No abstract available.
Anus Neoplasms* ; DNA* ; Ploidies*

No abstract available.
Anus Neoplasms* ; DNA* ; Ploidies*

BACKGROUND/AIMS: Primary appendiceal adenocarcinoma is a rare neoplasm that constitutes less than 0.5% of all gastrointestinal neoplasm. The aim of this study was to figure out its clinicopathologic characteristics that are not well understood. METHODS: We reviewed the medical records of nineteen patients (9 males and 10 females) with histologically proven appendiceal adenocarcinoma. They had been treated at Asan Medical Center between June 1989 and December 2002. Their median follow-up duration was 72.5 months. RESULTS: Their median age was 56.5 (range, 33~80) years. Thirteen patients had mucinous variants and the other five had adenocarcinoma. Seven patients (36.8%) were diagnosed as acute appendicitis. In fact, none of the patients was diagnosed correctly before surgery. The operative procedure, included right hemicolectomy in 9 patients, appendectomy alone in 2 patients, and debulking of their tumors or a biopsy in 8 patients. The 5-year survival rate was 20.5%. The patients with mucinous type had better prognosis than those with the non-mucinous type (p<0.01). In the patients with mucinous type, the survival rate after debulking operation was similar to that after right hemicolectomy. CONCLUSIONS: The most important prognostic factor of primary appendiceal adenocarcinoma was histology. The outcome of debulking operation is being watched compared with that of right hemicolectomy in mucinous variant.
Adenocarcinoma/*diagnosis/mortality/surgery ; Adult ; Aged ; Appendiceal Neoplasms/*diagnosis/mortality/surgery ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Survival Rate

BACKGROUND: Despite the importance of burn-induced encephalopathy, cerebral hemodynamics after burn injury and during resuscitation remains undefined. The aim of our study was to evaluate the effects of a large cutaneous burn injury on the cerebral circulation. METHODS: Anesthetized sheep(n=8) were prepared with vascular catheters, a urinary catheter and a Richmond bolt for intracranial pressure monitoring. A scald injury was inflicted on 70% of total body surface area with hot water. Resuscitation was started 30 minutes after scald with Ringer's lactate to restore and then maintain baseline oxygen delivery. Resuscitation maintained blood pressure, cardiac output and urine output at normal levels. Brain blood flow was measured with colored microspheres. RESULTS: During resuscitation intracranial pressure rose slowly from 10.6+/-1.5 to 17.0+/- 4.0 mmHg(P<0.05) and cerebral perfusion pressure was reduced from 86.4+/- 6.8 to 64.1+/- 2.8 mmHg(P<0.05). During early resuscitation cerebrovascular resistance declined to maintain brain blood flow and oxygen delivery at baseline or better. After 6 hours, cerebrovascular resistance was inappropriately increased during a period of reduced cerebral perfusion pressure which resulted in brain blood flow being half the baseline levels. CONCLUSIONS: These data suggest that autoregulation maintains brain blood flow immediately after burn shock and early resuscitation, but autoregulation may be less effective as burn resuscitation proceeds.
Blood Pressure ; Body Surface Area ; Brain ; Burns* ; Cardiac Output ; Hemodynamics ; Homeostasis ; Intracranial Pressure ; Lactic Acid ; Microspheres ; Oxygen ; Perfusion ; Resuscitation* ; Shock ; Skin ; Urinary Catheters ; Vascular Access Devices ; Water

Purpose: This descriptive study analyzed the factors affecting turnover intention among married nurses in smalland medium-sized hospitals with less than 300 beds. Methods: Data were collected from 177 married nurses located in K city from April 8, 2022 to April 21, 2022 using a questionnaire. Descriptive statistics, independent tests, one-way ANOVA, Pearson's correlation coefficient test, and multiple regression were analyzed using the SPSS/WIN 22 program. Results: Nurses rated items on a scale of five points. Their average rating for job satisfaction was 3.43±0.30, resilience was 3.51±0.38, and role conflict was 2.60±0.63. The nursing practice environment was rated 3.12±0.44, and turnover intention was 3.14±0.62 points. Age, job satisfaction, and nursing practice environment accounted for 25.1% of turnover intention (F=6.90, p<.001). Conclusion To decrease married nurses’ turnover intention in small- and medium-sized hospitals with less than 300 beds, these findings can help develop a program that addresses the causes of high turnover amongst married nurses in local hospitals.

BACKGROUND/AIMS: We aimed to verify the prognostic factors of stage II rectal cancer and the effect of radiation therapy on the survival and local recurrence rate. METHODS: This study was undertaken in 202 patients who underwent curative resection of rectal cancer and confirmed to be stage II between July 1989 and December 1996. Univariate and multivariate (Cox's model) analyses of survival were employed to identify prognostic factors. Statistical significance was assigned by p value of <0.05. RESULTS: Overall recurrence occurred in 32 patients. Four patterns of recurrence were observed: hematogenous recurrence in 17 patients, local recurrence in 11, peritoneal seeding in two and simultaneous hematogenous and local recurrence in two cases. Overall 5-year survival rate was 85.6% and 5 year disease free survival rate was 82.8%. There was no significant difference in local recurrence rate and survival according to radiation therapy or location of cancer. In multivariate analysis, the number of harvested lymph node was only a prognostic factor. CONCLUSIONS: The number of harvested lymph nodes has prognostic value in stage II rectal cancer. Postoperative radiation therapy should be considered for stage II rectal cancer with poor prognostic factors although radiation did not decrease local recurrence rate in present study.
Adolescent ; Adult ; Aged ; Child ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Rectal Neoplasms/pathology/*surgery

BACKGROUND/AIMS: Despite numerous studies on the relation of genetic polymorphisms with irritable bowel syndrome (IBS), the results still remain inconclusive. The aim of this study was to assess the possible association between SLC6A4 serotonin transporter gene linked polymorphic region (5-HTTLPR), ADRA2A -1291C>G, GNB3 825C>T, CCK1R intron 779T>C and TRPV1 945G>C polymorphisms and IBS based on Rome III criteria in Korea. METHODS: Study subjects were prospectively recruited from visitors to Seoul National University Bundang Hospital between July 2009 and January 2014. Ninety-nine IBS patients and 171 healthy controls were enrolled. Polymorphisms of above-mentioned 5 genes were genotyped. Serum serotonin from 101 participants was measured by ELISA and compared according to SLC6A4 5-HTTLPR polymorphisms and IBS subtypes. RESULTS: Regarding SLC6A4 5-HTTLPR polymorphism, L/L genotype was significantly associated with the total IBS, constipation predominant IBS (IBS-C) and mixture of diarrhea and constipation IBS (IBS-M) (adjusted OR: 4.35, 95% CI: 1.04-16.67; adjusted OR: 11.11, 95% CI: 1.69-50.00 and adjusted OR: 5.56, 95% CI: 1.05-33.33, respectively). Carrying ADRA2A -1291G allele was significantly associated with total IBS and diarrhea predominant IBS (adjusted OR: 3.37, 95% CI: 1.16-9.77 and adjusted OR: 5.64, 95% CI: 1.18-27.01, respectively). IBS-C patients showed reduced level of serum serotonin compared to controls and patients with diarrhea predominant IBS (50.2 ng/mL vs. 69.0 ng/mL and 92.9 ng/mL, P = 0.017 and P = 0.001, respectively). CONCLUSIONS: Genetic polymorphisms of SLC6A4 5-HTTLPR and ADRA2A -1291C>G could be one of the pathophysiological factors of IBS in Korea. Reduced serum serotonin shown in the IBS-C group suggested a role of serotonin in IBS, but large study is needed for confirming genotypic difference in serum serotonin level.
Alleles ; Constipation ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Genotype ; Humans ; Introns ; Irritable Bowel Syndrome* ; Korea ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prospective Studies ; Receptors, Adrenergic ; Seoul ; Serotonin ; Serotonin Plasma Membrane Transport Proteins*

Among various approaches to midline skull base tumors, anterior approaches can provide excellent visualization of the lesion. Since June 1989, 12 anterior procedures have been carried out on 9 consecutive patients presenting with midline skull base tumors(four transsphenodal approches, three Le Fort I osteotomies. Two lateral rhinotomies, two facial translocation approaches, and one craniofacial approach). These anterior procedures allowed good access to the lesions. Wound healing was rapid, with little discomfort to the patients. Cosmetic results were also excellent, and there were no significant problems related to malocclusion in the cases of Le Fort I osteotomy. Patients who underwent facial translocation approach developed nasolacrimal duct obstruction and small area hypesthesia on the cheek. Postoperatively, two patients died from tumor progression and meningitis secondary to CSF leakage, respectively. Although the number of cases and follow-up period are limited in our series, we think that anterior approaches may be useful in the surgical treatment to midline skull base tumors.
Cheek ; Follow-Up Studies ; Humans ; Hypesthesia ; Malocclusion ; Meningitis ; Nasolacrimal Duct ; Osteotomy ; Skull Base* ; Skull* ; Wound Healing

