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

Since 1987, dura mater graft-associated iatrogenic Creutzfeldt-Jakob disease (dCJD) has been reported in many countries. We report the first case of dCJD in Korea. A 54-yr-old woman, who underwent resection of the meningioma in the left frontal region and received a dura mater graft 23 yr ago presented with dysesthesia followed by psychiatric symptoms and ataxia. Her neurological symptoms rapidly progressed to such an extent that she exhibited myoclonus, dementia, and pyramidal and extrapyramidal signs within 8 weeks. The 14-3-3 protein was detected in her cerebrospinal fluid; however, an electroencephalogram did not reveal characteristic positive sharp wave complexes. Diffusion-weighted magnetic resonance images, obtained serially over 64 days, revealed the rapid progression of areas of high signal intensity in the caudate nucleus and cingulate gyrus to widespread areas of high signal intensity in the cortex and basal ganglia. Pathological examination of brain biopsy specimens confirmed the presence of spongiform changes and deposition of prion protein in the neurons and neuropils.
14-3-3 Proteins/cerebrospinal fluid ; Ataxia/diagnosis ; Brain/pathology ; Creutzfeldt-Jakob Syndrome/diagnosis/pathology/*transmission ; Dementia/diagnosis ; Dura Mater/*transplantation ; Female ; Humans ; Meningioma/surgery ; Middle Aged ; Paresthesia/diagnosis ; Prions/*analysis ; Republic of Korea ; Transplants

The efficacy of six commonly used Chinese patent medicines for replenishing Qi and activating blood in the treatment of chronic heart failure was evaluated systematically by network Meta-analysis. Randomized controlled trials(RCTs) about the treatment of chronic heart failure were searched against CNKI, Wanfang, SinoMed, PubMed, and Cochrane library. Network Meta-analysis was performed in Stata 16. A total of 154 RCTs involving 15 620 patients were eventually included. The network Meta-analysis showed that Qili Qiangxin Capsules+conventional western medicine had the highest total effective rate, followed by Tongxinluo Capsules+conventional western medicine, Qishen Yiqi Drop Pills+conventional western medicine, Naoxintong Capsules+conventional western medicine, Shexiang Tongxin Drop Pills+conventional western medicine, Yangxinshi Tablets+conventional western medicine, and conventional western medicine. As for left ventricular ejection fraction(LVEF), Yangxinshi Tablets+conventional western medicine had the highest value, followed by Shexiang Tongxin Drop Pills+conventional western medicine, Qili Qiangxin Capsules+conventional western medicine, Tongxinluo Capsules+conventional western medicine, Qishen Yiqi Drop Pills+conventional western medicine, Naoxintong Capsules+conventional western medicine, and conventional western treatments. As for N-terminal pro-B type natriuretic peptide(NT-proBNP), Qishen Yiqi Drop Pills+conventional western medicine was the most effective treatment, followed by Yangxinshi Tablets+conventional western medicine, Shexiang Tongxin Drop Pills+conventional western medicine, Qili Qiangxin Capsules+conventional western medicine, Tongxinluo Capsules+conventional western medicine, and conventional the most effective treatment was. As for left ventricular end-diastolic diameter(LVEDD), Naoxintong Capsules+conventional western medicine was the best therapy, followed by Tongxinluo Capsules+conventional western medicine, Shexiang Tongxin Drop Pills+conventional western medicine, Yangxinshi Tablets+conventional western medicine, Qili Qiangxin Capsules+conventional western medicine, Qishen Yiqi Drop Pills+conventional western medicine, and conventional western medicine. In summary, the combination of Chinese patent medicines for replenishing Qi and activating blood with western medicines is superior to conventional western medicine alone in the treatment of chronic heart failure. It effectively improves cardiac function indicators such as LVEF, NT-proBNP, and LVEDD, and thus is worthy of popularization in clinical practice. The results of this study provide evidence-based options for the clinical treatment of chronic cardiac failure by combining the Chinese patent medicines for replenishing Qi and activating blood with western medicine.
Capsules ; China ; Drugs, Chinese Herbal/therapeutic use* ; Heart Failure/drug therapy* ; Humans ; Network Meta-Analysis ; Nonprescription Drugs/therapeutic use* ; Qi ; Stroke Volume ; Tablets ; Ventricular Function, Left