No abstract available.

The main objectives of the surgical treatment of intrahepatic stones are complete removal of the stones and correction of biliary stasis and strictures. Hepatic resection is expected to yield a most satisfactory treatment result by eradicating the stones and the strictured bile duct as well. To evaluate the effectiveness and the risk of hepatic resection, we reviewed 149 patients who underwent hepatic resection due to intrahepatic stones over a fourteen-year period and who were followed up. There were 48 males and 101 females, and ages ranged from 20 to 70 years. The stones were located in the left lobe in 96 patients, the right lobe in 13 patients, and both lobes in 40 patients. The operative procedures executed in the patients were 96 lateral segmentectomies, 33 left lobectomies, 14 right lobectomies, one extended right lobectomy, and five partial resections. Biliary drainage procedures were added in 40 patients. Postoperatively, retained stones were found in 24.2% of the patients which was lowered to 10.7% at the time of discharge with assistance of radiologic interventions. During follow-up over a mean period of 63 months, 93.2% of the patients showed good rehabilitation, and recurrent stones had developed in 5 patients (3.5%). Operative complications were biliay fistula in 10 patients, intra-abdominal abscess in seven patients, hepatic failure in two patients, and postoperative bleeding in one patient, and the overall operative mortality rate was 2.0%. We conclude that hepatic resection is a safe and satisfactory treatment option for patients with intrahepatic stones.
Abdominal Abscess ; Bile Ducts ; Cholestasis ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver Failure ; Male ; Mastectomy, Segmental ; Mortality ; Rehabilitation ; Surgical Procedures, Operative

A 43 years old female patient who had known FSH form(Fascioscapulohumoral type) muscular dystrophy was scheduled for total abdominal hysterectomy due to uterine myoma. Induction of ansthesia was performed without muscle relaxant and maintained with fentanyl, oxygen and nitrous oxide. Muscle relaxation was excellent without neuromuscular blocking agent by the meuromuscular twitch monitoring(too week response to neuromuscular twitch at 70mA). After the end of operation, the patient was awaken without any problem and was transferred to recovery room.
Adult ; Female ; Fentanyl ; Humans ; Hysterectomy ; Leiomyoma ; Muscle Relaxation ; Muscular Dystrophies* ; Neuromuscular Blockade ; Nitrous Oxide ; Oxygen ; Recovery Room

A 43 years old female patient who had known FSH form(Fascioscapulohumoral type) muscular dystrophy was scheduled for total abdominal hysterectomy due to uterine myoma. Induction of ansthesia was performed without muscle relaxant and maintained with fentanyl, oxygen and nitrous oxide. Muscle relaxation was excellent without neuromuscular blocking agent by the meuromuscular twitch monitoring(too week response to neuromuscular twitch at 70mA). After the end of operation, the patient was awaken without any problem and was transferred to recovery room.
Adult ; Female ; Fentanyl ; Humans ; Hysterectomy ; Leiomyoma ; Muscle Relaxation ; Muscular Dystrophies* ; Neuromuscular Blockade ; Nitrous Oxide ; Oxygen ; Recovery Room

A series of clinical studies on the psychiatric aspects of hemodialysis and kidney transplantation were done with Korean patients, kidney donors, their families and unit nurses. All subjects were interviewed and evaluated for their psychiatric reactions and symptoms and for the underlying causes. Depression was the most common reaction, although the clinical features were somewhat different between groups studied. In addition, a unique and episodic psychotic syndrome was found in four patients. Depression and psychotic episodes seemed to reflect the psychodynamic components such as instinctual frustration, physical, familial and financial loss, dependency on a machine, sensory deprivation and the so-called fear of death and fear of life. These seemed to follow the unique features of hemodialysis and transplantation. The main defense mechanism seemed to be denial. The possible role of psychiatrists was discussed for evaluation, treatment, and prevention of these reactions and for the support of the family and the treatment team.
dult ; Aged ; Female ; Human ; Kidney Transplantation* ; Korea ; Male ; Middle Age ; Renal Dialysis/psychology* ; Transplantation, Homologous/psychology*

Chronic recurrent multifocal osteomyelitis(CRMO) is an unusual inflammatory process involving multiple osseous sites. No causative agent can be consistently isolated from these lesions despite multiple biopsies and the affected child purses a clinical course of chronic remissions and exacerbations independent of antibiotic therapy. Biopsy of the lesions did not reveal any pathogens. Immunologic investigation revealed no abnormality common to the patient and there was no indication of a genetic etiology. The natural history of chronic recurrent multifocal osteomyelitis appears to be slow, spontaneous resolution of the osseous lesions without specific treatment. We experienced a case of CRMO in an 11-year-old girl who had complained of fever, pain on knee and wrist joints for several weeks. We studied the clinical, radiographic, histological findings in this patient and we report a case of CRMO with brief review of related literature.
Biopsy ; Child ; Female ; Fever ; Humans ; Knee ; Natural History ; Osteomyelitis* ; Wrist Joint

BACKGROUND: Mycobacterium abscessus is the most pathogenic and drug-resistant rapid-growing mycobacterium. Clarithromycin or azithromycin are the only regular oral antimycobacterial agents that have an effect on M. abscessus. We tried to detect the clarithromycin-resistant strains from the clinical isolates of M. abscessus. METHODS: We tried to isolate the clarithromycin-resistant strains from 220 clinical isolates of M. abscessus by performing using reverse hybridization assay (RHA) and the broth microdilution test (BMT). RESULTS: Seven resistant strains (3.2%) from all the tested clinical isolates were detected by BMT. Three of these resistant strains were also detected by RHA and it was confirmed that they had point mutants. CONCLUSION: These results showed that clarithromycin resistance in M. abscessus clinical isolates is related to a point mutation and other unknown mechanisms.
Anti-Bacterial Agents ; Azithromycin ; Chimera ; Clarithromycin ; Mycobacterium ; Point Mutation

Multiple endocrine neoplasia type2a (MEN type2a) is a dominantly inherited cancer syndrome which is characterized by medullary thyroid carcinoma, pheochromocytoma and parathyroid hyperplasia or adenoma. Recent reports show that DNA analysis will be introduced into screening of MEN type2a families. Regular prospective screening and appropriate surgical intervention can reduce the morbidity and mortality due to MEN type2a. We experienced a case of MEN type 2a in a 46-year-old female patient. She had undergone bilateral adrenalectomy due to pheochromocytoma, followed by a total radical thyroidectomy, which revealed medullary thyroid carcinoma of the both thyroid gland and parathyroid hyperplasia.
Adenoma ; Adrenalectomy ; DNA ; Female ; Humans ; Hyperplasia ; Male ; Mass Screening ; Middle Aged ; Mortality ; Multiple Endocrine Neoplasia Type 2a* ; Multiple Endocrine Neoplasia* ; Pheochromocytoma ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND: There are several active tuberculosis (TB) cases in Korean high schools each school year. The risk of transmission in schools is extremely high due to the considerable time spent in closed classrooms. We evaluated the control of latent tuberculosis infection in Korean high schools. METHODS: When a student was identified with active TB, tuberculin skin testing was performed on their classmates and on students in their same school grade. When a student had a positive tuberculin skin tests (TST), they underwent follow-up testing with QuantiFERON-TB Gold In-Tube (QFT). The manufacturer recommended a cut-off of 0.35 IU/mL to determine QFT positivity was applied. RESULTS: A total of 131 pulmonary tuberculosis (TB) patients were included based on the criteria for screening TB contacts in the National Tuberculosis Control Program. Seventy-five (57.2%) students tested smear positive. TST were performed on 7,109 students who were classmates of, or in the same grade as, a TB patient. Of the contacts, 1,231 students (17.3%) were TST positive and they were screened with QFT. Six hundred-sixty-six (55.0%) of the tested students returned a positive QFT result and the rate of positivity was significantly associated with the increasing size of TST indurations (p<0.0001). CONCLUSION: The use of QFT resulted in approximately 45% of TST positive students not being given chemoprophylaxis.
Chemoprevention ; Follow-Up Studies ; Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Latent Tuberculosis ; Mass Screening ; Skin ; Skin Tests ; Tuberculin ; Tuberculin Test ; Tuberculosis ; Tuberculosis, Pulmonary

Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common, however, carcinoid tumors or adenocarcinomas arising in mature cystic teratoma are uncommon, especially simultaneously. We present an unusual case of premenopausal woman having carcinoid tumor and mucinous adenocarcinoma simultaneously arising in ovarian muture cystic teratoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Carcinoid Tumor* ; Carcinoma, Squamous Cell ; Female ; Humans ; Mucins* ; Neoplasms, Germ Cell and Embryonal ; Ovary ; Teratoma*