No abstract available.
Gastrectomy* ; Stomach Neoplasms* ; Stomach*

Lung cancer is one of the most common types of malignancy in western nations with serious health problem, and it has become the leading cause of cancer death of males, second only to stomach cancer, in Korea. A review of the histopathology of 1363 cases (1231 patients) of lung carcinoma, diagnosed at the Keimyung University Medical center from 1987 to 1996, was performed to reclassify the type of carcinomas and to investigate the change in the distribution of histologic types of lung carcinoma according to age, sex and year. Among the 1363 cases, 132 patients underwent a surgical operation after biopsy. The diagnosis of each case was proven by histopathologic analysis of surgical specimens (13.2%) and biopsy materials (86.8%). The histologic types in our study were basically based on modified WHO classification (1982) and on new WHO classification (1999). The classification of small cell carcinoma was based on International Association for the Small Cell Lung Cancer (IASLC, 1988). Of the 1231 patients with lung carcinoma, 1012 were male and 219 were female (male to female ratio was 3.6:1). According to the analysis of age distribution, the most prevalent age group was 60~69 years in both sex as (n=516, 42.0%). Changing trends in sex distribution of lung carcinoma patients showed that the proportion of men had decreased throughout the years, whereas the proportion of women had significantly increased. Histologically, squamous cell carcinoma was the most common (n=624, 50.7%), followed by small cell carcinoma (21.1%), adenocarcinoma (18.1%), large cell undifferentiated carcinoma (2.1%), adenosquamous carcinoma (0.4%), and large cell neuroendocrine carcinoma (0.4%), in order of frequency. In men, squamous cell carcinoma was the most frequent type (55.1%). In women, adenocarcinoma was the most frequent type (39.7%). In both sexes, adenocarcinoma was the most common type in patients under the age of 40 (n=12, 41.4%), while squamous cell carcinoma proved the most frequent type in patients over the age of 40 (n=617, 51.3%). Changing trends of histologic types of lung cancer showed that the incidences of squamous cell carcinoma had significantly decreased throughout the years, whereas those of adenocarcinoma and small cell carcinoma had increased. In conclusion, the results showing increases in the percentage of female patients and in the number of cases of adenocarcinoma were noteworthy, and well correlated with other related reports.
Academic Medical Centers ; Adenocarcinoma ; Age Distribution ; Biopsy ; Carcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Lung* ; Male ; Sex Distribution ; Small Cell Lung Carcinoma ; Stomach Neoplasms

No abstract available.
Extracorporeal Circulation* ; Heart* ; Potassium* ; Thoracic Surgery*

No abstract available.

Interventional procedures around the cervical spine have been classically performed under the guidance of fluoroscopy with radiation hazards to patients and doctors. Even though under fluoroscopic guidance, vascular and nerve structures cannot be shown and there are actual risks for the patient. Nowadays, we can use high resolution image ultrasound around cervical spine procedures. Real time imaging is possible. Cervical root block, medial branch block and many other interventions can be performed under ultrasound guidance. In out-patient clinics, ultrasound is very helpful in management of cervical problems in differentiating the origin of pain and treatment for the pain. Ultrasound is radiation free, easy to use and the imaging can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound enables visualization of major nerves and vessels and thus leads to improved safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore performed a review to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.
Fluoroscopy ; Humans ; Incidence ; Outpatients ; Spine* ; Ultrasonography

No abstract available.
Kidney Transplantation* ; Pregnancy*

BACKGROUND: Limited ischemic tolerance of the lung has remained one of the factors that limits the expansion of pulmonary transplantation as a treatment for end-stage pulmonary disease. Numerous studies on safe long term preservation for lung transplantation has been performed for the purpose of developing ideal preservation solution with extracellular type or intracellular type solutions. In this study, we examined the efficacy of LPDG solution in lung preservation longer than 20 hours by comparison with modified Euro-Collins solution. METHODS: Thirty-four adult mongrel dogs were divided into two groups. Donor lungs were flushed with LPDG solution(n=9) or modified Euro-Collins(MEC) solution(n=8) and stored for 24 hours at 10degrees C. All donor lungs were perfused through the pulmonary arteries with solutions containing prostaglandin E1 and verapamil. Left canine lung allotransplantations wereperformed. Assessment(hemodynamic indices and arterial blood gas analysis) of left implanted lung was made by occluding the right pulmonary artery for ten minutes using pulmonary artery Cuff. Assessment was repeated at the interval of 30 minutes, one hour, and two hours later after reperfusion and then chest X-ray, computed tomogram and lung perfusion scan were obtained. In survival dogs follow-up studies were done with assessment with chest X-ray, computed tomogram of the chest and lung perfusion scan on 7th day postoperatively. After preservation above 20 hours, pathological examinations for ultrastructural findings on right lung were performed in each group. RESULTS: With respect to arterial oxygen tension, LPDG group was superior to MEC but there was no statistical significance for 2 hours after reperfusion. Mean pulmonary artery pressure was less increased(p<0.05) and cardiac output higher(p<0.05) than MEC group until 2 hours after reperfusion. After 2 hours of reperfusion, both groups showed transplanted lung function deteriorated gradually. Perfusion scan of the transplanted lung in LPDG group showed better perfusion rate in immediate post-reperfusion, 3 days and 7 days later respectively but there was no statistical significance and corelation with PaO2 and computed tomographic views. In scanning electron microscopy of pulmonary artery after preservation, LPDG group relatively shows less irregular protrusion of the inner surface of endothelial cell of poulmonary artery than MEC group. CONCLUSIONS: We concluded that LPDG solution can offer safe lung preservation above 20 hours with adequate immunosuppressive therapy and prevention of the infection.
Adult ; Alprostadil ; Animals ; Arteries ; Cardiac Output ; Dogs ; Endothelial Cells ; Follow-Up Studies ; Humans ; Lung Diseases ; Lung Transplantation ; Lung* ; Microscopy, Electron, Scanning ; Organ Preservation ; Oxygen ; Perfusion ; Pulmonary Artery ; Reperfusion ; Thorax ; Tissue Donors ; Verapamil

