OBJECTIVES: To estimate the weighting for the disability caused by major cancers in Korea using the Delphi method. METHODS: We selected 19 panelists to estimate the disability weighting of major cancers in Korea by using the Delphi method. To select the relevant kinds of cancers, we used National Death Certificate Data produced by the National Statistical Office in 1996. Then the stability of each delphi round was calculated by using the coefficient of variance. RESULTS: The disability weight of major cancers for males was pancreas cancer(0.36), liver cancer(0.35), esophageal cancer(0.30), stomach cancer(0.27), lung cancer(0.26), and colorectal cancer(0.30). The disability weight of major cancers for females was pancreas cancer(0.36), liver cancer(0.34), esophageal cancer(0.29), stomach cancer(0.28), lung cancer(0.26), and colorectal cancer(0.28). CONCLUSION: The results of this study will provide baseline data useful for the measurement of the burden of disease caused by cancers in Korea.
Death Certificates ; Female ; Humans ; Korea* ; Liver ; Lung ; Male ; Pancreas ; Stomach

The purpose of this study is to evaluate the applicability of intravenous atropine sulfate therapy in infantile hypertrophic pyloric stenosis (IHPS). From 1998 to 2000 among 35 cases of IHPS, pyloromytomy was performed in 13 (Group A), and intravenous atropine was given as a primary therapy in 22 cases (Group B). In group A, all cases were cured completely. In group B, 13 (59 %) out of 22 cases were successfully treated with atropine, but 9 were failed therapy, and required operation. The recovery period to normal feeding and the hospital stay of the successful atropine group were longer than those of pyloromyotomy, 8.6 days vs. 2.9 days and 13.2 days vs. 4.1 days, respectively. In conclusion, intravenous atropine therapy did not replace pyloromyotomy, but it might be an alternative for the selected patients with contraindications for operation.
Atropine* ; Humans ; Length of Stay ; Pyloric Stenosis, Hypertrophic*

No abstract available.
Female ; Ovarian Hyperstimulation Syndrome*

OBJECTIVE: Chronic subdural hematomas (CSDH) are more common on the left hemisphere than on the right. We verified this left predilection of CSDH and tried to explain the reason for this discrepancy. METHODS: We investigated the laterality of CSDH in 182 patients who were treated from January 2005 to December 2009. We examined the symmetry of the cranium and the location of the lesion. RESULTS: CSDH was more common on the left-side. The cranium was symmetric in 63 patients, asymmetric in 119 patients. The asymmetric crania were flat on the right-side in 77 patients, on the left-side in 42 patients. The density of the CSDHs was hypodense in 29 patients, isodense 132 patients, and the others in 21 patients. Bilateral hematomas were more common in the hypodense group. In the right flat crania, the hematoma was more commonly located on the opposite side of the flat side. While in the left flat crania, the hematoma was more common on the same side. CONCLUSION: CSDHs occurred more frequently on the left side. The anatomical asymmetry of the cranium influences the left predilection of CSDH.
Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural, Chronic ; Humans ; Skull

OBJECTIVE: The purpose of this study was to determine the clinical significance of intraventricular hemorrhage (IVH) in patients with ruptured aneurysms. METHODS: Of 1034 patients who were admitted to our hospital with ruptured aneurysms between 1994 and 2007, 128 (12.4%) had IVHs. The clinical, radiologic characteristics, and surgical outcomes in the IVH group were compared with the no-IVH group. RESULTS: The IVH group had a shorter time interval to admission. The incidence of IVH was significantly higher in patients > 70 years of age (p=0.021), males (p=0.000), alcohol abusers (p=0.039), patients with a Glagow Coma Scale (GCS) < or =8 (p=0.000), and patients with a Hunt and Hess grade of 4-5 (p=0.000). IVH was more common in patients with ruptured posterior circulation aneurysms (p=0.000) and anterior communicating artery aneurysms (p=0.036). The incidence of thick, diffuse subarachnoid hemorrhage (SAH; p=0.004), intracerebral hemorrhage (ICH) >10 cc (p=0.006), rebleeding (p=0.010), and shunt-dependant hydrocephalus (p=0.000) was significantly higher in the IVH group than the no-IVH group. The mortality rate in the IVH group was significantly higher than the no-IVH group (48.4% versus 22.1%). The amount of IVH had an influence on the mortality; IVH involving all of the ventricles (59.7%) and IVH only involving some of the ventricles (33.9%) was associated with a 6.6- and 2.3-fold higher mortality than the no-IVH group, respectively. IVH was significantly associated with a poor surgical outcome; however, this association was not significant in patients with a GCS < or =8, or histories of rebleeding or seizures. CONCLUSIONS: In patients with ruptured aneurysms, IVH reflects the clinical severity of SAH. IVH has a negative influence on surgical outcome, except in patients with a poor clinical status pre-operatively.
Aneurysm ; Aneurysm, Ruptured ; Cerebral Hemorrhage ; Coma ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm ; Male ; Seizures ; Subarachnoid Hemorrhage

When halothane was first introduced into the clinical anesthesia in 1956, it was acclaimed as the ideal anesthetic agent. Soon after its clinical introduction, reports were published regarding jaundice and hepatic necrosis following its use. Stock and Strunin group the etiologic factors as biotransformation, hypersensitivity (immune-related), hypoxia and pharmacogenetic. In contrast, Calahan and Mangano list as possible causes hypoxia, trauma, viral hepatitis and toxic injury. A few cases of hepatitis following enflurane anesthesia have been described and a diagnosis of enflurane hepatitis was made. However, it is much rare than halothane hepatitis and the case remains unproven. Regional anesthesia with local anesthetic agent (lidocaine or bupivacaine) does not cause hepatic injury, even patients with moderate hepatocellular disease may well be able to metabolize durgs normally. Decrease in hepatic blood flow in healthy individuals will cause no problems with regional anesthesia, as the blood flow and cardiac output can be reestablished with the use of fluids or appropriate vasoconstrictors. This study was undertaken to evaluate the effects of halothane, enflurane, and regional anesthesia with lidocaine or bupivacaine on liver function, particularly with serum glutamic oxaloacetic and pyruvic transaminases (SGOT and SGPT) values which are the most frequently determined indicators of possible liver disease. Whereas SGOT is present in a variety of tissues, SGPT appears to be the liver-specific transaminase. We studied randomly-selected 219 patients, ASA class I or II, aged 15-68 yr, scheduled for elective surgery. They had no history of liver disease, and preoperative liver function tests were within normal limit. And we excluded blood transfused cases in this study. They were divided into three groups according to the anesthetic agent used; Group I: Halothane anesthesia (116 cases). Group II: Regional anesthesia (50 cases). Group III: Enflurane anesthesia (53 cases). We also divided subgroups according to the duration of anesthesia in each group; Subgroup A (Subg-A): under 2 hours of anesthesia. Subgroup B (Subg-B): more than 2 hours of anesthesia. SGOT and SGPT were measured before surgery, and on 1st, 3rd and 5th postoperatine days. The results we as follows: 1) The values of SGOT and SGPT were increased (p<0.01) in both Subg-A and B of Group I. However, on the 1st post-operative day they were more prominently elevated than the other postoperative days (P<0.05), but clinically the change of values was all within normal limits. 2) The values of SGOT were increased (P<0.05) in Subg-B of Group II on the 3rd postoperatine day hut clinically were within normal limits. The values of SGPT in Group II were slightly increased within normal ranges. 3) The values of SGOT were increased in Subg-A (P<0.05) and Subg-B (P<0.01) of Group III on the 1st postoperatine day, but clinically were within normal limits. The values of SGPT in Group III were slightly increased within normal ranges. 4) In comparing Group I and Group II, the value of SGOT in Group I was significantly increased than Group II (P<0.05), but clinically was within normal limits, and the change in that of SGPT was not significant. 5) In comparing Group II and Group III, the value of SGOT in Group II was significantly increased (P<0.01) on the 5th postoperatine day than Group III, but clinically was within normal limits, and changes of SGPT were not significant. 6) In comparing Group II and Group III, the values of SGOT and SGPT were not significantly different. 7) The results show that the effect of halothane on liver function (SGOT, SGPT) is not significantly different from those of enflurane and regional anesthesia with local anesthetics.
Alanine Transaminase* ; Anesthesia ; Anesthesia, Conduction* ; Anesthetics, Local ; Anoxia ; Aspartate Aminotransferases* ; Biotransformation ; Bupivacaine ; Cardiac Output ; Diagnosis ; Enflurane* ; Halothane* ; Hepatitis ; Humans ; Hypersensitivity ; Jaundice ; Lidocaine ; Liver ; Liver Diseases ; Liver Function Tests ; Necrosis ; Reference Values ; Transaminases ; Vasoconstrictor Agents

Congenital duodenal atresia is the most common cause of perinatal intestinal obstruction. Abdominal distension and projectile vomiting are the specific symptoms of neonatal gastro-intestinal obstruction. The incidence of duodenal atresia is between 1 in 2,710 and 1 in 10,000 live births.1 Most cases are thought to be failure of recanalization of the duodenal lumen during embryonic period.2 Duodenal atresia is associated with a high incidence of other associational anomalies, including esophageal atresia, biliary atresia, congenital heart disease and vertebral anomalies. Prenatal diagnosis, the ealry operation and the facotrs such as prematurity, combined abnormalities, nutirtion have a significant influence on complication and mortality.3,4 We report a case of congenital duodenal atresia diagnosed by ultrasonography prenatally in Andong general hostpital at 26 gestational weeks and operated the 7th day of cesarean section in Yeungnam university hospital with a brief review of literature.
Biliary Atresia ; Cesarean Section ; Esophageal Atresia ; Female ; Gyeongsangbuk-do ; Heart Defects, Congenital ; Incidence ; Intestinal Obstruction ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Ultrasonography, Prenatal* ; Vomiting

Cancer of the gallbladder, the fifth most common malignant disease of the digestive system, is almost always associated with an unfavorable prognosis, and the clinical outcome has not improved much during the past couple of decades. This study was intended to analyze our surgical experience and to evaluate the prognostic significance of clinicopathologic factors for primary carcinoma of the gallbladder. We retrospectively reviewed the data of 113 patients with gallbladder carcinomas operated on over a period of 9 years from Jan. 1987 to Dec. 1995 at our surgical Department. In addition, a comparison with an analysis of cases from the last 10 years and a review of the disease are presented. The sex ratio (M : ) was 1.02 : , and mean age was 58.9 years. The most common presenting complaint was abdominal pain, followed by nausea and vomiting, and weight loss. An accurate preoperative diagnosis was made in 57.5% of the patients. The most common histologic type was adenocarcinoma (85.8%). A curative resection was done in 57 cases (51.4%). The overall 5-year survival rate was 21.1%, and in curative resected patients, the rates according to AJCC stage I, II, and III were 100%, 42.3%, and 14.6%, respectively. In the curative resected group, a univariate logrank analysis of 16 clinicopathologic factors showed that depth of invasion, macroscopic finding, histologic grading, lymphatic metastasis, and tumor location were significant prognostic factors. Multivariate Cox-regression analysis of these five profound factors demonstrated that only the depth of invasion was an independent variable. An analysis of survival rates according to the significant depth of invasion was done, and the 5-year survival rates for T1, T2, T3, and T4 were 72.4%, 30.2%, 8.7%, and 0%, respectively. When our data were compared with those of a previous study, the rate of curative resection and the operative mortality in our study were found to be improved over those of the earlier study. However, no progress has been made in survival during the last 10 years. In conclusion, long-term survival may be achieved by early diagnosis with a curative, radical operation, and the establishment of adjuvant therapy is required for advanced T-lesions of the gallbladder carcinoma.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Digestive System ; Early Diagnosis ; Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Lymphatic Metastasis ; Mortality ; Nausea ; Prognosis ; Retrospective Studies ; Sex Ratio ; Survival Rate ; Vomiting ; Weight Loss

Nonsystemic vasculitic neuropathy (NSVN) is a localized vasculitis confined to the peripheral nerves. Absence of systemic manifestations frequently leads to mis- or under diagnosis without the aid of pathologic study. NSVN may present typically with multiple mononeuropathies or less commonly with a sensorimotor polyneuropathy. We report two cases of NSVN presenting with acute severe painful neuropathy. Sural nerve pathology showed unequivocal vasculitis. High dose corticosteroid therapy was effective in controlling the pain. NSVN should be considered as a treatable cause of acute painful neuropathy.
Acute Pain* ; Diagnosis ; Mononeuropathies ; Pathology ; Peripheral Nerves ; Polyneuropathies ; Sural Nerve ; Vasculitis

BACKGROUND: Although steroid is one of the most widely used therapeutic measures for brain edema, its effect on brain edema after intracerebral hemorrhage (ICH) remains to be clarified. We performed this study to evaluate the efficacy of high dose methylprednisolone and conventional dose dexamethasone on the development of brain edema after experimental ICH. METHODS: Fifty-four male Sprague-Dawley rats, weighing 350-450 g, were used. ICH was made by stereotaxic injection of autologous arterial blood (0.13ml) into the right caudatoputamen. The animals were divided into three groups (n = 18 each). Group A received intraperitoneal(IP) injection of normal saline at 8-hour interval. Group B received dexamethasone (0.2mg/kg IP 30minutes after blood injection and 0.1mg/kg IP every 8h thereafter). Group C received methylprednisolone (30 mg/kg IP 30 minutes after ICH, 15mg/kg IP at 2 h after initial dose, and every 8h thereafter). We sacrificed the rat after 3 days and the development of brain edema was determined by measuring brain water content. We compared brain water content in each group. RESULTS: Water content of the right hemisphere was slightly lower in the methylprednisolone-treated rats than other groups; mean + S.D. in group A, B, and C was 80.94 + 0.66%, 80.56 + 0.70%, and 80.42 + 0.91%, respectively. However, there was no statistical significance ( p > 0.1) by the ANOVA test. The difference of the mean water contents between the two hemispheres was slightly higher in the saline-treated group than other groups, but without statistical significance ( p > 0.1). CONCLUSION: We could not find any significant reduction of the brain water content in the groups treated with steroid regardless of the doses. Our results do not warrant the popular steroid therapy in patients with ICH.
Animals ; Brain ; Brain Edema* ; Cerebral Hemorrhage* ; Dexamethasone ; Humans ; Male ; Methylprednisolone ; Rats ; Rats, Sprague-Dawley