Improved access to lesions at the medial end of the sphenoid ridge, in the cavernous sinus, or in the interpeduncular cistern after mobilization of the zygoma has been a subject of growing interest in recent years. This study described out experience with 23 patients who underwent the zygomatic osteotomy for skull base tumors in the past 6 years. The follow-up period ranged from 5 months to 49 months. The patient' age range was 11 to 75 years, with an average age of 45 years. This zygomatic osteotomy was used from eleven patients with medial sphenoid ridge lesions, six with lesions arising in or involving the cavernous sinus, three with clival lesions, two with sellar/parasellar lesions, and one with temporal lobe lesions. The histology of these patients showed fourteen meningiomas, two pituitary adenomas, two chordomas, one neurinoma, one chondrosarcoma, one osteochondroma, one malignant lymphoma, and one dermoid cyst. Surgical treatment consisted of total removal in ten patients, subtotal removal in twelve, and partial removal in one. Instances of morbidities associated with basic lesions included cranial nerve injury in five patients, hemorrhage/infarction in three, hemiparesis in two, and transient aphasia in one. There were no significant problems related to zygomatic osteotomy. One patient who underwent zygomatic osteotomy for medial sphenoid ridge meingioma developed a frontalis nerve injury. No patient experienced a detachment of zygomatic arch in our series. Postoperatively, one patient with parasellar malignant lymphoma died 14 months after surgery from tumor progression. Our cases treated via this zygomatic osteotomy are as yet insufficient to determine whether the method offers definite adventages, in terms of patient mortality and morbidity, over conventional operative approaches, but we suggest that this procedure has some advantages such as minimal brain retraction, exposure of lesion in shortest distance, multidirectional viewing of the lesions, and can serve as an alternative approach to a usual pterional approach when cranial base pathologies are large or complex.
Aphasia ; Brain ; Cavernous Sinus ; Chondrosarcoma ; Chordoma ; Cranial Nerve Injuries ; Dermoid Cyst ; Follow-Up Studies ; Humans ; Lymphoma ; Meningioma ; Mortality ; Neurilemmoma ; Osteochondroma ; Osteotomy ; Paresis ; Pathology ; Pituitary Neoplasms ; Skull Base* ; Skull* ; Temporal Lobe ; Zygoma*

OBJECTIVE: The clinical uses of screws are increasing with broader applications in spinal disorders. When screws are inserted repeatedly to achieve optimal position, tips of screw pitch may become damaged during insertion even though there are significant differences in the moduli of elasticity between bone and titanium. The effect of repeated screw insertion on pullout resistance was investigated. METHODS: Three different titanium screws(cortical lateral mass screw, cancellous lateral mass screw and cervical vertebral body screw) were inserted into the synthetic cancellous material and then extracted axially at a rate of 2.4mm/min using Instron(Model TT-D, Canton, MA). Each set of screws was inserted and pulled out three times. There were six screws in each group. The insertional torque was measured with a torque wrench during insertion. Pullout strength was recorded with a digital oscilloscope. RESULTS: The mean pullout force measurements for the cortical lateral mass screws(185.66N+/-42.60, 167.10N+/-27.01 and 162.52 N+/-23.83 for first, second and third pullout respectively: p=0.03) and the cervical vertebral body screws(386.0N+/-24.1, 360.2N+/-17.5 and 330.9N+/-16.7: p=0.0024) showed consecutive decrease in pullout resistance after each pullout, whereas the cancellous lateral mass screws did not(194.00N+/-36.47, 219.24N+/-26.58 and 199.49N(36.63: p=0.24). The SEM after insertion and pullout three times showed a blunting in the tip of the screw pitch and a smearing of the screw surface. CONCLUSIONS: Repetitive screw insertion and pullout resulted in the decrease of pullout resistance in certain screws possibly caused by blunting the screw tip. This means screw tips suffer deformations during either repeated insertion or pullout. Thus, the screws that have been inserted should not be used for the final construct.
Elasticity ; Titanium ; Torque