No abstract available.
Animals ; Cats* ; Reflex*

OBJECTIVE: Obesity is considered a potential cause of several malignancies including endometrical cancer and breast cancer. We analyzed the relationship between obesity and cervical cancer to examine the role of obesity in developing cervical cancer and to prevent the cervical cancer. METHODS: A retrospective analysis was performed on 203 cervical carcinomas including 87 cervical adenocarcinoma and 116 cervical squamous cell carcinoma patients and as control group, 279 patients visiting severance hospital for PAP smear in the period 1994-2003. We analyzed medical records for patient characteristics and body mass index. The obtained data were analyzed using t-test, chi square test and logistic regression analysis by SPSS. RESULTS: There was no statistically significant risk factor in patient characteristics including body mass index between adenocarcinoma and control group. Between cervical squamous cell carcinoma and control group, patients age (odds ratio=0.952, p=0.06) and menopause status (odds ratio=2.420, p=0.02) were statistically significant risk factors. Body mass index was not significantly different among three groups (adenocarcinoma vs. control group, 23.0 +/- 3.4 vs. 22.4 +/- 3.2; squamous cell carcinoma vs. control group, 23.9 +/- 3.5 vs. 22.4 +/- 3.2). CONCLUSION: Our results were consistent with the concept that obesity was not a risk factor for cervical carcinoma. However menopause might be a potential risk factor in developing squamous cell carcinoma of the uterine cervix.
Adenocarcinoma ; Body Mass Index ; Breast Neoplasms ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Logistic Models ; Medical Records ; Menopause ; Obesity* ; Retrospective Studies ; Risk Factors* ; Uterine Cervical Neoplasms*

PURPOSE: We sought to evaluate the feasibility and outcomes of laparoscopic resection of giant hepatic cysts and surgical success, focusing on cyst recurrence. METHODS: From February 2004 to August 2011, 37 consecutive patients with symptomatic hepatic cysts were evaluated and treated at Dong-A University Hospital. Indications were simple cysts (n = 20), multiple cysts (n = 6), polycystic disease (n = 2), and cystadenoma (n = 9). RESULTS: The median patient age was 64 years, with a mean lesion diameter of 11.4 cm. The coincidence between preoperative imaging and final pathologic diagnosis was 54% and half (n = 19) of the cysts were located in segments VII and VIII. Twenty-two patients had American Society of Anesthesiologists (ASA) classification I and II, and nine had ASA classification III. Surgical treatment of hepatic cysts were open liver resection (n = 3), laparoscopic deroofing (n = 24), laparoscopic cyst excision (n = 4), laparoscopic left lateral sectionectomy (n = 2), hand assisted laparoscopic procedure (n = 2), and single port laparoscopic deroofing (n = 2). The mean fellow-up was 21 months, and six patients (16%) experienced radiographic-apparent recurrence. Reoperation due to recurrence was performed in two patients. Among the factors predicting recurrence, multivariate analysis revealed that interventional radiological procedures and pathologic diagnosis were statistically significant. CONCLUSION: Laparoscopic resection of giant hepatic cysts is a simple and effective method to relieve symptoms with minimal surgical trauma. Moreover, the recurrence is dependent on the type of pathology involved, and the sclerotherapy undertaken.
Cystadenoma ; Hand ; Humans ; Laparoscopy ; Liver ; Multivariate Analysis ; Recurrence ; Reoperation ; Sclerotherapy

OBJECTIVE: Rapid and effective hemostasis at femoral puncture sites minimizes both the hospital stay and patient discomfort. Therefore, a variety of arterial closure devices have been developed to facilitate the closure of femoral arteriotomy. The objective of this prospective study was to compare the efficacy of two different closure devices; a collagen plug device (Angio-Seal) and a suture-mediated closure device (the Closer S). MATERIALS AND METHODS: From March 28, 2003 to August 31, 2004, we conducted a prospective study in which 1, 676 cases of 1, 180 patients were treated with two different types of closure device. Angio-Seal was used in 961 cases and the Closer S in 715 cases. The efficacy of the closure devices was assessed, as well as complications occurring at the puncture sites. RESULTS: Successful immediate hemostasis was achieved in 95.2% of the cases treated with Angio-Seal, and in 89.5% of the cases treated with the Closer S (p < 0.05). The rates of minor and major complications occurring between the two groups were not significantly different. In the Closer S group, we observed four major complications (0.6%), that consisted of one massive retroperitoneal hemorrhage (surgically explored) and three pseudoaneurysms. In the Angio-Seal group, we observed three major complications (0.3%) that consisted of one femoral artery occlusion, one case of infection treated with intravenous antibiotics and one pseudoaneurysm. CONCLUSION: The use of Angio-Seal was found to be more effective than that of the Closer S with regard to the immediate hemostasis of the femoral puncture sites. However, we detected no significant differences in the rate at which complications occurred.
Treatment Outcome ; *Sutures ; Prospective Studies ; Postoperative Complications ; Middle Aged ; Male ; Humans ; Hemostatic Techniques/*instrumentation ; Femoral Artery/*surgery ; Female ; *Collagen ; Aged ; Adult ; Adolescent

STATEMENT OF PROBLEM: Titanium has many advantages of high biocompatibility, physical porperties, low-weight, low price and radiolucency, but it is incompatible with conventional dental porcelain due to titanium's oxidative nature. Many previous studies have shown that they used the method of sandblast for surface treatment prior to porcelain application, the researchs are processing about the method of acid etching or surface coating. PURPOSE: The purpose of this research is to study the effect on bond strength between titanium and porcelain when using macro-surface treatment and micro-surface treatment and macro and micro surface treatment . MATERIAL AND METHOD: In this study, we evaluated the bond strength by using 3-point bending test based on ISO 9693 after classified 7 groups - group P : polished with #1200 grit SiC paper, group SS : sandblasted with 50 micrometer aluminum oxides, group LS : sandblasted with 250 micrometer alumium oxides, group HC : treated with 10 % hydrochloric acid, group NF : treated with 17% solution of fluoric acid and nitric acid, group SHC : treated with 10 % hydrochloric aicd after sandblsting with 50 micrometer alumium oxides, group SNF : treated with 17 % solution of fluoric acid and nitric acid. RESULTS: Within the confines of our research, the following results can be deduced. 1. Group SS which was sandblasted with 50 micrometer aluminum oxides showed the highest bond strength of 61.74 MPa and significant differences(P<0.05). The bond strengths with porcelain in groups treated acid etching after sandblasting decreased more preferable than the group treated with sandblasting only. It gives significant differences(P<0.05). 2. After surface treatments, the group treated with sandblasting showed irregular aspect formed many undercuts, in the SEM photographs. The group treated with hydrochloric acid had the sharp serrated surfaces, the group treated with the solution of fluoric acid and nitric acid had the smooth surfaces, the group with sandblasting and hydrochloric acid had irrigular and porous structure, the group with sandblasting and the solution of fluoric acid and nitric acid had craterlike surfaces. But all of the groups treated with acid etching was not found and undercut. CONCLUSION: In above results, average surface roughness increase, bond strength also increase, but surface topographs influences more greatly on bond strengths.
Aluminum ; Dental Porcelain ; Hydrochloric Acid ; Nitric Acid ; Oxides ; Titanium

