PURPOSE: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. MATERIALS AND METHODS: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopy-assisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. DISCUSSION: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer.Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).
Arm ; Disease-Free Survival ; Endoscopy ; Gastrectomy ; Humans ; Informed Consent ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Postoperative Complications ; Prospective Studies ; Sample Size ; Stomach Neoplasms

It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.
Adenocarcinoma ; Lung Neoplasms ; Risk Factors ; Solitary Pulmonary Nodule ; Tuberculoma

OBJECTIVE: To find a new method and usefulness of study on sensory nerve conduction of lateral sural cutaneous nerve (LSCN). METHOD: The 60 extremities of 30 adults without peripheral neuropathy were placed in a prone position. Next, each subject was administered with an antidromic stimulation at a point 3 cm lateral from the center of the popliteal fossa. With the aid of active electrodes, the sensory nerve action potentials (SNAPs) were recorded at points 10 cm inferior and 1 cm lateral to the stimulation site. The method of sensory nerve conduction study suggested by Campagnolo et al. was performed simultaneously, to compare of the frequency of SNAPs and the amplitudes. RESULTS: For the sensory nerve conduction study of the LSCN suggested in this report, SNAPs were obtained in 49 extremities, with a revelation rate of 81.7%. The mean amplitude was 11.91+/-3.68micronV. In the results of the tests suggested by Campagnolo et al., the SNAPs were obtained in 29 extremities, with a revelation rate of 48.3%. The mean amplitude was 8.37+/-5.21micronV. Significance testing of the electrodiagnostic method recommended in this study revealed that many SNAPs were observed for the LSCN, with statistically significant action potential amplitudes. CONCLUSION: This study presents the new method and reference values of sensory nerve conduction for LSCN, which is thought to be useful in electrodiagnostic studies to diagnose entrapment neuropathy.
Action Potentials ; Adult ; Electrodes ; Electromyography ; Extremities ; Humans ; Nerve Compression Syndromes ; Neural Conduction ; Organic Chemicals ; Peripheral Nervous System Diseases ; Peroneal Nerve ; Prone Position ; Reference Values ; Sural Nerve

OBJECTIVE: The purpose of this study was to determine the natural history of symptomatic hands without electrodiagnostic evidence of carpal tunnel syndrome (CTS). METHOD: This study was comprised of 88 hands of 49 subjects with symptoms consistent with CTS without median mononeuropathy who were recruited during a community health examination and followed after two years. 88 hands of 44 people with age and sex-matched healthy controls were followed for comparison. Symptoms and electrodiagnostic findings were compared between the two groups. RESULTS: 62 hands of the symptomatic group had persistent symptoms after 2 years while 16 hands of the control group had symptoms consistent with CTS. Median motor distal latencies were significantly delayed after two years in the symptomatic group (p<0.05). Median sensory latencies were also delayed in the symptomatic group, but this was not statistically significant (p=0.064). The occurrence rate of median mononeuropathy at wrist was significantly higher in the symptomatic group than in the control group (13.6% vs. 2.3%)(p<0.05). CONCLUSION: The results of this study suggested that a significant number of symptomatic hands without electrodiagnostic evidence of CTS may have persistent symptoms and may progress to electrodiagnostically evident CTS.
Carpal Tunnel Syndrome* ; Follow-Up Studies* ; Hand* ; Mononeuropathies ; Natural History ; Wrist

OBJECTIVES: This study was conducted to evaluate individual susceptibility to carpal tunnel syndrome (CTS) by ultrasonographic measurement of the carpal tunnel configuration in workers doing repetitive work. METHODS: The study subjects consisted of 24 male and 11 female workers in a soundproof material manufacturing company in Gyeongju. We conducted a self-reported questionnaire survey, a physical examination and an electrodiagnostic study (EDS) in April 2000. After the examination, jobs were rearranged for workers with CTS. A follow up physical examination, EDS, and measurement of the carpal tunnel by ultrasonography was done six months later. RESULTS: Of those studied, prevalence of CTS was 63.6/100 persons among women and 29.2/100 persons among men. Mean depth and width of wrist was shorter in those with CTS compareal to the controls (p<0.05). The risk of CTS was higher in workers whose carpal tunnel ratio (displacement/width) was 0.17 or higher (OR 7.13, 95 % confidence interval 1.18-43.1), and in workers whose carpal tunnel area was less than 300 mm2 (OR 8.00, 95 % confidence interval 1.18-68.5). Carpal tunnel depth and depth/width ratio had a positive correlation with motor latency of the median nerve and median-ulnar sensory latency difference (p<0.05), whereas the carpal tunnel width, displacement/depth ratio, and area (width X displacement) had a negative correlation with median nerve latencies after adjusting for gender. Workers who showed an improvement in the clinical stage of CTS after job rearrangement had a significantly lower carpal tunnel displacement/width ratio and displacement/depth ratio. They also had smaller upper carpal tunnel area ( width X displacement) and larger upper carpal tunnel area [(depth-displacement) X width] than the controls (p< 0.05 ). CONCLUSIONS: Ultrasonographic measurement of the carpal tunnel is a good predictor of susceptibility and prognosis of CTS in workers doing repetivive work.
Carpal Tunnel Syndrome* ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Male ; Median Nerve ; Physical Examination ; Prevalence ; Prognosis ; Questionnaires ; Risk Factors* ; Ultrasonography* ; Wrist

OBJECTIVES: This study was conducted to evaluate individual susceptibility to carpal tunnel syndrome (CTS) by ultrasonographic measurement of the carpal tunnel configuration in workers doing repetitive work. METHODS: The study subjects consisted of 24 male and 11 female workers in a soundproof material manufacturing company in Gyeongju. We conducted a self-reported questionnaire survey, a physical examination and an electrodiagnostic study (EDS) in April 2000. After the examination, jobs were rearranged for workers with CTS. A follow up physical examination, EDS, and measurement of the carpal tunnel by ultrasonography was done six months later. RESULTS: Of those studied, prevalence of CTS was 63.6/100 persons among women and 29.2/100 persons among men. Mean depth and width of wrist was shorter in those with CTS compareal to the controls (p<0.05). The risk of CTS was higher in workers whose carpal tunnel ratio (displacement/width) was 0.17 or higher (OR 7.13, 95 % confidence interval 1.18-43.1), and in workers whose carpal tunnel area was less than 300 mm2 (OR 8.00, 95 % confidence interval 1.18-68.5). Carpal tunnel depth and depth/width ratio had a positive correlation with motor latency of the median nerve and median-ulnar sensory latency difference (p<0.05), whereas the carpal tunnel width, displacement/depth ratio, and area (width X displacement) had a negative correlation with median nerve latencies after adjusting for gender. Workers who showed an improvement in the clinical stage of CTS after job rearrangement had a significantly lower carpal tunnel displacement/width ratio and displacement/depth ratio. They also had smaller upper carpal tunnel area ( width X displacement) and larger upper carpal tunnel area [(depth-displacement) X width] than the controls (p< 0.05 ). CONCLUSIONS: Ultrasonographic measurement of the carpal tunnel is a good predictor of susceptibility and prognosis of CTS in workers doing repetivive work.
Carpal Tunnel Syndrome* ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Male ; Median Nerve ; Physical Examination ; Prevalence ; Prognosis ; Questionnaires ; Risk Factors* ; Ultrasonography* ; Wrist

OBJECTIVE: The purpose of this study was to investigate the prevalence of and risk factors for carpal tunnel syndrome in a rural population in Korea. METHOD: Among the 1004 residents in a rural district who participated in the health examination, 450 (165 male, 285 female) adults aged between 30 and 79 years were randomly selected. Hand symptom questionnaire and electrodiagnostic studies were used to diagnose and classify carpal tunnel syndrome. General characteristics, female-related factors, work-related factors and anthropometric measurements were compared between normal and carpal tunnel syndrome group to identify the risk factors for carpal tunnel syndrome. RESULTS: Subjects with carpal tunnel syndrome were 76 (16.9%), symptom only subjects were 168 (37.3%), asymptomatic slowing 27 (6.0%) and peripheral polyneuropathy were 16 (3.6%). Age, farming, body mass index and wrist depth width ratio were associated with risk of carpal tunnel syndrome and odds ratio were 1.03 (95% confidence interval 1.01~1.07), 2.62 (95% confidence interval 1.17~5.86), 2.24 (95% confidence interval 1.14~4.40) and 3.13 (95% confidence interval 1.64~5.96), each. CONCLUSION: These data suggest that the prevalence of carpal tunnel syndrome is high in a rural population and physical factors like wrist shape and body mass index, occupation and aging are associated with risk of carpal tunnel syndrome.
Adult ; Aging ; Body Mass Index ; Carpal Tunnel Syndrome* ; Hand ; Humans ; Korea ; Male ; Occupations ; Odds Ratio ; Polyneuropathies ; Prevalence* ; Surveys and Questionnaires ; Risk Factors* ; Rural Population* ; Wrist

