PURPOSE: Laparoscopy-assisted distal gastrectomy (LADG) is gaining wider acceptance for the treatment of early gastric cancer. However, firm evidence supporting the long-term outcome after LADG for gastric cancer is unknown. This study compared long-term quality of life after LADG versus an open distal gastrectomy (ODG) for early gastric cancer. METHODS: This study included 29 patients who underwent LADG and 57 patients who underwent ODG for the treatment of stage I gastric cancer. Quality of life was evaluated based on the Korean version of EORTC QLQ-C30 (version 3.0) and EORTC QLQ-STO22 one year after surgery. All patients underwent a Billroth II gastrectomy for stage I gastric cancer between January 2003 and December 2004. RESULTS: A total of 86 (58%) out of 154 patients responded to the questionnaire. Demographic features showed no difference between the two groups of patients for age, sex, depth of invasion, lymph node metastasis except for tumor size and the number of retrieved lymph nodes. The mean score for global health status was not statistically different (LADG, 60.3+/-20.4 vs ODG, 57+/-20.6; P=0.413). The total score of 21 items related to stomach cancer (EORTC QLQ-STO22) also was not statistically different (LADG, 68.9+/-64.9 vs ODG, 94.5+/-97.3; P=0.340). CONCLUSION: Based on the results of the Korean version of EORTC QLQ-C 30 (version 3.0) and EORTC QLQ-STO22, LADG does not seem to have any long-term benefit over ODG on 'quality of life'.
Gastrectomy* ; Gastroenterostomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Quality of Life* ; Surveys and Questionnaires ; Stomach Neoplasms

Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.
Angioplasty, Balloon ; Arteries ; Edema ; Humans ; Iliac Vein ; Leg ; May-Thurner Syndrome* ; Phlebography ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis

BACKGROUND: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigated the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. METHOD: 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. RESULT: Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure(PImax) was also significantly lower in the depleted group(p<0.05). CONCLUSION: We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.
Body Weight ; Electric Impedance ; Forced Expiratory Volume ; Humans ; Korea ; Mortality ; Nutritional Status* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Residual Volume ; Total Lung Capacity ; Vital Capacity ; Weight Loss

The purpose of this study was to observe the variation of malondialdehyde (MDA), an indirect index of oxidative damage, following 4-week of head-down suspension (HDS) at -45degreein rats as a model of simulated weightlessness. We also measured the activities of antioxidant enzymes, such as superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase for clarifying the mechanisms of renal oxidative damage. MDA was increased (p<0.05) at the 4th week of HDS rats compared to control horizontal positioned rats. Following HDS, the renal activity of SOD was also significantly increased (p<0.01) at the 4th week of HDS whereas the changes of renal GSH-Px and catalase activities were not significantly different from controls. The expression of renal SOD mRNA used by polymerase-chain reaction method showed the similar pattern with the change of renal SOD activity and was more increased (p<0.05) than control horizontal positioned rat. These results indicate that simulated weightlessness induces the augmented SOD gene expression in the kidney which results in increased SOD activity, and thus increased production of MDA due to increased production of hydrogen peroxide. And under this condition, GSH-Px and catalase do not play their protective roles against hydrogen peroxide.
Animals ; Catalase ; Gene Expression ; Glutathione Peroxidase ; Hydrogen Peroxide ; Kidney ; Malondialdehyde ; Rats* ; RNA, Messenger ; Superoxide Dismutase ; Weightlessness

PURPOSE: Previous studies have outlined mechanisms by which Mycoplasma pneumonia (M. pneumonia) infection may promote allergic lung inflammation and airway remodeling, and increasing evidence from human studies suggests that atypical bacterial infections contribute to asthma exacerbation, chronic asthma, and disease severity with changes in cytokine expression. The present study evaluated changes in serum levels of vascular endothelial growth factor (VEGF) and interleukin (IL)-5 in atopic children with Mycoplasma pneumoniae pneumonia. METHODS: We recruited a total of 72 children with pneumonia. The patients were divided into 4 groups: atopic children with M. pneumonia pneumonia (group I, n=24), non-atopic children with M. pneumonia pneumonia (group II, n=23), atopic children with viral pneumonia (group III, n=13), and non-atopic children with viral pneumonia (group IV, n=12). Serum levels of IL-5, IL-13, VEGF, and tumor necrosis factor-alpha were measured at admission and at recovery using enzyme-linked immunosorbent assays. RESULTS: Serum levels of VEGF and IL-5 were elevated in group I compared with the other groups at both admission phase and clinical recovery phase. In group I, serum levels of VEGF and IL-5 were higher at recovery phase than at admission phase (VEGF: 1,102.2+/-569.4 vs. 874.9+/-589.9 pg/mL, respectively; IL-5: 150.5+/-63.9 vs. 120.2+/-46.7 pg/mL, respectively). CONCLUSIONS: The serum levels of VEGF and IL-5 were more increased in atopic children with M. pneumonia pneumonia than in the other groups. In this group, the serum levels of VEGF and IL-5 were more increased at recovery phase than at admission phase. The results of this study suggest that increases in VEGF and IL-5 may contribute to the development of hypersensitivity during M. pneumonia infection. These cytokines may act through their respective pro-inflammatory pathways to aggravate the allergic status and induce airway hypersensitivity during M. pneumonia pneumonia in atopic children.
Airway Remodeling ; Asthma ; Bacterial Infections ; Child ; Cytokines ; Humans ; Hypersensitivity ; Interleukin-13 ; Interleukin-5 ; Interleukins ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Pneumonia, Viral ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

BACKGROUND: Despite of numerous researches on the mechanisms and new therapeutic methods of chronic pain, patients are still suffering even with the help of opioids. In recent years, however, with the development of molecular-biology cell transplantation gives us a new chance for treating intractable chronic pain. The major purpose of the present study was to determine if the chromaffin cells have robust analgesic effects in the spinal atlanto-occipital subarachnoid space even without nicotine stimulation. METHODS: In order to determine whether cultured bovine adrenal medullary chromaffin cells transplanted in the spinal cord can produce analgesic effects, we purified adrenal medullary chromaffin cells and implanted them into the subarachnoid space of rats' (n = 10) spinal cord without immunosuppression, and investigated the hot sensitivity of rats' hind-paw by a light-beam test. RESULTS: It was found that compared with the control group, hot response latency of the group which received adrenal medullary chromaffin cells had increased at 14 days and the analgesic efficacy was maintained for at least 3 months. CONCLUSIONS: Adrenal medullary chromaffin cells transplanted in the rats' spinal cord may provide a permanent and locally available source of neuropeptides for the relief of intractable pain. Furthermore, these kinds of analgesic effect even produced without any stimulation such as nicotine.
Analgesics, Opioid ; Animals ; Cell Transplantation ; Chromaffin Cells* ; Chronic Pain ; Humans ; Immunosuppression ; Neuropeptides ; Nicotine ; Pain, Intractable ; Rats* ; Reaction Time ; Spinal Cord* ; Subarachnoid Space ; Transplants

Gastric stump cancer is defined as cancers that develop in the gastric remnant after the gastric resection of nonmalignant lesions or malignant lesions. The interval between gastrectomy and the detection of gastric stump cancer must be over 5 years in nonmaligant lesions and 10 years in malignant lesions. Symptoms of gastric stump cancer are not specific, so, diagnosis is often delayed. Early detection and curative operation is very important in gasric stump cancer and follow-up endoscopic examination is the most importaint diagnostic tool to detect gastric stump cancer. Recently we experienced a case of early gastric stump cancer. We report review of the literature to remind the important of gastric stump cancer and the important of follow-up endoscopic examination.
Diagnosis ; Esophagus* ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump* ; Intestines* ; Stomach*

