We experienced a case of a primary aortoduodenal fistula, which was successfully diagnosed and repaired. This diagnosis must be considered in cases of gastrointestinal bleeding with an abdominal aortic aneurysm. If the correct diagnosis can be made promptly, surgical repair of the fistula is possible.
Aortic Aneurysm, Abdominal ; Diagnosis ; Fistula* ; Hemorrhage

Traditionally, it has been emphasized that hemolytic disease was the primary cause of gallstones (cholelithiasis) in most young patients. In recent years, gallstones and common bile duct calculi have been increasingly diagnosed in infants and children, unrelated to hemolytic diseases. On the matter, the World Health Organization (WHO) classified intraepithelial neoplasia (dysplasia) of gall bladder as one of the precursor lesions of invasive cancer. The following article describes the case of a 2-year-old girl who had a laparoscopic cholecystectomy due to cholelithiasis and the pathologic diagnosis was chronic cholecystitis with diffuse, mild mucosal dysplasia.
Child ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholelithiasis ; Gallbladder ; Gallstones ; Humans ; Infant ; Preschool Child ; Urinary Bladder ; World Health Organization

No abstract available.
Embryonic Structures* ; Extremities*

No abstract available.
Hand* ; Regional Blood Flow*

Premature birth is the single largest cause of perinatal mortality and morbidity in nonanomalous infants in developing countries. Advances in neonatal care have lead to increased survival and reduced short and long term morbidity for preterm infants. but the rate of preterm birth has actually increased. This review provides recent multifactorial approaches to treatment and prevention of preterm birth.
Developing Countries ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Obstetric Labor, Premature* ; Perinatal Mortality ; Pregnancy ; Premature Birth

Purpose: Cystoscopy, as with other endoscopic procedures, is a fearful and painful for the majority of patients. To this reduce fear, pain and discomfort, the routine administration of sedative drugs, such as midazolam and propofol, is widely accepted for a gastrointestinal endoscopy. There have also been some studies on midazolam anesthesia during cystoscopy. However, the effects and safety of propofol anesthesia during cystoscopy have not been established. Therefore, the effects and safety of propofol anesthesia during cystoscopy were investigated in this study. Materials and Methods: 200 male patients were divided into 2 groups: Group A consisted of 80 patients sedated using 1mg/kg propofol IV, and group B consisted of 120 patients who received normal saline IV instead of propofol. All patients received 90mg diclofenac IM for pain control. There were no significant differences in the ages and weights between the two groups. The vital signs and oxygen saturation were monitored before, during and after the cystoscopy. The degree of pain and satisfaction of the patients and urologist were measured. Results: The pain scales were significantly reduced in group A compared to group B. Group A patients and the operator were also significantly more satisfied than those in group B. Although the blood pressure, pulse rate or respiratory rate changed during the cystoscopy, they were not clinically significant and there was no need for additional treatment. 12 patients in group A showed temporary hypoxia; however, they were treated with oxygen administration and recovered within several minutes. Conclusions: Propofol anesthesia during cystoscopy can be performed safely and effectively as an outpatient procedure, as long as there is adequate preparation and monitoring.
Anesthesia* ; Anoxia ; Blood Pressure ; Cystoscopy* ; Diclofenac ; Endoscopy, Gastrointestinal ; Heart Rate ; Humans ; Male ; Midazolam ; Outpatients ; Oxygen ; Propofol* ; Respiratory Rate ; Vital Signs ; Weights and Measures

Primary carcinoma of the bile duct is uncommon but not rare and its prognosis is poor even though long-termsurvival had been reported. The authors presented 62 cases of bile duct cancer, which were confirmed at YUMC fromJan. 1971 to Dec. 1981. The results were as follows; 1. The most prevalent age group was 6th decade and a male-tofemale ratio was 1.9:1. 2. Jaundice was the most common clinical manifestations(84%), and followed by right
Bile Duct Neoplasms ; Bile Ducts ; Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Dilatation ; Hepatomegaly ; Humans ; Jaundice ; Prognosis ; Ultrasonography

Intraosseous neurogenic tumors are rare and have been reported most commonly in the mandible, possibly because of the long course of the mental nerve within this bone. They have also been reported very rarely in a vertebra. We experienced a case of intraosseous neurilemmoma arising from the body of the first lumbar vertebra, which resulted in paraplegia. The tumor was removed completely through anterior and posterior approaches by staged operation. Postoperative course was uneventful and paraplegia was recovered within three months postoperatively.
Mandible ; Neurilemmoma ; Paraplegia ; Spine

A temporary balloon occlusion of internal carotid artery (ICA) was performed in 3 patients for carotid artery endarterectomy and 1 patient require sacrifice ICA with neck malignancy. EEG monitoring and neurologic evaluation was done during the test. In one patient who has bilateral ICA stenosis more than 95% shows slurred speech and aphasia during test. Another 3 patients shows no clinical change during test, and operation was done without shunt. There were no postoperative neurologic complication. We believe that preoperative balloon occlusion of ICA provide another helpful criteria to decide using shunt. But it needs another hemodynamic analysis tool according to other's report.
Aphasia ; Balloon Occlusion ; Carotid Arteries* ; Carotid Artery, Internal ; Constriction, Pathologic ; Electroencephalography ; Endarterectomy ; Hemodynamics ; Humans ; Neck

PURPOSE: The autologous greater saphenous vein (GSV) is the most frequently used graft for leg artery bypass. But vein harvesting with long open incision as traditional method can be complicated by wound problem. Since we experienced endoscopic vein harvesting in leg artery bypass, we reviewed its advantage and indication. METHOD: Six patients received the endoscopic saphenous vein harvesting procedure for their leg artery bypass surgery. The endoscopic procedure was limited above knee avoiding of the injury to saphenous vein because it has more branching at below knee. We studied endoscopic using time, number of branch ligated, wound closure time, wound complication, postoperative pain and admission duration. RESULT: In one patient the procedure was failed because many branch and small GSV. In five patients mean endoscopic using time was twenty two minutes and 2.2 branch was ligated. There was no wound complication. Wound closure time and operation time was decreased but the statistical variables difficult to decide. In one patient for redo operation, contralateral GSV was harvested. CONCLUSION: Endoscopic GSV harvesting is technically simple procedure, which can reduce wound size in using reversed way of GSV in leg artery bypass. We also believe it reduce operation time, wound pain, hospital stay. But it needs further study and skill in our study.
Arteries* ; Humans ; Knee ; Leg* ; Length of Stay ; Postoperative Complications ; Saphenous Vein* ; Transplants ; Veins ; Wounds and Injuries