Mucous gland adenoma of the bronchus is a rare benign tumor arising from the bronchial mucous gland. It accounts for less than 0.5 % of all lung tumors. In adults, tracheal tumors are most often malignant. Among benign tumors arising in the trachea, mucous gland adenoma of the trachea is extremely rare. First case was reported by Ferguson and Cleeland in 1988, as "Mucous gland adenoma of the trachea". Microscopic study shows it to arise from normal submucosal mucous glands forming glandular or tubular structures composed of mucous secreting cells. Common symptoms were cough, hemoptysis, recurrent and protracted pneumonia, shortness of breath, and wheeze. Duration of symptoms before diagnosis varied from a few weeks to 10 years with prolonged symptoms being usual. Management of these tumors should be complete excision, including pulmonary resection because two instances of recurrence after local excision have been reported.
Adenoma* ; Adult ; Bronchi ; Cough ; Diagnosis ; Dyspnea ; Hemoptysis ; Humans ; Lung ; Pneumonia ; Recurrence ; Trachea*

We investigated a topographical distribution of managanese, and immunohistochemical density of tyrosine hydroxylase (TH), and histopathologic findings in globus pallidus and substantia nigra according to manganese dose and time course in the brain of rats which received MnCl2 intravenously. Topographical distribution of manganese was also investigated after injection of FeCl2. The manganese concentrations of brain in control and experimental group were highest in pituitary gland and thalamus, and lowest in the cerebral cortex. The manganese concentration of blood was increased proportionally to the dose administered, and the biological half-life of blood manganese was between 21 and 42 days. The manganese concentrations of brain were increased proportionally to the dose, and increase rate was highest in olfactory bulb, and the biological half-lives of brain manganese ranged from 42 days to 90 or more days; the longest were observed in pituitary gland, medulla oblongata and cerebral cortex. In case of administration of FeCl2, the manganese concentrations of brain were higher than that of control group in dose of 2.5 mg/kg, and decreased proportionally to the administered dose, resulting in lower level compared with control group in high dose of FeCl2 administered. Significantly decreased number of nerve cell and increased gliosis in globus pallidus were observed in experimental group, which were closely correlated with the duration after manganese injection, but no significant change of number of nerve cell expressing TH and gliosis were observed in substantia nigra. Density of immunohistochemical reaction for TH in globus pallidus made little difference between control and experimental group. These results suggest that pathology of manganese intoxication is caused by the loss of nerve cells in globus pallidus, and closely correlated with the duration after manganese exposure.
Animals ; Brain* ; Cerebral Cortex ; Gliosis ; Globus Pallidus ; Half-Life ; Manganese* ; Medulla Oblongata ; Neurons ; Olfactory Bulb ; Pathology ; Pituitary Gland ; Rats* ; Substantia Nigra ; Thalamus ; Tyrosine 3-Monooxygenase

BACKGROUND: STDs are major communicable disease group in Korea. This study was carried out to evaluate the current status of sexually transmitted diseases in Seoul. METHODS: We collected the laboratory data of those who visited 11 Public Health Centers in Seoul for venereal disease examination and analyzed abnormal results from Jan 1, 1993 to Dec 31, 1995. The diagnoses of STDs were made by VDRL quantification, TPHA test, Gram's stain, and culture of urine or urethral discharge. RESULTS: There were total of 10,302 patients. There were 7,836 male cases(76.1%) and 2,466 female cases (23.9%). Mean age was 30.6+/-9.7, and the most common age group was 25-34 yearn of age(42.1%). Diagnoses were as follows ; syphilis 2,036 cases(19.8%), gonorrhea 2,249 cases(21.8%), nongonococcal urethritis 4,973 cases(48.3%), vaginitis 954 cases(9.3%), mixed infection of syphilis and gonorrhea 13 cases(0.1% ), mixed infection of syphilis and NGU 50 cases(0.5%), mixed infection of syphilis and vaginitis 27 cases(0.3%). The proportion of PPNG among gonorrhea was as follows ; 43.4% in 1993, 55.1% in 1994, 43.8% in 1995. There were more WBCs on Gram's staining in gonorrhea cases than in NGU cases. CONCLUSIONS: The STD patients seen in 11 Public Health Centers in Seoul were mainly young men. Common diagnoses were as follows ; NGU, gonorrhea, syphilis, vaginitis. The proportion of PPNG increased at first and then decreased.
Coinfection ; Communicable Diseases ; Diagnosis ; Female ; Gonorrhea ; Humans ; Korea ; Male ; Public Health* ; Seoul* ; Sexually Transmitted Diseases* ; Syphilis ; Urethritis ; Vaginitis