PURPOSE:This study was carried out to evaluate the relationship with other clinicopath ologic factors and prognostic significance of tumor microvessel density in colorectal car cinoma. MATERIAL AND METHODS: 71cases of primary colorectal carcinoma (Modified Astler-Coller stage B and C) were analysed retrospectively who underwent curative resection at Wonkwang university hospital from September, 1991 to September, 1993. Male was 39cases. Age under 60 years was 31cases. 5 year survival rates were 80% (50 cases) in stage B and 52.4% (21 cases) in stage C. Tumor microvessels were stained by immuno histochemical method using anti-CD31 on paraffine embedded tissues, and were counted within 10x objective field (about 0.74 mm2) in the area of the most intense neovascu larization. RESULTS: Mean microvessel Density (MVD) was 56.3+/-18.0 (range 19~128). MVD was 55.2 in 11 cases of nonrecurrent group and 73.5 in 10 cases of recurrent group in stage C (p=0.012). There was no significant association between MVD and other parameters such as age, sex, tumor location and size, CEA, lymph node metastasis, and survival. The 5 year survival rates of 33 cases of MVD< or =56 and 38 cases of MVD>56 were 84.9 and 60.5% respectively(p<0.05). 5 year survival rates of MVD< or =56 groups adjusted for age, sex, tumor location, differentiation, and recurrence were higher than those of >56 groups. 5 year survival rates of MVD < or =56 and >56 groups in stage C were 100% (5 cases) and 37.5% (16 cases) (p<0.05). CONCLUSION:Tumor microvessl density may have somewhat prognostic significance in colorectal carcinoma.
Colorectal Neoplasms* ; Humans ; Lymph Nodes ; Male ; Microvessels* ; Neoplasm Metastasis ; Paraffin ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: Hyperhomocysteinemia has been identified as an independent risk factor in arterial and venous thrombosis. Mutations in genes encoding methylenetetrahydrofolate reductase (MTHFR), involved in the metabolism of homocysteine, may account for reduced enzyme activity and elevated plasma homocysteine levels. In this study, we investigated the interrelation of MTHFR C677T genotype and level of homocysteine in patients with arterial and venous thrombosis. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 146 patients who were diagnosed as having arterial and venous thrombosis. We excluded patients diagnosed with atrial fibrillation. We examined routinely the plasma concentration of total homocysteine level and MTHFR C677T polymorphism for evaluation of thrombotic tendency in all patients. Screening processes of MTHFR C677T polymorphism were performed by real-time polymerase chain reaction. RESULTS: Investigated groups consisted of thrombotic arterial occlusion in 48 patients and venous occlusion in 63 patients. The distribution of the three genotypes was as follows: homozygous normal (CC) genotype in 29 (26.1%), heterozygous (CT) genotype in 57 (51.4%), and homozygous mutant (TT) genotype in 25 (22.5%) patients. There were no significant differences among individuals between each genotype group for baseline characteristics. Plasma concentration of homocysteine in patients with the TT genotype was significantly increased compared to the CC genotype (P<0.05). CONCLUSION: We observed a significant interaction between TT genotypes and homocysteine levels in our results. The results might reflect the complex interaction between candidate genes and external factors responsible for thrombosis.
Atrial Fibrillation ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Mass Screening ; Medical Records ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Plasma* ; Real-Time Polymerase Chain Reaction ; Retrospective Studies ; Risk Factors ; Thrombosis ; Venous Thrombosis

We studied the age of onset, occupation, inducing or aggravating factors, distribution of skin lesions in 153 patients and recall antigen test in 15 patients of seborrheic dermatitis. The results were as follows : l. Seborrhic dermatitis occurred most frequently at the third decade and the number of patients was 1(0.7%) in the first decade, 41(26.8%) in the second decade, 58(37.9 %) in the third decade, 29(l9.0%) in the fourth decade, 12(7.8%) in the fifth decade, 5(3.3%) in the sixth decade, 4(2.6%) in the seventh decade, and 3(1.9%) in the eighth decade 2. There was family history of seborrheic dermatitis in 40 patients(26.1%) 3. Of the occupations, 48 patients(31.4%) were clerks or office workers, 42 patients (27.5%) were housewives, 23 patients(15.0%) were laborers or factory workers, ll patients(7.2%) were students, 9 patients(5.9%) were managers, and 6 patients(3.9%) were drivers. 4. Inducing or aggravating factors were emotional stress in 75 patrents(49.0%), seasonal change in 53 patients(34.6%), sunlight in 23 patients(15.0%), foods in 15 patients(9.8%), upper respiratory tract infection in 14 patients(9.2%), menstruation in 9 patients(5.9%), and drinking of slcohol in 9 patients(5.9%). 5. I,esions occurred on the scalp in 128 patients(83.7%), on the face in 115 patients (75.2,l6), on the neck in 42 patients(27.5%), on the trunk in 29 patients(19.096), on the intertriginous areas in 12 patients(7.8%), and on the extremities in 6 patients(3.996), 6. The intensity and rate of delayed hypersensitivity reaction in 15 patients of seborrhic dermatitis(1.62+/-0.92mm, 28.67+26.4596) were not significantly decreased than those of control group(1.99+1.08mm, 39.23+/-22.34%) (p>0.05). Anergy and hypoergy were found in 10 patients(6796) with seborrheic dermatitis in contrast to 6 persons(4096) in control group.
Age of Onset ; Dermatitis ; Dermatitis, Seborrheic* ; Drinking ; Extremities ; Female ; Humans ; Hypersensitivity, Delayed ; Menstruation ; Neck ; Occupations ; Respiratory Tract Infections ; Scalp ; Seasons ; Skin ; Stress, Psychological ; Sunlight

