No abstract available.

No abstract available.

Purpose: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator is useful in predicting postoperative adverse events. However, its accuracy in specific disorders is unclear. We validated the ACS NSQIP risk calculator in patients with gastric cancer undergoing curative laparoscopic surgery. Materials and Methods: We included 207 consecutive early gastric cancer patients who underwent laparoscopic gastrectomy between January 2018 and January 2019. The preoperative characteristics and risks of the patients were reviewed and entered into the ACS NSQIP calculator. The estimated risks of postoperative outcomes were compared with the observed outcomes using C-statistics and Brier scores. Results: Most of the patients underwent distal gastrectomy with Roux-en-Y reconstruction (74.4%). We did not observe any cases of mortality, venous thromboembolism, urinary tract infection, renal failure, or cardiac complications. The other outcomes assessed were complications such as pneumonia, surgical site infections, any complications requiring re-operation or hospital readmission, the rates of discharge to nursing homes/rehabilitation centers, and the length of stay. All C-statistics were <0 and the highest was for pneumonia (0.65; 95% confidence interval: 0.58–0.71). Brier scores ranged from 0.01 for pneumonia to 0.155 for other complications. Overall, the risk calculator was inconsistent in predicting the outcomes. Conclusions The ACS NSQIP surgical risk calculator showed low predictive ability for postoperative adverse events after laparoscopic gastrectomy for patients with early gastric cancer. Further research to adjust the risk calculator for these patients may improve its predictive ability.

No abstract available.
Atrioventricular Block* ; Myocarditis* ; Pancreatitis* ; Typhoid Fever*

Recent immunological investigations have demonstrated that the patients with psoriasis have various humoral and cellular immune abnormalities, such as increased serum IgG, IgE and secretory IgA, anti-IgC factor in psoriatic lesions, in peripheral blood lymphocytes and in serum, rhumatoid-like factors in IgA and IgG classes of immunoglobulins, antinuclear antibodies (ANA; reacting with the basal cell nuclei of uninvolved skin., anti-stratum corneum antibody and complements in psoriatic scales, immuoglobulin and complement bearing polymorphonuclear leucocytes in the Muro microabscess. These abnormal findings are enough to suggest an autoimmune mechanism in the pathogenesis of psoriasis. Several investigators have also reported the results of T cell enumeration in the peripheral blood in psoriatic patients. However, the results are not in general agreement,. Thee present study was undertaken to clarify any abnormality in the proportion of T cells in the peripheral blood in psoriatic patients. Forty-one patients with active psoriasis registered at the Department of Dermatology, Seoul National University Hospital entered this study from May, 1979 through April, 1980. Twelve healthy medical and paramedical personel the comprised the control group. Active and total T cells were enumerated by the method of E-rosetting technique, and the results were as follows. 1, in normal controls, the active and total T celIs identified as E rosetteforming cells accounted for 61.6+7.4% and 68.1+8.9% of the total lymphocyte population, respectively. 2. In patients with psoriasis, significant decrease of active T cells (54. 2,+11.0%,p<0.005) and total T cells (62.2+11.2%, p<0.05) was observed. More profound reduction of T cells was noted in patients with wide spread psoriasis than those with limited extent.
Antibodies, Antinuclear ; Cell Nucleus ; Complement System Proteins ; Dermatology ; Humans ; Immunoglobulin A ; Immunoglobulin A, Secretory ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins ; Lymphocytes ; Psoriasis* ; Research Personnel ; Seoul ; Skin ; T-Lymphocytes* ; Weights and Measures

OBJECTIVES: Lipocortin-1 (LC-1), a member of annexin family of calcium-binding proteins induced by corticosteroid, originally evoked interest as one of the secondary messengers in the antiinflammatory action of corticosteroid, But the exact mechanism of LC-1 responsible for antiinflammatory effect is still unclear. We investigated the potential role of LC-1 in the effect of corticosteroid on amelioration of collagen induced arthritis (CIA) in mice. METHODS: Four groups of DBA/1j mice were immunized by intradermal injection of 5mg/kg of type 2 collagen with complete Freunds adjuvant which was boostered on day 21 and 42. Group 1 received no treatment and group 2 received 1mg/kg dexamethasone intraperitoneally twice weekly from day 21. Group 3 and 4 were treated with 50 and 0.5microgram/kg of anti LC-1 monoclonal antibody subcutaneously and dexamethasone from day 21 twice weekly, respectively. The prevalence of arthritis and arthritis score were assessed twice weekly. At week 10, we measured serum anticollagen antibody levels and splenic mononuclear cell stimulation indices (SI) to collagen. RESULT: CIA started to develop after 4 weeks of collagen treatment in all groups. All mice of group 1 developed arthritis by the 9 week. Treatment with dexamethasone markedly inhibited arthritis development (P<0.05). Cotreatment of anti LC-1 monoclonal antibody and dexamethasone abolished the antiinflammatory effect of dexamethasone (P<0.05). But there was no significant difference in the serum levels of anticollagen antibody or splenic mononuclear cell SI among the groups. CONCLUSION: These findings support the hypothesis that LC-1 is involved, at least in part, in the antiinflammatory actions of corticosteroid in chronic inflammation, although the mechanism of which is unclear.
Animals ; Arthritis* ; Calcium-Binding Proteins ; Collagen* ; Dexamethasone ; Freund's Adjuvant ; Humans ; Inflammation ; Injections, Intradermal ; Mice ; Prevalence

Benzoyl peroxide has been known to have bacteriostatic activity against Corynebacterium acnes and to have comedolytic action in patients with acne vulgaris. The present study was undertaken to evaluate the therapeutic effect of Renoxal, a 5% benzoyl peroxide lotion, in patients with acne vulgaris. A total of 35 patients entered this study at the Department of Dermatology, Seoul National University Hospital during the five months period from March to July, 1978. All patients were instructed to apply Benoxal on their affected sites once or twice daily; and the number of lesions on three fixed areas were counted before and every week for four weeks after the treatrnent. Two female patients stopped the application due to developrnent of contact dermatitis to Benoxal The results observed in the 33 patients were as follows: 1. The percentage decrease in total number of lesions in four weeks after treatment was 51.1% 2. Closed and open comedones were gradually eliminated; and their numbers were decreased in four weeks after treatment by 45. 8% and 55. 3% respectively. The papules were decreased. by 59. 1 @2 after the first week of treatment, but showed. a transient lag around tbe second week and then marked 61. 5% in four weeks after treatment. 3. Observed side effects included burning sensation,(3 cases), tightness (3 cases), itching sensation (2 cases) and scaling (1 case). All were tolerable without any specific measure or discontinuance of the application. The authors concluded througb this experiment that Benoxal (5% benzoyl peroxide lotion) is a very effective local therapeutic agent in the treatment of acne vulgaris patients.
Acne Vulgaris* ; Benzoyl Peroxide ; Burns ; Dermatitis, Contact ; Dermatology ; Female ; Humans ; Propionibacterium acnes ; Pruritus ; Sensation ; Seoul ; Thiram

OBJECTIVE: To investigate whether the serum levels of IL-10 in patients with rheumatoid arthritis are different from those of normal controls and SLE patients and to find out any correlation with disease activity parameters of rheumatoid arthritis. METHODS: Sera from 20 healthy normal persons, 16 rheumatoid arthritis patients and 16 patients with systemic lupus erythematosus were collected and measured for IL-10 and IL-6. Various disease activity parameters were measured in RA patients. RESULTS: The serum level of IL-10 in RA patients was significantly elevated compared to normal controls but lower than those of SLE patients. In RA patients there was no definite correlation between the disease activity parameters and serum IL-10 levels. Despite significant improvements in terms of various disease activity parameters, there was no significant change of serum IL-10 levels after treatment in RA patients. In seropositive RA patients, positive correlation was found between serun IL-10 and rheumatoid factor levels. CONCLUSION: Our findings show that the serum IL-10 levels in patietns with RA are elevated compared to normal controls but lower than those of SLE patients. There was no correlation between serum IL-10 levels and disease acivity parameters of RA.
Arthritis, Rheumatoid* ; Humans ; Interleukin-10* ; Interleukin-6 ; Lupus Erythematosus, Systemic ; Rheumatoid Factor

BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical

OBJECTIVE: To evaluate the effect of IL-10 on development of collagen-induced arthritis, on humoral and cellular immunity and on the endogenous production of IL-10 in DBA/1J mice. METHODS: DBA/1J mice were immunized with chicken type II collagen in Freund s complete adjuvant. Murine recombinant IL-10 was given intraperitoneally twice a week from the day of second immunization (week 3) in doses of 0.002ug, 0. 02ug and 0. 2ug for 3 different groups, respectively. Dexamethasone was injected in one group to suppress the arthritis development and this group was used as negative control group. Levels of anti-collagen antibodies, serum IL-10 and stimulation indices of splenic monocytes to collagen were measured at the end of study. RESULTS: The 0. 02ug IL-10 and 0. 2ug IL-10 treated groups developed earlier and more severe arthritis (week 6 and 8) compared to that of the control group while the 0. 002ug IL-10 group has shown similar course to the control group in terms of incidence and severity of arthritis, At week 10, all groups with or without IL-10 injections developed arthritis with similar degree of severity while dexamethasone group showed far less incidence and severity of arthritis. The serum levels of anti-collagen antibody, IL-10 and spleen monocyte stimulation indices to collagen antigen showed no difference among control group, IL-10 injected groups and dexamethasone injected group. CONCLUSION: This study shows IL-10 could worsen the arthritis in CIA with the dosage used in this study without significant influence on the level of anti-collagen antibodies or stimulation indices of spenic monocyte to collagen.
Animals ; Antibodies ; Arthritis ; Arthritis, Experimental* ; Chickens ; Collagen ; Collagen Type II ; Dexamethasone ; Immunity, Cellular ; Immunization ; Incidence ; Interleukin-10* ; Mice ; Monocytes ; Spleen