PURPOSE: The incidence of upper gastric cancer and especially the diffuse type have increased in western countries. The aim this study was to investigate the chronologic changes of the clinicopathological features and survival rates of Korean upper gastric cancer patients. MATERIALS AND METHODS: 1,638 gastric cancer patients who underwent gastrectomy were included in this study and they were divided into two groups; the 1990's (1991~1999, n=987) and the early 2000's (2000~2003, n=651). We evaluated the differences of the clinicopathologic features and the factors that affected the survival rates by univariative and multivariative analysis. RESULTS: The older age (>60) patients increased from 42.7% to 50.7% respectively. Being overweight (body mass index> or =23) also increased from 31.5% to 43.2%. For the pathology, the incidence of stage Ia gastric cancer increased (29.8% to 44.5%) and the incidence of stage IV gastric cancer decreased (23.5% to 11.8%). Yet there was no difference according to the WHO classification, Lauren's classification and the location of tumor between the groups. The 5 year survival rates increased 67.7% to 83.7%, according to the group. Multivariative analysis showed that the odd ratios of the early 2000s was 0.715 (95% CI; 0.555~0.921) as compared to that of the 1990s. CONCLUSION: There were no changes of the clinicopathologic features, like the pattern in western countries, although the incidence early gastric cancer, old age patients and overweight patients increased. The survival rate of early 2000s was better that that of the 1990s.
Gastrectomy ; Humans ; Incidence ; Overweight ; Stomach Neoplasms ; Survival Rate

BACKGROUND: Current blood and blood components are prepared from 320ml or 400ml blood collection. The analytic values and standard values of blood and blood components were evaluated at Seo-Bu Blood Center, The Republic of Korea National Red Cross, Seoul, Korea. METHODS: Blood and blood components were analyzed with weight, specific gravity, content volume, RBC counts, WBC counts, platelets counts, hemoglobin, hematocrit, pH, total protein, albumin, factor VII and bacterial culture. RESLUTS: The volume, hemoglobin, hematocrit and pH of 320ml and 400ml standard unit of whole blood was 328 +/- 31ml and 405 +/- 22ml, 12.7 +/- 1.7g/dl and 14.8 +/- 2.0g/dl, 38.0 +/- 4.0% and 40.8 +/- 4.6%, mean of 7.16 and 7.13, respectively. The volume and hematocrit of packed red cells prepared from 320ml and 400ml standard unit of whole blood was 188 +/- 23ml and 248 +/- 23ml, 73.2 +/- 4.7% and 72.6 +/- 5.4%, respectively. Leukocytes poor red cells from 400ml standard unit of whloe blood showed 225 +/- 12ml of volume, 71 +/- 2.4% of hematocrit, and WBC removal was 87 +/- 5%. The volume, hematocrit and total protein in washed red cells was 224 +/- 11ml, 59 +/- 6.0% and 0.10 +/- 0.05g/unit, respectively. Leukocytes concentrates revealed 50 +/- 4.6ml of volume, 2.0 +/- 0.5x109/unit of WBC count and WBC recovery was 78 +/- 6.0%. Platelet concentrates prepared from 320ml and 400ml standard unit of fresh whole blood showed 38 +/- 3ml and 48 +/- 3ml of volume, 4.68 +/- 1.60x1010 and 5.55 +/- 1.80x1010 of platelet per unit, and 7.05 +/- 0.25 and 6.95 +/- 0.34 of pH, respectively. The fresh frozen plasma from 320ml standard unit of whole blood contained 143 +/- 25ml of volume, and that from 400ml whole blood showed 161 +/- 27ml of volume and 112 +/- 33 IU/unit of factor VII. The cryoprecipitate from 320ml whole blood showed 42 +/- 3ml of volume and 81 +/- 9 IU/unit of factor VII. There were no bacterial growth for all the components inoculated. CONCLUSION: At Seo-Bu Blood Center, we evaluated the characteristics of current blood and blood components, and established the standard values for whole blood (320ml, 400ml) as well as packed red cells, leukocytes poor red cells, washed red cells, leukocyte concentrates, platelet concentrates, fresh fozen plasma and cryoprecipates from 320ml and 400ml whole blood based on the present studies. Compared to the Standards for Blood Banks and Transfusion Services, American Association of Blood Banks, values of evluated items of current blood and blood components showed comparable results, but platelet counts from 320ml collection did not meet to those standards.
Blood Banks ; Blood Platelets ; Factor VII ; Hematocrit ; Hydrogen-Ion Concentration ; Korea ; Leukocytes ; Plasma ; Platelet Count ; Red Cross ; Republic of Korea ; Seoul ; Specific Gravity

