No abstract available.
Colorectal Neoplasms*

No abstract available.

No abstract available.
Leiomyosarcoma* ; Rectum*

OBJECTIVE: This study was designed to evaluate the effect of nasogastric tube on swallowing function in stroke patients with dysphagia. METHOD: Twelve stroke patients with dysphagia were included in this study. We evaluated the Functional Dysphagia Scale using videofluoroscopic swallowing study. Swallowing tasks were composed of swallowing 5 cc of thick food and same volume of fluid on nasogastric tube insertion state and then nasogastric tube removal state. RESULTS: As the result of measuring oral phase score before and after removing nasogastric tube, all of 12 patients showed no significant difference. There was statistically significant increase in score of residue in piriform sinuses on thick food swallowing after removing nasogastric tube (p<0.05). After removing nasogastric tube, aspiration was decreased on fluid swallowing in cases of 2 patients, while aspiration on thick food swallowing was increased in cases of 2 patients, compared with nasogastic tube insertion state. CONCLUSION: As the result of this study, the stroke patients with dysphagia on nasogastric tube were increased on fluid aspiration due to rapid descending and inhibition of epiglottic closure compared with the removal state of nasogastric tube. And there was significant increased in scores of residue in piriform sinuses on thick food swallowing and aspiration pneumonia after removing nasogastric tube.
Deglutition Disorders* ; Deglutition* ; Humans ; Pneumonia, Aspiration ; Pyriform Sinus ; Stroke*

The authors present a case of post-traumatic tension pneumocephalus of delayed onset. A 23-year-old man fell down and was admitted to our hospital with initial diagnosis of basal skull fracture associated with small amounts of pneumocephalus on brain computerized tomography(CT). At admission, the consciousness was alert without focal neurological deficit. During conservative therapy, headache was slowly progressive and consciousness became drowsy on 13th day after admission. The brain follow-up CT showed huge low air density lesion in the right frontal area. We performed unilateral subfrontal craniotomy with duroplasty for removal of air and dural repair with galea aponeurotica and abdominal fat. Postoperatively, the condition was recovered.
Abdominal Fat ; Brain ; Consciousness ; Craniocerebral Trauma ; Craniotomy ; Diagnosis ; Follow-Up Studies ; Headache ; Humans ; Pneumocephalus* ; Skull Fractures ; Young Adult

The present study was performed to examine whether acupuncture can regulate the expression of cytokines that play important roles in wound healing and morphological changes in the burn wound healing of rats, such as transforming growth factor (TGF)-beta1, TGF-beta3, epidermal growth factor (EGF), and interleukin-6 (IL-6). Sprague-Dawley rats weighing 250~300 g were divided into two control groups and two experimental groups. Among the control groups, no-treatment group was classified as C and acupuntured group as Ca. Among the experimental groups, burned group (n = 6) was classified as B and acupunctured group after burn (n = 6) as Ba. The lumbar area of rats was burned 15 x 25 mm in size for 15~18 seconds with special small iron adapter and acupunctured at 5~7 mm in diameter and 1 cm in depth using 0.25 mm x 50 mm acupuncture needle for 20 minutes in wound area. Rats in group Ca were acupunctured once. Rats in group Ba were acupunctured every 12 hours 3 times. Rats were sacrificed at days 1, 3, 7, 15 and 20 after burn treatment. Morphological changes were examined by hematoxylin-eosin staining methods. The expression profiles of TGF-beta1, TGF-beta3, EGF and IL-6 were detected by immunohistochemical staining methods. The results we obtained were as follows: 1. In gross observation, the burn wounds were less odorous and cleaner in the acupunctured group (Ba) compared with those of no-acupuncture group (B). 2. Reepithelialization and formation of panniculus carnosus and granulation tissue were more prominent at days 3 and 7 in the acupunctured group Ba than group B. However, this difference was disappear at day 15. 3. In the muscle of group B, TGF-beta1 was observed after day7. However, in group Ba, TGF-beta1 was observed as early as days 1 and 3 and rapidly turnovered at day 7. 4. For TGF-beta3, both B and Ba groups showed similar results. 5. At day 3, EGF was observed in the subcutaneous tissue in both B and Ba groups. However, in day 7, EGF was rapidly decreased in Ba group compared with that of B. 6. For IL-6, both B and Ba groups showed similar results in epidermis, dermis, subcutaneous tissue and muscle. But, at day 3, IL-6 was rapidly decreased in theconnective tissue under the muscle in Ba group compared with that of B. These results suggest that acupuncture may improve the wound healing in the early stage by increasing the TGF-beta1 that is essential for the formation of extracellular matix and by decreasing EGF.
Acupuncture* ; Animals ; Burns* ; Cytokines ; Dermis ; Epidermal Growth Factor* ; Epidermis ; Granulation Tissue ; Interleukin-6* ; Iron ; Needles ; Odors ; Rats* ; Rats, Sprague-Dawley ; Skin ; Subcutaneous Tissue ; Transforming Growth Factor beta1* ; Transforming Growth Factor beta3* ; Transforming Growth Factors ; Wound Healing* ; Wounds and Injuries*