BACKGROUND: Exercise testing is an importnat diagnostic and prognostic procedure in the assessment of patients with ischemic heart disease. But standard ST-segment depression criteria was not high enough to estimate coronary srtery disease. Recently, the heart rate adjustment of ST segment depression, ST segment/heart rate slope and index, have been proposed as a more accurate criteria for diagnosing significant coronary artery disease. The objective of this study was to compare the discriminating power of proposed ST segment/heart rate slope and index with that of a standard method of assessing exercise-induced ST segment depression for estimating coronary artery disease. METHODS: Sixty nine patients with ischemic heart disease were studied with exercise treadmill testing and coronary angiography. Computer-measured ST-segment amplitudes were obtained and analysis of the heart rate-adjusted ST segment depression(ST/HR slope and big up tri, Delta ST/HR index) was done. The sensitivity, specificity, and extent of coronary artery disease on each criteria were compared. RESULTS: 1) The sensitivity of big up tri, Delta ST/HR index partition of 1.6uV/beats/min was slightly higher(83%) and the specificity of ST/HR slope partition of 2.4uV/beats/min was higher(87%) than the standard exercise electrocardiographic criteria. 2) Early onset of ischemic ST-segment depression, profound ST-segment depression(> or =2mm), and downsloping ST-segment were associated with more extensive coronary artery disease. 3) On ST/HR slope, no CAD was 1.7+/-0.26uV/beats/min, one vessel disease was 2.6+/-0.34 uV/beats/min, two vessel disease was 2.7+/-1.36uV/beats/min, one vessel disease was 2.8+/-0.35uV/beats/min, and on big up tri, Delta ST/HR index, no CAD was 1.8+/-0.38uV/beats/min, one vessel disease was 2.8+/-1.36uV/beats/min, two vessel disease 3.4+/-1.44uV/beats/min, and three vessel disease was 3.7+/-2.95uV/beats/min. The increment of ST/HR slope and big up tri, Delta ST/HR index were associated with the coronary artery disease and its severity, but the correlations were not high enough. CONCLUSION: The heart rate adjustment of ST segment depression was not high enough for improved detection of coronary artery disease, compared with standard ST-segment depression criteria. But these indexes can be improved the clinical usefulness of the treadmill exercise test for coronary aretry disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Depression* ; Electrocardiography ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Myocardial Ischemia* ; Sensitivity and Specificity

Acute colonic pseudoobstruction was first reported in 1948 by Sir H. Ogilvie. It is characterized by an acute, abrupt right-sided colonic distention in the absence of physical reasons for obstruction. If untreated, it may progress to cecal perforation, peritonitis, and death. Although primary cases have been reported, 87 percent of cases were secondary results of medical or surgical conditions. The most common medical conditions were infections, cardiac disease, and neurologic problems. In surgical conditions, cesarean section has been reported as the most common cause of Ogilvie's syndrome. In 1995, the first case of Ogilvie's syndrome complicated after a cosmetic surgical procedure(abdominoplasty) was reported by Bradley et al. We report a case of Ogilvie's syndrome complicated after breast reconstruction with TRAM flap that developed in the postoperative third day in 35-year old woman. The complications are primarily related to decreased flap perfusion. No reference of intestinal pseudoobstruction was found in the literature conducted in regard to complications of TRAM flap breast reconstruction.
Adult ; Breast* ; Cesarean Section ; Colon ; Colonic Pseudo-Obstruction ; Female ; Heart Diseases ; Humans ; Intestinal Pseudo-Obstruction ; Mammaplasty* ; Perfusion ; Peritonitis ; Pregnancy

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis