No abstract available.
Carcinoma, Basal Cell* ; Mohs Surgery* ; Sutures*

Spinal anesthesia is a relatively ease and useful technique and provides excellent analge-sia and relaxation for a great number of surgical procedures. It has been used widelr until the introduction of Muscle relaxant to the general anesthesia. However, complications, including hypotension, nausea, postspinal headache, neurologic sequelae, and death have been reported. In addition to those problems, number of failures after administration of spinal anesthetic haute been reported. We collected the 316 cases of spinal anesthesia given between January to May, 1986.the incidence of failure and the int-errelationships between the incidence and technical factors were reuiewed. Variables exam-ined including the patient population, the technical aspects of performing subarachnoid tap and subsequent blockade, and the level 7f training of anesthetist. Total number of patients with administration of anesthesia for 5 monthes was 2075; 316 patients in spinal anesthesia(15.237). We found a 4, l1% incidence of spinal failure, defined as the need to use general anesthesia or frequent administration of anlgesics during the surgical procedures. The technical factors(position of patients, approach method, puncture sites, needle gauge, agents type, and the performer) were insignificantlr contributed to the failure rate, but the amount of local anesthetic was showed statistical significance.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal* ; Headache ; Humans ; Hypotension ; Incidence* ; Nausea ; Needles ; Punctures ; Relaxation

PURPOSE: To assess the prognostic value of computed tomography (CT) in acute pancreatitis, initial CT examinations were classified into 5 grades in terms of the degree of disease severity and CT findings were correlated with clinical course, objective prognostic signs, and complications. MATERIALS AND METHODS: In 29 consecutive patients with acute pancreatitis, the CT examination and clinical course were reviewed without knowledge of each other finding. Both Ranson's prognostic signs and modified Glascow prognostic signs were used for evaluation of acute pancreatitis. RESULTS: Of the 29 patients, 25 patients recovered with medical treatment while 4 patients (14%) developed pseudocysts and the other 4 patients (14%) developed abscesses. CT findings of the acute pancreatitis are as follows; 10 patients (35%) in grade A with normal pancreas, 2 patients (7%) in grade B with pancreatic enlargement, 2 patients (7%) in grade C with intrinsic pancreatic abnormalities associated with haziness, 3 patients (10%) in grade D with single, ill-defined fluid collection, and 12 patients (41%) in grade E with extensive and two or multiple fluid collections or presence of gas in or adjacent to the pancreas. Correlation coefficient is 0.46 (p=0.012) between CT findings and Ranson's prognostic signs, 462 (p=0.0115) between CT findings and modified Glascow prognostic signs. CONCLUSION: CT gradings of acute pancreatitis may be useful in predicting clinical course.
Abscess ; Humans ; Pancreas ; Pancreatitis*

Objective: To evaluate the radiographic characteristics of the ampulla of Vater cancer. Subjects and Methods:The authors analyzed retrospectively the US(n=25) and CT(n=15) findings in 25 cases of ampulla of Vater cancer, with emphasis on the potential of CT & US in regand to the detectibility of the mass. ERCP(n=15) and hypotonic duodenography(n=5) were also evaluated for the configuration of obstructed duct. RESULTS: The tumor was detected on sonography in only 12 cases(48%) as a small, relatively well delinated mass with slighty low echogenicity to the pancreas. The tumor was shown by CT in 8 cases(53% ) as a well delinated mass protruding into the second portion of duodenal lumen with slightly low attenuation to the pancreas. CBD was dilated in 25 cases(100%), but pancreatic duct was dilated in 15 cases(60%). Obstructed end of CBD was nipple shaped in 7 cases(47%), clubbed in 3, flat in 3, and indistict in 2 by ERCP. Hypotonic duodenogram showed irregular filling defect in the medial wall of second portion of the duodenum in 5 cases (100%). CONCLUSION: Mas detection rate crsing US or CT were not high in ampulla of Vater cancer. Except for a CT finding of a small mass protruding into the regional duodenal lumen, other finclings were nonspecific. Therefore, additional studies or more afgressive approach should be attempted for a correct diagnosis.
Ampulla of Vater* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Duodenum ; Nipples ; Pancreas ; Pancreatic Ducts ; Retrospective Studies

Of all the aeromedical treats to flying safety, G-induced loss of consciousness (G-LOC) must be one of the most important. The present study is undertaken to acquire the physiological normative data (including lifestyle and physical fitness) of KAF pilots and to investigate the factors that will be related with G-LOC. From 15 May through 27 Nov 2000, 464 KAF pilots underwent high G training and flight performance tests at the Aeromedical Research and Training Center are checked CBC, total cholesterol, PFT, physical fitness battery tests-muscular strength, muscular endurance, power, and flexibility. High G training and 2 kinds (before and after the G-training) of questionnaire were tried. Pilot's attitude for health promotion was relatively passive and the proportions as of high and borderline risk for atherosclerosis in total cholesterol level were 4.98% and 22.1%, respectively. 17.6% of the pilots had G-LOC and three quarters of them fell into G-LOC within the first 5 seconds. Variables showing significant correlation (p<0.05) with G-LOC were as follows; height, age, total flying time, and high G-training times. Trunk extension had positive correlation and curls ups had negative correlation, but the reasons are needed more following study. Also, the judgments of pilots and a supervisor in skillfulness of L1 maneuver were significant with G-LOC.
Atherosclerosis ; Cholesterol ; Diptera ; Health Promotion ; Judgment ; Life Style ; Physical Fitness ; Pliability ; Risk Factors* ; Unconsciousness ; Surveys and Questionnaires

Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.

