Twelve patients with inflammatory bowel disease had been operated at the department of surgery, Chonnam University Hospital during the period from March 1988 to February 1997. In this study, we report on the operative cases regarding age, sex, symptoms, duration of disease, location of disease, preoperative diagnosis, operative indication, frequency of operation, histopathologic findings and follow up. The results were as follows: 1) The male to female ratio in ulcerative colitis was 1 : 1, and the mean age was 54.5 years. In Crohn's disease, male to female ratio was 2.3 : 1 and the mean age was 42.1 years. 2) The mean duration of symptoms in ulcerative colitis was 39 months and in Crohn's disease was 13.9 months. The common symptoms in ulcerative colitis were abdominal pain, bloody diarrhea, indigestion, weight loss and in Crohn's disease abdominal pain, palpable mass, weight loss, indigestion. Extraintestinal symptoms in Crohn's disease were cholelithiasis like symptom, anal fistula, anal fissure. 3) The involvement site in ulcerative colitis was large bowel only, but in Crohn's disease small bowel (50%), large bowel (20%), small and large bowel (30%) were involved. 4) Preoperative diagnosis in ulcerative colitis was accurate, but in Crohn's disease accurate diagnosis was made only in 20% and the other cases were operated under the impression of different diseases or conditions (intestinal tuberculosis (50%), bowel perforation (20%), mechanical ileus (10%)). 5) The indication of surgery in ulcerative colitis was intractability to medical treatment, on the other hand, in Crohn's disease most operative cases were made under the emergentconditions (bowel perforation, bowel obstruction, enterocutaneous fistula, abdominal mass). The frequency of operation in ulcerative colitis were two times in one case, three times in one cases. In Crohn's disease half of cases experienced two or three times of surgery. The method of operation in ulcerative colitis was total proctocolectomy with J-pouch ileoanal anastomosis. In Crohn's disease resection of diseased bowel segment was performed.
Abdominal Pain ; Cholelithiasis ; Colitis, Ulcerative ; Colonic Pouches ; Crohn Disease ; Diagnosis ; Diarrhea ; Dyspepsia ; Female ; Fissure in Ano ; Follow-Up Studies ; Hand ; Humans ; Ileus ; Inflammatory Bowel Diseases* ; Intestinal Fistula ; Jeollanam-do ; Male ; Rectal Fistula ; Tuberculosis ; Weight Loss

Superficial gastritis has been classified as a type of chronic gastritis, since a report of Schindler in GASTRLTIS, 1947. Howev~er, Benedict reported that superficial gastritis is only acute gastritis or shows normal mucosa histologically. The com mon endopical findings of chronic superficial gastritis were adherent mucus, edema, redness. The common redness which were encounterd are patchy redness and comb-like redness(Kammrotung). We studied the relationship between the redness of superficial gastritis and acute inflammatory changes histologically. Each case of superfieial gastritis was biopsied to redening and non-redening mucosa respectively. We collected 24 cases with 48 biopsy specimens. The results are as follows: Acute inflammatory changes were found only one case in redness and none in non-redness groups. There was no difference in acute inflammatory changes in two groups. The degree of mucosal atrophy were 62.5%, 66.7% in normal mucosa, 12.5%, 16.7~% in mild atrophy, 25%, 12.5% in moderate atrophy, 0%, 4.l% in severe atrophy with respect to redness and non-redness mucosa respectively. There was no difference in degree of mucosal atrophy in two groups. Mucosal atrophies were higher in older ages above 41 years old than below 40 and with increasing age, there was increasing tendency of mucosal atrophy. In conclusion, There was no relationships between mucosal redness and acute in flammatory changes histologically and also between mucosal redness and degree of atrophy.
Adult ; Atrophy ; Biopsy ; Edema ; Gastritis* ; Humans ; Mucous Membrane ; Mucus

PURPOSE: To investigate the serial relationship of cytokine production during normal pregnancy and in the puerperium. METHODS: Plasma cytokine (TNF-alpha, INF-gamma, IL-2, TGF-beta, IL-4, and IL-6) levels were determined by enzyme-linked immunosorbent assay (ELISA) in 90 healthy gravidas during the second trimester and 6 weeks postpartum. RESULTS: TNF-alpha, INF-gamma, and TGF-beta levels increased significantly after delivery (p<0.05). Although IL-2, IL-4, and IL-6 had a tendency to increase after delivery, the change was not significant. CONCLUSION: There was a decrease in cytokine levels during pregnancy when compared to puerperium. In particular, TNF-alpha, INF-gamma, and TGF-beta were inversely related to the maintenance of normal pregnancy.
Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Plasma ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Second ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

OBJECTIVES: The differentiation of tuberculous effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. As the pathophysiology of tuberculous pleural effusion is an enhanced cell mediated immunity, Adenosine deaminase(ADA) and various cytokines including Inteferon-γ, tumor necrosis factor alpha(TNF-α) are considered as useful diagnostic tools in differentiating exudative pleural effusion The author would like to demonstrate the diagnostic usefulness of TNF-α in the differentiation of exudative pleural effusion, and compared the discriminating ability of TNF-α with ADA. METHODS: Pleural fluids obtained from 80 patients (tuberculous : 39, malignant : 31, parapneumonic : 10) with exudate pleural effusions were processed for cell counts and biochemical analysis including ADA and TNF-α RESULTS: Tuberculous pleural fluid showed higher levee of ADA and TNF-α, 48.7α 32.7U/L and 184.1±214.2pg/mL than that of non-tuberculous effusion 26.0α41.3U/L and 44.1α114.2pg/mL, respectively (ADA, TNF-α : p<0.05, p<0.01). Receiver operating characteristics(ROC) curves were generated for ADA and TNF-α, and the best cut-off value for adenosine deaminase and TNF-α were considered as 30U/L and 15pg/ml, respectively. Comparing the area under the ROC curves, there was no significant difference between ADA and TNF-α CONCLUSION: For the differential diagnosis of tuberculous pleural effusion from the other causes of exudative pleural effusions, TNF-α as well as ADA was considered as useful diagnostic method. However adding TNF-α to ADA has no further diagnotic benefit than ADA alone.
Adenosine ; Adenosine Deaminase ; Biopsy ; Cell Count ; Cytokines ; Diagnosis, Differential ; Exudates and Transudates ; Humans ; Immunity, Cellular ; Pleural Effusion* ; ROC Curve ; Tuberculosis ; Tumor Necrosis Factor-alpha*

Purpose: To identify factors affecting turnover intention of long-term care hospital nurses. Methods: After receiving permission from nursing managers at 10 nursing hospitals with 100 to 500 beds in three cities in South Korea, nurses who agreed to participate in this study were recruited and a survey was conducted. Final participants included 172 long-term care hospital nurses. Data collection was conducted from January 2, 2024 to April 30, 2024. Questionnaires included job stress, ethical dilemma, burnout, and turnover intention. Statistical analysis was performed using t-test, analysis of variance, Pearson’s correlation coefficient, and multiple regression analysis. Results: Ethical dilemma, job stress, burnout, and turnover intention of long-term care hospital nurses all had significant positive correlations. Age, position, job stress, and burnout were substantial in the turnover intention of long-term care hospital nurses. Conclusion Findings of this study can be used as primary data for improving the quality of nursing in long-term care hospitals, promoting efficient human resource management, and establishing policies.

The incidence of anomalous aortic origin of the coronary arteries in the general papulation is unknown. In recent reports from various laboratories, the incidence was between 0.6-12% in patients referred for coronary arteriogtaphy. Anomalous origin of the right coronary artery from the left sinus of Valsalva is reported to constitute from 6% to 27% of all coronary anomalies, For many years pathologists classified it as a minor anomaly of no clinical importance. Recently, manifstations of myocardial ischemia have been described in patients with this anomaly in the absence of additional atherosclerotic or other disease processes. These manifestations have included acute myocardial infarction, angina pectoris, syncope, nonfatal ventricular fibrillation, and sudden death. We report a case of 56-year-old male with the anomalous origin of the right coronary artery from the left sinus of Valsalva, who had been admitted due to severe substernal chest pain and acute inferior wall myocardial infarction. The coronary angiography revealed that the right coronary artery originated from the left coronary sinus without significant atheroscleotic narrowing. The anomalous right coronary artery passed anteriorly between pulmonary artery and aortic root without significant coronary obstruction.
Angina Pectoris ; Chest Pain ; Coronary Angiography ; Coronary Sinus ; Coronary Vessels ; Death, Sudden ; Humans ; Incidence ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia ; Pulmonary Artery ; Sinus of Valsalva ; Syncope ; Ventricular Fibrillation

BACKGROUND: The association of osteoporotic vertebral fracture or osteoporosis with coronary artery disease (CAD) was investigated in Korean men and women. METHODS: Four hundred consecutive postmenopausal women and men aged 50 years and older, undergoing coronary angiography, were enrolled for the evaluation of established or suspected coronary artery disease. CAD was diagnosed if there was narrowing of > 50% diameter in one or more major coronary artery. Morphometric vertebral fracture was assessed using lateral thoracic and lumbar spine radiographs. Bone mineral density was performed using dual-energy x-ray absorptiometry. RESULTS: Of the 400 subjects in the study (mean age of 61.9 +/- 11.6 years), 256 patients had CAD. Vertebral fracture was observed in 94 (23.5%) patients. There was no difference in vertebral fracture according to the presence or absence of CAD. In logistic regression analysis, vertebral fracture was not significantly associated with CAD after adjustment for multiple risk factors. Although women had lower BMD at any given site than men, BMD was not associated with the presence or absence of CAD among 191 patients. CONCLUSION: Our study demonstrated that osteoporotic vertebral fracture or osteoporosis was not associated with coronary artery disease in Korean men and women.
Aged ; Atherosclerosis ; Bone Density ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Female ; Humans ; Logistic Models ; Male ; Osteoporosis ; Risk Factors ; Spine

PURPOSE: Extensive local growth of rectal carcinoma and sigmoid colon carcinoma without evidence of extrapelvic dissemination occurs infrequently but does represent a small number of potentially curable neoplasms. Such lesions may present with bulk-related problems such as pelvic pain and lower colonic obstruction or with rectum, the vagina, or the bladder. Even in the absence of distant spread, many of these patients will have unresectable disease and will undergo an incomplete resection or proximal colostomy for pallliation. In selected patients, some of the locally advanced rectal cancer may be curable if total pelvic exenteration is performed. METHODS: This report describe a group of patients with locally advanced sigmoid or rectal carcinoma confined to the pelvis who underwent total pelvic exenteration at the Chonnam University Hospital. RESULTS: Seven patients had received total pelvic exenteration within five years and they were all men. One patient among them had recurred rectal cancer after previous abdominoperineal resection. Four rectal cancer and three sigmoid colon cancer were included and the range of age was third to eighth decade. According to modified Dukes' stage, stage B3 were five, and C2 were two. Postoperative complications were presented in three patients. They were wound infection, mechanical ileus, and anastomotic leakage. CONCLUSIONS: Postoperative death was presented in one patient due to sepsis with mechanical ileus. Long term follow up of these patients which was arranged from two to fourty-seven months showed five patients alive and one patient died.
Anastomotic Leak ; Colon ; Colon, Sigmoid* ; Colostomy ; Follow-Up Studies ; Humans ; Ileus ; Jeollanam-do ; Male ; Pelvic Exenteration* ; Pelvic Pain ; Pelvis ; Postoperative Complications ; Rectal Neoplasms ; Rectum* ; Sepsis ; Sigmoid Neoplasms ; Urinary Bladder ; Vagina ; Wound Infection

Wegener's granulomatosis is a small vessel vasculitis characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tracts and kidney. Early diagnosis and immediate treatment are very important for a better prognosis, but the nonspecific, variable clinical manifestations and radiologic findings make the diagnosis difficult. A positive proteinase 3-antineutrophil cytoplasmic antibody test is helpful for the diagnosis of Wegener's granulomatosis. Here, we report a case of Wegener's granulomatosis in 54-year-old man who initially presented with fever and multiple cavitary consolidations on the chest radiograph suggestive of a lung abscess. The final diagnosis of Wegener's granulomatosis was based on the medical history of otitis media, gradually developed microscopic hematuria, necrotizing granulomatous inflammation on lung histopathology, and a positive proteinase 3-antineutrophil cytoplasmic antibody test.
Antibodies, Antineutrophil Cytoplasmic ; Cytoplasm ; Early Diagnosis ; Fever ; Glycosaminoglycans ; Hematuria ; Humans ; Inflammation ; Kidney ; Lung ; Lung Abscess ; Lung Diseases, Interstitial ; Middle Aged ; Otitis Media ; Prognosis ; Respiratory System ; Thorax ; Vasculitis ; Wegener Granulomatosis

We report a patient suffering from Marie Unna's hypotrichosis. A 24-year-old man presented with a progressive hair loss. Since puberty, he had experienced a loss of hair on the scalp, eyebrow and eyelash, and the hair was coarse and twisted. On physical examination and laboratory studies, there were no associated abnormalities in the patient. The scanning electron microscopic examination of the affected hair demonstrated cuticular peeling, and twisting or angulation of hair shaft, which showed the typical clinical manifestations of Marie Unna's hypotrichosis.
Adolescent ; Eyebrows ; Hair ; Humans ; Hypotrichosis* ; Physical Examination ; Puberty ; Scalp ; Young Adult