BACKGROUND: Many studies in severe acute pancreatitis have demonstrated an increase in intestinal permeability, but not in mild acute pancreatitis. The current methods to measure intestinal permeability need much time and also laborious work. Therefore, we investigate the changes of intestinal permeability in patients with mild acute pancreatis and clinical predictive factor for the intestinal permeability in patients with acute pancreatitis. METHODS: The intestinal permeability were measured in 14 normal heathy controls, 41 patients with mild acute pancreatitis (alcoholic 14, biliary 12, idiopathic 15) by measuring 24 hour urine excretion of 51Cr-EDTA (51Cr-ethylenediaminetetraacetic acid) for evaluation of the gut barrier dysfunction. We compared the intestinal permeability with clinical characteristics of patients. RESULTS: The intestinal permeability was significantly increased in patients with mild acute pancreatitis (6.01+/-4.11%, p<0.001) versus control subjects (1.86+/-0.52%). There was no significant difference in the intestinal permeability among the patients with alcoholic, biliary and idiopathic pancreatitis. The correlation was not found between intestinal permeability and clinical characteristics in patients with mild acute pancreatitis. CONCLUSIONS: The intestinal permeability is increased in patients with mild acute pancreatitis regardless of etiology of pancreatitis. The predictive factor for gut barrier dysfunction is not detected in patients with mild acute pancreatitis.
Alcoholics ; Humans ; Pancreatitis* ; Permeability*

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

BACKGROUND: Laparoscopy with peritoneal carbon dioxide insufflation is a standard procedure in many gynecological departments. And more prolonged gynecological laparoscopic operations are being performed in recent years, and a steeper head-down position is required. Despite laparoscopic operations have many advantages, peritoneal insufflation of CO2 to create the pneumoperitoneum necessary for laparoscopy induces intraoperative hemodynamic changes that complicate anesthetic management of laparoscopy.The purpose of this study is to evaluate the effect of general anesthesia on hemodynamics during loparoscopic hysterectomy. METHODS: Twenty six women undergoing laparoscopic hysterectomy were randomly allocated to either a propofol (Group 1, n=13) intravenous anesthesia or a enflurane (Group 2, n=13) anesthesia with fentanyl-N2O/O2-vecuronium. Hemodynamic parameters were measured before induction (T1), 5 min after induction (T2), 5 min after head-down (T3), 5, 10, 15, 20 min after pneumoperitoneum (T4, T5, T6, T7), 5, 10 min after deflation (T8, T9). The MAP, HR, CI, SVRI, SI were measured by transthoracic electrical bioimpedence method and automated blood pressure device. RESULTS: The mean arterial pressure were increased during pneumoperitonem in both groups and heart rate were increased in Group 2. The cardic index were decreased in both groups after induction by 27.4 % in Group 1 and 25.7% in Group 2. The systemic vascular resistanace index were increased in both groups from head-down to after deflation by 68.3% in Group 1, 73.1% in Group 2 maximally. No significant changes of stroke index were observed during surgery in Group 1. CONCLUSIONS: Laproscopy with CO2 insufflation induces significant hemodynamic changes includig increases of MAP, SVR and a reduction of CI. And usual intraoperative hemodynamic monitoring; the blood pressure and heart rate give no information on the reduction in cardic output.
Anesthesia ; Anesthesia, General* ; Anesthesia, Intravenous ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Enflurane ; Female ; Heart Rate ; Hemodynamics* ; Humans ; Hysterectomy* ; Insufflation ; Laparoscopy ; Pneumoperitoneum ; Propofol ; Stroke

Nitric oxide (NO) is known to mediate penile erection by activating intracellular cyclic GMP pathway. It is also suggested that cGMP pathway, on penile erection, has dominant role over the other secondary messenger pathway with cAMP, etc. Based on the hyposthesis that activation of NO-cGMP pathway could represent a more physiologic and effective approach in the treatment of erectile dysfunction, several NO donors and activator of cGMP have been used in human and animal studies of impotence. However the efficacy of those remains debatable. In the present study, we investigated the effect of NO donor [linsidomine chlorhydrate (SIN-1), S-nitroso-N-acetylpcnicillamine (SNAP), sodium nitroprusside (SNP)] alone and in combination with zaprinast (cGMP specific phosphodiesterase inhibitor) on penile erection in rats. NO donors used in this study, except SNP, did not induce penile erection sufficiently. SNP-induced penile erection is comparable to the erection induced by cavernosal nerve stimulation. However, direct applicaion of SNP in the treatment of impotence may not be acceptable as it causes a marked hypotension. Zaprinast given intracayernously either alone or in combination with NO donor may not be clinically effective. Combination with zaprinast is not shown to enhance the effect of NO donor on penile erection. Therefore, combination of NO donor with other drugs modulating different pathway may be a therapeutic approach to erectile dysfunction worthy of further investigation.
Animals ; Cyclic GMP ; Erectile Dysfunction ; Humans ; Hypotension ; Male ; Nitric Oxide* ; Nitroprusside ; Penile Erection* ; Rats* ; Tissue Donors*

No abstract available.
Endosonography ; Gastrointestinal Stromal Tumors* ; Hematemesis ; Stomach

