We have experienced two cases of Wernicke's encephalopathy associated with hypere-mesis gravidarum. Delay in it's diagnosis caused a protracted illness and persisting neurol-ogic deficits. Because of its association with chronic alcoholism, possibility of Wernicke's encephalopathy may not be considered in early stage of disease. The clinical feature, the principle of management and the prevention of Wernicke's encephalopathy are discussed.
Alcoholism ; Diagnosis ; Female ; Hyperemesis Gravidarum* ; Pregnancy ; Wernicke Encephalopathy*

No abstract available.
Cholelithiasis* ; Korea*

No abstract available.
Urinary Bladder*

Cerebrovascular accident remains the second most common cause of death in Korea, following combined cancer mortality. It is one of the most common causes of disability, and atherothromboembolic ischemic infarction accounts for nearly half of stroke in Korea. Carotid endarterectomy is proven to be effective in preventing stroke from internal carotid artery stenosis. The authors report the results of prospective study of 63 carotid endarterectomies, performed from September, 1995 to November, 1997 at our institution, to clarify the persisting diversity of opinions as to ideal preoperative diagnostic tests, anesthetic management, intraoperative monitoring techniques for cerebral protection, type of arterial repair, and postoperative evaluation for cerebral function. We confirmed that preoperative diagnostic tests of duplex scanning and magnetic resonance angiogram can replace the invasive conventional cerebral angiography, and observation of consciousness under regional anesthesia is the most reliable and safe method for carotid endarterectomy utilizing selective shunting, if needed.
Anesthesia, Conduction ; Carotid Stenosis ; Cause of Death ; Cerebral Angiography ; Consciousness ; Diagnostic Tests, Routine ; Endarterectomy, Carotid* ; Infarction ; Korea ; Monitoring, Intraoperative ; Mortality ; Prospective Studies* ; Stroke

No abstract available.

In order to compare the efficacies of some surgical procedures for correction of congenital muscular tortiollis, we evaluate 36 patients who had been treated either by unipolar release (19 patients) or bipolar release (17 patients) of the sternocleidomastoid (SCM) muscle at Seoul National University Children Hospital from August 1985 to June 1993. The average follow up period was 4.1 years (range, 1 year to 7 years and 8 months). The average ages at the time of operation was 3.4 years (range, 11 months to 7 years and 1 month) in the unipolar group and 9.7 years(range, 4 years and 5 months to 16 years and 11 months) in the bipolar group. Postoperatively, flexion and extension range of motion of the neck was not limited of limited less than 10 degrees, if present, in all cases. In rotation motion, 89.4% of the unipolar group and 94.1% of the bipolar group showed no limitation or limitation of less than 10 degrees when compared to the normal side postoperatively. In lateral bending, however, 21.1% of the unipolar group and 21.5% of the bipolar group showed limitation of more than 10 degrees when compared to the normal side postoperatively. Facial asymmetry, which was present in 89.4% of the unipolar group and all cases of bipolar group preoperatively, disappeared in 73.7% of the unipolar group and 23.5% of the bipolar group and improved in 94.1% of the unipolar group and 64.7% of the bipolar group. The over-all functional and cosmetic results were assessed according to the modified Ling's criteria. In function results, 14 patients(73.3%) had excellent or good results in unipolar group and 12 patients(70.6%) in bipolar group. In cosmetic results, 15 patients(78.9%) had excellent or good results in unipolar group and 11 patients(64.7%) in bipolar group. Recurrence rate was higher in the unipolar group (15.8%) than in the bipolar group (5.8%). In conclusion, limitation of lateral bending was more resistant to the treatment than the limitation of rotation. Bipolar release of SCM muscle would be recommendable even in young children in terms of recurecce.
Child ; Facial Asymmetry ; Follow-Up Studies ; Humans ; Neck ; Range of Motion, Articular ; Recurrence ; Seoul ; Torticollis

