The suture techniques to anastomose successfully small vassels of 1mm in diameter were continuous suture and interrupted suture, and patency rate of them has been estabilished by orthopaedic surgeon. In 1962, Chase and Schwarz reported better results with interrupted suture than with a continuous suture, Firsching reported less time using with continuous suture than with interrupted suture, but no difference in flow rate, in 1984 Lilly reported that interrupted suture does no result in stenosis of venous end to end anastomoses by continuous suturing technique, Mao reported that there was no statically significant difference between two suture methods in patency rate. The authors have experimentally studied the patency rate and histopathological findings of two suture techniques in the 20 Newzealand white rabbit at the department of Orthopaedic Surgery, Hanyang University Hospital and can be obtained the following results. l. In arterial patency, the interrupted suture and continuous suture were 100% in rate and patency rate in veins were 95% in interrupted suture and 75% in continuous suture. 2. Subintimal hyperplasia occured earlier in arteries than in veins and it may be due to the medial component of vessel. 3. In anastomoses of small vessel the accurate apposition of cut vessels edges decreased the thrombi formation of vessel.
Arteries ; Constriction, Pathologic ; Hyperplasia ; Monoamine Oxidase ; Suture Techniques ; Sutures ; Veins

No abstract available.
Lymphatic Diseases*

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.
Anesthesia ; Cholecystectomy* ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Cost Control ; Health Expenditures ; Hospital Charges ; Humans ; Inpatients ; Insurance, Health ; Korea ; Specialization

No abstract available.
Humans

BACKGROUND: VEGF is an important factor for angiogenesis. Although many previous studies have reported an increased serum VEGF concentration in various malignant tumors, there are few studies on the relationship between serum VEGF concentration and its prognosis. This study investigated whether serum VEGF concentration is a prognostic indicator for lung cancer. METHODS: Using the ELISA kit, we measured the serum VEGF concentrations of 86 patients diagnosed with lung cancer on histologic examination. With a cut-off value of 686 pg/mL, the patients were classified as low-concentration (< 686 pg/mL, n=58) or high-concentration (> or=686 pg/mL, n=28) based on their mean serum VEGF concentration values to compare survival rates, and serum VEGF concentrations for different histologic types and stages. RESULTS: There was no significant difference in serum VEGF concentration based on stage and histologic type between the two groups. Moreover, there was no significant difference in survival rate between the high-concentration and low-concentration groups (p=0.86). CONCLUSION: This study demonstrates that serum VEGF concentration is not associated with the prognosis of lung cancer.
Carcinoma, Non-Small-Cell Lung/*blood/*mortality/pathology ; Female ; Human ; Lung Neoplasms/*blood/*mortality/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Survival Rate ; Tumor Markers, Biological/*blood ; Vascular Endothelial Growth Factor A/*blood

BACKGROUND: Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and vascular permeability. Increased serum VEGF concentrations (sVEGF) have been reported in various types of human cancer. In the current study, we assessed sVEGF to investigate the relationship between the sVEGF level and the prognosis of patients with lung cancer. METHODS: sVEGF was measured by enzyme-linked immunosorbent assay (ELISA) in 86 patients with lung cancer. Patients were divided into two groups according to 686 pg/mL of mean sVEGF (Low sVEGF group: sVEGF<686 pg/mL, n= 58; High sVEGF group: sVEGF>or=686 pg/mL, n=28). We analyzed the association of sVEGF according to the pathologic types and clinical staging, and compared the survival rates in two groups. RESULTS: There was no significant difference of sVEGF among the stages and pathologic types of lung cancer. And no difference was observed between overall survival rates of both groups regard to sVEGF (p=0.86). CONCLUSION: These results suggest that sVEGF may not be a good marker for prognosis of lung cancer, especially in the advanced cases.
Capillary Permeability ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lung Neoplasms* ; Lung* ; Prognosis* ; Survival Rate ; Vascular Endothelial Growth Factor A*