BACKGROUND: Induced hypotension is effective in decreasing blood loss and providing better visibility in the surgical field. Extensive epidural block to T4 with intravenous infusion of low-dose epinephrine allows mean arterial pressure to 50 mmHg. We investigated the effects of hypotensive epidural anesthesia comparing with normotensive epidural anesthesia during total hip arthroplasty. METHODS: 40 patients scheduled for total hip arthroplasty under epidural anesthesia were randomly divided into two groups. In hypotensive group, 0.5% bupivacaine 20cc was injected into L1-2 epidural space and if sensory block reached to T4, then epinephrine 1~5 g/min was intravenously injected with continuous infusion pump. As a result, mean arterial pressure was maintained 50 mmHg, and heart rate, 55~80bpm. In normotensive group, 0.5% bupivacaine 20cc was injected into L4-5 epidural space, and sensory block reached to T8. Therefore blood pressure was maintained within 20% of preoperative baseline. RESULTS: There was apparent difference in blood loss between two groups (hypotensive group: 259 +/- 75 ml, normotensive group: 803 +/- 144*ml) (*:p<0.05). In addition, in the case of hypotensive epidral group, transfusion was not required and CVP, heart rate were not changed postoperatively. Cardiac, renal, and cerebral function were preserved too. CONCLUSIONS: Hypotensive epidural anesthesia with low dose of epinephrine infusion is safely lowering mean arterial pressure to 50 mmHg. This technique is associated with low blood loss, reduction in perioperative transfusion requirements, and has no side effects on CNS, liver, kidney and heart function.
Anesthesia, Epidural* ; Arterial Pressure ; Arthroplasty, Replacement, Hip* ; Blood Pressure ; Bupivacaine ; Epidural Space ; Epinephrine ; Heart ; Heart Rate ; Humans ; Hypotension ; Infusion Pumps ; Infusions, Intravenous ; Kidney ; Liver

PURPOSE: This study was intended to determine how the choice of music affects the physiological and psychological status of women college student during music therapy. METHODS: A nonequivalent experimental group pretest-posttest design was used. 19 out of 54 subjects were assigned to listen to their favorite music and 17 to their unfavorite music for 20 minutes using MP3 players and headphones. Anxiety, blood pressure, pulse and blood glucose levels of the subjects were measured before treatment. The data was analyzed by Mann-Whitney and Wilcoxon signed rank test using the SPSS/WIN 10.0 program. RESULTS: The result showed that systolic blood pressure, blood glucose and anxiety level decreased significantly in the favorite music group. however systolic blood pressure, pulse rate and anxiety level increased significantly in the unfavorite music group. The favorite music group showed a significantly higher level of satisfaction than the unfavorite music group. CONCLUSION: Choice of music affects the physiological and psychological status of an individual. Favorite music listening would enhance the effect of music therapy. Therefore, selection of music must be considered in light of the subject's preference and characteristics.
Anxiety ; Blood Glucose ; Blood Pressure ; Female ; Heart Rate ; Humans ; Light ; MP3-Player ; Music ; Music Therapy

PURPOSE: This study was intended to determine how the choice of music affects the physiological and psychological status of women college student during music therapy. METHODS: A nonequivalent experimental group pretest-posttest design was used. 19 out of 54 subjects were assigned to listen to their favorite music and 17 to their unfavorite music for 20 minutes using MP3 players and headphones. Anxiety, blood pressure, pulse and blood glucose levels of the subjects were measured before treatment. The data was analyzed by Mann-Whitney and Wilcoxon signed rank test using the SPSS/WIN 10.0 program. RESULTS: The result showed that systolic blood pressure, blood glucose and anxiety level decreased significantly in the favorite music group. however systolic blood pressure, pulse rate and anxiety level increased significantly in the unfavorite music group. The favorite music group showed a significantly higher level of satisfaction than the unfavorite music group. CONCLUSION: Choice of music affects the physiological and psychological status of an individual. Favorite music listening would enhance the effect of music therapy. Therefore, selection of music must be considered in light of the subject's preference and characteristics.
Anxiety ; Blood Glucose ; Blood Pressure ; Female ; Heart Rate ; Humans ; Light ; MP3-Player ; Music ; Music Therapy