PURPOSE: The optimal surgical technique for inguinal hernia repair continues to be debated. This study was designed to investigate optimal surgical procedures in inguinal or femoral hernia. METHOD: We analyzed 153 cases of herniorrhaphy on inguinal or femoral hernias between August 1996 and November 2000. We divided patient into four groups according to the methods of hernia repair, i.e., 1) 78 cases of laparoscopic herniorrhaphy, 2) 42 cases of Lichtenstein herniorrhaphy, 3) 24 cases of Bassini herniorrhaphy and 4) 9 cases of McVay herniorrhaphy. RESULTS: The patient in the laparoscopic and Lichtenstein herniorrhaphy groups needed shorter hospital stays than those in the Bassini or McVay herniorrhaphy groups. The severity of pain was assessed by the total amount and duration of nonsteroidal anti-inflammatory drug injections, which was minimal in the laparoscopic group. There were no differences in complications between the groups. One patient in the laparoscopy group had a hernia recurrence and was reoperated with Lichtenstein herniorrhaphy. We compared two tension-free herniorrhaphies with each other. The numbers of patients not needing analgesic injections were more in the laparoscopic than the Lichtenstein herniorrhaphy group, reflecting less pain in the former group. Hospital stays were also shorter in the laparoscopic than the Lichtenstein herniorrhaphy group. CONCLUSION: We concluded that tension-free herniorrhaphy is superior to tension herniorrhaphy in terms of postoperative pain & recovery. Of the tension-free herniorrhaphies, laparoscopic herniorrhaphy is associated with less postoperative pain and shorter hospital stays than Lichtenstein herniorrhpahy.
Hernia ; Hernia, Femoral ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Laparoscopy* ; Length of Stay ; Pain, Postoperative ; Recurrence

No abstract available.
Heart* ; Thoracic Surgery*

PURPOSE: An in vivo study compared the effect of oral antibiotic ingestion to that of intraprostatic antibiotic injection in a rat model of chronic bacterial prostatitis. MATERIALS AND METHODS: Wistar rats were divided into four experimental groups: oral phosphate buffered saline (PBS) ingestion group (Op group), oral antibiotic ingestion group (Oa group), intraprostatic PBS injection group (Ip group) and intraprostatic antibiotic injection group (Ia group). Escherichia coli Z17 (O2:K1:H ) was inoculated to the prostatic urethra of the 4 experimental groups to develop the chronic bacterial prostatitis rat model. To confirm the chronic bacterial prostatitis, urine bacterial culture, tissue bacterial culture and histopathologic examinations were conducted 4 weeks after inoculation of E. coli. PBS and oral ciprofloxacin were administered orally twice a day for 1 week to the Op and Oa groups, respectively, and were injected into the prostate in the Ip and Ia groups, respectively. Urine bacterial culture, tissue bacterial culture and histopathologic examinations were conducted with specimens obtained 5 weeks after inoculation of E. coli. RESULTS: Microbiological culture of urine demonstrated that there was no significant difference among any of the four experimental groups (p>0.05). Microbiological culture of the prostate demonstrated that the mean Log10cfu/g of the Ia group was significantly lower than that of the other three experimental groups (p<0.05). The histopathology showed resolving prostatitis in the intraprostatic antibiotic injected groups compared with the other experimental groups. CONCLUSIONS: This study indicates that the effect of intraprostatic antibiotic injection for chronic bacterial prostatitis was more positive than oral antibiotic ingestion. This result suggests that intraprostatic antibiotic injection would be a treatment modality to overcome the difficulty of passage of antibiotics across blood-prostate barrier into the prostatic tissue.
Animals ; Anti-Bacterial Agents ; Ciprofloxacin ; Eating* ; Escherichia coli ; Models, Animal* ; Prostate ; Prostatitis* ; Rats* ; Rats, Wistar ; Urethra

No abstract available.
Chungcheongnam-do* ; Seoul*