PURPOSE: To compare standard laparoscopy-assisted Billroth I gastrectomies including standard lymph node dissection (LABIG) with hand-assisted laparoscopic surgery with the HandPort system (HALS) for the removal of early gastric cancers (EGC). METHODS: A prospective study was performed on 26 patients of EGC at Ewha Womans University Mok-Dong Hospital from July 1999 to August 2001. Seventeen patients (Group L) received LABIG using conventional laparoscopy-assisted methods and 9 patients received LABIG using HALS (Group H). We used staplers for the anastomosis, and a standard D2 lymph node dissection was done with ultrasonic shears or electrocautery. RESULTS: In group L, pathologic reports revealed 14 EGC (stage IA 14 cases), and 3 pm cancers (stage IB 1 case, II 2 cases). In group H, there were 9 early gastric cancers (stage IA 8 cases, IB 1 case). Significant differences (P<0.05) were present between group L and H in regards to the number of harvested lymph nodes (30.8 vs 18.9), estimated blood loss (462.1 vs 286.7 ml) and postoperative transfusion amounts (0.59 vs 0 unit). There were no differences in the mean operating time, distance from the lesion to the resection margin, postoperative leukocyte count, frequencies for pain control, wound size, time to diet, weight loss, serum protein, and postoperative hospital stay. Complications were present in 1 case in group L (enterocutaneous fistula) and 1 case in group H (gastric atony). There was one conversion to open surgery in group H. CONCLUSION: LABIG including standard lymph node dissections with both standard laparoscopic surgery and HALS were performed with equal outcome. The choice of surgical method depends on the characteristics of the lesion and the patient's physical factors.
Conversion to Open Surgery ; Diet, Reducing ; Electrocoagulation ; Female ; Gastrectomy* ; Gastroenterostomy* ; Hand-Assisted Laparoscopy* ; Humans ; Laparoscopy ; Length of Stay ; Leukocyte Count ; Lymph Node Excision ; Lymph Nodes ; Prospective Studies* ; Stomach Neoplasms* ; Ultrasonics ; Wounds and Injuries

BACKGROUND: The proliferation of vascular smooth muscle cell(VSMC) is a part of the major pathogenic mechanism for atheroscle- rosis. It has been reported that L-type calcium channel plays a role in the VSMC proliferation in diabetic rats. But there is a little study results about the association between L-type calcium channel and VSMC proliferation by glucose concentrations in culture media. So we examined the association between voltage-dependent L-type calcium channel of VSMCs and the proliferative activity of vascular smooth muscle cells. METHODS: Rat aortic VSMCs were isolated from the aorta of OLETF rat by enzyme method. VSMCs were cultured in various concentrations of glucose(5.5, 25 mM). The VSMCs(1x104 cells in 24-well plates) were incubated in the presence of Bay K 8644 (10-6M) with/without verapamil(10-6M) for 48 hours. Then the proliferation was assessed by MTT(methylthiazole tetrazolium) assay and expression of L-type calcium channel mRNA was measured by RT-PCR. RESULTS: The proliferative ability and the expression of L-type calcium channel of cultured VSMCs were increased dose-dependently by the glucose concentrations(p<0.05). Bay K 8644 enhanced the proliferation of VSMC and verapamil blocked the incremental effects induced by Bay K 8644. CONCLUSION: These results suggest that L-type calcium channel may play a role in VSMC proliferation of OLETF rat.
3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Animals ; Aorta ; Calcium Channels, L-Type* ; Cell Proliferation* ; Culture Media ; Glucose* ; Muscle, Smooth, Vascular* ; Rats ; Rats, Inbred OLETF* ; RNA, Messenger* ; Verapamil

No abstract available.
Dermatitis* ; Streptococcus pyogenes

The connective tissue nevus represents a hamartoma of various components of dermal connective tissue elements, predominantly collagen, elastin, or glycosa minoglycan. Zosterriform connective tissue nevus, described by Steiner, in 1944, clinically shows grouped papules in a zosteriform band without extracutaneous manifestations of family history, and peculiar histopathologic findings. We experienced 3 cases of typical zosteriforrn connective tissue nevus developed on the flank area of 30-year-old male and 21-year-old male, and on the inguinal area of 15-year-old female.
Adolescent ; Adult ; Collagen ; Connective Tissue* ; Elastin ; Female ; Hamartoma ; Humans ; Male ; Nevus* ; Young Adult

OBJECTIVES: To investigate the relationship between job stress and the variables associated with the organizational effectiveness of dental technicians. METHODS: The job stresses were divided into the following six components; somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility. The organi-zational effectiveness variables in this study included job satisfaction, occupational commitment, organizational commitment and intent to leave. The sample used in this study consisted of 248 dental technicians working in hospitals and dental laboratories. The data were collected with self-administered questionnaires between March 16 and April 29 in 2002, and the results analyzed with ANOVA and multiple regression analysis. RESULTS: Firstly, job stress of dental technicians was found to be significantly different in relation to the number of workers at the workplace and the working hours. The level of job stress was the highest when the number of workers were more than 10, or when the daily working hours were over 12. Secondly, of the six variables of job stress, five variables of somatization, interpersonal sensitivity, depression, anxiety, and hostility were found to have significant negative correlations with job satisfaction. Thirdly, all six job stress variables were found to have significant negative correlations with the occupational and organizational commitments of the dental technicians. Finally, depression was the only job stress variable found to have a significant effect on the dental technicians' intent to leave. CONCLUSIONS: The results of this study indicate that personal and organizational efforts are very important to improve the organizational effectiveness in reducing work related stress. Organizational support, especially for managing the depression of dental technicians is recommended.
Anxiety ; Dental Technicians* ; Depression ; Hostility ; Humans ; Job Satisfaction ; Laboratories, Dental ; Questionnaires

No abstract available.
Lymphangioleiomyomatosis* ; Tuberous Sclerosis*

Dysfunction of autonomic nervous system had been reported in a number of neurologic and medical diseases, but acquired primary dysautonomia is uncommon and usually tends to show a chronic progressive pattern. Acute panautonomic neuropathy characterized by selective involvement of sympathetic and parasympathetic nerves with complete or relative sparing of somatic motor and sensory functions was first described by Young et. Al, in 1969 and since then, about 26 additional cases had been reported in the literatures, but there have been no such reports in Korea. The present report describes a 22 year-old female patient who had been admitted to Severance hospital because of abruptly developed fever, generalized myalgia, hyperesthesia and difficulties in swallowing and voiding. On admission, physical and neurological examinations revealed orthostatic hypotension, unreactive pupils to light and accomodation, dereased gag reflex, and decreased sensation of pain and temperature on the face and neck. A few days following admission, progressive loss of deep tendon reflew was noticed, followed by distal muscle weakness and atrophy. The serial electrophysiologic studies revealed progressive peripheral axonal polyneuropathy. Autonomic function tests suggested pandysautonomia of postganglionic lesion. Spinal fluid protein was 16mg/dl on admission, but was increased up to 80mg/dl without pleocytosis on the twenty first hospital day. Recovery was poor over a four -month period and she died of disseminated pneumonia.
Atrophy ; Autonomic Nervous System ; Axons ; Deglutition ; Female ; Fever ; Humans ; Hyperesthesia ; Hypotension, Orthostatic ; Korea ; Leukocytosis ; Muscle Weakness ; Myalgia ; Neck ; Neurologic Examination ; Pneumonia ; Polyneuropathies ; Primary Dysautonomias ; Pupil ; Reflex ; Sensation ; Tendons ; Young Adult

Hailey-Hailey disease is a rare hereditary dermatosis that begins in the 2nd or 3rd decade of life. The skin lesion is characterized by a localized, recurrent eruption of small vesicles on an erythematous base. It courses remissions and exacerbations. It seldom begins in early childhood, and main treatment modalities are conservative ones. We report a case of Hailey-Hailey disease that began on a 7-month old infant and improved by surgical treatment. In according to review of the previous reports, it is probably the earliest onset age and it is may be the first case which was treated with surgery in Korea.
Age of Onset ; Humans ; Infant ; Korea ; Pemphigus, Benign Familial* ; Skin ; Skin Diseases

OBJECTIVE: For the treatment of carotid cavernous fistula(CCF), transarterial detachable balloon occlusion(DBO) is the method of choice. When it has failed to occlude the fistula, various embolization methods are used to treat the fistula. Transvenous embolization through the superior ophthalmic vein(SOV) is another method of treatment. The venous approach through the SOV after surgical dissection and exposure of this vein has been recommended by some delete, but(here) delete delete(an) alternative treatment method by percutaneous puncture of the SOV without surgical dissection(is described). METHODS: A 19-year-old woman admitted to our hospital two months after accident, presented with proptosis, chemosis, occulomotor and abducens nerve palsies, and bruit of the right eye. The authors tried DBO via transarterial route in initial treatment and the fistula was occluded with subsequent disapearance of bruit. However, 2 weeks later, she complained of recurence of bruit. Transarterial approach was attempted again, but the fistula hole was too small for this approach. The venous approach via SOV by percutaneous puncture was then tried. Puncture was made at the medial one third of the superior orbital rim and the fistula was embolized with Guglielmi detachable coils (GDCs). RESULTS: The fistula was completely occluded and no early and late complications noted. The patient's clinical symptoms were improved within a few days. CONCLUSION: Treatment of CCF by percutaneous puncture of the SOV is an alternative and effective method when other approaches are not feasible.
Abducens Nerve Diseases ; Exophthalmos ; Female ; Fistula* ; Humans ; Orbit ; Punctures* ; Veins* ; Young Adult

This is a report on attempts tp search for a suitable experimental animal model which is sensitive to the exocellular substances of M. ulcerans, prior to study of biochemical and pathogenic natures of the substances. Cells of M. ulcerans grown in a broth medium were harvested by filtration and washed with phosphate-buffered saline. The filtrate of culture supernatant was subjected to fractionation by addition of various amounts of ammonium sulfate. The washed cells and the preparations resulted from ammonium sulfate fractionation (ASF 45 and ASF 70) were inoculated by either foot-pad injection, subcutaneous or intradermal injection to the selected animal groups. Any skin response due to administration of the preparations; erythema, edema, pus formation, etc. was macroscopically observed along with time progression. Among the animals employed, such as guinea pig, mouse, and rabbit, the rabbit was the only animal group showing strong skin response to the washed cells, ASF 45 and ASF 70. The heat-treated preparation of ASF 45 seemed to be inactive in elucidating skin response of rabbits. Dependence of skin response upon dose of the washed cells and the preparation of ASF 45 was also discussed.
Animal ; Erythema/etiology ; Guinea Pigs ; Intradermal Tests ; Mice ; Mycobacterium/pathogenicity* ; Rabbits