No abstract available.
Lung* ; Microbubbles*

No abstract available.
Adenocarcinoma, Clear Cell* ; Vagina*

The endemic status of clonorchiasis and metagonimiasis along the Geum-gang (River) in Okcheon-gun (County) in Korea was examined. From February to December 2000, stools of total 1,081 inhabitants living in 5 villages were examined. Each stool specimen was examined by both the cellophane thick smear method and the formalin-ether sedimentation technique. Egg-positive cases were further analyzed by Stoll's egg-counting technique, and praziquantel was administered to positive cases. The egg-positive rates for Clonorchis sinensis and Metagonimus species were 9.3% and 5.5%, respectively, and the double infection rate was 3.5%. The numbers of eggs per gram (EPG) of feces of C. sinensis and Metagonimus sp. were 918 +/-1.463 and 711+/-947, respectively. The egg-positive rates for C. sinensis and Metagonimus sp. in the riverside area were 14.2% and 8.4%, respectively, which were significantly higher than those of the inland area (3.2% and 1.7%, respectively). The egg-positive rates of C. sinensis and Metagonimus sp. in males (16.7% and 10.0%) were significantly higher than those of females (3.5% and 1.8%). However, there were no significant differences of EPG values between localities and sexes. The prevalence of clonorchiasis and metagonimiasis in this survey was significantly lower than that in the previous reports. However, there is still a high prevalence of infection with C. sinensis and Metagonimus sp. in this region, especially in the riverside area.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Clonorchiasis/*epidemiology/parasitology ; Clonorchis sinensis/isolation & purification ; Feces/parasitology ; Female ; Heterophyidae/isolation & purification ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Prevalence ; Rural Population ; Sex Factors ; Time Factors ; Trematode Infections/*epidemiology/parasitology

Recently the use of hydrochloric acid as a toilet disinfectant has become more common, and the risk of its ingestion is though to be increasing. We experienced a case of 67 year-old man who accidentally ingested hydrochloric acid and as a result developed a postprandial epigastric fullness end pain 3 weeks thereafter, The patient underwent an UGI series, fiberoptic gastroscope and abdominal ultrasonography and was found to have a gastric midbody stricture. A total gastreetomy and Roux-en- Y esophagojejunostomy was performed. We report this case with brief review of the literature.
Aged ; Constriction, Pathologic ; Eating ; Gastritis* ; Gastroscopes ; Humans ; Hydrochloric Acid* ; Ultrasonography

Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.
Actinomycosis/*complications ; Aged ; Aneurysm, Infected/*etiology/*radiography/therapy ; Embolization, Therapeutic ; Human ; Male ; Pneumonia, Bacterial/*complications ; *Pulmonary Artery ; Treatment Outcome

BACKGROUND: This study was undertaken to compare nosocomial infection rates between intensive care units of military and civilian hospitals. METHODS: From July to December 2000, we surveyed the intensive care unit of Armed Forces Capital Hospital (AFCH). We compared device use ratios and device-day infection rates with those of Korean Society for Nosocomial Infection Control (KOSNIC) and National Nosocomial Infections Surveillance (NNIS) system. RESULTS: During the period of study, 185 cases were admitted and 24 nosocomial infections were detected: 7 cases of pneumonia, 6 urinary tract, 3 blood stream, 3 cardiovascular system, 3 surgical site infections, 1 skin and soft tissue, and 1 central nervous system infection. Ventilator, urinary catheter and central venous catheter use ratios were 0.14 (95% confidence interval, 0.12-0.16), 0.58 (0.56-0.60) and 0.33 (0.31-0.35). The ratios of NNIS were 0.41, 0.67 and 0.50. Ventilator-, urinary catheter- and central venous catheter-day infection rates were 18.69(11.36-53.32), 6.65 (3.36-14.20) and 1.95 (1.44-9.92). However, the rates of KOSNIC were 9.93, 5.29 and 3.62. The rates of NNIS were 11.24, 6.14 and 5.55. CONCLUSIONS: In AFCH ventilators were used less frequently than NNIS, but more ventilator-associated pneumonia were developed than KOSNIC and NNIS.
Arm ; Cardiovascular System ; Central Nervous System Infections ; Central Venous Catheters ; Cross Infection* ; Hospitals, Military ; Humans ; Intensive Care Units* ; Critical Care* ; Military Personnel* ; Pneumonia ; Pneumonia, Ventilator-Associated ; Rivers ; Skin ; Urinary Catheters ; Urinary Tract ; Ventilators, Mechanical

There is a widespread belief that nasogastric decompression in gastric cancer surgery allows better surgical field and leads to the reduction of postoperative complications. The aim of this study was to evaluate whether gastric cancer surgery can be safely performed without nasogastric decompression. From March to June 2000, 119 patients with gastric adenocarcinoma were randomized into either a tubeless group (n=56) or an intubated group (n=63). Exclusion criteria included a history of upper gastrointestinal bleeding and pyloric obstruction. No remarkable difference was found in the incidence of complications in the tubeless and intubated groups (mean 10.9%, p=0.945). The incidence of nasogastric tube insertion in the tubeless group was similar to the incidence of nasogastric tube reinsertion in the intubated group (p=0.747). Time to pass flatus was not different in the two groups (p=0.054), nor was the length of hospital stay (p=0.148). These results suggest that gastric cancer surgery can be performed safely without nasogastric decompression.
Adult ; Aged ; Comparative Study ; Female ; Human ; *Intubation, Gastrointestinal ; Male ; Middle Age ; Postoperative Complications/etiology ; Prospective Studies ; Stomach Neoplasms/*surgery

PURPOSE: Drainage of the peritoneal cavity after abdominal surgery has been routinely practiced, although few data exist to scientifically support the efficacy of such an approach. In gastric cancer surgery, drainage is regarded as an essential procedure to keep the peritoneal cavity clear after extended lymphadenectomy and, also, to facilitate early detection of hemorrhage, and anastomotic or duodenal stump leakage. In this context, we planned a randomized prospective trial of drainage use after gastrectomy with extended lymphadenectomy. METHODS: Between February and July 2001, 170 patients who underwent gastrectomy with extended lymphadenectomy were randomly allocated to either a non-drainage (n=84) or drainage group (n=86). The primary outcome measure was the complication rate. Additional outcome measures were operation time, requirements of rescue analgesics, changes in the level of serum albumin and hemoglobin, and hospital stay. RESULTS: Demographic details, preoperative physical status, and pathologic features were not different between the two groups. Incidences of total gastrectomy and splenectomy among total gastrectomies were similar in both groups. However, operation time was shorter in the non-drainage group than in the drainage group (P=0.022). There were no differences in surgical outcome, including changes in hemoglobin and albumin levels, requirement for rescue analgesics, time to flatus or soft diet, and length of hospital stay. Complication rates were not different between the two groups(P=0.691), nor in the patterns of complication in either group. There was no operative mortality or reoperation. CONCLUSION: Based on these results, routine abdominal drainage should not be mandatory or even standard after gastrectomy with extended lymphadenectomy for gastric cancer.
Analgesics ; Diet ; Drainage ; Flatulence ; Gastrectomy ; Hemorrhage ; Humans ; Incidence ; Length of Stay ; Lymph Node Excision ; Mortality ; Outcome Assessment (Health Care) ; Peritoneal Cavity ; Prospective Studies ; Reoperation ; Serum Albumin ; Splenectomy ; Stomach Neoplasms*

PURPOSE: Additional gastrectomy is needed after endoscopic resection for early gastric cancer when pathology confirms any possibility of lymph node metastasis or margin involvement. No studies depicted the optimal type of surgery to apply in these patients. We compared the short-term and long-term outcomes of laparoscopic gastrectomy with those of open gastrectomy after endoscopic resection to identify the optimal type of surgery. MATERIALS AND METHODS: From 2003 to 2010, 110 consecutive patients who underwent gastrectomy with lymphadenectomy either by laparoscopic (n=74) or by open (n=36) for gastric cancer after endoscopic resection were retrospectively analyzed. Postoperative and oncological outcomes were compared according to types of surgical approach. RESULTS: Clinicopathological characteristics were comparable between the two groups. Laparoscopic group showed significantly shorter time to gas passing and soft diet and hospital day than open group while operation time and rate of postoperative complications were comparable between the two groups. All specimens had negative margins regardless of types of approach. Mean number of retrieved lymph nodes did not differ significantly between the two groups. During the median follow-up of 47 months, there were no statistical differences in recurrence rate (1.4% for laparoscopic and 5.6% for open, P=0.25) and in overall (P=0.22) and disease-free survival (P=0.19) between the two groups. Type of approach was not an independent risk factor for recurrence and survival. CONCLUSIONS: Laparoscopic gastrectomy after endoscopic resection showed comparable oncologic outcomes to open approach while maintaining benefits of minimally invasive surgery. Thus, laparoscopic gastrectomy can be a treatment of choice for patients previously treated by endoscopic resection.
Diet ; Disease-Free Survival ; Follow-Up Studies ; Gastrectomy ; Humans ; Laparoscopy ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms

PURPOSE: There has been considerable controversy over the prognosis of gastric signet ring cell carcinoma (SRC). To clarify the biologic behavior of SRC, we evaluated the clinicopathologic features and the prognosis of SRC. METHODS: A total of 3,104 patients with a gastric carcinoma who had undergone a gastrectomy from 1987 to 1995 were analyzed retrospectively. Among them, 556 patients with SRC were compared to 2,548 patients with non-SRC. RESULTS: Patients with SRC were younger than those with non-SRC, and female were prevalent. Incidence of EGC were higher in patients with SRC. EGC with SRC had a larger proportion of mucosa-confined lesions and a lower rate of lymph node metastasis than EGC with non-SRC. Multivariate analysis showed that SRC was a negative inde pendent risk factor for lymph node metastasis. Among advanced gastric cancers SRCs showed a higher prevalence of large-sized lesions, Borrmann type IV lesions, and advanced nodal stage, as well as a higher rate of peritoneal metastasis. The 5-year survival rate of EGC with SRC (93.8%) was higher than that of non-SRC (91.2%). However, the prognosis of advanced SRC (49.0%) was poorer than that of non-SRC (53.5%). CONCLUSION: A female preponderance, a younger age, and a higher proportion of early gastric cancer characterized the peculiar biologic behavior of gastric signet ring cell carcinoma. In addi tion, the prognosis of SRC was poor once invasion had gone beyond the submucosa. These findings suggest that signet ring cell carcinoma of the stomach should be regarded as a distinct type of gastric cancer.
Carcinoma, Signet Ring Cell* ; Female ; Gastrectomy ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prevalence ; Prognosis* ; Retrospective Studies ; Risk Factors ; Stomach ; Stomach Neoplasms ; Survival Rate