No abstract available.
Blood Glucose ; Diabetes Mellitus, Type 2 ; Humans

BACKGROUND: It is well known that atrial fibrillation is common cardiac arrythmia in old age and poses a definitive risk factor of cerebral infarction. Therefore, effective treatment of atrial fibrillation is very important in the prevention of cerebral infarction. However, oral anticoagulant medication for the prevention of embolic ischemic stroke may be dangerous due to cerebral hemorrhage side effects. METHODS: This is a controlled case study designed to identify the risk factors in a large numbers of stroke and atrial fibrillation patients and to assess those patients with atrial fibrillation as a high risk group for cerebral infarction. All patient discharged from Chonnam National University Hospital were identified over a 42 month period who met our case standards of atrial fibrillation and ischemic stroke (n=62), and compared them with the control groups who were discharged with atrial fibrillation without stroke(n=68). We excluded the atrial fibrillation due to valvular heart disease, ischemic heart disease and congestive heart failure during the selection of subjects. RESULTS: Subjects and the controls were characteristically similar with common past medical histories of diabets, smoking, and hyperlipidemia. Sex, familial history, left ventricular hypertrophy in 2D-echocardiogram were also similar in both groups, however differences did exist. Subjects were significantly older than controls(68.9 : 63.9, p<0.001) and more likely to have a history of hypertension(56.5% : 23.5%, p<0.001) and left atrial enlargement(>40mm)(52.6% : 29.0%, p<0.001). Each of these 3 factors were assinged a measure of 1 point as a risk score, ischemic embolic stroke was found in 4 out of 28 patients(14.3%) with a risk score of 0, in 16 out of 39 patients(41.0%) with a risk score of 1, in 29 out of 41 patients(70.7%) with a risk score of 2, in 8 out of 11 patients(72.7%) with a risk score of 3. CONCLUSIONS: Based on the above results, a subject having more than two risk factors should be regarded as a high risk group for cerebral infarction and the long term anticoagulant therapy for the prevention of stroke may also be necessary even though some complications are present.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cerebral Hemorrhage ; Cerebral Infarction* ; Heart Failure ; Heart Valve Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy, Left Ventricular ; Jeollanam-do ; Myocardial Ischemia ; Patient Selection ; Risk Factors* ; Smoke ; Smoking ; Stroke

BACKGROUND: Small cell lung cancer (SCLC) disseminates early and has poor prognosis. However, SCLC is highly chemosensitive, thus chemotherapy has been established as the primary mode of treatment. This study evaluated the efficacy and toxicity of etoposide in combination with cisplatin in the treatment of extensive stage small cell lung cancer. METHODS: Thirty four patients (28 males, 6 females) with previously untreated extensive stage small cell lung cancer were treated with etoposide at a dose of 100 mg/m2, IV on days 1-3 with cisplatin at 100 mg/m2, IV on day 1. The median age was 63 (range 41~80). This combination chemotherapy was administered every 3-4 weeks. Response rate, response duration, survival, and toxicity were evaluated. RESULTS: The response rate was 50%. The median survival time was 29 weeks. The median response duration was 17.2 weeks in responders. The toxicity was acceptable. CONCLUSION: This study illustrated that the combination of etoposide and cisplatin is effective in the treatment of extensive stage small cell lung cancer, and can be administered with acceptable toxicity. Although this study was not designed to be a formal comparative trial, the efficacy and toxicity observed with this regimen were found to be comparable to previous reports.
Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Humans ; Male ; Prognosis ; Small Cell Lung Carcinoma*

PURPOSE: Although adjuvant chemotherapy after resection of gastric cancer is a popular practice in Korea, there are still controversies about the effectiveness of the treatment. The fact that the relatively less effective drugs have been used and the rarity of large-scaled controlled studies may be partially responsible for the controversies. FP(5-FU, Cisplatin) combination is one of the most active regimen against advanced gastric cancer, consistently showing a response rate of 50~60%. We tried the FP chemotherapy as an adjuvant treatment for high-risk patients after curative resection of gastric cancer. MATERIALS AND METHODS: Between February 1992 and June 1996, 35 patients with completely resected high-risk gastric cancer(postoperative stage III or IV except thase with M1) received six courses of FP chemotherapy. Endpoints were toxicities of treatment, relapse free survival, and overall survival. RESULTS: With a median follow-up time of 17.1 months, Kaplan-Meier estimates of 2-year overall survival was 63.3% and relapse free survival estimates was 49%. There were no differences between stage III and IV patients in terms of overall survival or relapse free survival. Hematologic and non-hematologic toxicities were tolerable for most of the patients. CONCLUSION: Postoperative FP combination chemotherapy was tolerable for patients with high-risk(stage III and IV) gastric cancer. It is too early to determine the long term survival rates for this patients, but 2-year overall and relapse free survival were comparable to that of historical non-cisplatin containing regimens. Randomized phase III studies are warranted.
Chemotherapy, Adjuvant ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Stomach Neoplasms* ; Survival Rate