No abstract available.
Animals ; Cricetinae* ; Fertilization in Vitro* ; Humans*

The spleen is the most common intraabdominal organ injured in blunt trauma, Although physical signs andsymptoms, coupled with abdominal paracentesis & peritoneal lavage confirm intraabdominal injury, but isolatedsplenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation ofplain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patiens of theautopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Malepatients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode oftrauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struckby fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occured in 2 cases(8.3%). 4. Commonpatterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a lacerationthat involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). Themost common plain abdominal roentgenographic findings was the evidence of intraabdominal fluid in 21 cases(87.5%).The others are included in order of frequency: gastric dilatation, prominent mucosal folds on greater curvature ofthe stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in theregion of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plainroentgenological findings. But the evidence of intraabdominal fluid is most important in the light of earlydiagnosis. 7. Diagnosis of splenic injury may be most helpul that in combination with clinical history, clinicalsymptoms & signs and plain film findings. In delayed rupture, diagnostic value of serial examination and surgicalobservation is emphasized.
Constitution and Bylaws ; Diagnosis ; Early Diagnosis ; Gastric Dilatation ; Incidence ; Lacerations ; Motor Vehicles ; Paracentesis ; Peritoneal Lavage ; Retrospective Studies ; Rupture ; Spleen ; Stomach ; Thorax

BACKGROUND: QT interval dispersion (QTD) reflects the regional inhomogeneity of ventricular repolarization, and heart rate variability reflects the autonomic tone of the heart. The relation between QTD and heart rate is not clarified yet. The object of this study was to examine the influence of heart rate on QTD using exercise treadmill test in healthy subjects. METHODS: The influence of heart rate on QTD was studied in 42 young healthy pilots by evaluating the changes in QTD induced by hyperventilation and exercise. QTpeak interval dis-persion (QTp D) was defined as the difference between maximum and minimum QTpeak interval measured on 12 lead ECG at single cardiac beat. Paired t test was used between QTp D at rest, QTp D after hyperventilation and QTp D after exercise to determine the effect of heart rate on QTp D. RESULTS: The QTp D after hyperventilation (37+/-11 msec) was greater compared to QTp D at rest (35 +/-14 msec), but there was no difference (P>0.05). The QTp D after exercise was 31 +/-11 msec at stage 1, 28 +/-13 msec at statge 2 and 31 +/-12 msec at stage 3. and there was the significant difference in QTp D at statge 2 compared to QTp D at rest (P<0.05). CONCLUSION: The QTp D significantly decreased at stage 2 after graded exercise in healthy men. This finding suggests that anti-arrhythmogenic effect associated with decreased QTp D during physiologic exercise is present in apparently healthy men.
Electrocardiography ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Hyperventilation ; Male

BACKGROUND AND OBJECTIVES: QT interval on ECG strongly depends on heart rate. Prolonged early phase of repolarization may be responsible for mechanisms of arrhythmogenesis. Investigation of physiologic behavior of QT interval and their relation to cardiac cycle length may explain mechanisms of arrhythmogenesis. The aim of this study is to investigate the physiologic behavior of the QT intervals during various stages of treadmill exercise test in healthy airlines pilots. METHOD: A retrospective analysis of treadmill exercise test ws done in 60 healthy men. Each underwent 10 ECG recordings, which were performed in resting, 1 minute, 2 minute and 3 minute of exercise stage 1, 2 and 3 of Bruce protocol respectively. The QT interval was measured as the time interval from the earliest Q onset to the peak T wave (QTp) in precordial lead V2. RESULTS: The mean heart rate before exercise was 72 +/-5 beats/minute, and at 1, 2 and 3 minute of exercise stage 1, 2 and 3 were 96 +/-8, 97 +/-7, 99 +/-9, 112 +/-9, 117 +/-9, 120 +/-10, 137 +/-12, 145 +/-12 and 152 +/-10, respectively. The d-QTp/d-RR at 1, 2 and 3 minute of exercise stage 1, 2 and 3 were 10.4 +/-5.9, 14.1 +/-5.8, 15.1 +/-6.2, 14.8 +/-4.2, 16.1 +/-3.7, 16.3 +/-3.5, 16.8 +/-2.9, 17.1 +/-3.0%, respectively. The QTp interval respond slowly for rapid changes in cycle length. The change of QTp interval showed a linear correlation with the change of the RR interval (y=0.189x-10.864, r=0.83, P<0.0001). CONCLUSION: The changes in QT interval lagged behind the rapid and sustained changes in the heart rate elicited by treadmill exercise test. It is concluded that the d-QTp/d-RR showed hysteresis in the changes in the RR interval may be useful in assessing in the dynamic regulation of the ventricular repolariza-tion process.
Electrocardiography ; Exercise Test ; Heart Rate ; Humans ; Male ; Retrospective Studies

PURPOSE: We report on a novel method and outcomes of laparoscopic gastric tubing with pyloromyotomy. METHODS: The abdominal procedure includes laparoscopic gastric mobilization, celiac axis lymph node dissection, formation of the gastric tube, and pyloromyotomy. Between January 2009 and April 2013, our minimally invasive esophagectomy (MIE) was performed on 54 patients with esophageal cancer. The short-term outcomes, including postoperative complications, were analyzed. RESULTS: There were no cases of conversion to open surgery. Of 54 patients, 52 patients had squamous cell carcinoma (SCC) and two had adenocarcinoma. The total operative time was 349.8+/-77.4 minutes, of which 90.6+/-27.6 minutes was required for the abdominal procedure. The mean estimated operative blood loss during the abdominal procedure was 40.0+/-355.5 ml. The postoperative complication rate was 24.1%; three patients died of pneumonia. CONCLUSION: Laparoscopic gastric tubing with pyloromyotomy is a feasible and safe treatm ent option for patients with esophageal cancer.
Adenocarcinoma ; Axis, Cervical Vertebra ; Carcinoma, Squamous Cell ; Conversion to Open Surgery ; Esophageal Neoplasms* ; Esophagectomy ; Humans ; Laparoscopy ; Lymph Node Excision ; Operative Time ; Pneumonia ; Postoperative Complications

OBJECTIVES: This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. METHODS: Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. RESULTS: Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. CONCLUSIONS: This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to Bpromote adherence to hand washing.
Adolescent ; Adult ; Child ; Female ; *Handwashing ; *Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Male ; Middle Aged ; Toilet Facilities

Endothelial cell have been shown to play an active role in many phases of immunologic process, including binding of T lymphocytes, neutrophils, platelets, and monocytes to the endothelium, as well as phagocytosis. Endothelial cells can also serve as targets that undergo cell injury. The most prominent mediators of endothelial cell activation are IL-1beta and TNF-alpha. VLA-4 was first identified as an endothelial cell surface receptor. We performed the culture of endothelial cells derived from human glomerular capillaries and studied the cytokine-regulated expression of VCAM-1, and the effect of dexamethasone and TGF-beta on the cytokine induced VCAM-1 expression using ELISA method. Expression of VCAM-1 was not detectable above background level in the basal unstimulated state. However, VCAM-1 was rapidly induced after exposure to IL-1beta (5ng/ml) or TNF-alpha (1, 10ng/ml) (O.D.=1.76+/-0.15, 1.95+/-0.35, 1.88+/-0.17, mean+/-S.E., control=0.36+/-0.028, n=8-24, P<0.05). But IFN-gamma did not increase the expression of VCAM-1. Addition of dexamethasone (10 micrometer) and TGF-beta1 (1ng, 10ng/ml) blunted IL-1beta and TNF-alpha induced expression of VCAM-1. Therefore, VCAM-1 could be inducible in human glomerular endothelial cells, and it was regulated by dexamethasone and TGF-beta1. The negative findings in histopathology may reflect the transience of VCAM-1 expression and does not necessarily exclude an important role of this molecule in the early stages of renal disease.
Capillaries ; Dexamethasone* ; Endothelial Cells* ; Endothelium ; Enzyme-Linked Immunosorbent Assay ; Humans ; Integrin alpha4beta1 ; Monocytes ; Neutrophils ; Phagocytosis ; T-Lymphocytes ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha ; Vascular Cell Adhesion Molecule-1*

