No abstract available.
Cholecystectomy, Laparoscopic* ; Humans

No abstract available.
Child* ; Gallbladder* ; Humans

A survey was conducted to study attitudes of physician, nurse and patient towards physician's and nurse's uniform, from March 1 to March 31, 1996. The study population was 130 physicians and 147 nurses engaged in Yeungnam University Medical Center and 211 inpatients of Yeungnam University Medical Center. A questionnaire method was used to collect data. The following are summaries of findings: In the respect of physician's uniform, both physicians and nurses preferred other type of gown to the traditional coat-typed one and especially, nurses preferred more than physicians. Patients showed no difference in the preference of the traditional one and other form of gown as a whole but those who had higher educational level preferred other form of gown(p<0.01). It tended to agree wearing casual wear of physician during the working time of weekend and holiday as a whole. Younger physicians showed significantly higher preference for it(p<0.05). Regarding the nurse's uniform, both physicians and nurses preferred trousers, and 96% of the nurses did. Especially, nurses who were forty years old or more and who served at outpatient department and administrative and aid parts expressed 100 percent partiality to trousers. For the patients, those who had lower educational level preferred skirt and those who had higher educational level preferred trousers. As to the color of nurse's gown, 46.7% of the physicians and nurses liked white color. The physicians preferred white and nurses preferred other color(p<0.01). Of the patients, 79.1% liked white color. Regarding the wearing cap, 95.9% of the nurses replied it didn't have to wear the cap. The nurses who were fifty or more and who served at outpatient department and special parts gave whole answers of not having to wear the cap. On the other hand, 77.7% of the patients answered nurse had to wear the cap. From the above findings, it would be advisable to give a change to the forms and colors of the gowns to match with the trend and sense of the time instead of insisting on the traditional typical ones.
Academic Medical Centers ; Hand ; Holidays ; Humans ; Inpatients ; Outpatients

No abstract available.
Arthroscopy* ; Elbow*

No abstract available.
Hypopituitarism* ; Hypothyroidism*

To define the basic sequential events of the healing process in normal fracture and evaluate the role of growth regulatory molecules and extracellular matrix components, the expression of transforming growth factor β(TGF-β), platelet-derived growth factor(PDGF), type I and II collagen, and chemistry during the healing process of an experimental fracture of tibia in 41 adult rats for 7 weeks using ABC methods. The phases of inflammation, reparation, and remodeling followed each other in sequence. The inflammatory phase was characterized by hemorrhage, edema, and infiltration of inflammatory cells on the first day. During the reparative phase, the undifferentiated mesenchyme undergoes rapid chondrogenesis, followed by endochondral ossification and supplemented by appositional bone formation. At day 3, the expression of TGF-β and PDGF was noted in the undifferentiated mesenchymal cells and from day 5, these two growth factors were detected in the osteoblasts and extracellular matrix in areas of endochondral ossification and newly formed periosteal bone. From day 3, the expression of type I collagen and osteonectin was noted in the osteoblasts and extracellular matrix in both endochondral ossification and appositional bone growth as a marker of ossification. From day 3, type III collagen was mainly expressed in the plump mesenchymal cells showing chondroid differentiation and chondroid matrix as a marker of cartilaginous reparative phase. From day 14, these growth factors and extracellular matrix components were decreased in staining intensity and at the 5th week, the histology and immunostaining pattern were similar to the mature bone.
Adult ; Animals ; Bone Development ; Chemistry ; Chondrogenesis ; Collagen Type I ; Collagen Type III ; Collagen ; Edema ; Extracellular Matrix ; Fracture Healing ; Hemorrhage ; Humans ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Mesoderm ; Osteoblasts ; Osteogenesis ; Osteonectin ; Rats ; Tibia ; Transforming Growth Factors

In consideration of the potential deleterious effects of blood transfusion, the effect of acute anemia on the healing of both small (SI) and large intestinal (LI) anastomoses was evaluated. Thirty-six white rabbits underwent resection of both the mid-ileum and the distal colon with primary anastomosis of each. One and two weeks post operation, all anastomoses were assessed by anastomotic bursting pressure (ABP) and histologic evaluation utilizing a modified Erhlich/Hunt scale with grading of the WBC influx, blood vessel ingrowth, fibroblast proliferation, and collagen deposition. Results were analyzed using oneway analysis of variance (ANOVA) and the Chi-Square approximation with p<0.05 being considered significant. The SI ABP, reported in mmHg SE, of the anemic rabbits was decreased at one week vs. the controls (234 mmHg 17 vs. 201 mmHg 16), reaching significance at two weeks (190 mmHg 6 vs. 257 mmHg 17). A decreased LI ABP was found at one week, though not quite reaching singnificance (p=0.06). Recovery to control values occurred by two weeks. Histologic assessment (anemia vs. control) demonstrated a uniform decrease in WBC infiltration, reaching significance in the LI group at two weeks. Blood vessel ingrowth was likewise depressed, but did not achieve significance. The collagen contents of both the SI and the LI groups at two weeks decreased, as were the SI fibroblast proliferation at one week (p<0.05). This study demonstrates that severe, acute anemia in rabbits undergoing intestinal anastomoses severely alters histologic parameters in both the SI and the LI anastomoses while decreasing the overall strength of the SI anastomoses.
Anemia* ; Blood Transfusion ; Blood Vessels ; Collagen ; Colon ; Fibroblasts ; Rabbits*