OBJECTIVE: This study was carried out to investigate the relationship between DNA ploidy, S-phase fraction (SPF), expression of cyclin A and clinical prognostic factors including stage, grade, CA-125 and residual tumor size in epithelial ovarian cancer, and to evaluate the association between DNA ploidy, SPF, expression of cyclin A and 3-year survival. METHODS: Study group consisted of 31 cases of epithelial ovarian cancer, 10 of borderline ovarian tumor and 5 of benign ovarian tumor diagnosed at the department of Obstet. and Gynecol. in Yonsei University College of Medicine, Seoul, Korea from Feb. 2000 to Jan. 2003. All patients underwent staging-laparotomy and postoperative chemotherapy. The level of CA-125 was assessed after 6th postoperative chemotherapy with cut-off value of 35 U/mL. DNA ploidy and SPF were evaluated by flow-cytometry of fresh ovarian tissue obtained at the operative field. The expression of cyclin A was evaluated by immuno-histochemical stain. Expression of 5% was considered as positive. Statistical analysis was done by two-sample t-test, chi-square test, and Kaplan-Meier survival curve using SPSS ver 11.0 software. RESULTS: In 46 ovarian tumors aneuploidy, SPF and expression of cyclin A were significantly higher in epithelial ovarian cancer as compared with benign and borderline tumors (p=0.004, 0.001, 0.001, respectively). Number of aneuploidy, SPF and expression of cyclin A were significantly higher in patients with higher grade, more advanced stage, higher level of CA-125 (more than 35 U/mL) and more than 2 cm of residual tumor size (p=0.004, 0.009, 0.05, 0.002 in aneuploidy; p=0.06, 0.01, 0.04, 0.007 in SPF; p=0.03, 0.004, 0.06, 0.02 in cyclin A). Aneuploidy and expressions of more than 10% of SPF and cyclin A were also associated with poorer overall survival (p=0.02, 0.02, <0.0001, respectively). Significantly positive correlations were observed among these factors. CONCLUSION: Number of aneuploidy, percentage of SPF and expression of cyclin A were higher in more advanced stage, higher grade, higher CA-125 and more than 2 cm of residual tumor size and associated with poorer overall survival. Thus DNA flow-cytometry and estimation of expression of cyclin A may provide major information about prognosis of disease in epithelial ovarian cancer patients.
Aneuploidy ; Cyclin A* ; Cyclins* ; DNA* ; Drug Therapy ; Humans ; Korea ; Neoplasm, Residual ; Ovarian Neoplasms* ; Ploidies ; Prognosis ; Seoul

OBJECTIVE: The prognosis of gynecologic malignancies was closely related to the nutritional status of patients as well as clinical or surgical staing at the time of diagnosis. The serum prealbumin has relatively short half-life among the nutritional parameters and could be used to detect immediate postoperative change of nutritional state in surgical patients. The purpose of this study was to evaluate the clinical impact of serum prealbumin and the validity of prealbumin in prediction and detection of postoperative complications in high risk patients with gynecologic malignancy. METHODS: 153 gynecologic malignant patients and 68 non-malignant patients operated from January 1999 to May 2003 were studied retrospectively. The serum albumin, total lymphocyte count (TLC), prealbumin were compared between the malignant and non-malignant patients, early and advanced stage cancer group, and complicated and uncomplicated group. Prealbumin was defined as the difference between preoperative and postoperative prealbumin concentrations. The correlation was statistically analyzed by Student's t-test, one way ANOVA test, and x2-test (SPSS ver. 11.0). RESULTS: There was significant difference in prealbumin between non-malignant patients and malignant patients (p=0.049). There was also significant difference in prealbumin between carcinoma in situ of uterine cervix and cervical cancer group (p=0.049). However there were no significant differences in prealbumin between early and advanced stage ovarian cancer and uterine cancer (p=0.48, p=0.67, respectively). There were no significant differneces between complicated and uncomplicated groups in prealbumin and delta prealbumin. CONCLUSION: Serum prealbumin was not useful in prediction and detection of high risk group of postoperative complications in gynecologic cancer patients.
Carcinoma in Situ ; Cervix Uteri ; Diagnosis ; Female ; Half-Life ; Humans ; Lymphocyte Count ; Nutritional Status ; Ovarian Neoplasms ; Postoperative Complications ; Prealbumin* ; Prognosis ; Retrospective Studies ; Serum Albumin ; Uterine Cervical Neoplasms ; Uterine Neoplasms

