From January 1993 to December 1995, 47 patients with rectal carcinomas underwent a rectal anastomosis using the double stapling technique at the Surgical Department of Kwang-ju Christian Hospital. The major advantages of the double stapling technique for lower rectal cancer over the single stapling technique or a hand-sewn operation are as follows:1) Insertion of a purse-string suture is eliminated, and application of a linear stapler to close the distal rectum may be performed with greater ease. 2) In addition, fecal contamination and spillage of tumor cells from the rectal segment are minimized. 3) Differences in the sizes of the colons and rectums are not a concern in constructing the anastomosis. 4) The operating time is shorter. The following results were obtained by a comparison with 24 patients with rectal carcinoma who had undergone a rectal anastomosis using the double stapling technique from January 1989 to December 1992 which was reported in a previous study:1) Anastomotic stenosis was decreased from 8.3% to 4.2% because of reduced ischemia due to the double row of staples and the reduced injury due to compression of tissue between the anvil and the cartridge with experience. In addition, it resulted from reduced tension of the anastomosis due to sufficients mobilization of the proximal colon and from selection of large cartridge (33 mm). 2) Anastomotic leakage, even though the same location as the tumor and in the advanced age group, was decreased from 4.2% to 0% because the blood circulation was maintained and unnecessary tension was reduced with experience. In addition, it resulted from reinforced suture of the anastomotic site which was performed after anastomosis. 3) Systemic recurrence was the same result as that of the previous study(4.2/4.3%). 4) Local recurrence, even though at the same distal distance from the margin of the cancer, was increased from 0% to 2.1% because of advancing the pathologic stage (B2, C1>B1, B2) and increasing the poorly differentiated pathologic type.
Anastomotic Leak ; Blood Circulation ; Colon ; Constriction, Pathologic ; Gwangju ; Humans ; Ischemia ; Postoperative Complications ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sutures

From January 1993 to December 1995, 47 patients with rectal carcinomas underwent a rectal anastomosis using the double stapling technique at the Surgical Department of Kwang-ju Christian Hospital. The major advantages of the double stapling technique for lower rectal cancer over the single stapling technique or a hand-sewn operation are as follows:1) Insertion of a purse-string suture is eliminated, and application of a linear stapler to close the distal rectum may be performed with greater ease. 2) In addition, fecal contamination and spillage of tumor cells from the rectal segment are minimized. 3) Differences in the sizes of the colons and rectums are not a concern in constructing the anastomosis. 4) The operating time is shorter. The following results were obtained by a comparison with 24 patients with rectal carcinoma who had undergone a rectal anastomosis using the double stapling technique from January 1989 to December 1992 which was reported in a previous study:1) Anastomotic stenosis was decreased from 8.3% to 4.2% because of reduced ischemia due to the double row of staples and the reduced injury due to compression of tissue between the anvil and the cartridge with experience. In addition, it resulted from reduced tension of the anastomosis due to sufficients mobilization of the proximal colon and from selection of large cartridge (33 mm). 2) Anastomotic leakage, even though the same location as the tumor and in the advanced age group, was decreased from 4.2% to 0% because the blood circulation was maintained and unnecessary tension was reduced with experience. In addition, it resulted from reinforced suture of the anastomotic site which was performed after anastomosis. 3) Systemic recurrence was the same result as that of the previous study(4.2/4.3%). 4) Local recurrence, even though at the same distal distance from the margin of the cancer, was increased from 0% to 2.1% because of advancing the pathologic stage (B2, C1>B1, B2) and increasing the poorly differentiated pathologic type.
Anastomotic Leak ; Blood Circulation ; Colon ; Constriction, Pathologic ; Gwangju ; Humans ; Ischemia ; Postoperative Complications ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sutures

Necrotizing fasciitis (NF) is a deep infection of the subcutaneous tissue that progressively destroys fascia and fat; it is associated with systemic toxicity, a fulminant course, and high mortality. NF most frequently develops from trauma that compromises skin integrity, and is more common in patients with predisposing medical conditions such as diabetes mellitus, atherosclerosis, alcoholism, renal disease, liver disease, immunosuppression, malignancy, or corticosteroid use. Most often, NF is caused by polymicrobial pathogens including aerobic and anaerobic bacteria. NF caused by Staphylococcus aureus as a single pathogen, however, is rare. Here we report a case of NF that developed in a healthy woman after an isolated shoulder sprain that occurred without breaking a skin barrier, and was caused by Staphylococcus aureus as a single pathogen.
*Arm ; Coagulase/metabolism ; Fasciitis, Necrotizing/*etiology/microbiology/pathology/surgery ; Female ; Humans ; Middle Aged ; Shoulder Joint/*injuries ; Sprains and Strains/*complications ; Staphylococcal Infections/*etiology/microbiology ; Staphylococcus aureus/enzymology/isolation & purification

No abstract available.
HIV* ; Korea*

PURPOSE: To evaluate the radiological and clinical outcomes of the operative treatment for the unstable distal radius fractures with displaced ulnar styloid process fractures. MATERIALS AND METHODS: From 2002 to 2005, 17 patients with unstable distal radius fractures with displaced ulnar styloid process fractures were treated operatively, using external fixation or internal fixation for distal radius and open reduction with tension band wiring for ulnar styloid process fractures. We evaluated postoperative outcomes with Mayo wrist score, range of motion, ulnar side wrist pain, wrist stress test, grip strength as well as radiological evaluation. RESULTS: All ulnar styloid process fractures were completely united, and according to Mayo wrist score, 7 cases(41%) were excellent, 8 cases(47%) were good. 14 cases(82%) had no ulnar wrist pain and 15 cases(88%) had grip strength more than 50% when compared with the normal side. Posterior instability of ulnar head occurred at 1 case. CONCLUSION: We got acceptable clinical and radiological results of operative treatment of ulnar styloid process fractures and concluded that ulnar styloid process fractures combined with distal radius fractures should be carefully evaluated and treated operatively according to their fracture types.
Exercise Test ; Hand Strength ; Head ; Humans ; Radius ; Radius Fractures ; Range of Motion, Articular ; Wrist

Objective: The establishment of a proper emergency care system can significantly decrease the number of deaths and disabilities. However, this is neglected in many low- and middle-income countries, including Cambodia. At present, many Cambodian hospitals lack designated emergency departments, formal triage systems, and staff trained in emergency medicine. This study sought to measure the functional capacity of the Cambodian emergency care system corresponding to each hospital level using the Emergency Care Assessment Tool (ECAT). Methods: We conducted a survey from April 19, 2021, to April 27, 2021, by distributing survey sheets to a total of eight Cambodian medical staff who were invited to a hospital in South Korea for an educational program. The ECAT comprises items evaluating the capability of hospitals to perform signal functions for each of the six emergent sentinel conditions that could occur prior to death. We analyzed the data by categorizing the hospitals into basic, intermediate, and advanced levels. Results: Basic-level hospitals had weaknesses in signal functions related to altered mental status and trauma care. The intermediate-level hospital showed weaknesses in signal functions related to respiratory failure, altered mental status, shock, and trauma care. Advanced-level hospitals had weaknesses in signal functions related to respiratory failure, trauma, and shock. Conclusion Our survey shows that most Cambodian hospitals lack the capability to perform the emergency signal functions expected at each level. We believe that this gap can be bridged with proper customized education targeting medical staff based on the level of their hospital and ensuring a proper supply of medical devices.

The purpose of this study was to find out the relationship between waist circumference, muscular strength, flexibility, and brachial-ankle pulse wave velocity (baPWV). Furthermore, the cut-off values of the physical fitness factors according to the baPWV were also calculated. The study was derived with total of 1,562 males (1,116 middle-aged and 446 old-aged). They were tested participant's baPWV, waist circumference, cardiopulmonary fitness, grip strength and flexibility. The results of this study is that the baPWV of the middle-aged men did not show significant changes in relationship with the waist circumference and physical fitness factors. The old-aged group with normal abdominal fat and high physical fitness level (group 4) showed significant baPWV values in comparison to those with waist circumference and low physical fitness levels (group 1); cardiorespiratory fitness p=0.026, grip strength p=0.000, flexibility p=0.000. The cut-off values of the physical fitness such as cardiorespiratory fitness, grip strength, flexibility according to the baPWV were 31.2 mL/kg/min (area under curve [AUC], 0.692; p=0.027), 37.0 kg (AUC, 0.588; p=0.014), and 1.0 cm (AUC, 0.589; p=0.014), respectively. In conclusion, these results demonstrate that waist circumference, cardiorespiratory fitness as well as muscular strength and flexibility effect inversely on arterial stiffness.
Abdominal Fat ; Hand Strength ; Humans ; Male ; Obesity, Abdominal ; Physical Fitness ; Pliability ; Pulse Wave Analysis ; Vascular Stiffness ; Waist Circumference

