No abstract available.
Anniversaries and Special Events* ; Hemorrhage* ; Liver* ; Shock*

No abstract available.
Rupture* ; Spleen*

No abstract available.
Breast Neoplasms* ; Breast*

Nuclear DNA content in 31 cases of thyroid neoplasm was determined by flow cytometry with the use of paraffin-embedded archival tissue. DNA aneuploidy was found in 6 cases (19.4%) of the 31 thyroid neoplasms; such as 2 of 8 (DI=1.16, 1.56) follicular adenomas, 1 of 6 (DI=1.10) follicular carcinomas, 1 of 15 (DI=1.18) papillary carcinomas and 2 of 2 (DI=1.76, 2.07) medullary carcinomas. The remaining tumors were diploid. No significant difference between follicular adenomas and carcinomas was detected with respect to the S phase fraction(SPF). In the papillary carcinoma group the SPF was higher than in the follicular neoplasm group, but it was statistically insignificant. Regional lymph node metastasis was present in 8 of 15( 53.3%) papillary carcinomas but absent in all of the 14 follicular neoplasms. In the medullary carcinoma group one case showed regional node metastasis at the time of resection and the other developed metastasis 11 months after surgical removal of the primary lesion. In this study tumors predominantly composed of Hurthle cells were found to have a significantly higher D.I. than those with few or no Hurthle cells. No significant difference was found between tumors with metastasis and those without metastasis.
Adenoma ; Neoplasm Metastasis

PURPOSE: Primary small bowel cancer is rare. In many cases, the diagnosis is difficult especially in jejunum and ileum, confirmed in advanced state with poor prognosis. This study was intended to clarify the characteristics of primary small bowel cancer. MATERIAL AND METHOD: We have reviewed 24 patients with primary small bowel cancer that have been operated at the Department of Surgery, hospital from Jan. 1990 until Dec. 1996. The clinical feature, diagnostic method, location and histologic finding of tumor, prognosis were analyzed. RESULTS: 1. The ratio of male to female was 1:1.18. The mean age was 53 years and the most prevalent age group was 6th decade (13 cases, 54.1%). 2. The most common primary site was jejunum (9 cases), followed by duodenum (8 cases) and ileum (7 cases). Leiomyosarcoma occurred most frequently in jejunum, adenocarcinoma in duodenum, and lymphoma in ileum. 3. The most common symptom was abdominal pain (66.7%), followed by anemia (54.2%), palpable mass (50%). 4. The accuracy rate of preoperative diagnosis or suspicion was 45.8%, and diagnostic measures were endoscopy in duodenum, small bowel series and/or abdominal CT. in jejunum and ileum. 5. Curative resection was performed in 14 cases (58.3%), and the cancer in which palliative resection was undertaken most frequently was leiomyosarcoma. 6. The mean follow-up period of 23 cases except 1 was 33 months, during this time 9 cases were dead, of whom 5 cases had leiomyosarcoma. CONCLUSION: Frequently, small bowel cancer is difficult in diagnosis, confirmed in late stage. High degree of suspicion and more endeavor to discover it is important and needed to bring a better result.
Abdominal Pain ; Adenocarcinoma ; Anemia ; Diagnosis ; Duodenum ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Ileum ; Jejunum ; Leiomyosarcoma ; Lymphoma ; Male ; Prognosis ; Tomography, X-Ray Computed

We retrospectively analyzed 40 adrenalectomies due to 13 cases of primary aldosteronism, 12 cases of Cushing's syndrome and 15 cases of pheochromocytoma, which were performed at Chungnam National University Hospital during the last 10 years. Of the 25 patients who presented with adrenal cortical tumors(primary aldosteronism and Cushing's syndrome), 23 had an adenoma and two had cortical hyperplasia. The overall ratio of males to females was 2:1. As to the age distribution, primary aldosteronism was predominant in the 4th and the 5th decades and Cushing's syndrome; in the 3rd and the 4th decades; however, pheochromocytoma was almost evenly distributed in 2nd through the 6th decades. Headaches, fatigue, and general weakness were the most frequent symptoms in primary aldosteronism; weight gain or a change in fat distribution in Cushing's syndrome; and headaches or blurred vision related to hypertension and palpitation in pheochromocytoma. Postoperative complications mostly occurred in patients with Cushing's syndrome: There were four wound infections, including one abdominal abscess, one pleurisy, one cerebral and cerebellar infaction, and two intestinal obstructions, but there were no postoperative deaths.
Abdominal Abscess ; Adenoma ; Adrenalectomy ; Age Distribution ; Chungcheongnam-do ; Cushing Syndrome ; Fatigue ; Female ; Headache ; Humans ; Hyperaldosteronism ; Hyperplasia ; Hypertension ; Intestinal Obstruction ; Male ; Pheochromocytoma ; Pleurisy ; Postoperative Complications ; Retrospective Studies ; Weight Gain ; Wound Infection

