BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.
Bleeding Time ; Blood Gas Analysis ; Coronary Angiography ; Creatinine ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Liver Function Tests ; Mass Screening* ; Partial Thromboplastin Time ; Physical Examination ; Platelet Count ; Prothrombin Time ; Retrospective Studies ; Thorax ; Urinalysis

BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.
Bleeding Time ; Blood Gas Analysis ; Coronary Angiography ; Creatinine ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Liver Function Tests ; Mass Screening* ; Partial Thromboplastin Time ; Physical Examination ; Platelet Count ; Prothrombin Time ; Retrospective Studies ; Thorax ; Urinalysis

No abstract available.

Infection with Helicobacter pylori (H. pylori) leads to gastritis, but the majority of infected persons are asymptomatic, and it has been recently described that the ability of H. pylori to cause more severe disease is related to the presence of the cytotoxin-associated gene A (cagA). We investigated the prevalence of cagA-bearing strains in a group of H. pylori-positive gastritis, and compared the morphologic differences between cagA-positive and cagA-negative cases on H&E stained slides. Polymerase chain reaction (PCR) assays for detection of H. pylori and cagA of 62 gastric biopsy specimens were performed. All the slides were analyzed by the updated Sydney system. Forty eight (77.4%) were PCR positive for H. pylori and thirty four (54.8%) were positive for cagA. There were no significant differences in numbers of H. pylori, degree of infiltration of mononuclear cells and degree of atrophy between cagA-positive and cagA-negative groups. The rates of neutrophilic infiltration and intestinal metaplasia were significantly higher in cagA-positive group than in cagA-negative group. In conclusion, the detection of H. pylori by PCR method is more sensitive than that of microscopic examination and H. pylori strains possessing cagA are associated with an enhanced induction of severe gastritis.
Atrophy ; Biopsy ; Gastritis* ; Helicobacter pylori ; Helicobacter* ; Humans ; Metaplasia ; Neutrophils ; Polymerase Chain Reaction ; Prevalence

Lymphangiectasia is a rsre occurrence, and may be due to an undgrlying disturbance of the lymph flow following surgery or irrediation. We present an unusual case of an extensive lymphangictasia of the vulva following radical abdominal hysterectomy and irradiation for cervical cancer.
Hysterectomy ; Uterine Cervical Neoplasms ; Vulva*

Intensive insulin therapy effectively delays the onset and slows the progression of nephropathy in patients with IDDM. TGF- 0 has recently been implicated in the pathogenesis of diabetic nephropathy. We evaluated the effects of different level of glucose control with insulin therapy on the progression of diabetic nephropathy in age-matched control rats(C) and 3 groups of streptozotocininduced diabetic rats', high blood glucose diabetic rats without insulin therapy(HG), rnoderate glucose diabetic rats with insulin therapy(MG), and normal glucose diabetic rats with intensive insulin treatment (NG). Glomerular volume(VG) was measured using Image-Pro morphometric software, glomerular TGF- Bl mRNA expression by in situ hybridization, and glomerular expression of TGF-8 and type IV collagen proteins by immunohistochemical staining. VG was significantly higher in HG than in other groups in 12 weeks. Kidney weight(KW) was the highest while the body weight the lowest in HG of all groups in 12 weeks. Daily urine albumin excretion (UAE) increased with time in all groups but was significantly larger in HG than in all other groups in 12 weeks. MG also had significantly larger UAE than C in 12 weeks. There was no difference in VG, KW, and UAE between NG and C. Glomerular TGF-Bl mRNA expression was significantly higher in HG than in all the rest of the groups in 4 and 12 weeks. Glomerular expression of TGF-B and type IV collagen proteins was proportional to the levels of blood glucose, being the highest in HG in 12 weeks. There was little or no expression of TGF-0 1 mRNA and protein or type IV collagen protein in NG. Thus these results support the view that high blood glucose is the prerequisite for glomerular injury in diabetes mellitus and that the glomerular injury in diabetes mellitus is mediated, in part, by TGF-01 and suppressed by glucose control.
Animals ; Blood Glucose* ; Body Weight ; Collagen Type IV ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies* ; Glucose ; Humans ; In Situ Hybridization ; Insulin* ; Kidney ; Rats ; RNA, Messenger

No abstract available.
Breast Neoplasms* ; Breast* ; Cytosol* ; Humans* ; Receptors, Steroid*

Fibromatosis can occur at various sites, but intracranial fibromatosis is exceptionally rare. Here, we report a case of intracranial fibromatosis arising in the suprasellar area of a 52-year-old woman who had undergone a surgery at that site. A computed tomography scan revealed a heavily calcified, highly enhancing, poorly demarcated mass in the left sellar area that extended into the left suprasellar, parasellar areas, and orbital apex and completely encased the left distal inferior cerebral artery. Histologic and immunohistochemical features were compatible with those of fibromatosis, although the cellularity was focally higher than usual. The etiology of extra-abdominal fibromatosis is unknown, but physical injuries such as trauma and irradiation have been reported to be associated with its occurrence. Although fibromatosis is rare in the intracranial area, it should be considered as a differential diagnosis when an intracranial mass occurs at a previously injured site.
Central Nervous System ; Cerebral Arteries ; Diagnosis, Differential ; Female ; Fibroma ; Fibromatosis, Aggressive ; Humans ; Middle Aged ; Orbit ; Sella Turcica

Fibromatosis can occur at various sites, but intracranial fibromatosis is exceptionally rare. Here, we report a case of intracranial fibromatosis arising in the suprasellar area of a 52-year-old woman who had undergone a surgery at that site. A computed tomography scan revealed a heavily calcified, highly enhancing, poorly demarcated mass in the left sellar area that extended into the left suprasellar, parasellar areas, and orbital apex and completely encased the left distal inferior cerebral artery. Histologic and immunohistochemical features were compatible with those of fibromatosis, although the cellularity was focally higher than usual. The etiology of extra-abdominal fibromatosis is unknown, but physical injuries such as trauma and irradiation have been reported to be associated with its occurrence. Although fibromatosis is rare in the intracranial area, it should be considered as a differential diagnosis when an intracranial mass occurs at a previously injured site.
Central Nervous System ; Cerebral Arteries ; Diagnosis, Differential ; Female ; Fibroma ; Fibromatosis, Aggressive ; Humans ; Middle Aged ; Orbit ; Sella Turcica

The current practice for the management of upper ureteral stones is to push the stone back into the renal pelvis before extracorporeal shock wave lithotripsy. But recent treatment modality for urinary stone is required to be less invasive and morbid. We evaluated 194 patients with upper ureter stones for the effectiveness or push-back. When in situ treatment was performed in 122 patients, the stone free rate at 3 months was 83.6% and the storage for complete fragmentation was 153.5. Push back was tried in 72 patients randomly. Out of them, 13 cases(18.6 %) were manupulated into the renal pelvis successfully and operation was required in 2 cases due to ureteral perforation. The stone free rate was 79.6% and storage for complete fragmentation was 153.7 in push back success group. There was no significant difference between two groups. We think that the primary treatment of choice for upper urinary stone is in situ ESWL. The treatment modality of push back is secondary choice in the case that was railed by primary in situ ESWL.
Humans ; Kidney Pelvis ; Kidney* ; Lithotripsy* ; Shock* ; Ureter* ; Urinary Calculi