No abstract available.
Humans ; Inpatients*

No abstract available.

In evaluating the early state of shock patients and their response to treatment, generally vital signs or additional hemodynamic values were used. Vital signs are easily obtained and repetitious values or continous monitoring is possible, whereas it cannot evaluate the patient's status properly nor is it a good prognostic factor. Meanwhile, additional hemodynamic values are obtained from pulmonary artery catheterization. But this procedure is difficult to proceed in the emergency room. Since central venous oxygen saturation has the advantage of being easily obtained and acts as a good prognostic factor for shock patients, we intended to prove its efficacy. From 1997 May to October, 50 patients admitted to Yonsei University Young Dong Severance Hospital in shock state, with systolic blood pressure below 90mmHg, were evaluated. Central venous catheter was inserted to obtain central venous oxygen saturation, serum lactate, base excess value, and its' initial value compared with the prognosis. The central venous oxygen saturation and base excess were low, while serum lactate value was high in the nonsurvival group. And in ROC(relative operating characteristic) curve, the AUC(area under curve) of central venous oxygen saturation was larger than the others. In comparing the MOF(multi-organ failure) group with the non-MOF group, the MOF group had a lower central venous oxygen saturation and base excess, and a higher serum lactate level, whereas in ROC curve, the AUC of base excess was larger than the others. Therefore, in estimating the prognosis of shock patients, the early central venous oxygen saturation proved to be a good prognostic factor.
Area Under Curve ; Blood Pressure ; Catheterization, Swan-Ganz ; Central Venous Catheters ; Emergency Service, Hospital ; Hemodynamics ; Humans ; Lactic Acid ; Oxygen* ; Prognosis ; ROC Curve ; Shock* ; Vital Signs

No abstract available.

The development of drug resistance is a major obstacle in effective cancer chemotherapy. Multidrug resistance(MDR) is a widely studied phenomenon of interest to both clinicians and research workers because many different cancer chemotherapeutic agents are involved and the genetic basis of MDR is understood to a large extent. Several studies show that the P-glycoprotein (P-gp), multidrug resistance-associated protein(MRP), glutathione-s-transferase-pi(GST-pi), and DNA topoisomerase II(topo II) have a complex role for the malignant phenotypes and MDR. Clearly, there is a need to investigate links between the diverse characteristics of tumors and the emergence of drug resistance. We have therefore used reverse transcription-polymerase chain reaction(RT-PCR) assay to analyze expressions of MDR-related genes including the mdr1, MRP, topo II and GST-t gene in normal testis and testis tumors. The results are as follows: 1. The expression levels of topo II and GST-n genes in testis tumors, especially in the nonseminomatous germ cell tumor(NSGCT), were significantly higher than in normal testis(p=0.015 and 0.025, respectively). 2. The MDR-related gene expressions in testis tumors did not appear to be correlated with stage(p>0.05 in each case) and chemotherapy status(p>0.05 in each case). 3. MRP expression levels in primary tumors were much higher than in metastatic tumors. 4. In NSGCT, the coexpressions of the topo II and GST-r or MRP genes were significantly correlated but, seminoma showed no correlation between MDR-related genes in the same sample. Although the mechanism of these connection are not known, the results suggest that these expression patterns and higher GST-rexpression in NSGCF compared to seminoma confer diverse characteristics including difference in the presentation of tumor markers and the responsiveness to chemotherapy on NSGCF and seminoma.
DNA Topoisomerases, Type I ; DNA Topoisomerases, Type II ; Drug Resistance ; Drug Therapy ; Gene Expression* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; P-Glycoprotein ; Phenotype ; Seminoma ; Testis* ; Biomarkers, Tumor

