acid, may act an important factor in the prevention of PPROM.
alpha-Tocopherol ; Amniocentesis ; Amniotic Fluid* ; Antioxidants ; Ascorbic Acid ; Chromatography, Liquid ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; gamma-Tocopherol ; Humans ; Interleukin-8 ; Lipid Peroxidation ; Lipid Peroxides ; Membranes* ; Oxygen ; Pregnant Women* ; Rupture* ; Tocopherols ; Uric Acid ; Vitamin A ; Vitamins

PURPOSE: To evaluate the use of CT in patients with vocal cord paralysis due to extralaryngeal cause s ,andto use CT for the assessment of extralaryngeal diseases causing vocal cord paralysis. MATERIALS AND METHODS: Weprospectively studied the results of CT in 41 patients with vocal cord paralysis in whom laryngoscopy revealed nolaryngeal cause and physical examination demonstrated no definite extralaryngeal cause. The extralaryngeal causeof vocal cord palsy was determined after comprehensive clinical diagnosis. Enhanced CT scans were acquired fromthe skull base and continued to the level of the aorticopulmonary window. We used CT to assess the detection ratefor extralaryngeal causes and to extimate the extent of extralaryngeal disease and the distribution of lesions. RESULTS: CT revealed that in 20 of 41 patients(49%) the extralarygeal causes of vocal paralysis were as follows :thyroid cancer(n=10), nodal disease(n=6), esophageal cancer(n=2), neurogenic tumor(n=1), aortic aneurysm(n=1).Lesions were located on the left side in 13 patients(65%), and in the tracheoesophageal groove in 15(75%). CONCLUSION: In patients with vocal cord paralysis in whom no definite lesion is seen on physical examination, CT could be a useful primary imaging method for the assessment of extralaryngeal causes.
Diagnosis ; Humans ; Laryngoscopy ; Paralysis ; Physical Examination ; Skull Base ; Thyroid Gland ; Tomography, X-Ray Computed ; Vocal Cord Paralysis* ; Vocal Cords*

The delayed vasospasm after aneurysmal subarachnoid hemorrhage is the main cause of morbidity and mortality in the treatment of intracranial aneurysm. Of 158 cases of ruptured intracranial aneurysm treated with radical surgery from October 1994 to December 1996, there were 29 cases of symptomatic vasospasm. Of these 12 cases were treated by intraarterial papaverine injection and/or transluminal balloon angioplasty. Refractoriness to conservative medical therapy was the main indicaiton for the endovascular treatment. Intraarterial papaverine injection was done in 11 cases and balloon angioplasty in 8 cases. After endovascular treatment, angiographic improvement was achieved in 9 cases(75%). Clinical improvement within 24 hours after treatment was observed in 8 cases(66.7%). There were two cases of complication; rupture of MCA and thromboembolism of distal branch. Outcome at the time of discharge were good recovery in 8 cases, moderate disability in 2, and death in 2. It is suggested that the endovascular method can be considered to be effective and powerful tool for the treatment of symptomatic vasospasm after aneurysmal SAH. But the complications related with this should be borne in mind. Exact indication and proper timing of endovascular treatment are to be further studied.
Aneurysm* ; Angioplasty, Balloon ; Intracranial Aneurysm ; Mortality ; Papaverine ; Rupture ; Subarachnoid Hemorrhage* ; Thromboembolism ; Vasospasm, Intracranial*

OBJECTIVE: Our purpose was to investigate lipid peroxide levels, total peroxyl radical-trapping antioxidative parameter (TRAP) values, and antioxidant vitamin levels in placental tissues of women with preeclampsia and to evaluate their roles in the pathophysiology of preeclampsia. STUDY DESIGN: Samples of placental tissue homogenates were obtained from 23 normal and 18 preeclamptic women between 33 and 40 weeks gestation. TNF-alpha was assayed by an enzyme-linked immunoassay. Lipid peroxide levels measured by thiobarbituric acid reaction. The TRAP values were measured by modified Wayners method. Ascorbic acid, uric acid, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography (HPLC) CoulArray detector. RESULTS: TNF-alpha levels in placental tissue homogenates of women with preeclampsia were significantly higher than that of women with preeclampsia (21.4+/-3.39 vs. 10.3+/-1.06 pg/ml, p<0.05). Lipid peroxide levels in placental tissue homogenates of women with preeclampsia were significantly higher than that of women with preeclampsia (6.65+/-0.57 vs. 4.98+/-0.37 nmol/mg protein, p<0.05). TRAP values in placental tissue homogenates of women with preeclampsia were significantly lower than that of women with normal pregnancy (0.24+/-0.02 vs. 0.31+/-0.03 mM, p<0.05). Ascorbic acid levels in placental tissue homogenates of women with preeclampsia were significantly lower than that of women with normal pregnancy (217.0+/-21.0 vs. 333.3+/-32.8 nmol/ml, p<0.05). CONCLUSION: The above results suggest that increased oxidative stress in placenta is involved in the pathophysiology of preeclampsia and ascorbic acid may act as an important preventive factor in the development of preeclampsia.
alpha-Tocopherol ; Ascorbic Acid ; Chromatography, Liquid ; Female ; gamma-Tocopherol ; Humans ; Immunoassay ; Oxidative Stress ; Placenta* ; Pre-Eclampsia* ; Pregnancy* ; Tumor Necrosis Factor-alpha ; Uric Acid ; Vitamin A ; Vitamins

Even though arterial embolization was introduced as a treatment tool for postpartum hemorrhage, it is not performed frequently. As authors applied arterial embolization successfully to the patient who contracted retroperitoneal hematoma after delivery, we reported this case with a brief review of literature.
Arteries* ; Hematoma ; Humans ; Postpartum Hemorrhage