Natural cytotoxicity mediated by natural killer (NK) cells is believed to play an important role in host anticancer defense mechanisms. The aim of this study is to compare the number of NK cells in patients with colorectal cancer and hemorrhoids, and before and after surgery in patients with colorectal cancer. Twenty colorectal cancer patients and twenty hemorrhoid ones were studied. Venous blood samples were obtained preoperatively, and on the 7th, and 14th postoperative days. Mononuclear cells were isolated over Ficoll-Hypaque gradients, and T cells, B cells, and NK cells were measured with CD3 FITC (T cell), CD 19 PE (B cell), and CD56 FITC (NK cell) antibody, The number of T cell (/mm3) was 1224, 1280, and 1125 at preoperative, 7th, and 14th postoperative day in hemorrhoid patients and 1195, 901, and 1060 in colorectal cancer patients respectively. The number of B cell (/mm3) was 243, 160, and 250 in hemorrhoid patients and 147, 78, and 113 in colorectal cancer patients. The number NK cell (/mm3) was 148, 156, and 143 in hemorrhoid patients and 129, 85, and 128 in colorectal cancer patients. There was no difference among Dukes stages in the number of NK cells. In conclusion, the number of NK cells was not changed in colorectal cancer patients compared with hemorrhoid ones. Major operation changed the number of NK cells in colorectal cancer patients.
B-Lymphocytes ; Colorectal Neoplasms* ; Defense Mechanisms ; Fluorescein-5-isothiocyanate ; Hemorrhoids ; Humans ; Killer Cells, Natural* ; T-Lymphocytes

Since the first report by Tansini in 1896, the latissimus dorsi muscle free flap has been widely used for various types of soft tissue defect due to reliable anatomy with a sufficient diameter of neurovascular pedicle and a sizable muscle. However, for relatively small soft tissue defect, latissimus dorsi free flap offers several distinct disadvantages of donor site including loss of the posterior axillary fold and flattening of the posterolateral chest wall, weakness of upper arm strength in extension, adduction and internal rotation. We treated three patients having various types of soft tissue defect using segmental latissimus dorsi muscular free flap depending on its descending branch of thoracodorsal neurovascular pedicles. There were no serious complications during 18 months of mean follow-up. We concluded that this method has some advantages such as no weakness of strength of the upper arm including walking on crutches, preserving the posterior axillary fold, preventing winging of the scapula and increased chance of using a flow-through technique. Here we present our cases of reconstruction of soft tissue defect using segmental latissimus dorsi free flap with a review of the literature.
Arm ; Crutches ; Follow-Up Studies ; Free Tissue Flaps* ; Humans ; Scapula ; Superficial Back Muscles* ; Thoracic Wall ; Tissue Donors ; Walking

OBJECTIVES: Objective: Cellular immortality is believed to be a critical step in tumorigenesis. As an important component of the telomere maintenance mechanism, the activation of the enzyme telomerase is tightly associated with cellular immortality and cancer. However, little is known about the status of telomerase during human cervical cancer development. To assess the role of telomerase in the development of malignant transformation of the uterine cervix, this investigation was performed. PATIENTS AND METHODS: Telomerase activity was measured by telomeric repeat amplification protocol(TRAP) assay in 8 cervical intraepithelial neoplasia(CIN) and 24 cervical cancers. The tissue adjacent to the lesions from the same patients was also examined for the presence of telomerase activity. RESULTS: Thirty one of the 32(96.9%) lesions were positive for telomerase activity. In the CIN patients, four of the 8(50.0%) lesions showed moderately to strongly positive activities. In the cervical cancer Ia lesions, five of the 9(55.6%), and beyond the stage Ib lesions, fourteen of the 15(93.3%) showed moderately to strongly positive activities. There was a positive correlation between the grade of the lesion and the telomerase activity(P=0.023). Patient's gravida and telomerase activity also had a positive correlation(P=0.022). CONCLUSION: Relatively weak telomerase activity was detected in the low grade cervical lesion and strong activity was detected in the high grade lesion. There was a progressive increase of telomerase activity in association with an increased degree of cervical lesion. Patient's gravida also had an association with telomerase activity. These results suggest that the expression of telomerase activity may play a crucial role in cervical carcinogenesis.
Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Female ; Humans ; Telomerase* ; Telomere ; Uterine Cervical Neoplasms