Cancer of the gastric stump, first described by Balfour in 1922, is defined as the cancer detected more than 5 years after surgery for a benign disease. We experienced a case of cancer found at the gastric stump after gastrojejunostomy in a 53 years old male patients, proven pathologically as a early cancer. He visited to our hospital with the chief complaint of epigastric pain and indigestion for 1 Months. On past history, he has been received gastrojejunostomy due to duodenal ulcer obstruction, 23 years ago, Gastrofiberscopy was done, and we could find the early gastric cancer lesions at the anterior wall of gastric angle as type Ilc+III and antrum as type IIa. The microscopic finding of the multiple endoscopic biopsies at the gastic angle and antrum revealed the adenocarcinoma of signet ring cell type infiltrated to the level of submucosa. And so, we could diagnose these lesions as a early gastric cancer in the gastric stump after gastrojejunostomy. He was treated with subtotal gastrectomy and discharged with cured condition. Therefore, we report this case with a literature review.
Adenocarcinoma ; Biopsy ; Duodenal Ulcer* ; Dyspepsia ; Gastrectomy ; Gastric Bypass* ; Gastric Stump* ; Humans ; Male ; Middle Aged ; Stomach Neoplasms

A new benzodiazepine derivative, Rohypnol (Ro 5-4200), was used for management of general anesthesia with nitrous oxide, narcotics and muscle relaxants to evaluate the effect on the cardiovascular and respiratory system in 35 surgical patients. In each patient, we observed the blood pressure, pulse rate, minute volume and arterial blood gas analysis and also local effects, postoperative recovery state and amnesia. The results are as follows; 1) Induction dosage of Rohypnol was not constant as other benzodiazepines. 2) Rohypnol showed a little effect an the cardiovascular system. 3) The effects of Rohypnol on the respiratory system were negligible but slight depression was seen. 4) If respiration became shallower or apnea occured during induction with Rohypnol, it was preferred to use assisted or controlled ventilation with 100% oxygen. 5) It was thought better to give oxygen through a nasal catheter for prevention of decreased PaO2 in recovery room. 6) When we used the non-depolarizing muscular relaxants instead of S.C.C. for intubation, we observed that a significantly decreased amount of relaxant was needed for maintenance of general anesthesia.
Amnesia ; Anesthesia, General ; Apnea ; Balanced Anesthesia* ; Benzodiazepines ; Blood Gas Analysis ; Blood Pressure ; Cardiovascular System ; Catheters ; Depression ; Flunitrazepam* ; Heart Rate ; Humans ; Intubation ; Narcotics ; Nitrous Oxide ; Oxygen ; Recovery Room ; Respiration ; Respiratory System ; Ventilation

Sine 1961, Dr. Safar postulated the new form of patient, so called "progressive patient care", the hospital service in all countries are fashioned with intensive therapy unit. Particulary the- World Federation Society of Anesthesiologists who have discusincerly at several International congress. we were interested from the literature and visited England, Denmark, United States. and Japan. Of course in Korea, the intensive therapy unit developed from the recovery room and is thus intimately oonnected with anesthesiologists. Here we reviewed with literature and introduced the activities af the intensive therapy unit of Hanyang University Hospital from May 1972 to October 1973, from the point view of the definition, building design, location, capacity, equipment, staff organization and charge of patient, several problems and regulations. Furthermore we recommended with the following new ideas for establishment in hospital of an intensive therapy. unit. a. The design should be arranged on the same floor (OR-RR-Anes.-1TU) and in central part of building. b. Several isolation rooms should be made in 1-T-U. c. One central monitoring system will serve each units. d. The 1-T-U equipment should be used with wall trolly system. e. The regulations of 1-T-U should be noted and advocated by all hospital members. f. The beds in 1-T-U should be arranged with open system.
Denmark ; England ; Humans ; Japan ; Korea ; Recovery Room ; Social Control, Formal ; United States