Interrupted aortic arch with concomitant intracardiac defects is a rare congenital anomaly that has an unfavorable natural course. We report a successful staged operation of interrupted aortic arch with apical muscular ventricular septal defect associating esophageal atresia with tracheoesophageal fistula in a 3-day-old neonate weighing 2.6 kg. We repaired esophageal atresia through the right thoracotomy and subsequently performed extended end-to-end anastomosis of the aortic arch with pulmonary artery banding through the left thoracotomy at same operation. The apical muscular VSD was repaired 87 day after first operation. The patient required multiple additional interventions before closure of the apical muscular ventricular septal defect, such as pyloromyotomy for idiopathic hypertrophic pyloric stenosis, anterior aortopexy for airway obstruction, and balloon aortoplasty for residual coarctation. She is now doing well.
Airway Obstruction ; Aorta, Thoracic* ; Esophageal Atresia* ; Heart Septal Defects, Ventricular* ; Humans ; Infant, Newborn ; Pulmonary Artery ; Pyloric Stenosis, Hypertrophic ; Thoracotomy ; Tracheoesophageal Fistula*

There have been many reports of angiographic extravasation since the first description by Jamieson in 1952. Preoperative differential diagnosis between epidural and subdural post-traumatic blood collections is not always possible on the basis of cerebral angiographic signs alone, but many authors considered that extravasation of the contrast medium from a ruptured meningeal vessel is commonly considered as a definitive angiographic sign of epidural hematoma. Some authors feel that an extravasation of contrast medium from rupture of the middle meningeal artery does not necessarily indicate an epidural hematoma since it may also be formed rarely in cases of subdural or intracerebral blood collections. The authors report 6 cases of angiographic extravasation in head injury patient, 3 epidural hematoma, 2 subdural hematoma and one intracerebral hematoma.
Craniocerebral Trauma ; Diagnosis, Differential ; Hematoma ; Hematoma, Subdural ; Humans ; Meningeal Arteries ; Rupture

A total of 30 cases of the peptic ulcer in children, who underwent operations from January 1981 to December 1995 because of complications at Department of the Surgery, Chonbuk National University Medical School, is reviewed. Twenty-three were males (76.7%), 7 females (23.3%) and male was preponderant at 3.3:1. There were 25 cases (83.3%) age 10 to 15 years, 3 (10.0%) between 2 and 9 years, and 2 (6.7%) below 2. The ulcer was located at duodenum in 27 (90.0%), and at stomach in 3 cases (10.0%). Complications were perforation in 19 cases (63.3%), pyloric obstruction in 9 (30.0%) and bleeding in 2 (6.7%). For perforation, truncal vagotomy with pyloroplasty was done in 11 cases, truncal vagotomy with hemigastrectomy and gastrojejunostomy in 6, and simple closure in 2 cases. For obstruction, truncal vagotomy with hemigastrectomy and gastrojejunostomy was done in 5, and truncal vagotomy and pyloroplasty in 3 cases. For bleeding lesions, truncal vagotomy and pyloroplasty was performed in 2 cases. Ten postoperative complications developed in 9 patients; adhesive ileus in 5, recurrence in 2, pneumonia 2, and wound seroma 1 case. One patient developed a primary duodenal perforation and another a recurrent obstruction. Both of patients had symptoms for more than 3 years and were treated with truncal vagotomy and pyloroplasty for the primary operations. Hospital stay was 11.5 days for the patient with perforated ulcer, 11.0 days for the patient with pyloric obstruction, and 14.5 days for the child with bleeding. Average hospital period was 11.6 days. To reduce recurrences after operation, extensive procedure such as distal gastrectomy with vagotomy at the first operation should be considered in case with severe complication or with patients who have been symptomatic for long periods.
Adhesives ; Child* ; Duodenum ; Female ; Gastrectomy ; Gastric Bypass ; Hemorrhage ; Humans ; Ileus ; Jeollabuk-do ; Length of Stay ; Male ; Peptic Ulcer* ; Pneumonia ; Postoperative Complications ; Recurrence ; Schools, Medical ; Seroma ; Stomach ; Ulcer ; Vagotomy ; Vagotomy, Truncal ; Wounds and Injuries

PURPOSE: Recurrence occurs in various forms and in different organs after a curative resection of gastric cancer. The most common location for hematogenous recurrence is the liver. The aim of this study was to evaluate the clinicopathological risk factors associated with hepatic recurrence after surgical treatment of gastric cancer. MATERIALS AND METHODS: We reviewed the medical records of 838 patients who had taken radical surgery for primary gastric cancers at Chonbuk National University Hospital between January 1992 and December 1999. According to the medical records, we retrospectively investigated the association between the clinicopathologic variables and hepatic recurrence. RESULTS: Recurrence of gastric cancer was documented in 201 out of the 838 patients (23.98%). Hepatic recurrences were found in 59 out of 201 patients (29.35%). Multiple logistic regression analysis identified the following as independent risk factors of hepatic recurrence: Lauren's Intestinal type (OR, 6.66; 95% CI, 1.53 to 28.9; p=0.011) and proximal resection of margin below 6 cm (OR, 3.76; 95% CI, 1.03 to 13.67; P=0.045). CONCLUSION: Various studies on clinocopathologic risk factors of liver recurrence with molecular biologic research should make possible the prediction of recurrence and help high-risk patients to find appropriate management.
Humans ; Jeollabuk-do ; Liver ; Logistic Models ; Medical Records ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Stomach Neoplasms*

PURPOSE: Recurrence occurs in various forms and in different organs after a curative resection of gastric cancer. The most common location for hematogenous recurrence is the liver. The aim of this study was to evaluate the clinicopathological risk factors associated with hepatic recurrence after surgical treatment of gastric cancer. MATERIALS AND METHODS: We reviewed the medical records of 838 patients who had taken radical surgery for primary gastric cancers at Chonbuk National University Hospital between January 1992 and December 1999. According to the medical records, we retrospectively investigated the association between the clinicopathologic variables and hepatic recurrence. RESULTS: Recurrence of gastric cancer was documented in 201 out of the 838 patients (23.98%). Hepatic recurrences were found in 59 out of 201 patients (29.35%). Multiple logistic regression analysis identified the following as independent risk factors of hepatic recurrence: Lauren's Intestinal type (OR, 6.66; 95% CI, 1.53 to 28.9; p=0.011) and proximal resection of margin below 6 cm (OR, 3.76; 95% CI, 1.03 to 13.67; P=0.045). CONCLUSION: Various studies on clinocopathologic risk factors of liver recurrence with molecular biologic research should make possible the prediction of recurrence and help high-risk patients to find appropriate management.
Humans ; Jeollabuk-do ; Liver ; Logistic Models ; Medical Records ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Stomach Neoplasms*

Previous studies have demonstrated an increase in bone mass and density with the use of bisphosphonate in osteoporosis. This agent acts as an inhibitor of osteoclastic activity, and results in increase of net osteoblastic activity. Currently, it has been reported that bisphosphonate has direct effect on osteoblast. This study was designed to evaluate the effect of alendronate on bone regeneration in defect of rat calvaria. The animals used for these experiments were 48 male rats, over 6-8 weeks old. They were divided into three groups according to the dose of alendronate(MK-217(R), Merck, USA) administered. After the calvarial defects were surgically created, the rats received a peritoneal alendronate(0.25mg/kg) in group I, a peritoneal alendronate(1.25mg/kg) in group II, and a peritoneal normal saline injection in the control group. Three and six weeks later, blood was sampled and evaluated for alkaline phosphatase activity. The animals were sacrificed for histological observation and histometric analysis of the level of bone formation. The alkaline phosphatase activity was similar in three groups at 3 weeks of experiment. The activity at 6 weeks increased more than twice, compared to 3 weeks, and was slightly higher in group I than the other two groups. In histological observation, all the groups at 3 weeks, osteoblast rimming and new bone formation were observed along the defect margin. At 6 weeks, the defect was almost closed with new and more mature bone, but new bone is thinner than original bone in the central portion of defect. In histometric analysis, group I and II at 3 weeks showed significantly greater new bone formation than the control, and all the groups at 6 weeks showed similar amount of bone formation. These result suggest that alendronate administration in the dose of 0.25mg/kg and 1.25mg/kg promote osseous regeneration.
Alendronate* ; Alkaline Phosphatase ; Animals ; Bone Regeneration* ; Humans ; Male ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Osteoporosis ; Rats* ; Regeneration ; Skull*

OBJECTIVE: To evaluate the epidemiological data of stroke patients admitted to Dong-Eui Hospital. METHOD: We performed a prospective study on 1370 cases of stroke consecutively admitted to the hospital from June, 2001 to May, 2002 during hospitalization by medical records and questionaire. RESULT: The highest incidence of the stroke was noted in the group of 60 years of age. The proportion of stroke subtypes were infarct (75.2%), intracranial hemorrhage (21.2%), and subarachnoid hemorrhage (3.6%). Sixteen percents of patients arrived over 24 hours after onset of stroke. The seasonal incidence was in order of frequency of spring, winter, autumn, and summer. The highest occurrence of the stroke was noted in May. The onset time of stroke was highest between 7: 00 am and 8: 00 am. Risk factors in stroke by the order of frequency were hypertension (61.1%), abnormal EKG at admission (45.5%), hyperlipidemia (38.3%), smoking (36.6%), previous stroke history (24.7%), and diabetes mellitus (24.7%). The common complications during hospitalization were pneumonia (7.6%), gastritis (5.6%), depression (4.8%), and hepatitis (4.6%). CONCLUSION: Although the results of this study obtained from one local hospital in Korea, they are valuable as basic epidemiologic data of stroke for the rospective community- based study in the future.
Depression ; Diabetes Mellitus ; Electrocardiography ; Epidemiology ; Gastritis ; Hepatitis ; Hospitalization ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Intracranial Hemorrhages ; Korea ; Medical Records ; Pneumonia ; Prospective Studies ; Risk Factors ; Seasons ; Smoke ; Smoking ; Stroke* ; Subarachnoid Hemorrhage

This prospective study was performed to determine the effective antibiotics for use in treating acute appendicitis patients during the perioperative period. To identify the sensitive antibiotics, the peritoneal fluid was cultured during operation. Also, wound infection was defined as pus or serous discharge in the wound or when we opened the wound under suspicious of a wound problem. The results were obtained as follows: 1) A total of 138 cases treated during the two years from January 1995 to December 1996 were examined; 84 of them (60.87%) were found to have positive peritoneal fluid cultures, of which 29 (34.52%) were monomicrobial and 55 (65.48%) were polymicrobial. 2) The most common species were Escherichia coli (73.81%), Bacteroides (32.14%), Klebsiella (16.67%), Pseudomonas (9.52%), and Streptococcus (9.52%). 3) In the sensitivity test, the most sensitive drugs were aminoglycosides and cefotaxime. 4) Infectious complications, which developed in 27 (19.6%) patients, were wound infection and intraabdominal abscess. 5) The average length of stay for all patients 9.9 days (range: 3 to 32 days). 6) The common organisms curtured from the complication cases were E. coli and Bacteroides.
Abscess ; Aminoglycosides ; Anti-Bacterial Agents* ; Appendicitis* ; Ascitic Fluid ; Bacteroides ; Cefotaxime ; Escherichia coli ; Humans ; Klebsiella ; Length of Stay ; Perioperative Period ; Prospective Studies ; Pseudomonas ; Streptococcus ; Suppuration ; Wound Infection ; Wounds and Injuries