This clinical study is based on review of records of 87 patients with postoperative adhesive intestinal obstruction who were managed at the Department of Surgery of Dongbu City Hospital during 5 years from September, 1992 to August, 1997. The results of study were as follows: 1) The most prevalent age group was 5th decade(44.8%) and male to female ratio was 1.7:1. 2) The previous operations were operation for appendicitis(32.2%), operations for peritonitis due to peptic ulcer perforation(24.1%), gynecologic operations(13.8%), operation for gastric malignancy(8.1%). 3) The mean value of duration between previous operations and postoperative adhsive intestinal obstruction was 36 months and the mean value of duration of symptoms was two days. 4) 42(49.2%) of 87 patients were admitted under 24 hours after onset of symptoms. 5) The chief complaints on admission were abdominal pain(98.8%), vomiting(81.6%), abdominal distension(78.2%), failure to flatus(55.2%). 6) 23 cases(45.1%) of 51 cases having one or more abnormal physical and laboratory finding(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis) were operated, and 5 cases(13.9%) of 36 cases having no physical finding were operated (p value < 0.05). 7) Emergency operation was performed in 9 cases, elective operation was performed in 19 cases which had deteriorating clinical course despite of conservative management for 48 hours, and conservative treatement was performed in 59 cases. 8) The postoperative complications were observed in 6 cases and the most common complication was wound infection(14.3%). In conclusions, The longer symptom duration and the longer interval between previous operation and onset of symptoms, the higer probability of surgical treatment is expected. The need for surgical treatment was increased acording the number of physical and laboratory findings(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis). For the cases which have unimproving and deteriorating clinical course despite of conservative management for 72 hours, surgical operation shoud be considered.
Adhesives* ; Defecation ; Emergencies ; Female ; Hospitals, Urban ; Humans ; Intestinal Obstruction* ; Male ; Peptic Ulcer ; Peritonitis ; Postoperative Complications ; Wounds and Injuries

As the span of life is prolonged by socioeconomic and medical development, the percentage of the geriatric population is increasing annually. Now, surgical therapy for the geriatric patients is an important area of medicine. To understand the clinical significance of surgical geriatric patients, an analysis was made of the records at the Surgical Department of City hospital, East Seoul, for 182 patients over 65 years of age, who were treated from January 1990 through December 1995. The results are as follows: 1) The number of surgical patients admitted during the 6 years was 2,734, and the number of surgical geriatric patients admitted during the same period was 257 patients (9.4% of all surgical patients). The percentage of geriatric patients show an increasing tendency from 8.1% in 1994 to 11.3% in 1995. 2) The sex distribution was 140 male patients (54.5%) and 117 female patients (45.3%), a ratio of 1 : 0.83. 3) The average duration of admission was 18.2 days and durations of admission of less than 1 week were most common (21.8% of all geriatric admissions). 4) Of the 182 cases treated surgically, 139 cases (76.4%) involved general anesthesia, 32 cases (17.6%) anesthesia administered spinally, and 11 cases (60%) local anesthesia; One hour or less of general anesthetic time was most common (41.7%). 5) Malignant disease was found in 46 patients (25.3%); stomach cancer was the most frequently found malignant disease. Non-malignant disese was found in 136 patients (74.7%); appendicitis was the most frequently found non-malignant disease. 6) Coexistent disease was noticed in 108 patients (59.3%); cardiovascular disease was the most frequently found (27.1%), and chronic pulmonary disease (21.3%) and hypoproteinemia (14.2%) were next. 7) Operations were performed on 182 patients of the total 257 patients, operation rate of 70.8%. The old age group had a low operation rate. 8) Postoperative complications were occurred in 43 cases (23.6%), and operative mortality was 2.7%. The significant factors affecting postoperative morbidity and mortality were malignancy, long duration for the general anesthetic time, coexistent disease, and emergency operation. The results suggest that the number and the rate of surgical geriatric patients have increased and that age has little effect on the postoperative prognosis. Thus, we believe that more active preoperative treatment, complete therapy for coexistent disease, execution of elective surgery and a short anesthetic time for intentional surgery are important factors for decreasing postoperative morbidity and mortality for surgical geriatric patients.
Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Appendicitis ; Cardiovascular Diseases ; Emergencies ; Female ; Hospitals, Urban ; Humans ; Hypoproteinemia ; Lung Diseases ; Male ; Mortality ; Postoperative Complications ; Prognosis ; Seoul ; Sex Distribution ; Stomach Neoplasms

