No abstract available.
Tissue Expansion*

No abstract available.
Cicatrix* ; Contracture* ; Syndactyly*

BACKGROUND: Nationwide evaluation of physicians' smoking rate may be helpful to predict future trend of smoking in a general population. Thus, we investigated physicians' smoking rate and their habits in Korea. METHODS: Ten percent of physicians among the registered members of the Korean Medical Association were chosen by stratified random sampling and a mail questionnaire survey was conducted in 2000. Of the 2,977 physicians to whom the questionnaires were delivered, 1,248 (41.9%) responded. RESULTS: Overall smoking rate among Korean doctors was 29.9%. Smoking rate of males was 34.9% and that of females was 2.3%. In the current smokers, the most frequently reported age when they had begun smoking were 15~20 years (60.3%), the majority of daily smoking amount was less than or equal to 1 pack (92.5%), and those who were planning to quit smoking within 1 month were 11.9%. In the ex-smokers, the most frequently reported age when they had begun smoking were in their 20s (67.7%) and the most frequently reported age when they had stopped smoking were in their 30s (38.0%). CONCLUSION: The smoking rate of Korean physicians was estimated to be less than that of the general Korean population, but higher than that of physicians in major developed countries. More efforts to lower smoking rate of physicians and regular follow up is needed.
Developed Countries ; Female ; Humans ; Korea* ; Male ; Postal Service* ; Prevalence* ; Smoke* ; Smoking* ; Surveys and Questionnaires

PURPOSE: There are few studies that have focused on the predictors of recurrence after gastrectomy for gastric carcinoma. This study analyzed the patients who died of recurrent gastric carcinoma and we attempted to clarify the clinicopathologic factors that are associated with the timing of recurrence. MATERIALS AND METHODS: From June 1992 to March 2009, 1,795 patients underwent curative gastric resection at the Department of Surgery, Hanyang University College of Medicine. Among them, 428 patients died and 311 of these patients who died of recurrent gastric carcinoma were enrolled in this study. The clinicopathologic findings were compared between the 72 patients who died within one year after curative gastrectomy (the early recurrence group) and the 92 patients who died 3 years after curative gastrectomy (the late recurrence group). RESULTS: Compared with the late recurrence group, the early recurrence group showed an older age, a more advanced stage, a poorly differentiated type of cancer and a significantly higher tendency to have lymphatic invasion, vascular invasion and perineural invasion.Especially in the gastric cancer patients with a more advanced stage (stage III and IV), the early recurrence group was characterized by a significantly higher preoperative serum carcino embryonic antigen level, perineural invasion and a relatively small number of dissected lymph nodes. CONCLUSIONS: The clinicopathologic characteristics of recurrent gastric cancer are significantly different according to the stage of disease, and even in the same stage. For the early detection of recurrence after curative surgery, it is important to recognize the clinicopathological factors that foretell a high risk of recurrence. It is mandatory to make an individualized surveillance schedule according to the clinicopathologic factors.
Appointments and Schedules ; Gastrectomy ; Humans ; Recurrence ; Stomach Neoplasms

PURPOSE: We evaluated the clinicopathological charicterics and prognostic impacts of lymphatic vessel invasion in gastric cancer without lymph node involvement. MATERIALS AND METHODS: Among 1,795 patients who underwent gastric surgery with gastric cancer at the department of surgery, Hanyang university college of medicine from June 1992 to March 2009, we retrospectively evaluated 890 patients with lymph node negative gastric cancer. RESULTS: The lymphatic vessel invasion correlated significantly with tumor stage, age, tumor size, perineural invasion and operation method. The survival rates were only significantly different between the patients with and without lymphatic vessel invasion in patients with stage Ia (P=0.036). Univariate and multivariate analysis demonstrated that blood vessel invasion and preoperative serum CEA level were significant factor influencing the survival rate in lymph node negative gastric cancer patients with lymphatic invasion. CONCLUSIONS: In patients with lymph node negative gastric cancer, the survival rate is significantly lower in those with lymphatic vessel invasion than in those without. Especially, in patients with stage Ia gastric cancer, the survival rates is significantly different between those with and those without lymphatic vessel invasion. Blood vessel invasion and preoperative serum CEA level is an adverse prognostic indicator in patients with stage Ia gastric cancer with lymphatic invasion. Thus we should consider further adjuvant therapies in case of need and need to show more concern to identify gastric cancer patients early at risk for recurrence.
Blood Vessels ; Glycosaminoglycans ; Humans ; Lymph Nodes ; Lymphatic Vessels ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

PURPOSE: To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. MATERIALS AND METHODS: We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. RESULTS: Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectively. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolaterally, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolaterally from the posteroinferior aspect of the canal for the saccular branch. CONCLUSION: Five bony nerve canals in the fundus of the internal auditory canal were detected by high-frequency on high-resolution temporal bone CT. Familiarity with these structures can prevent confusion with, or misinterpretation as, a fracture line, and further study such as MR imaging may be required when any enlargement or erosion of these nerve canals is present.
Cochlear Nerve ; Ear ; Facial Nerve ; Hearing Loss, Sensorineural ; Humans ; Magnetic Resonance Imaging ; Paralysis ; Recognition (Psychology) ; Retrospective Studies ; Temporal Bone* ; Vertigo ; Vestibular Nerve

Background and Objectives: This study aimed to examine factors of poor outcome by analyzing the outcomes of bilateral subthalamic deep brain stimulation in Parkinson’s disease after 3 years. Methods: We assumed that patients who could not manage independent life in their best stimulationon/medication-on condition after a defi ned period might not have been a good surgical candidate. A poor outcome is defi ned as a failure to maintain functional independence at three years during a stimulation-on/medication-on state. Results: A total of 84 patients underwent bilateral subthalamic deep brain stimulation and all were followed up for 3 years. We excluded one patient who had intracranial hemorrhage. Twenty-one patients of the 83 patients could not keep up independent life even during their best condition for the following reasons: freezing in 15 patients, dementia in 5, depression in 3, musculoskeletal problems in 7, and cancer in one patient. Conclusions: Many patients could not keep up independent life during their best condition as early as three years after deep brain stimulation. Musculoskeletal problems were one major cause of disabilities, as were freezing and dementia. We emphasize that musculoskeletal problems need more attention in the preoperative screening of deep brain stimulation candidates and during the follow up.

Transurethral resection of Prostate(TURP) is the current optimal therapy for benign prostatic hypertrophy. But in some cases of BPH patients, TURP cannot be performed because the patients have medical disorders not to be operated. Thus several alternatives have been used in the management of BPH patients, especially who had anesthetic contraindications to an operation. We experienced 12 cases of BPH patients applied with Intraurethral Cath(IUC) from April 1991 to September 1995. Eleven patients became able to void after IUC insertion. The maximal flow rates were 5.1 to 15.7 ml/sec and average value was 11.8 ml/sec. Almost all patients showed irritative voiding symptoms such as urgency, urge incontinence, frequency, and dysuria at first. In 7 patients, these symptoms disappeared spontaneously within 2 to 5 days and oxybutynin chloride was used orally in 2 patients. Suprapubic cystostomy was done in three patients because two patients had severe irritative voiding symptoms and one patient had persistent urinary retention. The stent was changed every 3 to 6 months. Stone formation around the device was noted in 2 patients and migration of device into the bladder was found in 2 patients. In 4 patients, TURP was performed when the patient's condition improved enough to be operated under epidural anesthesia. In conclusion, the use of IUC is thought to be a valid, cost effective and safe alternative to TURP in the treatment of highly operative risk patients with benign prostatic hypertrophy.
Anesthesia, Epidural ; Cystostomy ; Dysuria ; Humans ; Prostatic Hyperplasia* ; Stents* ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Incontinence, Urge ; Urinary Retention

BACKGROUND: Due to the antibiotic therapy and the appropriate treatment, the incidence of the infections of the neck decreased. But during last 5 years in the Red Cross hospital, there were the hundred cases. And a few significant complications were still experienced. OBJECTIVES: For the early treatment and the prevention of the infection of the neck, it is necessary to study the characteristics, the diagnosis, and the treatment. MATERIALS AND METHODS: The hundred cases of the infections of the neck in the Red Cross hospital from January in 1992 to December in 1996 were analyzed about the age and sex distribution related to spaces involved, the location of cellulitis and abscess, the side of lesion, the symptoms and signs, the etiologic events, the associated conditions, the results of culture, the special diagnostic methods, the treatments, and the complications. RESULTS: In the infections of the neck, the following contents were more frequent: male(sex), the third decade(age), pain and fever(symptoms and signs), acute tonsillitis and odontogenic origin(etiologic events), Diabetes Mellitus(associated condition), hemolytic Streptococcus and Bacteroides(the results of culture), and Computerized Tomography(the special diagnostic methods). There was no significant difference in the side of lesion. The useful treatment in the peritonsillar space infection was the incision and drainage and then tonsillectomy two or three weeks after the recovery of the infection, and in the deep neck space infection, only antibiotic therapy or the incision and drainage with the antibiotic therapy were useful. The complications were four cases with two cases of sepsis, one cases of mediastinitis, and one cases of internal jugular vein thrombosis. CONCLUSION: In spite of the antibiotic therapy and the appropriate treatment, there were some complications experieced. So, we must know the characteristics of the infection of the neck well, and the systemic and active attitude is necessary.
Abscess ; Cellulitis ; Diagnosis ; Drainage ; Incidence ; Jugular Veins ; Mediastinitis ; Neck* ; Palatine Tonsil ; Peritonsillar Abscess ; Red Cross ; Sepsis ; Sex Distribution ; Streptococcus ; Thrombosis ; Tonsillectomy ; Tonsillitis

BACKGROUND: Photodynamic therapy is a viable option for lung cancer treatment, and many studies have shown that it is capable of inducing cell death in lung cancer cells. However, the precise mechanism of this cell death has not been fully elucidated. To investigate the early changes in cancer cell transcription, we treated A549 cells with the photosensitizer DH-I-180-3 and then we illuminated the cells. METHODS: We investigated the gene expression profiles of the the A549 lung cancer cell line, using a DEG kit, following photodynamic therapy and we evaluated the cell viability by performing flow cytometry. We identified the genes that were significantly changed following photodynamic therapy by performing DNA sequencing. RESULTS: The FACS data showed that the cell death of the lung cancer cells was mainly caused by necrosis. We found nine genes that were significantly changed and we identified eight of these genes. We evaluated the expression of two genes, 3-phosphoglycerate dehydrogenase and ribosomal protein S29. The expressed level of carbonic anhydrase XII, clusterin, MRP3s1 protein, complement 3, membrane cofactor protein and integrin beta 1 were decreased. CONCLUSION: Many of the gene products are membrane-associated proteins. The main mechanism of photodynamic therapy with using the photosensitizing agent DH-I-180-3 appears to be necrosis and this may be associated with the altered production of membrane proteins.
Antigens, CD46 ; Carbonic Anhydrases ; Cell Death ; Cell Line ; Cell Survival ; Clusterin ; Complement System Proteins ; Flow Cytometry ; Gene Expression Profiling ; Gene Expression* ; Lung Neoplasms* ; Lung* ; Membrane Proteins ; Necrosis ; Phosphoglycerate Dehydrogenase ; Photochemotherapy* ; Photosensitizing Agents ; Ribosomal Proteins ; Sequence Analysis, DNA ; Transcriptome*