OBJECTIVES: The study was performed to compare the quality of life and mental health -depression, suicide etc- in homosexual men with those in heterosexual men and to identify how the quality of life is related with mental health. METHODS: 129 homosexual men and 114 heterosexual men in twenties and thirties were enrolled by crosssectional method. Quality of life, depression, suicidal idea, hopelessness, self esteem, coping strategy, social support, social conflict, familiar adaptability and familiar cohesion were measured by self-report scale to compare the homosexual and the heterosexual groups. RESULTS: The results showed that age, educational level, income, alcohol intake, smoking and reli-gion were not significantly different between homosexual group and heterosexual group. Teased experience about feminity, past psychiatric history, HIV test experience in homosexual group were higher than those in heterosexual group. The self- esteem, hopelessness, coping strategy, familiar ada-ptability and social support-conflict were not significantly different between two groups. Homosexual group had poorer quality of life, lower familiar cohesion, higher depression and higher suicidal idea than heterosexual group. Being alienated from home, social system and interpersonal relationship, which are subscales of the quality of life, scored lower by homosexual group as compared with hete-rosexual group. Therefore, high depression and low familiar cohesion had significant effect on the quality of life in homosexual group. CONCLUSION: Although homosexuality is excluded from DSM, the prevalences of many mental health problems are higher in homosexual group than heterosexual group. It is suggested that the more studies on depression and familiar function related to homosexuality are needed.
Depression ; Emigrants and Immigrants ; Heterosexuality* ; HIV ; Homosexuality* ; Humans ; Male ; Mental Health* ; Prevalence ; Quality of Life* ; Self Concept ; Smoke ; Smoking ; Suicide

Nosocomial infection represent a significant cause of patient morbidity and mortality, especially in the ICU and nosocomial pneumonia that cause high mortality may arise from contaminated respiratory equipments. This study was done to investigate the relationship of micro-organisms in upper respiratory tract and ventilatory equipment, especially humidifier. The total number of cases in this study was 20 and the specimen for bacteriologic culture were taken from the pharynx, the distilled water and the inner wall of humidifier and toilet of trachea at the 0, 4, 8, 12, 24, 48 hours after initiation of mechanical ventilation. The results obtained from the bacteriologic culture were as follows. 1) The most frequently found organism at the pharynx was Pseudomonas aeruginosa and next was Coagulase Negative Staphylococcus, followed by Streptococcus viridans, Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus group D, Enterobacter agglomerans, Acinetobacter spp. 2) The most frequently found organism at the trachea was Pseudomonas aeruginosa and next was Klebsiella pneumoniae followed by Coagulase Negative Staphylococcus, Streptocoecus viridans, Pseudomonas picketti, Staphylococcus aureus and no growth in 5 cases. 3) The most frequently found organism in the fluid of humidifier was Pseudomonas aeruginosa and next was Pseudomonas picketti, Klebsiella pneumoniae, Streptococcus group D and no growth in 2 cases. 4) The most frequently found organism at the pharynx was Pseudomonas aeruginosa and next was Pseudomonas picketti, Klebsiella pneumoniae, Streptococcus group D, Serratia liquefacines, Acinetobacter spp and no growth in 3 cases. 5) The number of isolated organisms in the fluid of humidifier was 3 at 0 hour and 18 after 48 hours and at the wall 2 at 0 hour and 15 after 48 hours. 6) The number of same organism that was isolated between the pharynx and trachea was 13 among 15 cases and between the wall and fluid of humidifier was 15 among 16 cases and between trachea and fluid of humidifier was 10 among 14 cases.
Acinetobacter ; Coagulase ; Cross Infection ; Enterobacter ; Enterococcus faecalis ; Humans ; Klebsiella pneumoniae ; Mortality ; Pharynx ; Pneumonia ; Pseudomonas ; Pseudomonas aeruginosa ; Respiration, Artificial ; Respiratory System ; Serratia ; Staphylococcus ; Staphylococcus aureus ; Trachea ; Ventilators, Mechanical* ; Viridans Streptococci ; Water

