BACKGROUND: Recently developed electrically stimulated gracilis neosphicter or artificial sphincter is quite a promising trial in fecal incontinence However, surgical technique is not simple, the devices are expensive and only specialists can perform the procedures successfully. The aim of this study is to evaluate the efficacy of a newly developed simple silicon device in incontinent dog model. METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured extemal balloon surrounding the internal balloon, a connecting tube disposed under the both infernal and external balloons and supply tube containing a pair of air passages and an enema fluid passage. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 22~26 kg of body weight were prepared. Anal incontinence was made by bilateral severing of the internal and external sphincters and puborectalis muscle under the general anesthesia. Marlex mesh ring was applied to the anal canal as Thiersch wire for the prevention of NCD expulsion in straining. After then, NCD with 2.5 cm of luminal diameter was inserted to the rectum proximal to the Malex mesh ring. Daily irrigation and evacuation was done with 800~1000 cc of tepid water in each dogs. Daily food contained 30 gm of Psyllium dextrose. RESULTS: Initially 6 dogs were observed for 7 days. Daily irrigation made evacuation of fecal matter well in each dogs. There was no prolapse of device through the anal orifice. Anoscopic examination after 7 days showed no rectal and anal mucosal injury. Two dogs were kept for 40 days as same manner. Sometimes spontaneous bowel movement without water irrigation was noted when the stool were loose. Weelky anoscopic examination revealed no evidence of mucosal injuries for 40 days also. There was no septic or other complication. CONCLUSION: NCD evacuated fecal matter well enough to empty the rectum in all incontinence dog model. Adequate sized NCD could be used for clinical trials in selected incontinence patients.
Anal Canal ; Anesthesia, General ; Animals ; Body Weight ; Colostomy* ; Dogs* ; Enema ; Fecal Incontinence ; Glucose ; Human Body ; Humans ; Phenobarbital ; Polypropylenes ; Prolapse ; Psyllium ; Rectum ; Silicones ; Specialization ; Water

The cystic lesions within the knee joint are rare, contrary to those located around the knee. They usually are eniscal or ganglion cyst, reported in association with the joint capsule of the knee or the menisci and close to the peroneal tendons. The intraarticular ganglion cyst arising from the cruciate ligaments are rare and cause pain, effusion and limitation of the knee joint. We report (he case of a patient with right knee joint pain caused hy an intraarticular ganglion cyst arising from the posterior cruciate ligament with review of reference.
Ganglion Cysts* ; Humans ; Joint Capsule ; Knee ; Knee Joint ; Ligaments ; Posterior Cruciate Ligament* ; Tendons

No abstract available.
Classification* ; Dermatoglyphics* ; Yersinia*

PURPOSE: CD24 is a small heavily glycosylated glycosyl- phosphatidylinositol-linked cell surface protein expressed in hematological malignancies as well as a large variety of solid tumors. It appears to function as a ligand of P-selectin, an adhesion molecule present in activated platelets and endothelial cells. The authors aimed to evaluate the expression of CD24 in adenomas and adenocarcinomas of the stomach and its correlation to clinicopathological data. METHODS: A series of 48 adenocarcinoma cases (advanced gastric carcinoma: 24 cases, early gastric carcinoma: 24 cases) and 12 adenoma cases of the stomach were immunohistochemically stained for correlation with the clinicopathological data. The staining was evaluated as stainability (negative, weak-, moderate-, strong-positive) and staining patterns (membranous vs. intracytoplasmic), which were used for statistical analyses. RESULTS: The present study clearly demonstrated that the stainability of CD24 expression increased with positive nodal status in advanced gastric carcinomas (P<0.005). The stainability of CD24 in the adenocarcinoma group was much higher than in the adenoma group, but this was not statistically significant. Intracytoplasmic CD24 expression was demonstrated only in the adenocarcinoma group, with the exception of the adenoma group, but this also was not statistically significant. CONCLUSION: The authors conclude that the stainability of CD24 could be a molecular marker for gastric adenocarcinomas which could help to predict lymphogenous metastasis.
Adenocarcinoma* ; Adenoma ; Endothelial Cells ; Hematologic Neoplasms ; Neoplasm Metastasis ; P-Selectin ; Stomach

Although MDR was previously thought to be predominantly caused by the expression of the MDR1 gene, it is now increasingly believed to be caused by other mechanism. Recently, over-expression of the multidrug resistance-associated protein (MRP) was suggested a possible mechanism for non-Pgp mediated MDR. Recent studies showed that MRP can confer resistance to a wide spectrum of natural product drug, but the clinical relevance of MRP-mediated MDR in human cancer is poorly understood. p53 is the most widely known tumor suppressor gene. It has been suggested that mutant p53 is related to abnormal proliferation of cell and some what is been related to cellular apoptosis. To determine the clinical significance of MRP and/or p53 expression in colorectal carcinoma, the authors investigated the expression of the MRP and p53 in 81 cases of primary colorectal carcinoma, the relationship between the MRP and/or p53 expression and clinical parameters including 5-yr. survival rate, and the relationship between the expression of MRP and p53. The results were as follows: 1) Of the 81 colorectal carcinomas, 36 (42%) were MRP positive and 28 (34%) were p53 positive. 2) The expression of MRP and/or p53 was not significantly correlated with sex, age, histologic grades, tumor invasion, tumor location, tumor size, lymph node metastasis, TNM stage and survival of patients. In conclusion, these results suggest that expression of MRP and/or p53 is neither related to the known prognostic factors nor a prognostic factor by itself.
Apoptosis ; Colorectal Neoplasms* ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Multidrug Resistance-Associated Proteins ; Neoplasm Metastasis ; Prognosis ; Survival Rate

