Since laparoscopic liver resection was first introduced in 2001, Korean surgeons have chosen a laparoscopic procedure as one of the treatment options for benign or malignant liver disease. We distributed and analyzed a nationwide questionnaire to members of the Korean Laparoscopic Liver Surgery Study Group (KLLSG) in order to evaluate the current status of laparoscopic liver resection in Korea. Questionnaires were sent to 24 centers of KLLSG. The questionnaire consisted of operative procedure, histological diagnosis of liver lesions, indications for resection, causes of conversion to open surgery, and postoperative outcomes. A laparoscopic liver resection was performed in 416 patients from 2001 to 2008. Of 416 patients, 59.6% had malignant tumors, and 40.4% had benign diseases. A total laparoscopic approach was performed in 88.7%. Anatomical laparoscopic liver resection was more commonly performed than non-anatomical resection (59.9% vs 40.1%). The anatomical laparoscopic liver resection procedures consisted of a left lateral sectionectomy (29.3%), left hemihepatectomy (19.2%), right hemihepatectomy (6%), right posterior sectionectomy (4.3%), central bisectionectomy (0.5%), and caudate lobectomy (0.5%). Laparoscopy-related serious complications occurred in 12 (2.8%) patients. The present study findings provide data in terms of indication, type and method of liver resection, and current status of laparoscopic liver resection in Korea.
*Hepatectomy/statistics & numerical data ; Humans ; *Laparoscopy/statistics & numerical data ; Liver/*surgery ; Liver Diseases/pathology/surgery ; Liver Neoplasms/pathology/surgery ; Postoperative Complications/epidemiology ; Questionnaires ; Republic of Korea

The aim of this study was to evaluate the effect of mouthrinse products containing deep sea water. We used original deep sea water (DSW) and processed deep sea water desalinated by reverse osmosis at one time (DDW-1), by reverse osmosis at two times (DDW-2) and concentrated by reverse osmosis (CDW). We made 2 kinds of mouthrinse products containing CDW and other agents for smell and taste and one product without deep sea water. The negative control was distilled water. In vivo study, the dental plaque index scores and the gingival index scores were reduced after 4 weeks mouthrinsing three times daily with 4 kinds of deep sea water and 3 kinds of mouthrinse products(p<0.05). The pH of dental plaque in 1 minute after mouthrinsing was not higher than 5.5 in all solutions, but the pH in 20 minutes after mouthrinsing was higher than 5.7 in DSW, CDW and 3 kinds of products which had higher mineral contents. In vitro study, the mouthrinse solutions containing the higher mineral contents were also the more effective in reduction of methyl mercaptan which is one of the causes of halitosis. The 2 kinds of products containing deep sea water killed Streptococcus mutans (ATCC 25175) in culture plates in one minute. These results indicate the usability of deep sea water in mouthrinses for oral hygiene management.
Dental Plaque ; Dental Plaque Index ; Halitosis ; Hydrogen-Ion Concentration ; Oral Hygiene ; Osmosis ; Periodontal Index ; Seawater* ; Smell ; Streptococcus mutans ; Water

Fanconi syndrome is a generalized functional disorder of the proximal tubule of the kidney and is characterized by aminoaciduria, glycosuria, hyperphosphaturia, dehydration, rickets, and growth failure. Nephrocalcinosis and hypercalciuria are rare manifestations of Fanconi syndrome. There is no case report of Fanconi syndrome complicated with nephrocalcinosis and hypercalciuria in Korea. A 6-year-old boy presented with genu valgum and waddling gaits for about 3 years. There was no family history of renal disease and his physical examination was normal except for genu valgum and corrected cleft lip and palate. Laboratory investigations showed generalized aminoaciduria, glycosuria, hyperphosphaturia, hypercalciuria, and low-molecular weight proteinuria including beta2-microglobulin. Serum 25-OH vitamin D3 was within the normal range, and 1,25-(OH)2 vitamin D3 was elevated. Bilateral renal medullary hyperechogenicity was demonstrated by ultrasonography. Analysis of the CLCN5 gene revealed no mutation. Here we describe a boy with Fanconi syndrome complicated with nephrocalcinosis and discuss the differential diagnosis.
Child ; Cholecalciferol ; Cleft Lip ; Dehydration ; Diagnosis, Differential ; Fanconi Syndrome* ; Gait ; Genu Valgum ; Glycosuria ; Humans ; Hypercalciuria ; Hypophosphatemia, Familial ; Kidney ; Korea ; Male ; Nephrocalcinosis* ; Palate ; Physical Examination ; Proteinuria ; Reference Values ; Rickets ; Ultrasonography

PURPOSE: There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists. METHODS: Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. RESULTS: Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% vs 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b (54.3-77.1%). CONCLUSION: Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.
Adrenal Cortex Hormones ; Appointments and Schedules ; Child* ; Surveys and Questionnaires ; Electronic Mail ; Haemophilus influenzae type b ; Hepatitis B ; Humans ; Immunization* ; Immunosuppression ; Influenza, Human ; Korea ; Nephrology* ; Nephrotic Syndrome ; Postal Service ; Surveys and Questionnaires ; Recurrence ; Renal Insufficiency ; Streptococcus pneumoniae ; Vaccination ; Vaccines ; Vaccines, Inactivated

Myocardial infarction in the newborn is usually seen in association with congenital heart disease, for example anomalous origin of the left coronary artery, tricuspid atresia and left ventricular outflow obstruction. However, it is very rare in infants with structurally normal coronary artery. In infants with structurally normal hearts and coronary arteries, the most common causes of myocardial infarction are perinatal asphyxia and thromboembolic occlusion. We experienced a case of neonatal myocardial infarction with structurally normal coronary arteries complicated sepsis and hypoglycemia. The diagnosis of myocardial infarction was made by EKG and increase of plasma myocardiac enzyme. We report this case with related literature.
Asphyxia ; Coronary Vessels* ; Diagnosis ; Electrocardiography ; Heart ; Heart Defects, Congenital ; Humans ; Hypoglycemia ; Infant ; Infant, Newborn ; Myocardial Infarction* ; Plasma ; Sepsis ; Tricuspid Atresia ; Ventricular Outflow Obstruction

PURPOSE: This study was attempted to evaluate the effect of adjuvant radiotherapy and chemotherapy after curative resection of extrahepatic bile duct cancer. MATERIALS AND METHODS: The authors performed a retrospective analysis of 57 patients with extrahepatic bile duct cancer not involving the hepatic duct confluence and curatively resected at Seoul National University Hospital between 1990 and 1995. Resection margins of all cases were confirmed pathologically as free of cancer cells. Among 57 patients, 29 received adjuvant therapy. Total 4000 cGy of external beam radiation was delivered to each. 5-fluorouracil (5-FU) was administered as a radiosensitizer. After 4 weeks of radiation therapy, 5-FU maintenance chemotherapy was started and given every 4 weeks up to 12 cycles or until evidence of relapse. RESULTS: The overall median survival of 57 patients was 24 months. I- and 2-year overall survival rate was 73.7 and 52.6%. There was no difference in overall survival rate between adjuvant therapy group (n=29) and operation-only group (n 28). We tried to evaluate the effect on survival of adjuvant therapy according to lymph node status. Patients of Tl stage were excluded from analysis. Adjuvant therapy had no survival benefit in the lymph node positive group. But in the lymph node negative group, 1- and 2-year survival rate of patients who underwent adjuvant therapy were 89.5% and 68.4% whereas 1 and 2-year survival rate of patients in operation-only group were 57.9% and 36.8%, which was statistically significant (p=0.0278, 0.0472). And by multivariate analysis, the survival improvement of 1- and 2-year survival rate in adjuvant therapy group was due to adjuvant therapy itself. CONCLUSION: Our trial of external beam radiotherapy combined with 5-FU chemotherapy after curative resection of extrahepatic bile duct cancer did not show improved overall survival. However the 1- and 2-year survival rate of patients with negative lymph node and advanced T stage ( > T 1) were improved in adjuvant therapy group, so adjuvant therapy may give survival benefit to a certain patient group with negative lymph node.
Bile Ducts, Extrahepatic* ; Drug Therapy ; Fluorouracil ; Hepatic Duct, Common ; Humans ; Lymph Nodes ; Maintenance Chemotherapy ; Multivariate Analysis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate

Carcinoid tumors have been described in almost every organ and may affect virtually every body system. Cardiac involvement manifesting as right-sided valvular disease is characteristic of the carcinoid heart disease. Myocardial metastasis is an unusual manifestation of carcinoid heart disease and it was manifested as a mass lesion in the previous reports. We observed a myocardial metastasis of carcinoid tumor manifesting as diffusely infiltrative pattern.
Carcinoid Heart Disease* ; Carcinoid Tumor* ; Neoplasm Metastasis

No abstract available.
Humans ; Teicoplanin*

No abstract available.
Allografts* ; Herpesviridae* ; In Situ Hybridization*

In addition to general charceteristics of tibial fracture, segmental tibial fracture is commonly combined with extensive soft tissue injury, comminution and displacement with poor blood supply in its middle segment. According to recent reports, intramedullary nailing was regarded as the excellent method in the management of this kind of fracture. Twenty-one cases were treated at the department of Orthopaedic Surgery, National Medical Center from January 1980 to December 1987 and following results were obtained; 1. Most common type of fracture was Type I (38.1%). Almost all the fractures were accompanied by open wounds(85.7%) and GIIIB open wounds were 12 cases(57.1%). 2. A verage union time was 31.8 weeks(union rate, 76.2%) and showed marked difference between closed fracture(20.2 weeks) and GIIIB open one(38.6 weeks). 3. Better results were seen in 8 cases of intramedullary nailing(average union time, 24.2 weeks), while all the plating method showed non-union in 3 cases of open wound.
Fracture Fixation, Intramedullary ; Methods ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Wounds and Injuries