No abstract available.
Endoscopy ; Gastrointestinal Hemorrhage*

BACKGROUND: Although drug eruption refers to a common dermatologieal condition, there are numerous setbacks in the diagnosis. In addition there are no annual average prevalence rates of drug eruptions according to time sequence in Korea. OBJECTIVE: This study attempts to detme the clinical features and causative drugs of drug eruptions, the diagnostic value of various skin tests and to evaluate the dome,stic annual average prevalence rate of drug eruptions according to time sequence. METHOD: 270 patients with drug eruptions were reviewed clinically. In 103 patients, intradennal, patch and scratch-patch tests were performed using suspected drugs. The annual average prevalence rate of drug eruptions was calculated from 10 different general hositals in Korea. RESULT: Exanthematous eruptions(49.3), fixed drug eruptions(30.1), and urticaria(10.0%) were the common types of drug eruptions. The common causative agents were antibiotics/antimicrobials, antipyretics(NSAIDs, and CNS depressants. 52 patients out of 103 had positive results after at least one skin test with suspected drugs. CONCLUSION: In our study, we were ahle to obtain somewhat meaningful results basnl on data from the combination of various skin tests. As a result, physicians need to prescrible drugs with care.
Central Nervous System Depressants ; Diagnosis ; Drug Eruptions* ; Humans ; Korea ; Prevalence ; Skin Tests* ; Skin*

BACKGROUND: The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of the radioallergosorbent test(RAST). The CLA permits quick, siultaneous detection of total and specific IgE in human serum up to 35 different allergens, as well as their semiquantitative concentrations into classes from 0(negative) to 4(very high). The CLA has shown sensitivity, specificity, and a good correlation with the RAST and also with skin pick testing. OBJECTIVE: The purpose of this study was to find the causatix llergens and to evaluate the clinical significance of CLA comparing the results of tbe CLA wi! h hose of the prick test in patients with chronic urticaria. METHODS: We performed the CLA with 35 allergens(MAST immunosunosystems, Inc., California, America) and the prick test with 51 allergens(Bencard Ltd., Bricantord, England) in 70 patients with chronic urticaria. The CLA detects the allergen-IgE reactic say the use of an enzyme-labeled anti-IgE and a coupled photoreagent mixture. lhe amount of the luminescent energy is measured by exposing a polarcid film and then semiquantitation is a sessed by using a densitometer. RESULTS: Except for those over the age of 60, all age-groups ealed a similar positive reaction to the CLA and prick test, but the positive reaction rate o the prick test(91.4%) was higher than that of the CLA(38.6%). The positive reaction rate oringle allergen and compound allergens was 10.0% and 28.6% in the CLA, but 10.0% and 81.4% in the prick test, respectively. In the CLA, the rate of positive reaction was 17(24.3%) in Dermatophagoides(D.) farinae, 15(21.4% ) in D. pteronyssinus, 5(7.1% ) in house dust, an 13(4.3%) in shrimp in that order. In the prick test, the rate of positive reaction was 39(55.7%) in house dust, 35(50.0%) in D. farinae, 29(41.4%) in D. pteronyssinus, and 21(30.0%) in haydrst(30.0%) in that order. The results of the CLA to 3 comrnon allergens showed a concordance rare of 67.6%, sensitivity of 34.3%, and specificity of 97.3% compared with those of the prick case. The levels of total IgE and eosinophils were elevated in 59(n=70, 843%) and in 5(n=56, 84.3%), respectively. CONCLUSION: The results of this study suggest that the CLA may be used as an alternative method for the diagnosis of chronic urticaria because it is and coiomic, safe, simple procedure with very high specificity and trelative low sensitivity, and is sirnilt. neously capable of testing to multiple allergens.
Allergens ; California ; Diagnosis ; Dust ; Eosinophils ; Humans ; Immunoglobulin E ; Luminescent Measurements* ; Sensitivity and Specificity ; Skin ; Urticaria*

Breast cancer is the second leading cause of cancer death in women. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. The purpose of the study is to analyze the results of breast reconstruction using free transverse rectus abdominis myocutaneous(TRAM) flap and to suggest the operative technique for more satisfactory results. 19 patients underwent immediate breast reconstruction from 1990 to 1998, and we experienced 2 cases of bilateral immediate reconstruction of breasts following mastectomy. We have performed the free TRAM flaps based on the deep inferior epigastric vessels using microvascular technique. TRAM flap included very small portion of rectus sheath and muscle-so called muscle sparing technique. So it reduced markedly donor site morbidity. The postoperative course of these cases was uneventful with minor complication. The free TRAM flap was an excellent method of immediate breast reconstruction using autogenous tissue and provided satisfactory outcome. The goals of the immediate breast reconstruction after mastectomy are to restore body image, to achieve near normal shape of breast, and to reduce the complications. This paper represents our experience of immediate breast reconstruction using free TRAM flap, and technical options to get more satisfactory result and reduce the complications. We think this method could be regarded as the first choice for immediate breast reconstruction.
Body Image ; Breast Neoplasms ; Breast* ; Female ; Humans ; Korea ; Mammaplasty* ; Mastectomy ; Rectus Abdominis* ; Tissue Donors