PURPOSE: This study was done to evaluate the differences in clinical parameters and survival rates between the primary tumor (T) and nodal involvement (N) in stage II cancers. METHODS: This report is a retrospective clinical analysis of 100 patients of stage II gastric cancer who were treated surgically at the Department of Surgery, Chonbuk National University Hospital from Jan. 1990 to Dec. 1999. Among the 100 patients, the pT3N0 group included 48 patients, and the pT2N1 group 52 patients. In this study, we used the UICC TNM staging system (the fourth edition). RESULTS: There were no significant differences except for age and tumor sizes between the pT3N0 and the pT2N1 groups with regard to the mode of presentation, sex, location of tumor, type of resection, lymph node dissection, Borrmann and Lauren classification, cell cytology, recurrence, number of resected lymph nodes, and the 5-year survival rate. Based on the number of lymph nodal metastases, no significant difference was observed in the 5-year survival rate, but based on the ratio of lymph nodal metastases, the 5-year survival rate for those with up to 20% frequency of metastases was 85.2% and the 5-year survival rate for those with greater than 20% was 40.0%, which is significant difference in the 5-year survival rate. CONCLUSION: In stage II gastric cancer, there was no difference between the pT3N0 and the pT2N1 group, except that in the pT2N1 group, a subdivision of the pN stage according to the ratio of lymph nodal metastases could be successfully applied to the clinical evaluation of stage II gastric cancer.
Classification ; Humans ; Jeollabuk-do ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

OBJECTIVES: It is well known that allergic rhinitis (AR) has positive association with adenotonsillectomy. However, the impact of AR on symptom improvement after adenotonsillectomy is not well documented. Hence, we aimed to evaluate the effect of AR on the symptom improvement after adenotonsillectomy between AR and nonallergic patients. METHODS: A retrospective analysis was performed on 250 pediatric patients younger than 10 years old who received adenotonsillectomy from June 2009 to June 2014 in a tertiary referral hospital. All patients underwent skin prick test or multiple allergen simultaneous test (MAST) before surgery and classified into AR group and control group. Obstructive and rhinitis symptoms including snoring, mouth breathing, nasal obstruction, rhinorrhea, itching, and sneezing were evaluated before and 1 year after surgery using questionnaire and telephone survey. RESULTS: AR group was 131 and control group was 119, showing higher prevalence (52.4%) of AR among adenotonsillectomized patients. Both groups showed dramatic improvement of symptoms such as snoring and mouth breathing after surgery (all P < 0.05). However, AR group showed significantly less improvement than control group in snoring, mouth breathing, nasal obstruction, and rhinorrhea (all P < 0.05). Multivariate analysis showed that preoperative mouth breathing and snoring were dependent on tonsil grade and postoperative symptoms were mainly dependent on presence of AR. Nasal obstruction was dependent on tonsil grade and presence of AR preoperatively and presence of AR postoperatively. These suggest the importance of AR as a risk factor for mouth breathing, snoring, and nasal obstruction. CONCLUSION: AR has positive association with adenotonsillectomy and not only allergic symptoms but also obstructive symptoms such as snoring and mouth breathing improved less in AR group than control group. Hence, patients with AR should be monitored for long-term basis and more carefully after adenotonsillectomy.
Adenoidectomy ; Child ; Humans ; Mouth Breathing ; Multivariate Analysis ; Nasal Obstruction ; Palatine Tonsil ; Prevalence ; Pruritus ; Retrospective Studies ; Rhinitis ; Rhinitis, Allergic* ; Risk Factors ; Skin ; Sneezing ; Snoring ; Telephone ; Tertiary Care Centers ; Tonsillectomy

PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.
Bile ; Decompression ; Drainage* ; Humans ; Needles*

Two of the synaptic receptors involved in the regulation of micturition, P2X(3) receptor, which is operated by ATP, and vanilloid receptor 1 (VR1), which is operated by capsaicin, are regarded as newcomers. To investigate the possibility that these receptors act as therapeutic targets for treatment of an overactive bladder, we investigated their distribution and reciprocal relationship. Eight-week-old Sprague Dawley rats were injected with retrograde nerve tracer within the bladder wall, and 15 rats were injected with 0.5% acetic acid inside the bladder. After a week, the animals were killed, and their dorsal root ganglia (DRG) at the levels of L6 and S1 were harvested. Immunohistochemistry or Western blot analysis of P2X(3) and VR1 were performed on the DRG. The DRG neurons with afferent fibers from the bladder had increased expression of VR1 and downregulated P2X(3) receptors. The P2X(3) receptor and VR1 seemed to account for the important parts of the hypersensitivity of the inflammatory bladder. We conclude that the simultaneous modulations of both P2X(3) receptor and VR1 may have a synergic effect on the treatment of overactive bladder and may produce greater response rates.
Acetic Acid ; Adenosine Triphosphate ; Animals ; Blotting, Western ; Capsaicin ; Diagnosis-Related Groups ; Ganglia, Spinal ; Hypersensitivity ; Immunohistochemistry ; Neurons ; Rats ; Rats, Sprague-Dawley ; Receptors, Neurotransmitter ; Urinary Bladder ; Urinary Bladder, Overactive ; Urination

As neonates are brought to the emergency department (ED) for various complaints, it is challenging for emergency physicians to clinically determine the urgency of the visit. We sought to explore clinical characteristics associated with urgent visits to the ED. We conducted a retrospective study by reviewing medical records of neonatal visits to a tertiary pediatric regional emergency center for 5 years. Cases of patients who were discharged after checking only chest or abdominal X-ray or discharged without workup, were classified as non-urgent visits. Cases where more examinations were performed, or when the patient was hospitalized, were classified as urgent visits. Various clinical features and process in the ED were compared between the groups. Of the 1,008 cases enrolled in this study, 856 (84.9%) were urgent and 152 (15.1%) were non-urgent visits. After adjustment by multiple logistic regression analysis, non-urgent visits were associated with self-referrals rather than physician-referrals (odds ratio [OR], 5.96), visits in the evening rather than at night or daytime (OR, 2.51), patient visits from home rather than from medical facilities (OR, 2.19; 95). Fever and jaundice were the most common complaints (25.7% and 24.5%, respectively), and their OR of non-urgent visit was relatively low (adjusted OR 0.03 and 0.03, respectively). However, other common complaints, such as vomiting and cough (7.4% and 7.1%, respectively), were more likely to be non-urgent visits (adjusted OR 2.96 and 9.83, respectively). For suspected non-urgent visits, emergency physicians need to try to reduce unnecessary workup and shorten length of stay in ED.
Cough ; Emergencies* ; Emergency Service, Hospital* ; Fever ; Humans ; Infant, Newborn ; Jaundice ; Length of Stay ; Logistic Models ; Medical Records ; Retrospective Studies ; Thorax ; Vomiting

In order to control the H9N2 subtype low pathogenic avian influenza (LPAI), an inactivated vaccine has been used in Korea since 2007. The Korean veterinary authority permitted the use of a single H9N2 LPAI vaccine strain to simplify the evolution of the circulating virus due to the immune pressure caused by the vaccine use. It is therefore important to determine the suitability of the vaccine strain in the final inactivated oil emulsion LPAI vaccine. In this study, we applied molecular rather than biological methods to verify the suitability of the vaccine strain used in commercial vaccines and successfully identified the strain by comparing the nucleotide sequences of the hemagglutinin and neuraminidase genes with that of the permitted Korean LPAI vaccine strain. It is thought that the method used in this study might be successfully applied to other viral genes of the LPAI vaccine strain and perhaps to other veterinary oil emulsion vaccines.
Animals ; Base Sequence ; Birds ; DNA, Viral/chemistry/genetics ; Hemagglutinin Glycoproteins, Influenza Virus/chemistry/genetics ; Influenza A Virus, H9N2 Subtype/genetics/*immunology ; Influenza Vaccines/genetics/*immunology ; Influenza in Birds/*immunology/prevention & control/virology ; Molecular Sequence Data ; Neuraminidase/chemistry/genetics ; Polymerase Chain Reaction/veterinary ; Republic of Korea ; Sequence Alignment ; Vaccines, Inactivated/genetics/immunology

A pulmonary sequestration is a mass of nonfunctioning, embryonic lung tissue that has no communication with the normal bronchial system and is usually supplied by an aberrant systemic artery. Bilateral intrapulmonary sequestration is very rare. This case was a 16 months old boy who showed persistent right lower lobe infiltration on chest X-ray. We found the consolidation lesions on left lower lobe and right lower basal segment which had the multiple cyst like lesions on the chest computed tomography. We confirmed the bilateral intrapulmonary sequestration by angiography which showed each sequestrated tissue being supplied by 2 aberrant arteries. The lobectomy of left lower lobe and the ligation of right aberrant artery were performed. Four months later, residual right lower lobe sequestrated tissue regressed markedly on the following chest computed tomography. Herein, we report a case of bilateral intrapulmonary sequestration which was successfully treated by the ligation of aberrant artery without subsequent complications.
Angiography ; Arteries ; Bronchopulmonary Sequestration ; Humans ; Infant ; Ligation ; Lung ; Male ; Thorax

A total of 30 cases of the peptic ulcer in children, who underwent operations from January 1981 to December 1995 because of complications at Department of the Surgery, Chonbuk National University Medical School, is reviewed. Twenty-three were males (76.7%), 7 females (23.3%) and male was preponderant at 3.3:1. There were 25 cases (83.3%) age 10 to 15 years, 3 (10.0%) between 2 and 9 years, and 2 (6.7%) below 2. The ulcer was located at duodenum in 27 (90.0%), and at stomach in 3 cases (10.0%). Complications were perforation in 19 cases (63.3%), pyloric obstruction in 9 (30.0%) and bleeding in 2 (6.7%). For perforation, truncal vagotomy with pyloroplasty was done in 11 cases, truncal vagotomy with hemigastrectomy and gastrojejunostomy in 6, and simple closure in 2 cases. For obstruction, truncal vagotomy with hemigastrectomy and gastrojejunostomy was done in 5, and truncal vagotomy and pyloroplasty in 3 cases. For bleeding lesions, truncal vagotomy and pyloroplasty was performed in 2 cases. Ten postoperative complications developed in 9 patients; adhesive ileus in 5, recurrence in 2, pneumonia 2, and wound seroma 1 case. One patient developed a primary duodenal perforation and another a recurrent obstruction. Both of patients had symptoms for more than 3 years and were treated with truncal vagotomy and pyloroplasty for the primary operations. Hospital stay was 11.5 days for the patient with perforated ulcer, 11.0 days for the patient with pyloric obstruction, and 14.5 days for the child with bleeding. Average hospital period was 11.6 days. To reduce recurrences after operation, extensive procedure such as distal gastrectomy with vagotomy at the first operation should be considered in case with severe complication or with patients who have been symptomatic for long periods.
Adhesives ; Child* ; Duodenum ; Female ; Gastrectomy ; Gastric Bypass ; Hemorrhage ; Humans ; Ileus ; Jeollabuk-do ; Length of Stay ; Male ; Peptic Ulcer* ; Pneumonia ; Postoperative Complications ; Recurrence ; Schools, Medical ; Seroma ; Stomach ; Ulcer ; Vagotomy ; Vagotomy, Truncal ; Wounds and Injuries

BACKGROUND: Recently, childhood obesity has been increasing steeply. Many obese children have complications and high risks to become obese as adults. Therefore, we performed this study to assess childhood obesity in Kwangju area. METHODS: We examined 11,039 children(boys:5,547, girls:5,492) of ages 6-12 years. We defined obesity as more than 97th percentile of weight at each height. We also examined the degree of obesity by comparing with stsndard weight, which is defined as more than 20% above the standard weight for height. We identified four groups according to the degree of obeiity. The ranges for each group was as follows : obesity at from 20% above the standard weight for height, mild obesity at 30% below and 20% above the standard weight for height, and moderate obesity at 50% below and 30% above the standard weight for height, and severe obesity at 50% above the standard weight for height. RESULTS: The prevalence of obesity that exceeded the weight centiles at each height by more than 97th pereentile was 12.17%. The prevalence of obesity that exceeded the standard weight for height by more than 20% was 13.31%. Among them, 8.02/o were mild obesity, 4.44% were moderate obesity and 0. 84% were severe obesity. CONCLUSIONS: Recently, the frequency of childhood obesity goes high in our society. We now know that obesity is a risk factor for some diseases, and therefore, more effective approaches should be developed treat and prevent childhood obesity.
Adult ; Child* ; Gwangju* ; Humans ; Obesity* ; Obesity, Morbid ; Pediatric Obesity ; Prevalence* ; Risk Factors

No abstract available.
Uterine Inversion*