We retrospectively analyzed 40 adrenalectomies due to 13 cases of primary aldosteronism, 12 cases of Cushing's syndrome and 15 cases of pheochromocytoma, which were performed at Chungnam National University Hospital during the last 10 years. Of the 25 patients who presented with adrenal cortical tumors(primary aldosteronism and Cushing's syndrome), 23 had an adenoma and two had cortical hyperplasia. The overall ratio of males to females was 2:1. As to the age distribution, primary aldosteronism was predominant in the 4th and the 5th decades and Cushing's syndrome; in the 3rd and the 4th decades; however, pheochromocytoma was almost evenly distributed in 2nd through the 6th decades. Headaches, fatigue, and general weakness were the most frequent symptoms in primary aldosteronism; weight gain or a change in fat distribution in Cushing's syndrome; and headaches or blurred vision related to hypertension and palpitation in pheochromocytoma. Postoperative complications mostly occurred in patients with Cushing's syndrome: There were four wound infections, including one abdominal abscess, one pleurisy, one cerebral and cerebellar infaction, and two intestinal obstructions, but there were no postoperative deaths.
Abdominal Abscess ; Adenoma ; Adrenalectomy ; Age Distribution ; Chungcheongnam-do ; Cushing Syndrome ; Fatigue ; Female ; Headache ; Humans ; Hyperaldosteronism ; Hyperplasia ; Hypertension ; Intestinal Obstruction ; Male ; Pheochromocytoma ; Pleurisy ; Postoperative Complications ; Retrospective Studies ; Weight Gain ; Wound Infection

BACKGROUND: Primary tumor of the small bowel is uncommon less than 6% of all gastrointestinal tumors. Its symptoms and signs are nonspecific and its diagnosis is difficult. METHODS: We analyzed 43 patients with primary small bowel tumor who had undergone operations at the Chungnam National University Hospital from January 1990 to December 1997. RESULTS: 1) In total 43 cases, 19 cases (44.2%) were male and 24 cases (55.8%) were female, benign tumors were 13 cases (30.2%) and malignant tumors were 30 cases (69.8%). The mean age was 51 year. 2) The primary sites of benign tumors were the duodenum in 5, jejunum in 3, ileum in 5 cases. The primary sites of malignant tumors were the duodenum in 13, jejunum in 9, ileum in 8 cases. 3) Polyp was most common benign tumor (30.7%), and leiomyosarcoma was most common malignant tumor (43.3%). 4) The most common symptom was abdominal pain (65.1%), followed by melena (34.9%) and weight loss (20.9%). The most common sign was palpable mass (39.5%) and anemia (39.5%). 5) In the duodenal tumors, the detectabilities of endoscopy and upper gastrointestinal series were 68.8% and 71.4%, respectively. In the jejunal and the ileal tumors, the detectabilities of small bowel series were 62.5% and 71.4%, respectively and those of abdominal computed tomogram were 50.0% and 42.9%, respectively. The accuracy of preoperative diagnosis was 7 cases (53.8%) in benign and 20 cases (66.7%) in malignant tumor. 6) In cases of malignant tumor, curative resection was performed in 18 cases (60.0%), palliative resection was performed in 10 cases (33.3%), and bypass procedure was performed in 2 cases (6.7%). In cases of benign tumor, small bowel resection was performed in 9 cases and excision of duodenal polyp was performed in 2 cases. 7) The mean follow-up period of malignant tumor of 27 cases except 3 hospital mortality cases was 35 months. During this time, 7 cases were dead due to recurrence. The mean survival time of 7 mortality cases was 20.4 months, of them 4 cases were leiomyosarcoma, 2 cases were adenocarcinoma, and 1 case was lymphoma. CONCLUSIONS: Because diagnosis of small bowel tumor is difficult and confirmed in late stage, high degree of suspicion and endeaver to discover it is important.
Abdominal Pain ; Adenocarcinoma ; Anemia ; Chungcheongnam-do ; Diagnosis ; Duodenum ; Endoscopy ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Ileum ; Jejunum ; Leiomyosarcoma ; Lymphoma ; Male ; Melena ; Mortality ; Polyps ; Recurrence ; Survival Rate ; Weight Loss

No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD). METHODS: A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events. RESULTS: Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events. CONCLUSION: Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.
Aged ; Aged, 80 and over ; Anger ; Anxiety ; Cohort Studies ; Coronary Artery Disease/*psychology ; Databases, Factual ; Depression ; Female ; Hostility ; Humans ; Male ; Prospective Studies ; Recurrence ; Risk Factors ; *Stress, Psychological