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

Cancer has become a major cause of death in Korea since 1989. Despite the major advances in the treatment of cancer, prevention and early detection is the most effective strategy to decrease the mortality from cancer. The indicence of invasive cervical cancer has declined since the 1950s, and indirect evidence suggests that this decline is the result of the institution of screening with cervical smear. However, cervical cancer continues to be a major health problem in the developing world today, where screening is not universal. Among Korean women, the incidence of cervical cancer is still high and was the 3rd most common cancer following stomach and breast cancer in 2000. If preinvasive conditions would be included, the disease would be the most frequent. The first organized screening programmes were initiated in 1949 at British Columbia, Canada. Since then, cervical cancer screening programmes have been implemented in almost all developed countries. In Korea, opportunistic screening began in the late 1950s, and organized screening began in 1998 by Health Insurance without a consensus meeting. The guidelines for the screening of cervical cancer were developed by National Cancer Center and the Koean Society of Obstetrics and Gynecology in May, 2001 ; and the national screening programmes were developed by the Supporting Evaluation Board of National Cancer Screening Program in December, 2001. This article introduces these programmes.
Breast Neoplasms ; British Columbia ; Canada ; Cause of Death ; Consensus ; Developed Countries ; Early Detection of Cancer ; Female ; Gynecology ; Humans ; Incidence ; Insurance, Health ; Korea ; Mass Screening* ; Mortality ; Obstetrics ; Papanicolaou Test ; Stomach ; Uterine Cervical Neoplasms* ; Vaginal Smears

No abstract available in English.
Humans ; Low Back Pain ; Spinal Canal ; Ultrasonics

BACKGROUND: Since the exact pathogenesis of sepsis-induced ARDS has not been elucidated, the mechanisms of enhanced neutrophilic respiratory burst were probed in endotoxin primed neutrophils associated with the roles of phospholipase A2 (PLA2), platelet activating factor (PAF) and apoptosis. METHODS: In isolated fresh human neutrophils, effects of the inhibition of PLA2 and PAF on the apoptosis were examined by the method of Annexin-FITC/dual PI flow cytometry. The roles of PLA2 and PAF on the neutrophilic respiratory burst were also examined by measuring oxidant generation in cytochrome-c reduction assay. Activities of the PLA2 and lysoPAF acetyltransferase (lysoPAF AT) of the neutrophils were determined to understand the effect of endotoxin on these enzymatic activities which may be related to the neutrophilic respiratory burst and apoptosis. In addition, the role roles of PLA2 and PAF in neutrophilic adhesion to bovine endothelial cells were examined in vitro by neutrophil adhesion assay. To investigate the effect of oxidants on pulmonary surfactant, cytochemical ultrastructural microscopy was performed. To inhibit PLA2 and PAF, non-specific PLA2 inhibitor mepacrine (100 nM) and WEB 2086 (100 nM) or ketotifen fumarate (10 kg/ml) were used respectively in all in vitro experimental sets. WEB 2086 is PAF receptor antagonist, and ketotifen fumarate is a lyso PAF AT inhibitor. RESULTS: The mapacrine treatment, provided after the endotoxin (ETX) treatment, resulted in increased apoptosis of neutrophils (p<0.001) while treatments of WEB 2086 and ketotifen did not. The inhibition of PLA2 and PAF decreased (p<0.001) production of oxidants from PMA-stimulated neutrophils. While endotoxin increased the PLA2 activity of neutrophils (p<0.01), mepacrine supressed (p<0.001) the activity, provided after treatment of ETX. The lyso PAF actyltransferase activity (lyso PAF AT) increased(p<0.01) after treatment of ETX. In contrast, mepacrine, WEB 2086 and ketotifen showed a tendency of decreasing the activity after treatment of ETX. The Treatment of ETX increased (p<0.001) neutrophil adhesion to endothelial cells, which was reversed by inhibition of PLA2 and PAF (p<0.001). The binding of oxidants to pulmonary surfactant was identified histologically. CONCLUSIONS: The enhanced neutrophilic respiratory burst by ETX plays a pivotal role in the pathogenesis of ARDS in term of oxidayive oxidative stress. Increased production of oxidants form neutrophils is mediated by the activations of PLA2 and lyso PAF AT.
Apoptosis* ; Endothelial Cells ; Flow Cytometry ; Humans ; Ketotifen ; Microscopy ; Neutrophils* ; Oxidants ; Oxidative Stress ; Phospholipases A2 ; Platelet Activating Factor ; Pulmonary Surfactants ; Quinacrine ; Respiratory Burst*

To determine the impact of intake large amount whole cow's milk (WCM) on iron status during early childhood (18~36 months), selected indices of complete blood count(CBC) and iron status were compared between the WCM large amount intake group (n=20)and small amount intake group (n=20). WCM large amount intake children's mean hemoglobin and mean hematocrit were 9.6+/-1.7 g/dL and 30.8+/-4.5% respectively. These range of peripheral blood with other indices of CBC disclosed the hypochromic microcytic anemia. WCM large amount intake children's some indices of CBC-hemoglobin, hematocrit, MCV, MCH-were significantly lower than those of small amount intake children (P<0.01). WCM large amount intake children had significantly lower mean iron, transferrin saturation and ferritin (P<0.01) and greater mean total iron binding capacity (P<0.05) than did small amount intake children. It is concluded that intake large amount of WCM for long duration impacts on the iron status of 18~36 months old children disadvantageously. It should be avoided for the protection of irreversible recognitive impairment and behavioral change.
Anemia ; Anemia, Iron-Deficiency ; Child ; Ferritins ; Hematocrit ; Humans ; Iron* ; Milk* ; Transferrin

Twenty-five paraffin-embedded tumor tissues were analyzed for detection of HPV 16 and 18 in cervical adenocarcinoma by polymerase chain reaction with type specific primers and by non-radioactive Southern blot hybridization for confirmation . The suitability of paraffin-embedded tissue as PCR material was confirmed by successful amplification of 100% of cervical specimens with human -globin specific primer. Eighty four percent of the cervical adenocarcinoma tissues were positive for HPV 16 and/or 18. HPV 16 positive rate was 68%, HPV 18 was 60%. The double infection with HPV 16 and 18 was found in 44%. Three cases of the negative specimen in PCR for each type of HPV DNA 16 and 18 were positive in Southern blot hybridization. The total positive rate was 92% for HPV 16 and/or HPV 18, HPV 16 positive rate was 80%. HPV 18 was 72%. The double infection with HPV 16 and 18 was 60%. These results suggest that the pattern of HPV types 16 and 18 is closely associated with carcinogenesis of cervical cancers. HPV type 18 appears to be preferentially related to cervical adenocarcinoma and the poor prognosis of these patients. Therefore, determination of HPV DNA type in cervical carcinoma patients is important in treatment and prognosis.
Humans ; Adenocarcinoma

The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.
Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative ; Polyarteritis Nodosa ; Prednisolone ; Recurrence ; Skin ; Streptomycin ; Tuberculosis, Cutaneous* ; Vasculitis*

No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Humans ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

No abstract available.
Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Pregnancy* ; Premature Birth*