AIM： To present our clinical experience with gallbladder perforation cases.METHODS： Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic betw...AIM： To present our clinical experience with gallbladder perforation cases.METHODS： Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen （4.8%） of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.RESULTS： Seven patients had type I gallbladder perforation, 7 type I gallbladder perforation, and 2 type m gallbladder perforation according to Niemeier＇ s classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h （mean 9 h） after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients.CONCLUSION： Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.展开更多
AIM： To test the hypothesis that pain and affect rather than impaired emptying determine symptom severity in patients with gastroparesis. METHODS： Adult patients with documented gastroparesis were enrolled prospecti...AIM： To test the hypothesis that pain and affect rather than impaired emptying determine symptom severity in patients with gastroparesis. METHODS： Adult patients with documented gastroparesis were enrolled prospectively in a single center and asked to complete the Gastroparesis Cardinal Symptom Index （GCSt）, Hospital Anxiety and Depression Scale （HADS）, the Short Form 12 （SF-12） as quality of life index, rate pain severity and answer 10 open-ended questions. RESULTS： A total of 55 patients （44 women） participated. Idiopathic （n = 29） or diabetic （n = 11） gastroparesis and connective tissue disease （n = 8） were the most common underlying causes. Antiemetics （n = 30） and prokinetics （n = 32） were most often prescribed. Seventeen patients used opioids on a daily basis. Nausea and/or vomiting （n = 28）, pain （n = 24） and bloating （n = 14） were most commonly listed as dominant symptoms. Patients subjectively attributed symptom improvement to nutritional and dietary therapy （n= 11）, prokinetics （n = 11）, antiemetics （n = 10） or analgesic agents （n = 3）. In univariate analyses, the physical subscore of the SF-12 and HADS, but not gastric emptying delay or symptom duration significantly correlated with disease severity as measured by the GCSI. In multivariate analyses, the combination of vomiting, bloating and depression best predicted the overall impact on quality of life. CONCLUSION： The study confirms the importance of pain and affect in gastroparesis, which requires novel approaches to improve more effectively the quality of life in patients with this disorder.展开更多
Peptic ulcer disease is uncommon in children and rarely suspected as a cause of abdominal complaints in this age group; the diagnosis is therefore made almost exclusively when complications develop. Peptic ulcer disea...Peptic ulcer disease is uncommon in children and rarely suspected as a cause of abdominal complaints in this age group; the diagnosis is therefore made almost exclusively when complications develop. Peptic ulcer disease is usually not considered in the differential diagnosis of pediatric patients. We present the case of a 30-month-old boy with duodenal perforation due to a peptic ulcer without a known etiology. The patient was admitted through the emergency department due to severe hematochezia and ongoing anemia; he presented with neither abdominal pain nor abdominal distension. There were no medical problems, and no drugs, such as corticosteroids or nonsteroidal anti-inflammatory drugs, had been prescribed or administered recently. We tried to control the active bleeding by medical treatment including arterial embolization, but the active bleeding was not controlled. Finally, an exploratory laparotomy was performed. A discrete anterior perforation with active bleeding of the duodenal wall was found. After the operation, there were no complications and the patient recovered fully.展开更多
The article defines knowledge about pelforated stomach ulcer that is formalized on the basis of an ontology model of medical diagnostics domain. The paper describes a base of observations for the disease and also know...The article defines knowledge about pelforated stomach ulcer that is formalized on the basis of an ontology model of medical diagnostics domain. The paper describes a base of observations for the disease and also knowledge base which determines a clinical presentation of the disease. The dependences on courses of the disease and process localization are taken into account during knowledge formalizing. The base of knowledge for the disease has the structure that is conventional for contemporary medicine. These knowledge will be used for building a medical intellectual system of for consulting and diagnostics.展开更多
Porous electrodes with three-phase reaction in low temperature fuel cells have attracted much attention by their flooding phenomena. In order to have a better understanding of the flooding phenomena inside electrode, ...Porous electrodes with three-phase reaction in low temperature fuel cells have attracted much attention by their flooding phenomena. In order to have a better understanding of the flooding phenomena inside electrode, it is important to evaluate various discharge conditions of the flooded electrodes. A model of flooded porous electrode under the influence of potential sweep was developed to evaluate the flooding conditions in-situ. The hysteresis of current density vs. time was observed at high sweep rates （1 O0 mV.sl）. It was not observed at low sweep rate （0.1 mV-s~）. In this study, these characteristics of flooding and hysteresis conditions were found to be markedly dependent on the potential scan rate. These dynamic behaviors are interpreted in terms of water saturation response, velocity of water movement, and evaporation rate of water.展开更多
Objective:To summarize the experience on diagnosis and treatment of blunt duodenal injuries,and thus to improve the therapeutic skills. Methods:Clinical data of 34 cases of blunt duodenal injuries admitted to our hosp...Objective:To summarize the experience on diagnosis and treatment of blunt duodenal injuries,and thus to improve the therapeutic skills. Methods:Clinical data of 34 cases of blunt duodenal injuries admitted to our hospital from 1990 to 2006 were retrospectively analyzed. Results:Among them,28 cases were cured,20 cases presented with complications,and 6 cases died.The causes of death were:duodenal or pancreatic fistula in 2 cases, intra-and retroperitoneal infection complicating septicopyemia in 2,disseminated intravascular coagulation in 1 and multiple organ failure in 1. Conclusions:Misdiagnosis and missed diagnosis predispose to happen for blunt duodenal injuries.Early recognition and surgical intervention are critical to a successful rescue.展开更多
文摘AIM： To present our clinical experience with gallbladder perforation cases.METHODS： Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen （4.8%） of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.RESULTS： Seven patients had type I gallbladder perforation, 7 type I gallbladder perforation, and 2 type m gallbladder perforation according to Niemeier＇ s classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h （mean 9 h） after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients.CONCLUSION： Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.
