PURPOSE: We analyzed the oncological outcome and prognostic factor of the chondrosarcoma arising from benign bone tumor due to malignant transformation. MATERIALS AND METHODS: From April 1986 to April 2009, 18 cases were considered eligible. We analyzed retrospectively the patient's characteristics and prognostic factors that affect to the local recurrence and distant metastasis. RESULTS: As classified by primary benign bone tumor, 4 cases were solitary osteochondroma, 11 cases were multiple osteochondromatosis and 3 cases were multiple enchondromatosis. The mean follow-up period was 85 months. The 5-year disease free survival rate of 18 patients was 85.9%. Their overall MSTS score was 25.2 (84%). There were local recurrence in 3 cases and no distant metastasis. We found that tumor location and surgical margin affected to the prognosis significantly. CONCLUSION: In secondary chondrosarcoma patients, the prognosis was good relatively and tumor location and surgical margin are important prognosis factor.
Chondrosarcoma ; Disease-Free Survival ; Enchondromatosis ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteochondroma ; Osteochondromatosis ; Prognosis ; Recurrence ; Retrospective Studies

PURPOSE: Purposes of this study were to develop a community-based respite program for family caregivers and to test the effects of the program. METHODS: Focus group interviews were performed to extract meaning of respite care for family caregivers (13 participants) and a survey was done to identify respite needs of family caregivers (157 participants). The community-based respite program for family caregivers was developed based on results of the focus group interview and survey. The program was used with 41 participants (19 experimental and 22 control). Independent t-test and Mann-Whitney U-test were used to test differences between control and experimental groups for respite needs, burden of caregivers, subjective wellbeing, social support, fatigue and functional status of elders with dementia. RESULTS: There were statistical differences in caregiver burden, subjective wellbeing, and social support after the program, but, none for respite needs, fatigue and functional status of elders with dementia. CONCLUSION: The results indicate that a respite program can be useful to decrease burden of caregivers and increase subjective wellbeing and perceived social support of family caregivers in community settings. Further intervention research is needed to increase the functional status of elders with dementia and decrease fatigue in caregivers.
Caregivers ; Dementia ; Fatigue ; Focus Groups ; Humans ; Respite Care

PURPOSE: Respite care is not a discrete intervention, but encompasses a range of services. This research was conducted to clarify the phenomenon of respite care for family caregivers of elders with dementia from a nursing perspective. METHODS: The Hybrid Model of concept development was applied to clarify the concept of respite care for family caregivers of elders with dementia. The study was conducted in the following three steps, theoretical phase, fieldwork phase, and final analytic phase. RESULTS: The definition of respite care for family caregivers of elders with dementia was delineated through integration of data analyses in theoretical and fieldwork phase, and has three dimensions; tailored supports for caregivers, tailored supports based on physical and cognitive function of elders with dementia and community interventions related to family care function. CONCLUSION: Through this study, the concept of respite care for family caregivers of elders with dementia is clarified and reformulated as nursing practice phenomena in the Korean context, which indicates ways to develop caring practice forms for a family living with an elder with dementia in a community setting.
Caregivers ; Chimera ; Dementia ; Humans ; Respite Care ; Statistics as Topic

For the evaluation of the correlation between the ETCO2 and the PaCO2 in post-extubated spontaneously breathing patients, we tested 30 patients in recovery room with Salter Divided Nasal Cannula, which have permanent bamer in the face piece and a dual tubing set that allows end tidal sampling from one nare and oxygen delivery to the other. When the wave form of capnogram looked regular and normal, the value of ETCO2 was recorded and the arterial blood was taken from the radial artery to analize blood gas immediately. The results were as following; 1. The mean value of PaCO2 was 42.0+/-4.8 mmHg. 2. The mean value of P(ET)CO2 was 39.3+/-5.1 mmHg. 3. The value of P(ET)CO2 acquired with Salter Divided Nasal Cannula hase close positive correlation with the values of the PaCO2. (PaCO2=0.75 x P(ET)CO2+/-12.64, r=0.79, p<0.001)
Catheters* ; Humans ; Oxygen ; Radial Artery ; Recovery Room ; Respiration*

BACKGROUND: Cardiac atrium is an endocrine gland secreting a family of natriuretic peptides. The secretion of atrial natriuretic peptide(ANP) had been shown to be controlled by variable factors. The change in atrial dynamics have been considered as one of the most prominent stimuli for the stimulation of ANP secretion. Hypoxic stress has been shown to increase cardiac ANP secretion. However, the mechanism by which hypoxia increases ANP secretion cardiac ANP secretions. However, the mechanism by which hypoxia increases ANP secretion has not to be defined. Therefore, the purpose of the present study was tow-fold: to develop a protocol to defined the effect of hypoxia on ANP secretion in perfused beating rabbit atria and to clarify the mechanism responsible for the accentuation by hypoxia of ANP secretion. MATERIAL AND METHOD: Experiments have been done in perfused beating rabbit atria. ANP was measured by radioimmunoassay. RESULT: Hypoxic stimulus with nitrogen decreased atrial stroke volume. The decrease in atrial stroke volume recovered basal level during the period of recovery with oxygen. ANP secretion and the concentration of perfusate ANP in terms of extracellular fluid(ECF) translocation which reflects the rate of myocytic release of ANP were increased by hypoxia and returned to basal levels during the recovery. Changes in ECF translocation paralleled by hypoxia and returned to basal levels during the recovery. Changes in ECF translocation paralleled to that of atrial stroke volume. At the start of recovery in atrial storke volume, ECF tranalocation incrased for several minutes. The above responses were stable and reproducible. Glibenclamide treatment prevented the recovery in atrial stroke volume. Increments by hypoxia of ANP secretion and ANP concentration were suppressed by glibenclamide. CONCLUSIONS: These results indicate that hypoxia incrased atrial myocytic ANP release and that the mechanism responsible for the accentuation is partially related to the change in K+ATP channel activity.
Anoxia ; Atrial Natriuretic Factor* ; Endocrine Glands ; Glyburide ; Heart Atria ; Humans ; Natriuretic Peptides ; Nitrogen ; Oxygen ; Radioimmunoassay ; Stroke Volume

OBJECTIVE: To evaluate the learning curve of laparoscopic radical hysterectomy (LRH) for gynecologic oncologists who underwent residency- and fellowship-training on laparoscopic surgery without previous experience in performing abdominal radical hysterectomy (ARH). METHODS: We retrospectively reviewed 84 patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB cervical cancer who underwent LRH (Piver type III) between April 2006 and March 2014. The patients were divided into two groups (surgeon A group, 42 patients; surgeon B group, 42 patients) according to the surgeon with or without ARH experience. Clinico-pathologic data were analyzed between the 2 groups. Operating times were analyzed using the cumulative sum technique. RESULTS: The operating time in surgeon A started at 5 to 10 standard deviations of mean operating time and afterward steeply decreased with operative experience (Pearson correlation coefficient=-0.508, P=0.001). Surgeon B, however, showed a gentle slope of learning curve within 2 standard deviations of mean operating time (Pearson correlation coefficient=-0.225, P=0.152). Approximately 18 cases for both surgeons were required to achieve surgical proficiency for LRH. Multivariate analysis showed that tumor size (>4 cm) was significantly associated with increased operating time (P=0.027; odds ratio, 4.667; 95% confidence interval, 1.187 to 18.352). CONCLUSION: After completing the residency- and fellowship-training course on gynecologic laparoscopy, gynecologic oncologists, even without ARH experience, might reach an acceptable level of surgical proficiency in LRH after approximately 20 cases and showed a gentle slope of learning curve, taking less effort to initially perform LRH.
Gynecology ; Humans ; Hysterectomy* ; Laparoscopy ; Learning Curve* ; Learning* ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Uterine Cervical Neoplasms