The present study was performed to examine whether acupuncture can regulate the expression of extracellular matrix proteins that play important roles in burn wound healing of rat, such as fibronectin, type I and IV collagens, and laminin. Sprague-Dawley rats weighing 250~300 g were divided into 4 groups such as normal control group (C), only acupuncture treatment group (Ca), burn treatment group (B), and a group for acupuncture treatment after burn (Ba). We burned 15x25 mm in size for 15~18 seconds at lumbar area of rats with special iron adapter and acupunctured at 5~7 mm in diameter and 1 cm in depth using 0.25 mm x 50 mm acupuncture needle for 20 minutes in wound area. Rats in group Ca were acupunctured once, and rats in group Ba were acupunctured every 12 hours 3 times. Rats sacrificed at days 1, 3, 7, 15 and 20 after burn treatment. Histological changes were examined by azan staining methods and expression profiles of fibronectin, type I and IV collagens, and laminin were detected by immunohistochemical staining methods. The results we obtained were as follows: 1. At day 1, fibers in epidermis, dermis and subcutaneous tissue in both groups B and Ba were not observed. However groups B and Ba exhibited fibers stained mildly and moderately, respectively, in muscle and connective tissues. At day 20 , the level of fiber in group B which was comparable to group C was less than that of in B group. 2. At day 3, fibronectin in group Ba was observed in the muscle. At days 15 and 20, fibronectin was increased in epidermis and dermis of group Ba compared with those of group B. 3. Type I collagen in subcutaneous tissue was observed at days 1, 3 and 7 in both groups B and Ba. However type I collagen was observed only in group Ba at day 15. In the epidermis of group Ba, type I collagen was observed at day 3 and maintained until day 20, while observing only at day 20 in group B. 4. For type IV collagen, both groups B and Ba showed similar results. 5. For laminin, both groups B and Ba showed similar results except the 7th day results. However after day 15, laminin was stained moderately and mildly in groups Ba and B, respectively. These results suggest that acupuncture may improve the burn wound healing by increasing fibronectin and type I collagen.
Acupuncture* ; Animals ; Burns* ; Collagen Type I ; Collagen Type IV ; Collagen* ; Connective Tissue ; Dermis ; Epidermis ; Extracellular Matrix Proteins ; Fibronectins* ; Iron ; Laminin* ; Needles ; Rats* ; Rats, Sprague-Dawley ; Skin ; Subcutaneous Tissue ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: The evaluation of behavioral and psychological symptoms (BPSD) is important for the diagnosis and management of Alzheimer's disease (AD). Previous studies have reported the prevalence and severity of BPSD changes. However, these studies have mainly focused on the AD patients with mild to moderate severity. Our study investigated the BPSD in AD patients with more advanced stages and looked at the prevalence and severity of BPSD with the progression of disease. METHODS: One hundred thirty six patients with probable AD received the Korean version of the neuropsychiatric inventory along with the expanded version of the Korean Clinical Dementia Rating Scale (CDR) and the Korean version of the Mini-Mental State Examination (K-MMSE). RESULTS: The mean K-MMSE, CDR and NPI scores were 10.1 (SD=7.1), 2.0 (SD=1.5) and 32.7 (SD=26.2), respectively. CDR and K-MMSE scores did not correlate with the total NPI score but did correlate with some of the subscale NPI scores. Apathy had the highest relationship to CDR (r=0.39, p<0.01). Aberrant motor was most correlated with the total score of NPI (r=0.65, p<0.01). The mean number of positive NPI items was 4.3, which ranged from 2.1 (CDR 5 group) to 5.4 (CDR 2 group). The most frequent symptom was apathy and the least was euphoria. The severity of BPSD increased as the dementia severity increased to CDR 2 except apathy. Night-time behavior and anxiety were frequent in the early stages whereas apathy and aberrant motor were frequent symptoms in later stages. CONCLUSIONS: These observations suggest that BPSD is relatively independent of cognitive functions. The prevalence and severity of BPSD with the exclusion of apathy, increased as the dementia severity increased from CDR 0.5 to CDR 2 and then declined declined except apathy.
Alzheimer Disease* ; Anxiety ; Apathy ; Dementia ; Diagnosis ; Euphoria ; Humans ; Prevalence

