No abstract available.
Child* ; Granular Cell Tumor* ; Humans

BACKGROUND/AIMS: Endoscopic sphincterotomy (EST) has become a well-established therapeutic modality for common bile duct stone (s). EST and subsequent stone extraction, including mechanical lithotripsy, can clear bile duct in 85% to 95% of patients. Other therapeutic modalities which have been developed to enhance bile duct clearance including extracorporeal shock-wave lithotripsy, electrohydraulic or laser lithotripsy, and chemical dissolution are high cost, not yet widely available especially in community hospital, yet to be perfected, or still under clinical evaluation. The use of biliary stenting has been proposed as an alternative therapy for patients at high risk for surgery. We carried out this prospective, controlled study to evaluate the long-term effect of biliary stenting for endoscopically unextractable common bile duct stone (s). METHODS: Of the 233 patients with common bile duct stone (s) admitted at Gil Hospital from Jan. 1995 to Dec. 1996, the stent group were 14 patients with retained comrnon bile duct stone (s) in which 7Fr polyethylene biliary stent was placed with the proximal end above the stone and the distal end in the duodenum. The control group were 6 patients with common bile duct stone (s) not treated, because of patients refusal of surgical or endoscopic management. Follow-up was achieved by direct interview and telephone, and consisted of prospective analysis of all complications that occured during long-term follow-up period. Complication rates in the both groups were compared using chi-square test and cumulative complication-free rates were calculated by Kaplan-Meier analysis.
Bile Ducts ; Common Bile Duct* ; Disulfiram ; Duodenum ; Follow-Up Studies ; Hospitals, Community ; Humans ; Kaplan-Meier Estimate ; Lithotripsy ; Lithotripsy, Laser ; Polyethylene ; Prospective Studies ; Sphincterotomy, Endoscopic ; Stents* ; Telephone

It has been reported that cigarette smoking increases free radical generation, which can also increase lipid peroxides and deplete antioxidants. The purpose of this study was to determine whether cigarette smoking and other lifestyle choices may affect serum lipid peroxide concentrations, serum antioxidant concentrations such as tocopherol and vitamin C, and serum antioxidant enzyme activity such as glutathione peroxidase and superoxide dismutase. Dietary intakes were assessed by 24-hour recall and survey questionnaires from 48 male non-smokers and 52 male smokers. Overnight fasting blood was collected and measured for individual antioxidant status. The daily vitamin C intakes of smokers tended to be lower than those of non-smokers, and the intakes of both groups were under the Recommended Daily Allowance (RDA). Vitamin E intake was suffcient for smokers and non-smokers. Serum lipid peroxide concentrations were no difference among all subjects. The serum alpha-tocopherol concentrations of all subjects were in a normal range, and they were highest in mild smokers (p<0.05). Mean serum vitamin C levels were lowest in heavy smokers (p<0.05). The activities of serum glutathione peroxidase and superoxide dismutase were not significantly different in smokes and non-smokers. In conclusion, smoking did not increase oxidative stress in heathy young men. However, it is desirable for heavy smokers to consume more vitamin C than the RDA sine their serum vitamin C concentrations are relatively low.
alpha-Tocopherol ; Antioxidants ; Ascorbic Acid ; Fasting ; Glutathione Peroxidase ; Humans ; Life Style ; Lipid Peroxides ; Male ; Oxidative Stress ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Reference Values ; Smoke* ; Smoking* ; Superoxide Dismutase ; Tocopherols ; Vitamin E ; Vitamins*

We retrospectively reviewed 48 pregnancies in 36 female patients after renal transplantation until February, 1998 at Yonsei University College of Medicine. All patients were maintained on cyclosporine-based immunosuppressive regimen before, during and after pregnancy. Patients were divided into two groups; group 1 (Delivery Group) of 25 women with 26 pregnancies and group 2 (Abortion Group) of 19 women with 22 pregnancies. Mean interval between renal transplantation and conception is 31.8+/- 22.9 months. Serum creatinine was reported before, during and after pregnancy and there was no significant changes of its mean value in both groups. Mean daily dosage of cyclosporine were similar in patients. Average gestational age was 37.0+/- 2.0 weeks and the incidences of very low birth weight (VLBW), low birth weight (LBW) and small for gestational age (SGA) were 7.7%, 63.5% and 84.6%, respectively. Pregnancy-related complications during pregnancy in group 1 were urinary tract infection in 11 cases, preeclampsia in 7 cases, hypertension in 4 cases and proteinuria in 3 cases. There was no acute rejection or graft loss during pregnancy. The premature deliveries less than 37 weeks were 12 cases (46.2%). Low birth-weight of neonate was significantly related with maternal pre-pregnant hypertension (1793.3+/- 393.0 gm in patients with hypertension vs. 2471.2+/- 468.1 gm in patients without hypertension; p=0.001). Pregnancy in female renal transplant patients is relatively safe while they are monitored in a tertiary care center with close monitoring of cyclosporine A (CsA) dosing, serum creatinine levels and the other laboratory values by a transplant surgeon, nephrologist, obstetrician and pediatrician.
Allografts* ; Creatinine ; Cyclosporine ; Female* ; Fertilization ; Gestational Age ; Humans ; Hypertension ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Kidney Transplantation* ; Mothers* ; Pre-Eclampsia ; Pregnancy* ; Proteinuria ; Retrospective Studies ; Tertiary Care Centers ; Transplants ; Urinary Tract Infections

BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE ; Cardiovascular System ; Complement System Proteins ; Critical Care ; Critical Illness ; Humans ; Injury Severity Score ; Intensive Care Units ; Mortality ; Multiple Trauma ; Retrospective Studies ; Survival Rate ; Trauma Centers

BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE* ; Cardiovascular System ; Complement System Proteins ; Critical Care* ; Critical Illness ; Humans ; Injury Severity Score ; Intensive Care Units* ; Mortality ; Multiple Trauma ; Retrospective Studies ; Survival Rate ; Trauma Centers

BACKGROUND: Platelet-rich plasma (PRP) contains high concentrations of growth factors involved in wound healing. Hydrogel is a 3-dimensional, hydrophilic, high-molecular, reticular substance generally used as a dressing formulation to accelerate wound healing, and also used as a bio-applicable scaffold or vehicle. This study aimed to investigate the effects of PRP and hydrogel on wound healing, in combination and separately, in an animal wound model. METHODS: A total of 64 wounds, with 2 wounds on the back of each nude mouse, were classified into 4 groups: a control group, a hydrogel-only group, a PRP-only group, and a combined-treatment group. All mice were assessed for changes in wound size and photographed on scheduled dates. The number of blood vessels was measured in all specimens. Immunohistochemical staining was used for the analysis of vascular endothelial growth factor (VEGF) expression. RESULTS: Differences in the decrease and change in wound size in the combined-treatment group were more significant than those in the single-treatment groups on days 3, 5, 7, and 10. Analysis of the number of blood vessels through histological examination showed a pattern of increase over time that occurred in all groups, but the combined-treatment group exhibited the greatest increase on days 7 and 14. Immunohistochemical staining showed that VEGF expression in the combined-treatment group exhibited its highest value on day 7. CONCLUSIONS: This experiment demonstrated improved wound healing using a PRP–hydrogel combined treatment compared to either treatment individually, resulting in a decrease in wound size and a shortening of the healing period.
Animals ; Bandages ; Blood Vessels ; Hydrogel* ; Intercellular Signaling Peptides and Proteins ; Mice ; Mice, Nude* ; Platelet-Rich Plasma* ; Tissue Scaffolds ; Vascular Endothelial Growth Factor A ; Wound Healing* ; Wounds and Injuries*

Adenomatous polyps of the duodenum is uncommon in general population, but duodenal adenomas are found in the majority of patients with both familial adenomatous polypasis and Gardner's syndrome. These polyps are usually small, multiple and most commonly found in the second portion of the duodenum, and may involve ampulla of Vater. They also have malignant potential so that routine surveillance of the duodenum including ampulla of Vater has been recommended in patients with adenomatous polyposis coli. The adenoma of ampulla of Vater can be found in approximately 50% of patients with familial adenomatous polyposis and usually is asymptomatic, but sometimes, especially villous adenoma, may exhibit clinical problems including partial gastric outlet obstruction, pancreatitis, bleeding, obstructive jaundice, in addition to a high incidence of malignancy. Among the non-malignant complications of the ampullary tumor, there are only a few case reports of acute pancreatitis as the presenting manifestation of an ampullary adenoma or carcinoma in patients with familial adenomatous polyposis in the English literature, but no cases have been reported in Korea. We present here a case of symptomatic adenoma of the ampulla of Vater presenting as acute pancreatitis in a patient with familial adenomatous polyposis.
Adenoma* ; Adenoma, Villous ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Ampulla of Vater ; Duodenum ; Gardner Syndrome ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Incidence ; Jaundice, Obstructive ; Korea ; Pancreatitis* ; Polyps

BACKGROUND: Capsular contracture is the most frequently reported complication after implant-based breast reconstruction. This study was first undertaken to present our experience with acellular dermal matrix for prevention of capsular contracture in implant-based immediate breast reconstruction with latissimus dorsi flap, and to assess the final aesthetic outcome. METHODS: We performed a retrospective review of all patients who underwent immediate latissimus dorsi flap breast reconstruction in combination with implant and acellular dermal matrix from January 2014 to December 2015. Demographics and clinical characteristics and postoperative complications, especially focused on capsular contracture, were assessed. They were also analyzed as the potential risk factors for the development of capsular contracture. The aesthetic outcome of the overall reconstruction and the final outcome of the inframammary fold were evaluated. RESULTS: During the study period, a total of 30 patients (30 breasts) were reviewed. The mean Baker grades for all 29 breasts (one breast was dropped out due to implant loss), evaluated at one year after reconstruction, was 1.21±0.49 capsular contracture. None of risk factors except seroma/hematoma (P=0.033) were significantly associated with the development of capsular contracture. Overall aesthetic outcome was 8.2±1.2 and aesthetic outcome of the inframammary fold was 3.5±0.6 for physician and 3.4±0.6 for patients. CONCLUSIONS: In this study, we have shown the ability of acellular dermal matrix to prevent capsular contracture observed in implant-based immediate breast reconstruction with latissimus dorsi flap and its use was proven to create superior aesthetic results.
Acellular Dermis* ; Breast Implants ; Breast* ; Contracture ; Demography ; Female ; Humans ; Mammaplasty* ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Superficial Back Muscles* ; Surgical Flaps

In published article by Li et al., an author's name was misspelled.