Purpose: Recently, the prevalence of eosinophilic gastrointestinal disease (EGID) has shown an increasing trend worldwide. As the diagnosis of EGID requires invasive endoscopy with biopsy, noninvasive markers for detecting EGID in suspected patients, particularly children, are urgently needed. Therefore, this study aimed to evaluate the diagnostic accuracy of serum eosinophil cationic protein (ECP) beyond peripheral eosinophil counts in pediatric patients with EGID. Methods: Overall, 156 children diagnosed with EGID were enrolled and 150 children with functional abdominal pain disorder (FAPD) were recruited as controls. All participants underwent endoscopic biopsy in each segment of the gastrointestinal (GI) tract and serum ECP measurement, as well as peripheral eosinophil percent and absolute eosinophil count. Results: Comparing EGID (n=156) with FAPD (n=150) patients, serum ECP levels were significantly higher in pediatric patients with EGID than in those with FAPD (25.8±28.6 µg/L vs. 19.5±21.0 µg/L, p=0.007), while there was no significant difference in peripheral eosinophil percent and absolute eosinophil counts between the two groups. Serum ECP levels were correlated with peripheral eosinophil percent (r=0.593, p<0.001) and the absolute eosinophil count (r=0.660, p<0.001). The optimal cutoff value of serum ECP for pediatric EGID was 10.5 µg/mL, with a sensitivity of 69.9% and a specificity of 43.4% with an area under the receiver operating characteristic curve of 0.562. Conclusion The combination of serum ECP levels and peripheral eosinophil counts, when employed with appropriated thresholds, could serve as a valuable noninvasive biomarker to distinguish between EGID and FAPD in pediatric patients manifesting GI symptoms.

Measurement of arterial preseure, either intermittently or continuously has teen used for almost 100 clears. A prospective study was conducted on 22 patients to compare the accuracy of arterial pressures treasured br a non-invasive (ACCUTORR,ACC) and an invasive (intra-arterial Line, IAL) arterial pressure monitoring systems. Overall, the accuracy or regroducibility of each method, as expressed in the individual variarlce, was shown to be statistically in significant between ACC and IA7. The difference in arterial pressures was particularly marked between ACC and IAL when srstalic BP was either less than 100 mmHg or greater than 140 mmHg.
Adolescent ; Anesthesia* ; Arterial Pressure ; Blood Pressure* ; Humans ; Prospective Studies

BACKGROUND: Chemokines and their receptors are important players in tumorigenesis by facilitating tumor proliferation and metastasis. Little is known about the possible function of chemokine receptors in relation to the development and progression of malignant cutaneous tumors. OBJECTIVE: The aim of this study was to determine the chemokine receptor CCR3 expression pattern and the protein expression level in selected malignant cutaneous tumors. METHODS: Four types of cell lines (G361, A431, SK-MEL-2, SK-MEL-24) were analyzed, using Western blotting, for the expression of CCR3 protein. Immunohistochemical staining for CCR3 was done on 36 skin cancer tissue samples that included 16 squamous cell carcinomas (SCCs), 16 basal cell carcinomas (BCCs), 16 malignant melanomas (MMs) and 6 normal tissue samples. RESULTS: Western blot analysis showed that CCR3 protein was more expressed in the MM cell lines (G361, SK-MEL-2,SK-MEL-24) than that in the SCC cell line (A431), and the immunohistochemical analysis showed that CCR3 protein was overexpressed in MM and SCC, it was mildly expressed in BCC and it was hardly expressed in normal tissue. CONCLUSION: This study demonstrated via immunochemistry that CCR3 was more expressed in MM, followed by SCC and BCC. The existence of CCR3 protein may enhance the tumorigenic potential of malignant cutaneous tumors.
Blotting, Western ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cell Line ; Cell Transformation, Neoplastic ; Chemokines ; Immunochemistry ; Melanoma ; Neoplasm Metastasis ; Receptors, CCR ; Receptors, Chemokine ; Skin Neoplasms

PURPOSE: Hyperhomocysteinemia is known as an independent risk factor for cardiovascular diseases such as atherosclesosis and myocardiac infarct. A common mutation in 5, 10-methylenetetrahydrofolate reductase(MTHFR) gene results in a valine for alanine substitution, which makes enzyme thermolabile and reduces enzymal activity. We examined the relation of MTHFR genetic mutation and Kawasaki disease. METHODS: We extracted DNA from the peripheral blood of Kawasaki disease patients who were treated in Ewha University Mokdong Hospital between January 2000 and June 2003, and normal children. We genotyped for the polymorphism by using PCR of known alleic varients and digested them with Hinfl restriction enzyme. Products were visualized after electrophoresis in 2.5% agarose gel. RESULTS:The respective prevalence of the homozygous and heterozygous genotypes(CC genotype, CT genotype, TT genotype) was 33.3%, 38.9%, and 27.8% in the control group and 31.3%, 47.9%, and 20.8% in the Kawasaki disease group(P>0.05). CONCLUSION:The mutation of MTHFR gene shows no relation to development of coronary artery complications in Kawasaki disease.
Alanine ; Cardiovascular Diseases ; Child ; Coronary Vessels ; DNA ; Electrophoresis ; Gene Expression* ; Genotype ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2) ; Mucocutaneous Lymph Node Syndrome* ; Polymerase Chain Reaction ; Prevalence ; Risk Factors ; Sepharose ; Valine