Emergency surgical patients are more frequently in critical state than elective patients and they have not enough time for physical and laboratory examinations. The evaluation of perio-perative data will improve the outcome of emergency operation. We analyzed 1053 anesthesias for emergency operation which were performed at the department of anesthesiology, Anam Hospital from September 1992 to August 1993 clinically and statistically according to age, sex, physical status, department, anesthetic duration, method and agent, types of trauma, amount of transfusion, etc. The results were as follows; 1) The percent of emergency surgery cases was 13.6 of total surgical patients. 2) The ratio of male to female was 1.15:1. 3) About 61.1% of all emergency patients were in the 21-40 years age group. 4) According to the ASA classification of physical status, the percent of patients in emergency class 1 and 2 was 86.2 of the total patients. 5) The most common operation was Cesarean section (19.9%), and appendectomy (13.8%) the next. 6) The most common anesthetic method for emergency operation was general anesthesia with enflurane. 7) The obstetric cases were most common and the general surgery cases were the next. 8) The percent of the cases which took less than 2 hours duration was 82.4 of total operation. 9) The transfusion was done in 108 cases (10.3%) and less than 2 units was transfused most frequently. 10) The transference to ICU was done in 144 (13.7%) cases and the patients of general surgery were transfered to ICU most frequently. 11) The majority of injuries were classified as blunt trauma (86.6%) while 13.4% were classified as penetrating trauma. 12) The lagest number of injuries involved the upper extremity (47.8%) and the next was the head & neck (31.9%).
Anesthesia* ; Anesthesia, General ; Anesthesiology ; Appendectomy ; Cesarean Section ; Classification ; Emergencies* ; Enflurane ; Female ; Head ; Humans ; Male ; Neck ; Pregnancy ; Upper Extremity

Nesidioblastosis is a rare disease characterized clinically by persistent hypoglycemia with inappropriately elevated circulating insulin concentration. Adequate early diagnosis should be established and subtotal pancreatectomy performed before itreversible cerebral damage caused by glucose deficit. The authors got a chance to anesthetize 56-day-old male patient for subtotal pancreatectomy because of nesidioblastosis, Following an induction of anesthesia with intravenous thiapental sodium 5 mg/kg and succinylchohne 1 mg/kg, endotracheal intubation was performed and anesthesia was maintained with pancuronium bromide and O2-N2O-enflurane. Intravenous fluid was maintained with 1-2-3 solution 30 ml and 15% D/W 40 ml mixed with 20 ml of 20 mEq/L NaCI.
Anesthesia* ; Early Diagnosis ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Intubation, Intratracheal ; Male ; Nesidioblastosis* ; Pancreatectomy* ; Pancuronium ; Rare Diseases ; Sodium

PURPOSE: We wanted to analyze the clinicopathologic characteristics of patients with gastric carcinoid tumor, which is a rare gastric tumor (less than 2% of all gastric tumors). MATERIALS AND METHODS: We reviewed all the carcinoid patients who were treated from 1996 to 2006. The clinicopathologic characteristics, the treatment modalities and the survival rates were retrospectively analysed. RESULTS: There were 8 type I patients and 10 type III patients, but there were no type II patients. The mean age of onset for type I was 47.75 years and that for type III was 57.90 years. More type III patients were female, but the gender ratio of type I patients was equal at a ratio of 1:1. There were 4 cases of solitary tumor, which were all T1 except for one case, and there was neither distant metastasis nor lymph node involvement for the type T1 cases. In the 13 patients who had no metastasis, 5 underwent endoscopic mucosal resection and 8 underwent surgery, and their combined 5 year survival rate was 92.3%. For the 5 cases who had metastastses, their mean survival was 22 months and especially, 3 of them underwent palliative surgery and their median survival were 24 months (95%, +/-6.52). CONCLUSION: Higher incidence of type III gastric carcinoid tumor and less multiplicity in type I gastric tumor were identified in our study compared with previous reports. For the type III cases, there were some noteable differences compared with the Western country's survival rate for the patients who underwent palliative surgery, so physicians must pay close attention to the definite clinicopathologic characteristics of gastric carcinoid patients.
Age of Onset ; Carcinoid Tumor ; Female ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Palliative Care ; Retrospective Studies ; Survival Rate

PURPOSE: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. MATERIALS AND METHODS: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. RESULTS: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). CONCLUSIONS: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.
Gastric Fundus ; Humans ; Incidence ; Linear Models ; Medical Records ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

PURPOSE: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. MATERIALS AND METHODS: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. RESULTS: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). CONCLUSIONS: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.
Gastric Fundus ; Humans ; Incidence ; Linear Models ; Medical Records ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

