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

The vein of Galen aneurysm is a rare vascular malformation but it can be detected by using conventional ultrasonography and diagnosed by using power Doppler ultrasonography. The prognosis of the vein of Galen aneurysm depends on congestive heart failure caused by cerebral shunt. Embolization at proper times can provide good outcome. We report a case of spontaneous delivery at 41 weeks of gestation by a 35-year-old woman presenting with a fetal vein of Galen aneurysm is described. The vein of Galen aneurysm was prenatally diagnosed by power Doppler ultrasonography and treated postnatally by embolization. This case is a report of successful prenatal diagnosis and postnatal management of the vein of Galen aneurysm.
Adult ; Aneurysm ; Cerebral Veins ; Female ; Heart Failure ; Humans ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Ultrasonography, Doppler ; Vascular Malformations ; Vein of Galen Malformations ; Veins

Glial cells play a critical role in morphine tolerance, resulting from repeated administration of morphine. Both the development and the expression of tolerance are suppressed by the analgesic lamotrigine. This study investigated the relationship between the ability of lamotrigine to maintain the antinociceptive effect of morphine during tolerance development and glial cell activation in the spinal cord. In a rat model, morphine (15 microg) was intrathecally injected once daily for 7 days to induce morphine tolerance. Lamotrigine (200 microg) was co-administered with morphine either for 7 days or the first or last 3 days of this 7 day period. Thermal nociception was measured. OX-42 and GFAP immunoreactivity, indicating spinal microglial and astrocytic activation were evaluated on day 8. Tolerance developed after 7 days of intrathecal morphine administration; however, this was completely blocked and reversed by co-administration of lamotrigine. When lamotrigine was coinjected with morphine on days 5-7, the morphine effect was partially restored. Glial cell activation increased with the development of morphine tolerance but was clearly inhibited in the presence of lamotrigine. These results suggest that, in association with the suppression of spinal glial cell activity, intrathecally coadministered lamotrigine attenuates antinociceptive tolerance to morphine.
Analgesics/*pharmacology ; Animals ; Antigens, CD11b/metabolism ; Astrocytes/cytology ; Drug Tolerance ; Immunohistochemistry ; Male ; Microglia/cytology ; Morphine/*pharmacology ; Nerve Tissue Proteins/metabolism ; Neuroglia/cytology/*metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord/*cytology ; Triazines/*pharmacology

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

PURPOSE: The aim of this study was to determine the risk factors for rhabdomyolysis in patients with carbon monoxide (CO) poisoning. METHODS: This was a retrospective study on patients with CO poisoning who visited the emergency department from January 1, 2014 to December 31, 2015. We compared clinical variables between patients with and without rhabdomyolysis. RESULTS: Among 120 patients who were included to this study, 108 patients exhibited normal value of CPK (creatine phosphokinase), and 12 patients were diagnosed as rhabdomyolysis. Sources of CO, duration of CO exposure, initial GCS (Grasgow coma scale), initial systolic and diastolic blood pressure, initial body temperature and AKI (Acute kidney injury) were showed significant difference between patients who developed rhabdomyolysis and patients who did not. In addition, initial white blood cell counts, troponin I level and carboxyhemoglobin (COHb) level were more higher in rhabdomyolysis group. pH and initial bicarbonate level were more lower. Duration of CO exposure (Odds ratio, 1.011; 95% confidence interval, 1.002∼1.020, P=0.021)was found to be only risk factor for rhabdomyolysis by logistic regression analysis. CONCLUSION: Duration of CO exposure is potential risk factor of rhabdomyolysis development in CO poisoning.
Blood Pressure ; Body Temperature ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin ; Coma ; Emergency Service, Hospital ; Humans ; Hydrogen-Ion Concentration ; Kidney ; Leukocyte Count ; Logistic Models ; Poisoning ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Risk Factors* ; Troponin I