Primary Closure of the Bile Duct without a T-tube for Treating Biliary Stone Disease

PURPOSE: The aim of this study is to examine whether conventional primary closure of the bile duct without routinely inserting a T-tube could be performed after all the surgeries used to treat choldocholithiasis. METHODS: From April 2002 to July 2005, we retrospectively analyzed 125 bile duct stone disease patients who underwent primary closure of the bile duct. RESULTS: Wound infection was the most frequent surgical complications, and it showed a higher trend in the patients who had a history of previous biliary operation, and it showed a trend to be slightly higher in the recurrent biliary stone cases than that in the de novo cases. However, these findings were not statistically significant. In addition, surgical complications developed in 16 of 100 patients who were older that 60 years, whereas there was only 1 of 25 patients who developed complications for the patients younger than 60 years. The development of complications has a tendency to be higher for the older patients, yet the level was not statistically significant. In regard to postsurgical hyperamylasemia, although a statistically significant difference could not be detected, this malady developed in 3 of 12 cases in whom endoscopic nasobiliary drainage (ENBD) tubes were inserted. This showed a trend to be higher than that for 13 cases of 113 patients for whom endoscopic nasobiliary drainage tubes were not inserted. Concerning the postsurgical hospitalization period, it was significantly longer in the cases who developed complications (p=0.018), and there was a tendency for a prolonged hospitalization period for the patients who were older than 60 years, for women, recurrent cases and the cases with a history of the bile duct surgery. Yet these had no statistical significance CONCLUSION: It appears that the primary closure of bile duct is a technique that could be performed safely for all choledocolithotomy patients , and this is regardless of the size of bile duct diameter, history of surgery on the bile duct system, gender, emergency operation, age, recurrent biliary stones, the presence of presurgical nasobiliary drainage tube and the presence of concomitant diseases.

A Case of Acute Appendicitis Associated with Enterobius Vermicularis

Enterobius vermicularis is one of the common parasites in the world. The infestation rate of Enterobius vermicularis is higher in children than in adults. Moreover, the egg-positive rate of Enterobius vermicularis is higher in the mentally retarded population. We report the case of a ten-year-old, mentally retarded boy, who was diagnosed as having acute appendicitis associated with Enterobius vermicularis.

Diverticula of Appendix Associated with Chronic Abdominal Pain: A case report

The incidence of an appendiceal diverticulum in instance of appendectomies has been reported to range from 0.004 to 2.1 percent. It is known that diverticulum of the appendix leads to diverticulitis, appendicitis, or perforation. Recently in the literature, appendiceal diverticulum without inflammation has been reported as a possible cause of chronic abdominal pain. We report the case of a 40-year-old man with appendiceal diverticula associated with chronic abdominal pain.

Hemangioma of the Breast: a Case Report / 한국유방암학회지

Vascular tumors of the breast are a highly infrequent finding. Hemangiomas are benign vascular tumors that are rarely present in the breast, and they are usually found incidentally on microscopy of biopsy material when checking for other diseases. Cavernous hemangioma also can develop at many anatomic sites, but there are only a few recorded examples of this lesion arising primarily in the breast. We report here on a case of cavernous hemangioma of the breast.

Septic Shock Caused by Acinetobacter Baumannii in Postoperative Patient

Acinetobacter baumannii is the most abundunt species of the Acinetobacter genus. The incidence of bacteremia caused by Acinetobacter baumannii among bloodstream infection has been increasing since 1986, when the taxonomy of the genus was first described. The mortality rate of bacteremia due to Acinetobacter baumannii is high, with reported ranging from 17 to 52%. We report a case of septic shock due to Acinetobacter baumannii in a 54-year-old man who underwent subtotal gastrectomy, with Billroth II reconstruction, for stomach cancer.

Spontaneous Rupture of the Spleen Secondary to Metastatic Choriocarcinoma

A spontaneous rupture of the spleen secondary to a metastatic choriocarcinoma is rare. To date, only five cases have been reported in the English literature. We report a case of a spontaneous rupture of the spleen secondary to a metastatic choriocarcinoma in a 29-year-old woman.

Cyclooxygenase-2 Expression in Colorectal Cancer

PURPOSE: Cyclooxygenase (COX) is an important enzyme that transforms arachidonic acid into prostaglandins and exists as two types of isoenzyme, COX-1 and COX-2. Recently, the expression of COX-2 was presented as an important factor in determining the prognosis in colorectal cancer, and the expressed COX-2 was related with recurrence and liver metastasis after an operation for colorectal cancer. Thus this study was to investigate the relationship between COX-2 expression and the prognosis for colorectal cancer. METHODS: We studied colorectal cancer patients who received operations at the Catholic University of Korea from Jan. 1993 through Dec. 2000, by reviewing their medical records and pathological reports. We used immunohistochemistry to determine the expression rate of COX-2 and to study its relationship with other clinical variables, the disease-free survival rat, and the recurrence rate. RESULTS: Among the 217 cases, 171 cases (78.8%) showed positive COX-2 expression. The COX-2 expression increased with the differentiation and was lower in cases with lymph-node metastasis. However, no statistically significant difference in age, sex, location of lesion, invasiveness, stage, organ of metastasis, disease-free survival rate, and recurrence existed between patients with positive COX-2 expression and those with negative COX-2 expression. CONCLUSIONS: There is no evidence that COX-2 expression is associated with a poor prognosis for colorectal cancer.