PURPOSE: Malignant disease of the anus is rare. Abdominoperineal resection was formerly considered to be the treatment of choice. But, in recent, less ablative and more effective combined therapeutic modalities have been developed. METHODS: we analyzed 33 patients who were diagnosed and treated as anal cancers at the Department of Surgery, Gospel Hospital, Kosin Medical Collage, from July 1, 1988 to Nov. 30, 1997. RESULTS: The ratio of male to female was 1.4:1 and mean age was 56.7 years old. Twenty-two (84.8%) of these cancers were located in the anal canal and 5 (15.2%) in the anal margin. Three main histologic types of the anal cancers were identified: squamous cell carcinoma was the most common lesion, accounted for 17 cases (51.1%), adenocarcinoma accounted for 8 cases (24.2%), malignant melanoma accounted for 8 cases (24.2%). The overall 3-year survival rate and 5-year survival rate of anal cancer were 54.1%, 41.7%. Eleven patients with squamous cell carcinoma were treated curatively: 6 patients were treated with chemoradiotherapy, 3 patients with abdominoperineal resection, one patient with chemoradiotherapy and abdominoperineal resection, one patient with local excision. CONCLUSION: In survival rate, there were no significant differences between chemoradiotherapy group and surgical treatment group. In squamous cell carcinomas, chemoradiotherapy had anal sparing benefit without loss of survival. On univariate analysis, T, N, type of treatment, histologic type had no statistical significances on survival. On multivariate analysis, location of lesion and distant metastasis had statistical significances.
Adenocarcinoma ; Anal Canal ; Anus Neoplasms* ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Female ; Humans ; Male ; Melanoma ; Multivariate Analysis ; Neoplasm Metastasis ; Survival Rate

Displaced acetabular fractures have given rise to difficulty to the management, It has been unique diagnostic and operative challanges for the surgeon. We made a retrospective study of hip arthroplasty in fourteen patients who had a history of previous acetabular fracture. The most of patients was sutfered from traumatic osteoarthritis, We performed two bipolar hemiarthroplasty, eleven non-cement cup and one case Charnley cup replacement were done. The purpose of this stady was to determine the outcome long-term cup. The clinical results showed that pain was most improved at foliow-up, but the incidence of radiographic loosening and revisions were higher 42.8% within 10 years. We conclude that a history of prior acetahular fracture has a significant adverse impact on the long term out come of acetabular cup in total hip arthroplasty.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Osteoarthritis ; Retrospective Studies

No abstract available.
Animals ; Cadmium Chloride* ; Cadmium* ; Nasal Mucosa* ; Rats*

BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism

No abstract available.
Ear, Middle*

No abstract available.
Adult* ; Hernia* ; Humans

No abstract available.
Amino Acid Sequence* ; HIV* ; Phenotype*

This study was designed to develop the life moking cessation program with multidisciplinary approach using the Bandura's theory of self-efficacy and confirm the effect of it on the self-efficacy and smoking amount in college students. For this purpose non-equivalent control group, pretest-posttest design was used. The participating subjects in this study were 46 male college freshmen, 23 in experimental and 23 in control group. The experimental group received the 8 sessions of lecture and small group discussions for 4 weeks and a telephone coaching program for a period of 8 weeks. The control group received 5 sessions of lecture without further treatments. The data was collected from March 15 to June 11, 1999, and analysed by SAS/PC program with X2 test, simple t, paired t test. The results were as follows. 1. The score of self-efficacy was significantly increased over time in the experimental group than those of the control group. 2. The amount of urine cotinine was decreased over time in the experimental group, number of cigarettes smoked a day were significantly decreased, and they were significantly less than those of the control group. In conclusion it was found that the Life Smoking Cessation Program with Multidisciplinary Approach was an effective nursing intervention for increasing self efficacy and reducing the amount of smoking in male college students. Therefore, future smoking cessation programs should always consider the concept of self-efficacy and ways to positively reinforce it.
Cotinine ; Humans ; Male ; Nursing ; Self Efficacy ; Smoke* ; Smoking Cessation* ; Smoking* ; Telephone ; Tobacco Products

No abstract available.
Myelitis, Transverse* ; Retrospective Studies*

OBJECTIVES: The purpose of this study was to determine the clinical significance of residual amniotic fluid volume, as measured by the amniotic fluid index(AFI), on the prediction of latency period and perinatal outcomes in patients with preterm premature rupture of the membranes(PPROM). METHODS: Study population consisted of 103 singleton pregnancies with PPROM between 24 and 34 weeks' gestation. Amniotic fluid index was determined using transabdominal ultrasound at admission. Latency period was defined as time interval in hours between admission and delivery. All medical records of mothers and neonates were reviewed. Spearman's rho rank correlation, receiver-operator characteristic(ROC) curve analysis, survival analysis and Cox's proportional hazard model were used for statistical analysis. RESULTS: There was a statistically significant correlation between latency period and AFI at admission. ROC curve analysis showed that AFI at admission had a significant predictive value in the prediction of latency period < 48 hours. Survival analysis demonstrated that AFI < 5.0 was strongly associated with the likelihood of shorter latency period, Cox's proportional hazard model indicated that AFI < 5.0 was a significant independent predictor for the occurrence of latency period < 48 hours even after adjustment of other independent variables. The patients with AFI <5.0 had a higher rate of cesarean section due to fetal distress than those with AFI > 5.0 but the incidence of chorioamnionitis was not significantly different between two groups. Comparing the perinatal mortality and neonatal morbidity including infectious morbidity between the neonates born to mothers with AFI <5.0 and those with AFI > 5.0, there was no significance after adjustment of gestational age at birth. CONCLUSION: AFI at admission has a significant correlation with latency period and predictive value in prediction of latency period in the patients with PPROM. AFI <5.0 is a independent predictor for the shorter latency period.
Amniotic Fluid* ; Cesarean Section ; Chorioamnionitis ; Female ; Fetal Distress ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Latency Period (Psychology)* ; Medical Records ; Membranes* ; Mothers ; Parturition ; Perinatal Mortality ; Pregnancy ; Proportional Hazards Models ; ROC Curve ; Rupture* ; Ultrasonography