PURPOSE: The insulin like growth factors (IGFs) circulate complexed to IGF-binding proteins(IGFBPs). IGFBP-3 is the major circulating IGFBP and is found primarily as a 150 kDa complex which contains an acid labile subunit(ALS), IGFBP-3, and IGF-I or IGF-II and is considered to be growth hormone(GH) dependent. In this study, we measured serum IGF-I, IGFBP-3 and 150 kDa levels in sera of growth hormone deficient children(GHD) before and after GH treatment respectively to clarify the utility of these factors as a diagnostic marker for GHD and to observe the alterations of these factors according to GH treatment. METHODS: Measurement of serum IGF-I, IGFBP-3 and 150 kDa complex were performed in 10 children with complete growth hormonr deficiency(cGHD), in 6 children with partial growth hormone deficiency(pGHD) and in 10 normal healthy subjects. Serum IGF-I was measured by radioimmunoassay (RIA). IGF-I was seperated from IGFBPs by Sephadex G-50 acid chromatography. Serum IGFBP-3 was assessed by Western ligand blot(WLB) analysis as described by Hossenlopp with minor modifications. To evaluate alterations of different molecular size classes of IGF-BP complexes according to GH treatment, WLB was done after neutral size-exclusion chromatography using Sephacryl S-200. RESULTS: 1) The serum IGF-I level in children with GHD was significantly lower than that of control subjects(96.2+/-40.1 ng/ml vs 147.5+/-37.9 ng/ml)(p<0.01). 2) The serum IGF-I level in children with cGHD was significantly lower than that of normal subjects (p<0.01). But four of the 10 children with cGHD the IGF-I levels were distributed within the range of -2 S.D.. The serum IGF-I level in children with pGHD was also lower than that of normal subjects but there was no statistical significance between two groups(P>0.05). 3) The serum IGFBP-3 level is markedly decreased in 9 of 10 children with cGHD, but only in 2 of 6 children with pGHD which was measured by WLB method. 4) The serum IGF-I level after GH treatment was increased significantly in children with GHD(138.7+/-49.2 ng/ml vs 78.7+/-23.4 ng/ml)(p<0.01). The serum IGFBP-3 level was also increased after GH treatment as similar pattern. 5) The marked decrement of serum IGFBP-3 level in children with cGHD was explained as the result of decline in the 150 kDa IGFBP complex, and after GH treatment 150 kDa complex was increased; in the 150 kDa IGFBP complex, free IGF-I binding sites were increased. CONCLUSIONS: The serum levels of IGF-I, IGFBP-3 and 150 kDa complex in children with cGHD were decreased significantly, but in children with pGHD these changes were not observed as prominant as cGHD. These findings suggest that the measurments of serum IGF-I, IGFBP-3 level may be useful not only in the diagnosis of GHD but also differentiate cGHD from pGHD and the serum IGFBP-3 level may be more sensitive for diagnosing GHD even though each test by itself has a limited diagnostic accuracy as a single test.
Binding Sites ; Child* ; Chromatography ; Diagnosis ; Growth Hormone* ; Humans ; Insulin* ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Radioimmunoassay ; Somatomedins

BACKGROUND: Psoriasis is a chronic relapsing skin disorder that is characterized by abnormal epidermal proliferation, inflammation and angiogenesis. It causes emotional and social consequences that go far beyond the skin; therefore, many methods to measure and monitor the severity of psoriasis have been reported. OBJECTIVE: This study aims to evaluate the usability of the flow cytometric analysis of the T cell subsets and their chemokine receptors in the peripheral blood of the psoriasis patients as a severity index. METHODS: The T cell subsets and their chemokine receptor expression (CXCR3, CCR4) in the circulating blood of thirty psoriasis patients (PASI score:2.2~44.2) and twenty healthy controls were examined by flow cytometry. The relationship between the PASI score and the T cell subsets/chemokine receptors was also analyzed. RESULTS: The patients showed significantly higher number of Tc1 (CD8+CXCR3+), Tc2 (CD8+CCR4+) and CXCR3/CCR4 expressing cells than did the control group. Especially, the moderate to severe patients (a PASI score greater that 5) showed a higher number of Tc1, Tc2 and CCR4 expressing cells than did the control group. In the severe patients (a PASI score greater than 10), the frequency of circulating Tc2 cells and CCR4 expressing cells was directly correlated with the PASI score. CONCLUSION: Our findings suggest that flow cytometric analysis of the circulating T cell subsets with further classification could serve as an indicator of the disease severity in psoriasis patients.
Flow Cytometry ; Humans ; Inflammation ; Organothiophosphorus Compounds ; Psoriasis ; Receptors, Chemokine ; Skin ; T-Lymphocyte Subsets ; T-Lymphocytes, Cytotoxic