An one day old female baby was admitted to the Pediatric department of Korea University Anam Hospital for the evaluation of her facial anomaly. She was born by spontaneous vaginal delivery at term weighing 3.8 kg. On initial examination, she was noted to have congenital trismus and have cleft lip and palate. Bands of fibrous tissue were noted to extend from the superior alveolar part to inferior part at decidual molar tooth region and allowed oral opening of only 5 mm. She was transfered to the Plastic Surgery department under the diagnosis of cleft palate lateral synechia syndrome for resection of her synechial bands. In the operating room ECG, pulse oximeter and precordial stethoscope were applied to the patient and then, anesthesia was induced with , O2, N2O and enflurane. The 60 cm Olympus fiberscope with an external diameter of 2 mm was used and well lubricated 3.0 mm uncuffed endotracheal tube was threaded over the fiberscope through the oral cavity. The fiberscope was advanced into the midtrachea, then the endotracheal tube was passed over the fiberscope into the trachea After securing of the endotracheal tube, two lateral synechial bands were surgically divided. She tolerated oral feedings on postoperative 5 days without difficulty and discharged from the hospital on postoperative 6 days.
Anesthesia ; Cleft Lip ; Cleft Palate* ; Diagnosis ; Electrocardiography ; Enflurane ; Female ; Humans ; Infant, Newborn* ; Intubation* ; Intubation, Intratracheal ; Korea ; Molar ; Mouth ; Operating Rooms ; Palate ; Stethoscopes ; Surgery, Plastic ; Tooth ; Trachea ; Trismus

In Korea, the study about the normal depth of insertion of dauble lumen tubes bas not been reported yet. So we studied 50 adult patients(30 males and 20 females) undergoing thoracic surgery under one lung ventilation. Endotracheal intubation was done with the disposable polyvinylchloride Robertshaw-type double lumen endobronchial tube. The exact position of a left-sided double lumen endobronchial tube was confirmed by passing a fiberoptic bronchoscope through the tracheal lumen of the double lumen, The depth was measured when we had a view of a clear straight-ahead view of the tracheal carina, the right lumen going off to the right, and the upper surface of the blue left endobronchial balloon just below the tracheal carina, The resullts were as follows; 1) In the male patients, the average depth of the tube was 30.7+/-1.4cm and this measure- ments were related with height but not the weight and age. 2) In the female patients the average depth of the tube was 28,3+/-l.2cm and this measurements were unrelated with height, age and weight. 3) Among the male and female patients the average depth of the tube was 30.0+/-1.8cm and this measurements were related with a height but not with weight and age.
Adult ; Bronchoscopes* ; Female ; Humans ; Intubation, Intratracheal ; Korea ; Male ; One-Lung Ventilation ; Thoracic Surgery

PURPOSE: This study evaluated the functional and oncological outcomes of proximal gastrectomy (PG) in comparison with total gastrectomy (TG) for upper-third early gastric cancer (EGC). MATERIALS AND METHODS: The medical records of upper-third EGC patients who had undergone PG (n=192) or TG (n=157) were reviewed. The PG group was further subdivided into patients who had undergone conventional open PG (cPG; n=157) or modified laparoscopy-assisted PG (mLAPG; n=35). Patients who had undergone mLAPG had a longer portion of their intra-abdominal esophagus preserved than patients who had undergone cPG. Surgical morbidity, recurrence, long-term nutritional status, and the incidence of reflux esophagitis were compared between the groups. RESULTS: The rate of postoperative complications was significantly lower for PG than TG (16.7% vs. 31.2%), but the five-year overall survival rate was comparable between the two groups (99.3% vs. 96.3%). Postoperative levels of hemoglobin and albumin were significantly higher for patients who had undergone PG. However, the incidence of reflux esophagitis was higher for PG than for TG (37.4% vs. 3.7%; P<0.001). mLAPG was related to a lower incidence of reflux esophagitis after PG (P<0.001). CONCLUSIONS: Compared to TG, PG showed an advantage in terms of postoperative morbidity and nutrition, and there was a comparable prognosis between the two procedures. Preserving the intra-abdominal esophagus may lower the incidence of reflux esophagitis associated with PG.
Esophagitis, Peptic* ; Esophagus ; Gastrectomy* ; Humans ; Incidence ; Laparoscopy ; Medical Records ; Nutritional Status ; Postoperative Complications ; Prognosis ; Recurrence ; Stomach Neoplasms* ; Survival Rate