No abstract available.
Adult ; Cholecystectomy ; Diagnosis, Differential ; Gallbladder Diseases/pathology ; Hemobilia/*diagnosis/pathology/ultrasonography ; Humans ; Male ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to explore levels of depression, anxiety, suicidal ideation in maladjusted Korean soldiers and identify factors that influence suicidal ideation. METHODS: Instruments were the CES-D (Center for Epidemiologic Studies-Depression Scale), STAI (State Trait Anxiety Inventory), and SSI (Scale for Suicidal Ideation). The participants were 94 maladjusted soldiers from one army base in Gyeong-gi Province. Data were collected using self-report questionnaires, and analyzed with the SPSS/WIN 20.0 program. RESULTS: Mean scores were; for CES-D, 42.1+/-13.10, for STAI-I (state-anxiety) and STAI-II (trait-anxiety), 60.3+/-15.05 and 61.9+/-12.14 respectfully, and for SSI, 23.1+/-9.52. There were significant differences in suicidal ideation according the general characteristics of education, prospects for the future, and having someone to talk about troubles. Major variables showing significant correlations were prospects for the future, depression, trait anxiety, state anxiety, and suicidal ideation. Depression and prospect for future were significant predictors of suicidal ideation (Adjusted R2 65%). CONCLUSION: Based on the findings of this study, it is important to assess significant mental health problems at the clinical level and provide suicidal ideation prevention in maladjusted soldiers. Active input from experts such as nursing officers and intervention programs that focus on depression are needed.
Anxiety ; Depression ; Humans ; Mental Health ; Military Personnel ; Surveys and Questionnaires ; Suicidal Ideation

Fatal complications including cerebral edema and neurologic collapse occur during treatment of diabetic ketoacidosis(DKA). A 6-week-old female infant with fever, dehydration and drowsy mental status was diagnosed as DKA and neurologically deteriorated during treatment. The cranial computed tomography scan revealed multifocal brain infarctions of the left caudate nucleus, bilateral frontal periventricular white matter, and right parietal cortex. A moderate amount of hemorrhage was also noted in both lateral ventricles. She recovered rapidly with supportive treatment over time. The clinical course and radiologic findings of this patient emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.
Brain Edema ; Brain Infarction* ; Brain* ; Caudate Nucleus ; Child ; Dehydration ; Diabetic Ketoacidosis* ; Female ; Fever ; Hemorrhage* ; Humans ; Infant* ; Lateral Ventricles ; Rabeprazole

BACKGROUND/AIMS: The indications for colorectal endoscopic submucosal dissection (ESD) vary in clinical practice. To establish colorectal ESD as a standard treatment, standard indications are essential. For establishing standard indications for colorectal ESD, we surveyed the preferences and criteria of endoscopists for colorectal ESD in their practices. METHODS: A multiple-choice questionnaire was sent to 27 members of the Korean Society of Gastrointestinal Endoscopy/ESD group. The indications of endoscopists for selecting ESD as a treatment for colorectal tumors ≥2 cm in diameter were surveyed. RESULTS: On the basis of the preprocedural assessment of histology, adenoma with high-grade dysplasia, mucosal cancer, and shallow submucosa invasive cancer were included in the indication for ESD. Based on gross morphology, laterally spreading tumor (LST) granular nodular mixed type, LST-nongranular (LST-NG) flat elevated type, and LST-NG pseudodepressed type were included. On the basis of the pit pattern by Kudo classification, types III, IV, and V-I were included. Based on the narrow band imaging pattern by Sano classification, types II and III-a were included. Other lesions, such as sporadic localized tumors in chronic inflammation and local residual early carcinoma after endoscopic resection, were also included in the indication for ESD. CONCLUSIONS: The indications of Korean endoscopists for colorectal ESD are broader than those in recent guidelines, and tend to include more benign-looking tumors. To find the appropriate indications for colorectal ESD, systematic data collection and analysis are required to reach a consensus in a timely manner.
Adenoma ; Classification ; Colorectal Neoplasms* ; Consensus ; Data Collection ; Inflammation ; Narrow Band Imaging

OBJECTIVE: Despite the good prognosis of borderline ovarian tumors (BOTs), a few BOT patients experience the relapse of disease, either borderline or malignant. However, the risk of recurrence of BOTs is somewhat controversial. We intended to find out the specific characteristics and prognosis of the recurrence of BOTs. METHODS: Between 1995 and 2012, 130 women were diagnosed with BOTs at a single institution. Eleven patients diagnosed and treated for the recurrence of BOTs including seven cancerous and four borderline relapses were included for the analysis in this retrospective study. Clinicopathological characteristics and surgical procedures as well as follow-up data with overall survival were assessed. Statistical analyses was performed using the chi2 test, t-test and log-rank test with Cox regression. RESULTS: One hundred and thirty patients with mean follow-up of 65.8 months were evaluated, of whom half were below 40 years old at their first diagnosis of BOTs. Among 11 recurrent cases (8.5%), 7 cancerous transformations (5.4%) and 4 borderline recurrences (3.1%) were detected with median time of 6 and 71 months after the primary surgery, respectively. Nine out of 11 recurrences were happened at their equal or below 40-years-old age at the primary diagnosis (P=0.027). Also, all 7 cancerous relapses arose from premenopausal women of median age of 35 years old. Twenty (15%) patients had laparoscopic surgery and they were all treated conservatively. Among those 20, 5 were suffered from relapse of BOTs and laparoscopic approach was proved to be a significant risk factor for disease relapse in our study (P=0.013). Although laparoscopic surgery was revealed had meaningful influence on disease free survival (P=0.024), it was not significant on overall survival (P=0.226). CONCLUSION: Laparoscopic conservative surgery for BOTs can be accepted under close follow-ups. And younger patients should be followed for long period to evaluate recurrence.
Diagnosis ; Disease-Free Survival ; Epithelial-Mesenchymal Transition ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Ovarian Neoplasms ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: Studies concerning the efficacy and safety of single-balloon enteroscopy (SBE) compared with that of double-balloon enteroscopy (DBE) often appear to be conflicting. However, previous studies were performed by endoscopists who were less experienced in SBE compared with DBE. METHODS: We performed a retrospective analysis of SBE and DBE data performed by a single enteroscopist, with expertise in SBE, using a prospective balloon-assisted enteroscopy registry from 2013 to 2015. Furthermore, we performed a comprehensive literature search and meta-analysis of available studies, including the current study, to clarify the efficacy and safety of SBE versus DBE. RESULTS: A total of 65 procedures in 44 patients with SBE and 74 procedures in 69 patients with DBE were analyzed. There were no significant differences in diagnostic yield (61.1% vs 77.3%, respectively, p=0.397), therapeutic yield (39.1% vs 31.8%, respectively, p=0.548), and complication rate (4.4% vs 2.3%, p=1.000). In the meta-analysis, which included four randomized controlled trials and three observational studies, there were no significant differences in the pooled relative risk and odds ratio for diagnostic and therapeutic yield and complications of SBE compared with those of DBE. CONCLUSIONS: The performance of SBE appears to be similar to that of DBE in terms of diagnostic and therapeutic yield and complications.
Double-Balloon Enteroscopy* ; Humans ; Odds Ratio ; Prospective Studies ; Retrospective Studies

PURPOSE: Adequate health-related information provided by health professionals may help cancer patients overcome their uncertain situation and manage their healthcare. To provide information effectively, there is a need to understand the content of the patients' essential information. The purpose of this study was to identify recent informational needs of postoperative gastric cancer patients. MATERIALS AND METHODS: Data were collected from 190 postoperative gastric cancer patients who attended the Stomach Cancer Patients' Day ceremony (18 November 2008) held by the Stomach Cancer Center of Samsung Medical Center with the use of a questionnaire which measured informational needs. A questionnaire with 37 items was comprised of domains of diagnostic tests, cancer therapy, prognosis, follow-up, sexual activity, stomach cancer-related information, and 7 single items. RESULTS: The priorities of informational needs were the domains of prognosis, ways of healthcare during treatment (a single item), follow-up, stomach cancer-related information, cancer therapy, and diagnostic tests (in descending order). Items related to prognosis, diet, and management of their healthcare ranked in the top 10 informational need scores. As age decreased, the degree of informational needs about diagnostic tests, cancer therapy, sexual activity, and stomach cancer-related information increased. CONCLUSION: We suggest that prognosis-related information based on the accumulated institutional therapeutic outcomes and objective prognosis data should be incorporated in the current education program. Health professionals should provide comprehensible information content to cancer patients and caregivers and encourage patients to participate in their therapy with a more positive attitude.
Caregivers ; Delivery of Health Care ; Diagnostic Tests, Routine ; Diet ; Follow-Up Studies ; Health Occupations ; Humans ; Prognosis ; Surveys and Questionnaires ; Sexual Behavior ; Stomach ; Stomach Neoplasms