Pegylated interferon alfa-2a (PEG-IFN) and ribavirin combination therapy is the first line treatment for chronic HCV infection. There are four reports of Bell's palsy associated with interferon-alpha (IFN-alpha) and ribavirin therapy. We report here a case of Bell's palsy that occurred in a patient with chronic HCV infection during combination PEG-IFN and ribavirin therapy. The patient was 49-year-old man with chronic hepatitis C for 2 years. The liver biopsy showed grade 1 and stage 1. Therapy with PEG-IFN (Pegasys) 180 microgram/week and ribavirin 1200 mg/day was initiated. After 3 weeks of treatment, the patient showed a loss of muscular tone on the left side of his face. A diagnosis of Bell's palsy was made, and the PEG-IFN and ribavirin therapy was stopped. Prednisolone 45 mg/d was given and then tapered for 8 weeks. His palsy improved over 6 weeks.
Adult ; Antiviral Agents/*adverse effects ; Bell Palsy/*etiology/immunology ; Hepatitis C, Chronic/complications/*drug therapy/virology ; Humans ; Interferon Alfa-2a/*adverse effects/therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols/*adverse effects/therapeutic use ; Ribavirin/administration & dosage/*adverse effects/therapeutic use ; Treatment Outcome

Purpose: The Korean National Cancer Screening Survey (KNCSS) is a nationwide annual cross-sectional survey conducted for the past 15 years. This study aimed to report trends in the overall screening rates of both organized and opportunistic cancer screening programs from 2004–2018. Materials and Methods: KNCSS data were collected using a structured questionnaire. For five major cancers (i.e., stomach, liver, colorectal, breast, and cervical cancer), we evaluated both the lifetime screening rate and the screening rate with recommendations. The study population included men aged 40–74 years and women aged 20–74 years with no cancer histories. Results: Screening rate with recommendations increased from 2004 annually by 4.4% and 1.5% until 2013 for stomach and liver cancers, respectively, by 4.0% until 2012 for breast cancer, and by 3.6% and 1.2% until 2014 for colorectal and cervical cancers, respectively, followed by nonsignificant trends thereafter. In 2018, screening rates with recommendations for these cancers were 72.8%, 26.2%, 63.1%, 58.4%, and 55.6%, respectively. Conclusion Screening rates for the five types of cancer demonstrated a marked increase between 2004 and 2018. However, many recent screening rates have been flattened with nonsignificant trends, and there are lower rates for cervical cancer screening among young age groups. Steady efforts are needed to achieve higher screening participation rates overall, especially for the cervical cancer screening of young women in their 20s.

Purpose: The Korean National Cancer Screening Survey (KNCSS) is a nationwide annual cross-sectional survey conducted for the past 15 years. This study aimed to report trends in the overall screening rates of both organized and opportunistic cancer screening programs from 2004–2018. Materials and Methods: KNCSS data were collected using a structured questionnaire. For five major cancers (i.e., stomach, liver, colorectal, breast, and cervical cancer), we evaluated both the lifetime screening rate and the screening rate with recommendations. The study population included men aged 40–74 years and women aged 20–74 years with no cancer histories. Results: Screening rate with recommendations increased from 2004 annually by 4.4% and 1.5% until 2013 for stomach and liver cancers, respectively, by 4.0% until 2012 for breast cancer, and by 3.6% and 1.2% until 2014 for colorectal and cervical cancers, respectively, followed by nonsignificant trends thereafter. In 2018, screening rates with recommendations for these cancers were 72.8%, 26.2%, 63.1%, 58.4%, and 55.6%, respectively. Conclusion Screening rates for the five types of cancer demonstrated a marked increase between 2004 and 2018. However, many recent screening rates have been flattened with nonsignificant trends, and there are lower rates for cervical cancer screening among young age groups. Steady efforts are needed to achieve higher screening participation rates overall, especially for the cervical cancer screening of young women in their 20s.

