No abstract available.
Rectal Prolapse*

PURPOSE: There have been numerous retrospective and uncontrolled study of laparoscopic appendectomy. Although most of these have concluded that the laparoscopic appendectomy is at least as good as open appendectomy, there has been considerable controversy as to whether laparoscopic appendectomy is superior. METHODS: We performed total 47 cases of laparoscopic appendectomy (LA) during one year from January 1997 to December 1997 and these were compared with 50 cases of open appendectomy (OA) in same period to assess the clinical usefulness. RESULTS: The sex, male to female ratio and severity of appendicitis were similar in both groups. The anesthetic time was longer in the LA group (P<0.05) but operative time was similar. Gas-passing time and diet-intake time in postoperative period were earlier in LA group (P<0.05). The LA group required less analgesics in postoperative period. In LA group, no case was converted to open appendectomy and overall complication rate was lower in LA group but this was not statistically significant. Among the postoperative complication, the wound infection rate was absolutely lower in LA group (P<0.05). The diagnostic rate for acute abdomen including acute appendicitis was superior in LA group, especially in reproductive women. The hospital stay was shorter in LA group (P<0.05) and hospital charges was not different in both group. CONCLUSION: Laparoscopic appendectomy offers considerable advantages over open appendectomy because this has ability to reduce postoperative complications and shorten recovery times and is useful for detecting the cause of acute abdomen other than acute appendicitis. So we expect this technique will be alternative operation or new standard operation in selected cases for suggestive acute appendicitis.
Abdomen, Acute ; Analgesics ; Appendectomy* ; Appendicitis ; Female ; Hospital Charges ; Humans ; Length of Stay ; Male ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Wound Infection

The authors analysed 196 cases of convulsive disorder in children who were admitted to the pediatric department of Kyunghee Hospital from June 1993. Blood samples were drawn immediately following seizures on arrival. Serum prolactin values were measured by radioimmunoassay. The results obtained were as follows: 1) Mean serum prolactin value was 55.4+/-20.8ng/ml in generalized seizures within 1 hr following seizures, 22.5+/-3.9ng/ml in partial seizures. There was a significant difference between generalized scizures and partial scizures (p<0.05). 2) Mean serum prolactin value was 23.5+/-9.7ng/ml in generalized seizures within 1~3 hrs following seizures, 10.4+/-4.9ng/ml in partial seizures. There was a significant difference between generalized seizures and partial seizures (p<0.05). 3) Mean serum prolactin value was 9.5+/-4.4ng/ml in generalized seizures 3 hrs following seizures, 9.8+/-4.8ng/ml in partial seizures. There was no significant difference between generalized seizures and partial seizures (p>0.05). We found transient hyperprolactinemia following generalized seizures but a little change following gartial seizures. Postictal elevation of serum prolactin may represent a biochemical marker of generalized and partial seizures.
Biomarkers ; Child ; Humans ; Hyperprolactinemia ; Prolactin* ; Radioimmunoassay ; Seizures

No abstract available.
Fluoroimmunoassay* ; Immunoenzyme Techniques*

Approximately two thirds of stroke survivors have residual neurological deficits that persistently impair function. Hence, alternative strategies are needed to reduce the long-term disability and functional impairment from severe weakness of limbs. Generalization of treatment effect takes place when the effects of the therapy spread to a variety of related behaviors and similar movements. And the transfer effect that training of the limbs on one side of the body appeared to be shared by those on the other side simultaneously. The two concepts are closely linked together. These forms of learning are organized through a higher-level cerebral mechanism and can be associated corpus callosum. Several promising new rehabilitation approaches such as bilateral training are based on the transfer effect. The purpose of this review is to introduce transfer effect of treatment on motor learning after stroke.
Corpus Callosum ; Extremities ; Generalization (Psychology) ; Humans ; Hypogonadism ; Learning ; Mitochondrial Diseases ; Ophthalmoplegia ; Stroke ; Survivors

No abstract available.
Aspergillosis ; Diabetes Mellitus ; Humans ; Liver Cirrhosis ; Liver ; Lung ; Maxillary Sinus

