No abstract available.
Colorectal Neoplasms* ; Electrophoresis* ; Genes, ras* ; Humans* ; Point Mutation* ; Polymerase Chain Reaction*

Nesidioblastosis is a rare disease characterized clinically by persistent hypoglycemia with inappropriately elevated circulating insulin concentration. Adequate early diagnosis should be established and subtotal pancreatectomy performed before itreversible cerebral damage caused by glucose deficit. The authors got a chance to anesthetize 56-day-old male patient for subtotal pancreatectomy because of nesidioblastosis, Following an induction of anesthesia with intravenous thiapental sodium 5 mg/kg and succinylchohne 1 mg/kg, endotracheal intubation was performed and anesthesia was maintained with pancuronium bromide and O2-N2O-enflurane. Intravenous fluid was maintained with 1-2-3 solution 30 ml and 15% D/W 40 ml mixed with 20 ml of 20 mEq/L NaCI.
Anesthesia* ; Early Diagnosis ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Intubation, Intratracheal ; Male ; Nesidioblastosis* ; Pancreatectomy* ; Pancuronium ; Rare Diseases ; Sodium

The surgeries based on the outpstient department have increased recently. One of the indications of outpatient surgery is chemical peeling of the face that usually re- quires only deep sedation of short duration. The purpose of this study was to evaluate the effeets of ketamine and midszolam for out patient facial chemical peeling. Fifty-nine unpremedicated patients undergoing chemical peeling of the face were anesthetized with bolus intravenous injection of 1mg/kg of ketamine and 0.1 mg/kg of midazolam. Additional dose of ketamine(10-20mg) was given as needed. During operation, we observed systolic and diastolic blood pressure with noninvasive blood pressure monitor and peripheral oxygen saturation(SpO2) with pulse oximeter. All patients were allowed to breathe spontane- ously without ventilatory support during the operation. There was no case of airway ob- struction and SpO2 value was over 97% in most cases. The systolic and diastolic blood pressure and pulse rate were increased after the injection of ketamine and midazolam. And we observed the untoward effect of anesthetics such as the purposeless movement(6.8%), involuntary phonation(3.4%), skin rash(3.4%) and headache(1.7%). In postoperative analysis about the recall, bad dream, mood, and the degree of satisfaction of this type of anesthesia, the rate of patient's positive acceptance was high(86.4%) and the reeovery time was 58min. We conclude that combination of intravenous ketamine and midszolam can produce satisfactory anesthesia with few complications for outpatient chemical peeling surgery of the face.
Ambulatory Surgical Procedures ; Anesthesia* ; Anesthetics ; Blood Pressure ; Blood Pressure Monitors ; Deep Sedation ; Dreams ; Heart Rate ; Humans ; Injections, Intravenous ; Ketamine* ; Midazolam* ; Outpatients* ; Oxygen ; Skin

OBJECTIVES: The purpose of this study was to investigate the prevalence and correlates of major and minor depressive disorders in college students. METHODS: A cross-sectional study was completed on a sample of 906 students (507 men and 399 women) with the self-administered form of Korean version of Mini International Neuropsychiatric Interview (K-MINI). RESULTS: Estimated 12-month prevalence of major depressive disorder was 4.2% in men and 9.5% in women, and that of minor depressive disorder was 15.4% in men and 23.2% in women. The factors, 'female gender' and 'age of 20-21', were significantly associated with major depressive disorder. 'Poor adaptation to school' was significantly associated with major depressive disorder both in men and women, but 'poor interpersonal relationship' and 'history of school withdrawal' were associated only in men. Idea of self-injury and suicidal behaviors (suicidal ideation, plan and attempt) were significantly associated with major depressive disorder in women, but were not associated with minor depressive disorder. CONCLUSION: Major and minor depressive disorders are highly prevalent in the college students. Major depressive disorder was more associated with dysfunctions and suicidal behaviors than minor depressive disorder. Campus-based mental health service is needed for the high-risk students.
Cross-Sectional Studies ; Depressive Disorder* ; Depressive Disorder, Major ; Female ; Humans ; Male ; Mental Health Services ; Prevalence* ; Risk Factors*

OBJECTIVES: This study evaluated the prevalence of suicide-related behaviors (suicidal ideation, plan and attempt) and the status of depression, anxiety and function in college students. METHODS: A cross-sectional study was completed to a sample of 880 students with the self-administered form of Korean version of the Mini International Neuropsychiatric Interview (K-MINI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS: Estimated lifetime prevalence of suicidal ideation was 39.2%, that of suicidal plan was 4.7% and that of suicidal attempt was 3.0%. Students with any suicide-related behaviors showed higher lifetime prevalence of major and minor depression, higher BDI and BAI scores, and poor interpersonal relationship, adaptation to college life and physical health compared to the students with no suicide-related behaviors. The average points of grades during their college life were not significantly different according to kinds of suicide-related behaviors they experienced (F=0.39, p=0.82). 96% of suicidal attempters did not use mental health services. CONCLUSION: Results suggest that a high proportion of college students experience suicide-related behaviors. The students who had experienced suicide-related behaviors showed higher depression and anxiety and poorer function compared to students with no suicide-related behaviors. Most of suicidal attempters, however, did not use mental health service. Establishing campus mental health system is necessary to early detect mental health problems and to prevent suicide of college students.
Anxiety ; Cross-Sectional Studies ; Depression ; Depressive Disorder ; Humans ; Mental Health ; Mental Health Services ; Prevalence ; Suicidal Ideation ; Suicide