Metallothionein (MT) is a cadmium binding protein that played major' roles in protective mechanism for cadmium toxicity. In the present study, competitive ELISA was established to assay the MT expression utilizing monospecific antibody which was generated against MT-L A total of 10 Sprague-Dawley rats was injected with CdCl2 for two weeks to induce MT. The cytosolic fraction of rat liver was obtained by differential centrifugation. Two major MT isozymes (MT-I & MT-II) at ca. 10 kDa were purified by Sephadex G-75 gel filtration followed by DEAE-Trisacryl-M anion exchange column chromatogra-phy, respectively. Two rabbits were immunized 4 times consecutively with the conjugate of purified MT-L The sera were collected by heart puncture. When immunoblot was carried out, the immunized rabbit sera (anti-MT-I) exhibited specific immunoreactive band at MT-I while showed any cross reactions neither with MT-II nor with other cytosolic proteins.. By chequerboard titration using the monospecific antibody, the competitive ELISA was established. The dose-dependent relationship was observed between anti-MT-I antibody and the amount of MT in biological samples (r(2)=O.9980). These results suggested strongly that competitive ELISA is a simple, rapid and reproducible method for screening cadmium exposure.
Animals ; Cadmium Chloride ; Cadmium* ; Carrier Proteins ; Centrifugation ; Chromatography, Gel ; Cross Reactions ; Cytosol ; Enzyme-Linked Immunosorbent Assay* ; Heart ; Isoenzymes ; Liver ; Mass Screening ; Metallothionein* ; Punctures ; Rabbits ; Rats ; Rats, Sprague-Dawley

Metallothionein (MT) is a cadmium binding protein that played major' roles in protective mechanism for cadmium toxicity. In the present study, competitive ELISA was established to assay the MT expression utilizing monospecific antibody which was generated against MT-L A total of 10 Sprague-Dawley rats was injected with CdCl2 for two weeks to induce MT. The cytosolic fraction of rat liver was obtained by differential centrifugation. Two major MT isozymes (MT-I & MT-II) at ca. 10 kDa were purified by Sephadex G-75 gel filtration followed by DEAE-Trisacryl-M anion exchange column chromatogra-phy, respectively. Two rabbits were immunized 4 times consecutively with the conjugate of purified MT-L The sera were collected by heart puncture. When immunoblot was carried out, the immunized rabbit sera (anti-MT-I) exhibited specific immunoreactive band at MT-I while showed any cross reactions neither with MT-II nor with other cytosolic proteins.. By chequerboard titration using the monospecific antibody, the competitive ELISA was established. The dose-dependent relationship was observed between anti-MT-I antibody and the amount of MT in biological samples (r(2)=O.9980). These results suggested strongly that competitive ELISA is a simple, rapid and reproducible method for screening cadmium exposure.
Animals ; Cadmium Chloride ; Cadmium* ; Carrier Proteins ; Centrifugation ; Chromatography, Gel ; Cross Reactions ; Cytosol ; Enzyme-Linked Immunosorbent Assay* ; Heart ; Isoenzymes ; Liver ; Mass Screening ; Metallothionein* ; Punctures ; Rabbits ; Rats ; Rats, Sprague-Dawley

Dextran 40, a polysaccharide with molecular weight of 40,000, has been used clinically for expansion of plasma volume, improvement of microcirculation in low flow states and thromboprophylaxis especially in major operation such as vascular and hip surgery. However severe anaphylactoid reaction to dextran 40 can occur rarely. We experienced a case of cardisc arrest due to a severe reaction of dextran 40 in a patient who underwent aortofemoral bypass surgery. The patient was resuscitated immediately and followed up carefully.
Dextrans* ; Heart Arrest ; Hip ; Humans ; Microcirculation ; Molecular Weight ; Plasma Volume

An anesthesiologist should keep in mind the various risk factors during anesthetic man- agement of geriatric patients. Unlike young patients, elderly patients may manifest more than one pathophysiologic process associsted with progressive degenerative changes in various organs. The successful anesthetic management requires detailed information about the cause and severity of the underlying disease, thorough understanding of geriatric specific hemodynamic particularities, and more careful monitoring by experienced personnel. We experienced a case of profound hypotension during general anesthesia for vaginal hysterectomy in a 67 year-old female patient. Anesthesia was induced with thiopental-vecuronium and was maintained with nitrous oxide, oxygen and enflurane. One hundred and five minutes after the induction, profound hypotension and bradycardia with S-T segment depression developed without specific events and were corrected by vigorous therapeutic managements. She discharged from the hospital on 7th postoperative day without complications.
Aged ; Anesthesia ; Anesthesia, General ; Bradycardia ; Depression ; Enflurane ; Female ; Geriatrics ; Hemodynamics ; Humans ; Hypotension* ; Hysterectomy, Vaginal* ; Nitrous Oxide ; Oxygen ; Risk Factors