No abstract available.
Asthma, Occupational*

We investigated whether there is differences in serum level of carcinoembryonic antigen (CEA) between patients with colon and rectal cancer. Preoperative serum levels of CEA was determined in 65 patients with colon cancer and in 88 patients with rectal cancer. Cut-off value recommended by manufacturers is 5 ng/ml for CEA. At the recommended cut-off levels for CEA, overall sensitivity of CEA was 43.1 percent for colon and 42.0 percent for rectal cancer. In colon cancer CEA was elevated in 38.4, 46.2, 60 percent of patients with Dukes Stages B, C, and D, respectively. In rectal cancer CEA was elevated in 12.5, 31.6, 44.8, 84.6 percent of patients with Dukes Stages A, B, C, and D, respectively. In Stages B, and C, sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. In Stages D, sensitivity of CEA was higher in rectal cancer than in colon cancer, but the difference was not significant. In overall stages sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. The difference was not significant either in overall or in different stages of colon and rectal cancer.
Carcinoembryonic Antigen ; Colon* ; Colonic Neoplasms ; Humans ; Rectal Neoplasms*

We analyzed records at Chonnam university hospital from Sep. 1. 1993 to Aug. 31. 1996 to assess clinical significance of the foreign body in the gastrointestinal tract. There were 133 episodes consisting of 79 pediatric and 54 adult patients as possible to review. In the pediatric patients, the coin was the most common cause of foreign body ingestion, while adult patients were usually caused by bones and meat. We removed foreign bodies in the oral cavity and oropharynx in 12 cases using direct laryngophanmgoscpy and forcep. Endoscopy was performed successfully in 47 of 51 patients in which was attempted; there were two complications composed of an aspiration pneumonia and a mediastinitis due to esophageal perforation. There were spontaneous passage of foreign bodies in 48 cases. We observed complications in 6 cases in which 4 cases needed operations due to complications. Foreign bodies which pass into the stomach can be observed for development of complications, as 94% of foreign bodies which reach the stomach spontaneously pass. Only 4 patients required interventions, which was done without mortality.
Adult ; Eating* ; Endoscopy ; Esophageal Perforation ; Foreign Bodies* ; Gastrointestinal Tract ; Humans ; Jeollanam-do ; Meat ; Mediastinitis ; Mortality ; Mouth ; Numismatics ; Oropharynx ; Pneumonia, Aspiration ; Stomach ; Surgical Instruments

PURPOSE: Botulinum toxin (BTX) acts by inhibiting acetylcholine (ACh) release at the presynaptic cholinergic neuromuscular junction, and is applied in various urethral and bladder dysfunctions, including detrusor external sphincter dyssynergia (DESD). We investigated the use of BTX in DESD patients as a reversible chemical sphincterotomy. MATERIALS AND METHODS: A total of 6 patients (male 3, female 3) with DESD were included. Their mean age was 45.5 years. The underlying diseases were multiple sclerosis (1), meningomyelocele (1), spinal cord injury (1), multiple systemic atrophy (1) and transverse myelitis (2). All the patients had severe voiding symptoms and large residual urine, despite anticholinergics and alpha-adrenoceptor antagonists with clean intermittent catheterization (CIC). Urodynamic studies were performed before and 1 month after treatment. A total of 100 units of BTX-A (Botox(R)) were injected at 4 sites, 3, 6, 9 and 12 o'clock relative to the external sphincter, under anesthesia, on an outpatient basis. The alpha-adrenoceptor antagonist medication was discontinued for evaluation after surgery. RESULTS: At 1 month after the injection, the mean maximal flow rate was increased (from 8.4 to 12.2ml/sec) and mean residual urine was decreased (from 258 to 120ml) compared to the baseline values. The external sphincter pressure was decreased. All patients were able to discontinue the CIC. There were no systemic complications, such as respiratory distress or myasthenic crisis. CONCLUSIONS: Transurethral BTX-A injections were safe and effective for releasing or ameliorating a lower urinary tract obstruction due to DESD, and a safe and valuable therapeutic option in DESD patients not desiring surgery or CIC, and who are resistant to medications. (Korean J Urol 2005;46:604-609)
Acetylcholine ; Anesthesia ; Ataxia* ; Atrophy ; Botulinum Toxins* ; Cholinergic Antagonists ; Female ; Humans ; Intermittent Urethral Catheterization ; Meningomyelocele ; Multiple Sclerosis ; Myelitis, Transverse ; Neuromuscular Junction ; Outpatients ; Spinal Cord Injuries ; Urethra* ; Urinary Bladder ; Urinary Tract ; Urodynamics