No abstract available.
Sinusitis*

No abstract available.
Foreign Bodies* ; Skull Base* ; Skull*

Aging processes are inevitably accompanied by structural and functional changes in vital organs. Skeletal muscle, which accounts for 40% of total body weight, deteriorates quantitatively and qualitatively with aging. Skeletal muscle is known to play diverse crucial physical and metabolic roles in humans. Sarcopenia is a condition characterized by significant loss of muscle mass and strength. It is related to subsequent frailty and instability in the elderly population. Because muscle tissue is involved in multiple functions, sarcopenia is closely related to various adverse health outcomes. Along with increasing recognition of the clinical importance of sarcopenia, several international study groups have recently released their consensus on the definition and diagnosis of sarcopenia. In practical terms, various skeletal muscle mass indices have been suggested for assessing sarcopenia: appendicular skeletal muscle mass adjusted for height squared, weight, or body mass index. A different prevalence and different clinical implications of sarcopenia are highlighted by each definition. The discordances among these indices have emerged as an issue in defining sarcopenia, and a unifying definition for sarcopenia has not yet been attained. This review aims to compare these three operational definitions and to introduce an optimal skeletal muscle mass index that reflects the clinical implications of sarcopenia from a metabolic perspective.
Aged ; Aging ; Body Mass Index ; Body Weight ; Consensus ; Diagnosis ; Humans ; Muscle, Skeletal* ; Prevalence ; Sarcopenia*

Gastrointestinal lipomas are rare and are most common in the right colon. They are in opposite distribution of predilection site in comparison to adenocarcinomas and adenomatous polyps. The peak incidence for lipoma of the large bowel is in the sixth decade when there is a high incidence of colorectal carcinoma. Because of their location and the age of the patients at presentation, large bowel lipomas are usually treated on the basis of a presumptive malignant diagnosis. A 79-year-old male is presented with a 1-year history of rectal bleeding. Colonoscopy demonstrated a pedunculated mass nearly obstructing the rectum. Anterior resection was performed. The mass consisted of submucosal lobulated mature fatty tissue with ulcerated mucosa. The authors describe a case of a submucosal lipoma of the rectum with review of literatures.
Adenocarcinoma ; Adenomatous Polyps ; Adipose Tissue ; Aged ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis ; Hemorrhage ; Humans ; Incidence ; Lipoma* ; Male ; Mucous Membrane ; Rectal Neoplasms ; Rectum* ; Ulcer

In the last decade, advances in laparoscopic equipments have allowed the development of laparoscopic surgical treatment for gynecologic affeetion. The purpose of this study is to investigate the cardiovascular effects and blood gas changes during laparoscope assisted vaginal hysterectomy (LAVH) in Trendelenburg position and intraabdominal CO2 insufflation to obtain optimal surgical field. Mean arterial pressure (MAP), heart rate. SaO2, PaO2, end-tidal CO2 (ETCO2) PaCO2, pH, and peak airway pressure (PAP) were measured in twenty patients who underwent laparoscope assisted vaginal hysterectomy in Trendelenburg position and intraabdominal CO2 insufflation. Each measurement was taken immedistely after intubation (control), 15 minutes after Trendelenburg position, 30 minutes after CO2 insufflation, 15 minutes, 1 hour and 6 hrs. after CO2 deflation. ETCO2 and PAP were not measured 1 hour and 6 hrs. after deflation The results were as follows; 1) Mean arterial pressure and heart rate were decreased after Trendelenburg position, but increased after CO2 insufflation. 2) Arterial O2 saturation was decreased after CO2 insufflation, 1 hour after deflation 3) Arterial PO2 was decreased after CO2 insufflation. 4) End-tidal CO2 was increased after CO2 insufflation. 5) Arterial PCO2 was increased after CO2 insufflation compared to control value, but it was decreased at 15 minutes after CO2 deflation. Arterial PCO2 at 1 hour after CO2 deflation was higher than at 15 minutes after CO2 deflation and 6 hrs. after CO2 deflation. 6) Arterial pH was decreased after CO2 insufflation. 7) Peak airway pressure was increased after Trendelenburg position and after CO2 insufflation.
Arterial Pressure ; Female ; Head-Down Tilt ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Hysterectomy, Vaginal* ; Insufflation ; Intubation ; Laparoscopes*