No abstract available.
Ischemia* ; Skin*

PURPOSE: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection. METHODS: This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40~92) months. RESULTS: Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138). CONSLUSIONS: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences.
Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies

Cutaneous leishmaniasis (oriental sore) is usually a self-limited infection of the skin caused by the protozoan Leishmania tropica. The disease is endemic to the Mediterranean, Asia, Africa, and the Middle East. It has been seen in this country among many Korean technical experts and labourers working in the endemic areas of the disease. Our patient had acquired cutaneous leishmaniasis in Saudi Arabia and it had remained active for six months. He had been treated with antimony and metronidazole but failed because of severe side effects. And then we treated the patient witb cryosurgery and the skin lesions were followed by resolution with cosmetically acceptable scar in 4 months. The brief review of literature on the treatment of cutaneous leishmaniasis was undertaken.
Africa ; Antimony ; Asia ; Cicatrix ; Cryosurgery ; Eczema* ; Humans ; Leishmania tropica ; Leishmaniasis, Cutaneous ; Metronidazole ; Middle East ; Saudi Arabia ; Skin

No abstract available.
Vibration*

PURPOSE:We report the results of image-guided percutaneous biopsies with a biopsy gun and evaluate the clinical usefullness. MATERIALS AND METHODS: One hundred and five biopsies under ultrasonographic or fiuoroscopic guidance were performed. Various anatomic sites were targeted (liver;50, chest;22, kidney;12, pancreas;8, intraperitoneum;7, retroperitoneum; ). RESULTS:Obtained tissue was diagnostic in 98 of the 105 biopsies(93%). In each instance, representative core tissue specimens were obtained. Evaluation of the core tissue by pathologist revealed consistent, uniform specimens that contained significant crush artifact in no case. Five biopsies yielded inadeguate tissues which were too small for histopathologic interpretation or were composed of necrotic debris. Two biopsies yielded adequate tissues, but tissues were not of the target. The diagnoses were malignancy in 77 biopsies and benign disease in 21 biopsies. No complications other than mild, localized discomfort were encountered except a transient hemoptysis and pneumothorax which was observed in two patients. CONCLUSION:Cutting biopsy with a biopsy gun provided sufficient amount of target tissue for an accurate diagnosis of malignant and benign disease. It was a safe and useful procedure for percutaneous biopsy.
Artifacts ; Biopsy* ; Diagnosis ; Hemoptysis ; Humans ; Pneumothorax

BACKGROUND: At the neuromuscular junction, pefloxacin (P) may exacerbate myasthenia gravis and reduce the tau of MEPC. So here we investigated the effect of P on the neuromuscular blocking action of rocuronium (R). METHODS: Hemidiaphragm-phrenic nerve preparations were obtained from male Sprague-Dawley rats (150-250 g). Preparations were bathed in Kreb's solution (in (mM): NaCl 118, KCl 5, CaCl2 2.5, NaHCO3 30, KH2PO4 1, MgCl2 1 and glucose 11), maintained at 32oC and then aerated with a mixture of 95% O2 and 5% CO2. Isometric forces generated in response to 0.1 Hz, and, 50 Hz for 19 seconds with supramaximal electrical stimulation(0.2 msec, rectangular) to the phrenic nerve, were measured with a force transducer. Single twitch tension (ST) and peak tetanic tension (PTT) were calculated as % reduction versus the control, and tetanic fade (TF), as a % increase. Each preparation was exposed to one of 4 P concentrations of Krebs' solution (0, 0.25, 0.5, 1.0 mM), and enough R solution was added to the tissue bath to achieve the desired R concentration. The effects of P and R were allowed to stabilize before measuring tension parameters. EC5, EC25, EC50, EC75, and EC95 of R for ST, PTT and TF were calculated using a probit model. The interactions between the two drugs were drawn with Berenbaum's additive isobole at 25% isobole, 50% isobole, and 75% isobole. Differences between EC50's of R according to P concentrations were tested by one way ANOVA with Tamhane for post hoc; P <0.05 was regarded as significant. RESULTS: The cumulative concentration-effect curves shifted to the right in ST, and to the left in TF as the concentration of P was increased. The interactions between these two drugs varied from additive to antagonistic according to the magnitude of relaxation effect, drug concentration, and the frequency of stimulation. CONCLUSIONS: P augmented the TF of R. Our results suggest that simultaneous 0.1 Hz and 50 Hz stimulations allow the neuromuscular blocking action of a drug to be correctly evaluated.
Animals ; Baths ; Drug Interactions ; Glucose ; Humans ; Magnesium Chloride ; Male ; Myasthenia Gravis ; Neuromuscular Blockade* ; Neuromuscular Junction ; Pefloxacin* ; Phrenic Nerve ; Rats* ; Rats, Sprague-Dawley ; Refractory Period, Electrophysiological ; Relaxation ; Transducers

BACKGROUND: Geriatric patients undergoing hip arthroplasty are generally considered to be at high risk for anesthesia and surgery. Thus, the evaluation of safe anesthetic methods for hip arthroplasty in geriatric patients is important and necessary. METHODS: 228 geriatrics, either sex, older than 65 years, who were performed hip arthroplasty from Mar. 1985 to Jun. 1995, were investigated for anesthetic techniques, postoperative complications and the other problems, retrospectively. According to the kinds of anesthetic techniques, the items including primary indication for operation, name of operation, blood loss, perioperative complications, time from the end of operation to the first analgesic requirement and frequency of analgesic requirements for postoperative 72 hours were analyzed. RESULTS: The mean age of the patients with caudal anesthesia was significantly higher than that with general inhalation anesthesia. The blood loss in patients with epidural anesthesia was significantly more than that in hypobaric spinal anesthesia. The most frequent perioperative complications were cardiovascular problems including hypotension, hypertension, arrythmias, and myocardial infarction. The numbers of analgesic requirement within the postoperative 72 hours was the lowest in epidural anesthesia. There was one postoperative fatal case, whose the cause of death was found to pulmonary thromboembolism by autopsy. CONCLUSIONS: This study suggested that there were many risks for anesthesia and operation in geriatric patients with hip arthroplasty, and the cardiovascular complications were the most frequent. Thus, for hip arthroplasty in geriatrics, the choice of optimal anesthetic techniques depending on the patients physical status and physicians skill should be emphasized with the proper perioperative anesthetic management.
Analgesia ; Anesthesia* ; Anesthesia, Caudal ; Anesthesia, Epidural ; Anesthesia, Inhalation ; Anesthesia, Spinal ; Arrhythmias, Cardiac ; Arthroplasty* ; Autopsy ; Cause of Death ; Geriatrics* ; Hip* ; Humans ; Hypertension ; Hypotension ; Myocardial Infarction ; Orthopedics ; Postoperative Complications ; Pulmonary Embolism ; Retrospective Studies*

The study was conducted to predict the risk of chronic exposure by neurobehavioral test and to use it as a basic source of the management for workers exposed to organic solvents. The exposed group was selected from coating department of textile processing industry. The unexposed group was selected from those who visited the clinic to take an annual check-up. The author administered WHO-NCTB (neurobehavioral core test battery). Also, Scandinavian Questionnaire 16 was tested by self-administration to find the correlation between subjective symptoms and NCTB results, and to assess the availability of the Questionnaire in mass screening test concurrently. The final analysed subjects were 78 (27 in exposed group and 51 in unexposed group) workers except who had a neurologic disease or systemic disease affecting the central nervous system. In Questionnaire study, there was no significant difference in total neurotoxic symptom scores between the exposed and the unexposed group. In NCTB, the exposed group had lower mean scores than the unexposed group for all tests. When the effect by age and education were considered, there was a statistically significant difference only in pursuit timing test. This study suggests the availability of NCTB and the Questionnaire for the assessment of neurobehavioral change in workers exposed to organic solvents.
Central Nervous System ; Education ; Mass Screening ; Questionnaires ; Solvents* ; Textiles*

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed. Due to high tissue thromboplastin concentration in cerebral tissue, more serious coagulation and fibrinolytic abnormalities may occur when concomitant head trauma is present. The aim of this study was to determine the changes in coagulation and fibrinolysis after trauma and the effects of head trauma on coagulation and fibrinolysis. METHODS: This study includes 35 trauma patients: 16 patients with head trauma (group A) and 19 patients without head trauma (group B). We measured the plasma levels of functional protein C, antithrombin III (AT III), thrombin antithrombin III complex (TAT), plasmin alpha 2 plasmin inhibitor complex (PIC), tissue plasminogen activator antigen (t-PA), and plasminogen activator inhibitor-1 antigen (PAI-1) on admission and on days 1, 2, 4, and 6 after the trauma. RESULTS: The TAT and the TAT/PIC were significantly higher in group A than in group B on all days. PIC was significantly lower in group A than in group B on all days except the day of admission. Over the course of time, the TAT and the TAT/PIC decreased in both groups and PIC increased. On admission, the PAI-1 of both groups was increased, but it decreased over the course of time. The t-PA was increased on admission, was suppressed on the 1st day, and then increased again. The PAI-1 and the t-PA showed no significant difference between the two groups. CONCLUSIONS: After multiple trauma, coagulation was enhanced and fibrinolysis was suppressed. Enhanced coagulation and suppressed fibrinolysis were significantly greater in group A than in group B.
alpha-2-Antiplasmin ; Antithrombin III ; Blood Coagulation ; Craniocerebral Trauma ; Fibrinolysin ; Fibrinolysis* ; Humans ; Multiple Trauma* ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein C ; Thrombin ; Thromboplastin ; Tissue Plasminogen Activator

The Continuing Professional Development (CPD) program of Korean medical doctors had problems that did not resolve for many years. The primary concern of this study is to examine the problems of the CPD program of Korean medical doctors and to suggest practical guidelines to resolve such barriers. The findings show that the major barrier for improving CPD program is the lack of total quality management. Such lack came from insufficient manpower to plan, execute, and evaluate the CPD programs. The insufficient financial support aggravated the situation. In order to enhance the CPD program, various problems in planning, executing, evaluation stage must be dealt. Specific plans and resolutions in each stage have been suggested.
Financial Support ; Porphyrins ; Program Development ; Total Quality Management