BACKGROUND: Using long-term (more than 30 years) data from a single center, this retrospective study evaluated changes of independent risk factors affecting renal allograft survival by transplant era. METHODS: Of 3,000 cases of kidney transplantation, 2,708 (90.3%), including their follow-up observations, were reviewed. Transplant era was classified according to immunosuppressive regimens as either early group (transplant serial No. 1~1,500) or recent group (transplant serial No. 1,501~3,000). RESULTS: There was a significant difference observed in pre-transplant clinical manifestations between the early and recent groups. The number of elderly recipients and donors, number of deceased donors, and cases related to pre-transplant diabetes, pre-emptive transplantation, and retransplantation were differed relative to transplant era. The short- and long-term graft survival rate of the recent group improved significantly, and the effect of human leukocyte antigen mismatching and living donor type disappeared in the recent group. Moreover, pre-emptive transplantation and retransplantation were effective only in the recent group. However, non-immunological factors such as elderly recipients and donors, and immunologic factors such as episodes of acute rejection and types of immunosuppressive regimen were persistent independent risk factors affecting graft survival rate. CONCLUSIONS: According to the retrospective survival analysis of a large number of recipients in a single center, risk factors for kidney transplant patients differed by transplant era. However, the independent risk factors associated with elderly recipients and donors (non-immunologic), and episodes of acute rejection, and types of immunosuppressive regimen (immunologic) persisted regardless of transplant era.
Aged ; Follow-Up Studies ; Graft Survival ; Humans ; Immunologic Factors ; Kidney ; Kidney Transplantation ; Leukocytes ; Living Donors ; Rejection (Psychology) ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplantation, Homologous ; Transplants

PURPOSE: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been increasing lately. Although minimally invasive surgery is more beneficial, no reported case of a totally laparoscopic distal gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experiences, to determine the feasibility of a totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy in treating early gastric carcinoma. MATERIALS AND METHODS: We investigated surgical results and clinicopatholgic characteristics of eight(8) patients with an early gastric carcinoma who underwent a totally laparoscopic distal gastrectomy at the Department of Surgery, Our Lady of Mercy Hospital, The Catholic University of Korea, between June 2004 and September 2004. The intracorporeal gastroduodenostomy was performed with a delta-shaped ananstomosis by using only laparoscopic linear staplers (Endocutter 45 mm; Ethicon Endosurgery, OH, USA). RESULTS: The operative time was 369.4+/-62.5 minutes (range 275~65 minutes), and the anastomotic time was 45.1+/-14.4 minutes (range 32~0 minutes). The anastomotic time was shortened as surgical experience was gained. The number of laparoscopic linear staplers for an operation was 7.1+/-0.6. The number of lymph nodes harvested was 31.9+/-13.1. There was 1 case of transfusion and no case of conversion to an open procedure. The time to the first flatus was 2.8+/-0.5 days, and the time to the first food intake was 4.1+/-0.8 days. There were no early postoperative complications, and the postoperative hospital stay was 10.0+/-3.9 days. CONCLUSION: A totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy with a delta-shaped anastomosis is technically feasible and can maximize the benefit of laparoscopic surgery for early gastric cancer.
Conversion to Open Surgery ; Eating ; Flatulence ; Gastrectomy* ; Humans ; Korea ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Operative Time ; Postoperative Complications ; Stomach Neoplasms ; Surgical Procedures, Minimally Invasive

Gallbladder agenesis is a rare condition of hepatobiliary congenital anomaly. It is caused by failure of development of the caudal division of the primitive hepatic diverticulum or failure of vacuolization after the solid phase of embryonic development. It is divided into 2 groups: (1) those whose conditions are discovered clinically because of persistent symptoms and proven by abdominal exploration with operative cholangiography; and (2) those who are asymptomatic during life and whose conditions are discovered only at necropsy. If symptoms are present, they are unlikely to be related to gallbladder disease. It is impossible, at present, to make a preoperative diagnosis of gallbladder agenesis. Operative cholangiography is absolutely necessary to rule out an intrahepatic gall bladder. Confirmation at surgery and autopsy requires thorough dissection of the biliary tract and liver bed. Therefore, we presented this case with a brief review of the related literature.
Autopsy ; Biliary Tract ; Cholangiography ; Diagnosis ; Diverticulum ; Embryonic Development ; Female ; Gallbladder Diseases ; Gallbladder* ; Liver ; Pregnancy ; Urinary Bladder