文摘AIM： To test the hypothesis that pain and affect rather than impaired emptying determine symptom severity in patients with gastroparesis. METHODS： Adult patients with documented gastroparesis were enrolled prospectively in a single center and asked to complete the Gastroparesis Cardinal Symptom Index （GCSt）, Hospital Anxiety and Depression Scale （HADS）, the Short Form 12 （SF-12） as quality of life index, rate pain severity and answer 10 open-ended questions. RESULTS： A total of 55 patients （44 women） participated. Idiopathic （n = 29） or diabetic （n = 11） gastroparesis and connective tissue disease （n = 8） were the most common underlying causes. Antiemetics （n = 30） and prokinetics （n = 32） were most often prescribed. Seventeen patients used opioids on a daily basis. Nausea and/or vomiting （n = 28）, pain （n = 24） and bloating （n = 14） were most commonly listed as dominant symptoms. Patients subjectively attributed symptom improvement to nutritional and dietary therapy （n= 11）, prokinetics （n = 11）, antiemetics （n = 10） or analgesic agents （n = 3）. In univariate analyses, the physical subscore of the SF-12 and HADS, but not gastric emptying delay or symptom duration significantly correlated with disease severity as measured by the GCSI. In multivariate analyses, the combination of vomiting, bloating and depression best predicted the overall impact on quality of life. CONCLUSION： The study confirms the importance of pain and affect in gastroparesis, which requires novel approaches to improve more effectively the quality of life in patients with this disorder.
基金Supported by (in part) The Chung-Ang University Research Grant in 2009
文摘Peptic ulcer disease is uncommon in children and rarely suspected as a cause of abdominal complaints in this age group; the diagnosis is therefore made almost exclusively when complications develop. Peptic ulcer disease is usually not considered in the differential diagnosis of pediatric patients. We present the case of a 30-month-old boy with duodenal perforation due to a peptic ulcer without a known etiology. The patient was admitted through the emergency department due to severe hematochezia and ongoing anemia; he presented with neither abdominal pain nor abdominal distension. There were no medical problems, and no drugs, such as corticosteroids or nonsteroidal anti-inflammatory drugs, had been prescribed or administered recently. We tried to control the active bleeding by medical treatment including arterial embolization, but the active bleeding was not controlled. Finally, an exploratory laparotomy was performed. A discrete anterior perforation with active bleeding of the duodenal wall was found. After the operation, there were no complications and the patient recovered fully.
文摘The article defines knowledge about pelforated stomach ulcer that is formalized on the basis of an ontology model of medical diagnostics domain. The paper describes a base of observations for the disease and also knowledge base which determines a clinical presentation of the disease. The dependences on courses of the disease and process localization are taken into account during knowledge formalizing. The base of knowledge for the disease has the structure that is conventional for contemporary medicine. These knowledge will be used for building a medical intellectual system of for consulting and diagnostics.
文摘Porous electrodes with three-phase reaction in low temperature fuel cells have attracted much attention by their flooding phenomena. In order to have a better understanding of the flooding phenomena inside electrode, it is important to evaluate various discharge conditions of the flooded electrodes. A model of flooded porous electrode under the influence of potential sweep was developed to evaluate the flooding conditions in-situ. The hysteresis of current density vs. time was observed at high sweep rates （1 O0 mV.sl）. It was not observed at low sweep rate （0.1 mV-s~）. In this study, these characteristics of flooding and hysteresis conditions were found to be markedly dependent on the potential scan rate. These dynamic behaviors are interpreted in terms of water saturation response, velocity of water movement, and evaporation rate of water.
文摘Objective:To summarize the experience on diagnosis and treatment of blunt duodenal injuries,and thus to improve the therapeutic skills. Methods:Clinical data of 34 cases of blunt duodenal injuries admitted to our hospital from 1990 to 2006 were retrospectively analyzed. Results:Among them,28 cases were cured,20 cases presented with complications,and 6 cases died.The causes of death were:duodenal or pancreatic fistula in 2 cases, intra-and retroperitoneal infection complicating septicopyemia in 2,disseminated intravascular coagulation in 1 and multiple organ failure in 1. Conclusions:Misdiagnosis and missed diagnosis predispose to happen for blunt duodenal injuries.Early recognition and surgical intervention are critical to a successful rescue.
