Since early gastric cancer (EGC) patients show an excellent surgical outcome and a long-term survival rate, the purpose and methods of postoperative follow-up need to be reconsidered. The recurrence rate after surgery is less than 2% in EGC. The mode of recurrence is diverse, of which hematogeous metastasis being most frequently encountered. Post-gastrectomy patients have a risk of nutritional deficiency and more chances to develop remnant gastric tumor or secondary tumor than normal population. Based on the pattern and developmental time span of recurrence, postoperative follow-up program for EGC should not be different from that for advanced gastric cancer. Most Korean doctors' post-operative follow-up with the patients range up to 5 years with an interval of 4 to 6 months. Gastroscopy, CT, and tumor markers are used for follow-up by more than 50% of doctors. Due to the increased rate of long-term survival, follow-up program should include assessment of functional aspect and nutritional well-being of the patients. Epidemiological studies for the long-term survivors and specialized strategies need to be developed for management of postgastrectomy cancer patients. Although early detection of recurrence is the primary goal of post-operative follow-up, postgastrectomy patients should be recognized as a risk group in terms of nutritional and medical problems on a life-long basis, and long-term management strategy should be developed.
Biomarkers, Tumor ; Follow-Up Studies ; Gastroscopy ; Humans ; Malnutrition ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms ; Survival Rate ; Survivors

A fifty-eight years old male patient was given general anesthesia for the clipping of aneurysm on the posterior communicating artery. The respiration of the patient was controlled with Ohmeda 7000 anesthesia ventilator. During the surgery there appeared curare cleft on the capnogram which did not disappear after the administration of neuromuscular blocker, but disappeared after the change of the anesthesia ventilator with another one. After that another curare cleft was made by the transient obstruction of the outlet of the excess patient circuit gas of the new anesthesia ventilator. It may be said that inappropriately functioning pop-off valve of the anesthesia ventilator can be one of the causes of curare cleft on the capnogram.
Anesthesia ; Anesthesia, General ; Aneurysm ; Arteries ; Curare* ; Humans ; Male ; Neuromuscular Blockade ; Respiration ; Ventilators, Mechanical

No abstract available.
Gastrectomy*

No abstract available.
Cytomegalovirus Infections*

PURPOSE: This study was designed to identify the possible mechanism of insensitivity of DU145 prostate cancer cells to the transforming growth factor (TGF)-beta1-mediated growth inhibition. MATERIALS AND METHODS: DU145 cells were treated with 4, 40, 100 pM TGF-beta1 for 3, 6, 9 days. Initially we performed the growth assay. After that, we analysed the change of cell cycle using fluorescence flow cytometry. At each time point, Western blot analysis with cell pellets was performed to investigate the change of expressions of epidermal growth factor(EGF), TGF-alpha, EGF receptor(EGFR) and TGF receptorII(TbetaR-II) proteins. RESULTS: The growth rate of TGF-beta1-treated cells was initially suppressed, but over time returned to control level. Flow cytometric analysis revealed that TGF-beta1-treated cells showed an increase in apoptotic/G1 phases, and concurrent decrease in S, G2/M phases until 6days. On day 9, however, TGF-beta1-treated cells showed a persistent increase of apoptotic unclei in spite of recovery of apoptotic/G1, S and G2/M phases. Western blot analysis showed that the intensity of EGF or TGF-alpha band decreased in dose-sependent manner on day 6. However, the intensity of each band increased up to the control level on day 9. the expression of EGFR or TbetaR-II protein did not change after treatment of TGF-beta1. CONCLUSIONS: these results suggest that EGF and TGF-alpha sould mediate in part the escape fron the inhibitory effect of TGF-beta1 in DU145 cells.
Blotting, Western ; Cell Cycle ; Epidermal Growth Factor* ; Flow Cytometry ; Fluorescence ; Prostate* ; Prostatic Neoplasms* ; Transforming Growth Factor alpha ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; United Nations

No abstract available.

no abstract available.

OBJECTIVE: To compare the effect of two different hand exercises on hand strength and vascular maturation in patients who underwent arteriovenous fistula surgery. METHODS: We recruited 18 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, 10 subjects performed hand-squeezing exercise with GD Grip, and other 8 subjects used Soft Ball. The subjects continued the exercises for 4 weeks. The hand grip strength, pinch strength (tip, palmar and lateral pinch), and forearm circumference of the subjects were assessed before and after the hand-squeezing exercise. The cephalic vein size, blood flow velocity and volume were also measured by ultrasonography in the operated limb. RESULTS: All of the 3 types of pinch strengths, grip strength, and forearm circumference were significantly increased in the group using GD Grip. Cephalic vein size and blood flow volume were also significantly increased. However, blood flow velocity showed no difference after the exercise. The group using Soft Ball showed a significant increase in the tip and lateral pinch strength and forearm circumference. The cephalic vein size and blood flow volume were also significantly increased. On comparing the effect of the two different hand exercises, hand-squeezing exercise with GD Grip had a significantly better effect on the tip and palmar pinch strength than hand-squeezing exercise with Soft Ball. The effect on cephalic vein size was not significantly different between the two groups. CONCLUSION: The results showed that hand squeezing exercise with GD Grip was more effective in increasing the tip and palmar pinch strength compared to hand squeezing exercise with soft ball.
Arteriovenous Fistula* ; Blood Flow Velocity ; Exercise* ; Extremities ; Forearm* ; Hand Strength* ; Hand* ; Humans ; Pinch Strength ; Renal Dialysis ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Resistance Training ; Ultrasonography ; Veins

Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract and is most frequently developed in the stomach in the form of submucosal tumor. The incidence of gastric gastrointestinal stromal tumor is estimated to be as high as 25% of the population when all small and asymptomatic tumors are included. Because gastric gastrointestinal stromal tumor is not completely distinguished from other submucosal tumors, a surgical excisional biopsy is recommended for tumors >2 cm. The surgical principles of gastrointestinal stromal tumor are composed of an R0 resection with a normal mucosa margin, no systemic lymph node dissection, and avoidance of perforation, which results in peritoneal seeding even in cases with otherwise low risk profiles. Laparoscopic surgery has been indicated for gastrointestinal stromal tumors <5 cm, and the indication for laparoscopic surgery is expanded to larger tumors if the above mentioned surgical principles can be maintained. A simple exogastric resection and various transgastric resection techniques are used for gastrointestinal stromal tumors in favorable locations (the fundus, body, greater curvature side). For a lesion at the gastroesophageal junction in the posterior wall of the stomach, enucleation techniques have been tried preserve the organ's function. Those methods have a theoretical risk of seeding a ruptured tumor, but this risk has not been evaluated by well-designed clinical trials. While some clinical trials are still on-going, neoadjuvant imatinib is suggested when marginally unresectable or multiorgan resection is anticipated to reduce the extent of surgery and the chance of incomplete resection, rupture or bleeding.
Benzamides ; Biopsy ; Esophagogastric Junction ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Hemorrhage ; Incidence ; Laparoscopy ; Lymph Node Excision ; Mucous Membrane ; Neoadjuvant Therapy ; Piperazines ; Pyrimidines ; Rupture ; Seeds ; Stomach ; Imatinib Mesylate

The changes in heart rate, systolic, mean and diastolic arterial blood pressure, and the plasma concentration of epinephrine and norepinephrine were measured before and thmughout the induction periods of anesthesia in 60 elective surgical patients in a randomized, double-blind manner to evaluate the effects of continuous intravenous infusion of esmolol for 1 minute at 500 ug/kg/min as a loading dose and for 4 minutes at 100 ug/kg/min as a maintenance dose. The control group (n=30) was given the continuous infusion of normal saline at the same volume-rate. During the study, anesthesia was maintained with N2O-O2-enflurane-vecuronium and controlled ventilation. In the esmolol group, statisticaUy, the heart rate at 1 minute after the intubation was less increased and systolic and diastolic pressure after 11 minutes were more decreased than the control group. And plasma norepinephrine concentration was elevated more than the control group at 3 minutes after the intubation. We concluded that the used infusion rate of esmolol blunted the hemodynamic changes following the laryngoscopy and endotracheal intubation but it is still needed to find the dosage for complete blocking the adrenergic response.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Epinephrine ; Heart Rate ; Hemodynamics* ; Humans ; Infusions, Intravenous* ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Norepinephrine ; Plasma ; Ventilation