The purpose of this study was to develop a curriculum for the oriental clinical nurse specialist program based on the understanding of Korean human beings so as to develop nursing as a profession and promote the client's health. The design of this study was based on literature review and nominal group study. The research was managed by East-West Nursing Research Institute of nursing science college at Kyung Hee University. The research team was composed of 17 professors of nursing departments of oriental medical colleges. We obtained opinions from Oriental Nurses Association, Oriental Nursing Research Association, and professors in oriental medical college. We reviewed articles, curriculums of other clinical nurse specialist programs, medical laws and the curriculum development plan for the oriental clinical nurse specialist program from Korean Nurses Association. We discussed a curriculum thoroughly in numerous meetings. We developed a following curriculum: 1. Educational philosophy was founded on the oriental human view which was based on Chun-In union theory. It was founded on the oriental health view which recognized health being in harmony with nature and the balance of body function with the harmony of Yin-Yang in the five elements. In addition, it was founded on oriental nursing view to promote these health states. 2. Educational goals were to train oriental clinical nurse specialists, oriental nursing educators and oriental nursing researchers who developed knowledge of oriental nursing theory, nursing practice and created a leadership. 3. Curriculum consisted of 48 credits, of which 36 credits are based on lectures and laboratory classes and 12 credits are based on clinical practice. 36 credits consisted of 5 general subject credits and 31 core subject credits. General subjects consisted of nursing theory, nursing research, law and ethics. Students who had earned master's degrees are not required to take the general subjects. Core subjects consisted of 11 subjects such as advanced physical examination and laboratory, oriental nursing theory, original text of oriental nursing, oriental medical nursing, oriental pediatric nursing, oriental gynecologic nursing, oriental gerontologic nursing, oriental pharmacology, oriental constitutional nursing, advanced nursing of channels and acupuncture points and laboratory and oriental rehabilitation nursing and laboratory. In addition, clinical practice in a hospital ward, out patient department, herb prepation room, department of physical therapy and health promotion center in oriental medical hospitals for 12 weeks. To admit this program, students should complete prerequisites of introduction to oriental nursing and nursing of channels and acupuncture points. 4. Course contents of each subjects were developed to include the course's goal and objectives and specific items. 5. Evaluation involved lecture, laboratory and in field practice. We applied various evaluation systems and methods that were based on both knowledge and skills of the students to ensure full credibility and validity.
Acupuncture Points ; Curriculum* ; Ethics ; Health Promotion ; Humans ; Jurisprudence ; Leadership ; Lectures ; Nurse Clinicians* ; Nursing ; Nursing Research ; Nursing Theory ; Pediatric Nursing ; Pharmacology ; Philosophy ; Physical Examination ; Rehabilitation Nursing ; Social Change ; Yin-Yang

PURPOSE: While E-cadherin in normal cells induces calcium-dependent cell-cell adhesion, in malignant cell, it plays a role in invasion and metastasis with a reduction of adhesion. Serum soluble E-cadherin is a result of the reduction of the cellular E-cadherin molecule and is found in the circulation of normal individuals, but it is particularly known to be increased in patients with malignancies. Accordingly, through checking the level of serum soluble E-cadherin in patients with gastric cancer and analyzing it in the view of clinicopathology, we investigated whether serum soluble E-cadherin could be translated into a clinicopathologic esult and used as a tumor marker. MATERIALS AND METHODS: The investigation targeted 88 patients who had been diagnosed as having gastric cancer by the Department of Surgery, St. Mary's Hospital, from October 1, 2002, to July 30, 2003, and who had under gone performed surgery. We measured the level of preoperative serum E-cadherin in the 88 patients by unsing ELISA. Among them, we collected gastric cancer tissues from 54 patients and executed immunohistochemistry for E-cadherin. The samples were compared with normal tissues in terms of both serum E-cadherin level and immunohistochemistry level, as well as with other clinicopathologic factors. RESULTS: The mean serum E-cadherin level of the 88 patients was 4368.7 ng/ml and was significantly higher than the level in 12 normal control patients, 3335.5 ng/ml (P=0.016). In terms of clinicopathology, the serum level of E-cadherin was significantly correlated with increasing age (P=0.0006) and was higher in positive venous invasion patients (P=0.0005). When the E-cadherin immunohistochemical stain was compared with the serum E-cadherin level in 54 patients, no significant statistically meaningful result was obtained (P=0.2881). However, 4 patients with serum E-cadherin levels about 6000 ng/ml were classified into the lower expression group (<80%) of E-cadherin immunohistochemicals stain. In the analysis for 36 patients who were early gastric cancer patients, the serum E-cadherin level in lymph-node-metastatic patients was higher than it was in the other patients (P=0.0442). CONCLUSION: The serum E-cadherin level in gastric cancer patients was higher than the level in normal control patients. In advanced gastric cancer patients, that the difference was increased. Also, since the E-cadherin level correlated with the serum E-cadherin level with venous invasion, it can be used as an effective tumor marker for gastric cancer. Particularly, in that the serum E-cadherin level correlated with lymph node metastasis in early gastic cancer, it can be used when a therapeutic method for early gastric cancer is selected.
Cadherins* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms*