From January 1993 to December 1995, 47 patients with rectal carcinomas underwent a rectal anastomosis using the double stapling technique at the Surgical Department of Kwang-ju Christian Hospital. The major advantages of the double stapling technique for lower rectal cancer over the single stapling technique or a hand-sewn operation are as follows:1) Insertion of a purse-string suture is eliminated, and application of a linear stapler to close the distal rectum may be performed with greater ease. 2) In addition, fecal contamination and spillage of tumor cells from the rectal segment are minimized. 3) Differences in the sizes of the colons and rectums are not a concern in constructing the anastomosis. 4) The operating time is shorter. The following results were obtained by a comparison with 24 patients with rectal carcinoma who had undergone a rectal anastomosis using the double stapling technique from January 1989 to December 1992 which was reported in a previous study:1) Anastomotic stenosis was decreased from 8.3% to 4.2% because of reduced ischemia due to the double row of staples and the reduced injury due to compression of tissue between the anvil and the cartridge with experience. In addition, it resulted from reduced tension of the anastomosis due to sufficients mobilization of the proximal colon and from selection of large cartridge (33 mm). 2) Anastomotic leakage, even though the same location as the tumor and in the advanced age group, was decreased from 4.2% to 0% because the blood circulation was maintained and unnecessary tension was reduced with experience. In addition, it resulted from reinforced suture of the anastomotic site which was performed after anastomosis. 3) Systemic recurrence was the same result as that of the previous study(4.2/4.3%). 4) Local recurrence, even though at the same distal distance from the margin of the cancer, was increased from 0% to 2.1% because of advancing the pathologic stage (B2, C1>B1, B2) and increasing the poorly differentiated pathologic type.
Anastomotic Leak ; Blood Circulation ; Colon ; Constriction, Pathologic ; Gwangju ; Humans ; Ischemia ; Postoperative Complications ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sutures

From January 1993 to December 1995, 47 patients with rectal carcinomas underwent a rectal anastomosis using the double stapling technique at the Surgical Department of Kwang-ju Christian Hospital. The major advantages of the double stapling technique for lower rectal cancer over the single stapling technique or a hand-sewn operation are as follows:1) Insertion of a purse-string suture is eliminated, and application of a linear stapler to close the distal rectum may be performed with greater ease. 2) In addition, fecal contamination and spillage of tumor cells from the rectal segment are minimized. 3) Differences in the sizes of the colons and rectums are not a concern in constructing the anastomosis. 4) The operating time is shorter. The following results were obtained by a comparison with 24 patients with rectal carcinoma who had undergone a rectal anastomosis using the double stapling technique from January 1989 to December 1992 which was reported in a previous study:1) Anastomotic stenosis was decreased from 8.3% to 4.2% because of reduced ischemia due to the double row of staples and the reduced injury due to compression of tissue between the anvil and the cartridge with experience. In addition, it resulted from reduced tension of the anastomosis due to sufficients mobilization of the proximal colon and from selection of large cartridge (33 mm). 2) Anastomotic leakage, even though the same location as the tumor and in the advanced age group, was decreased from 4.2% to 0% because the blood circulation was maintained and unnecessary tension was reduced with experience. In addition, it resulted from reinforced suture of the anastomotic site which was performed after anastomosis. 3) Systemic recurrence was the same result as that of the previous study(4.2/4.3%). 4) Local recurrence, even though at the same distal distance from the margin of the cancer, was increased from 0% to 2.1% because of advancing the pathologic stage (B2, C1>B1, B2) and increasing the poorly differentiated pathologic type.
Anastomotic Leak ; Blood Circulation ; Colon ; Constriction, Pathologic ; Gwangju ; Humans ; Ischemia ; Postoperative Complications ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sutures

No abstract available.
Infant, Newborn ; Meconium Aspiration Syndrome* ; Meconium* ; Mortality ; Suction*

BACKGROUND: Bupivacaine is a amide type local anesthetic agent, widely used for its excellent quality of analgesia and long duration of action. But unintended intravenous injection causes severe complication such as convulsion and cardiovascular collapse, which is known for its difficulty in resuscitation. With all the study, the exact mechanism is still unclear and there are much debate on the method of resuscitation. METHOD: We studied the effect of clonidine pretreatment on bupivacaine-induced cardiac toxicity and resuscitation in anesthetized dog. Twelve dogs were divided into two groups. : saline pretreatment group (control, N=6) and clonidine pretreatment group (clonidine group, N=6). The dogs were anesthetized with N2O-O2-enflurane and vecuronium. Thoracotomy was done in 4th or 5th intercostal space for open cardiac massage. After confirming stability of vital signs, we administered clonidine (10 mcg/kg) or saline, and then administered bupivacaine with the rate of 2 mg/kg/min. When the electeocardiogram showed asystole, 20 mcg/kg of epinephrine was administered via central venous line and open cardiac massage with the rate of 120 beat/min. was performed. We observed electrocardiogram (lead II), arterial blood pressure, heart rate, dose of infused bupivacaine to be required for QRS widening and arrest, required time and administered dose of epinephrine for resuscitation. RESULTS: Clonidine group showed significant decrease of heart rate after pretreatment (p<0.05). There was no significant difference in required dose for QRS widening between two groups. The dose administered for inducing arrest was less in clonidine group than control group (p<0.05). The time required for resuscitation was shorter in clonidine group than control group (p<0.05). The total dose of epinephrine required for resuscitation was less in clonidine group than control group (p<0.05). The blood concentration of catecholamine did not showed significant difference during the whole course of experiment. CONCLUSIONS: Above results demonstrated that clonidine, a central nervous system-mediated sympatholytic agent, facilitated cardiac arrest when bupivacaine was infused intravenously and cardiac rescucitation.
Analgesia ; Animals ; Arterial Pressure ; Bupivacaine ; Clonidine* ; Dogs* ; Electrocardiography ; Epinephrine ; Heart Arrest ; Heart Massage ; Heart Rate ; Injections, Intravenous ; Resuscitation* ; Seizures ; Thoracotomy ; Vecuronium Bromide ; Vital Signs

No abstract available.
Teratoma*

No abstract available.
Tuberculosis, Renal*

PURPOSE: To evaluate the radiologic findings of gastric MALToma, and to correlate these with its pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the pathologic slides of gastrectomy and gastroscopic biopsy specimens obtained between 1982 and 1996 and collected nine cases of gastric MALToma. Eight of these had been surgically confirmed, and one had been diagnosed by gastroscopic biopsy. A gastrointestinal series comprised eight cases ; five involved sonography and five, CT. RESULTS: The lesions were located at the body in five cases, at the antrum in one, and at the body and antrum in three cases. Pathologic diagnosis was low grade MALToma in four cases, and mixed high and low grade MALToma in five cases. Initial radiologic diagnosis was gastric lymphoma in four cases, early gastric carcinoma in three, and advanced gastric carcinoma in two cases. On retrospective analysis, radiologic diagnosis was changed to lymphoma in both cases initially diagnosed as advanced gastric carcinomas. One case showed marked thickening of the gastric wall, with poor enhancement on CT, and the other case showed a very small and shallow ulcer in comparison to diffuse infiltration of tumor in the upper gastrointestinal series. The final radiologic diagnosis was gastric lymphoma in six cases, and early gastric carcinoma in three. Radiologic findings of gastric MALToma were EGC II c-like lesion in three cases, marked gastric wall thickening in two, multiple discrete lesions in two, hyperugosity of gastric folds with discrete lesions in one, and diffuse infiltrative lesion with small ulcer in one case. The pathologic diagnosis of gastric MALToma was made by the presence of lymphoepithelial lesions, centrocyte-like cells, reactive follicles, plasma cell infiltration, and follicular colonization. There were no significant correlations between radiologic findings and pathologic results such as depth of tumor invasion, low grade MALToma or mixed high and low grade MALToma. CONCLUSION: There are no specific radiologic characteristics of gastric MALToma, but a gastric MALToma might show the radiologic findings of gastric lymphoma. Further radiologic evaluations of many cases of gastric MALTomas are needed in the future.
Biopsy ; Colon ; Diagnosis ; Gastrectomy ; Lymphoma ; Plasma Cells ; Retrospective Studies ; Ulcer

PURPOSE: The purpose of this study was to provide basic data on preventive child abuse program development. METHOD: Data were collected on 105 high-risk families of child abuse intervention was obtained from their main child rearer who raised the child under 18 years, olds during 10 months period from May, 2000 to March 2001. RESULT: The results were as follows : 1. Child abuse occurred in the subject's home, in the case of mild child abuse, 'throwing an object at the child' had the highest percentage 39.1%, in severe child abuse, 'rod, stick, belt, broom beating or using a variety of objects such as' had the highest percentage 49.5%, and in very severe child abuse, 'hospitalized by belting' had the highest percentage 3.8%. 2. The degree of child abuse potential showed high risk child abuse score with a mean of 213.3. The degree of beliefs in corporal punishment showed that subjects perceived corporal punishment of children positively with a mean of 32.2. 3. With respect to the child abuse potential, there were significant correlations with the subjects' age (r=.294, p=.002), education level (r=-.442, p=.000), and family income (r=-.355, p=.000). CONCLUSION: From this study not only child abuse occurrence but also child abuse potential were severely increased in poor livelihood families. Therefore to the high risk group, individual preventive approach must be applied.
Child ; Child Abuse ; Cytisus ; Education ; Humans ; Only Child ; Program Development ; Punishment

PURPOSE: The aim of study was to identify the effects of exercise on the relief of low back pain in patients on absolute bed rest after TAE. METHOD: A nonequivalent control group pretest-posttest design research design was used. The participants were 43 patients who had received TAE in a university hospital; patients in the experimental group (21) received both exercise therapy and general post-op nursing care and in the control group (22) only the latter. The exercise program used in this study was modified from exercise for post CABG to exercise for post TAE, which deflect the movement of thigh in which the catheter was inserted, the lumbar region of the back and pelvis. RESULTS: First, Low back pain scores in the experimental group were lower than the control group. Second, The first dose of analgesics in the experimental group was delayed compared to the control group. Third, There was no significant difference in bleeding complications between the experimental group control groups. CONCLUSION: The results suggest that the exercise program used in this study is effective for relief of low back pain in patients on absolute bed rest after TAE.
Analgesics ; Bed Rest ; Catheters ; Embolization, Therapeutic ; Exercise Therapy ; Hemorrhage ; Humans ; Low Back Pain ; Lumbosacral Region ; Nursing Care ; Research Design ; Thigh

PURPOSE: The purpose of this study was to develop a comprehensive self-management program promoting self efficacy for Type 2 diabetic patients. METHODS: The study was a methodological research design in which previous related research was reviewed to develop the comprehensive self-management program promoting self efficacy using self efficacy theory. RESULTS: Comprehensive self-management programs promoting self efficacy included the whole range of eight self-management domains: diet, exercise, medication, self-testing of blood glucose, complication or foot, stress, time, and general health, and consisted of four sources of self efficacy: enactive mastery experience, vicarious experience, verbal persuasion, and physiological and affective states, as strategies to promote self efficacy. Developmental methods included, in addition to large and small group education, individual education or counseling, and telephone counseling. CONCLUSION: Further studies are needed in community health centers or hospitals to establish the effects on self-management compliance and glycemic control of the comprehensive self-management program promoting self efficacy.
Blood Glucose ; Community Health Centers ; Compliance ; Counseling ; Diabetes Mellitus, Type 2 ; Diet ; Foot ; Humans ; Persuasive Communication ; Research Design ; Self Care ; Self Efficacy ; Telephone