A prospective serial ultrasonographic study was conducted to assess the incidence of subhepatic fluid collection in 130 elective cholecystectomy patients with and without surgical drains. Fluid collection was observed in 33(25.4%) of a total of 130 cases, comprising 16 of 60 cases (26.7%) in the drained group and 17 of 70 cases (24.3%) in the undrained group. This difference was not statistically significant (P > 0.05). At the time of the initial, second, and final serial scans, fluid collection was seen in 22.3% (29/130), 10%(13/30) and 1.5% (2/130) of the cases, respectively. There was no bile leakage among the patient receiving surgical drains, nor did fluid collection continue for more than 2 weeks that manifested clinical symptoms. These results indicate that drainage after uncomplicated elective cholecystectomy is unnecessary, and that the timing of ultrasonographic studies is one of the critical factors in determining the incidence of postcholecystectomy subhepatic fluid collections.
Ascitic Fluid* ; Cholecystectomy* ; Drainage ; Female ; Human ; Male ; Middle Age ; Postoperative Care ; Prospective Studies ; Ultrasonography*

The functional derangement of skeletal muscles which may be attributed to chronic hypoxia has been accepted as a possible mechanism of exercise impairment in patients with chronic obstructive pulmonary disease (COPD). The metabolc changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation early activation of anaerobic glycolysis and excessive lactate and hydrogen ion production with exercise. But the cause of exercise limitation in patients with chronic lung disease without hypoxia has not been known. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the exercise limitation in chronic lung disease patients without hypoxia, we compared the muscular metabolic data of seven male patients which had been derived from noninvasive 31P magnetic resonance spectroscopy(MRS) with those of five age-matched normal male control persons. 31P MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntatry contraction(MVC) force of the muscle was measured before the isometric exercise, and the 30% of MVC force was constantly loaded to each patient during the isometric exercise. There were no differences of intracellular pH (pHi) and inorganic phosphate/phosphocreatine (Pi/PCr) at baseline, exhaustion state and recovery period between two groups. But pHi during the exercise was lower in patients group than the control group (p<0.05). Pi/PCr during the exercise did not show significant difference between two groups. These results suggest that the exercise limitation in chronic lung disease patients without hypoxia also could be attributed to the abnormalities in the skeletal muscle metabolism.
Anoxia ; Exercise ; Forearm ; Glycolysis ; Humans ; Hydrogen-Ion Concentration ; Isometric Contraction ; Lactic Acid ; Lung Diseases ; Lung* ; Magnetic Resonance Spectroscopy* ; Male ; Metabolism* ; Muscle, Skeletal* ; Muscles ; Oxidative Phosphorylation ; Protons ; Pulmonary Disease, Chronic Obstructive

PURPOSE: Bone is the most frequent site of metastasis among breast cancer patients. We investigated prognostic factors affecting survival following bone-only metastasis in breast cancer patients. MATERIALS AND METHODS: The medical records of breast cancer patients who were treated and followed at Gangnam Severance Hospital retrospectively reviewed to identify patients with bone-only metastasis. RESULTS: The median time from the diagnosis of bone-only metastasis to the last follow-up or death was 55.2 [95% confidence interval (CI), 38.6-71.9] months. The Kaplan-Meier overall survival estimate at 10 years for all patients was 34.9%. In the multivariate Cox regression model, bisphosphonate treatment [hazard ratio=0.18; 95% CI, 0.07-0.43], estrogen receptor positivity (hazard ratio=0.51; 95% CI, 0.28-0.94), and solitary bone metastasis (hazard ratio=0.32; 95% CI, 0.14-0.72) were significantly associated with longer overall survival in the bone-only recurrence group. Among the treatment modalities, only bisphosphonate treatment was identified as a significant prognostic factor. CONCLUSION: Identifying the factors influencing breast cancer mortality after bone-only metastasis will help clarify the clinical course and improve the treatment outcome for patients with breast cancer and bone-only metastasis. Bisphosphonates, as a significant prognostic factor, warrant further investigation.
Adult ; Antineoplastic Agents/therapeutic use ; Bone Neoplasms/drug therapy/genetics/*secondary ; Breast Neoplasms/drug therapy/genetics/*pathology ; Female ; Humans ; Middle Aged ; Multivariate Analysis ; Prognosis ; Receptors, Estrogen/genetics ; Receptors, Progesterone/genetics ; Regression Analysis ; Retrospective Studies ; Survival Analysis