To investigate the seroprevalence of the Orientia tsutsugamushi infection of Apodemus peninsulae and genomic variations in O. tsutsugamushi isolates, 246 A. peninsulae were trapped in 14 mountainous areas approximately 500 meter above sea level in Korea during the period of 1997 and 2000. Seropositive rate of O. tsutsugamushi among A. peninsulae was 31.8% in Kyunggi, 8.2% in Chunbuk and 7.1% in Kangwon provinces by microimmunofluorescent test. The 56 kDa protein gene was amplified by PCR in the spleens of seropositive A. peninsulae. Two amplicons from seropositive A. peninsulae were sequenced and their phylogeny was analysed on the basis of sequence homology. The 56 kDa genes of A. peninsulae 98-12 strain and A. peninsulae 98-16 strain showed 98.7% nucleotide homology and 96.6% amino acid similarity. A. peninsulae 98-12 and A. peninsulae 98-16 strain were related to Kuroki, Boryong and Karp strains showing 93.3~92.2%, and 87.1~84.6% homologies in nucleotide and amino acids levels, respectively. In the phylogenetic analysis, A. peninsulae 98-12 and A. peninsulae 98-16 strain formed a distinct group with Boryong, Kuroki and Nishino strains and were clearly distinguished from other genetic groups. The results suggest that A. peninsulae might be an important reservoir of O. tsutsugamushi in Korea.
Amino Acids ; Animals ; Chungcheongnam-do ; Gangwon-do ; Gyeonggi-do ; Korea* ; Murinae* ; Orientia tsutsugamushi* ; Phylogeny ; Polymerase Chain Reaction ; Sequence Homology ; Seroepidemiologic Studies* ; Spleen

BACKGROUND: Large abdominal wall defect resulting from trauma, invasive infection, tumor resection, or other causes continue to be major problems for patients and surgeons. The lack of sufficient tissue may require the insertion of prosthetic materials. This study compares the results of PPM mesh and e-PTFE patch for repairs of abdominal wall defects. METHODS: The anterior abdominal walls of Sprague-Dawley rats, including fascia, muscle, and peritoneum were removed. The defects were repaired with a PPM mesh or an e-PTFE patch. Animals were killed at 1, 2, 6, and 12 weeks after the operation, and the implant were excised along their margins and evaluated for gross and microscopic differences. RESULTS: Histological examination showed that PPM was progressively infiltrated by whorled disorganized collagen fiber, which became densely adherent to the mesh. In contrast, the e-PTFE was infiltrated by fine fibrils of collagen, which progressively penetrated the interstices of the material, binding it firmly to the tissue. One of the most serious complications associated with fascial closure with PPM was the development of visceral adhesions. CONCLUSIONS: e-PTFE patch material has a lower foreign body reaction, a lower infectability, and a lower rate of adhesion formation than PPM mesh.
Abdominal Wall* ; Animals ; Collagen ; Fascia ; Foreign-Body Reaction ; Humans ; Peritoneum ; Polypropylenes* ; Polytetrafluoroethylene* ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To evaluate the long-term efficacy of laparoscopic Burch colposuspension, we reviewed the success rate and subjective satisfaction rate of this operation for female patients with stress incontinence. Materials and Methods: Between Sep. 1995 and Aug. 1999, 126 patients underwent laparoscopic Burch colposuspension. We reviewed 88 patients who had been followed up for more than 3 years. The mean patient age was 51.1 years and 26 of the 88 patients complained of urge incontinence. All were preoperatively assessed with voiding cystourethrography (VCUG), urodynamic study, cystoscopy and stress, emptying, anatomic, protection, and instability (SEAPI) score. Colposuspension was performed with 2 non- absorbable sutures (n=70) or polyprophylene mesh and Tacker (n=18) by the retroperitoneal approach. RESULTS: At the mean follow-up of 56 months, 58 patients (66%) were cured, and 19 patients (22%) showed significant improvements. Sixty one (94.4%) out of 66 patients who had previously required pad protection attained a pad-free status. Urge incontinence disappeared in 15 out of 26 patients, but 8 (9.1%) patients complained of de novo urge incontinence. The pre- operative factors (age, symptom periods, symptom score, abdominal leak point pressure (ALPP) and VCUG findings) made no difference for the success rate. The subjective satisfaction rate was 93%. The mean operation time was 88 minutes and it decreased to 67 minutes after 50 cases. The mean hospital stay was 3.5 days and mean duration of catheterization was 3.7 days. We had 5 (5.68%) cases of complications: two port site bleeding, one peritoneal injury, one respiratory acidosis and one obturator venous bleeding. However, all of them eventually recovered. CONCLUSIONS: Laparoscopic colposuspension revealed good results on the long-term follow-up, as well the operation as being a minimally invasive procedure. There was a 88% success rate, a 93% subjective satisfaction rate and 94% of the patients became pad free.
Acidosis, Respiratory ; Catheterization ; Catheters ; Cystoscopy ; Female* ; Follow-Up Studies ; Hemorrhage ; Humans ; Laparoscopy ; Length of Stay ; Sutures ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urodynamics

PURPOSE: To evaluate the long-term efficacy of laparoscopic Burch colposuspension, we reviewed the success rate and subjective satisfaction rate of this operation for female patients with stress incontinence. Materials and Methods: Between Sep. 1995 and Aug. 1999, 126 patients underwent laparoscopic Burch colposuspension. We reviewed 88 patients who had been followed up for more than 3 years. The mean patient age was 51.1 years and 26 of the 88 patients complained of urge incontinence. All were preoperatively assessed with voiding cystourethrography (VCUG), urodynamic study, cystoscopy and stress, emptying, anatomic, protection, and instability (SEAPI) score. Colposuspension was performed with 2 non- absorbable sutures (n=70) or polyprophylene mesh and Tacker (n=18) by the retroperitoneal approach. RESULTS: At the mean follow-up of 56 months, 58 patients (66%) were cured, and 19 patients (22%) showed significant improvements. Sixty one (94.4%) out of 66 patients who had previously required pad protection attained a pad-free status. Urge incontinence disappeared in 15 out of 26 patients, but 8 (9.1%) patients complained of de novo urge incontinence. The pre- operative factors (age, symptom periods, symptom score, abdominal leak point pressure (ALPP) and VCUG findings) made no difference for the success rate. The subjective satisfaction rate was 93%. The mean operation time was 88 minutes and it decreased to 67 minutes after 50 cases. The mean hospital stay was 3.5 days and mean duration of catheterization was 3.7 days. We had 5 (5.68%) cases of complications: two port site bleeding, one peritoneal injury, one respiratory acidosis and one obturator venous bleeding. However, all of them eventually recovered. CONCLUSIONS: Laparoscopic colposuspension revealed good results on the long-term follow-up, as well the operation as being a minimally invasive procedure. There was a 88% success rate, a 93% subjective satisfaction rate and 94% of the patients became pad free.
Acidosis, Respiratory ; Catheterization ; Catheters ; Cystoscopy ; Female* ; Follow-Up Studies ; Hemorrhage ; Humans ; Laparoscopy ; Length of Stay ; Sutures ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urodynamics

PURPOSE: This study was undertaken to evaluate the correlation between p53, bcl-2 expression and pathologic factors stage, anatomic location, histologic grade, gross pattern, lymph node metastasis of the colorectal cancer. METHODS: Analysis were made on archival pathology tissue of 56 patients with colorectal cancer. The oncoproteins were localized using commerically available monoclonal antibodies : DO-7 for, p53 and clone 124 for bcl-2. RESULTS: P53 protein was detected in 53 out of 56(94.6%) adenocarcinomas of the colorectal cancer and the most frequently expressed patterns of immunoreactivity of p53 were strong in intensity in 40 cases(71.4%) and were diffuse in pattern in 39 cases(69.6%). Bcl-2 protein was detected in 34 out of 56(60.7%) adenocarcinomas of the colorectal cancer and the most frequently expressed patterns of immunoreactivity of bcl-2 were weak in intensity in 17 cases(30.3%) and were diffuse in pattern in 16 cases(28.6%). There was no correlation between p53, bcl-2 expression and Dukes' stage, anatomic location ,histologic grade, gross pattern of tumor, lymph node metastasis of the colorectal cancer. CONCLUSION: 53 mutation and bcl-2 expression are frequent event in human colorectal carcinoma as shown in this study, but p53 and bcl-2 protein expression is not significant independent predicator of aggressiveness and progression of colorectal cancers.
Adenocarcinoma ; Antibodies, Monoclonal ; Clone Cells ; Colorectal Neoplasms* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogene Proteins ; Pathology

PURPOSE: It is believed that blood from the superior mesenteric vein and splenic vein mixes incompletely in the portal vein and maintains a streamline flow influencing its anatomic distribution. Although several experimental studies have demonstrated the existence of streamlining, clinical studies have shown conflicting results. We investigated whether streamlining of portal vein affects the lobar distribution of colorectal liver metastases and estimated its impact on survival. METHODS: Data of patients who underwent hepatectomy for colorectal liver metastases were retrospectively collected. The chi-square test was used for analyzing the distribution of metastasis. Cox analysis was used to identify risk factors of survival. Fisher exact test was used for subgroup analysis comparing hepatic recurrence. RESULTS: A total of 410 patients were included. The right-to-left ratio of liver metastases were 2.20:1 in right-sided colon cancer and 1.39:1 in left-sided cancer (P = 0.017). Cox analyses showed that margin < 5 mm (P < 0.001; 95% confidence interval [CI], 1.648–4.884; hazard ratio [HR], 2.837), age ≥ 60 years (P = 0.004; 95% CI, 1.269–3.641; HR, 2.149), N2 status (P < 0.001, 95% CI, 1.598–4.215; HR, 2.595), tumor size ≥ 45 mm (P = 0.014; 95% CI, 1.159–3.758; HR, 2.087) and other metastasis (P = 0.012; 95% CI, 1.250–5.927; HR, 2.722) were risk factors of survival. However, in 70 patients who underwent right hemihepatectomy for solitary metastasis, left-sided colorectal cancer was a risk factor (P = 0.019; 95% CI, 1.293–17.956; HR, 4.818), and was associated with higher recurrence than right-sided cancer (43.1% and 15.8%, respectively, P = 0.049). CONCLUSION: This study showed significant difference in lobar distribution of liver metastases between right colon cancer and left colorecral cancer. Furthermore, survival of left-sided colorectal cancer was poorer than that of right-sided cancer in patients who underwent right hemihepatectomy for solitary metastasis. These findings can be helpful for clinicians planning treatment strategy.
Colonic Neoplasms ; Colorectal Neoplasms ; Hepatectomy ; Humans ; Liver* ; Mesenteric Veins ; Neoplasm Metastasis* ; Portal Vein* ; Recurrence ; Retrospective Studies ; Risk Factors ; Splenic Vein