Although the incidence and mortality for most cancers such as lung and colon are decreasing in several countries, they are increasing in several developed countries because of an unhealthy western lifestyles including smoking, physical inactivity and consumption of calorie-dense food. The incidences for lung and colon cancers in a few of these countries have already exceeded those in the United States and other western countries. Among them, lung cancer is the main cause of cancer death in worldwide. The cumulative survival rate at five years differs between 13 and 21 % in several countries. Although the most important risk factors are smoking for lung cancer, however, the increased incidence of lung cancer in never smokers(LCINS) is necessary to improve knowledge concerning other risk factors. Environmental factors and genetic susceptibility are also thought to contribute to lung cancer risk. Patients with lung adenocarcinoma who have never smoking frequently contain mutation within tyrosine kinase domain of the epidermal growth factor receptor(EGFR) gene. Also, K-ras mutations are more common in individuals with a history of smoking use and are related with resistance to EFGR-tyrosine kinase inhibitors. Recently, radon(Rn), natural and noble gas, has been recognized as second common reason of lung cancer. In this review, we aim to know whether residential radon is associated with an increased risk for developing lung cancer and regulated by several genetic polymorphisms.
Adenocarcinoma ; Colon ; Colonic Neoplasms ; Developed Countries ; Epidermal Growth Factor ; Genetic Predisposition to Disease ; Humans ; Incidence ; Life Style ; Lung Neoplasms* ; Lung* ; Mortality ; Phosphotransferases ; Polymorphism, Genetic ; Protein-Tyrosine Kinases ; Radon* ; Risk Factors ; Smoke ; Smoking ; Survival Rate ; United States

Alterations of cardiovascular function associated with various thyroid states have been studied. In hyperthyroidism left ventricular contractility and relaxation velocity were increased, whereas these parameters were decreased in hypothyroidism. The mechanisms for these changes have been suggested to include alterations in the expression and/or activity levels of various proteins; alpha-myosin heavy chain, beta-myosin heavy chain, beta-receptors, the guanine nucleotide-binding regulatory protein, and the sarcolemmal Ca2+-ATPase. All these cellular alterations may be associated with changes in the intracellular Ca2+ concentration. The most important regulator of intracellular Ca2+ concentration is the sarcoplasmic reticulum (SR), which serves as a Ca2+ sink during relaxation and as a Ca2+ source during contraction. The Ca2+-ATPase and phospholamban are the most important proteins in the SR membrane for muscle relaxation. The dephosphorylated phospholamban inhibits the SR Ca2+-ATPase through a direct interaction, and phosphorylation of phospholamban relieves the inhibition. In the present study, quantitative changes of Ca2+-ATPase and phospholamban expression and the functional consequences of these changes in various thyroid states were investigated. The effects of thyroid hormones on (1) SR Ca2+ uptake, (2) phosphorylation levels of phospholamban, (3) SR Ca2+-ATPase and phospholamban protein levels, (4) phospholamban mRNA levels were examined. Our findings indicate that hyperthyroidism is associated with increases in Ca2+-ATPase and decreases in phospholamban levels whereas opposite changes in these proteins occur in hypothyroidism.
Ethanol ; Guanine ; Hyperthyroidism ; Hypothyroidism ; Membranes ; Muscle Relaxation ; Phosphorylation ; Relaxation ; RNA, Messenger ; Sarcoplasmic Reticulum* ; Thyroid Gland* ; Thyroid Hormones ; Ventricular Myosins

A lymphangioma of the small bowel is a rare benign tumor of the lymphatic system, which generally is non-symptomatic but can develop some complications such as gastrointestinal obstruction or bleeding. A 40-year-old female was admitted to our hospital due to chronic gastrointestinal bleeding of 17 months duration. Endoscopic evaluation, computed tomographic examination of the abdomen and pelvis, angiography and enteroclysis were performed, but no abnormal findings were found. A red blood cell (RBC) scan demonstrated the presence of active bleeding in the upper abdominal area; however, the precise location of the bleeding could not be determined. An exploratory laparotomy was performed, with an approximately 0.4 cm sized polypoid mass detected in the proximal jejunum just distal to the Treitz ligament on an intraoperative endoscopic examination through the incision in the mid-jejunum. A segmental resection of the jejunum containing the bleeding mass and primary anastomosis was performed. The final pathological diagnosis was a lymphangioma of the jejunum. In patients with a non-localized bleeding lesion in the small intestine, an intraoperative endoscopic examination could be a useful diagnostic method.
Abdomen ; Adult ; Angiography ; Diagnosis ; Erythrocytes ; Female ; Hemorrhage* ; Humans ; Intestine, Small* ; Jejunum ; Laparotomy ; Ligaments ; Lymphangioma* ; Lymphatic System ; Pelvis