BACKGROUND: The p16INK4a gene methylation has been reported to be a major tumorigenic mechanism. METHODS: We evaluated the methylation status of the p16INK4a genes in 231 invasive breast cancer and 90 intraductal carcinoma specimens using a methylation-specific polymerase chain reaction and p16 protein expression using immunohistochemistry. The quantity of cell-free methylated p16INK4a DNA in the plasma samples of 200 patients with invasive breast cancer was also examined using a fluorescence-based real-time polymerase chain reaction assay. RESULTS: The frequencies of p16INK4a methylation in invasive and intraductal tumors were 52.8% (122/231) and 57.8% (52/90), respectively. The p16 protein was overexpressed in 145 of the 231 invasive carcinomas (62.8%) and 63 of the 90 intraductal carcinomas (70%). High p16 expression in invasive carcinomas correlated significantly with a high histologic grade, a negative estrogen receptor and progesterone receptor status, p53 immunoreactivity and high Ki-67 expression with immunohistochemistry. In addition, the methylation index of p16INK4a was significantly higher in the cancer patients than the normal controls (p<0.001). CONCLUSIONS: High p16 immunoreactivity correlated with a loss of differentiation in breast carcinomas and high frequency of p16INK4a promoter methylation in both invasive and intraductal carcinomas, suggesting it may be involved in the pathogenesis of breast cancer.
Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; DNA ; Estrogens ; Genes, p16 ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Methylation ; Plasma ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Receptors, Progesterone

PURPOSE: We evaluated the accuracy of 18FFDG PET/CT for the detection of recurrence or metastasis after treatment in patients with primary head and neck cancer, and compared the results with those of CT/MRI. MATERIALS AND METHODS: We studied 34 patients with the diagnosis of head and neck cancer, who underwent treatment and follow up with 18FFDG PET/CT and CT/MRI. The patients were divided into two subgroups based on the difference in follow-up time interval and the type of treatment. Accuracy was evaluated by follow-up information and histopathology findings. The results of the 18FFDG PET/CT and CT/MRI were compared by statistical analysis. RESULTS: For the 18FFDG PET/CT results, 19 FDG uptake lesions were detected in 17 patients. Among these lesions, 18 were confirmed as recurrent or metastatic lesions and one as an inflammatory reaction from radiation therapy. Four lesions that had high FDG uptake were not detected by the CT/MRI. The sensitivity and specificity were 100% and 94.4% for the 18FFDG PET/CT and 77.8% and 94.4% for the CT/MRI (p<0.05). For the subgroup that received radiation therapy, 18FFDG PET/CT was more sensitive than CT/MRI (sensitivity = 100% vs. 63.6%, p<0.05). CONCLUSION: The results of this study showed that 18FFDG PET/CT was a useful screening modality for detecting recurrent or metastatic disease after treatment of patients with head and neck cancer, especially post-radiation.
Diagnosis* ; Follow-Up Studies ; Head and Neck Neoplasms* ; Head* ; Humans ; Mass Screening ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography* ; Recurrence ; Sensitivity and Specificity

BACKGROUND: To assess the effect of forward, backward walking exercise and pelvic floor muscle exercise on sexual function and functional fitness in elderly males. METHODS: Twenty two elderly males participated in this study. They were divided into two groups. The Complex Exercise(CE) group(n=11) performed the forward, backward walking exercise(3 days/week, 12 weeks) and pelvic floor muscle exercises(PFME; 5 days/week, 12 weeks). The PFME group(n=11) only performed PFME(5 days/week, 12 weeks). Both groups performed the PFME in the same manner. Outcomes were evaluated by IIEF-5(5-item version of the interna- tional index of erectile function), 6min walk, and 30sec & 1min sit-to-stand before exercise training, and at week 4, week 8, and week 12. RESULTS: Total scores and erectile function scores had significant interaction effect(p<0.05) in group and period. 6min walk wassignificantly different(p<0.05) in exercise period and 30sec(p<0.001) & 1min sit-to-stand(p<0.01) had signi- ficant interaction effectin group and period. CONCLUSION: Three months of forward, backward walking and pelvic floor muscle exercises did not have significant positive effects on sexual function and functional fitness in elderly males.
Aged ; Exercise ; Humans ; Male ; Muscles ; Pelvic Floor ; Sesquiterpenes ; Walking