This nationwide survey was conducted to evaluate the current status of clinical practice for gastric cancer patients in Korea. The Information Committee of the Korean Gastric Cancer Association (KGCA) sent questionnaires containing 45 items about the preoperative diagnosis, medical and surgical treatment, and postoperative follow-up for gastric cancer patients to all 298 KGCA members in 108 institutes. Response rates were 32.6% (97/298) for individuals and 59.3% (64/108) for institutes. Most university hospitals responded (response rate of university hospitals: 71.6%, 48/67). The preoperative staging work up was performed primarily by abdominal CT, followed by bone scans, abdominal ultrasound, endoscopic ultrasound, and so on. Gastric cancer patients with stages II, III, and IV usually received adjuvant chemotherapy after a curative operation. About half of the surgeons regarded 2 cm as a safe resection margin in early gastric cancer and 5 cm in advanced gastric cancer. More than half of surgeons usually performed a D2 lymph node dissection in early gastric cancer and D2+alpha lymph node dissection in advanced gastric cancer. About 20% of surgeons performed less invasive surgery and/or function-preserving surgery, such as a pylorus-preserving gastrectomy, a laparoscopic wedge resection, or a laparoscopy-assisted distal gastrectomy.
Academies and Institutes ; Chemotherapy, Adjuvant ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Hospitals, University ; Humans ; Korea* ; Lymph Node Excision ; Surveys and Questionnaires ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography

This nationwide survey was conducted to evaluate the current status of the database system on gastric cancer patients in Korea. The Information Committee of Korean Gastric Cancer Association (KGCA) sent questionnaires about the database management to all 402 KGCA members in 110 institutes. In addition, we asked them to send the gastric cancer sheet and the pathologic report of gastric cancer used in their institutes. Response rates were 18.9% (76/402) for individuals and 51.8% (57/110) for institutes, respectively. Most of the university hospitals responded to the questionnaire (response rate of university hospital: 74.6%, 44/59). A regular conference of gastric cancer and a digitalization of the database on gastric cancer patients were performed in 29 (50.9%) and 43 (75.4%) out of 57 institutes, respectively. MS excel was most commonly used for the digitalization of the database, followed by MS access and SPSS. A regularly formed gastric cancer sheet and pathologic report were used in 38 (66.7%) and 49 (86.0%) institutes, respectively. Hospital computerization, such as an Order Communicating System, an Electric Medical Record, and a Picture Archiving/Communicating System had been set up previously or would be set up in the near future in most institutes. In 25 gastric cancer sheets collected, the mean number of total items was 72.9 (15~177). Identification data for the patients, surgical data, and pathologic data were included on most of the sheets, but preoperative status, preoperative diagnostic data, and postoperative hospital course were not.
Academies and Institutes ; Hospitals, University ; Humans ; Korea ; Medical Records ; Surveys and Questionnaires ; Stomach Neoplasms*

No abstract available.
Education* ; Stomach Neoplasms*

Fatigue is the subjective sense which people experience and use commonly in their lives. Although factors regards with fatigue have been explored in specific population, minimal study has been devoted to exploring associated variables generally healthy women. This descriptive study examined the relationship of demographic factors and depressions to subjective fatigue among women in the community who have no critical health problems. From June 15 to July 15, 1996, a convenience sample of 255 adult women completed the questionnaire which was developed by the author on the basis of Yoshitake's(1978) and Zung(1965), respectively. Pearson's correlation, t-test, ANOVA and Mann-Whitney test were used to analyze the data with SPSS/PC+ 5.0 for Windows. The results were as follows ; 1) Average fatigue score of the subjects was 12.57(+/-7.15)(range 0~30). Fatigue scores by area were neuroperceptive fatigue(4.81+/-2.90), physical fatigue(3.99+/-2.46) and mental fatigue(3.71+/-2.91) in order. Subjects with the fatigue scores more than 20 were forty four, 17.2 percent of total subjects. 2) Average depression score was 46.1(+/-6.96)(range 16~64), which was not so high. 3) Statistically significant relationship was noted between fatigue and depression scores(r=-.6747, p<.001) that means the more depressive, the more be fatigued. Correlations with respective fatigue area and depression were mental fatigue(r=-.6833, p<.001), neuroperceptive fatigue(r=-.5293, p<.001) and physical fatigue(r=-.5189, p<.001) in order. 4) Presence of disease revealed as the statistically significant variable affecting fatigue scores(t=-4.31, p<.001). Other variables such as age, marriage and job, however, had no statistically significant effect on the fatigue scores. Fatigue can meaningfully undermine quality of life in women who are accustomed to leading active lives. Fatigue is disabling, and a serious symptom to those who suffer from it. It is important for health providers as well as the women to recognize that there exits the relationship between fatigue and depression. Further investigation is necessary to facilitate adequate resolution of the clients' problem from fatigue leading to diminishment of the significance.
Adult ; Demography ; Depression ; Fatigue* ; Female ; Humans ; Marriage ; Quality of Life ; Surveys and Questionnaires

No abstract available.
Classification* ; Humans ; Stomach Neoplasms*

No abstract available.
Humans ; Multivariate Analysis* ; Stomach Neoplasms*

Cervical fracture-dislocation continue to be a difficult therapeutic problem. It gives more prolonged and complexing neurological deficits and complications than any other injuries. Since the introduction of skull tongs for skeletal traction by Crutchfield in 1933, very little had been added to treat cases until the works of Dereymaeker, Smith and Robinson, and Cloward who introduced the value of anterior approach for cervical fracture-dislocations around 1955. The author reviewed 51 cases of cervical fracture-dislocation treated at Severance Hospital and Hanyang University Hospital from 1964 to 1972; 23 cases were treated by simple traction, 27 cases by anterior interbody fusion, and one cases by posterior internal splint using resin and wiring. 1. Early anterior approach offers a unique opportunity to treat the lesion under direct vision. The spinal instability can be corrected by a vertebral fusion, and prolonged immobilization in skull traction may be avoided. 2. Myelography and Queckenstedt's test is not indicated except in the few limited cases to find ruptured disc lesions. 3. Acute ruptured disc was found in almost all the surgical cases. In many cases, disc removal was imperative after conservative therapy. And interbody fusion gives the best prognosis. 4. For the reduction of new locked facets, posterior approach is easier and safer than anterior approach. But in the case of old locked facets, all scar tissue should be excised via anterior approach before performing posterior approach. 5. Postoperative anterior angulation of cervical spine resulted from compression of vertebral body at the time of injury, and it may be prevented by hyperextended surgical position of the cervical spine during interbody fusion and postoperative fraction for two to three weeks.
Cicatrix ; Immobilization ; Myelography ; Prognosis ; Skull ; Spine ; Splints ; Traction

No abstract available.
Colorectal Neoplasms* ; Gene Expression*

No abstract available.
Stomach Neoplasms*

BACKGROUND: In gastric cancer surgery, a splenectomy might enhance the radicality of the operation, but, on the other hand, it can alter the immune status of the patients. In the immunological aspect, many studies suggest that a splenectomy is therapeutically effective for stage IV gastric cancer and that the spleen must be preserved for stage I or II disease. However, a splenectomy for stage III gastric cancer is controversial. The purpose of this study was to evaluate the effect of splenectomy on the immune status of stage III gastric cancer patients. METHODS: From 1989 to 1995, a splenectomy was done in 76 patients with stage III gastric cancer at the Department of Surgery, College of Medicine, Seoul National University. From the patients treated during this period, we selected 18 patients for a splenectomy group and 18 patients for a non-splenectomy group. T-lymphocyte subset studies were performed pre-and post-operatively in all of these patients. Postoperative PHA stimulation lymphocyte cultures were performed in 10 patients of the splenectomy group and all of the patients in the non-splenectomy group. The postoperative studies were performed at around 2 years after the operations. RESULTS: In the splenectomy group, the ratio of T4 (helper cell)/T8 (suppressor cell) was significantly decreased after the operation; this may be due to a decrease in the proportion of T4. In the non-splenectomy group, the proportion of T3 was increased significantly after the operation; this may be due to an increase in the proportion of T8. The results of the PHA stimulation lymphocyte cultures did not show significant differences between the 2 groups. CONCLUSIONS: In stage III gastric cancer, a splenectomy may be detrimental because the effect of the reduction in the proportion of T4 can be somewhat higher than that of T8. Thus, a splenectomy in stage III gastric cancer might lower the patient's postoperative immune status.
Hand ; Humans ; Lymphocytes ; Seoul ; Spleen ; Splenectomy ; Stomach Neoplasms* ; T-Lymphocyte Subsets* ; T-Lymphocytes*