PURPOSE: To evaluate the therapeutic effectiveness of absolute ethanol and gelfoam particles and the degree of vascular recanalization after gelfoam embolization. MATERIALS AND METHODS: Transcatheter renal arterial embolization(TRAE) was performal in 16 rabbits ; Eight were embolized with absolute ethanol, and eight with gelfoam particles. Of this total, three died less than one week after embolization. Pre- and post embolization angiographies at five minutes, one week, two weeks(gelfoam group only) and 5-6 weeks after embolization were performed. Six rabbits were sacrificed at one week, and seven at 5-6 weeks after embolization. Pathologic examination was performed. RESULTS: The ethanol group(n=6) showed complete occlusion of the main renal artery on follow-up angiography at one week and 5-6 weeks after embolization. The pathologic finding was complete total necrosis of embolized kidneys. The gelfoam group(n=7) showed partial recanalization of renal arteries in follow upangiography at one week, two weeks and 5-6 weeks after embolization. The pathologic finding was partial lysis ofgelfoam particles within intrarenal arteries. CONCLUSION: Absolute ethanol can be used as a permanent embolicagent and gelfoam as a temporary such agent in various clinical applications. Gelfoam, however, did not show complete recanalization on angiography and pathology at six weeks after embolization.
Angiography ; Arteries ; Ethanol* ; Gelatin Sponge, Absorbable ; Kidney ; Pathology ; Rabbits* ; Renal Artery

PURPOSE: Myoepithelioma is a rare tumor that originates exclusively from myoepithelial cells of the salivary glands, breast and the prostate. Myoepithelioma accounts for less than 1% of all salivary gland tumors. The objective of our study is to present our experience of the infra- auricular mass which was finally diagnosed as a myoepithelioma. METHODS: A 54-year-old woman was presented with a firm, movable, slow-growing infra-auricular mass with 3 cm in diameter. MRI scans and fine needle biopsy was performed for preoperative diagnostic study. A superficial parotidectomy was preceded and removed tumor successfully. RESULTS: Histopathological study revealed a myoepithelioma of plasmacytoid type. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor for 9 months follow- up period. CONCLUSION: Myoepithelioma in the parotid gland shows similar clinical courses and intraoperative finding to the pleomorphic adenoma and superficial parotidectomy was selective choice for treatment.
Adenoma, Pleomorphic ; Biopsy, Fine-Needle ; Breast ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Myoepithelioma* ; Parotid Gland* ; Prostate ; Recurrence ; Salivary Glands

BACKGROUND: In general, we know that a thoracic sympathicotomy may have influence an cardiac autonomic nervous activity to change vital signs. The purpose of this study was to analyse preoperative and postoperative heart rate variability to evaluate the influence of a sympathicotomy on cardiac autonomic activity. METHODS: We studied 14 healthy patients, ASA physical status I and II, undergoing an endoscopic thoracic sympathicotomy. A laryngeal airway mask was performed on all patients for tracheal intubation. Intravenous anesthesia was induced by administration of propofol 10 mg/kg, and fentanyl 2ng/kg and was maintained with propofol 10ng/kg/hr and N2O-O2 (2 L/min-2 L/min). An electrocardiogram was checked in the supine position with Biopac Student Lab. at an hour before anesthetic induction, after a left and right sympathicotomy and at 3 - 4 hours after emergence. A spike 2 version 3.0 was used for analyzing heart rate variability and a Fast Fourier Transform was used to yield a power spectrum. Frequency bands were divided to low frequency (0.02 - 0.09 Hz), middle frequency (0.1 - 0.15 Hz), and high frequency (0.16 - 1.0 Hz) components. RESULTS: There were no significant changes of heart rate, high frequency component, low frequency component and ratio of low to high frequency component. CONCLUSIONS: Influence of a thoracic sympathicotomy on cardiac autonomic activity was less in the supine position at rest. However, we think that the response of the cardiac autonomic activity to sympathetic stimulation like position change and exercise after a sympathicotomy may yield different results and studies about this must be done.
Anesthesia, Intravenous ; Electrocardiography ; Fentanyl ; Fourier Analysis ; Heart Rate* ; Heart* ; Humans ; Intubation ; Masks ; Propofol ; Supine Position ; Vital Signs