The energy expended while playing tennis was determined from the players heart rate and from the amount of oxygen they consumed. This study was made using eight healthy but unathletic male college students. Expired air was collected for 2 minute periods during each game by the Douglas bag method. Samples were collected when serving and receiving. The air collected was measured using a wet test gas meter. The amount of air collected was expressed in STPD. Oxygen consumption was determined by measuring the oxygen content of the expired air with a Orzat gas analyzer. The energy expended during the tennis games was calculated indirectly. The caloric coefficient of oxygen was multiplied by the volume of oxygen consumed. The caloric coefficient of oxygen varied from 4.6 to 5.1 kcal/liter of oxygen. In this study the value of 5 kcal/liter of oxygen was used in the calculations. The accuracy of the measurements of energy expended was tested using regression analysis of the measured volume of oxygen. The mean values of heart rate, oxygen consumed and energy expended did not vary when the activity of serving and receiving was compared. The mean value of oxygen consumed during play was 1.4329+/-282 ml/min or 21.6+/-4.0 ml/kg/min. The energy expended was 7.15+/-1.46 kcal/min or 6.45+/-1.23 kcal/kg/min. The values were equivalent to 5.5 mets. When the levels of oxygen consumed were estimated using the formulas, they were found to be higher than the measured levels. The estimated amounts, however, were within 25% of the measured amounts.
Heart Rate* ; Heart* ; Humans ; Male ; Oxygen Consumption ; Oxygen* ; Tennis*

BACKGROUND: Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. METHOD: Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post perative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet ednothlial cell adhesion molecule, PECAM). RESULTS: Microvessel counts(MVCs)in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocaricinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage Iand II or NO stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). CONCLUSION: In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status (limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cell Adhesion ; Chemotherapy, Adjuvant ; Formaldehyde ; Humans ; Lung Neoplasms ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis* ; Radiotherapy ; Survival Rate

No abstract available.
Acute Kidney Injury* ; Hemoglobinuria, Paroxysmal*

BACKGROUND: Hypoxia inducible factor-1alpha(HIF-1alpha) is a transcription factor for various target genes that are involved in adapting cells to hypoxia. It promotes cell proliferation and survival via modulation of such cell cycle regulators such as cyclin A1 and cyclin B1 in response to hypoxia. This is associated with local failure of radiotherapy, which renders a poor prognosis for cervical carcinoma. METHODS: Using the tissue histologic sections and a tissue microarray of the archived biopsy and surgical specimens of uterine cervical carcinoma from 57 patients who were treated with radiation therapy alone, we performed immunohistochemical staining for HIF-1alpha and cyclin A1 and B1 to evaluate the correlations between the expressions of these proteins in tumors and the clinicopathologic parameters associated with the prognosis. RESULTS: The large tumor cell nests and invasive front margins of the tumors showed comparatively intense immunoreactivity of HIF-1alpha. There was no significant correlation between the HIF-1alpha, cyclin A1 and cyclin B1 expressions and the clinicopathologic factors. CONCLUSIONS: The HIF-1alpha expression showed marked intra-tumoral heterogeneity. The HIF-1alpha expression is neither a powerful predictor of resistance to radiotherapy nor is it a poor prognostic marker in cervical carcinoma patients who are treated with radiotherapy. The expressions of cyclin A1 and cyclin B1 are neither independently associated with the response of radiation therapy nor are they associated with the prognostic parameters of uterine cervical carcinoma.
Anoxia ; Biopsy ; Cell Cycle ; Cell Proliferation ; Cyclin A ; Cyclin A1 ; Cyclin B ; Cyclin B1 ; Cyclins ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; Population Characteristics ; Prognosis ; Proteins ; Transcription Factors ; Uterine Cervical Neoplasms

A variety of intrinsic and extrinsic factors have been studied to explain the pathogenesis of rhinosinusitis. Recently biofilms are emerging as an important cause. Biofilms are highly organized structures composed of a protective extracellular matrix and bacterial colonies, and provide the means for bacterial survival and virulence. Biofilms are known to be associated with intractable cases of rhinosinusitis and antibiotic resistance. Patients diagnosed with biofilm-related rhinosinusitis tend to suffer more severe disease that those without biofilms. Biofilm severity can also influence the prognosis of rhinosinusitis. We present two cases of pseudomonas-induced macroscopic biofilms (bioballs) of the maxillary sinuses. These bioballs cause intractable chronic rhinosinusitis as well, but unlike traditional biofilms, they can be surgically removed by endoscopy, and thus have a better prognosis than traditional biofilms. This is the first report of visible biofilms (bioballs) found in the maxillary sinuses.
Bacteria ; Biofilms ; Drug Resistance, Microbial ; Endoscopy ; Extracellular Matrix ; Humans ; Maxillary Sinus ; Prognosis ; Pseudomonas ; Virulence

Primary lung cancer can metastasize by a direct local extension, hematogenous dessemination, and lymphatic spread. However, it less commonly metastasizes via a transbronchial invasion. A pproximately half of all patients with lung cancer have metastases at the initial presentation. Autopsy data showed that there are an average of 4.8 metastatic sites. The most common sites for metastases include the lymph nodes, liver, adrenal gland, bone, and brain. However, clinically significant metastases isolated in the small bowel seldom occur. Here we report a case of lung cancer with a small bowel metastasis.
Adrenal Glands ; Autopsy ; Brain ; Humans ; Liver ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Neoplasm Metastasis*

PURPOSE: Surgical site infection (SSI) is the most common nosocomial infection in surgical patients, and this accounts for 38% of all patients with nosocomial infections. Despite the advances in techniques and knowledge to prevent infection, SSI remains a significant source of postoperative morbidity and mortality, and it results in a prolonged hospital stay and increased cost. This study aims to assess the incidence of SSI and to identify the risk factors associated with SSI for patients who undergo abdominal operation. METHODS: The data on 347 abdominal operations that were done under general anesthesia from 1 August 2005 to 31 July 2006 was collected and reviewed. RESULTS: The overall incidence of SSI was 4.9%. Comorbidity was the independent risk factor for the development of SSI (P=0.011). The development of SSI was related with the American Society of Anesthesiologists (ASA) preoperative assessment score (P=0.025). The duration of the operation had a statistically significant association with an increased risk of SSI on univariate analysis. The wound classification was not associated with SSI. Staphylococcus aureus was the most frequently isolated organism, and all of the cases were methcillin-resistant Staphylococcus aureus. CONCLUSION: This study demonstrate that comorbidity is a significant independent risk factor for SSI.
Anesthesia, General ; Comorbidity ; Cross Infection ; Humans ; Incidence ; Length of Stay ; Risk Factors ; Staphylococcus ; Staphylococcus aureus

BACKGROUND: We investigated the prognostic significance of tumor regression grade (TRG) after preoperative chemoradiation therapy (preop-CRT) for locally advanced rectal cancer especially in the patients without lymph node metastasis. METHODS: One-hundred seventy-eight patients who had cT3/4 tumors were given 5,040 cGy preoperative radiation with 5-fluorouracil/leucovorin chemotherapy. A total mesorectal excision was performed 4-6 weeks after preop-CRT. TRG was defined as follows: grade 1 as no cancer cells remaining; grade 2 as cancer cells outgrown by fibrosis; grade 3 as a minimal presence or absence of regression. The prognostic significance of TRG in comparison with histopathologic staging was analyzed. RESULTS: Seventeen patients (9.6%) showed TRG1. TRG was found to be significantly associated with cancer-specific survival (CSS; P = 0.001) and local recurrence (P = 0.039) in the univariate study, but not in the multivariate analysis. The ypN stage was the strongest prognostic factor in the multivariate analysis. Subgroup analysis revealed TRG to be an independent prognostic factor for the CSS of ypN0 patients (P = 0.031). TRG had a stronger impact on the CSS of ypN (-) patients (P = 0.002) than on that of ypN (+) patients (P = 0.521). In ypT2N0 and ypT3N0, CSS was better for TRG2 than for TRG3 (P = 0.041, P = 0.048), and in ypN (-) and TRG2 tumors, CSS was better for ypT1-2 than for ypT3-4 (P = 0.034). CONCLUSION: TRG was found to be the strongest prognostic factor in patients without lymph node metastasis (ypN0), and different survival was observed according to TRG among patients with a specific histopathologic stage. Thus, TRG may provide an accurate prediction of prognosis and may be used for f tailoring treatment for patients without lymph node metastasis.
Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Recurrence

OBJECTIVE: This study compared the area of the regurgitant orifice, as measured by the use of multidetector-row CT (MDCT), with the severity of aortic regurgitation (AR) as determined by the use of echocardiography for AR. MATERIALS AND METHODS: In this study, 45 AR patients underwent electrocardiography-gated 40-slice or 64-slice MDCT and transthoracic or transesophageal echocardiography. We reconstructed CT data sets during mid-systolic to enddiastolic phases in 10% steps (20% and 35-95% of the R-R interval), planimetrically measuring the abnormally opened aortic valve area during diastole on CT reformatted images and comparing the area of the aortic regurgitant orifice (ARO) so measured with the severity of AR, as determined by echocardiography. RESULTS: In the 14 patients found to have mild AR, the ARO area was 0.18+/-0.13 cm2 (range, 0.04-0.54 cm2). In the 15 moderate AR patients, the ARO area was 0.36 +/- 0.23 cm2 (range, 0.09-0.81 cm2). In the 16 severe AR patients, the ARO area was 1.00 +/- 0.51 cm2 (range, 0.23-1.84 cm2). Receiver-operator characteristic curve analysis determined a sensitivity of 85% and a specificity of 82%, for a cutoff of 0.47 cm2, to distinguish severe AR from less than severe AR with the use of CT (area under the curve = 0.91; 95% confidence interval, 0.84-1.00; p < 0.001). CONCLUSION: Planimetric measurement of the ARO area using MDCT is useful for the quantitative evaluation of the severity of aortic regurgitation.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aortic Valve/physiopathology/radiography/ultrasonography ; Aortic Valve Insufficiency/*radiography/*ultrasonography ; Area Under Curve ; Body Weights and Measures/methods ; Echocardiography/methods ; Echocardiography, Doppler, Color/methods ; Echocardiography, Transesophageal/methods ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Tomography, X-Ray Computed/*methods ; Young Adult

Oncocytic carcinoid is a very rare tumor and only few cases have been reported in the literatures. We have experienced one case of pulmonary oncocytic carcinoid occuring at the left upper lobe. The patient was a 56 years old female with no spedific symptoms. Chest Computed tomography showed about 3X3.5cm sized homogenous mass at the left upper lobe. After the evaluation, surgical resection was performed. Gross finding showed a well-defined and well-encapsulated mass of 3X4cm in size, and yellowish-gray in color. Pathohistologically, the tumor was abundant granular eosinophilic cytoplasm. Immunohistochemical stain showed positive cytokeratin and was focal positive reaction in EMA and chromograin. It was confirmed as pulmonary oncocytic carcinoid. Postoperative course was uneventful and the patient has been followed up with no problem.
Carcinoid Tumor* ; Cytoplasm ; Eosinophils ; Female ; Humans ; Keratins ; Lung Neoplasms ; Middle Aged ; Thorax