BACKGROUND: Carolic restriction as a treatment for obesity causes catabolism of body protein stores and produces negative nitrogen balance. GH administration causes acceleration of lipolysis and promotion of nitrogen conservation. We evaluated the effects of GH treatment and caloric restriction on lipolysis, anabolic effects and body composition in obese subjects. METHODS: 24 obese (20% over IBW) subjects (22 women and 2 men; 22-46yr old) were fed a diet of 25kcal/kg IBW with 1.2g protein/kg IBW daily during treatment. The subjects were assigned at random to either treatment with recombinent human GH (n=12, 0.06U/kg IBW every other day) or placebo (n 12, vehicle injection) for 12 weeks. Body fat was assessed by impedence and abdominal fat, visceral fat area at the umbilicus level and muscle area of mid thigh level were measured using computed tomography. RESULTS: Fraction of body weight lost as fat lost was significantly greater in GH treatment than in placebo group (1.21+-0.48%/kg, vs 0.52+-0.28%/kg, p0.05). GH treatment caused significant decrease in visceral fat area (35.3% vs 28.5%, p<0.05). In placebo group, there were significant loss of muscle area (-4.8 +-2.6cm ) and lean body mass (-2.62 +-1.51kg) after treatment. In contrast, GH treatment group had more increase in muscle area (3.5+-2.3cm ) and lean body mass (1.13 +-1.04kg) and positive nitrogen balance (1.81+-4.06g/day). GH injections cuased a 1.6-fold increase in IGF-I, despite caloric restriction. GH responses to L-dopa stimulation were blunted in all subjects and GH responses were increased after treatment. Both group showed hyperinsulinemia during oral glucose tolerance test (OGTT), and after treatment, they had decreased in insulin secretion. However, GH treatmnent group had not significant decrease, because GH might induce insulin resistance. FFA response areas during OGTT markedly decreased after treatment in both group. In GH treatment group, more decrease of FFA responses might result from the antilipolytic effect by higher level of insulin or more decrease in amount of fat. CONCLUSION: This study has demonstrated that in obese subjects fed hypocaloric diet, GH accelerates body fat loss and exerts anabolic effects.
Abdominal Fat ; Acceleration ; Adipose Tissue ; Adult* ; Anabolic Agents ; Body Composition ; Body Weight ; Caloric Restriction ; Diet* ; Female ; Glucose Tolerance Test ; Growth Hormone* ; Humans ; Hyperinsulinism ; Insulin ; Insulin Resistance ; Insulin-Like Growth Factor I ; Intra-Abdominal Fat ; Levodopa ; Lipolysis ; Male ; Metabolism ; Nitrogen ; Obesity ; Thigh ; Umbilicus

PURPOSE: To analyze the benefit and feasibility of this procedure compared with those of open method. METHODS: Abdominal procedure includes laparoscopic gastric mobilization, celiac axis lymph node dissection, formation of the gastric tube, and pyloromyotomy. The actual procedure performed during open surgery is the same as those of laparoscopic surgery except for the main incision. Minimally invasive esophagectomy (MIE) was performed on 54 patients with esophageal cancer. The short-term outcomes, including postoperative complications were analyzed and compared with 44 cases of open method. RESULTS: Although the total operative time was not different between 2 groups (349.8 minutes vs. 374.8 minutes, P = 0.153), the operation time of abdominal procedure was shorter in laparoscopic group (90.6 minutes vs. 162.1 minutes, P < 0.001). Operation related complications and hospital stay were not significantly different between the 2 groups. The number of transfused patients was significantly smaller in laparoscopic group (11.1% vs. 27.9%, P = 0.030). CONCLUSION: Laparoscopic gastric tubing with pyloromyotomy is a feasible and safe treatment option for patients with esophageal cancer.
Axis, Cervical Vertebra ; Esophageal Neoplasms* ; Esophagectomy ; Feasibility Studies ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Operative Time ; Postoperative Complications ; Surgical Procedures, Minimally Invasive

Schwannomas are rare tumors derived from the cells of Schwann which form the neural sheath. Some patients with gastrointestinal schwannoma have been previously reported in the literature. However, schwannomas of the colon are extremely rare. We herein describe a case of schwannoma of the colon. A 49-year-old woman was admitted with complaint of abdominal pain and investigations revealed the presence of a 4 cm sized mass in the ascending colon. Following right hemicolectomy, histopathology and immunohistochemistry confirmed the colonic lesion to be a benign schwannoma. There was no evidence of specific complication or recurrence until now.
Colon, Ascending/*pathology ; Colonic Neoplasms/*diagnosis/pathology/ultrasonography ; Female ; Humans ; Middle Aged ; Neurilemmoma/*diagnosis/pathology/ultrasonography ; S100 Proteins/analysis/immunology ; Tomography, X-Ray Computed