A spontaneous rupture into the sigmoid colon and peritoneal cavity is a most unusual complication for a mature cystic teratoma of the ovary. A 38-year-old woman with acute lower abdominal pain, presenting as peritonitis, visited our hospital. Physical examination revealed tenderness, rebound tenderness, and vague palpable mass in the right lower quadrant of the abdomen. A pelvic computed tomographic scan demonstrated a right ovarian cystic mass with bone and fat tissue, which had ruptured into the sigmiod colon, and peritoneal fluid collection. During a laparotomy, the ovary tumor was found to be densely adherent to the rectosigmoid junctional wall; also a solid element of the ovary tumor containg hair and skin tissue seemed to be in continuity with colonic lumen, and the ovarian wall was ruptured with spillage of purulent exudate into the peritoneal cavity. En bloc resection of the tumor-bearing segment of the sigmoid colon, together with the adherent right ovary and salpinx was carrried out. The diagnosis of a mature teratoma of the ovary was made by histologic examination of a surgical specimen; the tumor had perforated the sigmoid colon wall, had protruded into the bowel lumen, and had ruptured the intraperitoneal cavity due to inflammation its wall.
Abdomen ; Abdominal Pain ; Adult ; Ascitic Fluid ; Colon ; Colon, Sigmoid* ; Diagnosis ; Exudates and Transudates ; Fallopian Tubes ; Female ; Hair ; Humans ; Inflammation ; Laparotomy ; Ovarian Cysts ; Ovary* ; Peritoneal Cavity* ; Peritoneum ; Peritonitis ; Physical Examination ; Rupture* ; Rupture, Spontaneous ; Skin ; Teratoma*

No abstract available.
Cholecystectomy, Laparoscopic*

PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes

No abstract available.
Child* ; Humans

Laparoscopic cholecystectomy has been popularized all over the world as the treatment of choice for unnecessory symptomatic or asymptomatic gall stones. Initially, this surgery was applied to limited indications, but nowadays the indications of the surgery have been expanded to include severe, inflamed, complicated patients with gall stones, which used to be thought of as contraindications in the past. Surgeon,s technical improvement and newly devised surgical instruments made it possible to expand the limit of surgical indications for laparoscopic cholecystectomy. However, anatomical disorientation due to severe inflammed gall bladder is still the drawback to the possible occurrence of laparoscopic bile duct injury and bleeding. We have a clinical analysis of 32 cases of laparoscopic cholecystectomy for acute cholecystitis or G.B.empyema, surgical time,safety and case were evaluated. Two patients were converted to open laparotomy because of intraoperative bile duct injury and anatomical disorientation by hepatic flexure colonic interposition. As a result, we suggest that even in patients with subphrenic abscess or bile peritonitis secondary to G.B.empyema could be the indications for the laparoscopic cholecystectomy if surgeon's ability or patient's condition allow it.
Bile ; Bile Ducts ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Cholelithiasis* ; Colon ; Gallstones ; Hemorrhage ; Humans ; Laparotomy ; Peritonitis ; Subphrenic Abscess ; Surgical Instruments ; Urinary Bladder

Adrenal myelolipomas are rare benign tumors consisting of mature fat and hematopoietic elements resembling bone marrow. Due to the frequent use of ultrasound and computerized tomography their presence is now more frequently discovered. Although these tumors are usually asymptomatic and only found incidentally at autopsy, they can cause local symptomes or hemorrhage requiring surgical excision. We present the case of a large surgically and histologically confirmed, adrenal myelolipoma with retroperitoneal hemorrhage due to spontaneous rupture in a 32-year old man.
Adrenal Glands ; Autopsy ; Bone Marrow ; Hemorrhage* ; Myelolipoma* ; Rupture, Spontaneous* ; Ultrasonography

Adrenal myelolipomas are rare benign tumors consisting of mature fat and hematopoietic elements resembling bone marrow. Due to the frequent use of ultrasound and computerized tomography their presence is now more frequently discovered. Although these tumors are usually asymptomatic and only found incidentally at autopsy, they can cause local symptomes or hemorrhage requiring surgical excision. We present the case of a large surgically and histologically confirmed, adrenal myelolipoma with retroperitoneal hemorrhage due to spontaneous rupture in a 32-year old man.
Adrenal Glands ; Autopsy ; Bone Marrow ; Hemorrhage* ; Myelolipoma* ; Rupture, Spontaneous* ; Ultrasonography

The classic clinical manifestations of acute suppurative cholangitis were first described by Charcot in 1877 as a triad of fever(and chill),jaundice and right upper quadrant pain. In 1959,Reynolds and Dargan characterized acute suppurative cholangitis as a distinct clinical entity manifested by a clinical pentad of Charcot,s three signs plus shock and central nervous system depression.We have clinical analysis of acute suppurative cholangitis,218 cases who were admitted in Chonnam Hospital from Jan.1989 to Dec.1995.All cases were treated conservatively initially,and then delayed operation was performed when the patients were improved from the septic condition by cholangitis.
Central Nervous System ; Cholangitis* ; Humans ; Jeollanam-do ; Shock

This study was conducted to investigate whether there were any differences in the body image perception, dietary behavior and maternal dietary guidance between an obese group ("OG") and a normal weight group ("NWG"), and furthermore, to provide basic informations for comprehensive educational programs for obese children. For this purpose, the questionnaire method was used. The subjects were 1,501 elementary school children, in the 4th to the 6th grades in Seoul, Busan, Daegu, Gwangju, and Andong, and their mothers (1,459). The percentage of the children who misperceive their body image was higher among the girls (30.4%) than the boys (22.6%). The average scores for balanced dietary behavior as assessed by the children was higher in the OG than in NWG; the average scores for dietary control as assessed by their mothers was higher in the NWG than in the OG. The scores for dietary behavior as assessed by the children was different from those as assessed by their mothers. Assuming that the mothers would give more correct and balanced answers, the development of a reliable questionnaire for dietary behavior that could be more accurately answered by the children is necessary. Maternal dietary guidance for dietary control was more frequently given in the OG as compared with the NWG and more frequently in girls as compared with boys ; while that for balanced diet was more in the NWG as compared with the OG. The worse the mothers estimate of the dietary behavior for their children, the more they tried to guide their children in dietary behavior. It is recommended that the children should be taught to correctly recognize the degree of their obesity, and receive the appropriate educational program accordingly, including the maternal dietary guidance.
Body Image ; Busan ; Child* ; Daegu ; Diet ; Female ; Gwangju ; Gyeongsangbuk-do ; Humans ; Mothers ; Obesity ; Seoul ; Surveys and Questionnaires

PURPOSE: Gastric emptying after a gastric resection has been studied in early gastric cancer. Most reports are retrospective and show that gastric emptying after gastroduodenal reconstruction is faster than normal. This study was designed to evaluate the gastric-emptying pattern after a gastroduodenal reconstruction with preservation of the truncal vagus nerve had been performed on a patient whose preoperative gastric-emptying time had been normal. METHODS: From July 1996 to February 1998, we performed a distal gastrectomy with gastroduodenal reconstruction with preservation of the truncal vagus nerve in 11 patients (9 patients with early gastric cancer, 1 patient with advanced gastric cancer, and 1 patient with high-grade dysplasia) whose preoperative gastric-emptying times was normal. To evaluate the gastric emptying after the gastrectomy and gastroduodenal reconstruction, we analyzed the lag time (when 10% of food is delivered to the duodenum), T1/2 (when 50% of food is delivered to the duodenum), and the residual food in the stomach after 100 minutes (%) by means of radionuclide scintigraphy using a single-head gamma camera after ingestion of an 99mTc-tin-colloid steamed egg. We defined the delayed gastric emptying as T1/2 longer than the mean of the preoperative value by 2 standard deviation. RESULTS: Among the 11 patients with gastroduodenal reconstruction, gastric emptying was normal in 4 patients and delayed in 7 patients; only one of the delayed cases has GI symptoms such as early satiety. There were no rapid gastric emptying cases. CONCLUSION: Rapid gastric emptying after gastroduodenal recon struction with preservation of the truncal vagus nerve was rare.
Eating ; Gamma Cameras ; Gastrectomy ; Gastric Emptying ; Humans ; Ovum ; Radionuclide Imaging ; Retrospective Studies ; Steam ; Stomach ; Stomach Neoplasms ; Vagus Nerve*