No abstract available.
Peptic Ulcer*

No abstract available.
Facial Nerve* ; Paralysis* ; Temporal Bone*

PURPOSE: The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. MATERIALS AND METHODS: The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used (5-fluorouracil and leucovorin, capecitabine, or tegafur/uracil). Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. RESULTS: Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. CONCLUSION: Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.
Chemoradiotherapy ; Deoxycytidine ; Fluorouracil ; Humans ; Leucovorin ; Lymphocyte Count ; Multivariate Analysis ; Pelvis ; Rectal Neoplasms ; Capecitabine

Intrathecal and epidural narcotics have been widely used since 1979 to relieve pain and provide postoperative analgesia. Ketamine hydrochloride, a potent analgesic and anesthetic, has also been studied to its usefulness in epidural administration for postoperative pain relief devoid of the respiratory depression caused by morphine. This study was performed to evaluate whether a large dose of ketamine is effective for postoperative pain relief and the results were compared with those of epidural morphine. Forty patients undergoing lower abdominal and extremity surgery were randomly assigned in two groups of twenty. No patient was receiving narcotics or analgesic at the time of study. The operative anesthesia was provided by continuous epidural anesthesia with 27 ml of 1.5% lidocaine with 1:200,000 epinephrine. Ketamine 30mg or morphine 3-4 mg was administered about 30 minutes before the end of operation through the epidural catheter respectively. Patients were monitored every 15 minutes during the first hour and every hour during first 24 hours. Pain complaint, respiratory rate, heart rate, blood pressure, SaO2 and potential side effects were recorded. The results were as follows; 1) Two cases in the ketamine group and nine cases in the morphine group did not need the additional analgesics after operation. The duration of pain relief in the ketamine group varied from 1.83 hour to over 48 hours (less than 3 hours in 50% of patients). Mean analgesic time in the morphine group was 28.3+/-5.6 hours. 2) Dissociative anesthesia with hypotension (one), sedation (fifteen), dizziness (seven), nausea (six) and vomiting (six) in the ketamine group, whereas nausea (nine), and vomiting (five) in the morphine group were developed. We conclude that ketamine 30 mg administered epidurally, which had a more central actions and less analgesic effect than morphine, is inadequate for postoperative pain relief after lower abdomimal and extremity surgery.
Analgesia ; Analgesics ; Anesthesia ; Anesthesia, Epidural ; Blood Pressure ; Catheters ; Dizziness ; Epinephrine ; Extremities ; Heart Rate ; Humans ; Hypotension ; Ketamine* ; Lidocaine ; Morphine ; Narcotics ; Nausea ; Pain, Postoperative* ; Respiratory Insufficiency ; Respiratory Rate ; Vomiting

PURPOSE: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. MATERIALS AND METHODS: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. RESULTS: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was"excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. CONCLUSION: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.
Animals ; Ankle ; Arthritis ; Dislocations ; Follow-Up Studies ; Humans ; Osteoarthritis ; Postoperative Complications ; Retrospective Studies

Relapsing polychondritis is an uncommon disease associated with inflammation in cartilaginous tissues throughout the body, particularly affecting the cartilaginous structures of ears, nose, joints, and respiratory tract. Several autoimmune diseases, including vasculitis, are associated with the concurrent relapsing polychondritis. However, ankylosing spondylitis primarily affecting the sacroiliac joints and spine is rare in patients with relapsing polychondritis. We report on a 54-year-old man with concurrently relapsing polychondritis and ankylosing spondylitis.
Autoimmune Diseases ; Ear ; Humans ; Inflammation ; Joints ; Middle Aged ; Nose ; Polychondritis, Relapsing* ; Respiratory System ; Sacroiliac Joint ; Spine ; Spondylitis, Ankylosing* ; Vasculitis

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*

PURPOSE: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. MATERIALS AND METHODS: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. RESULTS: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. CONCLUSION: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.
Academic Medical Centers ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. MATERIALS AND METHODS: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. RESULTS: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. CONCLUSION: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.
Academic Medical Centers ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms*