No abstract available.
Humans*

PURPOSE: Our study aimed to investigate prognostic factors at presentation and the survival of patients with a resected hepatocellular carcinoma (HCC). METHODS: A retrospective analysis of medical records was performed for 58 patients (59 cases) identified through the Tumor Registry as having been evaluated for a hepatocellular carcinoma at the Chonbuk National University Hospital during the 10-year period from 1989 to 1999. RESULTS: The male:female ratio was 3.2:1, and the average age was 52.7 years. Liver cirrhosis and ascites were present in 64.4% and 8.5% of the patients, respectively, and 62.7% present with the HBs antigen. The positive alpha-fetoprotein (AFP) rate was 55.9% and the elevated alkaline phosphatase (ALP) rate was 32.2%. The Child-Pugh's classifications of the patients were as follows: 49 cases (83.1%) of Grade A, 8 cases (13.6%) of Grade B, 2 cases (3.4%) of Grade C. The Indocyanine green (ICG) tests of normal range (<10%) were 69.5%. The operative mortality was 3.4% (2 cases). Preopertive transarterial chemoembolization was performed in 23 cases (39.0%). The tumor was larger than 5 cm in 50.8% of the patients and was a single tumor in 72.9%. Portal vein invasion was present in 11.9% of the cases. The surgical procedure consisted of a curative resection in 43 cases (72.9%: lobectomy in 7, trisegmentectomy in 4, segmentectomy in 22, and wedge resection in 10) and a limited resection in 16 cases (27.1%). Of the patients, 44.1% had either TNM stage III or stage IV tumor. Recurrence of the tumor was diagnosed in 19 cases and was found in the residual liver in 13 cases (68.4%). Operative morbidity developed in 16 cases (27.1%) and hepatic failure, pleural effusion, ascites were common complications. CONCLUSION: A significantly higher survival rate was seen for HCC with no ascites and a normal ALP level. A curative resection was not superior to a limited resection in terms of survival. Recent management strategy and technical advances have improved the results of surgical treament for patients with a HCC.
Alkaline Phosphatase ; alpha-Fetoproteins ; Ascites ; Carcinoma, Hepatocellular* ; Classification ; Humans ; Indocyanine Green ; Jeollabuk-do ; Liver ; Liver Cirrhosis ; Liver Failure ; Mastectomy, Segmental ; Medical Records ; Mortality ; Pleural Effusion ; Portal Vein ; Prognosis* ; Recurrence ; Reference Values ; Retrospective Studies ; Survival Rate

To evaluate a new reliable sclerosant of the gallbladder, we attempted gallbladder ablation with 10% phenol, and the results compared with those from using 95% ethanol which had been used previousy as gallbladder sclerosing agent in laboratory animals in other reports. After laparotomy, ligation of the cystic dusts with silk and cannulation of gallbladder with 18 gauge angiocatheter were done. Then, transcatheter administration of two different scleroing agents was performed in 8 rabbits respectively and normal saline in four rabbits as a control. Additionally, preliminary washing with each agent were implemented to prevent the dilutional effect of residual bile and bleeding. All animals survived without complication. Eight animals were used for each agent, four each being sacrified two weeks and six weeks after adminstration of sclerosing agents respectively. In our results, 10% phenol was more effective than 95% ethanol in denuding the gallbladder epithelium and promoting fibrosis of gallbladder wall, And it was relatively safe in regard to the dilutional effect of residual fluid and bleeding during procedure. Toxic effects on the liver evaluated by examination of histologic specimen were non-specific except for edematous swelling on some cases, which had also been observed on others including control group. 10% phenol can be considered to be a promosing sclerosant for gallbladder ablation, but further study of its toxicity is needed before its application on human gallbladder.
Animals ; Animals, Laboratory ; Bile ; Catheterization ; Dust ; Epithelium ; Ethanol ; Fibrosis ; Gallbladder* ; Hemorrhage ; Humans ; Laparotomy ; Ligation ; Liver ; Phenol* ; Rabbits* ; Sclerosing Solutions ; Sclerosis* ; Silk

BACKGROUND AND OBJECTIVES: Otitis media is one of the most common inflammatory disorders in the field of otolaryngology. Fortunately, with development in antibiotics and advances in preventive therapy otitis media is on the decrease. Nevertheless, there are only few reports about the prevalence rate of otitis media in Korea. Therefore, we investigated the prevalence of each type of otitis media among young adults in Gwangju and the Province of Chonnam, Korea. SUBJECTS AND METHOD: 28, 200 men aged 19 years old who underwent physical examination for conscription at the Military Manpower Administration in Gwangju from February to september, 2002 were analyzed, retrospectively. RESULTS: The overall prevalence of otitis media was 0.219%. Prevalence of each subtype was as follows; acute otitis media, 0%; otitis media with effusion, 0.049%; chronic otitis media, 0.17%, respectively. In the group of chronic otitis media, chronic perforated otitis media was 95.8%. The prevalence of otitis media did not vary by urban-rural difference, nor by coastal-inland area. CONCLUSION: The prevalence rate of chronic otitis media was remarkably decreased, compared with 10 years ago (0.70%), and conspicuously with 20 years ago (2.81%). Therefore, we think this low prevalence rate is partially due to remarkable improvement in socioeconomic conditions with better nutrition, housing, hygienic condition, social environments and advances in public health and medical care.
Anti-Bacterial Agents ; Gwangju* ; Housing ; Humans ; Jeollanam-do* ; Korea* ; Male ; Military Personnel ; Otitis Media with Effusion ; Otitis Media* ; Otitis* ; Otolaryngology ; Physical Examination ; Prevalence* ; Public Health ; Retrospective Studies ; Social Conditions ; Young Adult*

Some patients with depression require electroconvulsive therapy performed undergeneral anesthesia. This requires rapid loss of consciousness, with minimal interferencefrom seizure activity, appropriate muscle relaxation status, prevention of hyperdynamicresponses to the electrical stimulus, and proper recovery of spontaneous ventilationand consciousness. The authors report the first case of electroconvulsive therapy performedwith the patient under general anesthesia at the Ewha Womans UniversityMedical Center, Korea.

PURPOSE: Incidence of chronic osteomyelitis in femur is lower than that of tibia due to abundantsurrounding soft tissue like muscles and subcutaneous fat. However, if the femur is infected, surgical approach would be very difficult because of surrounding soft tissue and bony defects would be getting larger due to the late detection. Chronic osteomyelitis of femur is an intractable disease with frequent recurrence and remained bone instability in spite of multiple classical operations . METHODS: From August 1998 to October 2005, we had 7 cases of fibular osteocutaneous free flap to reconstruct the femur. Those were followed-up for 23 months. All 7 cases were male. 4 cases were in midshaft and the others are distal part of femur. RESULTS: The 7 cases that had not been healed in spite of average 9.1 times previous operations were reconstructed successfully without the recurrence of chronic osteomyelitis. Continuous rehabilitation therapy and brace were very helpful for the ambulation. It took 5.6 months for complete union of bone, and 9.8 months for the ambulation. CONCLUSION: After wide resection, reconstruction of the femur using fibular osteocutaneous free flap guaranteed bone stability and prevented recurrence of osteomyelitis through rich blood supplying fibula and muscle. Double barrel graft of fibula would be needed in case of the sufficient strength and thickness of femur. We report the successful results of reconstruction of femur with fibular osteocutaneous free flap for chronic osteomyelitis of femur.
Braces ; Femur* ; Fibula ; Free Tissue Flaps* ; Humans ; Incidence ; Male ; Muscles ; Osteomyelitis* ; Recurrence ; Rehabilitation ; Subcutaneous Fat ; Tibia ; Transplants ; Walking

PURPOSE: We analyzed a cohort of patients with Langerhans cell histiocytosis (LCH) to understand the clinical findings, optimal management, and outcome of the disease. METHODS: We performed a retrospective clinical study of LCH from January 1993 to August 2002 at Chonnam National University Hospital. All 39 patients with histologically proven histiocytosis were categorized into Class I (n=22), Class II (n=15) and Class III (n=2) by WHO classification. RESULTS: There were 18 males and 21 females. Mean age at diagnosis was 3.2 years. The common clinical manifestations of Class I were soft tissue swelling, skin rash or nodule, otorrhea; and those of Class II were hepatosplenomegaly, fever, and respiratory symptoms. The most commonly involved organ of Class I was the skeleton; and that of Class II was bone marrow. Abnormal hematologic findings were found in 23 patients, especially in all Class II patients. Infectious etiology was documented in 5 Class II patients (CMV in 3, EBV in 1, mycoplasma in 1). Chemotherapy was given to 19 out of 22 Class I patients. Six of them showed complete remission. Four died during chemotherapy. The overall survival of Class I patients was 78% and that of Class II 63%. Poor prognostic factors of Class I were age < 1 year, over two organ involvement, hemoglobin < 10 g/dL, bilirubin > 1.5 mg/dL. CONCLUSION: The Langerhans cell histiocytosis is a heterogeneous disorder of significant morbidity and mortality. Early recognition and aggressive medical treatment might improve the survival rate.
Bilirubin ; Bone Marrow ; Classification ; Cohort Studies ; Diagnosis ; Drug Therapy ; Exanthema ; Female ; Fever ; Herpesvirus 4, Human ; Histiocytosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Jeollanam-do ; Male ; Mortality ; Mycoplasma ; Retrospective Studies ; Skeleton ; Survival Rate ; Treatment Outcome*

PURPOSE: Breast Cancer is an inter-tumoral and intra-tumoral heterogeneous disease. It remains unclear whether this heterogeneity results from different target cells or from different subsets of genetic abnormalities, otherwise from both. We postulated that in addition to genetic cloning, a variety of cells that exist during the defined developmental stages of the human mammary gland could give rise to the heterogeneity of breast cancer. To verify this postulation, we have analyzed pure ductal carcinoma in situ (DCIS) for the expression of the biomarkers that represent the mammary stem cell, the early progenitor cells, and the glandular and myoepithelial cells of the mammary gland. METHODS: We investigated the relationship between the immnuohistochemical expression of the mammary development-associated biomarkers {cytokeratin-18 (CK18), cytokeratin-6 (CK6), alpha-smooth muscle actin (SMA), Wnt-1, Notch 3} and some other factors {the menopausal status, the estrogen receptor (ER) status, the progesterone receptor (PR) status, c-erbB-2, and the number of tumor foci} in 26 cases of DCIS. RESULTS: All 26 cases included in this study showed the positive expressions of CK18 and SMA. The expression of all the markers was not correlated with the menopausal status. The positive expression of CK6 had a statistically significant relationship with a negative estrogen receptor (p=0.014), positive c-erbB-2 (p=0.048), high nuclear grade (p=0.001), and single focus of DCIS (p=0.017). The expression of Wnt-1 and Notch 3 did not have significant correlation with any factors. However, the positive expression of Wnt-1 showed a tendency of a negative ER (p=0.061) and the positive expression of Notch 3 also showed a tendency of a negative ER (p=0.086) and a high nuclear grade (p=0.086). CONCLUSION: The CK6 positive tumor is thought to originate from the more primitive cells compared to the CK6 negative tumor. Unifocality of the CK positive tumor might result from the arrest of differentiation of the original cell after disease affection. DCISs could be categorized into the CK6 positive and negative groups.
Actins ; Biomarkers ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Clone Cells ; Cloning, Organism ; Estrogens ; Keratin-6 ; Mammary Glands, Human* ; Population Characteristics ; Receptors, Progesterone ; Stem Cells*

BACKGROUND: Remnant lipoproteins are the lipolytic degradation product of the triglyceride-rich lipoproteins produced by the liver (very-low-density lipoprotein cholesterol) and intestine (chylomicrons). Recent studies have demonstrated a correlation between remnant lipoproteins and cardiovascular risk. Our study assessed the relationship between obesity and remnant lipoproteins and evaluated the factors related to remnant lipoprotein in children and adolescents. METHODS: Body mass index (BMI), waist circumference, systolic and diastolic blood pressures, body fat mass, total abdominal fat, visceral and subcutaneous fat areas, total cholesterol, triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and remnant lipoprotein cholesterol (RLP-C) were measured in 135 children and adolescents (67 boys and 68 girls). Plasma RLP fractions were isolated using an immunoaffinity gel containing specific anti-apoB-100 and anti-apoA-I antibodies. The subjects were divided into three groups: the low (< 50 percentile), mid (50~84 percentile), and high (> or = 85 percentile) BMI groups. RESULTS: RLP-C was significantly correlated with age, sex, BMI, waist circumference, systolic and diastolic blood pressures, visceral and subcutaneous fat areas, visceral fat area to subcutaneous fat area ratio (VSR), total cholesterol, TG, HDL-C, apoB, and HOMA-IR. From a multivariate regression analysis, TG (beta = 0.928, P < 0.001) was found to be independently correlated with RLP-C. After excluding TG as an independent variable, a multivariate regression analysis revealed that the HOMA-IR (beta=0.231, P=0.007) and systolic blood pressure (beta=0.169, P=0.046) were independently associated with RLP-C. CONCLUSION: RLP-C was significantly higher in obese children and adolescents. TG, systolic blood pressure, and insulin resistance were related to remnant lipoproteins.
Abdominal Fat ; Adipose Tissue ; Adolescent* ; Antibodies ; Apolipoproteins B ; Blood Pressure ; Body Mass Index ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Humans ; Insulin Resistance ; Intestines ; Intra-Abdominal Fat ; Lipoproteins* ; Liver ; Obesity ; Pediatric Obesity* ; Plasma ; Subcutaneous Fat ; Triglycerides ; Waist Circumference

BACKGROUND: Remnant lipoproteins are the lipolytic degradation product of the triglyceride-rich lipoproteins produced by the liver (very-low-density lipoprotein cholesterol) and intestine (chylomicrons). Recent studies have demonstrated a correlation between remnant lipoproteins and cardiovascular risk. Our study assessed the relationship between obesity and remnant lipoproteins and evaluated the factors related to remnant lipoprotein in children and adolescents. METHODS: Body mass index (BMI), waist circumference, systolic and diastolic blood pressures, body fat mass, total abdominal fat, visceral and subcutaneous fat areas, total cholesterol, triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and remnant lipoprotein cholesterol (RLP-C) were measured in 135 children and adolescents (67 boys and 68 girls). Plasma RLP fractions were isolated using an immunoaffinity gel containing specific anti-apoB-100 and anti-apoA-I antibodies. The subjects were divided into three groups: the low (< 50 percentile), mid (50~84 percentile), and high (> or = 85 percentile) BMI groups. RESULTS: RLP-C was significantly correlated with age, sex, BMI, waist circumference, systolic and diastolic blood pressures, visceral and subcutaneous fat areas, visceral fat area to subcutaneous fat area ratio (VSR), total cholesterol, TG, HDL-C, apoB, and HOMA-IR. From a multivariate regression analysis, TG (beta = 0.928, P < 0.001) was found to be independently correlated with RLP-C. After excluding TG as an independent variable, a multivariate regression analysis revealed that the HOMA-IR (beta=0.231, P=0.007) and systolic blood pressure (beta=0.169, P=0.046) were independently associated with RLP-C. CONCLUSION: RLP-C was significantly higher in obese children and adolescents. TG, systolic blood pressure, and insulin resistance were related to remnant lipoproteins.
Abdominal Fat ; Adipose Tissue ; Adolescent* ; Antibodies ; Apolipoproteins B ; Blood Pressure ; Body Mass Index ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Humans ; Insulin Resistance ; Intestines ; Intra-Abdominal Fat ; Lipoproteins* ; Liver ; Obesity ; Pediatric Obesity* ; Plasma ; Subcutaneous Fat ; Triglycerides ; Waist Circumference