No abstract available.
Female ; Hysterectomy, Vaginal*

No abstract available.
Female ; Hysterectomy, Vaginal*

Objective To observe effects and mechanisms of insulin on reperfusion injury after cerebral ischemia.Methods Sixty-six male Wistar rats were used in this study.All rats were divided into 3 groups as treated group(A),control group(B) and random sham-operated group(C).Four-vessel occlusion was used to establish global cerebral ischemia reperfusion model in study groups.The treated group were divided into 5 groups(A1-A5) and intraperineally injected with biosynthetic human insulin 2 IU/(kg?d) and 50%glucose 2 g/(kg?d) for 7 days,the blood glucose was monitored in preoperative and postoperative 3,6,12,24 h,and the blood glucose was maintained between 3.5-6.5 mmol/L.These animals of control group were given with saline 2 mL/(kg?d) for 7 days in abdominal cavity.All the rats were killed in the seventh day,brain homogenate was collected for detection of neuron specific enolase(NSE)and nitric oxide(NO).The hippocampus was separated for observation of electronic microscope.Results Concentration of NSE in brain tissue in group C was significantly higher than that of group A and group B,while the level in group A was higher than that of group B.Concentration of NO in group C was lower than that of group A and group B while the level of NO in group A was significantly lower than that of group B.Electron microscope showed that the ultrastructure of sham-operated group was nearly normal,damage degree of hippocampal neuron and gliacyte and capillary was gradually worse from group A1,A2 to A4,the damage degree of group B1,B2 and B4 was serious and there was no difference among them.Conclusion Insulin can really promote recovery of the cerebral injury after ischemia reperfusion.

Pi-dan is a signifi cant conception,which comes from Inner Canon of Huangdi.From the vivid description of Pi-dan in Inner Canon of Huangdi,we consider that the formation and process of Pi-dan is equivalent to metabolic syndrome.They are have the same etiological factor:obesity,the same pathogenesis:abdominal fullness and interior heat,and they can result in diabetes,hypertension,hyperlipidemia,fat liver,gout and a series of severity vascular complication.The theory of Pi-dan exactly points out that obesity the original cause of metabolic syndrome,and suggests that early prevention and treatment for obesity is an important method to prevention metabolic syndrome and its complications.The main pathogenesis of Pi-dan is abdominal fullness and interior heat,and the main therapeutic methods are Xiaogaojiangzhuo,Kaiyuqingre,and Huoxuetongluo.

The catfish (Ictalurus punctatus) retinal neurons were investigated by using the intracellular recording techniques to analyze the function of the chloride ions in the light responses and the ionic mechanisms of the depolarizing actions by GABA. Experiments were performed in the superfused retina-eyecup preparation. The retina was exposed by exicising the cornea, iris, and vitreous. A piece of absorbent tissue with a hole large enough to expose the retina was centered over the eyecup to serve as a wick to draw off the superfusate. Diffuse light stimuli were generated by light-emitting diode positioned above the eyecup. The recordings were made with the use of borosilicate glass micropipettes fashioned from' omega dot' capillary tubing filled with 2 M potassium acetate. Voltage recordings were obtained using an amplifier and amplified signals were recorded on a storage oscillocope, penwriter, and a data recorder. In the catfish retina, the dark membrane potentials were depolarized and the light evoked responses were enhanced in the chloride"-free medium on the catfish horizontal cells. The amplitude of the light evoked potentials were increased by chloride free Ringer's solution on the ON- and OFF-bipolar cells. But the dark membrane potentials were hyperpolarized on the ON-bipolar cell and depolarized on the OFF-bipolar cells in the chloride free medium. The chloride free Ringer's solution changed the light response from ON-sustained to OFF-sustained without any change in amplitude on the ON-sustained cell. The depolarizing actions by GABA on the horizontal cells were maintained in chloride-free environment. But GABA did not abolished the light evoked potentials of the horizontal cell and the ON-sustained cell under the chloride free environment. The results suggest that chloride ion has important roles on the signal transmission of the dark periods in the catfish retina and the depolarizing actions by GABA on the neurons in the catfish retina might be chloride dependent.
Capillary Tubing ; Catfishes* ; Cornea ; Evoked Potentials ; gamma-Aminobutyric Acid ; Glass ; Ions* ; Iris ; Membrane Potentials ; Neurons ; Potassium Acetate ; Receptors, GABA ; Retina ; Retinal Neurons* ; Retinaldehyde*

Combined resection of the spleen during total gastrectomy for gastric cancer is usually performed to remove the lymph nodes adequately and thereby achieving surgical radicality. However there is still controversy whether a total gastrectomy combined with a splenectomy can improve the survival rate. The authors retrospectively analyzed 557 gastric cancer patients, who underwent total gastrectomy at the Department of Surgery of Yonsei University during the 7-year period between 1987 and 1993, in order to investigate the influence of combined resection of the spleen upon the patients' survival. The patients were followed until March 1996, and the rate of follow up was 90.6%. The number of cases in which the spleen was saved was 101(the spleen conservation group, SC) and the number of cases in which the spleen was resected was 431(the spleen resection group, SR). Twenty-five cases were excluded due to incomplete data. Among the 431 cases for whom splenectomy was done, 343 were cases in which spleen was the only organ removed other than the stomach (SOR). For the other 88 cases, at least 1 more organs were resected along with the stomach and the spleen(Sp combined). There were no significant differences in the clinical characteristics such as age, sex ratio, tumor size, depth of invasion, nodal stage, TNM stage and histological type between SC and SOR group. In terms of the nodes removed during operation, there was significant difference between the SC and the SOR groups. Also, the Sp combined group showed significant differences in terms of tumor size, depth, nodal stage, TNM stage, and removed nodes. The overall 5-yr survival rate for the spleen conservation group(SC, N=101) was 61.2% and the survival rates according to TNM stage were 94.0% for stage I, 94.1% for stage II, 30.0% for III, and 0.0% for stage IV. The overall 5-yr survival rate for the 343 patients with splenectomy(SOR) was 51.9%, and the survival rates according to TNM stages were 88.7% for stage I, 57.0% for II, 44.0% for III, and 10.8% for stage IV. The overall 5-yr survival rate for the 431 patients with splenectomies or with splenectomies and multiple organ resection(SR) was 48.2%, and the survival rates according to the stages were 88.2% for stage I, 60.2% for II, 41.5% for III, and 6.8% for stage IV. The overall 5-yr survival rate was higher in SC group than in the SOR or the SR groups, but there was no statistical significance to this difference (p>0.05). In a compared according to the TNM stage, the SC group showed better survival rates in the relatively early stages (I, II) than the SOR or the SR groups did; in advanced stages (III, IV), the SOR and the SR groups showed better survival rates than the SC group. However, there was no statistically significant differences in survival among the three groups. These results suggest that during a total gastrectomy, it may be better to save the spleen in early stages of gastric cancer and that it may be better to resect the spleen for adquate lymphadenectomy in grossly advanced stages. To identify statistical difference in survival, it might be necessary to perform a randomized prospective study.
Follow-Up Studies ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Retrospective Studies ; Sex Ratio ; Spleen* ; Splenectomy ; Stomach ; Stomach Neoplasms* ; Survival Rate

OBJECTIVE: Premorbid demographic backgrounds of injured individuals are likely to reflect more accurately the status of patients with traumatic brian injury (TBI) than clinical factors. However, the concrete study about the relationship between the demographic factors and neurocognitive function in TBI patients has not been reported. The object of this study was to evaluate the effect of premorbid demographic factors on the recovery of neurocognitive function following TBI. METHODS: From July 1998 to February 2007, 293 patients (male: 228, female: 65) with a history of head injury, who had recovered from the acute phase, were selected from our hospital to include in this study. We analyzed the effect of premorbid demographic factors including age, sex, educational level and occupation on the recovery of neurocognitive function in each TBI subgroup as defined by Glasgow Coma Scale (GCS) score. Intelligence and memory are components of neurocognitive function, and the Korean Wechsler Intelligence Scale (K-WAIS) and the Korean memory assessment scale (K-MAS) were used in this study. The results were considered significant at p<0.05. RESULTS: The higher level of education was a good prognostic factor for intelligence regardless of GCS score and younger age group showed a better result for memory with an exception of severe TBI group. In the severe TBI group, the meaningful effect of demographic factors was not noted by the cause of influence of severe brain injury. CONCLUSION: The demographic factors used in this study may be helpful for predicting the precise prognosis and developing an appropriate rehabilitation program for TBI patients.
Brain Injuries ; Craniocerebral Trauma ; Demography ; Glasgow Coma Scale ; Humans ; Intelligence ; Memory ; Occupations ; Prognosis

There has been considerable controversy over the prognosis of mucinous gastric enocarcinoma (MGC). In this study we analyzed the clinicopathologic fferences between MGC and non-mucinous gastric carcinoma (NMGC). In addition, e relationship between mucin content and other clinicopathologic variables, cluding prognosis in MGC, was also investigated. We reviewed 2118 patients th pathologically-confirmed gastric cancer who underwent gastrectomy at the partment of Surgery, Yonsei University College of Medicine, during the period tween Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric carcinoma th extracellular mucin (MGC) and 1988 patients had gastric carcinoma without tracellular mucin (NMGC). We placed the MGC patients into two groups according mucin content: mucin content involving over 50% of the tumor (dominant type, = 94) and mucin content involving less than 50% of the tumor area (partial pe, n = 36). The results were as follows: MGC was more common in males than GC. The size of the tumor in MGC (mean 5.3 cm) was larger than that of NMGC ean 4.4 cm). The patients with MGC had a higher incidence of Borrmann type IV GC: 16.1%, NMGC: 9.9%), more frequent serosal invasion (MGC: 75.4%, NMGC: .6%), lymph-node metastasis (MGC: 75.4%, NMGC: 50.7%), and peritoneal tastasis (MGC: 10.0%, NMGC: 3.5%) than patients with NMGC. The patients with C were more advanced in stage at the time of diagnosis and had a worse overall -year survival rate (44.9%) than patients with NMGC (54.7%). However, the -year survival rate according to the stage of MGC was similar to that of NMGC. ere were no significant differences between the mucin content and other thologic variables, including prognosis, i.e. similar biologic behavior tween dominant type MGC and partial type MGC. In conclusion, we suggest that C was more frequently diagnosed in advanced stage than NMGC with a poorer ognosis and that it is reasonable to consider the carcinoma with mucin content volving more than 30% of the tumor area as MGC.
Adenocarcinoma/pathology ; Adenocarcinoma/metabolism ; Adenocarcinoma, Mucinous/pathology* ; Adenocarcinoma, Mucinous/metabolism* ; Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Male ; Middle Age ; Mucins/metabolism ; Neoplasm Staging ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/metabolism*

A retrospective study of 2,603 patients with gastric cancer who underwent a gastric resection at Yonsei University Hospital from 1987 to 1994 was performed to evaluate the clinicopathological characteristics and survival rates of patients with gastric cancer. There were 1721 males and 882 females (ratio=2:1) with a mean age of 54 years (range=22~85 years). All patients underwent gastric resection with curative intent, but 199 patients (7.6%) had a palliative resection. The types of operations were a subtotal gastrectomy in 1,917 patients (73.6%) and a total gastrectomy in 686 patients (26.4%). A D2 or a more extended lymph-node dissection was performed in 2530 patients (97.2%), and only 73 patients (2.8%) had less extensive surgery. The postoperative mortality was 0.9%. The mean diameter of a tumor was 5.6 cm. The most common location of a tumor was the lower third of the stomach (49.4%). Borrmann type III (64.7%) was the most common gross type. The major histologic type was a tubular adenocarcinoma (76.3%). The overall 5-year survival rate was 66.5%. The 5-year survival rates according to the stage were 94.3% in IA, 90.5% in IB, 76.6% in II, 60.1% in IIIA, 38.7% in IIIB, and 12.9% in IV. In the univariate analysis, poor survival was closely related to increasing age, tumor location in the upper one third, larger tumor size, Borrmann type IV tumors, increasing pT and pN classifications, an advanced tumor stage, and perforance of a total gastrectomy. The multivariate analysis revealed that distant metastasis, lymph-node metastasis, depth of invasion, gross type, age, and type of resection were significant prognostic factors. In conclusion, the prognosis for gastric cancer after a gastrectomy has remarkably improved, and the most significant prognostic factors were distant metastasis, lymph node metastasis, and depth of invasion. Therefore, early diagnosis of gastric cancer and aggressive multimodal therapy, especially in patients with stage IIIB and IV tumors might improve the quality of life and the survival of the patients with gastric cancer.
Adenocarcinoma ; Classification ; Early Diagnosis ; Female ; Gastrectomy* ; Humans ; Lymph Nodes ; Male ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Quality of Life ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate*

OBJECTIVE: We investigated whether Disability Evaluation (DE) situations influence patients' neuropsychological test performances and psychopathological characteristics and which variable play a role to establish an explanation model using statistical analysis. METHODS: Patients were 536 (56.6%) brain-injured persons who met inclusion and exclusion criteria, classified into the DE group (DE; n = 300, 56.0%) and the non-DE group (NDE; n = 236, 44.0%) according to the neuropsychological testing's purpose. Next, we classified DE subjects into DE cluster 1 (DEC1; 91, 17.0%), DE cluster 2 (DEC2; 125; 23.3%), and DE cluster 3 (DEC3; 84, 15.7%) via two-step cluster analysis, to specify DE characteristics. All patients completed the K-WAIS, K-MAS, K-BNT, SCL-90-R, and MMPI. RESULTS: In comparisons between DE and NDE, the DE group showed lower intelligence quotients and more severe psychopathologic symptoms, as evaluated by the SCL-90-R and MMPI, than the NDE group did. When comparing the intelligence among the DE groups and NDE group, DEC1 group performed worst on intelligence and memory and had most severe psychopathologic symptoms than the NDE group did. The DEC2 group showed modest performance increase over the DEC1 and DEC3, similar to the NDE group. Paradoxically, the DEC3 group performed better than the NDE group did on all variables. CONCLUSION: The DE group showed minimal "faking bad" patterns. When we divided the DE group into three groups, the DEC1 group showed typical malingering patterns, the DEC2 group showed passive malingering patterns, and the DEC3 group suggested denial of symptoms and resistance to treatment.
Brain ; Brain Injuries ; Denial (Psychology) ; Disability Evaluation ; Humans ; Intelligence ; Malingering ; Memory ; MMPI ; Neuropsychological Tests