Background: The purpose of this study was to identify the characteristics of dry mouth and gastrointestinal (GI) disorders in antidepressant patients. Methods: The study included 103 antidepressant-taking patients. Antidepressants were classified according to their mode of action. The GI disorders were investigated using the medical records of the patients. The Patient Health Questionnaire-15 and a questionnaire for assessing dry mouth symptoms were used in this study. Results: The score for “overall discomfort due to dry mouth in daily life” (31.72±33.82), “dry mouth at night or in the morning” (47.86±35.87), and “dry mouth during the day” (39.83±31.67) were slightly higher than “discomfort in chewing or swallowing foods”. According to somatization severity, the mean values were 116.36±113.34 in the mild, 213.18±136.98 in the moderate, and 277.59±201.44 in the severe, the between-group difference was significant (F=10.294, p<0.001). According to the class of antidepressants, the mean score was 180.00±147.5 for vortioxetine, 194.25±169.33 for selective serotonin reuptake inhibitors (SSRIs), 223.61±156.70 for serotonin and norepinephrine reuptake inhibitors (SNRIs), 75.00±57.00 for norepinephrine dopamine reuptake inhibitors (NDRIs), 201.67±174.66 for Nassau, and 116.67±132.03 for agomelatine. A total of 67 (65.0%) patients had at least one GI disorder. Conclusion The study findings are expected to help increase medication compliance in antidepressant patients by better controlling the side effects experienced by the patients.

During orthotopic liver transplantation (OLT), changes of hemodynamic, electrolytes and acid-base balance are frequently occurred. These changes may influence mortality and prognosis during and after surgery. The purpose of this study was to observe and evaluate the changes of hemodynamics and electrolytes occurring in 14 cases canine OLT. After insertion of endotracheal tube, anesthesia was maintained with 1%enflurane and pancuronium bromide. Swan-Ganz catheter(7.5 Fr.) was inserted into right external jugular vein and 20 gauge angiocatheter was also inserted into left femoral artery. Complete hemodynamic variables and electrolytes were measured 30 minutes after skin incision, anhepatic stage, 5 minutes before reperfusion, 5 and 30 minutes after reperfusion. The results were as follows; On reperfusion of grafted liver, 9 cases(64%) showed postreperfusion syndrome. In 9 cases showing Postreperfusion syndrome, cardiac output, systemic vascular resistance, mean pulmonary arterial pressure were decreased and serum potassium concentration was increased on reperfusion, but there were no significant changes in central venous pressure, pulmonary capillary wedge pressure, heart rate, body temperature and serum ionized calcium concentration when comparing with before reperfusion. Decreased mean arterial pressure during reperfusion in postreperfusion syndrome might be speculated through decrease of myocardial contractility and systemic vascular resistance.
Acid-Base Equilibrium ; Anesthesia ; Animals ; Arterial Pressure ; Body Temperature ; Calcium ; Cardiac Output ; Central Venous Pressure ; Dogs ; Electrolytes ; Femoral Artery ; Heart Rate ; Hemodynamics* ; Jugular Veins ; Liver Transplantation* ; Liver* ; Mortality ; Pancuronium ; Potassium ; Prognosis ; Pulmonary Wedge Pressure ; Reperfusion ; Skin ; Transplants ; Vascular Resistance

Prenatal ultrasonographic appearance and Doppler characteristics of extracranial masses are variable, depending on the location, vasculature, amount of arteriovenous shunting, and degree of proliferation. Epidermoid cysts are found in a variety of locations around the skull and midface. They are thought to occur as a result of the persistence of ectodermal elements at sites of suture closure, neural tube closure, and diverticulation of the cerebral hemispheres. They contain ectoderm but no skin element. We experienced 33-year-old primigravida with fetal extracranial mass at 23 weeks gestation. We presumed that this extracranial mass was hemangioma. However, the mass was suspected as scalp epidermoid cyst on postnatal ultasonography.
Adult ; Cerebrum ; Ectoderm ; Epidermal Cyst ; Hemangioma ; Humans ; Neural Tube ; Pregnancy ; Scalp ; Skin ; Skull ; Sutures