Purpose: The purpose of this study was to evaluate the mortality of patients over eighty years old with femoral neck fractures that have been treated with bipolar endoprostheses. Materials and Methods: We retrospectively studied 37 patients out of a total of 83, who suffered from hip fractures and were treated with surgery from 2000 through December 2004. We attempted to distinguish the differences between the 8 patients who died (Group A) and the 29 patients who lived (Group B). The variables that we analyzed, were: age, sex, operative time, the time period from admission to surgery, the time period from admission to discharge, the ASA score, and any medical comorbidities. Results: In Group A, 2 patients died within 1 month, 2 died between 1 and 6 months, 1 died between 6 and 12 months, and 3 died after 1 year. There were statistical differences between Group A and Group B with respect to two variables: the time period from admission to, and medical comorbidities. Conclusion: There were significant correlations with an increase in the mortality rate among patients with lung disease, female patients in general, and delays in surgery. Therefore, particular care should be paid to patients with these variables.
Comorbidity ; Female ; Femoral Neck Fractures ; Hip Fractures ; Hip* ; Humans ; Lung Diseases ; Mortality* ; Operative Time ; Retrospective Studies

Nevus lipomatosus superficialis presented as soft, yellowish papules or cerebriform plaques occurring usually on the buttock or thigh, less often on the ear or scalp. We herein report a case of nevus lipomatosus superficialis on the leg.
Buttocks ; Ear ; Leg* ; Nevus* ; Scalp ; Thigh

Basal cell carcinoma is a malignant tumor of the skin that is believed to arise from the hair follicle. In addition to the typical lesion just described, several clinical and histological varieties are recognized. Polypoid basal cell carcinoma, a new distinctive form, has been described as verrucoid, fungating or polypoid mass with stalk and histologically distinguished by restriction of the tumor aggregation to the mass from the other variants. We report a case of basal cell carcinoma of right knee that was pedunculated and had stalk with lobulated surface.
Carcinoma, Basal Cell* ; Hair Follicle ; Knee ; Skin

OBJECTIVES: We retrospectively studied the efficacy of anterior cervical discectomy and interbody fusion without plate fixation in degenerative cervical disease. METHODS: Thirty two consecutive patients with degenerative cervical disease treated by decompression and interbody fusion(Smith-Robinson technique) without anterior cervical plating were studied for postoperative complication rate as well as the clinical and radiologic outcomes and were compared the result of ours with other reported series where the anterior cervical plating was used. RESULTS: All cases were reviewed after average period of 13 months for the purpose of this study. There were 4 postoperative complications related to grafting. A solid fusion was obtained in all cases with single-level fusion(n=21) and 81.8 % of the cases with a two-level fusion(n=11). The overall fusion rate was 93.8 % and fusion rate per level fused was 95.3%. The clinical outcome of the patients was comparable with that in the literature, with one patient having a poor result. Comparing the result of this study with others of the anterior cervical plating, clinical outcome and fusion rate were not superior in plate fixation group in single-level fusion, but increased fusion rate and decreased graft-related complication rate were noted in multilevel fusion with plate fixation. However, the clinical outcome was not superior to noninstrumented fusion group of this study. CONCLUSION: These results demonstrate that anterior cervical discectomy and interbody fusion(Smith-Robinson technique) without instrumentation is safe and reliable method of single-level fusion in degenerative cervical disease. Plate fixation system doesn't seem necessary in single level fusion in degenerative cervical disease.
Decompression ; Diskectomy* ; Humans ; Postoperative Complications ; Retrospective Studies ; Transplants

Meralgia paresthetica is a syndrome consisting of numbness, pain, tingling, burning and/or a variety of other paresthesias on the distribution of the lateral femoral cutaneous nerve (LFCN) of the thigh. We report a case of meralgia paresthetica in a 41-year-old woman who complained of the symptoms of pain, burning sensation, and dysesthesia which occurred whilst standing up without any other constitutional symptoms. The authors suspect that frequent. and persistent squatting may play a role in the development of the present symptoms.
Adult ; Burns ; Female ; Humans ; Hypesthesia ; Paresthesia ; Sensation ; Thigh