No abstract available.
Heart* ; Thoracic Surgery*

PURPOSE: To determine whether initial corrected anion gap (C(o)AG), base excess caused by unmeasured anions (BEua), and strong ion gap (SIG) can predict the morbidity of critically ill patients admitted to emergency department (ED). METHODS: 138 patients who visited the critical section of the ED and were admitted to intensive care unit (ICU) were enrolled. We calculated the C(o)AG, BEua, and SIG from the initial blood samples of the patients and initial logistic organ dysfunction score (LODS) also. Then we measured the LODS at the last day of ICU stay again. Comparing with the initial LODS, we divided the patients into two groups based on the changes of the values: favorable group and poor group. RESULTS: There was a significant difference in the mean AGcorr (p=0.007), BEua (p=0.008), SIG (p=0.037) between favorable and poor group. The area under the receiver operating characteristic (AUROC) curves for morbidity prediction were relatively small: 0.66 (95% CI, 0.56-0.77) for C(o)AG, 0.65 (95% CI, 0.54-0.76) for BEua, and 0.59 (95% CI, 0.49-0.70) for SIG. CONCLUSION: We found the initial unmeasured anions at the ED of the patients who eventually showed improved LODS during ICU period are significantly different to those of the other patients. But they failed to show enough capability of discriminating the morbidities between two groups.
Acid-Base Equilibrium ; Anions* ; Critical Illness* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intensive Care Units ; Organ Dysfunction Scores ; Organization and Administration ; ROC Curve

We studied the effects of bile acids on the induction of apoptosis in HepG2 human hepatocellular carcinoma cells. Treatment with either ursodeoxycholic acid (UDCA) or lithocholic acid (LCA) resulted in a dose- and time-dependent decrease in cell viability assessed by MTT assay. Both UDCA and LCA also induced genomic DNA fragmentation, a hallmark of apoptosis, indicating that the mechanism by which these bile acids induce cell death was through apoptosis. Cycloheximide, a protein synthesis inhibitor, blocked the apoptosis induced by these bile acids, implying that new protein synthesis may be required for the apoptosis. Intracellular Ca2+ release blockers (dantrolene and 3,4,5-trimethoxybenzoic acid-8-(diethylamino)octyl ester) inhibited decreased cell viability and DNA fragmentation induced by these bile acids. Treatment of HepG2 cells with calcium ionophore A23187 induced DNA fragmentation. These results suggest that UDCA and LCA induce apoptosis in the HepG2 cells and that the activation of intracellular Ca2+ signals may play an important role in the apoptosis induced by these bile acids.
Apoptosis* ; Bile Acids and Salts* ; Bile* ; Calcimycin ; Calcium ; Carcinoma, Hepatocellular* ; Cell Death ; Cell Survival ; Cycloheximide ; DNA Fragmentation ; Hep G2 Cells ; Humans* ; Lithocholic Acid ; Ursodeoxycholic Acid

Endoscopic polypectomy was firstly introduced by Tsuneoka in 1969, and till now this method has been widely used for the treatment of benign and malignant polyps with the advent of technical improvement. This method is a very important modality as secondary prevention of malignancy because polyps in gastraintestinal tract are now being considered as precancerous lesion. Polypectomy with snare and electrocautery is mainly used for pedunclated polyps (eg. Yamada Class III, IV), but sessile polyps pose technical difficulty and occasionally cause serious gastrointestinal hemorrhage when resection margin adjacent polyp base. We performed polypectomy with "O"-ring used in endocopic variceal ligation (EVL) to make sessile polyp as semipedunclated form, and also to control bleeding, and then successfully remove it with conventional snare polypectomy. We report these 5 cases with the review of the literature.
Electrocoagulation ; Gastrointestinal Hemorrhage ; Hemorrhage ; Ligation* ; Polyps ; Secondary Prevention ; SNARE Proteins

BACKGROUND: Recently Live blood analysis was populated in korean society. so we evaluated clinical utility of Live blood analysis, as compared the Live blood analysis result of patients who have confirmed diagnosis of disease with that of controls who have no known health problems. METHODS: We carried out Live blood analysis to patients(n=30) who was entered to an admission in Yongdong severance hospital from February 2000 to March 2000 and to controls(n=30) who worked in that hospital at same time. We examined 3 abnormal finding; rouleau formation, spicule, protoplast, which were often observed in Live blood analysis. RESULTS: At comparison of patient group and control group, rouleau formation was observed in 27 patients except 3 patients and it was observed in all 30 controls. Spicule was observed 2in 9 patients except 1 patients and it was observed in all 30 controls. Protoplast was observed in 16 patients and 13 controls. There was no difference between patients and controls in observing 3 abnormal finding. CONCLUSION: We conclude that Live blood analysis may have no clinical significance.
Complementary Therapies ; Diagnosis ; Humans ; Protoplasts

No abstract available.
Adenocarcinoma*

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

No abstract available.
Humans

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

OBJETIVES: Gastric leiomyosarcomas are uncommon, represent 1 to 3% of primary malignant neoplasms of the stomach and variable in clinical outcomes. This paper is a retrospective study of the clinical behaviour, histopa thologic features and prognostic factors. METHODS: Between January 1990 and August 1996, the records of nine patients with primary gastric leio myosarcoma treated at Chung-Nam National University Hospital were reviewed for clinical presentations and histopathologic features. The statiscal analysis with SAS system was employed for evaluation of prognostic factors. RESULTS: 1) The median age of the patients was 53.4 years with even age distribution from 31 to 76 years. The male and female ratio was 1.25 to 1. 2) The common symptoms were abdominal pain(67%), bleeding(22%) and indigestion(11%). 3) The locations of the tumor was body(56%) and fundus(44%). The growth pattern of the tumor was mostly submucosal(67%). 4) The average size of tumors was 11cm (6-18cm). 5) The central ulcer on the tumor showed 100%. The endoscopically and preoperative diagnosed leiomyosar coma with endoscopic biopsy was 33% . 6) The low grade tumors were 7 cases and high grade was 1 in eight resected primary gastric leiomyosarcomas. 7) The overall resectability was 89%. The resected cases had no lymph node metastasis. Chemotherapy and radiotherapy was done 5 cases and 1 case, respectively in patients with high mitotic number, large size and distant metastases. 8) The follow-up period was 4 to 49 months and 3 patients were died. Two of 3 died patients were initially diagnosed stage IVA and 1 patient was stage II with very large size (18cm). The average survival time of 3 died patients was 37 months. 9) The two patients from surgically resected eight cases were recurred at liver and peritoneum and died 11 months and 31 months after recurrence, respectively. CONCLUSION: The advanced stage and recurred case has short survival time but the more many cases and longer follow-up periods should be need to identify for prognostic factors and the effective postoperative adju vant therapy should be studied for high risk patients.
Age Distribution ; Biopsy ; Coma ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leiomyosarcoma* ; Liver ; Lymph Nodes ; Male ; Myosarcoma ; Neoplasm Metastasis ; Peritoneum ; Radiotherapy ; Recurrence ; Retrospective Studies ; Stomach ; Ulcer