PURPOSE: Many surgical approaches for reconstruction of blowout fractures have been used, which include subciliary incision, transconjunctival incision, medial canthal incision and an endoscopic approach recently attempted, etc. The aim of this study was to demonstrate a surgical technique of endoscopic transnasal approach and to investigate the result & availability of endoscopic transnasal approach with or without subciliary incision for reconstruction of various blowout fractures. METHODS: Between March 2004 and August 2006, 106 patients, followed up at least 6 months, were treated through endoscopic transnasal approach with or without subciliary incision for reconstruction of the blowout fractures. All patients were operated under general anesthesia. In case of medial blowout fractures, we confirmed the size and the location of the fragmented medial orbital wall by identifying the herniation through the transnasal endoscope by pressing the affected eyeball. after reduction of herniated orbital tissue with periosteal elevators, a silastic sheet(1-mm thickness) and Merocel(R) packing were applied. In case of inferior blowout fractures, we identified the size and the location of the fragmented orbital wall through subciliary incision and inserted 1.6mm Medpor(R), and required the combined use of endoscope and the ballooning of a foley catheter. RESULTS: Most patients showed the improvement of preoperative symptoms. However, in patients with extensive medial and inferior blowout fracture, the complications such as diplopia, enophthalmos larger than 2mm, and limitation of extraocular motions had remained after operation. Ectropion, conspicuous scar, the protrusion or resorption of the alloplastic implants were not observed. CONCLUSION: In conclusion, a transnasal endoscopic correction may be considered a useful method for surgical repair of various blowout fractures, with excellent visualization and accuracy comparable to that of the subciliary approach.
Anesthesia, General ; Catheters ; Cicatrix ; Diplopia ; Ectropion ; Elevators and Escalators ; Endoscopes ; Endoscopy ; Enophthalmos ; Humans ; Orbit

OBJECTIVE: Distal anterior cerebral artery(DACA) aneurysms are relatively uncommon, and have special aspects. We discuss clinical features and surgical results of DACA aneurysms with review of literatures. METHODS: Among 725 cases of intracranial aneurysms operated from 1989 to 2001 in our hospital, 38 cases of DACA aneurysms were studied retrospectively. The clinical presentations, neurological findings, operative approaches and outcome were analyzed. RESULTS: The incidence of the DACA aneurysm was 5.2% of total 725 aneurysms. Multiple aneurysms were found in 10 patients. Among the 38 patients, 15 were men and 23 were women. The mean age was 49.8 years. 2 aneurysms were located at frontobasal artery, 5 at the origin of frontopolar artery, 28 at the bifurcation between callosomarginal and pericallosal artery, 3 at the origin of pericallosal artery. 32 patients had good outcomes after surgery. 4 patients remained disabled, and 2 patients died. Postoperative complications were vasospasm, cerebral infarction, intracranial hemorrhage, pneumonia. CONCLUSION: The incidence of DACA aneurysm was relatively rare than other location. We think that unilateral interhemispheric approach is useful for aneurysm in most DACA, and approaches should be chosen according to the location of aneurysm and presence or absence of multiple aneurysms. The Glasgow Outcome Scale score was good in patient with low Hunt & Hess grade preoperatively. And early operation can reduce the rate of rebleeding and improve outcome of DACA aneurysms.
Aneurysm ; Anterior Cerebral Artery* ; Arteries ; Cerebral Arteries ; Female ; Glasgow Outcome Scale ; Humans ; Incidence ; Infarction ; Intracranial Aneurysm* ; Intracranial Hemorrhages ; Male ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial