No abstract available.
Prospective Payment System* ; Prospective Studies*

No abstract available.

Twenty to twenty-five percent of patients are reported to experience problems with anorectal function after low anterior resection, complaining particularly urgency of defecation and minor fecal leakage, but the mechanisms underlying its cause and the recovery process are not well understood. We designed this study to elucidate the mechanism of anorectal functional problems and its recovery process after low anterior resection for rectal cancer by autonomic nerve preserving procedure. Standardized interviews and anorectal physiologic studies including balloon proctometry and manometry were performed in 32 patients preoperatively, and at 1 month, 3 months, 6 months and 1 year after the operation. Postoperatively stool frequency increased, the ability to defer defecation and discriminate stool characters were compromised, and anal incontinence scores increased, which recovered progressively by 6~12 months after the operation. Balloon proctometry showed that threshold volume, urgent volume and maximal tolerable volume decreased remarkably after the operation. The latter two parameters recovered considerably by 1 year after the operation. Rectal compliance also decreased significantly but it showed no evidence of recovery by 1 year after the operation. Anorectal manometry showed that maximum anal resting pressure decreased significantly after the operation which recovered significantly by 1 year after the operation. Maximum anal squeeze pressure showed no significant decrease after the operation. In most patients rectoanal inhibitory reflex was abolished after the operation, which recovered only in some cases by after 1 year. The group of short residual rectum(<4 cm, N=18) showed more impairment in continence and decrease in neorectal capacity and compliance than that of the long residual rectum(> or =4 cm, N=14). These results suggest impairment in fecal continence occurs due to decrease in rectal capacity, compliance, and anal canal pressure, and loss of rectoanal inhibitory reflex. Autonomic nerve preserving procedure could not prevent the decrease in resting anal pressure. Continence recovers clinically with increase in neorectal capacity, compliance and anal canal pressure but not with recovery of rectoanal inhibitory reflex. The length of the residual rectum seems to play an important role in the degree of impairment of continence and good continence can be expected when the residual rectum is more than 4 cm.
Anal Canal ; Autonomic Pathways ; Compliance ; Defecation ; Humans ; Manometry ; Rectal Neoplasms ; Rectum ; Reflex

Colorectoanal intussusception is a rare and distinct entity that differs from the more common rectal prolapse. Typically the intussusception occurrs with tumor at the apex of the intussuscepted segment acting as lead point. Here we present a case and review the literature of colorectoanal intussusception. The case presented here is that of an elderly woman with a proximal sigmoid colon cancer at its apex. Anterior resection was electively performed after reduction of the intussusception. It is important to differentiate a colorectoanal intussusception from the more common rectal prolapse because treatment may differ. The anorectum remains in its normal anatomic position in colorectoanal intussusception, whereas the anal canal is effaced with the prolapsed segment of bowel in rectal prolapse. Identification of a tumor at the apex of the intussuscepted bowel should also arouse suspicion that the condition is not a rectal prolapse.
Aged ; Anal Canal ; Colonic Neoplasms ; Female ; Humans ; Intussusception* ; Rectal Prolapse ; Sigmoid Neoplasms

BACKGROUND: As more than 80% of Korean hospital laboratories don't use glycerol blank for the triglyceride measurement, we investigated free glycerol interference on the measurement of triglyceride concentration. METHODS: We collected 237 specimens which had more than 300mg/dL of triglyceride measured by Abbott (without glycerol blank, USA) reagent from the 217 patients visiting Catholic University Hospital of Taegu Hyosung from September, 1995, to May, 1996. We retested them with Youngdong (without glycerol blank, Korea) reagent, and IRC reagent (with glycerol blank, Japan), and also measured free glycerol concentration with Youngdong reagent. Then we examined the clinical records of the patient showing increased glycerol concentration. RESULTS: Average triglyceride concentration measured by Abbott reagent was 448.0+/- 165.9 mg/dL and average glycerol interference to triglyceride concentration was 3.4+/- 6.7%, There were 8 patients (3.4%) who revealed more than 10 % of glycerol interference. Except these patients the average glycerol interference was 2.4+/- 1.4%. Among these 8 patients, 3 patients were treated with Frucenil and other 3 were with Intralipose(R), and the other 2 were diagnosed as diabetes and preeclampsia respectively. In vitro test, Frucenil mixed with serum in 1% (v/v) increased triglyceride concentration as high as 640.6% with Abbott reagent, but it did only 48.4% with IRC reagent. CONCLUSIONS: Triglyceride measurement by non glycerol blank method exceeded the recommended limit of National Cholesterol Education Program's precision, and this method extremely overestimated the triglyceride concentration for the patient with the glycerol containing fluid therapy. So all laboratories would be encouraged to use the glycerol blank method for triglyceride measurements.
Cholesterol ; Daegu ; Education ; Fluid Therapy ; Glycerol* ; Humans ; Laboratories, Hospital ; Pre-Eclampsia ; Triglycerides*

BACKGROUND: As more than 80% of Korean hospital laboratories don't use glycerol blank for the triglyceride measurement, we investigated free glycerol interference on the measurement of triglyceride concentration. METHODS: We collected 237 specimens which had more than 300mg/dL of triglyceride measured by Abbott (without glycerol blank, USA) reagent from the 217 patients visiting Catholic University Hospital of Taegu Hyosung from September, 1995, to May, 1996. We retested them with Youngdong (without glycerol blank, Korea) reagent, and IRC reagent (with glycerol blank, Japan), and also measured free glycerol concentration with Youngdong reagent. Then we examined the clinical records of the patient showing increased glycerol concentration. RESULTS: Average triglyceride concentration measured by Abbott reagent was 448.0+/- 165.9 mg/dL and average glycerol interference to triglyceride concentration was 3.4+/- 6.7%, There were 8 patients (3.4%) who revealed more than 10 % of glycerol interference. Except these patients the average glycerol interference was 2.4+/- 1.4%. Among these 8 patients, 3 patients were treated with Frucenil and other 3 were with Intralipose(R), and the other 2 were diagnosed as diabetes and preeclampsia respectively. In vitro test, Frucenil mixed with serum in 1% (v/v) increased triglyceride concentration as high as 640.6% with Abbott reagent, but it did only 48.4% with IRC reagent. CONCLUSIONS: Triglyceride measurement by non glycerol blank method exceeded the recommended limit of National Cholesterol Education Program's precision, and this method extremely overestimated the triglyceride concentration for the patient with the glycerol containing fluid therapy. So all laboratories would be encouraged to use the glycerol blank method for triglyceride measurements.
Cholesterol ; Daegu ; Education ; Fluid Therapy ; Glycerol* ; Humans ; Laboratories, Hospital ; Pre-Eclampsia ; Triglycerides*

No abstract available.
Animals ; Ischemia* ; Kidney* ; Rats* ; Reperfusion*

BACKGROUND: To prevent the platelet refractoriness, repeated plateletpheresis is often required in HLA matched single-donors. Korean Transfusion Standard permits the repeated plateletpheresis of a single donor at 72-hour intervals. To evaluate this standard, hematological responses of donors were assessed after plateletpheresis by Haemonetics V50 (Haemonetics Co., USA). METHODS: The pre- and post-donated hematological indices of 22 healthy donors(17 males and 5 females) were evaluated. Single donated donors were 12 males and 4 females. Multiple donated donors were 5 males and one female. Post-donated platelet counts were measured immediately, 6 hours, 12 hours, 1 day, 3 days, 5 days, 7 days and 9 days after plateletpheresis. Platelet aggregation test, serum protein, PT, and aPTT were also examined before and after platelet collection. RESULTS: Only 9 (56.2%) of 16 single-donated donors and 4 (66.7%) of 6 multiple donated donors showed normal restoration up to 97% of platelet counts of pre-donation levels at the day 3. In 9 (75%) of 12 single donated males restoration of platelet count was observed within 3 days, but 3 (75%) of 4 single donated females showed restoration of platelet count within 5 days. Changes of other indices were not significantly different between the pre- and post-donations of platelet. CONCLUSIONS: Although no clinical complication was noted after plateletpheresis, these data suggested that Korean Transfusion Standard on plateletpheresis should be reconsidered.
Blood Platelets ; Female ; Humans ; Male ; Platelet Aggregation ; Platelet Count ; Plateletpheresis* ; Tissue Donors*

Synovial sarcoma is a distinct and generally recognized soft tissue tumor that it’s origin still raises controversy. The synovial origin of synovial sarcoma has not been determined despite the accepted terminology implying synovium as stem cell. Three cases of primary synovial sarcoma (2 fibrous monophasic, 1 biphasic type) were studied with a panel of antibodies against different types of cytokeratin and other markers (EMA, CEA, vimentin, S-100 protein, lysozyme, 1-antichymotrypsin). Spindle shaped-cell in monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin. Epithelial cells lining of glands in biphasic synovial sarcoma reactive for CK7, pancytokeratin, EMA, and focally CEA but spindle cells only positive for vimentin. By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal destiny and discontinuous basal lamina. These results indicate that synovial sarcoma showes epithelial differentiation. We believe that synovial sarcoma arises in pluripotential connective tissue cells that is able to be differentiated into both mesenchymal and epithelial components. So, synovial sarcoma have been considered carcinosarcoma of soft tissues depending on the type of differentiation.
Antibodies ; Basement Membrane ; Carcinosarcoma ; Connective Tissue Cells ; Epithelial Cells ; Immunohistochemistry ; Intercellular Junctions ; Keratins ; Microscopy, Electron ; Muramidase ; S100 Proteins ; Sarcoma, Synovial ; Stem Cells ; Synovial Membrane ; Vimentin

No abstract available.
Animals ; Glutathione* ; Gonadal Steroid Hormones* ; Rats*