This is the first preliminary report among two consecutive papers. Partial mastectomy(PM), axillary lymph node dissection(AD) and radiotherapy (RT) were performed on seventeen operable breast cancer patients who had been admitted from April 1991 to March 1992 to the department of surgery, Yongdong Severance Hospital for improved cosmetic appearance and better survival rate. Of seventeen patients, 47% were T1 lesion and 76% were stage I and II. Extensive intraductal component(EIC) within or around the tumor was also analyzed. Twenty nine per cent of the patients were EIC positive. The mean number of axillary lymph nodes was 21.5 after PM with AD and 20.5 after mastectomy. For radiotherapy, 4,500 rad was delivered to the breast parenchyma and 1,600 rad of boost to the primary tumor site using the electron beam method after surgery. All patients have since been living well without any local recurrence and were satisfied with breast preservation for the one-year follow-up period. We concluded that the PM, AD and RT can be another surgical treatment modality of breast cancer. A longer follow-up data will be followed on the second paper.
Breast Neoplasms/radiotherapy/surgery/*therapy ; Combined Modality Therapy ; Female ; Human ; *Lymph Node Excision ; *Mastectomy, Segmental ; Radiotherapy/adverse effects

The primary objective of this study was to determine whether adenoid hypertrophy and subsequent adenoidectomy affect pediatric nasal airway resistance and nasal geometry. The secondary objective was to evaluate the relationships between the degree of adenoid hypertrophy and nasal airway resistance or nasal geometry. Fifty-one children, aged 5 to 10 years, selected for adenoidectomy due to chronic nasal obstruction and mouth breathing were enrolled. The size of adenoid was evaluated by cephalometric radiograph. Nasal airway resistance and nasal geometry were evaluated by active anterior rhinomanometry and acoustic rhinometry respectively. These measurements were repeated 3 months after operation. The size of adenoid was found well correlated to preoperative nasal airway resistance but was not to preoperative nasal geometry. Nasal geometry was not changed after operation. However, nasal airway resistance was reduced significantly at 3 months after operation and the size of adenoid was found well correlated to postoperative changes of nasal airway resistances.
Adenoidectomy* ; Adenoids ; Airway Resistance* ; Child ; Humans ; Hypertrophy ; Mouth Breathing ; Nasal Obstruction ; Rhinomanometry ; Rhinometry, Acoustic

This study was designed to investigate the effects of polyamines on mechanical contraction and voltage-dependent calcium current (VDCC) of guinea-pig gastric smooth muscle. Mechanical contraction and calcium channel current (I(Ba)) were recorded by isometric tension recording and whole-cell patch clamp technique. Spermine, spermidine and putrescine inhibited spontaneous contraction of the gastric smooth muscle in a concentration-dependent manner. Spermine (2 mM) reduced high K+ (50 mM)-induced contraction to 16+/-6.4% of the control (n=9), and significantly inhibited I(Ba) in a reversible manner (p<0.05; IC50=0.8 mM). Pre- and post-treatment of tissue with spermine (2-5 mM, n=10) also inhibited acetylcholine (10 micrometer)-induced phasic contraction to 5+/-6.4% of the control. Inhibitory effect of spermine on I(Ba) was observed at a wide range of test potentials of current/voltage (I/V) relationship (p<0.05), and steady-state activation of I(Ba) was shifted to the right by spermine (p<0.05). Spermidine and putrescine (1 mM each) also inhibited I(Ba) to 51+/-5.7% and 81+/-5.3% of the control, respectively. And putrescine (1 mM) inhibited I(Ba) at whole tested potentials (p<0.05) without significant change of kinetics (p<0.05). Finally, 5 mM putrescine also inhibited high K+ -induced contraction to 53+/-7.1% of the control (n=4). These findings suggest that polyamines inhibit contractions of guinea-pig gastric smooth muscle via inhibition of VDCC.
Pyloric Antrum/*drug effects/physiology ; Potassium/pharmacology ; Polyamines/*pharmacology ; Muscle, Smooth/*drug effects/physiology ; Muscle Contraction/*drug effects ; Male ; Guinea Pigs ; Female ; Calcium Channels/drug effects/physiology ; Calcium/metabolism ; Animals

Humans ; Adolescent ; Pandemics ; Substance-Related Disorders/epidemiology* ; Smoking ; Ethanol ; Republic of Korea/epidemiology* ; Alcohol Drinking/epidemiology*