Farghali, Mohamed M;Allam, Ihab S;Abdelazim, Ibrahim A;El-Kady, Osama S;Rashed, Ahmed R;Gareer, Waheed Y;Sweed, Mohammed S
Asian Pacific Journal of Cancer Prevention
/
v.16
no.15
/
pp.6691-6696
/
2015
Background: Endometrial carcinoma is the most common gynecological cancer and its treatment is still controversial, especially in its early stages. There are conflicting data about the efficacy of retroperitoneal lymphadenectomy during abdominal hysterectomy and bilateral salpingoophrectomy treatment. Lymphadenectomy carries a risk of severe complications, especially in women with co-morbidities. Selective lymphadenectomy has been widely employed for staging evaluation of endometrial carcinoma because it is simple and seems to provide reliable data regarding nodal metastasis. This study was designed to evaluate accuracy of sentinel node sampling in detecting lymph node metastasis in primary endometrial carcinoma during staging laparotomy. Materials and Methods: Ninety-three women with endometrial carcinoma at high-risk for nodal metastasis were studied. During laparotomy, methylene blue dye was injected into sub-serosal myometrium, then retroperitoneal spaces were opened and blue lymph nodes within pelvic and para-aortic regions were removed as separate specimens for histopathological examination (sentinel lymph nodes = SLNs). Hysterectomy and selective lymphadenectomy then performed for all women included in this study. Results: Deposition of methylene dye into at least one lymph node was observed in 73.1% (68/93) of studied cases. 18.3% (17/93) of studied women had positive lymph node metastasis and 94.1% (16/17) of them had positive metastasis in SLNs. In this study, SNLs had 94.4% sensitivity and 100% specificity in prediction of lymph node metastasis. Mean number of lymph nodes removed from each case decreased when SLNs biopsy were taken. Conclusions: SLNs are the key lymph nodes in endometrial tumor metastasis and their involvement could be an indicator for whether or not complete systematic lymphadenectomy is needed during staging laparotomy.
Park, Eun-Mi;Kim, Suk-Il;Park, Hyang;Kim, Ki-Soon;Ryu, So-Yeou;Park, Jong
Journal of agricultural medicine and community health
/
v.25
no.2
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pp.303-314
/
2000
In order to evaluate prevalence and perception on the intestinal trematodes of inhabitants at Docho-island, Shinan-gun, Chollanam-do, a questionnaire survey for the epidemiological study and stool examination for the detection of the eggs of the trematodes were done on 224 individuals at the island from January to February, 2000. The results were as follows: 1. Egg positive rate of the intestinal trematodes was 21.0%. 2. The egg positive rate has revealed significantly higher in the elderly over age 70 than other ages, higher in seashore villagers than inland ones, and higher in persons who had a rural and/or marine ph than persons with other jobs, respectively(P<0.05). 3. The egg positive rate of alcoholic drinkers was higher than non-alcoholic persons, and the rate was also higher in smokers than non-smokers. It was statistically significant(P<0.05). 4. The egg positive rate was shown to be significantly higher in inhabitants who ate raw mullet that was well known to be the source of infection with the intestinal trematodes than people who did not eat the raw marine fishes(P<0.01). 5. The egg positive rate was also significantly higher in humans who had the complaints of frequent abdominal pain and diarrhea than healthy people(P<0.05). In conclusion, the prevalence of intestinal trematodes at the island located in the south and west area in Korea was too high to eradicate the parasitic infections. So a special program is necessary for the control of the trematode infections in many adjacent islands at Chollanamdo.
Park Chul;Jung Dong-in;Kim Ha-Jung;Kang Byeong-Teck;Kim Ju-Won;Lim Chae-Young;Yoo Jong-Hyun;Park Hee-Myung
Journal of Veterinary Clinics
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v.22
no.4
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pp.396-400
/
2005
A 13-year old, female Maltese dog was presented due to a five-month history of episodic syncope. A diagnosis of sick sinus syndrome (SSS) with mitral valve endocardiosis (MVE) was made based on history takings, physical and cardiac examination, complete blood count (CBC), serum chemistry profiles, radiography, electrocardiography (ECG), atropine response test, hormonal assay, and echocardiography. In this case, SSS was definitely diagnosed by evaluation of ECG recording following atropine administration. Clinical signs were improved with medical management of theophylline (THEOLAN, KunWha Pharm, Seoul, Korea, 20 mg/kg, PO, BID). After 10 more month survival, the dog, died of respiratory distress and shock during the operation of abdominal mass removal in local animal hospital. Unfortunately, we were not able to perform necropsy after death due to owner's decline. This case demonstrates that theophylline can be used in management oF dog with SSS.
This study investigated the anthropometric and biochemical indices, and the health and nutritional factors influencing the two indices among 194 middle-aged and elderly subjects (108 middle-aged and 86 elderly) residing in a medium sized city for more than 10 years. In the examination of their dietary habits, 8.3% of the middle-aged subjects and 14.0% of the elderly subjects had two meals a day, and more female subjects had two meals per day. Of the subjects who ate meals at regular times, 75.0% were middle-aged and 79.1% were elderly, and the degree of irregularity of meals was greater for female subjects. The study of the dietary behavior of the subjects indicated that 71.3% and 66.3% of the middle-aged and elderly, respectively responded that the amount of food in each meal was sufficient. The subjects ate alone comprised 19.7% of the middle-aged females and 31.5% of the elderly females. The prevalence of smoking among the subjects was 28.1% for the middle-aged, 18.8% for the elderly male and 7.4% for the elderly females. The percentage of the subjects who drank alcohol was 34.4% of the middle-aged males and 13.2% of the middle-aged females. Slightly less than half of the subjects exercised more than once a week, with the male subjects showing a higher rate than the female subjects. The average body mass indices (BMI) were 24.5 and 24.6 for the middle-aged male and female, respectively, and 22.6 and 24.0 for the elderly male and female, respectively. BMI assessment showed that underweight subjects (BMI < 20) comprised 3.7% of the middle-aged, 14.0% of the elderly, and that 40.7% of the middle-aged and 24.4% of the elderly were overweight (25 < BMI < 30) , and 0.9% of the middle-aged and 1.2% of the elderly were classified as obese (BMI $\geq$ 30) . A waist/hip ratio (WHR) greater than 0.8 was found in 89.5% of the middle-aged females and 90.7% of the elderly females, showing high abdominal fat deposition in the majority of females. The average systolic blood pressure of females was 121.1 $\pm$ 17.1 mmHg for the middle-aged and 129.6 $\pm$ 21.3 mmHg for the elderly subjects. The systolic blood pressures showed a significantly difference between the two age groups. Those defined as anemic subjects based on hemoglobin values comprised 13.0% of the middled-aged group and 16.3% of the elderly group. There was a tendency for higher fasting glucose levels among the elderly subjects. An increase in total plasma cholesterol levels with age was shown. The female subjects had higher cholesterol levels than the males'The study of the correlation between the daily habits and health status showed that the amount of food eaten at each meal, the frequency of eating out, and the use of dietary supplements appeared to influence BMI, WHR, the plasma triglyceride and plasma cholesterol levels; omitting one meal had a positive correlation with the systolic blood pressure and plasma cholesterol. These results suggest that desirable dietary habits and concerns for health are contributing factors for maintaining good health, as indicated by normal blood lipid levels.
Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.
Kim, Chang-Sup;Cheong, Hae-Kwan;Jeong, Tae-Heum;Kim, Moon-Chan
Journal of Preventive Medicine and Public Health
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v.38
no.4
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pp.415-419
/
2005
Objectives : We wanted to evaluate the relationship between obesity and left colonic adenomatous polyps in Korean adult men. Methods : This study was conducted among 575 adults men (aged between 40 and 69), who had colonoscopy done from January to December 2002 during a routine health examination at Health Promotion Center, Ulsan University Hospital. The patients' colons were examined up to splenic flexure by using fiberoptic colonoscopy. A questionnaire survey on behavioral factors and physical measurements were also done. The body mass index (BMI) and waist-hip ratio (WHR) were used as the indices of obesity. The BMI was categorized into three levels: normal ($BMI{\leq}22.9$), overweight ($23{\leq}BMI{\leq}24.9$), and obese ($BMI{\geq}25.0$). The WHR was categorized into four levels with cutoff points at the 30th, 60th, and 90th percentile of the control group. Age, education, smoking, alcohol use and exercise were controlled for by performing multiple logistic regression analysis. Results : There were 99 cases of colonic adenomatous polyps. Four hundred seventy six subjects with normal colonoscopy findings served as the control. The BMI and WHR were associated with the adenomatous polyps (odds ratio, 1.81 [95% CI=1.02-3.19] for a $BMI{\geq}25.0$ as compared with a $BMI{\leq}22.9$, odds ratio, 3.94 [95% CI=1.77-8.77] for a $WHR{\geq}0.95$ as compared with a $WHR{\leq}0.86$). The BMI was not associated with the risk of adenomatous polyps after additional adjustment was made for the WHR, but the association between the WHR and adenomatous polyps was still positive and independent of the BMI (odds ratio, 4.15 [95% CI=1.63-10.59]). Conclusions : The results support that obesity, and particularly abdominal obesity, can be associated with an increased risk of incurring colonic adenomatous polyps.
Seok, Jong-Min;Jeon, Woo-Jin;Park, Young-Joon;Lee, Jin
Journal of the Korean Society of Radiology
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v.11
no.3
/
pp.109-115
/
2017
The purpose of this study was to evaluate the clinical efficacy of 128 MDCT (multi-detector computed tomography) for reducing the CareDose 4D dose and comparing the image quality with the fixed tube current technique. For this purpose, we conducted the phantom and clinical studies to evaluate the exposure dose and image of the subject before and after applying the CareDose 4D system in abdominal examination using 128 MDCT. In the phantom study, ROI (Region of interest) was located at the center, 3, 6, 9, 12 o'clock, into two groups: group A without CareDose 4D and Group B applied were measured. In the clinical study, ROI was located at the liver 8 segments, divided into two groups too. The measured items were CT number, noise, and dose length product (DLP) dose. The result of CTDIvol (CT Dose Index volume) measurements in phantom and clinical studies were lower than those before CareDose 4D application, and dose and effective dose were also measured lower (p<.05). There was no difference in CT number before and after application (p>.05). In conclusion, using CareDose 4D, we can obtain optimal image information without deteriorating image quality while reducing patient dose.
Purpose : Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. Patients & Methods : The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration. Results : The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n=1). The mean duration of fever was $11.95{\pm}6.54$days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8cases were below $4000/mm^3$ and 14 cases were above $10,000/mm^3$. In platelets counts, 4cases were below $150,000/mm^3$ and 10 cases were above $450,000/mm^3$. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation. Conclusion : Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatement and preventive measures due to possible fatal outcome.
Bakcground: To treat anastomosis site stenosis and occlusion of the artificial vessels used in vascular surgery, tissue-engineered artificial vessels using autologous cells have been constructed. We developed artificial vessels using a polymer scaffold and autologous bone marrow cells and performed an in vivo evaluation. Material and Method: We manufactured a vascular scaffold using biodegradable PLCL (poly lactide-co-${\varepsilon}$-caprolactone) and PGA (poly glycolic acid) fibers. Then we seeded autologous bone marrow cells onto the scaffold. After implantation of the artificial vessel into the abdominal aorta, we performed an angiography 3 weeks after surgery. After the dogs were euthanized we retrieved the artificial vessels and performed histological analysis. Result: Among the six dogs, 2 dogs died of massive bleeding due to a crack in the vascular scaffold 10 days after the operation. The remaining four dogs lived for 3 weeks after the operation. In these dogs. the angiography revealed no stenosis or occlusion at 3 weeks after the operation. Gross examination revealed small thrombi on the inner surface of the vessels and the histological analysis showed three layers of vessel structure similar to the native vessel. Immunohistochemical analysis demonstrated regeneration of the endothelial and smooth muscle cell layers. Conclusion: A tissue engineered vascular graft was manufactured using a polymer scaffold and autologous bone marrow cells that had a structure similar to that of the native artery. Further research is needed to determine how to accommodate the aortic pressure.
Bilirubin has an anti-inflammatory effect as an endogenous antioxidant and has been reported to be inversely correlated with hypertension, diabetes, metabolic syndrome, and insulin resistance. On the other hand, there is a lack of research evaluating the association between bilirubin and metabolic syndrome compared to liver-specific indicators. This study examined the association between the total bilirubin and metabolic syndrome prevalence in Korean adults who underwent health screening compared to ALT and GGT. This cross sectional study included 22,568 adult males and females aged 20 years or older who underwent a health examination at the General Hospital of Gyeonggi Province from March 2015 to February 2018. Metabolic syndrome was diagnosed based on the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) guidelines. In both genders, the metabolic syndrome diagnosed group had higher liver enzymes, and the total bilirubin and direct bilirubin were lower than those without the metabolic syndrome risk factors. The serum total bilirubin showed a weak inverse correlation with abdominal obesity (r=-0.066 vs r=-0.055) and triglyceride (r=-0.127 vs r=-0.136) in both males and females, which is weaker than ALT and GGT The data were statistically significant. In addition, total bilirubin as well as ALT and GGT in both men and women were not predictors of the likelihood of developing metabolic syndrome.
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