OBJECTIVE: To investigate whether human papillomavirus (HPV) associated with cervical intraepithelial neoplasia was successfully eliminated after surgical therapy such as large loop excision of transformation zone (LLETZ) or type I extended hysterectomy. METHODS: Seventy four cervical intraepithelial neoplasia (CIN) patients with HPV infection who were admitted for LLETZ or type I extended hysterectomy were recruited into this prospective study. HPV infection was confirmed by HPV DNA genotyping using HPV DNA Chip (Biomedlab, Seoul, Korea) before and after surgical therapy. RESULTS: According to the assay used (HPV DNA Chip(R)) at the postoperative visit, 82.5% of treated patients were completely free from HPV infection. And there was no statistical difference between LLETZ and type I extended hysterectomy (p=0.452). However, there was persistent infection in 17.5% of treated patients after final surgical therapy. CONCLUSION: Although the HPV infection associated with CIN was effectively eliminated after LLETZ and type I extended hysterectomy, there was persistent infection in 17.5% of treated patients. Therefore, the careful followed-up examination of HPV infection should be taken in these patients.
Cervical Intraepithelial Neoplasia* ; DNA ; Humans* ; Hysterectomy ; Oligonucleotide Array Sequence Analysis ; Papillomavirus Infections* ; Prospective Studies ; Seoul

PURPOSE: We developed an objective structured oral examination (OSOE) case to assess the medical ethics of students. The aim of this study was to assess the reliability of OSOE with generalizability theory. METHODS: One 10-minute OSOE that contained key questions was developed. The evaluation sheet consisted of 4 domains: moral sensitivity, moral reasoning, decision making, and attitude. The total number of items was 13. The numbers of checklist items and global rating items were 11 and 2, respectively. Items and key questions were validated by 6 professionals. Standardization of the raters and the pilot study was performed before the OSOE. Fifty-four third-year medical students participated in the OSOE. The OSOE was duplicated, and 2 professors assessed 1 student independently. Each station lasted 8 minutes and was followed by a 2-minute interval,during which raters completed the checklist forms. We analyzed the reliability of the OSOE with the GENOVA program. RESULTS: The reliability (generalizability coefficient) was 0.945, and the interrater agreement was 0.867. The type of item, checklist or global rating, was the largest variance component. The reliability of the checklist alone was 0.668 and that of the global rating alone was 0.363. CONCLUSION: The OSOE is reliable and can be used to assess ethics. More research should focus on achieving validity.
Checklist ; Clinical Competence ; Decision Making ; Diagnosis, Oral ; Educational Measurement ; Ethics, Medical ; Humans ; Mental Competency ; Pilot Projects ; Statistics as Topic ; Students, Medical

Physeal distraction is used for limb lengthening or correction of deformities in skeletally immature patients. But the effect of distraction on the physis is uncertain. The young rabbits were arranged into five groups according to the slow distraction rates: Group I (no distraction), Group II (distraction rate of 0.25mm per day), Group III (distraction rate of 0.5mm per day), Group IV (distraction rate of 0.75 mm per day), Group V (distraction rate of 1mm per day). The tibial length, size of proliferating zone, microscopic findings of physis immunostained with bromodeoxyuridine, and physeal response to physeal distraction on each group were studied. The results were as follows. 1. There was an increase in bone length on the distracted side (1.8 to 4.2mm). 2. There was an irregular increase in the thickness of the distracted physis. 3. There was an abnormal accumulation of hypertrophic chondrocytes in hypertrophic zone in distracted physis. 4. There was no evidence of anomalous cell proliferation, in the resting, proliferating and hypertrophic zones. These results conclude that the physeal distraction does not stimulate cell proliferation in the physis, even when it is seen to be thickened after the chondrodiatasis.
Bromodeoxyuridine ; Cell Proliferation ; Chondrocytes ; Congenital Abnormalities ; Extremities ; Humans ; Rabbits*