No abstract available.
Colorectal Neoplasms*

No abstract available.
Antigens, Viral, Tumor* ; Simian virus 40*

No abstract available.
DNA* ; Mucous Membrane* ; Ploidies* ; Stomach Neoplasms*

PURPOSE: The aim of this study was to estimate the prevalence of anatomic anal stenosis in patients with chronic anal fissure (CAF) and ascertain the results of lateral internal sphincterotomy (LIS) using a new calibrator. METHODS: Ninety-eight adults with CAF and a control group of 40 normal adults underwent anal calibration under spinal anesthesia. The calibrator was a conical design and the diameter was scaled in increments of 1 mm. The calibration was standardized and the reliability of it was assessed by two independent examiners for the same group (n=45). Confounding effects of age, sex, body weight, and height on the anal caliber were studied. The internal sphincter was divided to the level of the dentate line during LIS. RESULTS: The anal caliber was 34.6 +/- 1.4 mm (mean +/- SD) in the control group and 28.7 +/- 3.0 mm (mean +/- SD) in patients with CAF. Excellent correlation was obtained between the two examiners (r=0.958). The confounding effects of age, sex, body weight, and height were not significant. Therefore, anal stenosis was defined as when the measurement was 31 mm or below (mean-2SD of control value). Stenosis was present in 82 of 98 patients (84%) with CAF. Patients with stenosis had an anal caliber of 27.9 +/- 2.5 mm, with a range of 21 to 31 mm. Following LIS, 91 of 98 patients (93%) with CAF attained the normal range, two patients still had stenosis, and five patients had an anal caliber exceeding the normal value. CONCLUSIONS: Anatomic anal stenosis was found in 84% of the patients with CAF. Ninety three percent of these patients attained a normal anal caliber, 2 percent of the patients still had stenosis and 5 percent of the patients had an anal caliber exceeding the normal value after LIS.
Adult ; Anesthesia, Spinal ; Body Weight ; Calibration ; Constriction, Pathologic* ; Fissure in Ano* ; Humans ; Prevalence* ; Reference Values

Twelve patients with inflammatory bowel disease had been operated at the department of surgery, Chonnam University Hospital during the period from March 1988 to February 1997. In this study, we report on the operative cases regarding age, sex, symptoms, duration of disease, location of disease, preoperative diagnosis, operative indication, frequency of operation, histopathologic findings and follow up. The results were as follows: 1) The male to female ratio in ulcerative colitis was 1 : 1, and the mean age was 54.5 years. In Crohn's disease, male to female ratio was 2.3 : 1 and the mean age was 42.1 years. 2) The mean duration of symptoms in ulcerative colitis was 39 months and in Crohn's disease was 13.9 months. The common symptoms in ulcerative colitis were abdominal pain, bloody diarrhea, indigestion, weight loss and in Crohn's disease abdominal pain, palpable mass, weight loss, indigestion. Extraintestinal symptoms in Crohn's disease were cholelithiasis like symptom, anal fistula, anal fissure. 3) The involvement site in ulcerative colitis was large bowel only, but in Crohn's disease small bowel (50%), large bowel (20%), small and large bowel (30%) were involved. 4) Preoperative diagnosis in ulcerative colitis was accurate, but in Crohn's disease accurate diagnosis was made only in 20% and the other cases were operated under the impression of different diseases or conditions (intestinal tuberculosis (50%), bowel perforation (20%), mechanical ileus (10%)). 5) The indication of surgery in ulcerative colitis was intractability to medical treatment, on the other hand, in Crohn's disease most operative cases were made under the emergentconditions (bowel perforation, bowel obstruction, enterocutaneous fistula, abdominal mass). The frequency of operation in ulcerative colitis were two times in one case, three times in one cases. In Crohn's disease half of cases experienced two or three times of surgery. The method of operation in ulcerative colitis was total proctocolectomy with J-pouch ileoanal anastomosis. In Crohn's disease resection of diseased bowel segment was performed.
Abdominal Pain ; Cholelithiasis ; Colitis, Ulcerative ; Colonic Pouches ; Crohn Disease ; Diagnosis ; Diarrhea ; Dyspepsia ; Female ; Fissure in Ano ; Follow-Up Studies ; Hand ; Humans ; Ileus ; Inflammatory Bowel Diseases* ; Intestinal Fistula ; Jeollanam-do ; Male ; Rectal Fistula ; Tuberculosis ; Weight Loss

Colorectal carcinoma in patients under 40 years and over 70 years of age is unusual but not rare. The prognosis of these two groups, compared with remainder of patients, is thought to be unfavorable. From Jan. 1981 to Dec. 1997, 541 patients with primary colorectal cancer who were treated by surgical resection were analyzed retrospectively. They were divided into three age groups according to the age at admission, i.e. under 40 years, over 70 years and between 40 and 69 years(control group). Among three age groups, sex ratio, tumor characteristics(size, location , depth of invasion, lymph node metastasis, liver metastasis, peritoneal metastasis, histopathologic classification, stage, DNA ploidy pattern), serum CEA level and survival were compared and analyzed. The results were as follows: 1) In the young patient group(52 cases), female predominence, large tumor size, high proportion of mucinous adenocarcinoma in histopathologic classification, more frequent metastasis to regional lymph node, frequent peritoneal metastasis and high incidence in tumor location at transverse colon were noted(p<0.05). 2) In the elderly group(69 cases), deep invasion of tumor(T4) was noted (p<0.05). In addition, among them, concomittent diseases were presented in 25 patients(36%). They were diabetes(8), cardiac arrhythmia(4), old myocardial infarction(2), liver cirrhosis(5), COPD(3), previous cancer(3). 3) The 5-year survival rates of the young patient group and that of elderly patient group were lower than that of the other(p<0.01). 4) There was no significant differences in liver metastasis, tumor stage, DNA ploidy pattern, serum CEA level among three age groups.
Adenocarcinoma, Mucinous ; Aged* ; Classification ; Colon, Transverse ; Colorectal Neoplasms* ; DNA ; Female ; Humans ; Incidence ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Ploidies ; Prognosis ; Retrospective Studies ; Sex Ratio ; Survival Rate

BACKGROUND: Morphine has been commonly used for postoperative pain control. We measured plasma concentrations of morphine and compared the efficacy and safety of continuous epidural analgesia (CEA) using morphine-bupivacaine with intravenous patient controlled analgesia (IV-PCA) with morphine for 48 hrs after the end of the operation. METHODS: Nineteen patients undergoing Mile's operation were assigned to receive a morphine loading dose of 5 mg followed by IV-PCA with 0.1% morphine (IV-PCA group, n = 9) or a morphine loading dose of 2 mg and 0.125% bupivacaine 10 ml, followed by CEA with 0.004% morphine and 0.075% bupivacaine at a rate of 5 ml/hr (CEA group, n = 10). The plasma concentrations of morphine were measured and visual analog scales (VAS) for pain were recorded at 1, 6, 12, 24, and 48 hr postoperatively and the effects on respiration and any other side effects were noted. RESULTS: The mean maximal and minimal levels of plasma morphine were 40.2 +/- 21.2 ng/ml and 23.4 +/- 9.7 ng/ml for the IV-PCA group and 11.8 +/- 3.5 ng/ml and 8.2 +/- 1.9 ng/ml for the CEA group, respectively. Resting and dynamic pain scores were significantly lower in the CEA group than in the IV-PCA group. There were no significant differences for the effects on respiration and for any side effects between the two groups. CONCLUSIONS: We evaluated plasma concentrations of morphine with CEA using morphine-bupivacaine and IV-PCA using morphine for the postoperative pain control. The CEA group had better postoperative analgesia than that of the IV-PCA group and the incidence of side effects were not significantly different between the two groups.
Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Bupivacaine ; Humans ; Incidence ; Morphine ; Pain, Postoperative ; Plasma ; Respiration ; Weights and Measures

PURPOSE: This study was aimed to identify the effect of self-foot reflexology on the relief of premenstrual syndrome and dysmenorrhea in high school girls. METHOD: Study subjects was 236 women residing in the community, teachers and nurses who were older than 45 were recruited. Data was collected with self administered questionnaires from July 1st to August 31st, 2003 and analysed using SPSS/WIN 10.0 with Xtest, t-test, and stepwise multiple logistic regression at a significant level of =.05. RESULT: The breast cancer screening rate was 57.2%, and repeat screening rate was 15.3%. With the multiple logistic regression analysis, factors associated with mammography screening were age and perceived barriers of action, and factors related to the repeat mammography screening were education level and other cancer screening experience. CONCLUSION: Based on the results, we recommend the development of an intervention program to decrease the perceived barrier of action, to regard mammography as an essential test in regular check-up, and to giveactive advertisement and education to the public to improve the rates of breast cancer screening and repeat screening.
Adolescent ; Dysmenorrhea/*therapy ; Female ; *Foot ; Humans ; *Massage ; Premenstrual Syndrome/*therapy

PURPOSE: This study was aimed to identify the effect of self-foot reflexology on the relief of premenstrual syndrome and dysmenorrhea in high school girls. METHOD: Study subjects was 236 women residing in the community, teachers and nurses who were older than 45 were recruited. Data was collected with self administered questionnaires from July 1st to August 31st, 2003 and analysed using SPSS/WIN 10.0 with Xtest, t-test, and stepwise multiple logistic regression at a significant level of =.05. RESULT: The breast cancer screening rate was 57.2%, and repeat screening rate was 15.3%. With the multiple logistic regression analysis, factors associated with mammography screening were age and perceived barriers of action, and factors related to the repeat mammography screening were education level and other cancer screening experience. CONCLUSION: Based on the results, we recommend the development of an intervention program to decrease the perceived barrier of action, to regard mammography as an essential test in regular check-up, and to giveactive advertisement and education to the public to improve the rates of breast cancer screening and repeat screening.
Adolescent ; Dysmenorrhea/*therapy ; Female ; *Foot ; Humans ; *Massage ; Premenstrual Syndrome/*therapy

OBJECTIVE: To evaluate the efficacy of low dose gonadotropin releasing hormone agonist(GnRH-a) therapy combined with high dose human menopausal gonadotrpin(hMG) following estrogen & progesteron therapy for poor responders. METHODS: From May 1997 to Feb 1999, 36 patients who were defined as poor responders on previous consecutive two and more superovulation cycles were randomly allocated to lowdose GnRH-a short protocol with high dose hMG protocol pretreated with estrogen & progesterone(E/P therapy)(n=16)(study group) and the clomiphene citrate with hMG(n=20)(control group). All patients were planned to undergone in-vitro- fertilization(IVF) and embryo transfer(ET) after controlled ovarian hyperstimulation(COH). RESULTS: Two groups were similar with respect to clinical features and basal FSH and E2 levels. The mean level of E2 on day 5, 304.3+/-148.ng/ml in study group was significantly higher than that in control group, 182+/-34.9ng/ml. The mean levels of E2 on hCG day was also significantly higher in study group than control group(1324+/-320ng/ml, vs 414+/-168ng/ml). The mean day of hCG day in study group, 12.3+/-0.3 was shorter than that in control group, 13.8+/-0.4. The concellation rates of cycles were significantly lower in study group than control group(13.2% vs 84.2%). But clinical pregnancy rates did not showed the significant difference between two groups. CONCLUSION: The study suggested that a lowdose GnRH-a short protocol with high dose hMG pretreated with estrogen & progesterone can improve the ovarian response in poor responder group.
Clomiphene ; Embryonic Structures ; Estrogens ; Gonadotropin-Releasing Hormone* ; Humans ; Pregnancy Rate ; Progesterone ; Superovulation