Congenital absence of gallbladder

Nine surgically proven congenital absence of gallbladder (CAGB) cases were reviewed. All of them had one or more kinds of biliary symptom. Tests such as abdominal ultrasonography, intravenous or oral cholecystography and even endoscopic retrograde cholangiography not only failed to predict CAGB but misleadingly indicated other similar conditions. Only the abdominal computed tomography (CT), performed on one patient, enabled the accurate diagnosis of CAGB. All the patients underwent abdominal exploration, and CAGB was confirmed by the meticulous dissection of the entire extrahepatic biliary tree and the operative cholangiography. Five patients had concomitant biliary pathologies responsible for their symptoms, but four patients had isolated CAGB. CAGB is a rarely encountered condition for a clinician, but extensive diagnostic work-ups including abdominal CT should be performed in all situations where CAGB is suspected. Thus unnecessary exploration can be avoided in the isolated CAGB case.

Postoperative survival and prognostic factors in colorectal cancer

No abstract available.

A clinical study of 2789 gastric cancers

No abstract available.

Distribution of 5-Fluorouracil-14C in Body Tissues after Systemic and Regional Administration in Gastric Cancer

This study was to determine which of two routes of administration of 5-fluorouracil (5-FU) is more effective, by measuring the radioactvity in the body tissues of gastric cancer patients after the administration of 5-FU-l4C via the systemic intravenous and the regional intra-arterial routes. After the drug was administered intravenously in one group of patients, and intra-arterially in another; samples of portal venous blood, the liver, the lymph nodes, and the normal and the cancerous tissues of the stomach were obtained. The radioactivities of the samples were measured, and it was found that those of the regional lymph nodes, the liver, and the normal and the cancerous tissues of the stomach were much higher in the latter group. The regional intra-arterial routes is the more effective way to administer 5-FU in patients with stomach cancer.

Gall Stones in Young Adults

No abstract available.

Further Analysis of Various Renal Functions in the Korean I. Studies on Water Metabolism of the Korean

A typical pattern of daily water exchange was determined in 10 medical students during three different seasons: summer, autumn and winter. The daily water intake was averaged to 3,810ml of which 1,256ml was from liquids, 2,055ml from the water contained in food and 500ml from the water of oxidation. On the other hand, the daily water output was 1,844ml by urinary loss, 144ml by fecal loss and 1,819ml by evaporative loss. The above quantitative pattern of daily water exchange in the Korean remained unchanged throughout the year. The daily urinary output of NaCl and urea-nitrogen was in the order of 20gm and 10gm, respectively. Furthermore, the magnitude of daily water intake was well correlated to the daily urinary output of NaCl but little correlated to that of urea-nitrogen. A comparison of these data with the corresponding figures obtained from the occidental indicates that the daily water intake and the daily urinary output of NaCl were significant1y greater in the Korean than those in the occidental. On the basis of these results, the greater water intake in the Korean was attributed to their high salt intake.

Further Analysis of Various Renal Functions in the Korean II. Effect of High Protein Diet on Water Metabo1ism and Renal Functions

Effects of high protein diet on water metabolism and on various renal functions were studied in 4 medical students. The daily water intake during the high protein intake was averaged to 3,000ml of which 39% was from liquids, 49% from the water contained in food and 12% from the water of oxidation. Of the daily water output, 53% was by urine, 3% by feces and 44% by the evaporation. As compared to the occidental, this average daily water intake of 3,000ml on high protein diet was greater in the Korean. Moreover, the daily water intake for a given caloric intake or body weight was still significantly greater in the Korean. Moreover, the quantitative pattern of daily water exchange was not modified by the protein content in the diet. On the other hand, the urine osmolarity as well as the urea concentration increased when the protein intake was augmented. However, the urinary concentrations of Na+, Cl- and K+ were not affected by the amount of protein intake. When high protein diet was given, the values of CIN and CPAH showed only a slight increase but renal concentrating ability as judged by the magnitude of maximal negative free water clearance (T H20) showed a significant increase. From these results, it is evident that the lower renal concetrating ability of the normal Korean is most likely due to low protein intake. However, greater water intake in the Korean is independent of the changes in the renal concentrating ability. On the basis of these facts, it is again suggested that greater water intake in the Korean is attributable to greater salt intake.

Gastric Carcinoma(An eleven year review of 792 cases)

Statistical analysis of 792 cases of gastric carcinoma is reported. Materials were collected from the medical record room during the 11 year period from Jan. 1955 to Dec. 1965. Diagnosis of gastric carcinoma was established by pathologic examination of the resected specimen, by lymph node biopsy, and by physical and X-ray findings. The age of peak incidence was in the 5th decade. The male to female ratio was 3:1. In the order of frequency, the symptoms and signs which were the most prominent and common were epigastric pain or discomfort, indigestion, anorexia, a palpable mass, weight loss, and epigastric tenderness. More than 50% of the patients had symptoms for less than 6 months. About 70% of the patients and hypochlorhydria on gastric analysis. More than 60% of the carcinomas were located in the prepyloric region. Regional lymph-node metastasis was present in 76% of the cases. In order of frequency this occurred in the omentum, celiac nodes, liver, pancreas, and mesocolon. There was a 56.4% operability and 58.8% resectability. The most common postoperative complication was wound infection. There were 9 operative deaths which made a 3.4% mortality for cases resected, and 2% mortality for all cases coming to surgery. The five year survival rate was 12.9% for all cases coming to surgery, but was increased to 22.2% for patient having a total gastrectomy and 24.2% for patients having a subtotal gastrectomy. 12.0% of patients having gastrectomy in which there were positive nodal metastases survived five years, but, when metastasis was not noted the patients who had had a gastrectomy survived at a rate of 45.5% for five years. The surgical result was influenced by several fastors other than the presence or absence of metastases to the lymph nodes. These factors included the grade of the tumor microscopically, the presence or absence of serosal involvement, and the pathologic type of the tumor. It is our opinion that our surgical results, which are poor when compared with those in the literature, are due mainly to the fact of a late diagnosis. Some of the patients were so far-advanced as to be questioned as to their being candidates for surgery. Most of the patients come to the surgeon simply because of their symptoms and signs which have developed beyond the point of tolerance, or because of family pressures to come for treatment. This study revealed that the resectability rate, and the surgical results improved year by year. This fact explains why the early diagnosis is so very important. It is felt keenly that education of the public and increased alertness on the part of both patients and physicians is needed. This is particularly true when the patient is over 40 years of age, complains of indigestion, epigastric pain or discomfort. Each of these patients should have a complete check-up. Once the chance for cure of the disease has passed it is difficult to do more than a palliative procedure.