PURPOSE: This study was designed to evaluate the clinical charateristics, surgical treatment and outcome of carcinoid tumors of the rectum. METHODS: A retrospective review of the charts of all patients treated for rectal carcinoid tumors at Kangbuk Samsung Medical Center between Jan 1989 and April 1998. Thirteen patients with rectal carcinoids tumors were treated. Follow-up data, histopathological information and surgical procedures were obtained from case notes. RESULTS: There were 10 men and 3 women. The ages ranged from 28 to 60 years (mean 41.1 years for all, 43.8 years for men and 32 years for women). Eight patients (61.5%) had no symptoms. Of the five patients, four complained of rectal bleeding (30.8%), and one complained of defecational difficulty (7.7%). Size of rectal carcinoid tumor was less than 1 cm in 7 patients (53.8%), between 1 cm and 2 cm in 2 patients (15.4%), in four patients (30.8%) larger than 2 cm. Three patients were treated in Abdominoperineal resection. Two patients underwent stapled low anterior resection. The remaining 8 patients underwent conservative resection (3 colonoscopic polypectomy and electrocauterization, 2 colonoscopic snaring biopsy, 2 transanal resection and one Mason's operation). The depth of invasion was contained within sutmucosa in 3 patients. Liver metastasis was found in 2 patients. Average follow-up time was 35.6 months. Two patients died of mutiple mestastasis (liver, bone, peritoneum) 9 and 30months later. CONCLUSION: We concluded that tumors smaller than 1 cm could be managed by local treatment whereas larger than 2 cm should be managed by radical treatment.
Biopsy ; Carcinoid Tumor* ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Male ; Neoplasm Metastasis ; Rectum ; Retrospective Studies ; SNARE Proteins

The purpose of this review is to provide a comprehensive approach for optimal strategies of upper limb motor rehabilitation after stroke. Stroke is a common, serious, and disabling global health-care problem. Optimal organization of rehabilitation for stroke patients has been extensively documented. However, between 30% and 66% of individuals with stroke do not obtain satisfactory motor recovery of the affected upper limb with rehabilitative interventions. The recovery of the affected upper extremity depends on intensity, task progression, and repetition to neural plasticity, namely, the ability of central nervous system cells to modify their structure and function in response to external stimuli. Recently, constraint-induced movement therapy, motor imagery, action observation, or mirror therapy has emerged as interesting options as add-on interventions to standard physical therapies. In this review, we will discuss to establish a framework by which several promising interventions for neural plasticity.
Central Nervous System ; Humans ; Neuronal Plasticity ; Plastics ; Rehabilitation* ; Stroke* ; Upper Extremity*

Scalp reconstruction is challenging because the scalp is inelastic, stiff, and has hair follicles. Tissue expansion offers aesthetically pleasing outcomes with minimal donor-site morbidity. However, in a scarred scalp, the extent of possible dissection for the expander insertion may be limited and surgeons must make use of the limited scalp tissue. We successfully reconstructed scarred scalps using rectangular expanders. This report presents two cases: a 4× 3 cm chronic defect with widespread scarring and osteomyelitis and an 11× 7.5 cm scar tissue following a skin graft. Tissue expanders were inserted in the subgaleal plane and were inflated by 195 mL and 400 mL over periods of 2 and 3 months, respectively. Subgaleal elevation of a fasciocutaneous flap was achieved with the expanded tissue. The defects were well covered, with good color, texture, and hair-bearing tissue. There were no complications involving the tissue expanders. Rectangular expanders yield more available tissue than round or crescent-shaped expanders. Moreover, since the base of the flap is well defined, the expander can be easily inserted in a limited space. Therefore, rectangular expanders are recommended for the reconstruction of scarred scalps.

BACKGROUND: Tourniquet pain is probably mediated by C-fiber. The ability of fentanyl to interrupt this nociceptive conduction was studied by administering either fentanyl or saline intrathecally along with hyperbaric bupivacaine for spinal anesthesia. METHOD: The incidence of tourniquet pain was evaluated in 60 patients having orthopedic surgery of the lower extremities during spinal anesthesia by administering either 30 mcg fentanyl (group 2) or saline (group 1) along with 0.5% hyperbaric bupivacaine 10 mg. We measured the maximal sensory spread of analgesia to pinprick, the incidence of tourniquet pain, and the sensory anesthesia to pinprick at the onset of tourniquet pain. RESULTS: The average maximal sensory spread of analgesia was the same in both groups (T9). The incidence of tourniquet pain was significantly greater in group 1 (33%) than in group 2 (10%). The sensory levels of anesthesia at the onset of tourniquet pain were not different in two groups. CONCLUSIONS: Intrathecal fentanyl was effective against tourniquet pain for 2 hours of the orthopedic surgery of the lower extremities.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine* ; Fentanyl* ; Humans ; Incidence ; Lower Extremity ; Orthopedics ; Tourniquets*