The Alstrom syndrome is inherited autosomal recessive disorder, characterized by obesity, diabetes mellitus, pigmentary retinal degeneration, normal intelligence, sensorineural hearing loss, baldness, acanthosis nigricans, male hypogonadism, hyperuricemia and hypertriglyceridemia. There is no reported case of Alstrom syndrome in Korea yet. We experienced a 29-year-old female patient with clinical characteristics similar to Alstrom syndrome who was admitted due to poorly controlled diabetes mellitus and diabetic retinopathy with hemorrhage. We report this case with the review of literatures.
Acanthosis Nigricans ; Adult ; Alopecia ; Alstrom Syndrome* ; Diabetes Mellitus ; Diabetic Retinopathy ; Female ; Hearing Loss, Sensorineural ; Hemorrhage ; Humans ; Hypertriglyceridemia ; Hyperuricemia ; Hypogonadism ; Intelligence ; Korea ; Male ; Obesity ; Retinal Degeneration

Physical activity and health-related quality of life (HRQOL) are associated with overall health outcomes in adolescents with congenital heart disease (CHD). The purpose of this study was to compare the levels of physical activity and HRQOL in adolescents with CHD and healthy controls. In addition, we compared these variables using a propensity score matching to reduce the confounding effects. Participants were divided into three groups with simple CHD (n=55), complex CHD (n=173), and healthy controls (n=181). Self-reported physical activity levels (metabolic equivalent of task [MET]-hr/wk) were obtained using the Global Physical Activity Questionnaire. HRQOL was evaluated using the Pediatric Quality of Life Inventory questionnaire. Total scores of HRQOL in adolescents with complex CHD were significantly lower than those with simple CHD (p=0.022) and healthy controls (p<0.001), respectively; however, there was no significant difference in total scores of HRQOL between adolescents with simple CHD and healthy controls. Levels of physical activity in adolescents with complex CHD were significantly lower than those with simple CHD (p=0.001) and healthy controls (p<0.001). After propensity matched analysis (44 pairs), the results were consistent with the above results. In conclusion, HRQOL scores and physical activity levels are significantly lower in adolescents with complex CHD, but not in adolescents with simple CHD, than in healthy adolescents.
Adolescent* ; Heart Defects, Congenital* ; Humans ; Motor Activity* ; Propensity Score ; Quality of Life*

PURPOSE: Few reports have documented psychopathological abnormalities in patients with primary spontaneous pneumothorax (PSP). We analyzed the results of a multiphasic personal inventory test to investigate the psychopathologic impact of PSP in young Korean males. MATERIALS AND METHODS: The authors reviewed the results of a Korean military multiphasic personal inventory (KMPI) administered to military conscripts in South Korea. A total of 234 young males participated in this study. The normal volunteer group (n=175) comprised individuals who did not have any lung disease. The PSP group (n=59) included individuals with PSP. None of the examinees had any psychological problems. The KMPI results of both groups were compared. RESULTS: There were more abnormal responses in the PSP group (17.0%) than the normal volunteer group (9.1%, p=0.002). The anxiety scale and depression scale scores of the neurosis category were greater for the PSP group than the normal group (p=0.039 and 0.014, respectively). The personality disorder and paranoia scale scores of the psychopathy category were greater for the PSP group than the normal group (p=0.007 and 0.018, respectively). CONCLUSION: Young males with PSP may have greater tendencies to suffer from anxiety, depression, personality disorders, and paranoia compared to normal individuals. Clinicians should be advised to evaluate the psychopathological aspects of patients with PSP.
Anxiety ; Depression ; Healthy Volunteers ; Humans ; Korea ; Lung Diseases ; Male* ; Military Personnel ; Paranoid Disorders ; Personality Disorders ; Pneumothorax* ; Psychopathology

PURPOSE: Different techniques for cystocele repair including the conventional anterior colporrhaphy and mesh technique are known. Our goal was to evaluate the anatomical success and safety of our method of transvaginal anterior vaginal wall repair by the purse-string technique reinforced with three simple additional sutures in the repair of cystocele over a 4-year follow-up period. METHODS: This was a retrospective review of 69 consecutive patients (grades 2 to 4) who underwent the above operations between 2001 and 2011, including their success rates as assessed by use of the Baden-Walker halfway classification system. RESULTS: Of the patients, 62 patients (98%) were completely cured of cystocele and 1 patient showed grade 2 cystocele recurrence that required no further treatment. Two patients with grade 4 cystocele were completely cured. There was no vaginal erosion related to the cystocele repair. CONCLUSIONS: Transvaginal anterior colporrhaphy by a purse-string technique reinforced with simple additive sutures appears to be a simple, safe, and easily performed approach in cystocele repair. There is no need for other material for reinforcement, even in high-grade cystocele, which is an advantage of our technique.
Cystocele ; Follow-Up Studies ; Humans ; Imidazoles ; Nitro Compounds ; Prolapse ; Recurrence ; Reinforcement (Psychology) ; Retrospective Studies ; Sutures ; Urinary Bladder Diseases ; Vagina

Although spontaneous bacterial peritonitis is a frequent complication in the childhood nephrotic syndrome, it is very rare in adults with nephrotic syndrome. It frequently develops when the patients are either in relapse or receiving steroid therapy at the time peritonitis is diagnosed. We report an unusual case of a spontaneous bacterial peritonitis as the presenting feature in a 15-year-old male patient with nephrotic syndrome. He presented with diffuse abdominal pain and distension for 15 days. Abdominal paracentesis revealed the diagnostic laboratory findings of peritonitis, and the bacterial culture of the ascites showed a mixed growth of Escherichia coli and Pseudomonas aeruzinosa. His serum albu- min level was 1.6gldL and the amount of 24 hours proteinuria was 21.0g/day. Although he was treated with adequate antibiotics for 3 weeks, the peritonitis was more aggravated. We decided to insert a catheter into the peritoneal cavity for continuous drainage of the intractable ascites. Two weeks after drainage, the peritonitis improved as the peritonitis subsided, the proteinuria disappeared completely without a steroid therapy. Six months after spontaneous remission, the proteinuria have recurred, and the kidney biopsy then showed focal segmental glomerulorsclerosis.
Abdominal Pain ; Adolescent ; Adult ; Anti-Bacterial Agents ; Ascites ; Biopsy ; Catheters ; Drainage ; Escherichia coli ; Humans ; Kidney ; Male ; Nephrotic Syndrome* ; Paracentesis ; Peritoneal Cavity ; Peritonitis* ; Proteinuria ; Pseudomonas ; Recurrence ; Remission, Spontaneous

We report a case of an anomalous origin of left coronary artery from the pulmonary artery with severe mitral regurgitation. A 20-year-old female was admitted to hospital for recurrent syncope and dyspnea on exertion. Cardiac ausculatation revealed systolic murmur radiating to left axilla and blood pressure of 90/70 mmHg. Electrocardiography showed a nonspecific ST-T wave change on V1, V2, V6, I, & aVL leads. Holter monitering showed no significant abnormality except occasional premature ventricular complexes. Chest radiography showed mild cardiomegaly with mitral valvular heart configuration and no pulmonary abnormality. Echocardiography showed normal left ventricular dimension and systolic function with marked dilated left atrium, severe mitral regurgitation, & severe resting pulmonary hypertension. Aortogram didn't show left coronary artery ostium. Right coronary angiogram showed normal right coronary artery which supplied major left epicardial coronary arteries via good collaterals (Rentrop grade III). Pulmonary angiogram showed anomalous origin of left coronary artery from main pulmonary trunk. She underwent mitral valvuloplasty and coronary artery bypass graft.
Axilla ; Blood Pressure ; Cardiomegaly ; Coronary Artery Bypass ; Coronary Vessels* ; Dyspnea ; Echocardiography ; Electrocardiography ; Female ; Heart ; Heart Atria ; Humans ; Hypertension, Pulmonary ; Mitral Valve Insufficiency* ; Pulmonary Artery* ; Radiography ; Syncope ; Systolic Murmurs ; Thorax ; Transplants ; Ventricular Premature Complexes ; Young Adult

No abstract available.
Diabetes Mellitus, Type 1* ; Genotype* ; Humans ; Korea* ; Thyroid Diseases* ; Thyroid Gland*