The intestine is an organ involved with absorbing, processing, and transporting food into the body. However, if one were to assess the immunological portion of the intestine and compare it with better-known immunologically functioning organs such as the spleen, the intestine would be found to be the largest such organ and the extent of its immunologic function would be found to be equally proportionate. The mucosal surface of the intestine has the ability to respond to effector cells capable of protecting the host from potentially harmful organisms or local antigens. When there is increased intestinal permeability (Leaky gut syndrome), pathogenic bacteria and its products, toxins, antigens, chemicals and incompletely digested food penetrate the intestinal epithelium and are transported throughout the body. They activate the immune system and effect the pathophysiology of acute and chronic inflammatory disease and autoimmune disease. Therefore, by a better understanding of the importance of gut barrier function and the pathophysiology of gut related immunologic disease, we can make helpful suggestions for achieving optimal intestinal health.
Autoimmune Diseases ; Bacteria ; Complement System Proteins ; Immune System ; Immune System Diseases ; Intestinal Mucosa ; Intestines ; Permeability ; Spleen

The infradiaphragmatic type of Total Anomalous Pulmonary Venous Return(TAPVR) is a rare congenital cardiacanomaly which usually results in death during the period of early infancy. A two month-old baby boy with cyanosisand respiratory distress was suspected of having a TAPVR clinically and the two-dimensional echocardiographicfindings were compatible with the infradiaphragmetic type of TAPVR. The subsequent cardiac catheterization andcineangiogram revealed the common pulmonary vein connected with portal vein and inferior vena cava in theinfradiaphragmetic area with obvious obstruction. The surgery and the autopsy confiremd the preopeative diagnosis.Among infants presenting pulmonary venous congestion in the newborn period. TAPVR below the diaphragm shold be oneof the important diagnostic cosiderations.
Autopsy ; Cardiac Catheterization ; Cardiac Catheters ; Diaphragm ; Humans ; Hyperemia ; Infant ; Infant, Newborn ; Male ; Portal Vein ; Pulmonary Veins ; Scimitar Syndrome ; Vena Cava, Inferior

Gastric leiomyomas, which arise from smooth muscle tissue, are the most common non-epi- thelial tumors occurring in the stomach. This tumor is most commonly found incidentally at surgery or autopsy. The incidence of the leiomyoma is about 1-3% of all gastric tumors and sex distribution is equal. We have recently experienced a 59-year-old housewife who had epigastric pain and soreness of one month's duration. Physical examination disclosed tenderness with palpated mass in the left upper quadrant. Gastrofiberscopic finding revealed esophageal diverticulum in the mid-esophagus and 2 x 2 x 1 cm sized submucosal intramural mass with centrally depressed umbilication through ulcerative change on the greater curvature of lower body. Within the umbilication, there were food materials and blood clots. The sleeve segmental resection of stomach was performed. The histopathologic and post operative findings were atypical leiomyoma, perforated with abscess formation to the omentum.
Abscess ; Autopsy ; Diverticulum, Esophageal ; Humans ; Incidence ; Leiomyoma* ; Middle Aged ; Muscle, Smooth ; Omentum ; Physical Examination ; Sex Distribution ; Stomach ; Ulcer

Gastric leiomyomas, which arise from smooth muscle tissue, are the most common non-epi- thelial tumors occurring in the stomach. This tumor is most commonly found incidentally at surgery or autopsy. The incidence of the leiomyoma is about 1-3% of all gastric tumors and sex distribution is equal. We have recently experienced a 59-year-old housewife who had epigastric pain and soreness of one month's duration. Physical examination disclosed tenderness with palpated mass in the left upper quadrant. Gastrofiberscopic finding revealed esophageal diverticulum in the mid-esophagus and 2 x 2 x 1 cm sized submucosal intramural mass with centrally depressed umbilication through ulcerative change on the greater curvature of lower body. Within the umbilication, there were food materials and blood clots. The sleeve segmental resection of stomach was performed. The histopathologic and post operative findings were atypical leiomyoma, perforated with abscess formation to the omentum.
Abscess ; Autopsy ; Diverticulum, Esophageal ; Humans ; Incidence ; Leiomyoma* ; Middle Aged ; Muscle, Smooth ; Omentum ; Physical Examination ; Sex Distribution ; Stomach ; Ulcer

OBJECTIVE: Lumbar foraminal or extraforaminal disc herniations (FEFDH) have unusual clinical features and higher incidence in elderly patients compared to usual intraspinal canal disc herniations. We evaluated the efficacy of microdiscectomy via paramedian approach for lumbar FEFDH in elderly patients over the age of 65. METHODS: Retrospective study was performed in 68 patients over the age of 65 (23 male and 45 female patients; 71.46±3.87 years) who underwent microdiscectomy via paramedian approach for unilateral lumbar FEFDH causing sciatica. The radiological factors including degree of slippage, presence of instability, disc height, and degree of disc degeneration; pain and functional status by the means of visual analogue scale score, Oswestry Disability Index score, and Macnab classification were analyzed preoperatively and during the postoperative follow-up period of 3 years to evaluate the efficacy of the surgical treatment. RESULTS: Pain and functional status improved according to short- and long-term follow-up evaluations after surgery. Radiological changes following surgery, which can be understood as structural deteriorations and deformations, did not represent patient condition. Nine patients underwent additional surgery due to sustained or recurring leg pain of aggravation of back pain, and fusion surgery was required for 3 patients. Degree of preoperative slippage was the only statistically significant factor related to additional surgery (p<0.05). CONCLUSION: Microdiscectomy via paramedian approach for FEFDH may be a good surgical alternative in elderly patients. Radiological changes after surgery did not show a concordance with patients' actual functional status. The excessive preoperative slippage tended to lead to unfavorable result after surgery and was associated with additional surgery.
Aged* ; Back Pain ; Classification ; Female ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Leg ; Male ; Retrospective Studies ; Sciatica